Lisdexamfetamine: Difference between revisions

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==Chemistry==

Lisdexamphetamine is a [https://en.wikipedia.org/wiki/Codrug codrug] composed of the amino acid L-lysine, covalently bonded to [[dextroamphetamine]].<ref name="pmid17407369">{{cite journal | vauthors = Blick SK, Keating GM | title = Lisdexamfetamine | journal = Paediatric Drugs | volume = 9 | issue = 2 | pages = 129–135; discussion 136–138 | date = 2007 | pmid = 17407369 | doi = 10.2165/00148581-200709020-00007 | url = }}</ref> Amphetamine is comprised of a [[phenethylamine]] core featuring a phenyl ring bound to an amino (NH2) group through an ethyl chain with an additional methyl substitution at Rα. It can be referred to as a methyl homologue of [[phenethylamine]] as it has the same general formula, differing only in the addition of one methyl group.

Lisdexamphetamine is a [https://en.wikipedia.org/wiki/Codrug codrug] composed of the amino acid L-lysine, covalently bonded to [[dextroamphetamine]].<ref name="pmid17407369">{{cite journal | vauthors = Blick SK, Keating GM | title = Lisdexamfetamine | journal = Paediatric Drugs | volume = 9 | issue = 2 | pages = 129–135; discussion 136–138 | date = 2007 | pmid = 17407369 | doi = 10.2165/00148581-200709020-00007 | url = }}</ref> [[Amphetamine]] is comprised of a [[phenethylamine]] core featuring a phenyl ring bound to an amino (NH2) group through an ethyl chain with an additional methyl substitution at Rα. It can be referred to as a methyl homologue of [[phenethylamine]] as it has the same general formula, differing only in the addition of one methyl group.

==Pharmacology==

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===Pharmacokinetics===

As a [[prodrug]], lisdexamfetamine is inactive in the form administered. Once ingested, it is enzymatically cleaved into two parts: L-lysine, a naturally occurring essential amino acid, and [[dextroamphetamine]], a central nervous system stimulant. Thus lisdexamfetamine functions as an extended release version of [[dextroamphetamine]]. Because [[dextroamphetamine]] needs to be liberated from lysine via contact with red blood cells, effects are independent of route of administration. Conversion of lisdexamfetamine into active [[dextroamphetamine]] is enzymatically [[Rate-Limiting Step|rate-limited]], slowing down the time to achieve peak concentrations and decreasing its magnitude and dampening consequent striatal dopamine release, which is thought to be responsible for its euphoric and [[compulsive redosing]] effects.

As a [[prodrug]], lisdexamfetamine is inactive in the form administered. Once ingested, it is enzymatically cleaved into two parts: L-lysine, a naturally occurring essential amino acid, and [[dextroamphetamine]], a central nervous system stimulant. Thus lisdexamfetamine functions as an extended release version of [[dextroamphetamine]]. Because [[dextroamphetamine]] needs to be liberated from lysine via contact with red blood cells, effects are independent of route of administration. Conversion of lisdexamfetamine into active [[dextroamphetamine]] is enzymatically [[Rate-Limiting Step|rate-limited]], slowing down the time to achieve peak concentrations and decreasing its magnitude and dampening consequent striatal [[dopamine]] release, which is thought to be responsible for its euphoric and [[compulsive redosing]] effects.

===Pharmacodymanics===

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===Overdose===

A severe [[amphetamine]] overdose can result in a [[stimulant psychosis]] that may involve a variety of symptoms, such as paranoia, delusions, and hallucinations, including the infamous [[Shadow people]]. A Cochrane Collaboration review on treatment for [[amphetamine]], [[dextroamphetamine]], and [[methamphetamine]] psychosis states that about 5–15% of users fail to recover completely. According to the same review, there is at least one trial that shows antipsychotic medications effectively resolve the symptoms of acute amphetamine psychosis. Psychosis very rarely arises from therapeutic use. The combination of prolonged use of high doses combined with sleep deprivation significantly increases the risk of stimulant psychosis.

A severe [[amphetamine]] overdose can result in a [[stimulant psychosis]] that may involve a variety of symptoms, such as paranoia, delusions, and hallucinations, including the infamous [[Shadow people]]. A Cochrane Collaboration review on treatment for [[amphetamine]], [[dextroamphetamine]], and [[methamphetamine]] psychosis states that about 5–15% of users fail to recover completely. According to the same review, there is at least one trial that shows antipsychotic medications effectively resolve the symptoms of acute [[amphetamine]] [[psychosis]]. [[Psychosis]] very rarely arises from therapeutic use. The combination of prolonged use of high doses combined with sleep deprivation significantly increases the risk of [[stimulant psychosis]].

===Dangerous interactions===

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==Legal status==

~~Lisdexamphetamine is approved for medical use with a doctor's prescription, but in~~ most countries it is illegal to sell or possess without a prescription.{{citation needed}}~~ ~~

In most countries lisdexamfetamine is illegal to sell or possess without a prescription.{{citation needed}}

It requires a special certificate while traveling within the [https://en.wikipedia.org/wiki/Schengen_Area Schengen Area], which covers most of Europe, but not the United Kingdom.<ref name="swe" /><ref>http://www.felleskatalogen.no/medisin/elvanse-shire-pharmaceutical-contracts-ltd-588199</ref>

@@ Line 15: / Line 15: @@
 ==Chemistry==
-Lisdexamphetamine is a [https://en.wikipedia.org/wiki/Codrug codrug] composed of the amino acid <small>L</small>-lysine, covalently bonded to [[dextroamphetamine]].<ref name="pmid17407369">{{cite journal | vauthors = Blick SK, Keating GM | title = Lisdexamfetamine | journal = Paediatric Drugs | volume = 9 | issue = 2 | pages = 129–135; discussion 136–138 | date = 2007 | pmid = 17407369 | doi = 10.2165/00148581-200709020-00007 | url = }}</ref> Amphetamine is comprised of a [[phenethylamine]] core featuring a phenyl ring bound to an amino (NH<sub>2</sub>) group through an ethyl chain with an additional methyl substitution at R<sub>α</sub>. It can be referred to as a methyl homologue of [[phenethylamine]] as it has the same general formula, differing only in the addition of one methyl group.
+Lisdexamphetamine is a [https://en.wikipedia.org/wiki/Codrug codrug] composed of the amino acid <small>L</small>-lysine, covalently bonded to [[dextroamphetamine]].<ref name="pmid17407369">{{cite journal | vauthors = Blick SK, Keating GM | title = Lisdexamfetamine | journal = Paediatric Drugs | volume = 9 | issue = 2 | pages = 129–135; discussion 136–138 | date = 2007 | pmid = 17407369 | doi = 10.2165/00148581-200709020-00007 | url = }}</ref> [[Amphetamine]] is comprised of a [[phenethylamine]] core featuring a phenyl ring bound to an amino (NH<sub>2</sub>) group through an ethyl chain with an additional methyl substitution at R<sub>α</sub>. It can be referred to as a methyl homologue of [[phenethylamine]] as it has the same general formula, differing only in the addition of one methyl group.
 ==Pharmacology==
@@ Line 21: / Line 21: @@
 ===Pharmacokinetics===
-As a [[prodrug]], lisdexamfetamine is inactive in the form administered. Once ingested, it is enzymatically cleaved into two parts: L-lysine, a naturally occurring essential amino acid, and [[dextroamphetamine]], a central nervous system stimulant. Thus lisdexamfetamine functions as an extended release version of [[dextroamphetamine]]. Because [[dextroamphetamine]] needs to be liberated from lysine via contact with red blood cells, effects are independent of route of administration. Conversion of lisdexamfetamine into active [[dextroamphetamine]] is enzymatically [[Rate-Limiting Step|rate-limited]], slowing down the time to achieve peak concentrations and decreasing its magnitude and dampening consequent striatal dopamine release, which is thought to be responsible for its euphoric and [[compulsive redosing]] effects.
+As a [[prodrug]], lisdexamfetamine is inactive in the form administered. Once ingested, it is enzymatically cleaved into two parts: L-lysine, a naturally occurring essential amino acid, and [[dextroamphetamine]], a central nervous system stimulant. Thus lisdexamfetamine functions as an extended release version of [[dextroamphetamine]]. Because [[dextroamphetamine]] needs to be liberated from lysine via contact with red blood cells, effects are independent of route of administration. Conversion of lisdexamfetamine into active [[dextroamphetamine]] is enzymatically [[Rate-Limiting Step|rate-limited]], slowing down the time to achieve peak concentrations and decreasing its magnitude and dampening consequent striatal [[dopamine]] release, which is thought to be responsible for its euphoric and [[compulsive redosing]] effects.
 ===Pharmacodymanics===
@@ Line 141: / Line 141: @@
 ===Overdose===
-A severe [[amphetamine]] overdose can result in a [[stimulant psychosis]] that may involve a variety of symptoms, such as paranoia, delusions, and hallucinations, including the infamous [[Shadow people]]. A Cochrane Collaboration review on treatment for [[amphetamine]], [[dextroamphetamine]], and [[methamphetamine]] psychosis states that about 5–15% of users fail to recover completely. According to the same review, there is at least one trial that shows antipsychotic medications effectively resolve the symptoms of acute amphetamine psychosis. Psychosis very rarely arises from therapeutic use. The combination of prolonged use of high doses combined with sleep deprivation significantly increases the risk of stimulant psychosis.
+A severe [[amphetamine]] overdose can result in a [[stimulant psychosis]] that may involve a variety of symptoms, such as paranoia, delusions, and hallucinations, including the infamous [[Shadow people]]. A Cochrane Collaboration review on treatment for [[amphetamine]], [[dextroamphetamine]], and [[methamphetamine]] psychosis states that about 5–15% of users fail to recover completely. According to the same review, there is at least one trial that shows antipsychotic medications effectively resolve the symptoms of acute [[amphetamine]] [[psychosis]]. [[Psychosis]] very rarely arises from therapeutic use. The combination of prolonged use of high doses combined with sleep deprivation significantly increases the risk of [[stimulant psychosis]].
 ===Dangerous interactions===
@@ Line 148: / Line 148: @@
 ==Legal status==
-Lisdexamphetamine is approved for medical use with a doctor's prescription, but in most countries it is illegal to sell or possess without a prescription.{{citation needed}}<br />
+In most countries lisdexamfetamine is illegal to sell or possess without a prescription.{{citation needed}}
 It requires a special certificate while traveling within the [https://en.wikipedia.org/wiki/Schengen_Area Schengen Area], which covers most of Europe, but not the United Kingdom.<ref name="swe" /><ref>http://www.felleskatalogen.no/medisin/elvanse-shire-pharmaceutical-contracts-ltd-588199</ref>