ADDERALL

Amphetamine has over a century of clinical history and remains a first-line treatment for ADHD and narcolepsy, with robust evidence of short-term efficacy. A systematic review of adult ADHD treatments found amphetamines (mixed salts and lisdexamfetamine) had the most robust evidence among alternative agents, but noted serious side effects including psychotic symptoms and hypertension. A 2024 randomized non-inferiority trial comparing amphetamine-dextroamphetamine to modafinil for idiopathic hypersomnia and narcolepsy type 2 failed to demonstrate non-inferiority on the primary outcome but showed non-inferiority on multiple secondary measures. Long-term safety data remain limited, and the balance of benefit to risk is the key clinical challenge. Case reports document rare but serious adverse events such as ischemic colitis.