Dexamfetamine

General information

Dexamfetamine or (+)-amfetamine is significantly more potent than (−)-amfetamine. The use of dexamfetamine as an appetite suppressant has rapidly declined, because of appreciation of its potential for abuse and addiction. These arise mainly from euphoria, which may be followed by depression as the effect of the drug wears off. Stimulant effects were reported in 23% of 347 patients using dexamfetamine as an appetite suppressant [ ].

Dexamfetamine is extremely variable in its effects, and can even produce drowsiness in a small proportion of subjects. Postmenopausal women are more prone to drowsiness, anger, and sadness than euphoria [ ]. Adverse effects due to sympathetic overactivity are fairly common but not usually serious. However, in view of dexamfetamine’s addiction potential, other anorectic drugs should be considered first.

When it was first introduced, one of the most frequent uses of amfetamine was as an anorexigenic agent in the treatment of obesity. A number of anorectic agents, many of them related to amfetamine, have since been manufactured. Most are stimulants of the central nervous system. In descending order of approximate stimulatory potency, they are dexamfetamine, phentermine, chlorphentermine, mazindol, diethylpropion, and fenfluramine. The last of these has a stimulatory effect only in overdosage. One of the problems that has concerned clinicians over the use of anorectic drugs for the treatment of weight reduction is that despite 6 weeks to 3 months of weight reduction efficacy, the effect begins to wear off and on withdrawal weight gain rebounds.

The anorectic agents produce adverse effects mainly of the central nervous system sympathomimetic type. Therapy should therefore only be allowed under strict medical supervision, to ensure the earliest possible detection of any signs of drug abuse. Long-term drug treatment of obesity should be avoided altogether.

Drug studies