Everything you need to know about Adderall
What is Adderall?
A doctor may prescribe Adderall to treat ADHD.
Image credit: DMTrott, 2010
Adderall is a prescription medication that contains two stimulant drugs: amphetamine and dextroamphetamine.
Stimulant drugs increase the activity of certain brain chemicals.
Amphetamine and dextroamphetamine increase the availability of norepinephrine and dopamine in the brain. Together, these brain chemicals play a vital role in wakefulness and attention.
Adderall is available as either an oral tablet under the brand name Adderall or an extended-release oral tablet under the brand name Adderall XR.
The Food and Drug Administration (FDA) have approved Adderall for the treatment of ADHD and narcolepsy.
ADHD is a condition that usually appears in childhood or early adolescence. Characteristic symptoms include hyperactivity, impulsiveness, and difficulty paying attention.
Research shows that these symptoms are partly the result of decreased dopamine activity in the brain. Dopamine is a brain chemical that plays an important role in movement, motivation, and attention.
Adderall increases the availability of dopamine in the brain, helping alleviate ADHD symptoms.
Narcolepsy is a chronic sleep disorder that causes the following symptoms:
- excessive daytime sleepiness
- sleep attacks, in which a person experiences sudden overwhelming sleepiness
- sleep paralysis
- disrupted nighttime sleep
- cataplexy, or sudden muscle weakness that occurs in response to strong emotion
Narcolepsy may stem from the death of a particular type of brain cell. These cells produce the chemical hypocretin, which is essential for regulating the sleeping and waking cycle.
Stimulant medications, such as Adderall, boost the levels of a brain chemical called norepinephrine, which helps promote wakefulness.
Taking stimulants at the start of the day can promote daytime wakefulness, which may also help a person sleep better at night.
Common side effects of Adderall include headaches, dizziness, and anxiety.
Common side effects of Adderall include:
Children taking stimulant medications such as Adderall may also experience:
- temporarily delayed growth
- moodiness and irritability
In some cases, Adderall may cause more serious side effects. People should phone a doctor right away if they notice the following symptoms in themselves or a child in their care while taking Adderall:
- blurred vision
- increased blood pressure and heart rate
- chest pain
- shortness of breath
- cognitive impairments
- delusional thinking
- racing thoughts
People who feel as though they are experiencing a medical emergency should phone 911 or the emergency number in their area.
The risk of serious side effects is higher among people with certain preexisting medical conditions, such as:
- heart problems or heart defects
- a history of stroke or heart attack
- high blood pressure
- circulatory problems
- depression or anxiety
- bipolar disorder
- drug misuse or addiction
- recent use of monoamine oxidase inhibitors
- an allergy or hypersensitivity to stimulant drugs
While Adderall is a safe treatment option for many people, there are several possible risks. These include or relate to:
Pregnancy and breastfeeding
According to the FDA, there are no adequate, well-controlled studies investigating the effects of Adderall use during pregnancy.
It is possible that infants who have exposure to amphetamines during gestation are at increased risk of:
- premature birth
- low birth weight
- amphetamine withdrawal symptoms
According to the FDA, doctors should only prescribe Adderall during pregnancy if the likely benefit justifies the potential risks.
As the body excretes amphetamines in breast milk, people who take these drugs should avoid breastfeeding and talk to a doctor about either changing medications or using formula.
Infants who ingest amphetamines through breast milk may experience side effects.
Tolerance and drug dependence
Adderall is a schedule II controlled substance, meaning that it has a high potential to lead to dependence and abuse.
Long-term use of prescription stimulants such as Adderall can lead to tolerance, which is when a person needs increasing amounts of a drug for it to be effective.
In some cases, people who take large doses of Adderall for an extended period may become physically dependent on the drug. They might experience withdrawal symptoms when they stop taking the drug.
A person can minimize the symptoms of withdrawal by gradually reducing the dosage over time.
The dosage depends on which condition Adderall is treating and the age of the person taking it.
As a treatment for ADHD
The FDA do not recommend Adderall for children under 3 years of age.
Children aged 3–5 years should begin with a starting dosage of 2.5 milligrams (mg) per day. If necessary, a doctor may increase the daily dose by 2.5 mg at weekly intervals to establish the minimum effective dosage.
For children aged 6 years or above, the recommended starting dosage is 5 mg once or twice per day. The doctor may increase the daily dose by 5 mg each week until they find a dosage that works.
For adults with ADHD, the starting dosage of Adderall is 5 mg once or twice per day. If necessary, a doctor may then increase the daily dose by 5 mg at weekly intervals.
The recommended maximum daily dose (MDD) for adults with ADHD is 40 mg.
As a treatment for narcolepsy
Although it is rare, narcolepsy can sometimes occur in children under the age of 12 years.
For children 6–12 years in age, a doctor may prescribe Adderall at an initial dosage of 5 mg per day. They may increase the daily dose by 5 mg each week, stopping when they find the optimal dosage.
For children and adults aged 12 years and above, the FDA recommend a starting dosage of 10 mg per day. A doctor may raise the daily dose by 10 mg each week if necessary.
The MDD for adults with narcolepsy is 60 mg per day. A person will need to divide this amount into two or three smaller doses and take them throughout the day, rather than taking all 60 mg at once.
If Adderall is ineffective or causes intolerable side effects, a doctor may recommend a different medication.
Other medications for ADHD
A doctor may prescribe other medications for ADHD, such as Vyvanse, Ritalin, or Focalin.
Besides amphetamine, other stimulants may help treat ADHD. The following are suitable for use in children:
- lisdexamfetamine (Vyvanse)
- methylphenidate (Ritalin)
- dexmethylphenidate (Focalin)
Stimulant drugs may not work for some people, or they may cause intolerable side effects. In these cases, a doctor may prescribe one of the following nonstimulant drugs instead:
- guanfacine (Tenex)
- clonidine (Catapres)
- atomoxetine (Strattera)
Other medications for narcolepsy
Stimulants, antidepressants, and lifestyle changes may all be useful in treating the symptoms of narcolepsy.
Some examples of each include:
- stimulants: methylphenidate (Ritalin) and modafinil (Provigil)
- antidepressants: fluoxetine (Prozac) and sertraline (Zoloft)
- lifestyle changes: taking short naps and exercising daily
Doctors may sometimes also prescribe the central nervous system depressant sodium oxybate (Xyrem) to treat cataplexy and excessive daytime sleepiness.
Adderall is a prescription medication that contains the stimulants amphetamine and dextroamphetamine. These drugs can be effective in treating the symptoms of ADHD and narcolepsy.
A doctor will not prescribe Adderall without first taking a detailed medical history to be sure that a person has the correct diagnosis.
Adderall can cause a range of side effects. It may not be suitable for people with certain medical conditions.
People who are taking Adderall should talk to a doctor if they have concerns about the side effects or risks of the drug. The doctor may adjust the dosage or recommend an alternative medication if necessary.