Dexamphetamine

How is dexamphetamine used?

Dexamphetamine is usually swallowed.⁷

Non-prescribed use can involve crushing and snorting tablets, and sometimes injecting or smoking/inhaling.⁷

Effects of dexamphetamine

Use of any drug can have risks. It’s important to be careful when taking any type of drug.

Prescribed stimulants work on the parts of the brain involved in regulating attention and arousal (being alert and awake). The medications can greatly improve concentration, impulse control and hyperactivity in about 80% of children with ADHD.⁸

In adults, ADHD is quite different — and the symptoms are unique for each individual.⁹

It is estimated that around 533,300 adults (aged 20+) have ADHD in Australia.¹⁰

Dexamphetamine affects everyone differently based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken.

Onset and duration of effects

How fast a drug takes effect and how long it lasts can vary depending on how it's taken - for example, whether it's snorted, swallowed, or injected.¹¹

• Dexamphetamine: When swallowed, effects can be felt in 15 – 30 minutes and can last for 4 – 6 hours.
• Lisdexamfetamine (Vyvanse®): When swallowed, effects can be felt in 15 – 30 minutes and can last for 8 – 12 hours.^{12, 13}

Effects

Effects can include:

• enhanced mood and/or motivation
• increased energy and/or confidence
• increased alertness and/or focus
• fast heartbeat.¹⁴

Side effects may include:

• nausea
• vomiting
• abdominal pain
• headache
• dizziness
• mood changes such as depression or irritability
• increased heart rate and blood pressure
• heart palpitations
• restlessness, nervousness, tremor
• sleep difficulties
• loss of appetite, or weight loss.⁴

Side effects are generally mild and more likely to occur during the first few days of

treatment, and may disappear as the body adjusts.⁴

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’):

• Set: a person’s state of mind, previous encounters with the drug, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using dexamphetamine may result in an unpleasant experience and make those feelings worse.
• Setting: the physical and social environment where you take dexamphetamine – whether it’s known and familiar, who you're with, if you're indoors or outdoors, the type of music or sounds, and lighting. The ideal setting to take dexamphetamine will vary based on the individual and drug they’re using.¹⁵

Being in a good state of mind, with trusted friends and a safe environment before taking dexamphetamine reduces the risk of having a bad experience.¹⁵

Overdose 

If you take a large amount of dexamphetamine you could overdose.

Your risk of overdose can also increase if you mix dexamphetamine with alcohol or other drugs, including medications.

Dexamphetamine overdose can cause death.¹³

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide more instructions).

Signs of dexamphetamine overdose can include:

• unconscious or non-responsive
• spasms or seizures
• feeling tired or fatigued
• heart attack symptoms such as:
• difficulty breathing
• sharp pain/discomfort in chest, arm, shoulder, back, neck, or jaw
• severe agitation, confusion, or panic
• racing heartbeat
• hot, flushed (red), or sweaty skin
• very large pupils.^{16, 17}

Learn more on overdose and drug-related emergencies

Mixing with other drugs

Mixing dexamphetamine with other drugs can have unpredictable effects and increase the risk of harm.

Mixing includes using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• Dexamphetamine and other stimulants (speed, ice, caffeine, cocaine etc.): Combined stimulants increase strain on heart, anxiety & risk of stroke.
• Dexamphetamine and alcohol: may feel less intoxicated due to stimulant effects of amphetamine and lead to drinking more. Increases risk of alcohol poisoning.
• Dexamphetamine and tricyclic antidepressants/MAOI inhibitors: increased heart rate and blood pressure.^{12, 18}

Use of more than one drug or type of drug consumed at the same time is called polydrug use.¹⁹

Reducing harm

There are ways you can reduce the risk of harm when taking dexamphetamine prescribed to you:

• Only take as prescribed and don’t change dose without first speaking with your prescribing doctor/specialist
• Check with your doctor before taking any other medications or supplements
• Until you know how dexamphetamine affects you, be careful when driving, operating machinery or doing heavy exercise
• Avoid mixing dexamphetamine with alcohol or other drugs

Reducing the risk of harm from non-prescribed use:

• Use where you feel safe and with people you trust, and always tell someone what you’ve taken
• Avoid driving or operating machinery after use
• Always use sterile injecting equipment and never share injecting equipment
• Safely dispose of used injecting equipment
• if you’ve never used it before, start with a small amount and wait for effects
• avoid mixing with other drugs, including alcohol

Coming down

Experiencing comedown effects is less likely when dexamphetamine is taken as prescribed, but some people may still experience a comedown or ‘crash’ after use.^20-23

Comedown effects can be more likely when dexamphetamine isn’t taken as prescribed (also called non-prescribed use) and can include feeling exhausted, restless sleep, irritability and anxiety.^20-23

If you experience any effects that worry you, speak with your prescribing doctor or specialist.

Long-term effects

Long-term effects can vary depending on how much, how often and how dexamphetamine is consumed. Regular use may eventually contribute to:

• cardiovascular complications
• reduced growth (weight and height) in children.^{20, 21}

Dexamphetamine and mental health

For some people, dexamphetamine use can lead to:

• increased anxiety
• trouble sleeping/insomnia
• psychosis/psychotic symptoms.²⁴

The risk of experiencing psychosis or psychotic symptoms is higher when dexamphetamine isn’t taken as prescribed, especially for long periods at high doses. Psychosis is when someone loses the ability to distinguish between what is real and what isn’t real. It can includes symptoms such as paranoia, delusions, and hallucinations.^{25, 26}

If you have a history of anxiety, insomnia or psychosis, speak with your prescribing doctor about whether dexamphetamine is suitable.²⁴

Tolerance

Regularly taking dexamphetamine can lead to developing a tolerance, which means you need to take larger amounts to get the same effects.¹³

When dexamphetamine is taken as prescribed, tolerance can take several weeks or months to develop, and it usually does not significantly reduce the benefits of treatment.²⁷

A doctor can manage tolerance by changing medications, recommending a short break from dexamphetamine, or reviewing your treatment.²⁷

Dependence 

For people who take dexamphetamine as prescribed, they may feel they depend on it to manage their condition and/or regular functioning.²⁷

ADHD medications, including dexamphetamine, should be reviewed by you and your healthcare professional at least once a year.²⁸

People who regularly use dexamphetamine not as prescribed may become dependent. They may feel they need to use dexamphetamine to go about usual activities like working, studying and socialising, or just to get through the day.12

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on a drug, or who has been using it regularly over time, stops or reduces their use.²⁹

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).²⁹

Symptoms - including how strong they are and how long they last - will vary depending on the type of drug and a person’s history of use.²⁹

Withdrawal symptoms

Most people don’t experience withdrawal effects from dexamphetamine after stopping if the recommended dose is taken.⁸

Some children stop taking the medication on the weekends and school holidays and do not experience any adverse effects.⁸

But some people may experience withdrawal effects. The risk of experiencing withdrawal is higher if using dexamphetamine non-prescribed over longer periods of time. Symptoms can include:

• cravings
• extreme fatigue/tiredness
• anxiety, depression or irritableness
• increased appetite
• restless sleep.³⁰

Pregnancy and breastfeeding

ADHD is a life-long condition which means that it can affect someone before, during, and after pregnancy.³¹

Currently there is mixed evidence on the impact of ADHD medications, including dexamphetamine, on pregnancy and breastfeeding.³¹

Recent evidence suggests that using prescribed ADHD medication during pregnancy is not linked to significant harm for the pregnant person or baby.^{31, 32}

This research also found that continuing ADHD medication during pregnancy may have some benefits for the pregnant person, including improved mood and family functioning.^{31, 33, 34}

There’s also evidence to suggest that suddenly stopping your prescribed dexamphetamine may increase your risk of miscarriage.³³

If you’re taking prescribed dexamphetamine, talk to your doctor before making any changes while trying to become pregnant, during pregnancy, or while breastfeeding.

Getting Help

If your use of dexamphetamine is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone, there is help and support.

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs.
• Search our Help and Support directory to find your preferred support, by adding your location or postcode and filtering by service type.