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Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
Dexedrine and Adderall are two prescription medications classified as central nervous system (CNS) stimulants. Dexedrine and Adderall are brand-name medications, but they have generics available. These two CNS stimulants are used in the treatment of a condition known as attention deficit hyperactivity disorder (ADHD) as well as narcolepsy. These drugs affect neurotransmitters in the brain which affect how focused and alert a patient feels.
What are the main differences between Dexedrine and Adderall?
Dexedrine is a brand medication whose generic is dextroamphetamine sulfate. It is a CNS stimulant, and more specifically, it is a type of amphetamine. Amphetamines stimulate the release of norepinephrine, and the primary site of this activity is in the cerebral cortex of the brain. CNS stimulation by amphetamines leads to a decreased sense of fatigue, increased motor activity and alertness, and an overall better mood. Dexedrine (Dexedrine details) is FDA approved in the treatment of ADHD and narcolepsy. It is also used off-label, or without approval from the FDA, in the treatment of certain types of obesity-resistant to other interventions. Dexedrine is available in immediate-release tablets, spansules, and extended-release capsules are available as well.
Adderall is a combination of amphetamine salts, containing a 3 to 1 ratio of dextroamphetamine (d-amphetamine) and levoamphetamine (l-amphetamine). It contains the active ingredient of Dexedrine, combined with other amphetamines. It is a prescription drug used in the treatment of ADHD and narcolepsy and works in the same manner as Dexedrine. Adderall is available in a much wider range of strengths as compared to Dexedrine. Adderall (Adderall details) comes in immediate-release tablets. Adderall XR is an extended-release capsule formulation.
The Drug Enforcement Agency (DEA) deems Dexedrine and Adderall schedule II narcotic drugs. Due to the fact that they are habit-forming and have a high potential for abuse, there are restrictions and guidelines for obtaining these drugs, which vary by state.
| Main differences between Dexedrine and Adderall | ||
|---|---|---|
| Dexedrine | Adderall | |
| Drug class | Central nervous system stimulant | Central nervous system stimulant |
| Brand/generic status | Brand and generic available | Brand and generic available |
| What is the generic name? | Dextroamphetamine sulfate | Amphetamine salts (d-amphetamine and l-amphetamine) |
| What form(s) does the drug come in? | Tablets, spansules, and extended-release capsules | Tablets and extended-release capsules |
| What is the standard dosage? | 5 mg once or twice daily titrated up to 40 mg/day | 5 mg once or twice daily titrated up to 60 mg/day |
| How long is the typical treatment? | Long-term (indefinite) | Long-term (indefinite) |
| Who typically uses the medication? | Children and adolescents 3 years of age and older; adults | Children and adolescents 3 years of age and older; adults |
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Conditions treated by Dexedrine and Adderall
Dexedrine and Adderall are indicated in the treatment of ADHD. ADHD is characterized by moderate to severe distractibility, short attention span, hyperactivity, and impulsivity. If left untreated, ADHD can affect academic and professional performance, as well as basic daily functions.
Dexedrine and Adderall are each indicated in the treatment of narcolepsy as well. Narcolepsy is excessive and uncontrollable daytime sleepiness. Like ADHD, untreated narcolepsy can have negative effects on day-to-day activities.
Dexedrine is used off-label in the short-term (few weeks duration) treatment of obesity that has not been responsive to other interventions such as diet, exercise, group programs, or other drugs.
Only your physician can determine what treatment is best for your condition.
| Condition | Dexedrine | Adderall |
| Attention hyperactivity deficit disorder (ADHD) | Yes | Yes |
| Narcolepsy | Yes | Yes |
| Refractory obesity | Off-label | No |
Is Dexedrine or Adderall more effective?
An analysis of 19 studies compares amphetamine-type treatments to placebo in the treatment of ADHD. In general, the analysis showed that amphetamine treatments reduced the severity of ADHD symptoms but were also linked with a higher number of patients who withdrew from the studies due to side effects. When comparing Dexedrine and Adderall directly, studies appeared to show that while Adderall showed an ability to decrease symptoms of ADHD overall, there was no evidence that Dexedrine reduced ADHD symptoms. Based on this information, Adderall may be preferred over Dexedrine.
Only your physician can decide which treatment is best for you.
Coverage and cost comparison of Dexedrine vs. Adderall
Dexedrine is a prescription medication that is typically covered by commercial insurance. Coverage by Medicare plans may vary or require special exceptions to be made. The out-of-pocket price for Dexedrine can cost more than $800. A coupon from SingleCare can bring the generic price to less about $91.
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Adderall is a prescription medication that is typically covered by commercial insurance. Coverage by Medicare plans may vary or require special exceptions to be made. The out-of-pocket price for Adderall can be more than $300. A coupon from SingleCare can bring the price of the generic to approximately $230 for 30, 20 mg tablets at select pharmacies.
| Dexedrine | Adderall | |
| Typically covered by insurance? | Yes | Yes |
| Typically covered by Medicare Part D? | No | No |
| Standard dosage | 30, 15 mg ER capsules | 60, 30 mg tablets |
| Typical Medicare copay | n/a | n/a |
| SingleCare cost | $91-$145 | $29-$50 |
Common side effects of Dexedrine vs. Adderall
Dexedrine and Adderall have a similar list of potential adverse effects. This is expected due to the similarities in ingredients. Dexedrine and Adderall have been linked to serious side effects such as elevated blood pressure, tachycardia, and palpitation. In some instances, myocardial infarction (heart attack) and sudden death have occurred. Caution should be used when prescribing stimulants in patients when pre-existing cardiac abnormalities.
Dexedrine and Adderall may lead to a sleep disorder known as insomnia, or an inability to fall and stay asleep. This can affect daily functioning and should be monitored. These drugs are also known to cause dry mouth and dizziness. You should discuss these adverse events with your healthcare provider if they occur and are bothersome.
The following is not intended to be an all-inclusive list of potential side effects. A complete list can be obtained from your healthcare professional.
| Dexedrine | Adderall | |||
| Side effect | Applicable? | Frequency | Applicable? | Frequency |
| High blood pressure | Yes | Not defined | Yes | Not defined |
| Tachycardia | Yes | Not defined | Yes | Not defined |
| Palpitation | Yes | Not defined | Yes | Not defined |
| Insomnia | Yes | Not defined | Yes | Not defined |
| Loss of appetite | Yes | Not defined | Yes | Not defined |
| Vomiting | Yes | Not defined | Yes | Not defined |
| Weight loss | Yes | Not defined | Yes | Not defined |
| Dry mouth | Yes | Not defined | Yes | Not defined |
| Dizziness | Yes | Not defined | Yes | Not defined |
Source: Dexedrine (DailyMed) Adderall (DailyMed).
Drug interactions of Dexedrine vs. Adderall
Dexedrine and Adderall, when used concurrently with serotonergic drugs, may increase the incidence of serotonin syndrome. This syndrome can result in the patient feeling agitated, dizzy, and having an increased heart rate. Common antidepressants such as selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors, as well as the pain medication Tramadol, may cause this interaction with Dexedrine or Adderall.
Dexedrine and Adderall should not be used in patients taking monoamine oxidase inhibitors (MAOIs). MAO inhibitors slow amphetamine metabolism, increasing the amphetamine’s effect on the release of norepinephrine and other monoamines from the nerve endings causing headaches and other signs of hypertensive crisis.
The following list is not intended to be a complete list of drug interactions. It is best to consult your doctor or pharmacist for a complete list.
| Drug | Drug class | Dexedrine | Adderall |
| Selegiline Isocarboxazid Phenelzine Linezolid |
Monoamine oxidase inhibitors (MAOIs) | Yes | Yes |
| Fluoxetine Paroxetine Sertraline Citalopram Escitalopram |
Selective serotonin reuptake inhibitors (SSRIs) | Yes | Yes |
| Venlafaxine Duloxetine Desvenlafaxine |
Selective norepinephrine reuptake inhibitors (SNRIs) | Yes | Yes |
| Sodium bicarbonate Sodium lactate |
Antacid | Yes | Yes |
| St. John’s Wort | Supplement | Yes | Yes |
| Topiramate | Antiepileptic | Yes | Yes |
| Tramadol | Opioid pain reliever | Yes | Yes |
| Sumatriptan Rizatriptan Eletriptan Zolmitriptan Naratriptan Frovatriptan |
5HT3 Antagonists (Triptans) | Yes | Yes |
| Desipramine Protriptyline Amitriptyline Nortriptyline |
Tricyclic antidepressants | Yes | Yes |
| Omeprazole Esomeprazole Pantoprazole Rabeprazole Lansoprazole |
Proton pump inhibitors (PPI) | Yes | Yes |
Warnings of Dexedrine and Adderall
Dexedrine and Adderall have each been associated with strokes, myocardial infarction, and sudden death in children and adults. These may be more likely to occur in patients with pre-existing cardiac conditions. Prescribers should screen for these conditions and use extreme caution in prescribing these drugs for patients who may have cardiac abnormalities.
Dexedrine and Adderall, along with other CNS stimulants, have been associated with moderate increases in blood pressure and heart rate. These parameters should be monitored when patients take stimulants.
Some types of ADHD medication, such as Dexedrine and Adderall, can exacerbate behavior disturbances in patients with pre-existing psychiatric disorders. These patients should be monitored closely if CNS stimulants are necessary. Bipolar patients may experience mixed or manic episodes while on CNS stimulants.
Long-term use of stimulants in children and adolescents has been linked to growth suppression. Patients experiencing slow growth while on stimulants may be encouraged to temporarily pause treatment. Oftentimes, healthcare providers recommend taking breaks from treatment when children are not in school, such as on weekends, holidays, and summer breaks.
If you have experienced allergic reactions to other stimulants or amphetamine drugs, you should not take Dexedrine or Adderall.
Frequently asked questions about Dexedrine vs. Adderall
What is Dexedrine?
Dexedrine is a CNS stimulant used in the treatment of ADHD and narcolepsy. It is considered a schedule II narcotic by the DEA due to its abuse potential and is available by prescription only. Dexedrine is available in a variety of strengths in immediate-release tablets and spansules, as well as extended-release capsules.
What is Adderall?
Adderall is a CNS stimulant used in the treatment of ADHD and narcolepsy. It is also considered a schedule II narcotic by the DEA due to its abuse potential and is available by prescription only. Adderall is available in a variety of strengths in both immediate-release tablets and extended-release capsules.
Are Dexedrine and Adderall the same?
Dexedrine and Adderall are similar drugs but are not exactly the same. Dexedrine is composed of dextroamphetamine sulfate, while Adderall is made of mixed amphetamine salts, including dextroamphetamine. Both drugs are CNS stimulants and have similar side effects and drug interaction profiles.
Is Dexedrine or Adderall better?
Collective data across multiple studies comparing amphetamine treatments to placebo in the treatment of ADHD showed that Adderall may be preferred as it showed some improvement in ADHD symptoms, while Dexedrine did not. Amphetamine drugs overall cause side effects that may make it difficult for some patients to continue treatment long term.
Can I use Dexedrine or Adderall while pregnant?
Dexedrine and Adderall are pregnancy category C, meaning there are no adequate, controlled studies to establish safety. These drugs should only be used in pregnancy when the benefit clearly outweighs the risk.
Can I use Dexedrine or Adderall with alcohol?
Alcohol use could increase the serum blood concentrations of Dexedrine and Adderall, and therefore alcohol should be avoided when on these medications.
