There are rare cases where it's appropriate. Other amphetamines, such as Adderall, activate more norepinephrine at comparable effective dosages, while Desoxyn skews more strongly to just dopamine, which can make Adderall cause more anxiety, bigger heart rate spikes. Adderall also has a different metabolic pathway, which can sometimes mean that Adderall causes problematic side effects that Desoxyn may not.

Still, it's very rare for it to be prescribed because the stigma and related regulatory, insurance, and patient acceptance factors just make it impractical even where it may be appropriate.

Most people would not be able to tell the difference between the two drugs if taken at similar effective dosages and routes of administration. The recreational meth heads you might encounter out in the streets are generally either smoking or injecting it, and at dramatically higher dosages than what would ever be prescribed therapeudically.