Since its first prescription in the 1930's, dextroamphetamine has been used by a broad variety of people. Children and adults have been prescribed the drug for treatment of Attention Deficit Hyperactivity Disorder, but it has also been used recreationally as speed because it is part of the amphetamine family.

Like other amphetamines, dextroamphetamine is a central nervous system stimulant. It is considered highly addictive, both physically and psychologically, because of its long-lasting effects. In its early years of production, it was used for treatment of a variety of neurological disorders, from narcolepsy to Parkinson's disease. During World War II, the drug was administered by the U.S. military to troops serving on the front lines in Europe, and to this day its use continues in the military. The U.S. Air Force uses it to keep pilots alert during extended missions (although it is being phased out in favor of modafinil, another narcolepsy treatment), and it was found to have been used extensively during Operation Desert Storm.

During the early days of the space program, NASA officials also employed dextroamphetamine during the Mercury missions. When combined with scopolamine, an anti-nausea agent well-known to cruise ship passengers, it worked to prevent motion sickness and also reduce fatigue. NASA continued using it through the first several space shuttle missions before replacing it with promethazine.

Due to its addictive nature, dextroamphetamine is tightly regulated in many countries. Under Australia's Standard for the Uniform Scheduling of Drugs and Poisons (SUSDP), it is a Schedule 8 or "Controlled" drug. Britain's Misuse of Drugs Act from 1971 classifies it as a Class B drug, and New Zealand's 1975 act of the same name marks it as Second Schedule, also called "Controlled." In the United States, the Controlled Substances Act designates dextroamphetamine as a Schedule II drug, meaning that it is only available by prescription and its distribution is monitored by the Drug Enforcement Administration.

When used by prescription, though, dextroamphetamine has several uses. Its best-known use is in children and adults with ADHD, and it is considered an alternative to methylphenidate (sold under the brand names Ritalin and Concerta), but another widespread use is as treatment for narcolepsy. In both cases, dextroamphetamine works by activating nerve cells in the brain and spinal cord, resulting in increased motor activity and alertness and reduced drowsiness and fatigue. For children ages three to six with ADHD, dextroamphetamine is usually given in 2.5mg doses once per day; children ages six and older often take 5mg once or twice a day. Adults may be given 5mg to 60mg daily, depending on the severity of their ADHD. The adult dosage for narcolepsy is the same as the adult dosage for ADHD, and narcoleptic teenagers may take 10mg per day. Children ages six to twelve should take 5mg per day for narcolepsy. Side effects of dextroamphetamine include nervousness, insomnia, and loss of appetite. It also may cause an increase in blood pressure and pulse rate.

Dextroamphetamine has also been used in the treatment of depression, although this usage is not common. It is typically reserved for patients with a terminal illness (such as cancer or HIV) who do not respond to other treatments for depression. At times, however, it has also been used for depressed patients without a terminal illness who do not respond to other pharmaceutical treatment or psychotherapy. The use of dextroamphetamine for depression, though, is not common primarily because of its time-limited nature: although patients feel better while the medication is active in their system, they experience a "crash" when it wears off. Another use of dextroamphetamine is as a prescription diet aid, because it reduces hunger, but once again it is not frequently prescribed because it is so addictive.

Like other amphetamines and stimulants, dextroamphetamine has enormous potential for abuse. College students may take it during exam week, either orally or by crushing the tablet form of the drug and snorting it. This type of use may evolve into addiction to the stimulant high the drug produces, making it not unlike other forms of speed even though it does have an approved clinical use. Additionally, dextroamphetamine addicts will develop a tolerance level, and must continually keep increasing the dosage to keep getting the high. Signs of frequent amphetamine abuse include irritability, insomnia, and changes in personality. In the most severe cases, it produces psychotic symptoms that are quite similar to schizophrenia. A particularly addictive response occurs when dextroamphetamine is given with amphetamine, a combination sold under the brand name Adderall.

Dextroamphetamine is sold throughout the world. Its best-known brand name is Dexedrine, which is made by the pharmaceutical company GlaxoSmithKline. Dexedrine comes in two forms, tablets and Spansules. The tablets are orange and triangular, and are generally only available at 5mg each; these typically last from two to five hours. The Spansules are a black and orange sustained release capsule, which comes in 5mg increments and lasts from eight to ten hours. Another brand of dextroamphetamine is Dextrostat, and it is also available in the United States in generic form. In Australia and New Zealand, the drug is known as Dexamphetamine, and in Switzerland it is known as Dexamphetamini.

Dextroamphetamine has found its way into popular culture through a few avenues. Writers Jack Kerouac and Allen Ginsberg were both frequent users of the drug, and it has appeared in the works of Tom Clancy, Michael Herr, and Robert Stone. The British band Dexys Midnight Runners, popular in the 1980's, took their name from dextroamphetamine.

Additional resources
http://www.healthoptions.com/dexedrine.html
http://bulkpharm.mallinckrodt.com/_attachments/msds/DXPTM.htm
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a605027.html
http://www.drugabusehelp.com/drugs/dexedrine/

originally written for nonficwrimo 06