Search for articles or Rx savings
Key takeaways
Dexedrine and Adderall are both central nervous system stimulants used to treat ADHD and narcolepsy, but they contain different active ingredients, with Dexedrine containing dextroamphetamine sulfate and Adderall containing mixed amphetamine salts.
While both medications are generally covered by insurance, Dexedrine can be more expensive out-of-pocket than Adderall, and pricing with coupons through services like SingleCare can significantly reduce costs for both.
Both drugs share similar side effects including elevated blood pressure and insomnia, and they have potential for abuse, leading to their classification as schedule II narcotic drugs by the DEA.
Studies suggest that Adderall may be more effective than Dexedrine in reducing ADHD symptoms, although individual responses can vary and the final treatment decision should be made by a healthcare provider.
Dexedrine and Adderall are two prescription medications classified as central nervous system (CNS) stimulants. They are brand-name medications, but they each have generics available. These two CNS stimulants are used primarily to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. These drugs affect neurotransmitters in the brain, which affect how focused and alert a patient feels.
| Dexedrine | Adderall | |
| Drug class | Central nervous system stimulant | Central nervous system stimulant |
| Brand/generic status | Brand and generic available | Brand and generic available |
| What is the generic name? | Dextroamphetamine sulfate | Amphetamine salts (d-amphetamine and l-amphetamine) |
| What form(s) does the drug come in? | Tablets, spansules, and extended-release capsules | Tablets and extended-release capsules |
| What is the standard dosage? | 5 mg once or twice daily titrated up to 40 mg/day | 5 mg once or twice daily titrated up to 60 mg/day |
| How long is the typical treatment? | Long-term (indefinite) | Long-term (indefinite) |
| Who typically uses the medication? | Children and adolescents 3 years of age and older, Adults | Children and adolescents 3 years of age and older, Adults |
What are the main differences between Dexedrine and Adderall?
Dexedrine is a brand-name medication whose generic is dextroamphetamine sulfate. It is a CNS stimulant, and more specifically, it is a type of amphetamine. Amphetamines stimulate the release of norepinephrine, and the primary site of this activity is in the brain’s cerebral cortex. CNS stimulation by amphetamines leads to decreased fatigue, increased motor activity and alertness, and an overall better mood. Dexedrine is FDA-approved for the treatment of ADHD and narcolepsy. It is also used off-label, or without approval from the FDA, in the treatment of certain types of obesity-resistant to other interventions. Dexedrine is available in immediate-release tablets in strengths of 5 mg and 10 mg. Dexedrine spansules are available in strengths of 5 mg, 10 mg, and 15 mg. Extended-release capsules of the generic dextroamphetamine are available in 5 mg, 10 mg, and 15 mg.
Adderall is a combination of amphetamine salts, containing a 3 to 1 ratio of dextroamphetamine (d-amphetamine) and levoamphetamine (l-amphetamine). It contains the active ingredient of Dexedrine, combined with other amphetamines. It is a prescription drug used in the treatment of ADHD and narcolepsy and works in the same manner as Dexedrine. Adderall is available in a much wider range of strengths as compared to Dexedrine. Adderall comes in immediate-release tablets. Adderall XR is an extended-release capsule formulation.
The Drug Enforcement Agency (DEA) deems Dexedrine and Adderall schedule II narcotic drugs. Due to the fact that they are habit-forming and have a high potential for abuse, there are restrictions and guidelines to obtaining these drugs, which vary by state.
Conditions treated by Dexedrine and Adderall
Dexedrine and Adderall are indicated in the treatment of ADHD. ADHD is characterized by moderate to severe distractibility, short attention span, hyperactivity, and impulsivity. If left untreated, ADHD can affect academic and professional performance, as well as basic daily functions.
Dexedrine and Adderall are each indicated in the treatment of narcolepsy as well. Narcolepsy is excessive and uncontrollable daytime sleepiness. Like ADHD, untreated narcolepsy can have negative effects on day-to-day activities.
Dexedrine is used off-label in the short-term (few weeks duration) treatment of obesity, which has not been responsive to other interventions such as diet, exercise, group programs, or other drugs.
Only your healthcare provider can determine what treatment is best for your condition.
| Condition | Dexedrine | Adderall |
| Attention hyperactivity deficit disorder (ADHD) | Yes | Yes |
| Narcolepsy | Yes | Yes |
| Refractory obesity | Off-label | No |
Is Dexedrine or Adderall more effective?
An analysis of 19 studies compares amphetamine-type treatments to placebo in the treatment of ADHD. In general, the analysis showed that amphetamine treatments reduced the severity of ADHD symptoms but were also linked with a higher number of patients who withdrew from the studies due to side effects. When comparing Dexedrine and Adderall directly, studies appeared to show that while Adderall showed an ability to decrease symptoms of ADHD overall, there was no evidence that Dexedrine reduced ADHD symptoms. Based on this information, Adderall may be preferred over Dexedrine.
Only your healthcare provider can decide which treatment is best for you.
Coverage and cost comparison of Dexedrine vs. Adderall
Dexedrine is a prescription medication that is typically covered by commercial insurance. Coverage by Medicare plans may vary or require special exceptions to be made. The out-of-pocket price for Desoxyn can be as high as $849. A coupon from SingleCare can bring the generic price to less than $91.
Adderall is a prescription medication that is typically covered by commercial insurance. Coverage by Medicare plans may vary or require special exceptions to be made. The out-of-pocket price for Adderall can be more than $300. A coupon from SingleCare can bring the price of the generic to approximately $230 for 30, 20 mg tablets at select pharmacies.
| Dexedrine | Adderall | |
| Typically covered by insurance? | Yes | Yes |
| Typically covered by Medicare Part D? | No | No |
| Standard dosage | 30, 15 mg ER capsules | 60, 30 mg tablets |
| Typical Medicare copay | n/a | n/a |
| SingleCare cost | $91-$145 | $29-$50 |
Common side effects of Dexedrine vs. Adderall
Dexedrine and Adderall have a similar list of potential adverse effects. This is expected due to the similarities in ingredients. Dexedrine and Adderall have been linked to serious side effects such as elevated blood pressure, tachycardia, and palpitation. In some instances, myocardial infarction (heart attack) and sudden death have occurred. Caution should be used when prescribing stimulants in patients with pre-existing cardiac abnormalities.
Dexedrine and Adderall may lead to a sleep disorder known as drug-induced insomnia or an inability to fall and stay asleep. This can affect daily functioning and should be monitored. These drugs are also known to cause dry mouth and dizziness. You should discuss these adverse events with your healthcare provider if they occur and are bothersome.
The following is not intended to be an all-inclusive list of potential side effects. A complete list can be obtained from your healthcare professional.
| Dexedrine | Adderall | |||
| Side effect | Applicable? | Frequency | Applicable? | Frequency |
| High blood pressure | Yes | Not defined | Yes | Not defined |
| Tachycardia | Yes | Not defined | Yes | Not defined |
| Palpitation | Yes | Not defined | Yes | Not defined |
| Insomnia | Yes | Not defined | Yes | Not defined |
| Loss of appetite | Yes | Not defined | Yes | Not defined |
| Vomiting | Yes | Not defined | Yes | Not defined |
| Weight loss | Yes | Not defined | Yes | Not defined |
| Dry mouth | Yes | Not defined | Yes | Not defined |
| Dizziness | Yes | Not defined | Yes | Not defined |
Source: Dexedrine (DailyMed) Adderall (DailyMed).
Drug interactions of Dexedrine vs. Adderall
Dexedrine and Adderall, when used concurrently with serotonergic drugs, may increase the incidence of serotonin syndrome. This syndrome can result in the patient feeling agitated, dizzy, and having an increased heart rate. Common antidepressants such as selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors, as well as the pain medication Tramadol, may cause this interaction with Dexedrine or Adderall.
Dexedrine and Adderall should not be used in patients taking monoamine oxidase inhibitors (MAOIs). MAO inhibitors slow amphetamine metabolism, increasing the amphetamine’s effect on the release of norepinephrine and other monoamines from the nerve endings, causing headaches and other signs of hypertensive crisis.
The following list is not intended to be a complete list of drug interactions. It is best to consult your healthcare provider or pharmacist for a complete list.
| Drug | Drug Class | Dexedrine | Adderall |
| Selegiline
Isocarboxazid |
Monoamine oxidase inhibitors (MAOIs) | Yes | Yes |
| Fluoxetine | Selective serotonin reuptake inhibitors (SSRIs) | Yes | Yes |
| Venlafaxine | Selective norepinephrine reuptake inhibitors (SNRIs) | Yes | Yes |
| Sodium bicarbonate
Sodium lactate |
Antacid | Yes | Yes |
| St. John’s Wort | Supplement | Yes | Yes |
| Topiramate | Antiepileptic | Yes | Yes |
| Tramadol | Opioid pain reliever | Yes | Yes |
| Sumatriptan | 5HT3 Antagonists (Triptans) | Yes | Yes |
| Desipramine | Tricyclic antidepressants | Yes | Yes |
| Omeprazole | Proton pump inhibitors (PPI) | Yes | Yes |
Warnings of Dexedrine and Adderall
Dexedrine and Adderall have each been associated with strokes, myocardial infarction, and sudden death in children and adults. These may be more likely to occur in patients with pre-existing cardiac conditions. Prescribers should screen for these conditions and use extreme caution in prescribing these drugs for patients who may have cardiac abnormalities.
Dexedrine and Adderall, along with other CNS stimulants, have been associated with moderate increases in blood pressure and heart rate. These parameters should be monitored when patients take stimulants.
Some types of ADHD medication, such as Dexedrine and Adderall, can exacerbate behavior disturbances in patients with pre-existing psychiatric disorders. These patients should be monitored closely if CNS stimulants are necessary. Bipolar patients may experience mixed or manic episodes while on CNS stimulants.
Long-term use of stimulants in children and adolescents has been linked to growth suppression. Patients experiencing slow growth while on stimulants may be encouraged to temporarily pause treatment. Oftentimes, healthcare providers recommend taking breaks from treatment when children are not in school, such as on weekends, holidays, and summer breaks.
If you have experienced allergic reactions to other stimulants or amphetamine drugs, you should not take Dexedrine or Adderall.
Frequently asked questions about Dexedrine vs. Adderall
Are Dexedrine and Adderall the same?
Dexedrine and Adderall are similar drugs but are not exactly the same. Dexedrine is composed of dextroamphetamine sulfate, while Adderall is made of mixed amphetamine salts, including dextroamphetamine. Both drugs are CNS stimulants and have similar side effects and drug interaction profiles.
Is Dexedrine or Adderall better?
Collective data across multiple studies comparing amphetamine treatments to placebo in the treatment of ADHD showed that Adderall may be preferred as it showed some improvement in ADHD symptoms, while Dexedrine did not. Amphetamine drugs overall cause side effects, which may make it difficult for some patients to continue treatment long-term.
Can I use Dexedrine or Adderall while pregnant?
Dexedrine and Adderall are pregnancy category C, meaning there are no adequate, controlled studies to establish safety. These drugs should only be used in pregnancy when the benefit clearly outweighs the risk.
Can I use Dexedrine or Adderall with alcohol?
Alcohol use could increase the serum blood concentrations of Dexedrine and Adderall, and therefore, alcohol should be avoided when on these medications.
Is there a supply shortage of Dexedrine or Adderall in pharmacies?
In late 2022, the FDA publicly announced that there was a shortage of Adderall in the U.S. drug marketplace. Since then, periodic shortages of many stimulants, including Dexedrine generics, have continued. These shortages are expected to be mostly corrected at this time, but you may need to check with your pharmacy to ensure they have the drug in stock.
Sources
- Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults, Cochrane Database Syst Rev (2018)
- A Randomized Controlled Trial of Interventions for Growth Suppression in Children With Attention-Deficit/Hyperactivity Disorder Treated With Central Nervous System Stimulants, J Am Acad Adolesc Psychiatry (2020)
- Dexedrine, NIH DailyMed (2023)
- Adderall, NIH DailyMed (2023)
- FDA Announces Shortage of Adderall, FDA (2023)