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PubMed1976

Levoamphetamine vs dextroamphetamine in minimal brain dysfunction. Replication, time response, and differential effect by diagnostic group and family rating.

Double-blind crossover randomized Latin square comparison of placebo, dextroamphetamine, and levoamphetamine in 31 consecutively diagnosed children with minimal brain dysfunction (MBD) replicated a smaller nonrandom study. Both isomers showed significantly more benefit than placebo but were not significantly different from each other. Dextroamphetamine showed a nonsignificant trend of superiority over levoamphetamine. Of 25 subjects who responded well to drugs, three responded only to levoamphetamine, five only to dextroamphetamine, and 17 to both. This study seems to confirm the efficacy of levoamphetamine in MBD. An unsocialized aggressive subgroup (308.4) showed a nonsignificant trend for levoamphetamine superiority, in contrast to the hyperkinetic (308.0) and overanxious (308.2) subgroups. Those who responded best to levoamphetamine tended (not significantly) to be from poorer functioning families. Parents' ratings, but not teachers' or psychiatrists' ratings, showed significant placebo effect.

Amphetamine↗
PubMed1976

Methylphenidate, dextroamphetamine, and levamfetamine. Effects on schizophrenic symptoms.

Methylphenidate hydrochloride dextroamphetamine sulfate, and levamfetamine succinate have potential as pharmacologic tools for the indirect evaluation of the role of neurotransmitters in schizophrenia. In actively ill schizophrenic patients, methylphenidate administered intravenously causes a brief but clear intensification of preexisting psychotic symptoms, such as hallucinations and delusions. In our study, methylphenidate, dextroamphetamine, and levamfetamine were administered in equimolar doses to schizophrenic patients. Methylphenidate was a more effective activator of symptoms than dextroamphetamine, which in turn was more effective than levamfetamine. Levodopa (L-dopa) given orally also reportedly produces a temporary worsening of schizophrenic symptoms. While these findings augment a body of information suggesting that dopamine and norepinephrine may play a role in the activation of schizophrenic symptoms, our findings with methylphenidate (reportedly weak in eliciting stereotyped behaviour in rat) and our review of the literature indicate complexities that remain to be resolved. There is some utility of the procedure for differential diagnosis and selective therapy, but this is still of occasional and limited potential.

Acute Disease↗
PubMed1981

Paradoxical cortisol responses to dextroamphetamine in endogenous depression.

Dextroamphetamine hydrochloride was administered intravenously (IV) in the morning and evening to 22 unmedicated patients with severe endogenous depressions and 18 normal control subjects. While the normal subjects generally had a sharp increase in plasma cortisol level by 30 minutes after drug administration, two thirds of the depressed patients showed instead a paradoxical suppression of cortisol levels by 60 minutes. Discrimination between normal subjects and depressives was greatest in the evening. These results are consistent with other reports of abnormal cortisol responses in depressed patients to smaller IV doses of dextroamphetamine and larger doses of methamphetamine hydrochloride. A defect in activation or noradrenergic alpha receptors may account, in part, for the abnormal cortisol responses. The dextroamphetamine cortisol test in other patient populations requires study before its diagnostic use in endogenous depression can be established.

Adolescent↗
PubMed1982

Antipsychotic effects of pimozide in schizophrenia. Treatment response prediction with acute dextroamphetamine response.

Acute behavioral response to 20 mg of dextroamphetamine (intravenous) predicted fourth-week antipsychotic response to double-blind pimozide treatment. Patients whose psychotic condition improved with dextroamphetamine administration showed more antipsychotic response to pimozide therapy than those whose condition worsened or did not change. Multiple regression analysis indicated amphetamine-induced response predicted pimozide response after four weeks for fifth-week pimozide response was more accurately predicted by prepimozide psychosis ratings. Our study provides some evidence that mechanisms underlying early and late pimozide response are not necessarily identical. Because patients who did not respond to dextroamphetamine administration still improved with pimozide therapy, our data do not support the concept that schizophrenia can be divided into two groups (dopamine-sensitive or dopamine-insensitive) but, rather, that dopamine responsiveness changes over time. Clinical application is not warranted until studies with larger samples have replicated our findings.

Adolescent↗
PubMed1979

The effects of LSD-25 and dextroamphetamine on the use of defensive language.

Verified that psychotomimetics attenuate verbal defense mechanisms. This was accomplished by reanalyzing the 5-minute monologues of 7 neurotic depressives who participated in a project (Mechaneck, Feldstein, Dahlberg, & Jaffe, 1968) that examined the effects of LSD and dextroamphetamine on timing aspects of speech. Dosages were subhallucinatory: 15-25 mg dextroamphetamine, 50-100 mg LSD, and a matching placebo. Volunteers received each drug (double-blind) seven or eight times on a random schedule over a 1 1/2-year period; there was a 3-week intertrial interval. The patient provided 5-minute monologues both before and after drug effects. The monologues were transcribed and scored for formal measures of defensive language. Results indicated that LSD caused individuals to make more personal statements and to use explanation and evaluations less often. Dextroamphetamine was found to decrease the use of nonpersonal references.

Adult↗
PubMed1997

Dextroamphetamine as a treatment for depression and low energy in AIDS patients: a pilot study.

This report documents findings from an open trial of dextroamphetamine in the treatment of depression and low energy in AIDS patients. Dextroamphetamine offers the potential for rapid onset of effect and activation properties, both of which are important to persons with late stage HIV illness. Primary inclusion criteria included having a DSM-III-R depressive disorder, debilitating low energy, CD4 cell count below 200 cells/mm3, and no history of drug dependence. The trial consisted of open treatment in a 6-week protocol, with indefinite follow-up. Twenty-four men entered the study, 18 of 19 (95%) patients who completed at least 6 weeks of treatment reported substantial improvement with regard to both mood and energy at a median dosage of 10 mg/day. These results suggest that dextroamphetamine is a potentially effective, fast acting antidepressant treatment for this population and call for a larger, controlled trial.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Methylphenidate and dextroamphetamine abuse in substance-abusing adolescents.

The prevalence of methylphenidate and dextroamphetamine misuse and abuse was examined in 450 adolescents referred for substance abuse treatment. Twenty three percent reported nonmedical use of these substances and six percent were diagnosed as methylphenidate or dextroamphetamine abusers. Abuse was more common in individuals who were out of school and had an eating disorder. Methylphenidate and dextroamphetamine abuse appears to be much less common than abuse of most other substances. It does occur, however, and parents and schools need to exert greater control over the dispensing of these medications. Physicians are advised to prescribe non-stimulant medications (eg, bupropion) when treating attention deficit hyperactivity disorder in substance-abusing individuals.

Adolescent↗
PubMed2000

Efficacy of modafinil compared to dextroamphetamine for the treatment of attention deficit hyperactivity disorder in adults.

Our objective was to compare the efficacy of the new wake-promoting drug modafinil to that of dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD) in adults. Twenty-two adults who met DSM-IV criteria for ADHD participated in a randomized, double-blind, placebo-controlled, three-phase crossover study comparing placebo, modafinil, and dextroamphetamine for the treatment of ADHD. The twice-daily study medications were titrated to doses of optimum efficacy over 4-7 days and then held constant during the rest of each 2-week treatment phase. Measures of improvement included the DSM-IV ADHD Behavior Checklist for Adults, the Controlled Oral Word Association Test (COWAT, using the letters C, F, and L version), Stroop, and Digit Span (Wechsler Adult Intelligence Scale version). For the 21 (96%) completers, the mean (+/- SD) optimum doses of modafinil and dextroamphetamine were 206.8 mg/day +/- 84.9 and 21.8 mg/day +/- 8.9, respectively. Scores on the DSM-IV ADHD Checklist (p < 0.001) were significantly improved over the placebo condition following treatment with both active medications. Performance on the COWAT (p < 0.05) reached trend levels of significance. Both medications were generally well tolerated. This preliminary study suggests that modafinil may be a viable alternative to conventional stimulants for the treatment of adults with ADHD.

Adolescent↗
PubMed1989

The neuroendocrine response to oral dextroamphetamine in normal subjects.

In 24 male subjects oral dextroamphetamine 20 mg caused a statistically significant rise in cortisol, prolactin, TSH, FSH, and LH compared to placebo. Dextroamphetamine caused a short-lived rise in growth hormone and attenuated the later rise which occurred after placebo. The findings are discussed in the light of previous reports of the neuroendocrine response to dextroamphetamine in normal subjects and in psychiatric patients.

Adolescent↗
PubMedDate not supplied

Comparative effects of dextroamphetamine and reserpine on halothane and cyclopropane anesthetic requirements.

Cyclopropane minimum alveolar concentration (MAC) values in dogs following intravenous administration of 0.5, 1 or 2 mg/kg of dextroamphetamine were 27.8, 28.4, and 28.4 volumes percent, respectively. Those values did not differ significantly from each other but were 44 percent greater than average control (no dextroamphetamine(MAC values. Halothane MAC values following the same dextroamphetamine doses were 1.51, 1.71, and 1.64 volumes percent. These values were 75 percent greater than average controls, and this increase was significantly more than the 44 percent noted with cyclopropane. In contrast, 2 mg/kg of reserpine decreased halothane MAC 20 percent vut decreased cyclopropane MAC 40 percent- the difference between the two anesthetics again being statistically significant. These results suggest that alteration of anesthetic potency by centrally active adrenergic drugs depends on the sympathetic activity induced by the anesthetic. Conversely, this suggests that anesthetics may influence their own potency by altering central nervous system adrenergic activity.

Animals↗
PubMed2002

Steady-state pharmacokinetics and tolerability of modafinil administered alone or in combination with dextroamphetamine in healthy volunteers.

The potential for a drug-drug interaction between modafinil and dextroamphetamine, each at steady state, was investigated in an open-label, randomized, single-period studyin 32 healthy male and female volunteers. All subjects received modafinil orally once daily for 28 days (200 mg on Days 1-7; 400 mg on Days 8-28). On Days 22 to 28, half of the subjects also received dextroamphetamine (20 mg) orally 7 hours after modafinil. Samples for pharmacokinetic (PK) profiling were obtained on Days 21 and 28. The mean changes in PK parameters for modafinil and its two circulating metabolites between the two groups were not statistically significantly different, except Cmax for modafinil acid. Adverse events obtained in the two groups were similar and mild or moderate in nature. The results indicate that administration of low-dose dextroamphetamine in this dosing regimen does not alter the steady-state pharmacokinetics of modafinil. The combination has a similar tolerability profile as modafinil alone.

Adult↗
PubMed1982

Growth hormone response to dextroamphetamine in depressed patients and normal subjects.

The human growth hormone (HGH) response to dextroamphetamine sulfate (doses, 0.1 and 0.15 mg/kg) was determined in both the morning and evening in patients with endogenous and atypical depression and in normal young men and normal postmenopausal women. Although the HGH response was found to be reduced in endogenously depressed postmenopausal women, it was equally reduced in normal postmenopausal women and in patients with atypical depression. Depressed and normal men had larger HGH responses, but there were no differences between depressed and normal men. These results do not confirm an earlier report that the reduced HGH response to dextroamphetamine is specific to endogenous depression. The results do suggest the importance to control for other variables in studies of HGH responses in psychiatric patients.

Adult↗
PubMed1976

Effects of dextroamphetamine on psychomotor skills.

Twelve healthy male volunteers were given 0, 5, 10, 15 mg/70 kg dextroamphetamine orally in a randomized double-blind fashion. Blood pressure increased linearly with dose while heart rate was unchanged. Although selected individual tests of stance stability and motor function improved in a dose-related fashion, a generalized improvement in performance was not found. Delayed Auditory Feedback (DAF) failed to show improvement in mental performance after dextroamphetamine.

Acoustic Stimulation↗
PubMed1983

Pharmacology of dextroamphetamine-induced cardiovascular malformations in the chick embryo.

We have observed dextroamphetamine sulfate to cause cardiovascular malformations in the 4-day-old chick embryo. Essentially all malformations were of the heart and great vessels. About one-half of these were the abnormal persistence of the left fourth aortic arch. Ventricular septal defects comprised the vast majority of the other malformations. Since d-amphetamine has both a direct and, more importantly, an indirect mode of alpha and beta adrenergic stimulation, three drugs were used to try to inhibit malformation production: alpha-methyl-p-tyrosine (AMT), a catecholamine synthesis inhibitor; metoprolol, a beta 1 blocker; and phentolamine, an alpha blocker. When given with d-amphetamine, all three drugs significantly reduced the malformation rate resulting from d-amphetamine alone. We speculate that the embryonic chick is capable of responding to the alpha and/or beta properties of dextroamphetamine sulfate. These properties may be causally related to the malformations observed.

Abnormalities, Drug-Induced↗
PubMed1983

A comparison of bupropion, dextroamphetamine, and placebo in mixed-substance abusers.

The subjective, behavioral, and physiological effects of bupropion, a nontricyclic antidepressant, were compared with those of dextroamphetamine and placebo in a randomized double-blind crossover study. The volunteers who participated were multiple-drug abusers. Six acute drug treatments, three doses of bupropion (100, 200, 400 mg), two doses of dextroamphetamine (15, 30 mg), and placebo were administered orally at intervals of not less than 72 h. Results indicated that the subjective effects of amphetamine as measured by the Addiction Research Center Inventory (ARCI) differed markedly from bupropion and placebo. Bupropion, in contrast to amphetamine, had no peripheral sympathomimetic effects and did not reduce appetite or caloric intake.

Adult↗
PubMed1978

Dextroamphetamine and placebo practice effects on selective attention in hyperactive children.

Three groups of boys referred to a hospital study unit for evaluation of hyperactive behavior were tested on a classification task involving selective attention while on either dextroamphetamine (D) or placebo (P). In two sessions, groups had D first, P second (DP), or PD, or PP. Amphetamine reduces a response times in general and reduces interference due to orthogonally varying irrelevant information. Practice while on placebo improves performance in a subsequent placebo session. Practice while on amphetamine does not, however, improve performance in the subsequent session on placebo. Assessment of the extent of the drug-state-related practice effect is necessary for evaluation of long-term benefits of dextroamphetamine therapy in these children.

Attention↗
PubMed1980

Autonomic and behavioral effects of dextroamphetamine and placebo in normal and hyperactive prepubertal boys.

The hypothesis is tested that the response to dextroamphetamine in terms of activity, attention, impulsivity, and autonomic activity is similar in normal (N) and hyperactive (H) children. Fourteen N and 15 H boys had skin conductance (SC), heart rate (HR), and finger temperature (ST) recorded during rest, presentation of eight 75-dB tones, and a reaction time (RT) procedure on three occasions: off drug (Day 1) and after ingestion (double-blind) of placebo and of .5 mg/kg dextroamphetamine. Both N and H groups showed drug effects, compared to placebo, of reduced motor activity and impulsivity, improved attention (RT), increased HR and HR slowing during RT foreperiods, and decreased ST. Both groups also had decreases in SC responsivity but in different parts of the test. Placebo compared to Day 1 produced increased activity and autonomic "arousal" but no change in Rt. Stimulant drugs thus have similar behavioral and autonomic effects in both N and H boys, but the beneficial effects on behavior do not depend critically on increases in arousal.

Arousal↗
PubMed1997

Minimal effects of dextroamphetamine on scopolamine-induced cognitive impairments in humans.

The central anticholinergic drug scopolamine has been used to model aspects of the memory impairment that occurs in Alzheimer's disease and in aging. To determine whether nonspecific stimulant effects can attenuate the cognitive impairment induced by scopolamine, we studied the effects of scopolamine and the stimulant dextroamphetamine in 17 young normal volunteers. After a baseline day of cognitive testing, subjects participated in two study days, in which they received dextroamphetamine (d-AMP) (0.25 mg/kg p.o.) + scopolamine (0.5 mg i.v.) and placebo + scopolamine, in randomized order under double-blind conditions. There were no statistically significant differences in cognitive test performance between the two drug conditions with the exception of one of the category retrieval tasks. Stimulant effects were documented to occur by other measures. We conclude that d-AMP at the dose used does not attenuate the memory impairment induced by scopolamine.

Adult↗