Adderall is a prescription drug which contains a combination of amphetamine salts including amphetamine and dextroamphetamine. Today, it’s the first choice treatment for ADHD and narcolepsy, and it’s also used as an athletic performance enhancer and a cognitive stimulant. Recreationally, it is used as an aphrodisiac and euphoriant.
What is Adderall?
Adderall falls under a class of medication called central nervous system (CNS) stimulants. It works by changing the levels of some naturally occurring chemicals from the brain, and it also increases the levels of dopamine. The drug enhances attention span, focus, and concentration and it has received the FDA approval. Today it is one of the most popular accepted treatments for ADHD in both adults and children. It is also used in the treatment of fatigue or various sleep disorders such as narcolepsy in adults. Adderall is used illicitly as a nootropic for its properties of enhancing the body’s energy.
Adderall is administered as a part of a total treatment program which includes educational, social and psychological therapy. It is available only with a medical prescription.
Active Ingredients: Amphetamine and Dextroamphetamine
What Are the Central Nervous System Stimulants?
The main ingredients in Adderall’s formula are amphetamine and dextroamphetamine. Other ingredients include the following: gelatin, cellulose, Silicon dioxide and magnesium stearate (from vegetable source). The composition does not contain soybeans, wheat, dairy, egg, gluten, peanuts, fish or tree nuts.
Amphetamine and dextroamphetamine belong to a group of medicines called CNS stimulants, and they work by increasing attention and decreasing restlessness in patients who cannot concentrate and are overactive, or who are distracted very easily.
CNS drugs are used for increasing mental alertness and wakefulness. They act by enhancing the activity in the brain and by stimulating the feeling of wakefulness and the alertness of the mind. CNS stimulants improve concentration, and they work on the part of the brain which regulates mental alertness by promoting the release of certain chemicals which are called neurotransmitters. They have the purpose of increasing the nerve activity in that particular part of the brain.
CNS stimulants are prescribed for oral use and for extended periods of time in treating health conditions such as narcolepsy and severe, persistent attention deficit disorder in a treatment program for children. If the CNS stimulants are prescribed for a longer period for children, their growth will have to be monitored due to the possibility of a slower development.
The majority of CNS stimulants have a composition which is chemically similar to the neurohormone norepinephrine, and they stimulate the inherited syndrome called “fight or flight” which is associated with sympathetic nervous system arousal.
Amphetamines and their derivates have quite a high potential for abuse; therefore they should be used in weight reduction programs only when alternative therapies have been proven their inefficiency. Administration for longer periods of time may lead to drug addiction, so these drugs are classified as schedule II under federal drug control regulations.
Amphetamines and their derivates are contraindicated in some health conditions such as symptomatic cardiovascular disease, advanced arteriosclerosis, moderate to severe hypertension and hyperthyroidism. They shouldn’t be used with patients who have a history of drug abuse, and when there are used for treating health conditions in children, higher caution is needed.
Typical responses of amphetamines and the common adverse effects of CNS stimulants include the following: overstimulation, restlessness, dizziness, and hematologic reactions such as leucopenia and bone marrow depression.
Regarding the withdrawal syndrome, an abrupt discontinuation following prolonged high dosage of CNS stimulants may cause fatigue, changes in the sleep habits and mental depression. These reactions are mostly seen in amphetamines, but they may also be observed with other CNS stimulants over extended periods of time.
Adderall is used to treat attention deficit disorder (ADHD) and narcolepsy.
Treating ADHD with Adderall
Attention-deficit/hyperactivity disorder (ADHD) is a brain condition marked by an ongoing pattern of hyperactivity-impulsivity and/or inattention which interferes with proper development and functioning.
Hyperactivity/impulsivity and inattention are the main behaviors of people with ADHD. Some patients only have problems with one of these two behaviors, and others seem to have issues with both of them. Most children manifest a combined type of ADHD. It’s okay to have a certain degree of inattention, impulsivity or unfocused motor activity, but in the case of people with ADHD, these types of behaviors will be more severe, they will occur more often and will also interfere or even reduce the quality of their social functioning in a job or school.
Inattention symptoms include the following:
- Overlooking/missing certain details and making mistakes
- Having problems sustaining attention in particular tasks
- People with inattention don’t seem to listen when they’re spoken to directly
- Failing to finish duties and chores
- Having problems to organize tasks and activities, messy work and poor time management
- Disliking tasks that require mental effort
- Losing things
- Being easily distracted by unrelated thoughts
- Forgetting things related to daily activities
People with hyperactivity-impulsivity symptoms will often manifest the following behaviors:
- Squirming in their seats
- Leaving their seat in situations when staying seated is required
- Running or dashing around when such actions are inappropriate
- Being unable to play or engage in certain activities quietly
- Being constantly in motion
- Talking nonstop
- Having trouble waiting for their turn
- Interrupting others and intruding
Scientists are not sure what exactly causes ADHD, but it’s certain that some factors can contribute to the illness: genes, smoking, using alcohol/drugs during pregnancy, exposure to toxicity during pregnancy or at a young age, brain injuries and low weight at birth.
Pharmaceutical amphetamines seem to improve brain development and nerve growth, and studies have suggested that long-term treatment with Adderall can decrease abnormalities in brain structure and functions in patients with ADHD.
Reviews of clinical stimulant research have proven the effectiveness and the safety of long-term continuous amphetamine use for people who suffer because of ADHD.
The benefits of Adderall use in patients with ADHD include the following:
- Reducing the core symptoms of ADHD
- Enhancing the quality of life and academic achievements
- Improving various functional outcomes in case of problems related to driving, antisocial behavior, occupation, obesity, drug use, self-esteem, social functions
- Increasing the IQ and attention
- Decreasing disrupting behaviors and hyperactivity
Treating Narcolepsy with Adderal
Narcolepsy is a neurological disorder which affects the control of sleep and the wakefulness. Patients with narcolepsy experience excessive states of daytime sleepiness and uncontrollable and intermittent episodes of falling asleep during the day. Such “sleep attacks” may occur during any activity of the patient. This health condition usually starts between the ages of 15 and 25, but it can become symptomatic at any age. In lots of cases, narcolepsy will, unfortunately, remain undiagnosed and untreated.
The symptoms of narcolepsy include the following:
- EDS – excessive daytime sleepiness: this also involves mental cloudiness, lack of energy and concentration, memory lapses, depressed mood, extreme exhaustion.
- Cataplexy: a sudden loss of muscle tone causing feelings of weakness and a loss of muscle control. It also involves slurred speech and even total body collapse.
- Hallucinations: they are usually visual, but other senses may also be involved.
- Sleep paralysis: the temporary inability to move/speak while waking up or falling asleep.
The causes of narcolepsy are not yet known, but scientists have made progress in identifying some genes that are associated with it. These genes control the production of certain chemicals in the brain which signals awake and sleep cycles. Researchers have discovered some abnormalities which contribute to the development of symptoms and it seems that this health condition may be caused by a deficiency in the production of a chemical known by the name of hypocretin from the brain.
There is no known cure for narcolepsy, but the most disabling symptoms can be controlled with drug treatment. Sleepiness is successfully treated with the help of stimulants such as Adderall, and the symptoms of abnormal sleep are treated with certain antidepressant medicines.
Enhancing Performance with Adderall
In 2015, systematic reviews and analysis of high-quality clinical trials proved that small doses of amphetamine improve cognition, working memory, inhibitory control, long-term episodic memory and attention in healthy adults. Adderall improves memory consolidation and recall of information, and they also stimulate the motivation to perform tasks and cause a state of wakefulness. Adderall’s composition improves performance on tedious and challenging tasks, therefore, it’s very beneficial for students who use it for performance enhancement not as a recreational drug. However, high amphetamine doses which are above the therapeutic range can and will interfere with working memory and with some aspects of cognitive control.
Amphetamines are also used by some athletes for their athletic and psychological performance-enhancing effects such as alertness and increased endurance. On the other hand, it’s important to know that non-medical amphetamine use is prohibited at sporting events which are regulated by anti-doping agencies.
It has been proven that in healthy people, if used in therapeutic doses, amphetamines will increase muscle strength, athletic performances, acceleration, and endurance, and they can also improve reaction time. Adderall improves reaction time and endurance through reuptake inhibition and effluxion of dopamine in the central nervous system.
An important fact is that Adderall has been banned in the National Football League (NFL), Major League Baseball (MLB), National Basketball Association (NBA) and the National Collegiate Athletics Association (NCAA).
Recreational Use of Adderall
Adderall is considered to have quite a high potential for being misused as a recreational drug. For instance, Adderall tablets can be crushed and snorted or dissolved in water and injected. Injecting Adderall into the bloodstream can be highly dangerous because insoluble fillers from the tablets’ composition can lead to blockage of small blood vessels.
After Adderal is absorbed into the bloodstream, the substances from its composition enter the central nervous system and then they are taken up by the brain’s neurons. Adderall targets certain storage areas of the brain which hold neurotransmitters such as Norepinephrine, Dopamine, and Adrenaline. These hormones are also known as the catecholamines, and they are part of the body’s stress response system. They’re being released at times of high stress and also during states of excitement when our body needs more focus and energy.
Adderall artificially activates the adrenergic system, and it increases the release of the key neurotransmitters mentioned above into the central nervous system. The result consists of a range of effects which are characteristic to amphetamine stimulants: increased heart rate, increased blood pressure, higher energy levels, enhanced alertness, concentration, and attention.
Adderall Benefits and Advantages
Clinical studies have already shown the drug’s effectiveness, and it stacks well with other nootropics.
The main benefit of using Adderall is mood elevation. According to most users, Adderall can even lead to mild euphoria and, as a direct result of the increasing levels of Serotonin, Dopamine, and Adrenaline, the uses will experience a change in the brain chemistry. This shift involves more attention and focus.
Increased levels of productivity and higher motivation are the key advantages of Adderall, and this is the main reason for which it is being prescribed to patients with ADHD.
There is also substantial evidence of the fact that Adderall stimulates and increases the size of certain areas of the brain which are considered to be of great help in controlling motivation, attention, and focus.
Adderall is also an effective appetite suppressant and sometimes is used for off-label weight loss purposes.
According to the International Programme on Chemical Safety (IPCS) and the United States Food and Drug Administration (USFDA), amphetamines are contraindicated in the following cases:
- People with a history of drug abuse
- Patients with cardiovascular disease
- Cases of severe agitation or anxiety
- Individuals who are currently experiencing arteriosclerosis (hardening of the arteries)
- Individuals who suffer from glaucoma (increased eye pressure)
- Patients with hyperthyroidism (excessive production of thyroid hormone)
- Patients with moderate to severe hypertension
- Individuals who have experienced various allergic reactions to other stimulants or patients who are taking monoamine oxidase inhibitors (MAOIs)
Other health conditions which involve monitoring the symptoms of patients who take amphetamine include the following:
- Anorexia nervosa
- Bipolar disorder
- Kidney or liver problems
- Raynaud’s phenomenon
- Thyroid problems
- Tourette syndrome
On the other hand, some evidence from human studies indicates that therapeutic amphetamine doses don’t cause developmental abnormalities in the fetus or newborns, but amphetamine abuse will indeed pose risks to the fetus. Amphetamine passes into breast milk, therefore, mothers are advised to avoid breastfeeding while using Adderall.
Side Effects of Adderall
The side effects of Adderall are many, and they vary, but the main factor in determining the severity of the side effects is the amount of substance consumed by the patients. At present, Adderall is approved for long-term therapeutic use by the USFDA.
Recreational use of Adderall involves much larger doses than therapeutic use, therefore, the risks of serious side effects are significantly bigger and more dangerous in such cases.
Physical Side Effects of Adderall
When standard therapeutic doses of Adderall are involved, the physical side effects will vary widely from one person to another.
- Cardiovascular side effects: hypertension, hypotension, tachycardia (increased heart rate), reduced blood flow to the extremities.
- Sexual side effects: erectile dysfunction, frequent erections or prolonged ones.
- Abdominal side effects: abdominal pain, nausea, appetite loss, weight loss.
- Other side effects: blurred vision, dry mouth, nosebleed, excessive grinding of the teeth, profuse sweating, nasal congestion, tics, reduces seizure threshold
The amphetamines from Adderall’s composition stimulate the medullary respiratory centers, producing deeper and faster breaths. In healthy people who only take therapeutic doses of Adderall, this thing is usually not noticeable, but when the respiration is already compromised, these effects are noticeable.
Adderall also contracts the urinary bladder sphincter – the muscle which is responsible with urination, and this can cause difficulties while urinating. This effect can be though useful in treating loss of bladder control and bed wetting.
Adderall’s effects on the gastrointestinal tract are quite unpredictable. In the case of high intestinal activity, the amphetamines from its composition may reduce gastrointestinal motility (the rate at which the content of the intestines moves through the digestive system). Adderall may increase motility while the smooth muscle of the intestinal tract is relaxed.
Amphetamines also have a light analgesic effect, and they can enhance the pain relieving effects given by opioid treatments.
Other physical side effects include lower back or side pain, dry mouth, cold or flu-like symptoms, chills and fever, cough or hoarseness, confusion, convulsions, difficulty while speaking and swallowing, uncontrolled repetitive movements in the face area, red and irritated eyes, skin rash.
USFDA – commissioned research and studies from 2011 have shown that in young adults, children and also adults there is no association between serious adverse cardiovascular events (such as stroke, heart attack, sudden death) and medical use of amphetamines, therefore when used properly, Adderall is safe.
Psychological Side Effects of Adderall
The psychological side effects related to Adderall consumption in therapeutic doses which are commonly seen in users include the following:
- Increased alertness, concentration, and apprehension
- Decreased sense of fatigue
- Mood swings (euphoria followed by depression)
- Increased initiative
- False/unusual sense of well-being
- Wakefulness and insomnia
- Sociability and a very high state of self-confidence
Some less common side effects which depend on the user’s current mental state and personality are:
- Libido changes
- Obsessive and repetitive behaviors
Heavy users may experience psychosis (paranoia and delusions), and although this effect is very rare, such psychosis can also occur in the case of therapeutic doses during long-term therapy.
According to USFDA  there is not enough evidence that the use of Adderall produces hostility or aggressive behavior if the drug is used in therapeutic doses.
Proper Use and Dosage
It goes without saying that a qualified medical professional should be consulted before starting to take Adderall and the drug should only be used under the medical supervision of a doctor. The proper dosage of Adderall is usually determined by several factors which include: the age of the person who will take the product and the purpose for which the medicine is taken.
Adderall should be taken only as directed by a doctor and you should not take less or more of it than your doctor ordered. Also, you mustn’t take it more often. If you take too much of the drug, it may become habit-forming, and it may cause physical or mental dependence.
Adderall should come with a Medication Guide which should be read carefully, and the instructions must be followed correctly. If you have any questions, you should talk to your doctor. If you feel that the medicine is not working properly after you’ve taken it for several weeks, it’s important that you will not increase the dosage.
The tablet should be taken in the morning and the afternoon, because if you take it in the evening, you’ll have trouble falling asleep at night.
In case you are using the extended-release capsule you should follow these instructions:
- Swallow the whole capsule with water or any other liquid, without crushing, breaking or chewing it.
- Take the pill in the morning, because if you take it in the evening, you might have insomnia.
- The tablet may be taken with or without food.
If you cannot swallow the capsule, you should carefully open it and sprinkle the small beads over a spoonful of applesauce; then you should swallow the mixture without chewing it. Don’t crush or chew the content of the capsule.
The dose of this drug is going to be different for each patient, therefore, you should carefully and precisely follow the doctor’s orders and the directions from the label. The following info includes only the average doses of Adderall and, if your dose is different, don’t change it without your doctor telling you to do so.
The amount of medicine you should take depends on its strength; the number of necessary doses per day, the time allowed between them and the length of time you take them; these all rely on the medical problem for which you’re using Adderall.
Extended-release capsules for oral dosage form
- Adults: 20 mg once a day in the morning. Your doctor may adjust the dose if necessary.
- Teenagers 13-17 years of age: at first, 10 mg once a day, in the morning. Your doctor may adjust the dose if necessary.
- Children 6-12 years of age: at first, 10 mg once a day in the morning. Your doctor may adjust the dose if necessary. The dose is not more than 30 mg per day.
- Children younger than six years of age: A doctor must determine usage and dosage.
Tablets for oral dosage form:
- Adults and children of 6 years or older: at first, 5 mg one or two times a day. Your doctor may adjust the dose if necessary.
- Children 3-5 years of age: at first, 5 mg once a day. Your doctor may adjust the dose if necessary.
- Children younger than three years of age: Adderal is not recommended in their case.
- Adults and children of 12 years of age or older: at first 10 mg per day, divided and taken in 2 doses. Your doctor may adjust the dose if necessary.
- Children 6-12 years of age: at first, 5 mg per day. Your doctor may adjust the dose if necessary.
- Children younger than six years of age: the doctor will determine use and dose.
In the case of missing a dose
If you miss a dose of Adderall, you must take it as soon as possible. On the other hand, if it’s almost time for your next dose, you should skip the missed one and go back to your regular dosing schedule. You must not double doses to catch up!
Adderal should be stored at room temperature and away from moisture and light. Don’t store it in the bathroom. Keep all drugs away from children and pets.
Don’t flush medication down the toilet or pour them into a drain unless you are instructed to do so. Properly discard the product when it is expired/no longer needed. Regarding its disposal, consult your pharmacist or the local waste disposal company.
Amphetamine overdose can lead to various symptoms, but it is rarely fatal if appropriate care is assured. The severity of overdose symptoms increases/decreases with tolerance to the drug. Individuals who have developed tolerance to the drug have been known to take as much as 5 grams of amphetamine throughout a day, and this is 100 times the maximum daily therapeutic dose.
If someone has overdosed and has severe symptoms such as passing out or trouble to breathe, you should call 911. Otherwise, you should immediately call a poison control center. Overdose symptoms include the following, among others: severe mood/mental changes, seizures, persistent/severe headache, severe restlessness, tremor, muscle twitches, confusion, panic, hallucinations, aggressiveness, nausea, vomiting, diarrhea, uneven heartbeats, stomach pain, fainting, muscle weakness or pain, aggressiveness, dark colored urine, fast breathing and coma.
Adderall Addiction and Tolerance
Addiction is a severe risk with heavy recreational amphetamine use, but it is very unlikely to arise from the typical long-term medical use of therapeutic doses of Adderall. Drug tolerance develops very rapidly in amphetamine abuse, therefore, periods of extended use will require larger and larger doses of this drug to achieve the same effects like the ones from the beginning of the administration.
Dependence and Withdrawal Symptoms of Adderall
According to research and studies on individuals who compulsively use amphetamine, when such heavy users abruptly discontinue the drug use, many of them report a time-limited withdrawal syndrome which occurs within 24 hours of their last dose. Withdrawal symptoms in high-dose, chronic users are frequent, and they occur in 87,6% of cases, persisting for 3-4 weeks. A marked “crash” phase occurs during the first week.
Amphetamine withdrawal symptoms include the following: drug craving, anxiety, depressed mood, increased appetite, fatigue, increased or decreased movement, sleeplessness or sleepiness, lack of motivation, lucid dreaming.
The severity of these symptoms is correlated with the age of the individual and with the extent of the dependence.
Drug interactions may change the way that your medications work or they may increase your risk of serious side effects. Do not start, stop or change the dosage of your medicines without the approval from your doctor.
- Monoamine oxidase inhibitors (MAOIs) taken with Adderall may cause a hypersensitive crisis if they’re taken within two weeks after the last use of a MAOI type drug.
- Enzyme inhibitors which directly metabolize amphetamines will cause a prolonged elimination of amphetamines from the body.
- Stimulants and antidepressants (sedatives and depressants) may increase (decrease) the effects of Adderall and also vice versa.
- Dietary pH affects the absorption and the elimination of Adderall; alkaline diets increase the absorption rate and reduce the excretion rate, and acidic foods do exactly the opposite.
- Zinc supplementation may reduce the minimum effective dose of Adderall when it’s used for treating ADHD.
Adderall is considered to be a highly effective drug, but there are some severe side effects involved in its use; therefore you must speak to a health professional before starting to take it. It is worth trying if you want to overcome your ADHD or sleeping disorders, Remember to pay considerable attention to the way in which your body reacts to the drug and if you notice any adverse side-effect, you should stop the use of this medication, and you should also consider consulting your doctor immediately.
As Adderall is habit-forming, you should never share this medicine with another person, especially if they’re someone with a history of drug addiction or abuse.
When it’s used correctly, Adderall has enormous benefits for people with serious health conditions that include narcolepsy and ADHD, and it helps them lead a healthy life.