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What Is Adderall (Adderall XR)?

Posted on November 20, 2017
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What is Adderall?

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 is used to treat narcolepsy and attention deficit hyperactivity disorder (ADHD). Adderall may also be used for purposes not listed in this medication guide.

Adderall is the brand name of a prescription medication used to treat attention deficit hyperactivity disorder (ADHD) in children and adults.

Adderall is a combination of two stimulant drugs, amphetamine and dextroamphetamine. Adderall XR is an extended-release form of the drug. Doctors also prescribe Adderall (but not Adderall XR) to treat narcolepsy.

Adderall may help people with ADHD control their activities and increase their attention spans. The drug may also prevent symptoms of narcolepsy, which include excessive sleepiness and sudden attacks of daytime sleepiness. The Food and Drug Administration (FDA) approved Adderall in 1960. The agency also has approved the combination of amphetamine and dextroamphetamine as a generic drug. DSM Pharmaceuticals makes the brand-name drug, and many drug companies make a generic version.

Adderall belongs to a class of drugs called central nervous system stimulants. The drug works by increasing levels of the brain chemical dopamine, which stimulates the brain.

This stimulation has a calming and focusing effect on people with ADHD.

Adderall Information

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 inhibitorin the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. 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, 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:

  • high blood pressure, heart disease, coronary artery disease (hardened arteries);
  • overactive thyroid;
  • glaucoma;
  • severe anxiety, tension, or agitation (stimulant medicine can make these symptoms worse); or
  • a history of drug or alcohol addiction.

Some medicines can interact with amphetamine and dextroamphetamine and cause a serious condition called serotonin syndrome. 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.

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, mental illness, bipolar disorder, psychosis, or suicidal thoughts or actions;
  • motor tics (muscle twitches) or Tourette’s syndrome;
  • seizures or epilepsy;
  • an abnormal brain wave test (EEG); 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.

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 ‘High’ and Abuse

Use of Adderall has surged in recent years.

Research shows that the number of ADHD medications prescribed to children increased 45 percent from 2002 to 2010. Of these drugs, Adderall was the second most-prescribed medication.

Sales of the drug jumped more than 3,000 percent from 2002 to 2006. In 2010 alone, the total number of Adderall prescriptions topped 18 million.

One reason for the surge in Adderall prescriptions is that increasing numbers of children and teenagers are getting an ADHD diagnosis.

However, doctors also prescribe the drug to children and adults who do not have ADHD.

This increased availability of Adderall has led to widespread abuse of the medication. Because Adderall increases dopamine levels, it can trigger a feeling of euphoria among people who don’t have a medical reason to take it. As a result, it has become a drug of choice among people trying to get “high,” who often crush and snort the pills or mix them water and inject them.

Because stimulants like Adderall increase alertness and attention, a growing number of people who do not have an ADHD diagnosis are using the drug to enhance their ability to think and focus.

This off-label use of Adderall is a growing trend, particularly among high school and college students who are trying to study for exams or boost their academic performance. Stimulants like Adderall, sometimes called “smart pills,” are currently the second most common form of drug use on college campuses.

Despite the widespread belief that Adderall can improve a person’s ability to learn, the drug does not enhance thinking ability in people who do not have ADHD. Young people who do not have ADHD but are taking Adderall to get better grades in school or gain an academic advantage are at risk for potentially deadly side effects.

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.

dosage

Doses of Adderall are individualized, so your dose will depend on why you’re taking Adderall, and on your response to the drug.

Doctors usually start with a low dose and increase the amount gradually. The best dose will be the lowest possible dose that works. A child older than 5 who is taking Adderall for ADHD would typically start with a dose of 5 milligrams (mg) and increase it gradually to 30 mg.

A typical dose for an adult with narcolepsy may start at 5 mg and increase to 60 mg. You can take Adderall and Adderall XR with or without food. People usually take Adderall tablets every four to six hours during the day.

People take Adderall XR capsules once a day, in the morning. Adderall taken in the evening can interfere with sleep.

Guidelines call for swallowing capsules whole. Or, you can open the capsule and sprinkle the contents into a teaspoon of applesauce. It’s important to take any opened medicine right away.

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

Comments:
-IR: The first dose should be given upon awakening; 1 to 2 additional doses should be given at intervals of 4 to 6 hours.
-Where possible, drug administration should be interrupted occasionally to determine if continued therapy is required.

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.

Comments:
-The first dose should be given on awakening; 1 to 2 additional doses should be given at intervals of 4 to 6 hours.
-The usual dose is 5 to 60 mg per day in divided doses, depending on the individual patient response.
-Dosage should be reduced if bothersome adverse reactions (e.g., insomnia, anorexia) appear.

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

Comments:
-IR: The first dose should be given on awakening; 1 to 2 additional doses should be given at intervals of 4 to 6 hours.
-Where possible, drug administration should be interrupted occasionally to determine if continued therapy is required.

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.

Comments:
-The first dose should be given on awakening; 1 to 2 additional doses should be given at intervals of 4 to 6 hours.
-The usual dose is 5 to 60 mg per day in divided doses, depending on the individual patient response.
-Dosage should be reduced if bothersome adverse reactions (e.g., insomnia, anorexia) appear.
-Narcolepsy rarely occurs in children under 12 years of age.

Use: Narcolepsy treatment

overdose

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amphetamine and dextroamphetamine 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.

Symptoms of an Adderall overdose may include:

  • Extreme restlessness
  • Confusion
  • Aggression
  • Panic attack
  • Hallucinations
  • Rapid breathing
  • Fever
  • Tremors
  • Extreme fatigue
  • Racing heart
  • Seizures
  • Loss of consciousness

Missed Dose of Adderall

Take Adderall exactly as directed by the doctor. Do not stop taking Adderall suddenly. This can cause severe depression, extreme tiredness, and other Adderall withdrawal symptoms. If you miss a dose of Adderall, take the missed dose as soon as you remember.

But, if it’s almost time for the next dose, skip the missed dose.

Do not double the dose to make up for a missed dose.

Adderall Warnings

Adderall can increase your risk for heart problems, high blood pressure, and stroke. If the person taking Adderall has a history of a heart defect or other heart problems, there is a risk for sudden death.

Doctors need to check children for any heart problems before prescribing Adderall. Adderall may increase your risk for mental health problems, including depression, bipolar disorder, and unusual behaviors including aggressive or hostile behavior.

Children on Adderall also may develop psychotic symptoms, which include seeing things that are not there (hallucinations) and believing things that are not true (delusions).

Adderall may be habit-forming. This is more likely if you take Adderall in larger doses, more often, or for longer than recommended by your doctor. You may need to take increasingly greater doses to control symptoms, but taking larger doses increases your risk for heart and mental health problems.

Children younger than 3 should not take Adderall, and children younger than 6 should not take Adderall XR.

Always tell your doctor if you have allergies to any medications. Let your doctor know about any:

  • Reactions you have had to other stimulants
  • Family history of heart problems, high blood pressure, or stroke
  • Family history of mental problems
  • Previous drug or alcohol abuse

Several other conditions your doctor will need to be aware of before prescribing Adderall for you include any history of:

  • Hyperthyroidism
  • Glaucoma or any eye problems
  • Anxiety
  • Tourette’s syndrome or any sudden, uncontrolled movements
  • Seizures
  • Liver disease
  • Kidney disease

If your child is taking Adderall, you should talk to the doctor about the risk for delayed growth.

Some stimulants may delay growth and development in children. A doctor will need to check your child regularly while the child is on Adderall.

It’s also important confirm a diagnosis of ADHD before treating a child with Adderall.

Sometimes, poor school performance or behavioral issues are symptoms of other problems that need treatment, such as trauma, dyslexia, or mental illness. Medical experts do not know whether Adderall is safe for elderly people. If you are older than 65, ask your doctor whether there are other drug options that might be safer for you.

Adderall Withdrawal

If you suddenly stop taking Adderall, you may have Adderall withdrawal symptoms, also known as an “Adderall crash.” Symptoms of Adderall withdrawal can include depression, insomnia or other sleep disorders, irritability, and extreme fatigue. You are at higher risk for Adderall addiction if you have abused drugs or alcohol in the past.

Adderall withdrawal can be managed with help from your doctor, who may advise you to slowly taper off your use of the drug.

Adderall and Pregnancy

Adderall might be unsafe to take during pregnancy. Because of this, talk with your doctor before starting Adderall if you are pregnant or may become pregnant, and call your doctor right away if you get pregnant while on Adderall.

Also, do not take Adderall while breastfeeding because the drug can pass through breast milk to a breastfeeding baby.

Adderall Side Effects

 Common side effects of Adderall include:

  • Nervousness
  • Dizziness
  • Restlessness
  • Headache
  • Stomach ache
  • Decreased appetite
  • Trouble sleeping
  • Dry mouth
  • Nausea
  • Weight loss
  • Constipation or diarrhea
  • Loss of interest in sex

If more serious side effects develop, call a doctor right away. Serious side effects of Adderall may include:

  • Changes in vision
  • Seizures
  • Chest pain
  • Trouble breathing
  • Fainting
  • Severe weakness or numbness
  • Uncontrolled movements or voice sounds
  • Hallucinations or delusions
  • Aggressive behavior
  • Uncontrollable behavior
  • Severe skin rash
  • Swelling of face, lips, or tongue
  • Difficulty swallowing or talking
  • Irregular heartbeat
  • 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 Adderall side effects may include:

  • stomach pain, loss of appetite;
  • weight loss;
  • mood changes, feeling nervous;
  • fast heart rate;
  • headache, dizziness;
  • sleep problems (insomnia); or
  • dry mouth.

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:

  • lithium or other medicine to treat depression or mental illness;
  • blood pressure 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 amphetamine and dextroamphetamine. 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.

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