Mixed amphetamine salts extended release: a clinical review of its use in the treatment of attention-deficit hyperactivity disorder

Mixed amphetamine salts extended release (MAS-XR) has been demonstrated in pediatric, adolescent and adult studies to be a well tolerated and effective treatment for attention-deficit hyperactivity disorder (ADHD). MAS-XR utilizes a double-pulse delivery system to replicate the pharmacokinetic properties of equal doses of immediate-release MAS administered 4 h apart. Doses of 20 mg MAS-XR produce significant reductions of core symptoms of ADHD over a 12-h period. Adverse effects observed in controlled studies include anorexia, weight loss, dry mouth, insomnia and abdominal pain, and rates of adverse effects are comparable to other stimulant agents approved for ADHD. At this time, there are no data to suggest that sudden death due to cardiovascular complications occurs more frequently in patients treated with MAS-XR than in the general population, but careful consideration of the risks and benefits of MAS-XR is warranted in patients with pre-existing structural heart disease and adult patients with a history of hypertension.