Download Garrett Peters 3/31/2013 Writing 340 Adderall: An A+ in a Bottle

Garrett Peters
3/31/2013
Writing 340
Adderall: An A+ in a Bottle
Adderall is a prescription medication typically used to treat people with attention deficit
hyperactivity disorder (ADHD). The drug is a mixture of amphetamine salts that work by
manipulating dopamine receptors in the nervous system. Long term and recreational use
of the drug can have some notable side-effects. Recently, the drug has grown in
popularity on college campuses. Adderall’s ability to increase focus, motivation, and
energy makes it an ideal pill for all-nighters and finals studying.
Keywords: Adderall, Amphetamines, Study Drugs, ADHD, Attention Deficit Hyperactivity
Disorder, Isomers, Stereochemistry, Dopamine, Chemistry, Chemical Engineering
Multimedia:
http://thebrain.mcgill.ca/flash/i/i_03/i_03_m/i_03_m_par/i_03_m_par_amphetamine.html
Bio: Garrett Peters is a sophomore studying chemical engineering at USC’s Viterbi School of
Engineering. Currently, he is conducting research on campus on the hydrogen storage capability
of carbon nanotubes and aspires to work in the pharmaceutical industry after college.
Garrett Peters
3/31/2013
Writing 340
Introduction
Finals season is one of the most stressful periods for college students. Finding the drive
to study hours on end for multiple classes is challenging, to say the least. For some, finding the
energy and focus is as simple as popping a pill. Adderall, a mixture of amphetamine salts,
provides many students with the ability to stay energized and motivated to study [1]. Many of
these students lack a prescription for the drug and obtain the medication from a friend or another
student. The use of Adderall has become ubiquitous around college campuses, causing worry
amongst parents and administration. Understanding the mechanisms behind how these
amphetamines work provides a glimpse into organic chemistry and how our nervous systems
operate. Although the side effects of the drug are mostly harmless, the morality and implications
of Adderall use in academia are questionable.
Attention Deficit Disorder
Adderall’s primary intended use is to treat ADHD. Attention Deficit Disorder is a
condition in which “a person has trouble paying attention and focusing on tasks, tends to act
without thinking, and has trouble sitting still” [2]. These symptoms are not ideal in a classroom
setting, especially during long lectures. Students and children suffering from this condition may
find it hard to perform well in school regardless of adequate effort. Doctors are unsure of the
causes of the condition, but there are several treatment options available. The first option is
usually behavior therapy in which parents and children learn strategies to improve focusing
power. This therapy is typically coupled with the use of medicine such as Adderall. Adderall
improves symptoms for 70% of ADHD sufferers and makes classroom education possible [2].
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Chemistry of Adderall
Adderall is effective at treating ADHD because it is composed of a mixture of
amphetamine salts. Each pill is made of a quarter of the following compounds:
dextroamphetamine, saccharate, dextroamphetamine sulfate, amphetamine aspartate
monohydrate, and amphetamine sulfate. The driving forces behind the mechanism of Adderall
are the actions made by these amphetamines. Amphetamines have the chemical formula C9H13N,
meaning they have 9 carbon atoms, 13 hydrogen atoms, and one nitrogen atom [3]. The structure
of an amphetamine can be seen Figure 1.
Figure 1: Chemical Structure of Amphetamine [3]
Each bending point between the line segments represents a carbon atom. The lines
themselves represent a bond between the atoms while the double lines in the ring represent a
double bond between carbons atoms. Chemical bonds are simply the sharing of an electron
between two atoms. Although Figure 1 appears flat, the carbon and nitrogen bonds outside the
ring lie in a 3 dimensional plane. A hydrogen atom is also bonded to the carbon that the arrow
points to (the lack of the hydrogen atom is merely a shortcut that chemists use for these types of
pictures; the hydrogen atoms are “implied” in the drawing). This formation creates a tetrahedral
shape for that section of the compound. There are two different molecules depending on the
orientation of the tetrahedral even though the molecular formula is the same. This concept is the
same idea behind your left and right hand. Although they are pretty much the same composition
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Writing 340
and structure, your left hand and right cannot be superimposed onto each other. You cannot flip
around a right –handed glove in any way to make it fit on your left hand. Figure 2 shows
tetrahedral compounds displaying this concept. If you try to spin one of the compounds, it will
never match the other.
Figure 2: Mirror Image Isomers [4]
In chemistry, these structures with the same chemical formulas but different structures
are called isomers [4]. Amphatemine has two isomers. If the hydrogen is sticking into the paper,
it is dextroamphetamine. Looking back to Figure 1, if the hydrogen is sticking out of the paper, it
is levoamphetamine [3]. Adderall has a dextroamphetamine to levoamphetamine ratio of 3:1 [1].
Many of the negative peripheral side effects of Adderall come from levoamphetamine such as
high pulse, headaches, and depression. Dextroamphetamine, on the other hand (literally and
figuratively), provides most of the positive mental side effects of Adderall and is responsible for
the sense of euphoria and other mind effects. Mirror image molecules, known specifically as
enantiomers, have all the same physical properties as their partner molecules such as boiling
point and melting point due to their similar spatial arrangements. However, this makes them
difficult to separate, especially because most production methods will produce these enantiomers
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in equal amounts [3]. Leaving a little levoamphetamine in Adderall actually does provide some
positive effects in addition to saving money for pharmaceutical companies through incomplete
purification. The enantiomer helps to improve poor sustained attention, which in layman’s terms
is the pill’s ability to physically lock people into what they are focusing on [5]. People who have
trouble with the negative side effects of Adderall can try out Dexedrine, which only has the
dextroamphetamine isomer of amphetamine that is easier on the body.
Mechanism of Action
Dextroamphetamine and levoamphetamine, the active ingredients of Adderall, are
stimulants. Stimulants are a class of drugs that increase physical and mental function [6]. These
drugs work mainly by manipulating dopamine receptors. On a normal synaptic terminal of
dopamine neurons (a nerve cell with dopamine receptors), dopamine molecules (DA) are held
inside storage vesicles. The vesicular monoamine transporter (VMAT) controls the flow of
dopamine into the vesicle. To release dopamine, the vesicles will travel to the plasma membrane
of the cell and directly release dopamine outside the nerve. Once outside, the dopamine attaches
to the dopamine receptors to send off their positive signals to the brain. Afterwards, the
dopamine reuptake valve (DAT) controls the flow of dopamine back into the cell where they will
be trapped inside another vesicle through the VMAT so as to not overload the receptors with
dopamine signals [6].
Amphetamine and its isomers change this process. These drugs are actually substrates of
the DAT and VMAT, meaning they can travel through both transporters. Amphetamines
compete with dopamine for travel back through the DAT, leaving more dopamine outside the
nerve cell. Once inside, amphetamines will travel through the VMAT and replace the dopamine
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inside the vesicles. The dopamine is unnaturally forced out of the vesicles and travels through the
DAT to the dopamine receptors outside the cell. This mechanism increases the total amount of
dopamine being released. Cocaine, another stimulant, works in an eerily similar fashion. Cocaine
inhibits the DAT from letting dopamine back into the nerve cell, forcing a buildup of dopamine
around the dopamine receptors [6]. Figure 3 outlines the mechanism of both of these drugs.
Figure 3: Diagram of Cocaine and Amphetamine Mechanisms [6]
In addition, amphetamines can bind with and hinder monoamine oxidase, a molecule which
breaks down and destroys dopamine [7]. Also, amphetamines can bind to the DAT and make it
work in reverse to shoot out dopamine that was just released from a vesicle [7]. Dopamine is a
neurotransmitter responsible for reward driven learning and your body’s feeling of pleasure [6].
The increase in dopamine from amphetamines increases energy, drive, and focus for the duration
of the drug. Therefore, you want to focus and study because it feels good. However, drugs that
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increase dopamine levels are also extremely addictive [6]. Frequent use of Adderall can lead to
an addiction to the drug that can potentially cause problems.
Short-Term Side Effects
Although Adderall can be very useful for people diagnosed with ADHD through its
manipulation of dopamine levels, there are potential side effects of the drug that should not be
ignored. Primarily, stimulants are known for their ability to decrease appetite. Adderall was first
introduced into the world as Obetrol, a pill used for weight loss [8]. This side effect remains and
is still a concern for Adderall users and many lose unhealthy amounts of weight. Furthermore,
Adderall prevents sleep. For this reason, the drug is also prescribed for people with narcolepsy
[1]. This side effect does not cause too much of a problem for college students since most want
to stay awake and study all night when taking the drug. While on the drug, some users
experience increased irritability and paranoia [1]. Again, a student studying would not have a
problem with these side effects when they are isolated with their studies. The drug can also
trigger headaches, stomach pain, restlessness, and nausea for some users of the drug [1]. Overall,
Adderall is not harmful to the majority of short-term users who understand these potential sideeffects.
Long Term Side Effects
Extended use of Adderall can have different effects on patients. A year of Adderall use or
other stimulants “increases your diastolic blood pressure by ~ 3-5mm HG, systolic blood
pressure by ~ 2-5mm HG and your heart rate ~ 3-5 beats per minute” [9]. Whether or not this is
harmful for your body is not necessarily known yet, but in general, faster heart rates at those
levels are not that dangerous. However, studies have shown that users of Adderall that do not
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have ADHD are more likely to have heart problems, especially if the user already has preexisting
heart conditions. Specifically, users are 20% more likely to go to the emergency room for a
heart condition while on the drug [9]. Furthermore, Adderall has a permanent effect on the brain.
Studies conclude that stimulant use in ADHD patients grows parts of the brain in control of
“focus, motivation and attention” [9]. Interestingly, this is a constructive side effect that users
benefit from in the long term. On the negative side, Adderall can stunt growth with extended use
during adolescent ages [1]. Because most college students have gone through their growth spurts,
this side-effect has little impact on university campuses. Despite a lack of long-term studies on
non-prescribed users of Adderall, the general consensus suggests that intermittent long term use
is safe. Fortunately for people suffering from ADHD, long term use of Adderall does not
decrease its potency. People who use the drug for years do not develop a significant tolerance
and therefore Adderall can be a long term solution for people suffering from ADHD [9].
Recreational Use
Adderall is used for more than its original prescribed purposes. Because of the drug’s
ability to energize by releasing dopamine, amphetamines are often consumed for recreational
use. Like cocaine and other stimulants with similar mechanisms, Adderall allows people to stay
up and party for longer periods of time without getting tired and falling asleep [10]. Although
overdosing on the drug is possible, the main concern from Adderall comes from its combination
with alcohol. The stimulating effects from Adderall mask the depressant side effects induced
from alcohol. As a result, people drink more to compensate this lack of feeling “drunk.” In
actuality, they are much more intoxicated than they perceive and can to drink to the point of
alcohol poisoning [10]. Caffeinated alcoholic drinks have a similar effect, but not to the same
degree as amphetamines.
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Use in Academia
Although recreational use is a concern, the main issue regarding Adderall abuse on
campuses is its use as a study drug. 34.5% of college students admitted to using Adderall in
2012 and this number continues to grow [11]. The increase in pressure for students to do well has
driven nonprescription Adderall use to new highs, especially with the competition in today’s job
market. The morality of this use is debatable. Students with ADHD need the drug to be able to
study and pay attention. Non-ADHD users, on the other hand, are able to study hours on end and
pull all-nighters with the drug which most students are normally incapable of [12]. This drug
gives students an incredible edge over non-users, and even prescribed ADHD users are unable to
keep up with non-ADHD student users. Essentially, the drug is the steroid of the academic
world. For around $5.00 a pill, a student can crank out hours of studying or write full essays.
This is an inexpensive cost considering how much money is put into college tuition versus the
edge the pill provides. Because the pill is relatively harmless for most students, parents should
not be too concerned for the health of their children who might be using the drug in school. The
side effects are temporary and the risk of addiction is low when used sporadically for finals and
an occasional essay or project.
Future of Adderall
There is little that can be done to decrease Adderall use on campus. Doctors can be
stricter with their diagnosis of ADHD and pharmacies can limit the supply of the drug. However,
the drug’s high demand and its profitability in the pharmaceutical industry will likely keep the
drug alive in academia for future years. Adderall is too effective at increasing focus and drive for
extended periods of time with a relatively small financial cost for students. Fortunately, the short
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term and long term side effects of the drug suggest that there is little harm for occasional use in
academia. The main concern towards the drug should be directed at the general implications of a
study-drug. In today’s competitive job market, how far are we willing to go to receive better
grades to secure a solid career? Although Adderall may be harmless for most users, future studydrugs and other routes to good grades may not be so forgiving. People may feel pressured into
taking these harmful drugs to keep up with other students in an increasingly completive
atmosphere. Regardless, Adderall is still an invaluable solution for many victims of ADHD who
would normally be unable to function in a school or work setting without the help of the drug.
Garrett Peters
3/31/2013
Writing 340
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