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In the 1950s in the context of widespread prescription and misuse of dexamphetamine, there were case reports of amphetamine psychosis and malnutrition, together with depression on drug withdrawal. Subsequently, dexamphetamine prescribing was restricted; its main use over the past 60 years has been for treating children with ADHD. However, with the rising cost of obesity and the expense of approved medical and surgical interventions , it is timely to question the traditional teaching that dexamphetamine is too dangerous to use for treating obesity.
There have been few recent studies that have used amphetamines for treating obesity. In 1947, Ray treated obese patients with racemic amphetamine and methamphetamine and after 8 months achieved weight losses of 12.7 kg in men and 11.0 kg in women . More recently, Levy et al. used stimulant medication (mainly amphetamine) in a predominantly female cohort of obese individuals, principally to treat newly diagnosed ADHD . They reported weight loss of 15.1 ± 10.4 kg (12.4 ± 7.2% of initial body weight) after an average of 466 days on treatment.
In 2011, Desouza et al. treated veterans with obesity and apathy with low-dose methylphenidate, to test whether it would improve motivation and assist with the lifestyle changes required for weight loss . Subjects were randomized to a motivation program with or without methylphenidate, or to standard nutrition counseling. Apathy scores improved comparably in all groups, with no enhancement in those on methylphenidate. However, only those on methylphenidate achieved statistically significant weight loss (average 4.6 kg over 6 months). This modest weight loss could have been due to appetite suppression. This study reported no psychotropic effects, perhaps because the dose was too low.
In the treatment of ADHD, it is important for the dose of stimulant medication to be individually adjusted to optimize behavioral functioning. The aims of this pilot study were to investigate the safety and efficacy of a 6-month period of treatment with dexamphetamine for achieving weight loss and to evaluate dose titration limited by adverse amphetamine symptoms and cardiovascular effects. The long-term aim of this research is to evaluate whether behavioral changes can be established safely using dexamphetamine and lead to maintenance of weight loss after treatment is withdrawn.
It’s true — decreased appetite and weight loss are possible side effects of Adderall use. Both adults and children can have these effects while using this drug. However, Adderall is not approved by the U.S. Food and Drug Administration (FDA) for use as a weight loss drug. It’s only approved to treat ADHD and narcolepsy.
However, your doctor may prescribe Adderall off-label to help you lose weight. “Off-label” means the use of the drug has not been reviewed or approved by the FDA. You should only use Adderall as a weight loss tool if your doctor has prescribed it for you. It’s important for your doctor to monitor you to make sure the drug is effective and safe for you.
Adderall can cause serious side effects, which is a good reason not to misuse it to lose some weight. A few of the many possible side effects of Adderall use include:
- high blood pressure
- increased heart rate
- mood swings
- trouble sleeping
Adderall use is especially dangerous for people with heart defects or other heart problems. Even if you have ADHD or narcolepsy, your doctor will likely not prescribe Adderall for you if you also have a heart condition or a high risk of developing one.
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Serious health warnings
Adderall has a boxed warning, the most serious warning the FDA provides. It states that Adderall has a high risk of dependence, which means that you can become psychologically and physically addicted to it. The warning also advises that Adderall can cause sudden death as well as serious heart problems.