Medication approval journey

amphetamine (Adderall XR)

Approved for ADHD in children, adolescents and adults

FDA approvedStimulantTaper risk: moderate

Before changing anything

Stopping abruptly causes withdrawal effects that can be severe

Stopping a stimulant abruptly after regular use commonly causes a crash — fatigue, low mood, heavy sleep. It is not usually dangerous, but it is worth planning rather than improvising.

How long the trials actually ran

The gap between how long the trials ran and how long people actually take these medications is the single most important thing on this page. It is not evidence that longer use is unsafe or ineffective. It is evidence that longer use was not what got tested.

The approval, step by step

  1. Step 1

    What the approval was actually based on

    Which studies did the FDA rely on, how long did they run, and who was in them?

    A double-blind, randomized, placebo-controlled, parallel-group study was conducted in children aged 6 to 12 (N=584)... for three weeks... A double-blind, randomized, placebo-controlled, parallel-group study was conducted in adults (N=255) who met DSM-IV criteria for ADHD... or placebo once daily in the morning for four weeks.
  2. Step 2

    The approval

    When was it approved, under what application, and by whose review?

    Approved
    October 11, 2001
    Application
    NDA021303
    Review
    STANDARD
  3. Step 3

    What was added after it was on the market

    Which warnings arrived only after millions of people were already taking it?

  4. Step 4

    What independent research has found since

    What has been learned by people who were not selling it?

  5. Step 5

    What still is not known

    Which questions you might reasonably have has nobody answered yet?

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