Differences Between Dextroamphetamine vs. Adderall

Find Out if You Are Covered by Insurance

VERIFY INSURANCE

What you will learn

• Both dextroamphetamine and Adderall are prescription stimulants for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy.
• There is no universally better medication. The choice is based on response to medication, symptom type and severity, and presence of adverse side effects.
• While Adderall is composed of more than one amphetamine salt compared to dextroamphetamine, Adderall is not necessarily stronger than dextroamphetamine-based products.
• Both medications are classified as Schedule II controlled substances, as both have a high potential for misuse and development of physical dependence.

As the use of prescription stimulants continues to grow, it is increasingly important to understand the differences between commonly prescribed medications.

Some of the most common stimulants for ADHD are Adderall, which contains mixed amphetamine salts; dextroamphetamine products, such as Dexedrine and Zenzedi; methylphenidate products, such as Ritalin and Concerta; and Vyvanse, which contains lisdexamfetamine.

For those considering Adderall, Dexedrine, and Zenzedi, understanding the differences between the active ingredients in these medications can aid in communication with your prescriber and contribute to an overall sense of confidence in your current treatment plan.

Dextroamphetamine Products vs. Adderall at a Glance

All of these medications are classified as Schedule II controlled substances.[1] This means both have a high potential for misuse that could lead to severe psychological or physical dependence. Due to their Schedule II status, both medications require a valid prescription prior to dispensing, and both are subject to close monitoring once dispensed to prevent misuse.

The Biggest Dextroamphetamine and Adderall Difference

Dextroamphetamine

One main difference between dextroamphetamine-based products and Adderall is that dextroamphetamine products contain only the dextro isomer of amphetamine.[2] The dextro isomer of amphetamine has a higher potency to stimulate the CNS (central nervous system, the network of the brain and spinal cord that regulates most bodily functions). This increased potency contributes to improved focus and concentration.

Adderall

Adderall, on the other hand, contains a combination of both the dextro isomer and levo isomer of amphetamine. This combination results in approximately 75% being the dextro isomer and 25% being the levo isomer. The addition of the levo isomer may produce additional peripheral effects for some individuals, such as increased heart rate or blood pressure.[3]

How the Physiological Response to Each Medication May Differ

Why Some People Describe Dextroamphetamine as Smoother

Some users describe that dextroamphetamine produces a “smoother” physiological response compared to Adderall, with less peripheral stimulation. However, this varies by user.

Why Others Prefer Adderall

Other people respond better to the mixed amphetamine formulation in Adderall. This often comes down to individual brain chemistry, which can make one medication feel more effective or better tolerated than the other.

Why Experiences Differ From Person to Person

There are multiple variables that can impact how an individual responds to either dextroamphetamine or Adderall:

• Genetic predisposition
• Metabolic processing times
• ADHD subtype diagnosed
• Presence of co-existing anxiety disorder(s)
• History of previous stimulant exposure

Comparing Dextroamphetamine and Adderall: What Works Best for Me?

While both medications have similar overall efficacy when taken as directed for the treatment of ADHD and narcolepsy, neither medication is superior to the other. Physicians frequently prescribe alternative medications or adjust dosages for patients whose original medication is ineffective or causes unwanted side effects. Treatment trials, or trial-and-error approaches, are typical when trying to determine which medication works best for a patient’s unique condition.

Bottom Line: The ultimate “better” medication is the one that controls symptoms with minimal side effects for that particular individual.

Is Adderall or Dextroamphetamine More Potent?

Many people assume that because Adderall contains multiple amphetamine salts (dextroamphetamine + levoamphetamine), it must be more powerful than products that contain only dextroamphetamine.

However, this assumption does not accurately reflect how these medications interact within the body. CNS stimulation by dextroamphetamine tends to be greater than by its counterpart, levoamphetamine. Dextroamphetamine tends to produce more focused cognitive effects than Adderall, while physical effects may be felt more strongly in individuals who receive the additional levoamphetamine in Adderall.[4]

• Myth: Adderall is automatically stronger because it contains more ingredients.
• Fact: Effectiveness depends on dose, formulation, and individual response, not simply the number of active ingredients.

Similarities Between Dextroamphetamine and Adderall

Both dextroamphetamine and Adderall received approval from the U.S. Food and Drug Administration (FDA) for treating ADHD and narcolepsy.

How They Work

Although both medications function similarly, they do so by affecting dopamine and norepinephrine. These two chemicals are involved in regulating various aspects of cognition. As a result, improvements in both attention and impulse control are possible.

According to information released by the National Institute on Drug Abuse (NIDA), stimulant medications such as these affect both the brain’s reward pathways and its ability to focus on tasks. It is this dual action that makes them useful treatments for ADHD but also increases their potential for misuse and dependency.[5]

Controlled Substance Status

Both dextroamphetamine and Adderall are classified as Schedule II controlled substances due to their potential for misuse and dependency when not taken as prescribed, and neither carries a significantly higher risk than the other.

Comparison of Adverse Side Effects

Adverse side effects reported for both medications tend to be quite similar:

• Loss of appetite
• Difficulty falling asleep
• Dry mouth
• Weight loss
• Headaches
• Increased heart rate
• Anxiety

More serious side effects may include cardiovascular issues, circulatory problems, allergic reactions, and psychiatric symptoms, including psychosis (a long-term state with symptoms like delusions and hallucinations), hallucinations (perceiving sensory input that does not exist), and delusions (holding false beliefs).

Types of Available Medications Based on Length of Action

Both dextroamphetamine and Adderall are available in immediate-release and extended-release forms. Regardless of which medication you are taking, duration of action is determined by which type of formulation you are taking (immediate-release or extended-release). This factor determines how often you must take doses during the day.

Determining if Someone Would Respond Better to Either Medication

When deciding whether to prescribe dextroamphetamine versus Adderall, clinicians may consider recommending dextroamphetamine for someone who:

• Has difficulty tolerating multiple amphetamine salts in Adderall
• Exhibits heightened sensitivity to peripheral stimulation
• Has experienced successful outcomes previously with dextroamphetamine

Clinicians may recommend Adderall for someone who:

• Displays favorable responses to the additive benefits provided by combining multiple amphetamine salts
• Has familiarity with the medication
• Has experienced a successful outcome previously with Adderall

It is essential to note that these recommendations serve as general guidelines rather than strict rules. An individual who responded favorably to one medication may not exhibit an identical response with the alternate medication.

Can You Switch Between Dextroamphetamine and Adderall Without Medical Guidance?

Changing from one medication to the other should never occur without first consulting a prescriber. A prescriber will typically guide this switch, though dose equivalence between the two medications is not always exact, and effectiveness will need to be monitored closely afterward, along with any necessary side effect adjustments.

Risks of Misusing Prescription Stimulants

Misusing prescription stimulants, including dextroamphetamine and Adderall, can result in

• Developing addiction
• Building tolerance, meaning the body needs more of the medication over time to feel the same effects
• Diverting or distributing prescription stimulants to someone they were not prescribed for
• Suffering withdrawal symptoms if discontinued abruptly

Safe storage is important to help prevent misuse, and taking medication exactly as prescribed is the best way to reduce these risks.

When to Talk With Your Prescriber

Reach out to your prescriber if you notice any of the following:

• Your medication stops working as well as it used to
• Side effects worsen
• Sleep problems develop
• Appetite or weight changes become significant
• Mood changes occur
• Heart symptoms appear, such as heart palpitations

Help for Stimulant Abuse

When used as prescribed, Adderall and dextroamphetamine-based medications like Dexedrine and Zenzedi can be very helpful in managing ADHD symptoms.

But if your relationship with stimulants is becoming something that’s hard to handle, then Ascendant NY is here to help. Reach out today to talk to one of our admissions specialists and learn more about our stimulant treatment options. You don’t have to manage this alone.