Amphetamines

What are amphetamines?

Amphetamines are stimulant drugs that make your central nervous system more active. They treat many conditions, including attention-deficit/hyperactivity disorder (ADHD) and obesity.

How do amphetamines work?

Amphetamines (pronounced “am-FET-uh-meens”) make your body release extra dopamine and norepinephrine. These are neurotransmitters, which are like chemical messengers. The more of them you have circulating in your body, the more active the affected systems are. Amphetamines also make these neurotransmitters stick around in your body longer.

Amphetamines have a big effect on your central nervous system, especially your brain. They can make you feel:

• Alert or awake
• Attentive or focused
• Energetic or motivated
• Less hungry
• Upbeat or positive

When taken in certain ways, amphetamines can cause a “high” feeling. Because of this, you should take amphetamines exactly as prescribed. Using them in an unprescribed way can lead to substance use disorder and addiction. When taken as prescribed, the risk of addiction is very low.

What are the brand names of amphetamines?

There are several prescription amphetamine drugs, and even more brand names. The drugs and their brand names include:

• Amphetamine: Adzenys®, Evekeo®
• Amphetamine combinations: Adderall®, Dyanavel®, Mydayis®
• Benzphetamine: Didrex®
• Dextroamphetamine: Dexedrine®, Dextrostat®, Procentra®, Xelstrym®, Zenzedi®
• Lisdexamfetamine: Vyvanse®
• Methamphetamine: Desoxyn®
• Phentermine: Adipex®, Lomaira®
• Phentermine combinations: Qsymia®

Other prescription amphetamine drugs

There are a few drugs that are technically amphetamines, but have very different effects from most others. They include:

• Iofetamine. This medication has a history of use in nuclear imaging scans.
• Hydroxyamphetamine. This medication comes in eye drops that dilate your pupils for retinal eye exams.
• Levmetamfetamine. You can find this in over-the-counter decongestant nasal sprays.

Nonmedical amphetamine use

Nonmedical amphetamine use is common with amphetamine, dextroamphetamine and methamphetamine. This includes using them without a prescription or in a way other than prescribed. It also includes using them in other ways, like smoking or injecting them.

One amphetamine that doesn’t see any prescription use — but does see widespread nonmedical use — is MDMA. Better known as “Ecstasy” or “Molly,” it’s best known for its use as a “party drug.” But researchers are exploring the use of MDMA for its potential in treating post-traumatic stress disorder (PTSD).

What conditions do amphetamines treat?

Many amphetamines treat multiple conditions. Some examples of amphetamines and the conditions they treat include:

• Amphetamine and amphetamine combination drugs: ADHD, narcolepsy and obesity
• Benzphetamine: Obesity
• Dextroamphetamine: ADHD, narcolepsy and obesity
• Lisdexamfetamine: ADHD and binge-eating disorder
• Methamphetamine: ADHD
• Phentermine: Obesity

What is the difference between amphetamine and methamphetamine?

Amphetamine and methamphetamine have similar chemical structures. But there are also major differences. Some key things to know about them include:

• What they treat. Methamphetamine only has U.S. Food and Drug Administration (FDA) approval to treat ADHD. Amphetamine has FDA approval to treat ADHD, narcolepsy and obesity.
• Strength. Methamphetamine is significantly stronger than amphetamine.
• How fast it affects you. Methamphetamine’s effects happen faster than amphetamine.
• Frequency of prescription. Methamphetamine prescriptions are much rarer than amphetamine prescriptions. That’s partly because of the side effects and because of the risks, like dependency and addiction.

What’s the difference between amphetamine and dextroamphetamine?

Dextroamphetamine is a subtype of amphetamine. Amphetamine is a 50-50 mix of dextroamphetamine and levoamphetamine. These two are the same molecule, but they’re mirror images of each other. It’s similar to how your hands have the same structure but are mirror images of each other.

Dextroamphetamine’s effects are stronger than levoamphetamine’s. Because of this, some drugs only contain dextroamphetamine or have it in greater proportions.

What forms do amphetamines come in?

Amphetamines come in many forms, including:

• Tablets. These are often immediate-release forms of a medication.
• Capsules. These contain a mix of immediate-release and extended-release granules. That’s why these medications are effective for longer periods.
• Oral solution. Some amphetamines come in liquid forms that you take by mouth.
• Skin patches. Dextroamphetamine patches let your body slowly absorb this medication through your skin.

What dosage strengths does amphetamine come in?

The dosage strengths for amphetamines vary widely depending on the drug. Some pills have dosages as low as 3.1 mg, while others go as high as 70 mg. And other forms, like patches or oral solution, have their own dosages.

In general, your healthcare provider will recommend starting your dosage as low as possible. They’ll then gradually increase it until the medication is effective. If the side effects of a medication start to outweigh the benefits, your provider can lower your dose or recommend a different medication.

What are the side effects of amphetamines?

Amphetamines can cause a wide range of side effects. Most of these are minor or manageable. But a few of them can be severe.

The most common side effects of prescribed amphetamines include:

• Decreased circulation in your hands and feet (making them feel cold or causing color changes, like Raynaud’s phenomenon)
• Decreased hunger (which may cause unintended weight loss)
• Dizziness
• Fast heart rate or higher blood pressure
• Feeling anxious, jittery, restless or irritable
• Headaches
• Insomnia or other sleep-related issues
• Nausea and vomiting
• Sex drive changes and/or sexual dysfunction
• Stomachache (abdominal pain)
• Tremors
• Vision changes like blurring

Some side effects are less common but are more serious. They can include:

• Allergic reactions, including ones severe enough to cause anaphylaxis
• Bruxism (tooth-grinding)
• Compulsive skin-picking (dermatillomania)
• Dependency and addiction
• Hair loss (alopecia)
• Heart-related symptoms chest pain (angina) or heart palpitations
• Mania or symptoms that look like it
• Psychosis
• Serotonin syndrome
• Unexplained wounds appearing on your fingers or toes

Your healthcare provider or pharmacist can tell you more about possible or likely side effects. They can also tell you which side effects need immediate care and which can wait for an appointment.

What other medications interact with amphetamines?

Amphetamines can interact with many other medications. Your healthcare provider or a pharmacist are the best experts to tell you about medications to avoid so you don’t have interactions. These may include:

• Antacids
• Antihistamines
• Blood pressure medications
• Insulin and other blood sugar-affecting medications
• MAOIs
• Medications that increase serotonin levels
• Proton pump inhibitors
• Tricyclic antidepressants

Make sure your healthcare provider knows about every medication, herbal remedy or supplement you take. Even ones available over the counter might interact with prescription medications like amphetamines.

Can I drink alcohol with amphetamines?

You shouldn’t drink alcohol too soon after taking an amphetamine. These drugs can interact with alcohol and have unwanted effects. Your healthcare provider can tell you more about how long you should wait after taking your medication before it’s OK to drink alcohol.

Do amphetamines cause withdrawal symptoms?

Yes, amphetamines can cause withdrawal symptoms. But these are unlikely when you take your medications exactly as prescribed.

Amphetamines can also have another effect when they wear off. People who take these medications often describe it as a “crash,” causing them to suddenly feel:

• Anxious, irritable or tired
• Hungry
• Depression-like feelings
• Like they can’t concentrate

If you’re regularly experiencing this crash effect and it’s disrupting your life, talk to your healthcare provider. They may offer solutions like changing your dose or shifting when you take your medication. They may even recommend changing you to another form of the medication, like an extended-release form.

Amphetamine prescription shortages

In October 2022, the FDA announced shortages of some amphetamine medications, especially drugs containing amphetamine, dextroamphetamine and lisdexamfetamine. Those shortages affect various dosages and formulations (immediate release vs. extended release) into 2025 and possibly beyond. That might affect the availability of some of these medications from your pharmacy.

If you have questions about whether or not a shortage might affect you, ask your provider or a pharmacist. They may also be able to offer suggestions on how to avoid running out of your medications.