Adderall is a psychostimulant amphetamine drug that is most commonly prescribed to reduce symptoms of ADHD. Unfortunately, it is also widely abused due to its supposed “cognitive-enhancing” effects, which can lead to addiction and other serious negative consequences. Read on to learn about its potential adverse side-effects and other risks associated with it!
Disclaimer: This post is not a recommendation or endorsement for Adderall. This medication is only FDA-approved for the treatment of certain specific medical disorders, and can only be taken by prescription and with oversight from a licensed medical professional. We have written this post for informational purposes only, and our goal is solely to inform people about the science behind Adderall’s effects, mechanisms, current medical uses, and potential risks.
Adderall Side Effects
Overall Safety
Given that Adderall has met FDA approval for official medical use, the majority of scientific evidence supports the overall safety and effectiveness of Adderall when used as prescribed, and under the supervision of qualified medical professionals.
Nonetheless, like any drug, there is always at least some potential of experiencing adverse side-effects, and so it’s important to be aware of these.
In general — and similar to many commonly-used pharmaceutical drugs — the rate of adverse side-effects tends to increase at progressively higher doses [1].
Serious Side Effects
If you experience any of the following symptoms occur after taking Adderall, contact your doctor immediately [2, 3]:
- Seizures (convulsions)
- Changes in vision or blurred vision
- Pupil dilation (mydriasis)
- Allergic reactions: symptoms of this can include itching or hives, swelling of the mouth, face, or hands, difficulty breathing, feeling like you are about to pass out, or tightness in the chest.
- Anxiety
- Fever or sweating
- Muscle problems such as spasms or twitching
- Nausea, vomiting, or diarrhea
- Hallucinations (visual and auditory)
- Chest pain
- Fainting
- Extreme energy
- Confusion
- Agitation
- Unusual mood or behavior
- Signs of heart problems (can be fast, slow, or uneven heartbeats)
- Signs of circulation problems (unexplained bruises, numbness, cold, color changes, or pain in fingers or toes)
Finally, abuse of Adderall by athletes may be especially dangerous, as it can cause dramatically elevated body temperature (hyperthermia), which may, in turn, induce heat stress. The dangers are further increased because the subjectively “stimulating” and “energizing” effects of Adderall abuse can cover-up (“mask”) the symptoms of heat stress — such as sudden exhaustion or fatigue — which, when ignored or unnoticed, can result in major medical emergencies [4].
Common Side Effects
The following side-effects are not as severe, but have been reported to occur slightly more frequently in patients taking Adderall [2]:
- Dry mouth
- Dizziness
- Headache
- Loss of appetite
- Weight loss (Although weight loss may potentially be counteracted through the use of other (complementary) medications such as cyproheptadine, or even simply by consuming a higher-calorie diet [5])
- Insomnia
- Stomach pain
According to one report, Adderall may impair short-term memory in some users [4].
Psychological Side Effects
Adderall may also lead to “antisocial” feelings, keeping users from enjoying or participating in interactions with others [6].
Some of the psychological side-effects of Adderall may occur due to the greatly elevated levels of dopamine that Adderall (and other amphetamines and stimulants) cause throughout the brain — a mechanism that is also shared by other major psychiatric disorders, such as schizophrenia. For example, according to one study of 14 amphetamine-dependent patients, 12 were reported to go on to develop psychosis. This reportedly led to a number of schizophrenia-like symptoms, such as intense paranoia and hallucinations [7, 8].
Weight-Related Side Effects
According to one study of 56 child and adolescent ADHD patients, one of the most commonly reported negative side-effects of Adderall was weight loss. This was more prominent at higher doses [1].
Although Adderall-induced weight loss is usually not severe, in some cases it has been reported to lead to anorexia. For example, one study of 584 children found that anorexia occurred in 21.9% of psychostimulant patients. Similarly, a study of 287 teens reported the occurrence of anorexia in as much as 35.6% of the treated ADHD patients [1, 9, 10].
However, in some relatively rarer cases, Adderall may actually cause weight gain. For example, the authors of a single case study of an 11-year old boy reported that Adderall use increased one young boy’s weight by 8.8 lbs. in just 6 weeks. Changing the timing of Adderall consumption from right after meals to 45 minutes before meals reportedly helped to normalize this sudden and severe weight gain [11].
Cardiovascular Side Effects
One of the most dangerous side-effects of treatment with amphetamines — including Adderall and others — can be a heart attack or stroke. Although these side-effects can potentially occur in anyone, patients with a personal or family history of heart conditions are believed to be at an especially elevated risk of experiencing such complications [12, 13].
These heart problems and other adverse cardiovascular side-effects may be brought about by the significant changes in heart rate and blood pressure that are commonly seen following Adderall consumption. On average, Adderall increases heart rate by 1-2 beats per minute. As the dose is increased, heart rate increases proportionately — and this can result in dangerously elevated heart rate or blood pressure [14, 5].
Adderall also stimulates β-adrenergic receptor sites all over the body, which causes the release of the neurotransmitter norepinephrine. Norepinephrine is believed to play a prominent role in stimulating increased heart rate and blood pressure, which may further contribute to some of Adderall’s potential cardiovascular risks [3, 15].
Additionally, some researchers have reported that the cardiovascular risks of Adderall may be greatly increased when it is combined with alcohol — and therefore patients are often advised against consuming alcohol while on an Adderall prescription [16, 17].
Because Adderall can increase heart rate, some researchers have advised that prospective patients should undergo electrocardiogram testing before proceeding with therapy. In part, this is because it is believed that many of the (otherwise rare) cases of patients who suffered from amphetamine-induced heart attacks were not screened for potential underlying heart problems, which therefore could have possibly prevented these unfortunate (though relatively rare) incidents [5].
Adderall Contraindications & Drug Interactions
Contraindications
Although Adderall has a number of relatively well-supported medical uses when administered by qualified medical professionals, there are a number of factors that doctors may look for that might disqualify someone from receiving Adderall treatment (due to elevated risk of negative side-effects or other adverse reactions).
One of the most dangerous potential side-effects of Adderall can be cardiovascular issues, such as heart attacks or strokes. Patients with a personal or family history of heart conditions are believed to be at significantly elevated risk of these types of side-effects, and are therefore generally highly discouraged from using Adderall or other amphetamines or stimulant medications [12, 13].
Some of the other contraindications against Adderall use include [18, 2]:
- High blood pressure (hypertension) and various other cardiovascular conditions
- Severe anxiety
- Glaucoma
- Tourette’s syndrome (muscle twitches, otherwise known as tics)
- Depression
- Frequent seizures
- History of drug abuse
- Overactive thyroid (hyperthyroidism)
- History of allergies or hypersensitivities to Adderall or any other amphetamines
Additionally, due to potential safety concerns, you consult with your doctor before taking Adderall if you have any of these conditions [2, 18]:
- Pregnancy / breastfeeding
- Heart or blood vessel diseases
- Kidney disease
- History of heart attack, stroke, or seizure
- Self-history or family history of depression or mental health problems
- Liver damage
Also be sure to tell any doctor or dentist you see that you are on Adderall, as it can affect the results of certain medical tests [2].
Drug Interactions
Like many drugs, Adderall (and other amphetamines and stimulants) can interact with the effects of other drugs, which can potentially cause significant and highly-dangerous health complications.
As always, the best way to minimize the risk of adverse drug interactions is to discuss all treatment options with your doctor, and to make sure that he or she is fully informed about any other medications or supplements you are taking, other pre-existing health conditions, or any other potentially health-related factors that may affect your treatment.
For example, combining alcohol with Adderall has been linked with significantly increased risks of heart attacks and other adverse cardiovascular events [16, 17].
Combining Adderall and monoamine-oxidase inhibitors (MAOIs) can also be highly dangerous. Combining these two types of drugs can result in potentially-severe side-effects such as [19]:
- Agitation
- Muscle spasms (hyperkinesis and opisthotonus)
- Fever (of up to 109.4 ℉)
- Coma
- Convulsions
It is also important to note that MAOIs can remain in the body for up to several days or weeks after stopping these medications. For these reasons, many experts advise patients who have taken MAOIs to wait at least 14 days before starting a subsequent prescription for Adderall [19].
In addition to these two examples, Adderall has also been reported to interfere with many other drugs and medications. Ask a doctor about using Adderall if taking any of the following medications or substances [2]:
- Acetazolamide
- Ammonium chloride
- Buspirone
- Chlorpromazine
- Ethosuximide
- Fentanyl
- Glutamic acid
- Guanethidine
- Haloperidol
- Hydrochlorothiazide
- Lithium
- Meperidine
- Methenamine
- Phenobarbital
- Phenytoin
- Propoxyphene
- Quinidine
- Reserpine
- Ritonavir
- Sodium acid phosphate
- St. John’s Wort
- Tramadol
- Tryptophan supplements
- Allergy medicine
- Antacids
- Cimetidine
- Esomeprazole
- Omeprazole
- Pantoprazole
- Sodium bicarbonate
- Blood pressure medications
- Desipramine
- Fluoxetine
- Paroxetine
- Protriptyline
- Migraine medications
On the other hand, there are also some potential interactions that can be harmful by interfering with the therapeutic effects of Adderall in people who are taking it as directed by their doctor. For example, taking high doses of vitamin C (such as by using vitamin supplements), or even just drinking juices high in vitamin C, have each been reported to interfere with the absorption or action of Adderall in the body, which may in turn “cancel out” the intended therapeutic effects of the medication [2].
Adderall Addiction and Withdrawal
Adderall is widely considered to have a relatively high risk of addiction, dependence, and withdrawal symptoms [20].
This is true even when it is used properly and legally, under the supervision of a medical professional. However, doctors generally minimize these risks by prescribing the appropriate dosage to each patient, based on their individual therapeutic needs and medical history. This medical approach to minimizing risk is one of the main reasons why it is so important to only use psychostimulant medications like Adderall exactly as prescribed and directed by a doctor.
Conversely, the risks for addiction, dependence, and potentially-severe withdrawal syndromes are dramatically increased when Adderall (and other psychostimulant medications) are illegally abused [20].
Withdrawal can involve a number of moderate-to-severe symptoms, including [20]:
- Amphetamine cravings
- Fatigue
- Depression
- Social dysfunction
Adderall Abuse (Non-Prescribed Use)
Prevalence
Due to the increasing prevalence and normalization of Adderall use among certain populations, many people have mistaken beliefs that Adderall abuse is not significantly dangerous. In fact, according to a recent survey of university students, only 2% of students that abused Adderall believed that the drug could be “very dangerous,” while up to 81% of Adderall abusers believed Adderall to be “not dangerous at all” or only “slightly dangerous” [21].
Abuse rates have also been increasing in adults. For example, the number of adults over the age of 55 that have been sent to the ER due to complications from amphetamine abuse increased by 700% just between the years of 1995 and 2002 alone. Relatedly, some public health studies have estimated that the number of adults that will need treatment for amphetamine abuse will rise from 1.7 million in 2000 to as much as 4.4 million in 2020 [4, 22, 20].
Additionally, some evidence suggests that the ability to “clear out” (metabolize) amphetamines tends to decrease with age. This has led some researchers to suggest that adults may be at a relatively increased risk of amphetamine abuse and addiction since their bodies can’t process the drug as effectively [20].
Adderall Abuse for “Cognitive Enhancement”
One of the most prevalent reasons that people report abusing Adderall is to increase their ability to focus, or enhance their motivation for school- and work-related activities.
For example, according to a recent survey of students who abuse Adderall (“non-prescription Adderall users”), 93.5% reported abusing Adderall and other stimulants in order to increase their focus during studying [4, 23].
Students who abuse Adderall also commonly report [24]:
- Improvements in mood
- Increased motivation to work
- Less time needed to accomplish tasks
- Increased physical and mental energy
However, there is actually very little scientific evidence supporting the fact that Adderall genuinely or significantly improves cognitive performance in non-prescription users [23].
For example, one study of 46 volunteers reported that Adderall had no detectable effects on memory, creativity, intelligence, or standardized test scores — even though the volunteers falsely believed that their performance was improving [25]!
Merely believing that Adderall can “improve” cognitive performance may, in fact, help some people simply by increasing self-confidence. Therefore, even if there is no actual “cognitive boost,” some of the “cognitive enhancements” that Adderall abusers typically claim to experience may simply be driven by the placebo effect [25, 23].
Nonetheless, many researchers believe that these considerably widespread and persistent misconceptions about the so-called “cognitive-enhancement effects” of amphetamines continue to be one of the main factors driving people to abuse Adderall and other controlled substances [23].
Takeaway
Adderall is among the most commonly prescribed medications for ADHD. It has a good safety profile compared to other stimulants when used properly.
Serious side effects like seizures, confusion, changes in perception, and heart problems are rare. Get immediate medical help if you experience any of them.
Mild weight and psychological side effects are also possible but rarely severe.
Unfortunately, Adderall abuse is on the rise due to a false belief that this drug is “harmless.” College students and adults take it for “cognitive enhancement” and athletes abuse it to “boost physical performance.”
Adderall has a high potential for addiction and it can interact with alcohol and many prescription drugs. Adderall abuse massively increases the risk of serious side effects, dependence, and withdrawal.
