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Amphetamine, commonly known by its trade names Adderall, Dyanavel XR and Evekeo, is a stimulant drug used in the treatment of a number of disorders including ADHD (attention deficit hyperactivity disorder), narcolepsy, depression, and obesity.


Adderall Mechanism of Action


Adderall is a strong neurostimulator. It causes the release of noradrenaline (norepinephrine) from adrenergic presynaptic neurons. Norepinephrine is a central nervous system stimulant, and this stimulant effect is thought to underlie the drugs therapeutic actions in ADHD.


Common Side Effect of Amphetamines


Adderall is usually a well tolerated drug with few side effects. However it is associated with a number of ADHD medication adverse reactions. These include (occur in more than 1% of patients):


  • Epistaxis (nose bleeds)
  • Allergic rhinitis (stuffy nose)
  • Upper abdominal pain


Less Common Side Effects of Amphetamines

A number of side effects have been reported when taking amphetamine (Adderall) but have not had their frequency reported in large scale trials. These side effects include:


  • Euphoria
  • Dysphoria
  • Insomnia
  • Restlessness
  • Dizziness
  • Dyskinesia (involuntary movement)
  • Tremor
  • Headaches
  • Dry mouth
  • Diarrhea
  • Constipation
  • Impotence
  • Frequent erections
  • Increase libido
  • Decreased libido
  • Weight loss
  • Anorexia


How Does Pharmacogenetic Testing Work?


As previously mentioned, Adderall is usually a well-tolerated drug that has few side effects in most patients. However, a small portion of individuals will suffer multiple severe adverse reactions. This inter-patient variation is partially accounted for by the genetic differences between individuals. Polymorphisms in genes that code for receptors and enzymes that interact with amphetamine could increase the probability of developing side effects when taking the drug.


For instance, amphetamine is metabolized by the cytochrome P450 superfamily of enzymes, namely isoenzyme CYP2D6. Studies have suggested that polymorphisms in CYP2D could increase the probability of developing side effects when taking Amphetamine. Other studies have suggested that variants in the mu opioid receptor OPRM1 mediated the euphoria often seen in patients taking Amphetamine.


Understand Your Risks with the Rxight® Genetic Test


Identifying these polymorphisms can therefore aid a clinician’s decision making when prescribing amphetamine and other ADHD stimulant medications. A clinician may lower the dose given a specific allele or recommend the drug not be prescribed at all. Unfortunately routine genomic screening in not performed by most health care providers. MD Labs’ genetic testing program, Rxight®, sequences 18 genes (including OPRM1 and CYP2D6) to establish how a patient is likely to respond to hundreds of clinically relevant medications (including Adderall).








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