The original Adderall, introduced in 1996, was an instant release tablet that combine the amphetamines dextroamphetamine and racemic . Dextroamphetamine is better known under its brand name of Dexedrine and whilst racemic form the basis of Desoxyn. In theory this combination gave Adderall a smooth effect that Ritalin, its direct rival, however there is very little evidence to support this.
Adderall XR (eXtended Release) was introduce in 2001 and directly competes with Concerta. The aim of the slow release mechanism is to have a smoother build-up and come-down effect on the patient. This is important as fast effecting stimulants with a sharp drop-off, such as cocaine, have been linked to problems with abuse and addiction.
The extended release Adderall is a different mixture active ingredients to the standard capsule using two different forms of dextroamphetamine and two different forms of levoamphetamine, more commonly known as amphetamine. This blend of different stimulants is what gives Adderall its long duration. The different chemicals are processed by the body at different rates with the levoamphetamine giving fast initial onset and the dextroamphetamine providing the longer effectiveness.
To further enhance the duration of the tablets effect, Adderall XR consists of two beads, each with about four hours supply of the active ingredients. The first bead dissolves straight away and the other after about four hours. Drinking acidic drinks such as Coke can effect the chemical balance of the stomach and increase the speed at which the second Adderall bead dissolves. Under normal circumstances Adderall reaches it peak effect at about eight hours. Eating before taking the tablet does not effect the medications onset time but does lengthen the duration of its effect.
In 2005 the Health Canada, the Canadian equivalent of the FDA, suspended the use of Adderall after the sudden death of patients using it. A few months later they allowed Adderall’s use after establishing most of the deaths where related to structural problems in the heart. Its is not clear if the medication had any role in triggering the deaths so the FDA say that Adderall should not be used by children or adults with structural heart problems. Overall, there are more reports of Adderall Side Effects and contraindications that there are with Ritalin and Concerta. If Adderall is taken with Propoxyphene (a pain killer) and MAO inhibitors (anti-depressents) the results can be fatal.
Adderall was tested in studies of 584 6 to 12 year old children diagnosed with ADD or ADHD. The study lasted three weeks and the recipients of Adderall XR were rated by teachers as being more attentive and less hyperactive than those who where just receiving the placebo treatment. A trial with 255 adults lasting four weeks also found significant improvements in those receiving Adderall XR. However there was no evidence that doses larger than 20mg a day conferred any additional benefit.
In common with other ADHD medications there is no evidence on exactly how Adderall helps children with ADHD or what long-term effect it has on the brain. The longest trial for Adderall only lasted four weeks so its effectiveness beyond that is unknown as are its long-term side effects.
Adderall and Adderall XR are produced by Shire Pharmaceuticals and in 2005 earned them $770 million in worldwide sales. That was up by more than 20% on 2004 sales figures. Overal, Adderall has about the same market share as Concerta ($900 million in 2006).
The non-active ingredients of Adderall XR are: Gelatin capsules, hydroxypropyl methylcellulose, methacrylic acid copolymer, opadry beige, sugar spheres, talc, and triethyl citrate. Gelatin capsules contain edible inks, kosher gelatin, and titanium dioxide. The 5 mg, 10 mg, and 15 mg capsules also contain FD&C Blue #2. The 20 mg, 25 mg, and 30 mg capsules also contain red iron oxide and yellow iron oxide.