Methamphetamine
DESOXYN
Pronunciation: meth-am-FET-a-meen
“I Desire oxy and Meth”
What it isPotent CNS stimulant that increases synaptic dopamine and norepinephrine; approved for ADHD and rarely for short-term obesity treatment.
Why this oneCan work in severe refractory ADHD, but offers little practical advantage over safer stimulants.
What limits itVery high abuse liability plus cardiovascular and psychiatric toxicity make it a last-line choice; avoid with MAO inhibitors and serious heart disease.
FDA-approved for
- ADHD / obesity (Desoxyn, Schedule II) (1943)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| ADHD | peds >=6 yr | 5 mg QD or BID | 20-25 mg/day | 25 mg/day |
Titration Increase in 5 mg increments at weekly intervals
Renal Undefined
Hepatic Undefined
Instructions
- Give once daily or in two divided doses; avoid late-evening dosing due to insomnia risk
- Screen for cardiac disease and tics/Tourette history before starting
- Urinary acidifiers lower and alkalinizers raise blood levels; adjust dose by response
Available strengths
- tab 5 mg
Contraindications
- MAOIs (concurrently or within 14 days) due to risk of serotonin syndrome
Cautions
- Serious cardiac disease — avoid use
- Increased blood pressure and heart rate
- Psychiatric adverse reactions (new psychosis/mania)
- Long-term growth suppression in pediatric patients
- Peripheral vasculopathy incl. Raynaud phenomenon
- May lower seizure threshold
- Serotonin syndrome with serotonergic agents
- Motor/verbal tics and worsening Tourette syndrome
Adverse reactions
- Elevated blood pressure, tachycardia, palpitations
- Psychotic episodes, dizziness, insomnia, tremor, restlessness, headache
- Dry mouth, unpleasant taste, diarrhea/constipation
- Urticaria
Pregnancy No drug-associated risk of major birth defects/miscarriage identified; risk of neonatal withdrawal, premature delivery, low birth weight
Lactation Breastfeeding not recommended
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 5 mg | tab | per unit | $5.10/ea | not offered |
Generic entry2004
⚠ BOXED WARNING
- High potential for abuse and misuse leading to substance-use disorder, addiction, overdose, and death; assess risk and monitor throughout treatment
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityVery high misuse potential with severe hyperthermia, psychosis, cardiovascular collapse and neurotoxicity.
Serotonin and MAOI
Provisional washout figures
Elevating mechanismNone identified
Non-elevating actionNone recorded
Exposure dependenceNo serotonin-elevating mechanism identified
Evidence confidenceModerate
InterpretationNo clinically meaningful serotonin-elevating mechanism identified in this first-pass Gillman-based review.