Eli5 how Adderall works
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I know this is ELI5, but I find overly simplistic explanations to be inaccurate and missing important information. I prefer to just lay things out and try to explain them.
Adderall is a mix of 4 different amphetamine salts. Amphetamine itself is a chiral molecule, which means it has two stereoisomers; an isomer is a form of a molecule that is shaped differently but retains the same chemical formula, and more specifically, a stereoisomer is an isomer whose shape is identical in all ways aside from being mirrored. The best analogy would be your hands; they have the same tendons and bones arranged in the same configuration, but they’re mirrored.
That’s what Adderall IS. What it DOES is it acts as a triple monoamine releaser. Monoamines are neurotransmitters (molecules that brain cells release to send signals to one another), and in this case the “triple” refers to dopamine, serotonin, and norepinephrine. Amphetamine shares structural similarities to these monoamines, and so can be taken into the brain cells by transporter proteins, which usually do the job of collecting extra neurotransmitters and bringing them back into the cell to be reused.
What it does when it gets into the cell is reverse the direction of the transporter proteins, pumping more monoamines out of the cell, causing the cells to send stronger signals to one another. While amphetamine is TECHNICALLY a triple monoamine releaser, it predominantly targets dopamine and norepinephrine with little activity regarding serotonin. A drug like Ritalin/methylphenidate is also a CNS stimulant, but it selectively targets dopamine and norepinephrine transport proteins without any action at serotonin whatsoever. Also, Ritalin is merely a reuptake protein inhibitor and does not cause any release like amphetamine does. Cocaine is yet another stimulant, and it is a triple monoamine reuptake inhibitor, but does not cause release.
What all of THAT does is enhance focus, memory, and motivation because dopamine and norepinephrine are not just neurotransmitters, they’re neuromodulators. A neurotransmitter like glutamate or GABA send a single signal between cells, but neuromodulators can send signals from one region of the brain to another and cause entire cascades of resulting signals depending on which cells are talking to which region. Neurotransmitters are like a bunch of employees sitting in a conference room talking amongst each other, whereas the neuromodulators are like the team leads who come down with a message from corporate and tell everyone at the conference what it is to discuss.
So amphetamine releasing higher levels of dopamine and norepinephrine than normal starts activating the parts of the brain responsible for taking in information and assigning it importance in order to commit it to memory, as well as raising energy levels in order to put thoughts into action and begin taking steps in order to achieve a goal. Say you stumbled upon a nice berry bush in the wild and ate some berries; the sugar causes a release of dopamine, and the dopamine makes your brain start taking notes of where you are, what the bush looks like, how you got here, etc. So that you are more likely to repeat the process in the future and acquire more berries next time you’re hungry. Similarly, say you stumble upon a bear you weren’t expecting and your norepinephrine starts pumping; your respiration and heart rate elevate, and non-time sensitive processes such as digestion are put on hold in order to divert energy towards decision making and physical exertion to get out of danger.
These are naturally occurring examples of the roles these neuromodulators play in our lives and how they developed to serve those roles. Adderall bypasses the need for external stimuli to leverage these chemicals in order meet those same purposes in a world that isn’t as exciting or high stakes for people with ADHD, or for people whose ADHD is bad enough that they struggle to do things they do enjoy.
It’s a very wordy and technical explanation, but I still think most people can understand it and it paints the full picture. Even if it doesn’t fully satisfy you now, your understanding of what I’ve laid out can develop over time and you can reach a more satisfying answer to your question.
Edit: Thank you everyone for the positive feedback! I’m used to getting told “That’s too complicated, no 5 year old would understand that” and having to remind people this sub isn’t for literal 5 year olds.
It may take me a bit because I get burnt out on replying very quickly but if anyone has any further questions, feel free to leave them and I will get back to everyone with as much info as I can. While my knowledge can be extensive, it tends to be very narrow in scope.
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