Adderall is the brand name for the combination of amphetamine and dextroamphetamine, sometimes referred to as amphetamine salts. The two ingredients are central nervous system (CNS) stimulants and are classified as Schedule II substances. Schedule II substances have a high potential for misuse and can lead to abuse, dependence and addiction.
Adderall’s primary effect is the increased release of dopamine and norepinephrine, which are neurotransmitters associated with regulating mood, motivation and wakefulness. Adderall may also inhibit the breakdown of dopamine, which makes it more available in the brain. However, it is unclear how exactly Adderall manages symptoms of ADHD and narcolepsy.
There are two versions of Adderall: Adderall IR, which is an immediate-release formulation, and Adderall XR, which is an extended-release formulation. Adderall IR is usually taken every four to six hours, while Adderall XR is taken once daily.
Adderall IR is FDA-approved to treat attention-deficit/hyperactivity disorder (ADHD) and narcolepsy in both children and adults, while Adderall XR is approved for ADHD only. In people with ADHD, Adderall can improve attention and focus while reducing hyperactivity and impulsivity.
Narcolepsy is characterized by excessive and spontaneous daytime sleepiness. Since Adderall promotes wakefulness, it can allow people with narcolepsy to maintain normal daytime routines. There are off-label uses for Adderall as well, including treatment-resistant depression and obsessive-compulsive disorder. However, there is some controversy about whether Adderall is truly effective for these disorders.
Adderall is often misused for its stimulant properties. High school and college students are particularly likely to misuse Adderall for its ability to enhance focus and concentration, hence its popularity as a “study drug.” Some people use Adderall as an alternative to other stimulants, such as methamphetamine.
Adderall and other ADHD medications are all CNS stimulants that increase dopamine and norepinephrine levels in the brain. They are all classified as Schedule II drugs, meaning that they require a prescription and have a high risk for misuse and addiction. Although they are similar in many ways, they also have some different characteristics:
Adderall comes in pill form. Pills are round or elliptical, and the colors vary based on the dosage:
Adderall XR comes in capsule form, and the colors vary based on the dosage:
Adderall should always be started at the lowest dose and, if needed, incrementally increased until an effective dose is reached. The starting dose is generally 5 mg per day. Dosage can be increased at a rate of 5 mg per week until an effective dose is reached. The maximum recommended dose is 40 mg per day (for narcolepsy, the maximum recommended dose is 60 mg per day). The first dose is taken upon waking, and subsequent doses are taken at 4–6 hour intervals.
The only approved administration route for Adderall is oral. Routes of administration when Adderall is misused include snorting, smoking or injecting intravenously.
Adderall is associated with several side effects, including:
Some serious side effects may warrant medical attention. Call your doctor right away if you experience any of the following:
Adderall may indirectly increase serotonin levels, which can be dangerous when other drugs (particularly antidepressants) are taken with Adderall. Serotonin syndrome is a potentially life-threatening condition caused by excess serotonin in the brain. If you notice any of the following side effects, call your doctor:
Before starting Adderall, make sure your doctor is aware of any other drugs you may be taking. Even over-the-counter drugs may potentially have adverse interactions with Adderall.
As a Schedule II controlled substance, Adderall can be addictive even when taken as prescribed. Regular Adderall use causes tolerance, which means that higher and higher doses are needed in order to achieve the same effect. Adderall dependence means that withdrawal symptoms are experienced when the dose is reduced or eliminated, but it is not associated with compulsive drug-seeking behavior. Adderall addiction is an extension of dependence and is characterized by an inability to control the impulse to use Adderall.
Adderall and alcohol are a bad combination. A drug interaction between them increases the risk of cardiovascular side effects like high blood pressure and increased heart rate. If you have pre-existing heart problems, this can be especially dangerous.
In addition, consuming alcohol while on Adderall can be risky. Since Adderall is a stimulant, it can mask the effects of alcohol, making you feel less drunk than you otherwise would. This can be dangerous if you feel sober enough to operate a vehicle and don’t realize you’re drunk. In addition, you may continue to drink, which can increase your risk of alcohol overdose.
When you take Adderall for an extended time and suddenly stop, you may experience withdrawal symptoms as your body tries to adjust to no longer having the stimulant. A medically supervised detox can help you avoid withdrawal symptoms. In detox, doctors and nurses can help you get off Adderall and treat any withdrawal symptoms that occur.
In addition, you may also experience a longer-term, protracted withdrawal phase (PAWS) after the first withdrawal phase is complete. PAWS can last up to two months and may include symptoms such as:
Adderall withdrawal can be hard, and each person can have their own method of coping with Adderall withdrawal. Attending a medical detoxification program can help. Medical detox programs treat the withdrawal side effects as they occur to keep you comfortable and safe. Medical detox is highly recommended for those with moderate to severe Adderall addictions.
Some programs will help you taper off Adderall to minimize withdrawal symptoms. When you gradually decrease your Adderall dose, you can minimize withdrawal effects. The taper is then continued until your body is completely rid of the stimulant. Those with mild Adderall use disorders may discuss this option with their doctor. Your detox center can help you pick which method works best for your needs.
Everyone’s withdrawal and detox journeys are different. However, a general Adderall timeline is predictable for some people. A common Adderall withdrawal timeline is:
Treatment for Adderall addiction should begin with an evaluation by a medical professional who specializes in addiction. Mild Adderall use disorders may be successfully treated by participating in an outpatient rehab program that can provide behavioral therapy sessions.
More serious addictions may require a detox period and residential rehab. Ending Adderall use when a strong addiction has taken hold can lead to uncomfortable withdrawal symptoms. These symptoms often include profound fatigue, lethargy, depression and even suicidal thoughts. For these reasons, moderate to severe addiction detox is best done under the care of professionals in a medically assisted detox program.
After detox, many people find that they have the most success in recovery by participating in a residential rehab program that provides cognitive behavioral therapy and motivational interviewing. Both of these therapies help clients reframe negative thoughts and understand why they misused Adderall. Another important objective of rehab is to identify and define specific short- and long-term goals for recovery.
Finding a rehab center that can evaluate whether a dual diagnosis treatment is appropriate can be incredibly valuable. For many people, Adderall use disorders are tied to underlying mental health disorders. When treated, it can drastically reduce the desire to misuse Adderall. Look for a rehab center with a multidisciplinary team that can evaluate whether Adderall use disorder may be one part of a co-occurring disorder.
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The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.