2008 Woodie Awards
A focus on Adderall
Jeremy A. Teissere: Assistant Professor of Biology and Neuroscience
Issue date: 11/1/07 Section: Focus
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A therapy and a recreational drug might be found in the same brown bottle. This can make it very difficult for the pharmacologist to formulate clear arguments about the usefulness of a drug and simultaneously warn the abuser of the dangers of the same drug when taken in excess. At the very best, these types of "informational" testimonials can provide helpful information about drug mechanisms and side-effects; at the worst, they can sound cheap, moralistic, and duplicitous. There is a sense of burden: how can we reasonably argue for both utility and control?
Consider the current use and abuse of Adderall, an alternative to Ritalin in the treatment of ADHD (Attention Deficit/Hyperactivity Disorder). Adderall is a pharmacological portmanteau of sorts: it contains a mixture of both L- and D-forms of amphetamine (it would be helpful to pull out your organic chemistry notes here). This molecular one-two punch alleviates the symptoms of ADHD by increasing synaptic levels of dopamine and epinephrine in the central nervous system. Because these neurotransmitters underlie states of high arousal in the brain and stimulate body circuits involved in stress, Adderall has the effect of maximizing alertness and focus in low doses. Ritalin, which is not composed of an amphetamine but a related compound, methylphenidate, works similarly. It may seem strange that a stimulant would be an effective therapy for ADHD - but this is a classic example of paradoxical pharmacology: amphetamine quenches the behavioral stimulation that ADHD sufferers crave, thereby reducing the need to jump attentional focus every few minutes.
The use of Adderall in the clinic marks a return to amphetamine-based therapies of the middle twentieth century. From 1936 to about 1965, amphetamine was the preferred pharmacotherapy for not only ADHD but also narcolepsy, excessive sleepiness, and obesity. From its synthesis in the 1930s, amphetamine has been given to soldiers to promote alertness in combat. It has also been touted as a remedy for hypotension, seasickness, caffeine and nicotine dependence, and severe hiccoughs. Although amphetamines are now used to treat ADHD, the dangers of chronic administration, specifically addiction, have prevented further expansion into the clinical arena.
Consider the current use and abuse of Adderall, an alternative to Ritalin in the treatment of ADHD (Attention Deficit/Hyperactivity Disorder). Adderall is a pharmacological portmanteau of sorts: it contains a mixture of both L- and D-forms of amphetamine (it would be helpful to pull out your organic chemistry notes here). This molecular one-two punch alleviates the symptoms of ADHD by increasing synaptic levels of dopamine and epinephrine in the central nervous system. Because these neurotransmitters underlie states of high arousal in the brain and stimulate body circuits involved in stress, Adderall has the effect of maximizing alertness and focus in low doses. Ritalin, which is not composed of an amphetamine but a related compound, methylphenidate, works similarly. It may seem strange that a stimulant would be an effective therapy for ADHD - but this is a classic example of paradoxical pharmacology: amphetamine quenches the behavioral stimulation that ADHD sufferers crave, thereby reducing the need to jump attentional focus every few minutes.
The use of Adderall in the clinic marks a return to amphetamine-based therapies of the middle twentieth century. From 1936 to about 1965, amphetamine was the preferred pharmacotherapy for not only ADHD but also narcolepsy, excessive sleepiness, and obesity. From its synthesis in the 1930s, amphetamine has been given to soldiers to promote alertness in combat. It has also been touted as a remedy for hypotension, seasickness, caffeine and nicotine dependence, and severe hiccoughs. Although amphetamines are now used to treat ADHD, the dangers of chronic administration, specifically addiction, have prevented further expansion into the clinical arena.