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Adderall: Uses, Side Effects and Abuse

Adderall, prescription medication
Adderall is a prescription medication used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Pictured: 20-mg capsules of Adderall XR.
(Image: © Patrick Mallahan III / Creative Commons)

Adderall is a prescription medication used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Adderall, a brand name, is a combination of amphetamine and dextroamphetamine, which are central nervous system stimulants. Taking Adderall may help increase the ability to focus, pay attention and control behavior.

The drug increases the activity of the brain chemicals dopamine and norepinephrine, according to the National Institute on Drug Abuse (NIDA). Adderall mainly stimulates the sympathetic nervous system, which triggers the body's "fight or flight" responses, such as pupil dilation, increased blood pressure and heart rate and increased sweating.

Dosage of Adderall

Adderall is available as a tablet and as an extended-release capsule (Adderall XR). It comes in varying doses, ranging from 5 mg to 30 mg. The prescribed dose will depend on the size of the patient and the severity of symptoms. Doctors typically start patients with a low dose and gradually increase the dose, according to the National Institutes of Health (NIH).

The tablet is usually taken two to three times daily and the extended-release capsule is usually taken once daily, according to the NIH.

Side effects

Dextroamphetamine and amphetamine may cause side effects, including:

  • Nervousness
  • Restlessness
  • Difficulty falling asleep or staying asleep
  • Uncontrollable shaking of a part of the body
  • Headache
  • Changes in sex drive or ability
  • Dry mouth
  • Stomach pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Loss of appetite
  • Weight loss

Some side effects can be serious, and the NIH says that anyone who experiences any of these symptoms should call their doctor immediately:

  • Fast or pounding heartbeat
  • Shortness of breath
  • Chest pain
  • Excessive tiredness
  • Slow or difficult speech
  • Dizziness or faintness
  • Weakness or numbness of an arm or leg
  • Seizures
  • Motor tics or verbal tics
  • Believing things that are not true
  • Feeling unusually suspicious of others
  • Hallucinating (seeing things or hearing voices that do not exist)
  • Mania (frenzied or abnormally excited mood)
  • Aggressive or hostile behavior
  • Changes in vision or blurred vision
  • Fever
  • Blistering or peeling skin
  • Rash
  • Hives
  • Itching
  • Swelling of the eyes, face, tongue or throat
  • Difficulty breathing or swallowing
  • Hoarseness (abnormal voice changes)

Who should not use Adderall

Adderall is not for everybody. It should not be used by patients with a history of glaucoma, severe anxiety or agitation, a personal or family history of tics, or Tourette syndrome. Stimulants can also cause sudden death in patients with congenital heart defects or serious heart problems. As a result, patients should alert their doctors if they have a history of heart disease, heart rhythm disorder, coronary artery disease or heart attacks, according to the NIH. Doctors should also be alerted if the patient has a history of high blood pressure, mental illness, peripheral vascular disease or seizure disorders.

Adults ages 65 and older should usually not take Adderall because it is not as safe as other medications for this age group, the NIH says.

Some drug interactions could be harmful. The NIH says that people should not take Adderall if they have taken a monoamine oxidase inhibitor (MAOI), a type of antidepressant, in the last two weeks.

Adderall and children

For children with ADHD, or hyperactive-impulsive or inattentive symptoms that cause impairment and appear before the age of 7, Adderall can be considered part of a total treatment program. ADHD must be diagnosed through a series of tests that rule out other mental disorders. Other treatment measures will include psychological, educational and social aspects — drug treatments may not even be necessary.

For treating ADHD, Adderall is approved for use in children ages 3 years and older, and Adderall XR is approved for children ages 6 and older, according to the NIH. For children with narcolepsy, the drug is approved for those ages 12 and older.

Adderall is not intended for use in children who exhibit symptoms that are secondary to environmental factors or exhibit symptoms that indicate other psychiatric disorders, such as psychosis, according to the Food and Drug Administration (FDA).

There is evidence that Adderall may slow a child's growth or weight gain, so doctors should monitor children's growth carefully while they are on the medication, the NIH says.

Abuse and addiction to Adderall

Adderall is a Schedule II controlled substance, which means there is a high risk for addiction or abuse and is why any usage should be closely monitored by a medical professional.

According to the Mayo Clinic, simply taking too much Adderall can cause dependence. People using Adderall should not take a larger dose or take it more often or for a longer time than prescribed by a doctor. Also, abruptly stopping the medication can cause depression, fatigue and sleep problems.  

“When taken as prescribed by a physician, there is little risk of addiction, but if taken recreationally for the 'euphoric' effect, the risk of abuse will be enhanced,” said Dr. Maria Pino, a toxicologist and course director for pharmacology at Touro College of Osteopathic Medicine in New York.

There is a rising trend of college students abusing Adderall and similar drugs, like Ritalin, to perform better on tests and papers. A study by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that full-time college students were twice as likely as non-students to have used Adderall non-medically.

"Adderall has become one of the mainstay drugs at many party events both on [college] campus[es] and off because it is cheap and easy to access," said Dr. Marc J. Romano, assistant medical director at Ocean Breeze Recovery in Pompano Beach, Florida.

Romano also noted that individuals often report using Adderall when drinking alcohol to offset the effects of the latter drug. They feel that they do not get as drunk as they would when taking Adderall. Individuals may drink more alcohol when taking Adderall, though, which can result in serious impairment, including death from alcohol poisoning.

This medication should not be sold or shared; doing so is not only dangerous, but also illegal. There is evidence that abuse of this drug may be related to an increase in emergency room visits involving prescription stimulants. A 2016 study published in The Journal of Clinical Psychiatry found that nonmedical use of Adderall by adults had gone up by 67.1 percent and emergency department visits involving the medication had gone up by 155.9 percent, from 2006 to 2011.

Long-term abuse and overdose

Chronic abuse is marked by severe rash, insomnia, irritability and personality changes. The most severe symptom of abuse is psychosis, which is often clinically indistinguishable from schizophrenia, according to the FDA.

Toxic symptoms from taking an overdose of Adderall can come at low doses. Initial signs of an overdose include restlessness, tremor, confusion, hallucinations and panic, the FDA says. After this central stimulation, the patient will undergo fatigue, depression, and often cardiovascular and gastrointestinal symptoms. The NIH says that people should contact a medical professional immediately if they suspect that they or someone they know has overdosed on Adderall.

Additional resources:

This article is for informational purposes only and is not meant to offer medical advice. This article was updated on March 28, 2016 by Live Science Contributor, Alina Bradford, and again on Oct. 18, 2018 by Live Science Senior Writer, Rachael Rettner.