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Adderall and Mydayis are trade names for a combination drug containing four salts of amphetamine. The mixture is composed of equal parts racemic amphetamine and dextroamphetamine, which produces a (3:1) ratio between dextroamphetamine and levoamphetamine, the two enantiomers of amphetamine. Both enantiomers are stimulants, but differ enough to give Adderall an effects profile distinct from those of racemic amphetamine or dextroamphetamine. Adderall is indicated in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. It is also used as an athletic performance enhancer, cognitive enhancer, appetite suppressant, and recreationally as a euphoriant. Such uses are usually illegal in most countries. It is a central nervous system (CNS) stimulant of the phenethylamine class.
At prescribed doses, Adderall can create emotional and mental effects like euphoria, changes in sex drive, better focus, and increased alertness. Physically, it may improve reaction time, reduce feelings of fatigue, and boost muscle strength. However, taking much larger amounts can have the opposite effect — reducing self-control, breaking down muscle tissue, triggering panic attacks, or even causing psychosis, which may include paranoia, delusions, or hallucinations.
Side effects vary from person to person, but the most common ones include trouble sleeping, dry mouth, loss of appetite, and weight loss. When used as directed at low daily doses, such as for treating ADHD, the risk of addiction or dependence is very small. But taking higher daily doses regularly carries a much greater risk of addiction because of the drug’s rewarding effects at those levels. Recreational use usually involves doses far higher than what doctors prescribe, which greatly increases the chance of serious harmful effects.
Adderall is most often prescribed to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy.
Studies on animals show that very high, long-term exposure to amphetamines can cause problems with dopamine systems or even nerve damage. However, in people with ADHD, long-term use of Adderall at prescribed doses seems to have the opposite effect. Research suggests it may actually support healthy brain development and nerve growth.
Brain imaging studies also show that long-term Adderall treatment can reduce some of the structural and functional differences seen in the brains of people with ADHD. Improvements have been observed in several regions of the brain, including the right caudate nucleus, a part of the basal ganglia that helps control movement and behavior.
Narcolepsy is a long-term sleep disorder that causes extreme daytime sleepiness, sudden loss of muscle control (cataplexy), and sometimes episodes of sleep paralysis.
Doctors classify narcolepsy into two types. Type 1 includes cataplexy, while type 2 does not. Type 1 narcolepsy is linked to the loss of about 70,000 brain cells in the lateral hypothalamus that normally release a chemical called orexin. Orexin plays a key role in staying awake, and when its levels in the brain and spinal fluid are very low, it serves as an important marker for diagnosing type 1 narcolepsy.
The brain cells that release orexin send signals to many areas of the brain responsible for wakefulness, including those that use norepinephrine, dopamine, histamine, and serotonin. This widespread signaling helps explain why the loss of orexin leads to the excessive sleepiness seen in narcolepsy.
Adderall comes in two main types: immediate-release (IR) tablets and extended-release (XR) capsules. Mydayis, a related medication, is only made in an extended-release form.
Adderall XR is approved to treat ADHD in people age 6 and older and lasts for up to 12 hours. It uses a special double-bead system inside the capsule. Half of the beads release the medication right away, while the other half are coated to dissolve more slowly, giving a second dose later. This design makes it work the same as taking two doses of Adderall IR spaced four hours apart. The capsule can be swallowed whole or opened and sprinkled onto applesauce without changing how it is absorbed.
Mydayis is designed to last even longer — up to 16 hours — and is approved for people age 13 and older. It uses a triple-bead system to release medication at three different times throughout the day.
In the United States, both the IR and XR versions of Adderall are available as generics. Generic versions of Mydayis also became available in 2023.
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