Desoxyn is prescription methamphetamine, also sold illegally. Its only approved use is childhood attention deficit hyperactivity disorder; all adult use is off the label. It reduces inattention and lifts alertness for a few hours, against the strongest addiction warning regulators issue, lasting blood pressure and heart rate rises, psychosis risk and sleep loss. Prolonged prescribed use is untested. (Full Review)

Protocol

Standard labelled protocol

5 mg once or twice daily

5 mg immediate-release tablets, in 5 mg weekly steps to a labelled 20–25 mg daily

Best time of day

On waking; second dose by midday

Later dosing overlaps the sleep window; splitting smooths the afternoon trough, single dosing better protects sleep

Baseline biomarkers influencing response

Ferritin above 50 ng/mL, thyroid corrected

Both distort response and can be mistaken for non-response; untreated sleep apnoea, anxiety or insomnia are treated first

Time to effect

Long-term dose identified

3–5 weeks

Weekly titration is usually needed to find the long-term symptom-control dose

Alertness and attention

30–60 minutes

Change follows the first dose and holds for several hours

Appetite suppression fades

Within weeks

Tolerance to the appetite-suppressing effect develops within weeks

Benefits

Medium: Reduction of core attention deficit hyperactivity disorder symptoms; acute improvement in alertness and psychomotor performance

Low: Short-term appetite suppression and weight loss; reduced illicit stimulant use as substitution therapy

Contraindications

Amphetamine hypersensitivity (prior angioedema, anaphylaxis)

Monoamine oxidase inhibitors, or within 14 days of stopping

Structural cardiac abnormality, cardiomyopathy, serious arrhythmia, coronary or other serious cardiac disease

Myocardial infarction (<90 days), unstable angina, Class III–IV heart failure

Uncontrolled hypertension (≥160/100 mmHg)

Untreated hyperthyroidism

Pulmonary arterial hypertension of any cause

Psychotic disorder or bipolar I, unless specialist-managed

Stimulant, cocaine or alcohol use disorder, or in a household member

Pregnancy and breastfeeding

Renal impairment (eGFR <30 mL/min/1.73 m²)

Narrow-angle glaucoma

Key Interactions

Serotonergic antidepressants (sertraline, venlafaxine)

CYP2D6 inhibitors (paroxetine, fluoxetine, bupropion, quinidine, terbinafine, ritonavir)

Tricyclics (amitriptyline, nortriptyline, imipramine)

Decongestants (pseudoephedrine, phenylephrine), high-dose caffeine

Antacids and urinary alkalinisers (sodium bicarbonate, calcium carbonate, potassium citrate)

Stimulant supplements (synephrine, higenamine, yohimbine, 1,3-dimethylamylamine analogues)

Serotonergic or catecholaminergic supplements (St John's wort, 5-hydroxytryptophan, L-Tryptophan, L-Tyrosine, high-dose S-adenosylmethionine)

Exposure-altering supplements (magnesium citrate, sodium bicarbonate, ascorbic acid)

Antihypertensives and guanethidine

Insulin and glucose-lowering drugs

Risk & Side Effects

High: Abuse, misuse, dependence and addiction; elevated blood pressure and heart rate; new-onset psychosis and mania; insomnia and sleep disruption

Medium: Cardiomyopathy and heart failure; pulmonary arterial hypertension; appetite suppression and unintended weight loss; headache, dry mouth, tremor, dizziness and gastrointestinal upset

Low: Persistent cognitive impairment after heavy exposure; stroke, arrhythmia and other acute cardiovascular events; peripheral vasculopathy and Raynaud's phenomenon; reduced seizure threshold; motor and verbal tics, and worsening of Tourette's syndrome; serotonin syndrome with serotonergic co-medication; Parkinson's disease risk

Speculative: Striatal dopamine terminal loss

Monitoring

Marker	Target	Why
Seated blood pressure	110–125 / 65–80 mmHg	Detects the sustained rise in blood pressure
Resting heart rate	55–70 bpm	Detects the drug's effect on heart rate
Corrected QT interval (QTc)	<430 ms	Screens arrhythmia risk from sympathomimetic stimulation
Body weight and body composition	Within 3% of pre-treatment weight, lean mass stable	Detects unmanaged appetite suppression
Ferritin	50–150 ng/mL	Iron is a cofactor for dopamine synthesis; low stores blunt response
Thyroid-stimulating hormone (TSH)	0.5–2.0 mIU/L	Excludes hyperthyroidism, which mimics and compounds stimulant effects
Fasting glucose and HbA1c	75–90 mg/dL; HbA1c 4.8–5.3%	Appetite suppression and altered meals change glycaemic control
Estimated glomerular filtration rate (eGFR)	>90 mL/min/1.73 m²	Clearance is predominantly renal, so declining function raises exposure
Serum potassium and magnesium	Potassium 4.0–4.5 mmol/L; magnesium 2.0–2.4 mg/dL	Low levels compound arrhythmia risk
Validated symptom scale score	Change from the individual's own pre-treatment score	The only direct measure of whether the drug is delivering benefit

Cadence: Blood pressure and heart rate twice weekly through titration, then at 4 weeks, 12 weeks and every 3–6 months; weight and symptom scales at those same points; laboratory work annually; electrocardiogram only if symptoms or a substantial dose increase warrant it.

Qualitative Assessment

Total sleep time and morning refreshment, tracked nightly — the earliest signal of dosing that is too late or too high
Afternoon rebound irritability or flatness, pointing to a trough rather than too low a dose
Appetite and meal completion, recorded rather than recalled
Anxiety, jaw clenching and restlessness, usually appearing before blood pressure moves
Cold or colour-changing fingers and toes
Breathlessness or reduced exercise tolerance
Any perceptual disturbance, paranoid thinking or several consecutive nights of reduced sleep with elevated mood — a stop signal, not a monitoring item

Desoxyn for Health & Longevity

Protocol

Benefits

Risk & Side Effects

Monitoring

Qualitative Assessment