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PubMed1991

Hormonal responses to dextroamphetamine in depressed and normal adolescents.

Because of its neuroendocrine effects, amphetamine infusion has been used as a probe to investigate neurobiological correlates of depressive illness. In two separate studies, a total of 72 adolescents with major depressive disorder and 66 normal adolescents were given dextroamphetamine, 0.15 mg/kg, intravenously. Their cortisol, growth hormone, and prolactin responses were measured. These endocrine responses did not reliably distinguish adolescents with major depressive disorder from those without it, nor did they reliably delineate any specific depressive subgroup. These findings are compared with those from similar studies of adult depression.

Adolescent↗
PubMed2001

Comparing guanfacine and dextroamphetamine for the treatment of adult attention-deficit/hyperactivity disorder.

The objective of this study was to compare the efficacy of the alpha-2a agonist guanfacine with that of dextroamphetamine for the treatment of adult attention-deficit/hyperactivity disorder (ADHD). Seventeen adult outpatients who met DSM-IV criteria for ADHD participated in a double-blind, placebo-controlled, crossover study comparing drug effects on ADHD symptoms. Measures of change included the DSM-IV ADHD Behavior Checklist for Adults and the Copeland Symptom Checklist for Adult Attention Deficit Disorders. Cognitive measures of attention included the Stroop and Controlled Oral Word Association Test using the letters "C," "F," and "L" (COWAT, CFL version). For each trial, the drug was administered daily and titered up to optimal doses of maximum efficacy but with a minimum of side effects, and then data were collected. Both drugs significantly reduced ADHD symptoms on the DSM-IV Adult Behavior Checklist for Adults over placebo (p < 0.05). The Stroop Color subscale showed significant improvement for both drugs (p < 0.05), but the Color-Word measures showed significant improvement for guanfacine only (p < 0.01). The average dose of guanfacine was 1.10 (SD = 0.60), and the most common side effect of guanfacine was fatigue. No subjects discontinued drug trials. This preliminary study indicates that guanfacine may be a well-tolerated treatment option for adult ADHD.

Adrenergic Uptake Inhibitors↗
PubMed2001

Dextroamphetamine for cocaine-dependence treatment: a double-blind randomized clinical trial.

A properly implemented agonist treatment regimen should improve retention and reduce illicit drug use. Cocaine-dependent subjects (N = 128) were enrolled in a 12-week randomized, double-blind, placebo-controlled trial. In the multistage dosing design, subjects initially received placebo (PBO) or 15 to 30 mg of dextroamphetamine sulfate, sustained-release capsules. At week 5, the dose doubled to 30 mg or 60 mg for active groups. Subjects attended the clinic twice a week, provided urine samples, obtained medication, and had one behavioral therapy session a week. Retention was best for the 15- to 30-mg group, whereas the proportion of benzoylecgonine-positive urine screens was, from lowest to highest, 30 to 60 mg, 15 to 30 mg, and PBO at study end. Dosing must be refined. The results provide support for additional examination of the agonist model in psychostimulant-dependence treatment.

Adult↗
PubMed1991

Ischemic colitis associated with dextroamphetamine use.

Ischemic colitis can be caused by a variety of medications including a number of sympathomimetic agents. We report the case of a 47-year-old narcoleptic man who had abdominal pain and rectal bleeding. The clinical, radiographic, and histologic findings supported the diagnosis of ischemic colitis associated with oral dextroamphetamine use.

Colitis↗
PubMed1976

Treatment of chronic post-traumatic organic brain syndrome with dextroamphetamine: first reported case.

In view of its therapeutic efficacy in the treatment of children with minimal brain dysfunction syndrome, dextroamphetamine was administered to a young adult with a chronic organic brain syndrome secondary to cerebral trauma. That D-amphetamine was critical to the resulting marked diminution in confusion, paranoia, and deficit in short term memory was confirmed by the occurrence of a relapse coincident with placebo administration as part of a double blind evaluation. Amitriptylline appeared to potentiate the therapeutic effects of D-amphetamine. The results achieved, although observational and subjective in nature, warrant replication in controlled, quantitative clinical studies.

Accidents, Traffic↗
PubMed1993

Classroom academic performance: improvement with both methylphenidate and dextroamphetamine in ADHD boys.

Daily academic classroom performance was recorded in a day hospital school using a commonly employed reading and math series as part of an 11-week double-blind, placebo controlled, crossover comparison of dextroamphetamine (d-AMPH) and methylphenidate (MPH) in 33 hyperactive boys. Students attempted more math and reading tasks while on either active drug. The percent correct and the number of attempted problems of the reading series improved with both drugs while the percent correct for the math series occurred with d-AMPH only. No dose-response relationship was found for either stimulant. Moderate, transient adverse effects were common for both drugs.

Achievement↗
PubMed1978

Dextroamphetamine: cognitive and behavioral effects in normal prepubertal boys.

The behavioral, cognitive, and electrophysiological effect of a single dose of dextroamphetamine (0.5 milligram per kilogram of body weight) or placebo was examined in 14 normal prepubertal boys (mean age, 10 years 11 months) in a double-blind study. When amphetamine was given, the group showed a marked decrease in motor activity and reaction time and improved performance on cognitive tests. The similarity of the response observed in normal children to that reported in children with "hyperactivity" or minimal brain dysfunction casts doubt on pathophysiological models of minimal brain dysfunction which assume that children with this syndrome have a clinically specific or "paradoxical" response to stimulants.

Attention Deficit Disorder with Hyperactivity↗
PubMed1983

Maternal use of dextroamphetamine and growth of the fetus.

Data from a large prospective study were analyzed to determine if taking dextroamphetamine during pregnancy affects fetal growth or fetal/neonatal mortality. 237/42,101 women took the drug to control weight gain. Birth weights were not significantly affected when the drug was discontinued before the 28th week of gestation, but after the 28th week birth weights were 4% lower (144 g) when the drug had been taken in high weight gain gestations (p less than 0.01). The body lengths and head circumferences of neonates were not affected. The perinatal mortality rate was 38/1,000 births for both offspring of drug users and nonusers.

Birth Weight↗
PubMed2005

Physiotherapy coupled with dextroamphetamine for rehabilitation after hemiparetic stroke: a randomized, double-blind, placebo-controlled trial.

BACKGROUND AND PURPOSE: Hemiparesis is the commonest disabling deficit caused by stroke. In animals, dextroamphetamine (AMPH) paired with training enhances motor recovery, but its clinical efficacy is uncertain. METHODS: In a randomized, double-blind, placebo-controlled trial, 71 stroke patients were stratified by hemiparesis severity and randomly assigned to 10 sessions of physiotherapy coupled with either 10 mg AMPH or placebo. Study treatments were administered by 1 physiotherapist, beginning 5 to 10 days after stroke and continuing twice per week for 5 weeks. Outcomes were assessed by 1 physiotherapist at baseline, after each treatment session, at 6 weeks, and at 3 months. The primary outcome was motor recovery (impairment level) on the Fugl-Meyer (FM) scale. Secondary outcomes assessed mobility, ambulation, arm/hand function, and independence in activities of daily living. RESULTS: Baseline hemiparesis was severe overall (mean FM score 27.7+/-20.0). Motor scores improved during treatment in both groups (mean change, baseline to 3 months 29.5+/-16.6). Repeated-measures ANOVA revealed no significant differences in recovery between the treatment groups for the entire cohort (n=67) or for subgroups with a severe hemiparesis (n=43), moderate hemiparesis (n=24), or cortically based stroke (n=26). In the moderate subgroup, there was a significant drug x time interaction for upper extremity motor recovery (F=5.14; P<0.001), although there was a significant baseline imbalance in motor scores in this subgroup. CONCLUSIONS: In stroke patients with a severe motor deficit, 10 mg AMPH coupled with physiotherapy twice per week for 5 weeks in the early poststroke period provided no additional benefit in motor or functional recovery compared with physiotherapy alone. Patients with moderate severity hemiparesis deserve further investigation. Increased intensity and longer duration drug/therapy dosing regimens should be explored, targeting the upper and lower limbs separately.

Aged↗
PubMed2003

Utility of dextroamphetamine for attenuating the impact of sleep deprivation in pilots.

INTRODUCTION: Dextroamphetamine (Dexedrine) is an effective fatigue countermeasure for use in military subject pilots who are deprived of sleep. Anecdotal reports have indicated Dexedrine (Dex) is effective in "real world" sustained operations, and controlled laboratory tests have yielded positive results as well. The aim of this study was to substantiate the efficacy of Dex for sustaining the alertness and performance of pilots during periods of sleep deprivation by showing the robust effects of the medication and its consistent effects across several research efforts. METHODS: In the present report, selected data from several controlled aviation studies were reviewed and combined to corroborate the efficacy of Dex as a fatigue countermeasure. RESULTS: The results showed Dex to be effective for maintaining flight skills, psychological mood, and physiological activation (measured via electroencephalograph data) in sleep-deprived pilots. The positive benefits of the medication were not offset by marked disruptions in recovery sleep, although some negative effects were observed (sleep was lighter for several hours following drug administration). CONCLUSIONS: Dex is a viable remedy for fatigue in aviation sustained operations. However, Dex is not a substitute for proper crew-rest scheduling because there is no replacement for adequate restful sleep.

Adult↗
PubMed1991

Effects of dextroamphetamine on the cognitive and social play of a preschooler with ADHD.

This study investigates how deficits in attention and impulse control are reflected in the social and cognitive play of a 4-year-old boy with attention-deficit hyperactivity disorder. In addition, an A-B-A-B reversal design was employed to evaluate the effectiveness of dextroamphetamine (2.5 mg, twice a day) for treatment of preschool attention-deficit hyperactivity disorder. The most dramatic effects of medication were observed on the level of sustained attention and the pattern of cognitive play. Sustained attention during play and in a structured group activity improved, and play became more sequentially organized and symbolic. Results are discussed with respect to the following: 1) attention-deficit hyperactivity disorder and preschool play; 2) the efficacy of psychostimulant medication; and 3) the adequacy of teacher ratings versus direct observation in measuring medication response.

Attention↗
PubMed1990

Relative efficacy of long-acting stimulants on children with attention deficit-hyperactivity disorder: a comparison of standard methylphenidate, sustained-release methylphenidate, sustained-release dextroamphetamine, and pemoline.

Twenty-two children with attention deficit-hyperactivity disorder underwent a double-blind, placebo-controlled, crossover evaluation of the efficacy of standard methylphenidate twice a day and comparable doses every morning of a sustained-release preparation of methylphenidate (SR-20 Ritalin), a sustained-release form of dextroamphetamine (Dexedrine Spansule), and pemoline. The children were participating in a summer treatment program in which they engaged in recreational and classroom activities. Dependent measures include evaluations of social behavior during group recreational activities, classroom performance, and performance on a continuous performance task. Results revealed generally equivalent and beneficial effects of all four medications. Dexedrine Spansule and pemoline tended to produce the most consistent effects and were recommended for 10 of the 15 children who were responders to medication. The continuous performance task results showed that all four medications had an effect within 2 hours of ingestion, and the effects lasted for 9 hours. The implications of these results for the use of long-acting stimulant medication in children with attention deficit-hyperactivity disorder are discussed.

Adolescent↗
PubMed1971

Comparison of the effects of chlorpromazine, dextroamphetamine and methylphenidate on the behaviour and intellectual functioning of hyperactive children.

Chlorpromazine, dextroamphetamine and methylphenidate were significantly superior to placebo in producing overall improvement in the behaviour of hyperactive children. Chlorpromazine was effective for the majority of the children, but reduced only hyperactivity, having no demonstrable effect on distractibility, aggressivity or excitability. Both stimulants produced more goal-oriented behaviour and reduced distractibility. Methylphenidate was the most effective of the drugs in prpducing exceptional improvement. All three active drugs had to be discontinued in a few of the children because of side effects. Not all hyperactive children were benefited by the drugs.No background variables (with the exception of mother-child relationship) were found in the present studies to predict favourable response to the drugs.Methylphenidate became our drug of choice for this group of hyperactive children.

Child↗
PubMed1984

The neuroendocrine and behavioral response to dextroamphetamine in normal individuals.

Dextroamphetamine 30 mg and placebo were administered by mouth in a double-blind randomized cross-over trial to ten subjects. Behavior was assessed and blood samples analyzed for growth hormone (GH), prolactin (PRL), homovanillic acid (HVA), and amphetamine. There was a statistically significant increase in well-being following d-amphetamine as compared to baseline and placebo on both the Amphetamine Interview Rating Scale and the Hopkins Mood Scale. No subject became psychotic. There was a statistically significant increase in GH from baseline to peak following d-amphetamine ingestion. When compared to placebo, the increase in GH was invariable and statistically significant for the 90-min sampling. PRL decreased from baseline following both d-amphetamine and placebo and there was no significant drug-placebo difference. Serum HVA was measured at baseline and 120 min, for eight subjects. Six subjects had an increase in HVA following d-amphetamine but there was no significant drug effect.

Adult↗
PubMed1995

Acute mood improvement after dextroamphetamine and methylphenidate in narcolepsy.

Mood changes following ingestion of dextroamphetamine (D-AMP) or methylphenidate (MPH) were examined in 40 narcoleptic patients. The Profile of Mood Status (POMS) and eight additional adjectives describing feelings were used to quantify changes in mood before taking stimulant medication and approximately 90 minutes after ingestion of medication. No significant differences were found between the effects of the two stimulants. When the data from D-AMP and MPH were combined, significantly higher ratings on the POMS factor of Vigour-Activity and the adjectives of 'confident', 'talkative' and 'competitive' were found. Lower ratings after medication were noted for the POMS factors of Fatigue-Inertia, Depression-Dejection and Confusion-Bewilderment (all P < 0.001). These effects are similar to those previously reported in normal subjects as well as in certain other patient populations. The findings indicate a possible therapeutic role of stimulant medication not only for the treatment of excessive sleepiness but also for improving affect, motor and mental vigour, and aspects of cognition.

Journal Article↗