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Mixed amphetamine salts (MAS) is a central nervous system (CNS) stimulant composed of a specific 3:1 ratio of dextroamphetamine and levoamphetamine salts. The formulation typically includes four distinct salts: dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate. It is primarily indicated for the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. The drug's mechanism of action involves increasing the synaptic concentrations of the monoamines dopamine and norepinephrine. It achieves this by acting as a competitive inhibitor and a substrate-releaser at the dopamine transporter (DAT) and norepinephrine transporter (NET), as well as by activating the trace amine-associated receptor 1 (TAAR1) and inhibiting the vesicular monoamine transporter 2 (VMAT2). Originally developed by Richwood Pharmaceutical (later acquired by Shire, which was subsequently acquired by Takeda), it is available in immediate-release (Adderall) and various extended-release (Adderall XR, Mydayis) formulations.
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