This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Adderall: 7 things you should know
Medically reviewed by Carmen Pope, BPharm. Last updated on April 4, 2023.
1. How it works
- Adderall is a combination of four different amphetamine salts: dextroamphetamine saccharate, dextroamphetamine sulfate, amphetamine aspartate, and amphetamine sulfate.
- Experts aren’t sure exactly how Adderall works in Attention Deficit Hyperactivity Disorder (ADHD) but suggest it blocks the reuptake of the neurotransmitters, dopamine, and norepinephrine, which increases their concentration in the neuronal synapse (the space between two nerves).
- Adderall belongs to the group of medicines known as central nervous system (CNS) stimulants.
2. Upsides
- Used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) to increase attention and decrease hyperactivity and impulsiveness.
- May be given to increase alertness in people with the sleep disorder, narcolepsy.
- When given for ADHD, Adderall should be used in conjunction with other treatment options, such as psychotherapy, education about the disorder, and social integration advice.
- FDA approved for children over the age of three.
- Adderall is available as a generic under the name mixed amphetamine salts (which may be abbreviated to MAS or M. amphet salts).
3. Downsides
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Insomnia (inability to sleep), headache, dry mouth, loss of appetite, nervousness, and nausea are the most common side effects.
- May also cause heart palpitations, constipation and other GI disturbances, weight loss, changes in libido, alopecia (hair loss), elevated blood pressure and muscle twitching, stiffness, or tightness.
- High potential for dependence especially when administered for long periods of time.
- High potential for abuse. May be sought after by drug abusers or people with addiction disorders. Misuse may cause sudden death or cardiovascular events. Overdosage has resulted in psychosis which is indistinguishable from schizophrenia.
- May exacerbate pre-existing psychiatric disorders such as bipolar disorder, psychotic disorder, or mania; and increase anxiety, tension, and agitation.
- May impair judgment or reaction skills; exercise caution before driving or operating machinery until the full effects of Adderall are known.
- Reports indicate some temporary slowing of growth may occur when regular Adderall is given to children aged 7 through 10 years. Doctors should monitor height and weight and consider treatment interruption if growth suppression is suspected.
- May increase the risk of seizures and peripheral circulatory problems and cause visual problems.
- May not be suitable for people with certain heart conditions, as the risk of sudden death is increased even with usual dosages. May also not be suitable for people with thyroid disease, glaucoma, psychiatric disease, a history of drug abuse or agitation, a tic disorder, seizures, liver or kidney disease, or circulation problems.
- May interact with a number of other drugs including other antidepressants, medications used to treat heart disease, blood thinners, decongestants, tramadol, and proton pump inhibitors.
- Interaction or overdosage may cause serotonin syndrome (symptoms include mental status changes [such as agitation, hallucinations, coma, delirium]), fast heart rate, dizziness, flushing, muscle tremor or rigidity, and stomach symptoms (including nausea, vomiting, and diarrhea).
- Extreme fatigue and depression have been reported when Adderall has been stopped suddenly, particularly in those who have been taking more than the recommended dose.
- Rare cases of priapism (painful erections more than 6 hours in duration) have been reported.
- Adderall should not be used during pregnancy unless the potential benefit justifies the risk. There are no well-controlled studies investigating its use in humans during pregnancy. Case reports document severe congenital bone deformity and other birth defects; animal studies have reported long-term neurochemical and behavioral alterations in pups exposed to amphetamines in utero.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
4. Bottom Line
Adderall is a combination of four different amphetamine salts and may be used to improve attention, focus, or reduce impulsive behaviors in children over the age of 3 and adults with ADHD. It can also be used to treat narcolepsy. Adderall is potentially addictive and can cause insomnia.
5. Tips
- Take in the morning if using once daily. If using twice daily, avoid late evening dosages to reduce the risk of insomnia.
- May be taken with or without food.
- Take exactly as directed by your doctor and never increase the dosage without his or her advice.
- Ensure your child partakes in other psychological, educational, or social treatment measures as recommended by your doctor as these are also an important part of ADHD treatment.
- Do not suddenly stop taking Adderall, unless it is an emergency. Sudden discontinuation may precipitate a withdrawal reaction. Symptoms include extreme tiredness, depression, or agitation.
- Seek medical advice if symptoms persist or worsen despite treatment, or if psychotic symptoms (such as hearing voices or signs of paranoia) or hallucinations develop.
- Seek urgent medical help if you experience chest pain, shortness of breath, or fainting while taking Adderall or other worrying symptoms such as unexplained nausea or vomiting, a fast heartbeat, agitation, hallucinations, coma, delirium, flushing, muscle tremor, or rigidity.
- Do not drive or operate machinery if Adderall impairs your judgment or reaction skills. Alcohol may contribute to these effects and should be avoided.
- Seek medical advice if any new numbness, pain, skin color change, sensitivity, or unexplained wounds occur in your fingers or toes.
- Keep out of reach of children and pets. Keep your medicine in a safe, private storage area, out of view of any person that may illegally misuse it.
- Do not use if pregnant or breastfeeding unless specifically recommended by your doctor.
6. Response and effectiveness
- Parent training in behavior management and/or behavioral classroom interventions should be used before medicines to treat ADHD.
- Effective at improving symptoms such as attention and focus and reducing impulsive behaviors.
- Small trials have reported similar effectiveness to Vyvanse. One study reported that both seemed equally effective at improving attention-span, rule-following, and interactions with peers and adults for classroom-based behavior in a group of children with ADHD. Similar results were reported in a trial of 18 adults with ADHD. It took about two hours for Adderall to start working and three hours for Vyvanse, and the effects of each drug lasted for approximately 16 hours. Side effects such as decreased appetite, insomnia, and abdominal symptoms are common to most ADHD treatments.
- Peak concentrations are reached within three hours following a single dose.
- Not all the hepatic enzymes involved in the metabolism of Adderall have been defined; however, CYP2D6 is known to be one of the enzymes responsible, which means that variations may occur in the way different individuals metabolize Adderall. Many other drugs rely on CYP2D6 for metabolism and may interact with Adderall.
7. Interactions
Medicines that interact with Adderall may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Adderall. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with Adderall include:
- anticoagulants (blood thinners), such as warfarin, or other drugs that have blood-thinning effects such as aspirin or NSAIDs
- anticonvulsants, such as phenytoin, phenobarbital, or primidone
- antidepressants, such as tricyclic antidepressants (eg, amitriptyline), monoamine oxidase inhibitors (eg, isocarboxazid, phenelzine, and tranylcypromine), or SSRIs (eg, fluoxetine, sertraline)
- antipsychotics (such as butyrophenones, phenothiazines, or thioxanthenes) and atypical antipsychotics (eg, olanzapine, quetiapine, ziprasidone)
- any medication that may cause drowsiness, such as benzodiazepines (eg, diazepam, lorazepam), first-generation antihistamines (such as doxylamine or promethazine), metoclopramide, or opioids (such as codeine, morphine)
- beta-blockers, such as atenolol, labetalol, or metoprolol
- cold, flu, or allergy medications that contain decongestants such as phenylephrine or pseudoephedrine
- diuretics such as furosemide
- medications that increase or decrease the pH of the stomach or urinary tracts, such as PPIs (eg, omeprazole, pantoprazole), sodium bicarbonate, acetazolamide, ascorbic acid, or ammonium chloride
- medications that inhibit CYP2D6 enzymes
- heart medications such as doxazosin, prazosin, clonidine, or methyldopa
- HIV medications (fosamprenavir, ritonavir)
- other medications that affect serotonin, such as amphetamines, fentanyl, lithium, tramadol, triptans (eg, almotriptan, eletriptan, or sumatriptan), or St. John’s Wort
- propoxyphene.
Avoid drinking alcohol or taking illegal or recreational drugs while taking Adderall.
Note that this list is not all-inclusive and includes only common medications that may interact with Adderall. You should refer to the prescribing information for Adderall for a complete list of interactions.
More about Adderall (amphetamine / dextroamphetamine)
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Adderall
Medically reviewed by Kaci Durbin, MD. Last updated on Nov 8, 2022.
What is Adderall?
Adderall is used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Adderall contains a combination of amphetamine and dextroamphetamine. Amphetamine and dextroamphetamine are central nervous system stimulants that affect chemicals in the brain and nerves that contribute to hyperactivity and impulse control.
Adderall may also be used for purposes not listed in this medication guide.
Warnings
Adderall may be habit-forming, and this medicine is a drug of abuse. Tell your doctor if you have had problems with drug or alcohol abuse.
Stimulants have caused stroke, heart attack, and sudden death in people with high blood pressure, heart disease, or a heart defect.
Do not use this medicine if you have used a MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine or have received a methylene blue injection.
Adderall may cause new or worsening psychosis (unusual thoughts or behavior), especially if you have a history of depression, mental illness, or bipolar disorder.
You may have blood circulation problems that can cause numbness, pain, or discoloration in your fingers or toes.
Call your doctor right away if you have: signs of heart problems – chest pain, feeling light-headed or short of breath; signs of psychosis – paranoia, aggression, new behavior problems, seeing or hearing things that are not real; signs of circulation problems – unexplained wounds on your fingers or toes.
You may not be able to use Adderall if you have glaucoma, overactive thyroid, severe agitation, moderate to severe high blood pressure, heart disease or coronary artery disease, vascular disease, or a history of drug or alcohol addiction.
Before taking this medicine
Do not use this medicine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
You may not be able to use Adderall if you are allergic to any stimulant medicine. You may not be able to use Adderall if you have:
- glaucoma;
- overactive thyroid;
- severe anxiety or agitation (stimulant medicine can make these symptoms worse);
- high blood pressure;
- heart disease or coronary artery disease;
- vascular disease or hardening of the arteries; or
- a history of drug or alcohol addiction.
Some medicines can interact with amphetamine and dextroamphetamine and cause a serious condition called serotonin syndrome. Tell your doctor about any other medications you are using. Be sure your doctor knows if you also take opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications. Symptom of serotonin syndrome may include agitation, hallucinations (hearing or seeing things that are not real), coma, fast heart rate, dizziness, sweating, feeling hot, muscle rigidity or shakiness, seizures, nausea, vomiting, or diarrhea. Stop Adderall immediately if you experience these symptoms.
Stimulants have caused stroke, heart attack, and sudden death in certain people. Tell your doctor if you have:
- heart problems or a congenital heart defect;
- high blood pressure; or
- a family history of heart disease or sudden death.
To make sure Adderall is safe for you, tell your doctor if you or anyone in your family has ever had:
- depression, anxiety, mental illness, bipolar disorder, psychosis, problems with aggression, or suicidal thoughts or actions;
- motor tics (muscle twitches) or Tourette’s syndrome;
- seizures or epilepsy;
- an abnormal brain wave test (EEG); or
- liver or kidney disease; or
- blood circulation problems in the hands or feet.
Taking Adderall during pregnancy can cause premature birth, low birth weight, or withdrawal symptoms in the newborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
The medications in Adderall (amphetamine and dextroamphetamine) can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine.
Adderall is not approved for use by anyone younger than 3 years old.
How should I take Adderall?
Take Adderall exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Adderall may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.
Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
You may take Adderall with or without food, first thing in the morning.
Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.
To make swallowing easier, you may open the capsule and sprinkle the medicine into a spoonful of applesauce. Swallow right away without chewing. Do not save the mixture for later use.
While using this medicine, your doctor will need to check your progress at regular visits. Tell any doctor who treats you that you are using this medicine.
Adderall can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using this medicine.
Store at room temperature away from moisture, heat, and light.
Keep track of your medicine. Adderall is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
Dosing information
Usual Adult Dose of Adderall for Attention Deficit Disorder:
IR:
-Initial Dose: 5 mg orally 1 or 2 times a day
-Maintenance Dose: Daily dose may be raised in 5 mg increments at weekly intervals until optimal response is obtained.
-Maximum Dose: Only in rare cases will it be necessary to exceed 40 mg per day.
XR:
Patients starting treatment for the first time or switching from another medication:
-Initial Dose: 20 mg orally once a day
Use: As part of a total treatment program for Attention Deficit Hyperactivity Disorder (ADHD).
Usual Adult Dose of Adderall for Narcolepsy:
IR:
-Initial Dose: 10 mg orally per day in divided doses
-Maintenance Dose: Daily dose may be raised in 10 mg increments at weekly intervals until optimal response is obtained.
Use: Narcolepsy treatment
Usual Pediatric Dose of Adderall for Attention Deficit Disorder:
IR:
Age 3 to 5 Years:
-Initial Dose: 2.5 mg orally per day
-Maintenance Dose: Daily dose may be raised in 2.5 mg increments at weekly intervals until optimal response is obtained.
Age 6 to 17 Years:
-Initial Dose: 5 mg orally 1 or 2 times a day
-Maintenance Dose: Daily dose may be raised in 5 mg increments at weekly intervals until optimal response is obtained.
-Maximum Dose: Only in rare cases will it be necessary to exceed 40 mg per day.
XR:
Age 6 to 12 Years (starting treatment for the first time or switching from another medication):
-Initial Dose: 5 or 10 mg orally once a day in the morning
-Maintenance Dose: Daily dose may be raised in 5 to 10 mg increments at weekly intervals.
-Maximum Dose: 30 mg/day
Age 13 to 17 Years (starting treatment for the first time or switching from another medication):
-Initial Dose: 10 mg orally once a day
-Maintenance Dose: Daily dose may be increased to 20 mg/day after one week if symptoms are not adequately controlled.
-Maximum Dose: 30 mg/day
Use: As part of a total treatment program for Attention Deficit Hyperactivity Disorder (ADHD).
Usual Pediatric Dose of Adderall for Narcolepsy:
IR:
Age 6 to 11 Years:
-Initial Dose: 5 mg orally per day in divided doses
-Maintenance Dose: Daily dose may be raised in 5 mg increments at weekly intervals until optimal response is obtained.
Age 12 Years and Older:
-Initial Dose: 10 mg orally per day in divided doses
-Maintenance Dose: Daily dose may be raised in 10 mg increments at weekly intervals until optimal response is obtained.
Use: Narcolepsy treatment
What happens if I miss a dose?
Take the missed dose as soon as you remember, but not late in the day. Skip the missed dose if it is almost evening. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Adderall could be fatal.
Overdose symptoms may include restlessness, tremor, muscle twitches, rapid breathing, confusion, hallucinations, panic, aggressiveness, muscle pain or weakness, and dark colored urine. These symptoms may be followed by depression and tiredness. Other overdose symptoms include nausea, vomiting, diarrhea, stomach pain, uneven heartbeats, feeling light-headed, fainting, seizure (convulsions), or coma.
What to avoid
This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Avoid drinking fruit juices or taking vitamin C at the same time you take Adderall. These can make your body absorb less of the medicine.
Adderall side effects
Get emergency medical help if you have signs of an allergic reaction to Adderall: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Adderall may cause serious side effects. Call your doctor at once if you have:
- signs of heart problems – chest pain, trouble breathing, feeling like you might pass out;
- signs of psychosis – hallucinations (seeing or hearing things that are not real), new behavior problems, aggression, hostility, paranoia;
- signs of circulation problems – numbness, pain, cold feeling, unexplained wounds, or skin color changes (pale, red, or blue appearance) in your fingers or toes;
- a seizure (convulsions);
- muscle twitches (tics); or
- changes in your vision.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Adderall can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using this medicine.
Common side effects of Adderall may include:
- stomach pain;
- loss of appetite;
- weight loss;
- mood changes;
- feeling nervous;
- fast heart rate;
- headache;
- dizziness;
- sleep problems (insomnia); or
- dry mouth.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Adderall?
Ask your doctor before using a stomach acid medicine (including Alka-Seltzer or sodium bicarbonate). Some of these medicines can change the way your body absorbs Adderall, and may increase side effects.
Tell your doctor about all your current medicines and any you start or stop using, especially:
- buspirone, lithium, selective serotonin reuptake inhibitor (SSRI) drugs (including citalopram, fluoxetine, paroxetine, sertraline, others), tricyclic antidepressants (amitriptyline, others) or other medicine to treat depression or mental illness;
- blood pressure medicine;
- heartburn medicine;
- a blood thinner such as warfarin, Coumadin, Jantoven;
- cold or allergy medicine that contains a decongestant;
- opioid (narcotic) medicine; or
- seizure medicine.
This list is not complete and many other drugs can interact with Adderall. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
Popular FAQ
It would take just over 2 days for a dose to be out of your system. You should allow for longer (7 days) if you have taken Adderall frequently and at high doses. Continue reading
The main difference between Adderall and Vyvanse is that Adderall is a mixture of four different kinds of amphetamine salts (one of which is dextroamphetamine) while Vyvanse only contains one type of amphetamine salt, called lisdexamfetamine. Lisdexamfetamine gets converted into dexamphetamine once it is in the body. One advantage of Vyvanse is that it may be less likely to be abused; however, there is no generic form available so it is more costly than Adderall. Because both drugs contain amphetamines, they work in a similar way. Studies have shown that Vyvanse is just as effective as Adderall, and side effects, including the risk of dependence, are similar. Continue reading
When taken as prescribed, the effects of Adderall last for about 4 to 6 hours. The effects of Adderall XR last for up to 12 hours because this brand of Adderall is designed for slow and sustained release. Continue reading
Although Adderall is only FDA-approved for the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy, it has been used rarely and off-label to treat depression that has not responded to other treatments. However, this is controversial and there is a lack of good quality evidence to support its use. There is no evidence that Adderall helps with anxiety and in many people with pre-existing mood disorders, Adderall can make depression and/or anxiety worse. Continue reading
Qelbree (viloxazine ER) and Adderall (mixed amphetamine salts) are oral medications used to treat attention deficit hyperactivity disorder (ADHD) in adults and children. Differences are that Qelbree is a long-acting, once daily nonstimulant medicine and is less likely to cause trouble with sleeping or lead to abuse. Adderall is a short-acting stimulant medication given 1 to 3 times a day, is a C-II controlled substance, and can be abused.
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More about Adderall (amphetamine / dextroamphetamine)
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- Compare alternatives
- Pricing & coupons
- Reviews (465)
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- Side effects
- Dosage information
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- Drug class: CNS stimulants
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