Adderall

A brief history of Adderall

            The drug is obtained from the chemical Amphetamine, which was initially synthesized in the year 1887 by Lazar Edeleanu. Adderall physiological impacts [Editor1] were later discovered by Golden Ales, a Californian doctor, upon injecting himself with 50 miligrams of the drug (Rasmussen 98). Then the brand was introduced in the year 1996, consisting of Amphetamine with two different molecular structures (Rasmussen 98). Initially, the drug was commonly used by truckers, bikers, speed freaks, tweakers [Editor2] as well as the all-night sex orgies[Editor3] . The drug is essential for such activities [Editor4] as it aided[Editor5]  in the improvement of concentration and physical fitness. The original users [Editor6] were motivated by the notion that the drug played both a smart and deceptive role; thus, it would boost their performances in their duties (Rasmussen, 98).

            Further, the drug was employed[Editor7]  in the treatment of a broad range of diseases[Editor8] . For this reason, the drug was not accompanied by prescriptions from a medical practitioner.[Editor9]  With time, the drug began attracting a wide range of restrictions (Rasmussen, 98). Presently, the drug is identified as a textbook example of translational validity[Editor10]  due to its efficacy, safety in humans [Editor11] as well as its pharmacological mode of action.[Editor12]  As a result of the development, the drug has played a significant role in containing[Editor13]  ADHD and narcolepsy (Moore 100). The development of the drug has been motivated by the desire to create both genuine and once-daily medicine that would address problems of therapeutic coverage alongside reducing the risk of recreational abuse and diversion.

The basic biology of the drug

            The main component used in the process of containing[Editor14]  ADHD by the drug is the neurotransmitter, catecholamine called dopamine[Editor15] . An individual with ADHD has dysfunctional dopamine, thus lacking a reasonable level of the neurotransmitter (Langwith, 124). An enzyme-catalyzed process is involved in the synthesis of dopamine in the body. The substrates from the reaction are used in making complex products. On the other hand, the neurotransmitters are biosynthesized by the adrenal glands and the nervous tissues. Dopamine is then repackaged into vesicles that are emancipated into the synaptic knob. The release is done in that the structures formed in the synapse allow for a neuron to pass an electric charge to other cells through the axions (Moore, 100). On return, action potential generates and moves across the axons on neurons to improve the connections around the synapses.

            Cell to cell signaling through the synapses allows for effective regulation of neurotransmitters like dopamine. Neurotransmitter molecules are released by a neuron at the synaptic cleft, which is next to another neuron. The particles produced play a role in binding the receptors on the adjacent and receiving cell that is a side of the synaptic cleft to the postsynaptic area (Moore, 100). Neurotransmitters are then cleared out of the presynaptic section in a bid to prepare it for the subsequent signals. Again, dopamine plays a significant role in the regulation of pre and postsynaptic neurotransmission. Yet, the neurotransmitter is essential, particularly in the brain, as it aids in processes of cognition, attention, sleep, mood, voluntary movement, motivation, learning, punishment, and working memory.

            The process of absorption of Adderall takes place in the gastrointestinal tract through means of passive diffusion and active transport. Absorption of the drug takes place in the gut membrane and the colon. Passive diffusion may either involve lipophilic drugs across the membrane and through gap junctions and pores. The passive diffusion through the gut membrane facilitates the flow of lipophilic drugs into the cell membranes. Contrastingly, water-soluble drugs penetrate through paracellular spaces while moving across the barrier by a blend of convective volume flow with water and concentration drove diffusion. The paracellular absorption is aided by factors such as a small molecule, opposite charges of cells, and the adjacent junctions and ionized intestinal pH of a range of 5.5 to 7.0 (Moore, 100).

            The drug is metabolized in the liver, prompting the production of several excreted metabolic. With CYP2D6 being genetically polymorphic, metabolism of Amphetamine is done with ease (Moore, 100). As such, Amphetamine inhibits monoamine oxidase, while the ability of Amphetamine and its metabolites to inhibit distinct P450 isoenzymes has not been comprehensively shown.

            The elimination process of Adderall is facilitated by the acidic pH that converts the drug into a water-soluble form of a cation. Following the metabolism of the drug in the liver, the drug is changed into a variety of excreted metabolic products (Moore, 100).

            Moreover, the half-life of Adderall is between 9 to 14 hours after the dosage (Moore, 100). As such, approximately half of the drug is retained by the body system. However, the body holds the remaining half and eliminates it on the third day. The implication is that the body entirely clears the system in three days. In spite of this, the rate of clearance of the drug from the system is influenced by factors such as body composition, food available in the order, the functioning of organs like the kidney and the liver, pH levels of the urinary and gastrointestinal tracts, frequency of the drug usage and the dosage amount (Moore, 100).

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Uses of the drug

            Adderall is commonly used in the treatment of ADHD. The drug is a mixture of Amphetamine and dextroamphetamine[Editor16] , which are stimulants of the central nervous system [Editor17] (Langwith, 124). Nonetheless[Editor18] , the drug is used in the treatment of a sleeping disorder called narcolepsy. As a result, the drug helps one stay awake during the day. The drug should not be used by individuals who either want to hold off sleep or tired but strictly those with sleeping disorders[Editor19]  (Moore, 100).

Common and serious side effects of the drug

            When one is taking Adderall, they ought to look out for common side effects such as loss of appetite, dry mouth, nervousness, headache, fever, trouble sleeping, stomach upset, nausea changes in vision, dizziness as well as weight loss. Conversely, the serious side effects are heart attack, stroke, uncontrollable shaking seizure or tics, deteriorating mental health conditions, paranoia, thought problems, hallucinations, depression, and anxiety (Moore 100).      

The typical clinical presentation of ADHD

            The disorder that is commonly treated by Adderall is the attention deficit hyperactivity disorder (ADHD) (Langwith 124). Based on DSM-5, the disease has been diagnosed with an increase in the rate of occurrence over the last period. The condition has been seen in school-aged children when either the parent or the teacher raises the alarm. Keen observations on the output of the child’s work at home or their academic performances are vital in identifying the disorder—a wide range of healthcare professionals aid in initiating the diagnosis. The caregivers may include child psychiatrists, primary care physicians, as well as psychologists. Again, the Diagnostic and Statistical Manual of Mental Disorders, call for a development of an inappropriate development behavior (Moore, 100). The manual compares a child’s reaction to that of other children of the same age who are at the same level of development. On close monitory, the symptoms are evident before a child attains twelve years and are consistently, observable for six months. The symptoms are also characterized by triggering particular impairments during the child’s interaction with peers either at home or school.

            Therefore, DSM-5 presents ADHD as primarily inattentive, hyperactive-impulsive, and ADHD combined. The case presents symptoms such as disruptive behavior, particularly in preschool-aged children, inattention, distractible, disorganization evident among the adolescents and adults, aggression as well as motor restlessness (Goldstein & DeVries, 98).  Since distraction and inattention are characteristic of developmental norms, ADHD is usually challenging to diagnose at the preschool level. Again, children with ADHD have been discovered to have one co-occurring mood expressing, anxiety, oppositional, and conduct disorders, as well as learning. As such, children with this disorder experience difficulty that triggers substantial functional impairment. The impairments may arise from the interplay of risk and protective factors resulting in distinct manifestations as perceived by healthcare professionals, teachers, youth, as well as the parents (Goldstein & DeVries, 98).

             Upon meeting with the healthcare professional, an individual with ADHD disorder would present as one having difficulties in their way of paying attention, thus demonstrating both defiant and conduct disorder. Again, the person may readily respond to distractions due to their reduced concentration and impulsivity (Goldstein & DeVries, 98). In other instances, the individual may be interrupting the processes of questioning while ignoring some queries. On the other hand, on meeting with people on a social setup, the ADHD individual may show discomfort to a point they run away or hide (Goldstein & DeVries, 98).

            The symptoms of ADHD impact the daily functioning of an individual in the sense that the inattentive nature may prompt academic difficulties, parent and child relations that are challenging, and poor social skills. Again, reduced concentration causes a significant chance of consideration for both employment and academic attainment. As a result, such individuals may often not be in the position of securing jobs hence suffer from poverty levels due to lack of an income (Goldstein & DeVries, 98). Furthermore, poor concentration alongside high levels of inactivity prevalent during preschool levels calls for constant supervision from parents, teachers, or relatives. The weak intensity of play alongside great motor restlessness causes an individual to be sluggish in their mode of execution of duties (Goldstein & DeVries, 98).

            The delayed development, poor social skills, and oppositional behavior among children result in difficulties in absorbing ordinary requests and advices. As a result, such individuals may find themselves doing contrary to the expectations prompting endless conflicts among people who fail to understand the disorder (Goldstein & DeVries 98). Again, for such a child with ADHD disorder, their poor socialization skills may prompt exclusion among peers leading to increased feelings of worthlessness. Instances of exclusion may be evident in outings, shopping when visiting family members, or when out in the park with peers.

             The poor sleep patterns associated with children with ADHD calls for more parental monitory, thus disrupting the regular schedule of activities (Langwith 124). The poor sleeping patterns may strain relationships between parents as the monitory consumes time amongst them. As a result, the condition may trigger breakdown bring forth extra strain on finances and social interactions. Teenagers with ADHD disorder are more likely to be found in conflict, violation of the rights of others, and the law due to provocative and dissocial behavior. Research has revealed that families of children with ADHD disorder have high feelings of dissatisfaction when compared to those of control children (Goldstein & DeVries 98).

 Primary, peer-reviewed literature that demonstrates why Adderall is used for treatment of symptoms for the ADHD[Editor20] 

            According to the journal on brain-behavior, Lakhan, and Kirchgessner terms, ADHD as a multifactorial disorder where disrupted dopamine neurotransmission plays a significant role in pathophysiology (Lakhan, and Kirchgessner, 138). Therefore, polymorphisms in the dopamine receptor are associated with the condition. Adderall constitutes both the MPH and the d-MPH, which are responsible for enhancing the rate of signaling of dopamine in the brain. The drug increases neurotransmission by blocking dopamine transporters (DATs). The blockage proceeds to AMP by initiating the release of DA from the terminal of the nerve. The process of obstruction of AMP and the release of DA is made possible by carriers in the form of DAT (Lakhan & Kirchgessner 138).MPH increases dopamine in the ventral striatum in adults and adolescents in healthy controls. The ventral striatum is the region of the brain responsible for reward and motivation and, which aids in the improvement in the symptoms of attention upon an increase in dopamine produced by intravenous MPH.

             The main symptom of ADHD of attention deficiency is, therefore, countered by increased DA in the temporal and prefrontal cortices (Langwith 124). A decrease in dopamine in the cortices can thus be associated with the low rates of attention as such increasing DA plays a significant role in inhibiting the causes of inattention, thus improving neurotransmitters’ therapeutic importance. The article has aided in painting a clear image of the effectiveness of Adderall in the process of containing individuals diagnosed with ADHD (Langwith 124).

Works Cited

Goldstein, Sam, and Melissa DeVries. Handbook of DSM-5 Disorders in Children and Adolescents. Springer, 2017.

Lakhan, Shaheen E., and Annette Kirchgessner. “Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects.” Brain and Behavior 2.5 (2012): 661-677.

Langwith, Jacqueline. ADHD. Greenhaven Publishing LLC, 2009.

Moore, Elaine A. The Amphetamine Debate: The Use of Adderall, Ritalin, and Related Drugs for Behavior Modification, Neuroenhancement, and Anti-Aging Purposes. McFarland, 2014.

Rasmussen, Nicolas. On Speed: The Many Lives of Amphetamine. NYU P, 2009.