Eli5: researching amphetamines and methylphenidates mentions isomers frequently, I don’t get the biochemistry of it

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Don’t even know what isomers do in the body. I’m trying to find a stimulant that will work well with my brain, it tells me a lot about how my brain works when I can tolerate vyvanse over adderall. I’ve researched on every single stimulant available & they essentially all work on dopamine, seratonin & the other one lmao. I know some have just dextro & then dextro and levo, I get the chemistry of it but how the chemistry works in the brain is confusing me, I get that some tell dopamine to keep producing & some overflow dopamine, I just don’t get what isomers & the many other things it’s doing. I want to know every single detail of what they’re doing to my body and why. I want to find the most effective one for me & know how to keep myself healthy based on what it effects.

Note: I see a psychiatrist but she is not going to teach me chemistry so this is for my own awareness. It is also fascinating. Even if I were to take medical advice, a medical professional would have to approve it so I don’t get those comments.

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Two isomers of the same chemical have the same constituent make-up of atoms, but a different molecular shape. The dextro- and levo- distinction refers to the molecule’s chirality, meaning the shape has a twist to it. Something with a twisted shape can twist either to the left or to the right (right = dextro). If you had a box of bolts and half of them had threads that twisted the opposite way, it would be difficult to use them. Not impossible, but annoying.

In biochemistry, chirality is sometimes really important and sometimes not at all important. Interactions between proteins in the body are often dependent on chirality – a left handed bolt will not fit into a right handed nut, even though it looks just like a regular bolt at first glance. On the other hand, a crescent wrench can be fitted very easily onto the hex-head of any right or left-handed bolt, because it doesn’t interact with the threaded part at all. So the presence of isomers makes a difference if the chiral (twisted) part of the protein is part of its function.

All hormones and neurotransmitters are proteins. Some are chiral, some are not. Some chiral proteins depend on the chiral structure to perform their function, some don’t.

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