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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Bekka H. on March 24, 2002, at 16:16:10
If Dexedrine is indeed the "better half" or "better quarter" of Adderall, then why do so many doctors prefer to prescribe Adderall rather than Dexedrine? Is this the result of yet another highly successful marketing campaign by the Adderall people, or is there some valid reason for this?
Dexedrine is supposed to have a much greater effect on the CNS, whereas Adderall, which is only 25% dextroamphetamine, has a much greater effect on the cardiovascular system due to the presence of the l-isomer (levo-amphetamine). I read in Stephen Stahl's "Essential Psychopharmacology" that Adderall seems to affect norepinephrine a little more, and Dexedrine seems to affect dopamine more, but they both affect both neurotransmitters.
Any thoughts on why doctors prescribe Adderall more often?
Bekka
Posted by Ritch on March 24, 2002, at 17:19:40
In reply to Dexedrine vs. Adderall, posted by Bekka H. on March 24, 2002, at 16:16:10
> If Dexedrine is indeed the "better half" or "better quarter" of Adderall, then why do so many doctors prefer to prescribe Adderall rather than Dexedrine? Is this the result of yet another highly successful marketing campaign by the Adderall people, or is there some valid reason for this?
>
> Dexedrine is supposed to have a much greater effect on the CNS, whereas Adderall, which is only 25% dextroamphetamine, has a much greater effect on the cardiovascular system due to the presence of the l-isomer (levo-amphetamine). I read in Stephen Stahl's "Essential Psychopharmacology" that Adderall seems to affect norepinephrine a little more, and Dexedrine seems to affect dopamine more, but they both affect both neurotransmitters.
>
> Any thoughts on why doctors prescribe Adderall more often?
>
> Bekka
Hi Bekka,When they first forulated "Obetrol" a long time ago, weight loss was the indication for its use. If you already formulated something, why spend money to reformulate something else? Just a hunch. Also, when I took Adderall I was more vigilant (probably due to the l-isomer), and hence focused a little better then plain dexedrine. But that extra "vigilance" wound up making me panicky and uptight around people. Now, on just "plain" dexedrine, I feel a no doubt about it pronounced calming effect. It is very strange, almost a benzo-like effect. Very unexpected.
Mitch
Posted by 3 Beer Effect on March 24, 2002, at 18:23:31
In reply to Dexedrine vs. Adderall, posted by Bekka H. on March 24, 2002, at 16:16:10
I am not sure about this but I think since Shire pharmaceuticals bought Obetrol from another company and renamed it Adderall, they may have had patent protection for a few years, so then they could justify spending lots of money on comps for doctors & advertising.
Now with Adderall XR I think they get patent protection again & justify marketing costs.Most importantly, Adderall lasts about 6 hours so kids can take it right before they go to school & have efficacy for the entire school day. With Ritalin, they would have to go see the school nurse to get their mid day dose of Ritalin, & so risk being made fun of by non-ADD kids. (Ritalin SR turned out to be an inconsistent/erratic medicine & was rated "poor" by both doctors & parents). The makers of Ritalin have recieved FDA approval to make Ritalin LA which supposedly is a big improvement over Ritalin SR- not sure when Ritalin LA is coming out, but it has to compete with Concerta now. But, Focalin is now available by the makers of Ritalin & is a major improvement over Ritalin. Focalin (dexmethylphenidate) is only the d-isomer of Ritalin without the bad side effect causing l-isomer, so it provides max brain stimulation without much peripheral stimulation.
Because it covered the entire school day, Adderall rapidly started taking Ritalin's dominance over the ADD market & blew dexedrine off the map as an ADD medicine. On the other hand, Ritalin did so well when doctors started diagnosing kids with Ritalin because "it wasn't an amphetamine"- which parent were deathly afraid of- probably since they were around in the sixties when amphetamine abuse was rampant.
Dexedrine used to be #2 in the ADD market & was much more popular when the ADD diagnosis started becoming much more common, but lost most of its sales when Adderall came out- probably because Dexedrine only lasts 4.5 hours (not enough coverage for the entire school day).Dexedrine & Dexedrine Spansules have been around for atleast 50 years & GlaxoSmithkline beecham probably doesn't make all that much money off of Dexedrine b/c of generics.
My personal opinion/conclusion is that the makers of Dexedrine blew a major opportunity of capturing the ADD market. They only have 1 dose available 5 mg, & the spansules are old technology compared to Concerta & Adderall XR. (Adderall has atleast 5 different doses available in both IR & XR forms including 10, 20, 30 mg). If Dexedrine was available with a wide range of IR doses & a technologically advanced sustained release pill similar to concerta they would have had much higher sales.
Interestingly enough, the makers of Adderall make their own version of Dexedrine called Dextrostat which is exactly the same medicine (d-amphetamine) except its a bit cheaper & is availabe in both 5 & 10 mg tablets.Dexedrine is available in generic form, & when a generic is available companies sometimes lose 80% of sales within a few years to generics (this is why Eli Lilly co was/is so afraid of generic Prozac).- When your doctor writes a prescription for Dexedrine, the pharmacy will only give you brand name Dexedrine if you specifically ask for it, or if the doctor writes "no substitutions allowed" on the prescription. Otherwise, the pharmacy makes more money and will give you the generic dextroamphetamine without even telling you (This is what they do in Texas, not sure about the rest of the country). The first time I got a prescription for "Klonopin" the pharmacy gave me the Walgreens store brand generic purepac "clonazepam" without even asking or saying anything about it.
Posted by Ritch on March 24, 2002, at 22:00:57
In reply to History of Ritalin, Dexedrine, Adderall, posted by 3 Beer Effect on March 24, 2002, at 18:23:31
Posted by Zo on March 26, 2002, at 4:43:21
In reply to Dexedrine vs. Adderall, posted by Bekka H. on March 24, 2002, at 16:16:10
Adderall is mixed amphetamine salts, so. .. likelier to hit the right spot. It's certainly clearer than Dex for me, but each pstim is soooo individual, it's also way too anxiety-provoking for me.. .
Zo
Posted by DiscoPuppy on June 15, 2002, at 1:36:19
In reply to Dexedrine vs. Adderall, posted by Bekka H. on March 24, 2002, at 16:16:10
So right now, if you had to guess, how would the psychostimulant market share be distributed? I'm just curious.
I'm on Adderall now. Makes my head feel cloudy, gives me a bit of anxiety but also does not help with my concentration all that much more.
I'd like to ask for Dexedrine on during my next visit. I'm really interested in the Spansules. Anyone have any first-hand experience with it? Any literature you can point me to (outside of psychobabble realm) that will give me first-hand experiences and not abstract studies I won't be able to understand?
-puppy-
> If Dexedrine is indeed the "better half" or "better quarter" of Adderall, then why do so many doctors prefer to prescribe Adderall rather than Dexedrine? Is this the result of yet another highly successful marketing campaign by the Adderall people, or is there some valid reason for this?
>
> Dexedrine is supposed to have a much greater effect on the CNS, whereas Adderall, which is only 25% dextroamphetamine, has a much greater effect on the cardiovascular system due to the presence of the l-isomer (levo-amphetamine). I read in Stephen Stahl's "Essential Psychopharmacology" that Adderall seems to affect norepinephrine a little more, and Dexedrine seems to affect dopamine more, but they both affect both neurotransmitters.
>
> Any thoughts on why doctors prescribe Adderall more often?
>
> Bekka
This is the end of the thread.
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