Why the sudden media spotlight on adderall? Seriously, it seems like it’s been all over the news lately. In the past six months, the New York Times has published a slew of occasionally terrifying articles about adderall, ritalin, and other attention-enhancing drugs. People condemn it and praise it, scoff at it and crave it, but I’m mostly just left wondering, “Isn’t adderall made of amphetamine…like methamphetamine? Why are we not all zombie meth addicts killing each other for pills in the library?” So, I set out to figure out what goes on in your brain when you pop an Addy and settle in for a long night in Butler. But first, I know this is a contentious topic (just read some of those Times articles…then read some of the comments on those articles), so I’d like to say right off the bat: this is neither a condemnation nor a condoning of the use of stimulants in adults or children, prescribed or not. It is merely a look into the psychopharmacology of the drug so that we can all understand what the media’s favorite pill does in our brains.
Adderall is a mix of two stereoisomers of amphetamine, a stimulant related to the recreational drugs methamphetamine and MDMA, or ecstasy. Adderall’s chemical structure is close to those of the catecholamine family of neurotransmitters and hormones, which includes epinephrine, norepinephrine, and dopamine. This similarity confers Adderall’s neurotropic effects by allowing it to mimic the action of these brain chemicals.
Normally, catecholamines function in areas of the brain that control emotion and arousal, among other things. Dopamine, for instance, plays a prominent role in reward and pleasure pathways, and norepinephrine modulates the sympathetic nervous system, which drives our “fight or flight” response. The hormone epinephrine (probably better known as adrenaline) also has a part in the sympathetic catecholaminergic response, and contributes to the rush we feel when we are nervous or excited.
As a catecholamine agonist, taking Adderall recreates these sensations by binding to the receptors for dopamine and norepinephrine in the brain and epinephrine in the adrenal gland. Additionally, it blocks the activity of the transporters that remove catecholamines from the synapse to end the response, and actually allows for some reverse transport of endogenous catecholamines out of the neuron into the synapse so that they can bind their receptors as well. Effectively, Adderall floods the brain with amp-up, feel-good chemicals, leaving us feeling alert, euphoric, and ready for anything.
Like any drug, though, Adderall comes with a host of side effects and potential dangers. The intense arousal can lead to insomnia and anxiety, which in turn can descend into schizophrenia-like psychosis (as one of those Times articles I mentioned above discusses). Since amphetamines work on the body as well as on the brain, Adderall causes elevated heart rate and increases in blood pressure, which can be bad news for people with pre-existing heart conditions. And, like all other drugs (you name it – alcohol, caffeine, which is actually works by a similar mechanism to amphetamines and which wrote about a while back in CSR), Adderall has the potential to be addictive. A Schedule II controlled substance, it shares its high risk of dependence with the likes of cocaine, opium, oxycodone, and methamphetamine.
Given these properties, are A.D.H.D. sufferers and overachieving students alike all unwitting meth users destined to the throws of addiction? Not quite. Though studies have shown that when taken in comparable doses, methamphetamine and Adderall (amphetamine) are effectively identical, there are some differences between the two drugs. For example, it is believed that the additional methyl group on methamphetamine makes it more fat soluble and, therefore, more efficacious. Also, some researchers believe meth may not be as villainous as we make it out to be, so even if the conflation of Adderall and methamphetamine is justified, it is not necessarily a death sentence to occasional and regular amphetamine users.
So, whether you swear by Adderall or shudder at the thought of it, at least now you know how it works. Use it. Or don’t. Either way, please try not to end up like him or her. And next time you’re staring straight into the ugly face of another all-nighter and have some choices to make, use science as your guide. Happy studying!