Talk:Adderall/Archive 1

I'm going to provide more info on Adderall and side-effects. The main one being teeth grinding, and how to reduce it.

First let me begin by saying. Everything I will state, will be from years of personal experience and information provided by a Dr. The most common side-effects of Aderall are; Teeth grinding, Insomnia, increased heart rate, and anxiety. The last 2, are usually more dependent on the individual. Everyone I know, that takes Adderall, experiences insomnia, and teeth grinding. All amphetamine and most drugs that can be considered an "Upper" will cause these side-effects. I have noticed, when you take more than prescribed, or get an increased dose; will cause these to be worse. Also (from my Exp.,) induced the anxiety, and increased heart rate. Overtime it should ease up, but there are ways to help cope with teeth clenching and grinding. 1.) Mouth guards. 2.) Magnesium & Calcium. (Be careful, be sure it is okay to mix with your meds!) 3.) Gum can help for awhile, but usually will make your teeth and jaw more sore over time... Now on to the insomnia. This is tricky, because the things you can take to reduce it, will effect and work on different levels for everyone. *My* personal way of coping with this is take 2 sleep aids, 2 Melatonin (5mg), and I usually smoke a little weed too. If you do take the sleep aid and Melatonin, start with one. If that doesn't help, up the dose for each. If you cant find over the counter ways of reducing this, and if you don't smoke; or it isn't legal where you are. Then you should get with your doctor and see what he can do for you with his endless arsenal of meds to prescribe.

The last thing is, I saw a comment on erectile dysfunction. I have not ever experienced this. I have found it maybe a little harder to get up, but once it gets up (which it does for me.) Its like I could have intercourse for the longest. Like many other things though, this is most likely dependent on the individual.. The rest of the side effects mentioned, I have not ever experienced. Hope this helps someone!

Citation Errors

I have added citations to replace (cite needed) tags throughout much of the document (especially the first few sections regarding generic equivalents), however there is an issue with a reference labeled adderall_XR_rxinfo (currently 16 I believe) which has not been defined anywhere in the article that I can tell. I don't know where this reference is supposed to point, so if anyone has an idea please let me know or step in. I will check back in time and if no solution presents itself, I will remove this ref tag in the multiple locations it is used and replace with a suitable substitute if that is agreeable. I just want to give a little time to fix the original if possible... --Wikisystole (talk) 20:52, 18 June 2008 (UTC)

-Issue has seemingly been resolved... --Wikisystole (talk) 22:11, 18 June 2008 (UTC)

Weasel Words

Avoid weasel words. For instance, saying Adderall has a genuine medical use is kind of controversial, though most people acknowledge its uses for the reasons listed. However, some people disagree. Furthermore, marijuana seems to have "genuine" use too, but the government as well as many people disagree. Thus the proper word is accepted use. This implies that it is generally recognized to be of value, which is true by treaties, rather than genuine, which implies that it is inherently more valuable than other drugs, such as marijuana, regardless of condition (using marijuana to treat narcolepsy is stupid, but using Adderall to treat lack of appetite and nausea is probably dumber, and thus no one uses it for that purpose).66.24.35.55 (talk) 22:59, 22 February 2008 (UTC)

CAS number

300-62-9 (will be useful once an infobox is added). --Itub (talk) 15:11, 12 February 2008 (UTC)

"Performance-enhancing use"

I don't know about the second paragraph, but the first paragraph of this section is an utter joke. The link is to a typo-riddled site that I believe to be a joke, and the listed "source" doesn't mention any of the specific details given. 68.189.174.118 (talk) 06:10, 9 January 2008 (UTC)

sorry about the site vandalism. I'm editing this to make a point about wikipedia for a college newspaper editorial. I'm done now, so you can delete it and not worry about it.

I agree with the main poster here, it seems a bit odd. I know its possible obviously, but how real does a proffessor with the name of William Frankenburger sound to anyone? I bit strange if you ask me. Maybe just coincidence. --Nikandros (talk) 04:41, 7 May 2008 (UTC)

Um, you know you could Google the guy's name and find that he really does exist. Just a thought.

Source number 9

Just a heads up - the link for source number 9 (http://www.drugabuse.gov/PDF/nid) points to a 404 error. Walmartshopper67 00:07, 4 November 2007 (UTC)

ADD/ADHD

Attention-deficit hyperactivity disorder is the name preferred by the DSM-IV-TR, and that is the title of our article on the subject, not Attention-deficit disorder. I propose changing the language in this article to reflect that. It should also reflect the ICD-10 name, Disturbance of activity and attention. Anyone opposed to these changes? --Ginkgo100^talk 14:42, 9 March 2007 (UTC)

teeth grinding

This is not a rare side effect. Every single person I've ever known to use the drug, myself included, experiences this —The preceding unsigned comment was added by 69.142.140.177 (talk) 15:43, 18 January 2007 (UTC).

I take the drug as do a number of others that I know, none experience that symptom. Your claim for a common side effect is bogus. Check the literature.

--Scuro 14:06, 20 January 2007 (UTC)

In my experience, I've only seen teeth-grinding occur at high(er) doses. Wish I had soem statistics to throw at you, but I don't. The only other thing I can say is that I have taken 20mg Adderall to counter adult ADHD for 2 years and I've never experienced this side effect.Yakwhacker 04:30, 13 February 2007 (UTC)

I was recently prescribed adderall and I also thought that teeth griding was a usual side effect because everytime I take it, I experience it, however as my body has gotten more used to it, it has lessened, chewing gum helps a lot though.--68.187.39.163 02:18, 27 February 2007 (UTC)

I could take Adderall and be suicidal. None of the above observations mean anything because they are personal subjective observations in a sample of one. If I eat an orange and become suicidal does that mean oranges cause one to commit suicide? For Wiki the citation of reliable sources is the only thing that matters.

--scuro 04:29, 28 February 2007 (UTC)

Jaw clenching/teeth grinding, otherwise known as bruxism, is a common problem related to amphetamines. You want sources? Fine, here you go. Several of them are in the context of methamphetamine abuse, but since the dopaminergic effects of the drugs are similar, the majority of the conclusions apply to Adderall and other amphetamine drugs as well.

• S.-J. See, E.-K. Tan. Severe amphetamine-induced bruxism: treatment with botulinum toxin. Acta Neurologica Scandinavica. Feb 2003, Vol. 107 Issue 2, p161-163.

"While chewing and grinding movements have been observed in amphetamine addicts, recognition and management of this problem have rarely been highlighted."

"Several months before the onset of bruxism, our patient had inhaled and consumed various types of amphetamines, including 3,4-methylenedioxymethamphetamine or Ecstasy on a daily basis. [...] He first experienced bruxism 1 month after the cessation of amphetamine use."

"Based on animal and human studies, dopaminergic system dysfunction may be implicated in bruxism. Drugs that alter dopaminergic stimulation can cause bruxism. [...] Disruption of the norepinephric (NE) system could also be involved."

The above article also cited this letter. I couldn't find the full text, but if you can it should be worth a look.

• Ashcroft GW, Eccleston D, Waddell JL. Recognition of amphetamine addicts. Br Med J 1965;1:57. (Letter).

• Donaldson M., Goodchild JH. Oral health of the methamphetamine abuser. Am J Health Syst Pharm. 2006 Nov 1;63(21):2078-82.

"...bruxism as a result of drug-induced hyperactivity [has been implicated as a cause of tooth decay and wear in methamphetamine users]"

"Another contributing factor to tooth wear in these patients is bruxism. Methamphetamine users are extremely active and 'wired' during times of intense drug use. As the drug effects wane, users begin 'tweaking,' characterized by restlessness, anxiety, irritability, fatigue, and dysphoria. During times of acute use, users tend to grind and clench their jaws, further contributing to tooth wear."

• Lobbezoo F., Naeije M. Bruxism is mainly regulated centrally, not peripherally. J Oral Rehabilitation, Volume 28, Number 12, December 2001, pp. 1085-1091(7)

"In addition, bruxism appears to be modulated by various neurotransmitters in the central nervous system. More specifically, disturbances in the central dopaminergic system have been linked to bruxism."

Take the previous article coupled with the following:

• White SR. Amphetamine toxicity. Semin Respir Crit Care Med, 2002 Feb; Vol. 23 (1), pp. 27-36.

"In addition, there is a growing body of evidence that even recreational abuse of methamphetamine and MDMA may produce long-lasting damage to dopaminergic and serotonergic neurons."

Fifteen minutes with the university library website; can we settle this now? Mystic Pixel 00:30, 3 March 2007 (UTC)

The article is about Adderall which is a medication. None of your citations are valid with regards to this medication when it is taken at therapeutic levels as prescribed. Drug abuse or drug addiction can cause the all sorts of symptoms but that's not the point now is it? With drug abuse the drug is typically injected or snorted causing the instant high as all of the drug reaches the brian in a second or two. Then we have the crash that follows. When one ingests the drug it enters the body through the stomach lining and slowly reaches the brain. Alcohol injected into the body would also be a highly harmful drug. It's all in the delivery system and therefore your claims are consequently bogus. Stimulants taken as prescribed are one of the most safest AND effective classes of medication out there. --scuro 16:32, 11 March 2007 (UTC)

It's the same substance. Saying "it's all in the delivery system" is an excuse; by that standard about half of the side effect list should be removed from the article. The point remains that Adderall, as a prescription medication, when taken *as* prescribed, can cause side effects such as bruxism in certain people. Trying to find articles that explicitly state, "Adderall causes X, Y and Z" is going to be difficult; literature is going to say "amphetamine" instead. It's necessary to read somewhat deeper to settle this question.

Another thing: where does this emphasis on injection/insufflation come from? Neither was mentioned in any of the articles I linked. Surely you are not suggesting that it is impossible to abuse a drug by ingestion. Any amount of firsthand experience will prove that there is also a "crash" when Adderall is taken orally. Yes, delivery mechanism does influence the absorption time, but saying "drug abuse involves injection/snorting, and your articles are about drug abusers, therefore none of them apply" is just not true. It may be the case that certain side effects (re: the original point of contention, bruxism) occur only with higher amounts outside the bounds of normally accepted doses; I don't disagree. My original goal here is to offer a counterpoint to your earlier statements about how a sample size of one is insignificant with research linking amphetamine-based drugs and bruxism, and I feel that I have successfully done that. If you believe I am in error, please cite your sources. Mystic Pixel 05:18, 13 March 2007 (UTC)

It is ALL ABOUT THE DELIVERY SYSTEM. You call this an "excuse", and I rely on clinical studies that support my points. "Reinforcing effects occur when methylphenidate elicits large and fast dopamine increases that mimic those of phasic dopamine cell firing, whereas therapeutic effects occur when methylphenidate elicits slow, steady-state dopamine increases that mimic those of tonic firing. Thus, the characteristics of clinical use (low doses administered orally and titrated for therapeutic effects) constrain methylphenidate’s abuse". Here is a study that shows that therapeutic levels of stimulants actually decrease the likelihood of stimulant abuse. It's "the same substance", how can that be? Stimulants are just supposed to be bad, no???!??

Is bruxism mentioned as a clinically proven side effect of Adderall? I haven't found that in literature and it looks like you are having a hard time as well. You say we "need to read deeper", I call that going out on a limb to make an insupportable point for who knows what reason. Theraputic stimulants are one of the safest and most effective classes of drugs out there but abuse the drug and it is highly dangerous. Take it as prescribed and it has been clinically shown to reduce the symptoms of ADHD for 9/10 of those with ADHD.

By the way, the articles you cited ARE all about drug abuse. No where in them do I read "therapeutic use of stimulants", instead I read "drug abuse", "inhaled"( there goes your insufflation contention), "toxicity", "wired", "severe- amphetamine abuse"...etc etc. so my contention that all of the articles are about drug abuse still holds. --scuro 03:42, 20 March 2007 (UTC)

Citing scholarly sources does not an argument make. If you are going to go all "academic" about this, please be sure you know what you're doing. Using research on the effects of drug abuse in meth/amphetamine addicts to argue that bruxism is a side effect of low-level, therapeutic Adderall use gives your argument extremely poor external validity.

Adopting your line of logic, I assert that having a daily glass of red wine (a low-level therapeutic intake of another substance with high potential abuse) comes with the common side effect of... seizures. Everyone knows Seizures and alcohol have a well-known link. Oh snap, and I have the citations to prove it:

Alldredge, B.K., & Lowenstein, D.H. (1993), Status epilepticus related to alcohol abuse. Epilepsia, 34, 033–1037.

“The results indicate that alcohol abuse is a common cause of SE and that SE may be the first presentation of alcohol-related seizures.”

Brathen, G., Brodtkorb, E., Helde, G., Sand, T., & Bovim, G. (1999). The diversity of seizures related to alcohol use. A study of consecutive patients. European Journal of Neurology, 6, 697–703.

”Partial onset seizures are more frequent among hazardous drinkers than hitherto recognized. A generalized onset seizure in adults warrants a high suspicion of alcohol as a provoking factor.”

Hillbom, M.E. (1980). Occurrence of cerebral seizures provoked by alcohol abuse. Epilepsia, 21, 459–466.

“Alcohol intoxication was detected in the immediate history of 277 (49%) of the 560 consecutive seizure patients brought to the emergency room of Meilahti hospital in Helsinki during the course of a year…”

Ng, S.K.C., Hauser, W.A., Brust, J.C.M., & Susser, M. (1988). Alcohol withdrawal and consumption in new-onset seizures. New England Journal of Medicine, 319, 666–673.

“We conclude that the relation of seizures to alcohol use is dose dependent and appears to be causal, and that seizures can be interpreted as a disorder induced by the ingestion of alcohol, independently of alcohol withdrawal.”

Rathlev, N.K., Ulrich, A.S., Delanty, N., & D’Onofrio, G. (2006). Alcohol-related seizures. Journal of Emergency Medicine, 31(2), 157-163.

“Alcohol-related seizures represent a diverse spectrum of disease that presents in adults with chronic alcohol dependence.”

Since it was hard to find studies that said "a daily glass of wine causes X, Y, or Z" besides health benefits, I found that using research on alcoholics served just as well. Ok, so those studies focused on a completely different population than casual wine drinkers, and I guess there *might* be a small, statistically insignificant difference in their alcohol consumption... whatev, same substance (sort of). The point remains that drinking *one serving* of red wine a day, for health benefits, can cause side effects such as seizures in some people. Since I even put my clever scientific citations in APA formatting, this must make my argument *extra* true. /sarcasm. I hope I've made my point. My Adderall makes research fun.

On a last note, there are plenty of articles that explicitly state "Adderall does X, Y, and Z", and they are quite easy to find if you have University access to e-journals. Literature is going to call is "mixed amphetamine salts", group it under the keyword "psychostimulants", or just simply call it "Adderall". If anyone cares, here's a decent review of ADHD research focusing on the adverse effects of stimulant-type medication:

Null, G., & Feldman, M. (2005). Benefits of going beyond conventional therapies for ADHD. Journal of Orthomolecular Medicine, 20(2), 75-88.

Cheers. 141.211.231.65 07:46, 20 March 2007 (UTC)

Personally, I've only experienced teeth-grinding from methamphetamine, but never from amphetamine/adderall. Not even at 80mg/day, which appears to be a relatively high dose just looking at what others have mentioned. I do pop my ears a lot though. --67.42.147.238 (talk) 07:04, 10 May 2008 (UTC)

Alcohol

I take Adderall and I'm wondering if it's safe to drink alcohol while on Adderall or if it's fatal. 65.93.58.123 03:21, 16 June 2007 (UTC)

You can drink even more than usual on Adderall, and then when the Adderall wears off you'll be left super-drunk!

I have been taking adderall for almost 10 years and I can contest to the side effects of:

     teeth grinding
     and a definite cause of erectile disfunction, every time I take it I cannot sustain an erection    
     for at least 24 hours, but if I do not take it for several days I am fine; so as long as I find 
     women who are not into me for my intelligence I am fine

I take Adderall and I have developed superhuman powers.

It is for statements like mine and the one above that Wikipedia developed thess policies.WP:NOR and WP:COS

--scuro 01:40, 27 June 2007 (UTC)

Im really happy your googling skills are up to par and your capable of doing 5th grade level research. But honestly, regardless of whether a doctor documents info or I sit here in Iraq with other men of integrity in the armed forces that can tell you these side effects are regular occurring instances. And i dont need a lab, some mice, or a control group to tell you —Preceding unsigned comment added by 213.255.230.133 (talk) 14:32, 1 March 2008 (UTC)

I have no idea what these other people are talking about, but ultimately it's not really recommended. Yeah, alcohol depresses the CNS but the combo. can be dangerous. I always hear people saying that alcohol and amphetamine are a good combo., but good god, it depends on how much of each you take. Think about it. --67.42.147.238 (talk) 07:10, 10 May 2008 (UTC)

Method of action

Anyone with a basic understanding of human biochemistry knows amphetamines work because they are structurally similar to adrenaline - they do NOT interfere with dopamine reuptake as does cocaine and several antidepressants. Someone fix it!!

I believe you, but could you provide a citation saying as much?Yeago 21:50, 11 January 2007 (UTC)

You know, I genuinely hope someone can find sources on this because as an Adderall user myself (prescribed) that notion makes a lot of sense. Often after taking an XR (or even an IR) I find myself restless and often unable to sleep even after the focus effect wears off. So 14 hours later I'll still be wide awake but unable to focus. Perhaps this has to do with my 19.9 BMI (5'9 135lbs Male). Anymore information on this would be amazing!OlympicBronze

According to Sandman, Vigor-Zierk et al (1992 Biological Psychiatry)and cited at Los Alamos (2004), imbalance in the pacemaker system of the brain and cardiovascular system can explain the paradoxial calming effects of stimulants in the immature brain. Stimulants increase the conduction velocity in the slow loop of the re-entrant circuit, created by de-synchonized conduction velocities in inter-pacemaker connections, thereby the slowing the "tachycranias" resulting from re-entry into the pacemaker circuit, a mechanism well understood in the pacemaker circuity of the heart, but not studied by most neurologists and psychiatrists Carey S. Vigor-Zierk MD as cited by the biophysics group at Los Alamos 2004 feel free to email me for the pdf of the Los Alamos citation...at carey31626@msn.com —Preceding unsigned comment added by 66.184.34.210 (talk) 20:01, 24 October 2007 (UTC)

Less Common Side Effects-problems

"Shrinkage"? Uh...really? Is that fact, or vandalism? How do I ate corm 00:57, 9 January 2007 (UTC) ...and one more thing. What is "Erectile Disorder"? I noticed somebody changed "Erectile Dysfunction" to "Disorder". How do I ate corm 01:00, 9 January 2007 (UTC)

The whole side effects section needs a possible edit. I've read packages and never seen some of the side effects mentioned. Some of the more severe side effects also seem to have made their way into common side effects. This section seems to attract vandalism and is frequently edited. Furthermore side effects take up about a third of the length of the article. Could we not simply have an image of the written side effects from say Shire or some other reliable source? That way this section would always be accurate, take up less space, and could not be tampered with. --Scuro 01:21, 9 January 2007 (UTC)

Long-term Adderall (10+ years) User (prescription) edit: I just wanted to point out shrinkage does occur, but it's only when the penis is flaccid, and it's certainly not permanent. Blood is rushed to the brain, and kept in the upper body, and therefore lower parts of the body get less blood. However, when excited, erection strength isn't affected as far as I can tell. I wasn't really sure how to edit it that but i wanted to make it known what really happens with daily use. Also, I'd like to point out that I have experienced some of the mentioned side-effects like tachycardia (heart beat), fever, and some of the other ones, but they are often very intermittent.

Notes about Side effects I've personally encountered:

Bruxism (teeth grinding) - this only happens to me when I stay up all night and then take adderall, keeping myself awake. I grind my teeth and push down really hard without realizing it when i'm on little to no sleep and on adderall.

Pyrexia (fever) - my normal body temp is slightly lower than 98.6 degrees F, often 98 even or 97.8-9. And while on adderall, probably about 50-75% of the time my temperature is around 99. I tested this by going off the adderall for several months and taking daily temps.

Mydriasis (pupil dilation) - this will happen...anyone trained to notice pupil dilation will notice you're on uppers.

Tachycardia (heart beat) ~ After 4 years of taking it I started noticing changes in my heart beat, especially during fitness trials at the high school. My resting heartbeat was 120. This was both a mixture of the Adderall and my health at the time as I was not in great shape. But after high school i began running to lose weight and my heart beat seemed to level off. I was down to less than 60bpms resting, and once in awhile it's up and other times its down.

Psychosis: I really can't be sure about this one...I can't really tell if it's the adderall that made me think a certain way of if it was me. But sometimes it's really not a good feeling..Do not take this for recreation for too long...trust me.

Notes on the rest: (laziness isn't a symptom but i don't feel like typing out all of the other ones):

Again, many of these are intermittent....and MOST of them have to do with Adderall sleep inhibition...if you're up for days and continue to take the drug, you will experience many of these symptoms, if not all of them.

Admins can take or leave any of this, i thought it would help.

I also read somewhere that long term use can lead to parkinson's later in life. My personal psychiatrist says i have nothing to worry about but he's been trained to be in full support of everything he hands out...so further study needs to be done.

side effect section is out of control

Compare Shire's list of common side effects (dry mouth, loss of appetite, difficulty falling asleep, headache, and weight loss) to Wikipedia (Increased heart rate, Insomnia, Loss of Appetite, Vertigo, Headache, Diarrhea, Sweating, Dry mouth, Irritability, Tremor, Euphoria)

The other two sections are totally out of control.

Less common side effects

   * Upset stomach
   * Amphetamine psychosis
   * Nervousness
   * Mydriasis
   * Bruxism (teeth grinding)
   * Formication (in excessive doses [3])
   * Urinary retention
   * Pyrexia
   * Tachycardia
   * Tics
   * Urticaria
   * Erectile Disorder
   * Increased Urination
   * Blunted affect
   * Shrinkage

Rare side effects

   * vocal tics
   * high blood pressure
   * hallucinations
   * tourettism
   * cardiomyopathy
   * hair loss

These symptoms are not accurate. It seems that there are a number of subjective and biased entries in these lists. As an example, I recently edited out shrinkage. What does shrinkage refer to with regards to Adderall? It's back in. --Scuro 12:39, 10 January 2007 (UTC)

Slang/"street names"

Does every slang name for adderall need to listed in this article? It seems fairly pointless. I suggest that we remove all but the most common. Any thoughts? Foolishben 05:32, 4 January 2007 (UTC)

Update: I went ahead and removed all the slang terms for adderall. There are plenty of websites that have endless lists of slang terms for drugs. We do not need to waste space and bandwidth for such widely available knowlage. I also removed the link to a personal website used for citation. It was terribly written and very poorly sourced. Had the website been fantastic I still would have removed it. If you cite something cite the origional research, not just another artical that uses the research.Foolishben 21:17, 4 January 2007 (UTC)

Street Names Necessary?

It seems to me that the listing of the street names for Adderall is a bit excessive and seems to play up the 'party-drug' image. I'm only a casual Wikipedia user so I'm not sure if issues like this have come up before with pharmaceutical drugs being abused, but on a quick run through the Cocaine page and the Cannabis page I didn't see a long listing of alternate names.

I'm not sure if that sort of thing really breaks any Wikipedia rules... but I can't imagine those sort of lists are very accurate very long, or are practicial (or even possible) to provide accurate citations for.

Any opinions? —The preceding unsigned comment was added by 71.72.55.99 (talk) 22:47, 27 December 2006 (UTC). 66.219.159.2 14:59, 28 December 2006 (UTC)bamurphymac

Are you volunteering to do a 1-by-1 Google search to verify their use? At the very least they could be sorted. Then, later we can deal with the ones we're not sure of.Yeago 20:13, 4 January 2007 (UTC)

I removed all slang terms as they don't contribute much to the article, and they can be found in many other places. If people want to find slang terms or more specific prices they can do what everyone else does and google it. I didn't feel like logging in but I did these edits under foolishben. 198.176.185.102 20:47, 10 January 2007 (UTC)

~Actually, there is a nickname for Adderall, Jams. It was created around 2005 by Tommy Ray Garza, Justin David French, and Jimmy Vesstles. The verb form of it is Jammin'.

It makes more sense with Adderall than with street drugs. I would be willing to bet the majority of people can name at least 1 or 2 nicknames for marijuana (bud, Mary-Jane) or cocaine (blow, snow). I spent a year in paramedic school and worked on an ambulance in high drug areas, but I don't know any street names for Adderall. 65.96.38.93 (talk) 23:09, 20 May 2008 (UTC)

Contradictory Edit History

This article used to claim that the increased urination was due to increased water intake. The article now attributes this side-effect to hypertension.[1] Which is it? shotwell 20:54, 11 October 2006 (UTC)

From my experience, it's due to increased water intake because of dry mouth.

Well I just removed it because nobody had provided a source either way. shotwell 17:44, 22 November 2006 (UTC)

Regarding "bennies"

There's some dispute as to whether "bennies" is actually a slang term for Adderall (although I might be on my own saying it isn't).

My point was that "benny" refers to either benzodiazepines (irrelevant) or benzedrine. Benzedrine is closely related to Adderall, but not the same thing. Specifically, Adderall is a mix of amphetamine salts, while Benzedrine is a variant of amphetamine itself. Perhaps I'm being a bit pedantic, though -- certainly more pedantic than teenagers and their durn drug slang! :) Adking80 15:55, 25 May 2005 (UTC)

Uhh, yeah, any drug that has analogous effects can have the same slang applied to both. This somewhat stems from the fact that all illegally produced drugs offer different highs between batches, brands, and genetics. There are two general types of weed, X is more often than not doped with different speeds and hallucinogens. Indolering

'Benny' is not common slang for Adderall (Though drug slang is just that, slang. Someone probably calls it that.) I've only heard it used as slang for Benzedrine (like the old inhalers and such) which did contain amphetamine, dl-amphetamine is just the racemic mixture (not separated into dextro and levo amphetamine. William S Burroughs has an entry on this in the slang index of Junkie, I believe. (Might be Naked Lunch or Queer, don't have it on hand at the moment, though I'm fairly positive it is in the current edition of Junkie.) --Shplongl 03:05, 13 July 2007 (UTC)

Factual and NPOV issues (tolerance, magnesium treatments, half-life)

Something got screwed up here - I will clean up this article when I get the chance. But the section on Tolerance is poorly backed up at best; it smacks of being lifted from an herbal-remedy page. I haven't seen good evidence that tolerance is an issue with these drugs in therapuetic doses, and the magnesium solution just isn't in agreement with the NMDA article. For that matter, NDMA as a means of achieving tolerance seems wrong; and again I sure can't find any evidence of a link.

Certainly there's an NPOV problem in advocating a certain treatment (Magnesium)... I don't think wikipedia has any place doing so.

If, somehow, the tolerance stuff is accurate, it should be included in all the amphetamine-related articles. Right now, none of them even contain the word "tolerance". Given the lack of conclusive study or at least a half-decent source, I will edit this section out shortly.

Also it is stated that the drug has a "short half-life", but in the same page, the half-life is mentioned as being 10-13 hours.

--JimboOmega 23:00, 16 May 2005 (UTC)

Regarding the half-life issue, I think this particular confusion stems from mixed-up terminology because there are two separate types of half-lives that are not sufficiently differentiated in the article. Although the elimination half-life of Adderall may indeed be between 10-13 hours, this is a different half-life from plasma half-life which is more correlated to the effective time-period of the drug (and which is in fact rather short for amphetamine-class pharms like Adderall). Therefore, I re-added the sentence mentioning the short-term effects of Adderall caused by its short half-life, but I modified it to clarify that this refers to the plasma half-life of Adderall (rather than the elimination half-life). --Ryanaxp 15:32, May 17, 2005 (UTC)

I think you've still got it wrong. If you look at the the prescribing information (PDF), you will see that the plasma concentration peaks late (with adderall XR, almost 8 hours after initial dosing). A significant amount remains in the plasma even 24 hours after administration (more than a third of peak).

It is, however, a matter of some debate as to how plasma concentration relates to effectiveness. Some users in an ADD forum I frequent complain of declining effectiveness past 5 hours, even with XR, so it's hypothesized that the alleviation of symptoms is best noticed by the CHANGE in plasma concentration. It hasn't been satisfactorily proved to me; Shire's research has shown effectiveness at 4 hours to be similiar to effectiveness at 12 hours. My personal theory is that changing concentration is most noticeable to the user, but in fact total concentration is most relevant to smyptom control. This is not a scientifically tested fact by any stretch, though.

It's also thought these effects could be very different for those without ADD, and it's *also* thought that a dose that's too high can actually impair concentration -- this together could be taken to imply that for a non-ADD person to use the medication, the therapuetic benefits could be very minimal and only in a certain (small) range of plasma concentration.

--JimboOmega 16:10, 17 May 2005 (UTC)

I may well have it wrong; certainly (regrettably?), I'm not a pharmacologist. I'm sure you understand the significance, but it also bears mentioning that Adderall XR would of course be expected to have a prolonged presence in the plasma compared to "straight" Adderall, but that is probably more attributable to the extended release feature than to the half-life of the amphetamine ingredients themselves.

Also, although this has no bearing on the article, I can contribute my own anecdotal two cents and emphatically agree that subjectively at least, Adderall wears off rather sooner than I wish it would—despite the fact that its plasma concentration might remain fairly steady. It's frustrating because the doct takes a skeptical view when I report this, probably because the blurb in the PDR makes no mention of this effect. --Ryanaxp 01:29, May 18, 2005 (UTC)

Removed image

I removed the picture added to this article by User:MrMojoRisin because that picture does not show Adderall (it is a picture of generic amphetamines manufactured by Barr labs). --Ryanaxp 02:52, Apr 24, 2005 (UTC)

I'm not sure how or where to do this, but I feel this picture [2] should be added to the article. I felt that this picture is a good quality picture and shows a variety of Adderall in some of it's various forms. wickedspikes 23:03, 03 June, 2006 (PST)

Although it's a good image, it looks to me like it's probably copyrighted, which is something we're trying to avoid. Mystic Pixel 18:07, 12 June 2006 (UTC)

---

I just edited the "External links" section to include two websites which do not focus on negative aspects of this medication. Part of the reason I added these was for their factual content (e.g., the second website reports the relative effectiveness of Adderall vis a vis Ritalin SR), but another was because the existing three externally linked websites were each focused on harmful aspects of Adderall, which in my reckoning added perceived bias to the Wikipedia article (although not necessarily in the external articles themselves). Make no mistake, this is a powerful medicine, with potential for abuse—however, it also has helped many, many people control their ADHD symptoms and the great majority of people prescribed Adderall do not abuse their medication. --Ryanaxp 15:01, Feb 16, 2005 (UTC)

I have a question about food consumption and "prolonging" Tmax. What exactly does it mean to "prolong?" Take this except from Shire:

Food does not affect the extent of absorption of d-amphetamine and l-amphetamine, but prolongs Tmax by 2.5 hours (from 5.2 hrs at fasted state to 7.7 hrs after a high-fat meal) for d-amphetamine and 2.1 hours (from 5.6 hrs at fasted state to 7.7 hrs after a high fat meal) for l-amphetamine after administration of ADDERALL XR® 30 mg. Opening the capsule and sprinkling the contents on applesauce results in comparable absorption to the intact capsule taken in the fasted state. Equal doses of ADDERALL XR® strengths are bioequivalent.

Could someone possibly explain in laymen terms what it means for Tmax to be "prolonged" from 5.2 to 7.7 hours. Does that mean Tmax will last 2.5 hours longer or you won't reach Tmax until 2.5 hours later. I would think "longer" because it says food does affect the absorption of Adderall, so how would it make Tmax later? Again, I have no idea and I am just trying to make sense of things. No where on the web is this cleared up as everyone takes their pharmacokinetics section directly from Shire. Also, what does it mean to be bioequivalent in this context?

Adderal

There is also a topic named "Adderal," which is just a stub of the topic we all are browsing, "Adderall" (NOTICE THE TWO L's AT THE END)

I don't know how to do this, but they should be merged, or at the very least, the other should be removed to prevent confusion.

[THIS HAS BEEN CHANGED, THANKS FOR THE HEADS-UP]

Proposing a name change to Mixed Amphetamine Salts

So I recognize that I'm kinda beating a dead horse here, but titling this page "Adderall" is really not justified (and yes, this needs to be brought up again, hear me out). I know there's a lot of generic names, and that it has no INN/USAN/etc, but that's still no excuse! Mixed Amphetamine Salts (MAS) is the generic name pretty much universally used in the scientific literature on this drug. Why don't we use that? Here's a sampling of some of the major mentions in the literature:

Extended content

format: year published - title - major mentions in publication (title/abstract/full text) - pmid 2000 - Low-dose amphetamine salts and adult attention-deficit/hyperactivity disorder. - "Pediatric studies have suggested that a mixed amphetamine salt product (Adderall) is safe and effective in the treatment of childhood forms of ADHD" - 10901338 2001 - Efficacy of a mixed amphetamine salts compound in adults with attention-deficit/hyperactivity disorder - (see title), "We report on a controlled trial of a mixed amphetamine salts compound (Adderall, dextroamphetamine sulfate, dextro-, levoamphetamine sulfate, dextroamphetamine aspartate, levoamphetamine aspartate, and dextroamphetamine saccharate) in the treatment of adult attention-deficit/hyperactivity disorder (ADHD)" - 11483144 2001 - Placebo-Controlled Evaluation of Amphetamine Mixture—Dextroamphetamine Salts and Amphetamine Salts (Adderall): Efficacy Rate and Side Effects - "A product comprised of mixed amphetamine salts (Adderall, Shire Richwood Inc) has been marketed for the treatment of ADHD since 1994" - 11134474 2001 - SLI381: a long-acting psychostimulant preparation for the treatment of attention-deficit hyperactivity disorder. - "SLI381 (Adderall-XR) is a longer-acting form of Adderall, a compound of mixed amphetamine salts that is now the most frequently prescribed brand of psychostimulant medication for attention-deficit hyperactivity disorder (ADHD) in the US" - 11772303 2002 - A randomized, double-blind, placebo-controlled, parallel-group study of SLI381 (Adderall XR) in children with attention-deficit/hyperactivity disorder - "The extended-release nature of this new formulation of mixed amphetamine salts allowed adequate control of the signs and symptoms of ADHD using a once-a-day dosing schedule" - 12165576 2002 - SLI381 (Adderall XR), a two-component, extended-release formulation of mixed amphetamine salts: bioavailability of three test formulations and comparison of fasted, fed, and sprinkled administration - (see title) - 12432966 2003 - Pharmacokinetics of SLI381 (ADDERALL XR), an extended-release formulation of Adderall - "To assess the pharmacokinetic (PK) properties of a single daily dose of Adderall (mixed amphetamine salts) and the extended-release formulation, SLI381 (ADDERALL XR), in pediatric attention-deficit/hyperactivity disorder (ADHD)", "Adderall (mixed amphetamine salts) is a fixedcombination amphetamine composed of equal amounts of dextroamphetamine saccharate, dextroamphetamine sulfate, racemic amphetamine aspartate monohydrate, and racemic amphetamine sulfate", "SLI381 (ADDERALL XR) is a new stimulant preparation containing the same ratios of mixed amphetamine salts found in Adderall", "Acute-dose and chronic-dose pharmacokinetic studies of mixed amphetamine salts were conducted within an analog classroom laboratory assessment of SLI381" - 12921476 2004 - Adderall XR: long acting stimulant for single daily dosing - "Adderall XR (SLI381) is the latest addition to the group of psychostimulant formulations, which provides the mixed amphetamine salts contained in Adderall as a single-daily dose formulation" - 15853519 2005 - Long-term tolerability and effectiveness of once-daily mixed amphetamine salts (Adderall XR) in children with ADHD - (see title), "To evaluate the long-term tolerability and effectiveness of extended-release mixed amphetamine salts (MAS XR; Adderall XR) in children with attention-deficit/hyperactivity disorder (ADHD)", "Two previous studies demonstrated a 12-hour duration of effect and short-term safety and efficacy of an extended-release formulation of mixed amphetamine salts (MAS XR; Adderall XR®) (Biederman et al., 2002 and McCracken et al., 2003)" - 15908835 2005 - Long-term effects of extended-release mixed amphetamine salts treatment of attention- deficit/hyperactivity disorder on growth - (see title), "The aim of this study was to examine the long-term effects of extended-release mixed amphetamine salts (MAS-XR) with 10-30-mg doses on the growth of children being treated for attention-deficit/hyperactivity disorder (ADHD)", "Most prior studies of growth effects of ADHD medication had been conducted prior to the advent of long-acting versions of methylphenidate (Greenhill et al. 2002; Wolraich et al. 2001) and mixed amphetamine salts (MAS) (Biederman et al. 2002). To address the effect of long-acting medications on growth, we present data from a two-year cohort study of extendedrelease mixed amphetamine salts (MAS-XR). Mixed amphetamine salts consist of a mixture of neutral salts of dextroamphetamine sulfate, amphetamine sulfate, the dextro-isomer of amphetamine saccharate, and d,l-amphetamine aspartate" - 15910204 2005 - An interim analysis of the Quality of Life, Effectiveness, Safety, and Tolerability (QU.E.S.T.) evaluation of mixed amphetamine salts extended release in adults with ADHD - (see title), "Evaluate safety and efficacy of mixed amphetamine salts extended release (MAS XR) in adults with attention-deficit/hyperactivity disorder (ADHD)" - 16344838 2005 - Long-term cardiovascular effects of mixed amphetamine salts extended release in adults with ADHD - (see title), "To assess long-term cardiovascular effects of mixed amphetamine salts extended release (MAS XR) in adults with attention-deficit/hyperactivity disorder (ADHD) combined subtype" - 16344839 2005 - Mixed amphetamine salts extended release for the treatment of ADHD - (see title) - 16344840 2006 - A post hoc subgroup analysis of an 18-day randomized controlled trial comparing the tolerability and efficacy of mixed amphetamine salts extended release and atomoxetine in school-age girls with attention-deficit/hyperactivity disorder - (see title), "This post hoc analysis compared the efficacy, tolerability, and time course of the effect of mixed amphetamine salts extended release (MAS XR) and atomoxetine in school-age girls with ADHD", "As in trials of older immediate-release psychostimulant agents, 14-16 clinical trials of newer, long-acting formulations of methylphenidate and mixed amphetamine salts have generally indicated comparable improvements from baseline in ratings of core ADHD symptoms such as hyperactivity and inattention within hours of dosing. 14,17,18", "St.A.R.T. was the first randomized controlled trial in school-age children with ADHD to directly compare the overall efficacy, tolerability, and time course of effect of the stimulant mixed amphetamine salts extended release* (MAS XR) with those of the nonstimulant atomoxetine} during laboratory school sessions", - 16678649 2006 - Efficacy and safety of mixed amphetamine salts extended release (adderall XR) in the management of oppositional defiant disorder with or without comorbid attention-deficit/hyperactivity disorder in school-aged children and adolescents: A 4-week, multicenter, randomized, double-blind, parallel-group, placebo-controlled, forced-dose-escalation study - (see title), "The goal of this study was to assess the efficacy and safety of mixed amphetamine salts extended release (MAS XR) for the treatment of ODD in children and adolescents aged 6 to 17 years" or (in text) "Thus, the objective of the current study was to assess the efficacy and safety of mixed amphetamine salts extended release (MAS XR)* for the treatment of ODD in school-aged children and adolescents" - 16750455 2006 - Efficacy and safety of mixed amphetamine salts extended release (Adderall XR) in the management of attention-deficit/hyperactivity disorder in adolescent patients: a 4-week, randomized, double-blind, placebo-controlled, parallel-group study - (see title), "The primary goal of this study was to assess the efficacy and safety of mixed amphetamine salts extended release (MAS XR) in the management of adolescents with ADHD", "Mixed amphetamine salts extended release (MAS XR)* is a once-daily, single-entity amphetamine approved by the US Food and Drug Administration for the management of ADHD in children aged 6 to 12 years and in adults" - 16678648 2006 - Mixed amphetamine salts extended-release in the treatment of adult ADHD: a randomized, controlled trial - (see title), "This prospective, multisite, randomized, double-blind, placebo-controlled, parallel-group, dose-escalation study was conducted to assess the efficacy, safety, and duration of action of mixed amphetamine salts extended-release (MAS XR) in adults with ADHD, combined type" - 16871129 2006 - An open-label study of the tolerability of mixed amphetamine salts in adults with attention-deficit/hyperactivity disorder and treated primary essential hypertension - (see title), "To evaluate the short-term tolerability of an extended-release preparation of the stimulant medication mixed amphetamine salts (MAS XR) in adults with attention-deficit/hyperactivity disorder (ADHD) whose hypertension has been successfully treated with antihypertensive medications" - 16841618 2007 - Cardiovascular effects of mixed amphetamine salts extended release in the treatment of school-aged children with attention-deficit/hyperactivity disorder - (see title), "The cardiovascular safety of mixed amphetamine salts extended release (MAS XR) was evaluated in 2968 children 6-12 years of age with attention-deficit/hyperactivity disorder (ADHD)", "Mixed amphetamine salts extended-release (MAS XR; Adderall XR, Shire Pharmaceuticals, Wayne, Pennsylvania) capsules include immediate-release pellets of mixed amphetamine salts that release the first half of the dose upon ingestion and delayed-release pellets that begin to release active drug approximately 4 hours later. The MAS XR capsule contains the same 3:1 ratio of dextroamphetamine to levoamphetamine as the mixed amphetamine salts immediate-release (MAS IR; Adderall, Shire Pharmaceuticals) tablets, and the bioavailability and pharmacokinetic profiles associated with the daily dosing of MAS XR 20 mg are comparable to those associated with the twice-daily dosing of MAS IR 10 mg (Tulloch 2002)" - 16899230 2007 - Forecasting three-month outcomes in a laboratory school comparison of mixed amphetamine salts extended release (Adderall XR) and atomoxetine (Strattera) in school-aged children With ADHD - (see title), "Compare observed and forecasted efficacy of mixed amphetamine salts extended release (MAS-XR; Adderall) with atomoxetine (Strattera) in ADHD children", "Previously, we reported a greater level of behavioral and clinical improvement in response to 3 weeks of treatment with once-daily stimulant medication (in the form of mixed amphetamine salts extended release [MAS-XR]) than to once-daily atomoxetine in a head-to-head comparison from a randomized, double-blind, controlled clinical trial (Wigal et al., 2005)." - 17606774 2007 - Lisdexamfetamine dimesylate and mixed amphetamine salts extended-release in children with ADHD: a double-blind, placebo-controlled, crossover analog classroom study - (see title), "This phase 2, randomized, double-blind, placebo- and active-controlled crossover study compared the efficacy and safety of lisdexamfetamine (LDX: 30, 50, or 70 mg) with placebo, with mixed amphetamine salts extended-release (MAS XR: 10, 20, or 30 mg) included as a reference arm of the study, in 52 children aged 6 to 12 years with attention-deficit/hyperactivity disorder (ADHD) in an analog classroom setting" - 17631866 2007 - Stimulant therapy in the management of ADHD: mixed amphetamine salts (extended release) - (see title), "An extended-release formulation of mixed amphetamine salts (MAS XR) provided the first long-acting amphetamine formulation, and thus, filled an important gap in available treatments for ADHD", "A mixed amphetamine salts extended-release (MAS XR; Adderall XR  , Shire US, Inc.) formulation has been shown to be effective and well tolerated in the treatment of ADHD" - 17714065 2007 - Bioavailability of triple-bead mixed amphetamine salts compared with a dose-augmentation strategy of mixed amphetamine salts extended release plus mixed amphetamine salts immediate release (note that this refers in part to an unreleased product, and this study was authored by Shire employees) - (see title), "To compare the single-dose pharmacokinetics of triple-bead mixed amphetamine salts (MAS), an oral, once-daily, enhanced extended-release amphetamine formulation, with MAS extended release (MAS XR) (Adderall XR) + MAS immediate release (MAS IR) administered 8 h later", "Mixed amphetamine salts extended-release (MAS XR) (Adderall XR) capsules contain equal amounts of four amphetamine salts (dextro-amphetamine sulfate, dextroamphetamine saccharate, racemic amphetamine aspartate monohydrate, and racemic amphetamine sul­fate), which provide a 3:1 ratio of d-amphetamine to l-amphetamine" - 17519073 2007 - The impact of the withdrawal of Adderall XR (long-acting mixed amphetamine salts) from the Canadian market on paediatric patients and their families - (see title), "In February 2005, the proprietary medication Adderall XR (Shire BioChem Inc, Canada) (mixed amphetamine/dextroamphetamine salts) was withdrawn from the Canadian market by Health Canada (3)" - 19030388 2008/2009 - Simulated driving changes in young adults with ADHD receiving mixed amphetamine salts extended release and atomoxetine - (see title), "This was a randomized, double-blind, placebo-controlled, crossover study of simulated driving performance with mixed amphetamine salts-extended release (MAS XR) 50 mg/day (Cohort 1) and atomoxetine 80 mg/day (Cohort 2) in young adults with ADHD", "Under current guidelines, treatment with psychostimulants (e.g., methylphenidate or mixed amphetamine salts [MAS]) is the recommended first-line pharmacologic treatment, with the nonstimulant atomoxetine considered first line for patients with an active substance abuse problem, comorbid anxiety, tics, or severe side effects with stimulants (Pliszka et al., 2007)" - 18815438 2009 - Effects of omeprazole on the pharmacokinetic profiles of lisdexamfetamine dimesylate and extended-release mixed amphetamine salts in adults - (see title), "To evaluate the pharmacokinetics of lisdexamfetamine dimesylate (LDX), a long-acting prodrug stimulant, and mixed amphetamine salts extended-release (MAS XR), alone or with omeprazole, a proton pump inhibitor (PPI)" - 19820270 2010 - The mixed amphetamine salt extended release (Adderall XR, Max-XR) as an adjunctive to SSRIS or SNRIS in the treatment of adult ADHD patients with comorbid partially responsive generalized anxiety: an open-label study - (see title), "To examine the changes in partially responsive anxiety symptoms utilizing adjunctive treatment with the mixed amphetamine salt extended release (Adderall XR, MAX-XR) in the treatment of adult ADHD patients, with comorbid refractory anxiety" - 21432593 2011 - Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults (a Cochrane review!) - "The three amphetamine derivatives investigated (dextroamphetamine, lisdexamphetamine and mixed amphetamine salts (MAS)) were all efficacious for reducing ADHD symptoms, but MAS also increased retention in treatment" - 21678370 2011 - Medication adherence and symptom reduction in adults treated with mixed amphetamine salts in a randomized crossover study - (see title), "The study objectives were to 1) evaluate medication adherence for adults with attention-deficit/hyperactivity disorder (ADHD) treated with 3 times daily (TID) mixed amphetamine salts immediate release (MAS IR) versus once-daily (qAM) MAS extended release (MAS XR) in a randomized, crossover study; and 2) to examine the associations between adherence and efficacy for MAS IR and MAS XR" - 21904088 2011 - Dose effects and comparative effectiveness of extended release dexmethylphenidate and mixed amphetamine salts - (see title), "To compare the dose effects of long-acting extended-release dexmethylphenidate (ER d-MPH) and ER mixed amphetamine salts (ER MAS) on attention-deficit/hyperactivity disorder (ADHD) symptom dimensions, global and specific impairments, and common adverse events associated with stimulants", "For the two stimulant medications, we chose Dexmethylphenidate Hydrochloride ER (Focalin XR [brand name], here referred to as d-MPH ER) and Adderall XR (mixed AMP salts [MAS] ER). MAS ER is a racemic mixture of dextro- and levo-isomers of AMP salts that contains 50% IR MAS and 50% delivered at a second pulse 4 hours later. MAS ER is one of the most frequently prescribed stimulant medications for ADHD (Olfson, Marcus and Wan 2009)" - 22136094 2012 - Comparative treatment patterns, resource utilization, and costs in stimulant-treated children with ADHD who require subsequent pharmacotherapy with atypical antipsychotics versus non-antipsychotics - "To compare treatment patterns, resource utilization, and costs to U.S. third party payers between stimulant-treated ADHD children who switch to or augment their stimulant treatment with AAPs (risperidone, aripiprazole, quetiapine, olanzapine, ziprasidone, paliperidone, and clozapine) compared with non-antipsychotic medications (atomoxetine, clonidine immediate-release (IR), guanfacine IR, dexmethylphenidate, mixed amphetamine salts, methylphenidate, lisdexamfetamine, and dextroamphetamine)" - 23206211 2012 - The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid attention-deficit/hyperactivity disorder - "Bupropion is a reasonable first-line treatment for BD+ADHD, while mixed amphetamine salts and methylphenidate also may be considered in patients determined to be at low risk for manic switch", "First-line pharmacotherapeutic options for adult ADHD recommended by the Canadian ADHD Resource Alliance (CADDRA)14 and the British Association for Psychopharmacology99 include long-acting preparations of mixed amphetamine salts (MAS), methylphenidate, and atomoxetine" - 22303520 2013 - Objective and subjective cognitive enhancing effects of mixed amphetamine salts in healthy people - (see title), "Psychostimulants such as mixed amphetamine salts (MAS, brand name Adderall) are widely used for cognitive enhancement by healthy young people, yet laboratory research on effectiveness has yielded variable results", "20 mg of mixed amphetamine salts (sulfate salts of dextroamphetamine and amphetamine, with the dextro isomer of amphetamine saccharate and D, Lamphetamine aspartate monohydrate, with D-amphetamine and L-amphetamine in 3:1 ratio) and placebo were administered in visually indistinguishable capsules" - 22884611 2013 - Potential trends in Attention Deficit Hyperactivity Disorder (ADHD) drug use on a college campus: wastewater analysis of amphetamine and ritalinic acid - "The most widely used ADHD medications are the amphetamine-type compounds Adderall (mixed amphetamine salts) and Ritalin (methylphenidate)" (although this study does use the brand-name over MAS in the text, which seems to be a first so far, with other studies strongly preferring MAS) - 23500822 2014 - Safety of medicines used for ADHD in children: a review of published prospective clinical trials - "The drugs studied were atomoxetine (two studies, 802 patients), osmotic-controlled released oral methylphenidate formulation (two studies, 512 patients), extended release formulation of mixed amphetamine salts (one study, 568 patients) and transdermal methylphenidate (one study, 326 patients)", "Tics were reported in all long-term studies regarding methylphenidate, while emotional lability was reported only with mixed amphetamine salts" - 24748641 2014 - Dopamine transporter genotype and stimulant dose-response in youth with attention-deficit/hyperactivity disorder - "This study seeks to determine if variation in the dopamine transporter gene (SLC6A3/DAT1) moderates the dose-response effects of long-acting dexmethylphenidate (D-MPH) and mixed amphetamine salts (MAS) in children with attention-deficit/hyperactivity disorder (ADHD)" - 24813374 2015 - Extended-Release Mixed Amphetamine Salts vs Placebo for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cocaine Use Disorder: A Randomized Clinical Trial - (see title), "One hundred twenty-six adults diagnosed as having comorbid ADHD and cocaine use disorder were randomized to extended-release mixed amphetamine salts or placebo" - 25887096 This is just a selection anyways, nowhere near all of the research, I only included a sampling of the most major studies over time. It excludes quite a bit of literature with less direct usage, including countless mentions in literature on methylphenidate (I've read quite a bit of it). Basically, the usage of MAS is extremely common, and it is the defacto generic name for Adderall among researchers. The Canadian product monograph for ADDERALL XR (Canada) calls it "mixed salts amphetamine". The US monograph calls it "mixed salts of a single-entity amphetamine product" and "mixed amphetamine salts". The terms "amphetamine mixed salts", "amphetamine salts", "dextroamphetamine saccharate and amphetamine aspartate monohydrate and dextroamphetamine sulfate and amphetamine sulfate", "amphetamine/dextroamphetamine mixed salts", "dextroamphetamine mixed salts of a single-entity amphetamine product", etc -- none of these are widely-adopted at all for this kind of usage, although pharmacies may use the second one commonly (I'm not completely sure), and they are often used in certain cases where long-form is fine. But the terms that are most frequently used? "Mixed Amphetamine Salts", "mixed salts of a single-entity amphetamine product", and (possibly) "mixed salts amphetamine". Now, "Adderall" is widely-known, short, etc. But WP:PHARMOS does not support using it, and neither does WP:NAMINGCRITERIA. In the previous discussion, the issue of recognizability and naturalness is brought up, along with conciseness. As far as conciseness goes, this is no longer an issue with the new definition, unlike with previous definitions. "Mixed Amphetamine Salts" is concise. It is also fairly recognizable and natural. You may argue that most people are going to be familiar with the brand name, but that is true of almost any drug! There are endless examples of drugs where the brand name is much better recognized than the generic. Here's some research on how clinicians use names: pubmed 17443372 - "For 20 commonly used drugs, the median frequency of brand name use was 98% (interquartile range, 81-100%). Among 12 medications with no generic competition at the time of the survey, the median frequency of brand name use was 100% (range 92-100%). Among 8 medications with generic competition at the time of the survey ("multisource" drugs), the median frequency of brand name use was 79% (range 0-98%; P < .001 for difference between drugs with and without generic competition). Physicians refer to most medications by their brand names, including drugs with generic formulations. This may lead to higher health care costs by promoting the use of brand-name products when generic alternatives are available." pubmed 17443372 - "Physicians may prefer brand names for a variety of reasons. Brand names are often more memorable or evocative than generic names and easier to pronounce (in our sample, brand names had on average 1.5 fewer syllables than their generic counterparts).7 Many physicians may be familiar only with the brand name of certain drugs or unaware of the correspondence between generic and brand names.8–10 In addition, in certain cases physicians may believe that generic formulations are not as effective as the brand name product.11 Although the interchangeability of certain drugs remains a matter of debate,12 many physicians may not be aware of the strict controls imposed by FDA to prove bioequivalence before a generic formulation can be approved.13" pubmed 19261956 - "In 1993/1994, the 25 most commonly mentioned drugs were referred to by their brand names a median of 89% of the time. Over the ensuing decade, use of brand-name terminology decreased by a median of 11%. Drugs that first faced generic competition within 10 years of the baseline study year had large declines in brand-name use (43-58% decline), whereas drugs that first faced generic competition more than 10 years before or after the baseline study year had minimal change in brand-name use (2-3% decline; p = 0.02 for difference in rate of decline among drug groups). Year of drug introduction, baseline rate of brand-name use, clinical setting, and national region were not associated with reductions in brand-name use.""

I have numerous examples that'd fall under WP:OR, so I won't include them, but I hope it's pretty clear just how common the use of brand names is and how well recognized they are vs generics. I've spent too much time on this already to research further, but I'd be surprised if there isn't more research on consumer recognition and usage of brand names out there that'd back this up even more strongly.

My argument is basically that you cannot use the lack of a INN/USAN as justification to use the brand name -- this is not at all consistent with other drug articles. Yes, it's a semi-unique case, but even then, consistency demands the use of the accepted generic name, which appears to be either "Mixed Amphetamine Salts" or "mixed salts of a single-entity amphetamine product", with the former having better evidence to support its use, but the latter being slightly more official due to its use in FDA documents and the monograph. There is no remaining justification for the continued use of Adderall. As with other drugs, a redirect from Adderall to the correct page name should be created, and that is more than enough to address the issue of it being more familiar to people -- this is what every other drug article does about brand names.

So, here's my arguments, my evidence to support the usage of "Mixed Amphetamine Salts", etc. I think this makes a very strong case for the name change. Garzfoth (talk) 01:06, 21 September 2015 (UTC)

Excuse me if I'm being simplistic, but my understanding is that Adderall is a mixed amphetamine salt, but a mixed amphetamine salt is not necessarily identical to Adderall. I'm not just referring to current drugs, but also those that could be developed in the future. Sundayclose (talk) 01:29, 21 September 2015 (UTC)

True, but with some limitations. Adderall formulations are the only approved forms of Mixed Amphetamine Salts in existence, and will likely remain that way long-term. In the event that some other form of mixed salts is approved in the future, the page could extend to cover both drugs (which is pretty viable IMO), or another solution could be worked out, but that isn't a current concern. Given the widespread usage of MAS in the literature (usually preferred over the brand name), it's clear that the naming is widely accepted/used with little concern for conflicts. There's a lot of methylphenidate formulations, but we only have one page to cover all of them despite the large differences between methylphenidate formulations. Garzfoth (talk) 03:18, 21 September 2015 (UTC)

Special:Permalink/682022807#Changing Title Back to "Amphetamine Mixed Salts" Seppi333 (Insert 2¢) 03:08, 21 September 2015 (UTC)

Methylphenidate is a generic name, which is why all the formulations can be included in one article. Thanks for bringing this up for discussion, but I think the title should remain as it is. This is a unique situation that requires a unique solution, not using a title that may at some point be inaccurate or obsolete. Sundayclose (talk) 13:56, 21 September 2015 (UTC)

Clearly 'Mixed amphetamine salts' has some usage in literature as Garzfoth has quite extensively documented above. Since this isn't the official generic name, the question is whether 'Amphetamine mixed salts' is represented more in literature than 'Adderall'. I am inclined to believe 'Adderall' is more prevalently used, although I am open to numbers showing otherwise. Sizeofint (talk) 17:34, 21 September 2015 (UTC)

Actually MAS may be more commonly used in research literature because researchers try not to use brand names. It is not incorrect for a researcher to use MAS if Adderall is studied because Adderall is a MAS. But it would be potentially inaccurate, in my opinion, to title a Wikipedia article on Adderall "Mixed amphetamine salts" because there could be MAS drugs that are not Adderall. Sundayclose (talk) 19:33, 21 September 2015 (UTC)

This discussion gives me the urge to facepalm.

But WP:PHARMOS does not support using it, and neither does WP:NAMINGCRITERIA. - I have no clue what this is referring to in either of these policies. MOS:MED/MOS:PHARM were revised after the previous discussion closed to ensure exceptional drug articles with brand name titles like Heroin and Adderall don't have to follow their nonproprietary names in the title.

AMS and MAS are both names for the generic formulation. They are not nonproprietary names for Adderall. As for pubmed prevalence, 95 pubmed articles include the term "mixed amphetamine salts" and 0 include the term "amphetamine mixed salts" while 177 include the term "Adderall". In practice, I've never seen the AMS or MAS terms used outside of pubmed. Seppi333 (Insert 2¢) 19:43, 21 September 2015 (UTC)

Edit: and 178 articles include the term "Obetrol" Obetrol is apparently indexed to "Adderall" on pubmed. Seppi333 (Insert 2¢) 19:44, 21 September 2015 (UTC)

Good grief! I thought the previous discussion put this issue to rest. My biggest problem with the name "amphetamine mixed salts" is that it is imprecise. Yes, generally we have only one article to represent different formulations of the same drug. However we also have different articles to represent racemic mixtures or optically pure versions of the same parent compound. Adderall is special case which is neither racemic nor optically pure but optically enriched. Furthermore the ratio of enantiomers in the mixture does result in subtle but none-the-less important pharmacological differences. The precise generic name for Adderall is "dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate and amphetamine sulfate" which is way too long to be used as an article name. The only practical way to name this article is Adderall. Boghog (talk) 20:20, 21 September 2015 (UTC)

This may settle the debate over the generalizability of MAS: pubmed 25973928 - "Amphetamine (AMP) drug substance refers to the racemic 1:1 mixture of two enantiomers with central nervous system stimulant activity: dextroamphetamine [D-AMP; S-AMP (IUPAC)] and levoamphetamine [L-AMP; R-AMP (IUPAC)]. Mixed AMP salts (MAS) products are nonracemic combinations of four salts in a 1:1:1:1 ratio (by weight): D-AMP sulfate, D-AMP saccharate, AMP aspartate, and AMP sulfate. The ratio of D-AMP salts to L-AMP salts in MAS products is 3:1, whereas the ratio of base D-AMP to base L-AMP is approximately 3.15:1. This combination of AMP salts was approved for the treatment of attention deficit hyperactivity disorder (ADHD). Adderall IR (NDA 11522) is an immediate-release (IR) tablet formulation of MAS, and Adderall XR (NDA 21303) is an oral formulation of MAS consisting of two types of pellets in the ratio of 1:1 (in terms of drug load) in a gelatin capsule: an IR pellet and a delayed release (DR) pellet.6" Garzfoth (talk) 20:44, 21 September 2015 (UTC)

Is this typical usage of the terms or are these just definitions for the purposes of that paper? Sizeofint (talk) 22:17, 21 September 2015 (UTC)

That is not clarified explicitly, but given that this is a publication produced by FDA researchers and classified as U.S. Government work, the explicit definitions of MAS products used here are extremely significant to this discussion. Garzfoth (talk) 01:05, 22 September 2015 (UTC)

There are two problems with that argument. First, the FDA position does not necessarily represent a world view and the scope of Wikipedia is wider than the U.S. Second, the FDA has arbitrarily defined amphetamine mixed salts as identical to Adderall. There are an infinite number of possible mixed salts of amphetamine. Adderall is only one. Boghog (talk) 19:09, 22 September 2015 (UTC)

Adderall is marketed exclusively or almost exclusively in the United States (and to a limited extent, Canada). It's unclear if it's actually available to any significant degree outside of these two countries, there's enough supporting evidence to strongly suspect the drug is literally not marketed internationally at all! Thus the US-centric view is more than appropriate here, in fact, it is the only appropriate view to take here, as we are the only country where this drug is marketed and sold. The use of generic names is intended to remove the specific formulation-drug ties, hence, a mixed amphetamine salts article would cover any mixed amphetamine salts products in the same way that the methylphenidate article covers any methylphenidate products. This is exactly the current usage of wikipedia. The action of Concerta is substantially different to the action of Ritalin, but as both use methylphenidate as the active ingredient, they do not get separate articles. The method and action of bupropion differs substantially with formulation, but we don't have separate articles for IR/SR/XL, nor do we for Zyban. The same applies to any generic drug or just any drug with multiple release forms. We only have separate articles under certain conditions. The split of this article out of the amphetamine article is justified on the basis that the mixed amphetamine salts formulation is a separate entity from the generalized superset of amphetamine pharmaceutical products, which includes lisdexamfetamine, dextroamphetamine, and even methamphetamine. It now includes racemic amphetamine too, which did not get its own article, although that may be an issue worth addressing. At any rate, I am not really disputing the legitimacy of having an article for MAS, I am disputing the legitimacy of considering Adderall to be a specific MAS formulation deserving its own article when the generic term always applies to numerous possible formulations, many of which differ substantially in their effects! Your argument rests on the assumption that we cannot consider MAS to be a generic name due to its broadness, but the only reason for this that you have been able to produce is a hypothetical new formulation of amphetamine salts that also uses the name MAS, which would either just fall under this page anyways due to the use of MAS, or not use the name MAS in the first place due to MAS being very firmly defined as the 1:1:1:1 mixture of specific amphetamine salts.

It is also noteworthy that in this particular document relating to Adderall XR, the "Established Name" is defined as "Mixed Amphetamine Salts". In this letter, Adderall is again defined as "mixed amphetamine salts". This noteworthy document demonstrates that MAS is considered the generic term for equivalent products. This older document shows the FDA's use of MAS alongside the lengthier "mixed~salts of a single entity amphetamine product" definition (followed by using it throughout the document instead of the longer definition", which is also interesting for defining that any non-equivalent formulations of amphetamine salts would require another ANDA -- which does not mean that the same generic name could even be used, and if so, if it would be any different from the usage of the same generic name for multiple branded drugs that is widespread. We have no evidence to support the claim that another drug would use the same brand name, and we have no justification to split apart the drug pages in the unlikely event of that happening. This is in part an issue that the FDA would be expected to handle, and the way they handle it would have a significant impact on how the naming of this article could function. We still do not have anything to support not combining multiple MAS drugs with different ratios -- especially as there are multiple amphetamine formulations covered under single pages. The only difference is that there may be a different change in the pharmacological action with different ratios -- but how is this different from the changes depending on release mechanism? I'm not denying the difference, I'm just saying that it's not substantial enough to not combine these hypothetical drugs into a single article, and that it should be treated no differently from brand names of other generic drugs.

Sorry, this turned into a whole wall of text, it's hard to explain this clearly. I can see your argument, but I don't agree that it works here, especially given how broadly acknowledged the term "mixed amphetamine salts" is by the FDA and in the literature, including in many many major papers, a Cochrane review, publications from Shire employees, etc. The papers that do not immediately cite MAS when citing Adderall have an entirely different composition to the ones that do, and many only show that the use of the brand name is popular among clinicians, and as the research I included earlier shows, clinicians suffer from a universal brand-name bias. This also applies to other users who are not familiar with the field, who revert to the brand name -- and much of the research papers where the only mention of Adderall is in passing, and it is notable that a large number of these are also using the brand names for other drugs (especially stimulant drugs), indicating that the use of brand names over generics is not exclusive to Adderall in many cases. Widespread usage of a brand name by this population is not a counterpoint, as this is common with drugs, and the usage of only brand names for these papers (both in not defining/using an Adderall generic name, and in only using brand names for multiple mentioned drugs) is supportive of this view. As I have quite extensively illustrated in my initial post (which was close to thirty-thousand character and contained an extremely impressive slice of the research literature), MAS is the accepted generic name in a very large amount of high quality literature across a long span of time. A crucial point from the literature I mentioned is that the term MAS is usually used in place of the brand name with few exceptions, indicating that not only is it the generic name, but it is the preferred name for researchers! This is important too, because the other potential generic names are NOT preferred by researchers in this way in other literature, they are only mentioned in passing and are not used further. Again, it's important to highlight the drastically different composition of the literature not using MAS, as well as the differences in how brand names are used in this set of research, especially in cases where other drugs are defined by brand names too.

I could go on and on about this... The contrast between the two groups of literature is stark. I will admit that it illustrates the widespread usage of the brand name among the broader population, but it fails to disprove that MAS is the preferred generic term, and most importantly, it does not allow you to claim that Adderall should be used over MAS because this usage difference is no different from any other case of a drug name vs a drug generic! This is a major point -- we do NOT name wikipedia articles solely to attract the largest number of people for a large number of reasons, because if we did, every other drug article would not be using the generic name. Methylphenidate is a good example once again, as most people know it as Ritalin or Concerta. Wellbutrin is a pretty good example (I think I already mentioned this), there are countless others, Vyvanse is a particularly good illustration of a case where the generic name is rarely used and will likely never become frequently used, yet we name it lisdexamfetamine all the same. Poorer but quick examples I can think of include certain antidepressants (Prozac, Zoloft, Lexapro, Luvox, Celexa, Paxil, Cymbalta, Effexor (this is a good example), etc), a number of PPIs (Nexium, Prevacid, Prilosec, Losec, etc), antipsychotics (Abilify, Geodon, Invega, Latuda, Risperdal, Seroquel, Zyprexa, Thorazine, etc), drugs like Viagra/Cialis, a number of benzos (Xanax, Ativan, Klonopin, Valium, etc), Z-drugs (Ambien, Lunesta, etc), AEDs/mood stabilizers (Lamictal, Topamax, Depakote, Keppra, etc), and that's just a tiny slice of the drugs out there focusing primarily on psych/neuro drugs... I know that Adderall is a slightly different case, and that the usage of the brand name is somewhat unusually prolific with it, but the difference does not justify this, the same policy should apply, especially so given that this drug has been available as a generic for so long. We should not be using a brand name over a generic name whenever possible, and this drug is far different from the very rare exceptions to the policy of using generic names. I strongly dispute the claim that usage of the brand name in any way supports using Adderall.

So... Why not go with Mixed Amphetamine Salts? Like methylphenidate (MPH), it has a useful shorthand form (MAS). It's very well supported by certain major sources, much more so than any other generic name or even the brand name itself. The argument that popularity alone overrules this fails in light of the countless drugs where the generic name is used irregardless of how popular it is or is not, establishing quite firmly that this should not be a consideration here when we have evidence supporting this broadly-accepted generic name. We may not have a USAN or INN to guide the naming of the article, so this is a unique case, but it is my view that we should handle this unique case by using the name that the FDA had defined as the "Established Name", the name used by so many widespread sources, by researchers behind the most major papers (representing a large chunk of the literature), by a Cochrane review, by publications from Shire employees, by the FDA itself, and by numerous third-parties too... It appears to be a drug that is only available in US/CA, so international issues do not even apply, and in particular there are no issues with using the FDA as a major source.

So anyways, there's my response. Garzfoth (talk) 17:02, 23 September 2015 (UTC)

TL;DR If you have something to say, say it succinctly. Boghog (talk) 18:41, 23 September 2015 (UTC)

He summarizes his argument in the last paragraph. Sizeofint (talk) 19:40, 23 September 2015 (UTC)

Thanks for mentioning that Sizeofint, I suppose that does summarize most of it. Boghog, it's like 1600 words, that shouldn't take too long to read, and I covered a lot of stuff in the detail it needed rather than making inaccurate oversimplifications. Don't use Tl;Dr as an excuse, that's complete bullshit here. Garzfoth (talk) 21:16, 23 September 2015 (UTC)

Specious, Cynical Lack of Contextualization, Historical Background

The article as is sounds as if written directly by the various, currently extremely commercially-glutted beneficiaries of what we call "Adderall" (and no I am not a left-wing nut and I support the Austrian conservative libertarian theory of private property, if my frank words about the "elephant in the room" might lead to attempts to delegitimize me, here is how I will end it: the left-wing myth of "Big Pharma" is populist hysteria - YET - real-world correspondences and approximations to such a thing DO exist).

Hidden full text of long, anonymous, source-free essay.

The literal patent holders and their esoteric co-workers in the sub-manufacturers have been energetically engineering the democratization and massification of the drug, or diverse forms of these related drugs, from the start, and without that central, specific factor, Adderall would NOT exist. Often what is most notable, one notices in wikipedia, is what is silently, bizarrely unmentioned. While the article does give a brief genealogy of a sort in a way, not really, the issue is totally "septically cleansed" for the sake of cynical all-too-human reasons, probably in passive "deference" to those recently commercially-satisfied entities, who have made this synthetic alteration of natural Ephedra, a "common household" notion/concept in America and the West, with apparently practically near half of the decadent Western world artificially kept alive in its Spenglerian decline, taking these things in in its abortive attempt to "cure" its own metaphysical intellectual bifurcation and obscuration, by the cheapest means, choosing the path of lab-engineered stimulants in its psychological disaggregation. Stims. won't keep this crepscular civilization alive when it is so ontologically and psycho-spiritually decentralized, and are only one sign of the times. Ceasing digression: The article dances around the issue: Adderall is DIRECTLY and I do mean DIRECTLY derived from "BIPHETAMINE" (and in a more insignificant roundabout extrinsic way, Obetrol), in the way that matters, however you research the matter; the fact that when one types in "Biphetamine" in wikipedia's search engine, the user ends up right here, and yet, curiously (cynically, presumptively) the article fails to mention the fact that its "very humanly motivated" development in the pharmaceutical syndics is DIRECTLY known, traceable, confirmable, - so very shameful to the "editors"... One can easily look up Adderall's striated, complex genesis and relevant brute facts, if one is interested in the truth, even in the older Physician's Desks References (PDAs). The purpose here, as to Adderall's rather NOTABLE genesis, sadly, in this anodyne article, is to darken the public mind opportunistically, for a variety of "all-too-human" but UNACADEMIC reasons; perhaps the one most familiar to folk, because in the 70's the abused "street" version of Biphetamine was known as the "notorious" "Black Beauties", the under-class went nuts abusing these things apparently, doing things like home making bizarre mixtures of dangerous drugs themselves, and so stigma hypocritically developed: what is politically incorrect does not permit us to nullify our ethical or academic standards. Adderall did not appear out of nowhere - as if there was this mysterious time hole between the first artificial prototype derived from natural Central Eurasian Steppe, Ephedra, and 2023: there is a VERY SPECIFIC and VERY DEFINITE history of its "creation". All of this history is intrinsically neither "good" nor "bad" moralistically but the silent suppression of the dissemination of this crucial background contextual history, immediately casts suspicion on the article's professionalism, "cancelling" such an important part of the "story of Adderall", is irresponsible, immoral and academically untenable; we are, if actual encyclopedists instead of operatives of psy-ops or propaganda, bound to dispassionately report objective reality, documentation-ironclad: the "septic" failure to mention Biphetamine, etc. in the article, is psycho-socially revealing, as to how wikipedia works and its ethics, in its...ahem.....Machiavellian, why mince words?...omission. I noticed, ludically, the longest articles on Wikipedia are on so-called "anti-Semitism" and what else, Covid?, Mass Effect video-games, and similar fripperies. As I said, what is unmanifest manifests what is significant. The timing and complexity of these matters should be illuminated and not whitewashed: suddenly, Biphetamine is withdrawn from the market and cotemporally, Shire enigmatically acquires "Obetrol", Adderall's other parent, the other progenitor or antecessor in a botched chaotic generation. SO: Suddenly ADHD becomes a sort of public health crisis of late-American Western civilization at the same time as these things are happening; ADHD was previously known more impolitely as "MINIMAL BRAIN DYSFUNCTION" and doctors spoke of the condition as if the "disease" was organically-rooted and hopeless to those suffering and, tersely, it was the softest form of "mental retardation." We really can't try to be more honest and ethical in presenting matters here, instead of pretending like Adderall appeared magically out of an alter-verse in recent history, with no correlates in human history? The article, as is, is "superstitious." Biphetamine and associated meds were created in the 50s, 60s and 70s by countless pharmaceutical entities and are the direct, deliberately humanly engineered "precursors" of what we understand as "Adderall": the ratio of Biphetamine, l-amph, 50% and d-amph, 50%, whereas, racemically, Adderall is 75% d-amph. These pills were being made as early as the late 50s legally, all sorts of companies, some companies more than others...spiking in the 60s and 70s, and existed most "popularly" in 20 mg form, 10 d-amph and 10 l-amph from Strasenburgh Labs (latterly, Fisons). Or, rather, the most "popular" form was the adulterated "Black Beauties" of the street gang ambience I am sure some of your grandparents might have a smatch of acquaintance with, AHEM. The fact that some of these companies were manufacturing other "creative", atypical drugs (mixtures of barbiturates/antipyschotics,etc. and amphetamines, etc., nearly everything imaginable) is simply not relevant from the perspectival angle and "telling the story of Adderall". "Adderall" HAS a *very, very* SPECIFIC "history": DOCUMENTED, COPIOUSLY CONFIRMABLE and RELEVANT scholastically and in terms of ethical public enlightenment. Strasenburgh Labs, or Fisons (the last holders to the "patent" of Biphetamine), should not be over-emphasized as these historically random, meaningless, contingent corporative groups were not the only relevant pharm. companies doing very similar activities, all part a very, very specific sub-culture with a very, very "all-too-human" motivational axis, part of, in truth, an entire socio-cultural extreme cultural shift in Western civilization.

Our "woke" civilization, this Dark Age, is beyond such things as anything but the most prettified, herd-animalized, dumbed-down and simplism-based realities, so let us obey as puppets, our master, Political Correctness and, even in the modality of an alleged channel of "online democratic education", this wikipedia, ignore and distort and censor and attitudinize and turn up the Tartuffery, obscuring the "story of Adderall"... — Preceding unsigned comment added by 2600:6C40:4700:4D:2C17:C9B9:B992:847B (talk) 13:57, 14 March 2023 (UTC)

Cool story Bro. Gravel for breakfast (talk) 12:44, 2 November 2023 (UTC)

Use of the word "story" seems apt. There is not a single citation to the published work of others in this judgmental critique; and this quotation mark-, all caps-, and hyphenated descriptor-laden content otherwise presents as being entirely editorial, indicating the 2600 IP does not begin to understand what it means to write for Wikipedia.

73.8.193.28 (talk) 00:28, 3 December 2023 (UTC)