Summary:
A new review from the University of Sydney suggests that dexamphetamine, a stimulant used to treat narcolepsy and ADHD, may not be as addictive as previously believed. Researchers analyzed over 1,700 studies but found only seven papers directly addressing dexamphetamine addiction, with just four possible individual cases documented. Dexamphetamine was widely prescribed for conditions like asthma, depression, and weight management before restrictions were imposed in the 1960s due to concerns about addiction and psychiatric effects. Given the limited evidence of addiction risk, researchers question whether current regulations should be reassessed—particularly as the drug is being explored as a potential lower-cost treatment for obesity. The study’s authors emphasize the need for scientific rigor in evaluating pharmaceutical risks and are conducting further research into dexamphetamine’s safety and effectiveness.
Key Takeaways:
- Limited Evidence of Addiction Risk – Despite dexamphetamine’s long-standing classification as a restricted substance, a review of over 1,700 studies found only four possible cases of documented addiction.
- Regulatory Restrictions Stem from Decades-Old Concerns – Originally used for conditions beyond narcolepsy and ADHD, dexamphetamine was restricted in the 1960s due to reports of psychiatric disturbances and addiction concerns, despite a lack of extensive supporting evidence.
- Potential for Expanded Use in Obesity Treatment – Researchers are conducting a clinical trial to assess whether dexamphetamine could be a safe, cost-effective alternative for obesity treatment, with a focus on its addiction potential at prescribed doses.
Dexamphetamine—a restricted stimulant drug used to treat narcolepsy and attention deficient hyperactivity disorder (ADHD)—might not be as addictive as previously thought, new research from the University of Sydney suggests.
In a narrative review published in Psychoactives, a team of researchers reviewed more than 1,700 papers to evaluate evidence underpinning dexamphetamine’s classification as a restricted drug. Surprisingly, the research team found only seven papers addressed dexamphetamine addiction directly, with only four possible individual cases of addiction detailed.
Senior author Alison Poulton, MD, senior lecturer in pediatrics and child health at the Nepean Clinical School, says the study raises questions about the evidence underpinning its restriction by the Therapeutic Goods Administration and the US Food and Drug Administration (FDA).
“After carrying out a comprehensive review of the available evidence, it’s surprising that we have only been able to find a handful of potential dexamphetamine addiction cases documented,” says Poulton in a release. “Dexamphetamine is well-known as an effective drug in the treatment of ADHD and narcolepsy—but it is also known to have possible benefits in the treatment of other conditions including obesity, where it has the potential to be a lower-cost alternative to other drugs, such as semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro).
“It’s important that we apply scientific rigor in assessing the potential risks of pharmaceutical drugs, especially when they could have significant benefits for patients.”
The study was carried out by searching for relevant research on PubMed, Scopus, and Embase using the keywords “dexamphetamine,” “addiction,” and “dependence.” The research team looked at papers written in English, and the types of studies assessed included case reports, database audits, cohort studies, randomized control trials, and systematic reviews.
Background on Dexamphetamine
Dexamphetamine was widely in use from the 1950s to treat conditions such as asthma, depression, and a variety of psychiatric disorders and was also found to be a useful drug for weight management.
However, in 1962 a paper published in the British Medical Journal presented evidence of dexamphetamine addiction, with psychosis and psychiatric disturbance reported in patients who had been hospitalized following large doses of the drug.
As a result, the FDA restricted the use of amphetamines, allowing them to be continued in the treatment of narcolepsy and ADHD but effectively banning them from being used in the treatment of depression, psychiatric conditions, and obesity.
Next Steps
To understand more about the addictive potential of dexamphetamine, the research team is carrying out a further study into the number of people being admitted to drug centers with addictions to the prescription stimulant.
Poulton’s team is also carrying out a clinical trial using dexamphetamine to treat obesity. The trial will also assess whether the drug shows any addictive potential at the dosage prescribed.
First author Hazer Khalifa, a PhD candidate in the faculty of medicine and health and researcher involved in the clinical trial, says in a release, “Obesity is a major health problem that affects millions of people worldwide.
“If the clinical trial suggests that dexamphetamine can be used in the treatment of obesity without causing addiction, then it could be a significant inexpensive tool for clinicians to help people manage excess weight.”
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