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Mixed amphetamine salts is a central nervous system (CNS) stimulant medication composed of four salts of amphetamine: dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate. This specific combination results in a 3:1 ratio of the dextroamphetamine (d-amphetamine) and levoamphetamine (l-amphetamine) isomers. It is primarily indicated for the treatment of Attention-Deficit Hyperactivity Disorder (ADHD) and narcolepsy. The drug works by increasing the synaptic concentrations of dopamine and norepinephrine through several mechanisms, including the inhibition of reuptake via the dopamine transporter (DAT) and norepinephrine transporter (NET), and the promotion of neurotransmitter release from presynaptic neurons. It also acts as an agonist at the trace amine-associated receptor 1 (TAAR1) and inhibits the vesicular monoamine transporter 2 (VMAT2). Originally developed by Richwood Pharmaceutical (later acquired by Shire, now part of Takeda), it is available in both immediate-release and extended-release formulations.
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