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Adderall XR + mixed amphetamine salts immediate release is a combination therapy involving both the extended-release (XR) and immediate-release (IR) formulations of mixed amphetamine salts. Both formulations contain four different amphetamine salt forms—dextroamphetamine saccharate, dextroamphetamine sulfate, amphetamine aspartate monohydrate (racemic), and amphetamine sulfate (racemic)—in a 3:1 ratio of dextroamphetamine to levoamphetamine. The IR formulation provides rapid onset and short duration of action (4–6 hours), while the XR formulation uses a dual-bead delivery system for biphasic release over up to 12 hours. This combination is sometimes used clinically to provide both sustained symptom control throughout the day and flexibility for acute symptom management in attention deficit hyperactivity disorder (ADHD) or narcolepsy. Mechanistically, these drugs act as central nervous system stimulants by increasing synaptic concentrations of dopamine and norepinephrine through promoting their release from presynaptic neurons[1][2][3][5][8].
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