Getting up to speed on Adderall

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The Bottom Line

Adderall is a combination of 2 central nervous stimulants: amphetamine and dextroamphetamine. It is available as immediate release and extended-release formulations.

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What is Adderall? 

Adderall is a combination of 2 central nervous stimulants: amphetamine and dextroamphetamine. It is available as immediate release and extended-release formulations. 

What is Adderall used for?

Adderall is used for the treatment of attention deficit hyperactivity disorder (ADHD). It increases the levels of dopamine and norepinephrine in the brain which improves focus and cognitive performance. It is used to treat narcolepsy, a disorder characterized by daytime sleepiness which causes the person to suddenly fall asleep during the day. It is also abused for its euphoric effect, to suppress appetite, and to improve athletic performance. 

Common side effects of Adderall 

Common side effects include anxiety, nervousness, headache, talkativeness, weakness, sleep disturbances, dry mouth, stomachache, constipation, and a decrease in appetite leading to weight loss. Your body may get used to some of these side effects so that they eventually disappear or improve.  

More serious side effects are less common, but can include an increase in blood pressure, dizziness, tics (sudden recurrent movements or sounds), bruxism (teeth grinding), rashes, panic attacks, hallucinations, depression, and paranoia. 

Symptoms of an Adderall overdose

Central nervous system effects include euphoria, severe anxiety, agitation, psychosis, seizures, and coma. Cardiac effects include increased heart rate, significant increased blood pressure, myocardial ischemia, and heart attack. 

Other physical effects include muscle spasm and rigidity, involuntary muscle contractions, tremors, sweating, and bruxism. Deaths are due to ventricular arrhythmias, uncontrolled seizures, intracranial hemorrhage, or markedly elevated temperature. 

Do any other drugs interact with Adderall? 

Yes, many drugs interact with Adderall. Some examples include antidepressants, antivirals, migraine medications, pain killers (some opioids), antipsychotics, seizure medications, gastrointestinal medications (including antacids, H2 blockers, and proton pump inhibitors), and blood pressure drugs. Adderall can also interact with some herbals, vitamins, alcohol, and foods (such as caffeine). Therefore, it is important to check with your doctor or pharmacist about potential interactions if you are taking Adderall. 

What to do if someone is experiencing negative effects of Adderall? 

If someone is experiencing mild side effects from therapeutic doses, contact the prescriber to see whether a lower dose or different medication is indicated. If someone is experiencing more severe side effects or has taken an overdose, referral to an emergency department is probably needed. If you are unsure what to do, help from experts is available through the webPOISONCONTROL online tool and by phone at 1-800-222-1222. Poison Control’s expert guidance is always free, confidential, and available 24 hours a day.

 

Wendy Klein-Schwartz, Pharm.D., MPH
Clinical Toxicologist 

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Store medicines up, away, and out of sight of children.
  • Take the prescribed dose at the scheduled time.
  • Avoid using Adderall for recreational or non-medical purposes.
  • Do not share your Adderall with others or take someone else’s Adderall.
  • Consult with a physician or pharmacist or use an online drug interaction checker before taking other medications, herbal supplements, vitamins, caffeine or alcohol with Adderall.
  • Be aware of potential side effects and let your physician know if you think you are experiencing them.
  • Do not abruptly stop taking Adderall, since it may precipitate withdrawal symptoms such as agitation, depression or extreme tiredness. It may be necessary to taper the dose over time.
  • Do not use it if pregnant or breastfeeding unless your doctor feels that benefits outweigh risks.

This Really Happened

An 18-month-old girl swallowed 2-3 of her brother’s Adderall pills. She became agitated and restless, with dystonic movements. She was staring out into space and not responding to her name.  The mother called Poison Control and was told to take her daughter to the emergency department (ED). In the ED, she was hypertensive, with an elevated heart rate and respiratory rate, as well as a mildly elevated temperature. She was awake but restless, irritable, and crying on and off. She was not responding to her mother, the doctors, or the nurses. Urine toxicology screen was positive for amphetamines. Other lab values were normal. She was admitted for observation and started on intravenous fluids. She did not need other treatment. Over the next 8-12 hours, she became responsive and interactive with normal blood pressure, heart rate, and temperature. She was discharged the following day.


References

Aria A, Pourbadakhshan N, Alizadeh A. Evaluation of the Clinical and Paraclinical Symptoms of Children Intoxicated With Amphetamines in Akbar Hospital of Mashhad, Iran 2021-2022. Pediatr Emerg Care. 2024 Nov 1;40(11):766-769. doi: 10.1097/PEC.0000000000003234. 

Clemow DB, Walker DJ. The potential for misuse and abuse of medications in ADHD: a review. Postgrad Med. 2014 Sep;126(5):64-81. doi: 10.3810/pgm.2014.09.2801.

DeCoster MM, Spiller HA, Badeti J, Casavant MJ, Rine NI, Michaels NL, Zhu M, Smith GA. Pediatric ADHD Medication Errors Reported to United States Poison Centers, 2000 to 2021. Pediatrics. 2023 Oct 1;152(4):e2023061942. doi: 10.1542/peds.2023-061942.

Kaland ME, Klein-Schwartz W. Comparison of lisdexamfetamine and dextroamphetamine exposures reported to U.S. poison centers. Clin Toxicol (Phila). 2015 Jun;53(5):477-85. doi: 10.3109/15563650.2015.1027903. 

King SA, Casavant MJ, Spiller HA, Hodges NL, Chounthirath T, Smith GA. Pediatric ADHD Medication Exposures Reported to US Poison Control Centers. Pediatrics. 2018 Jun;141(6):e20173872. doi: 10.1542/peds.2017-3872. 

Leonard JB, Howard AK, Hines EQ. Toxicity of acute exploratory amphetamine-salt medication in amphetamine-naïve pediatrics: a retrospective cohort study. Clin Toxicol (Phila). 2020 Sep;58(9):907-912. doi: 10.1080/15563650.2019.1703997. 

Spiller HA, Hays HL, Aleguas A Jr. Overdose of drugs for attention-deficit hyperactivity disorder: clinical presentation, mechanisms of toxicity, and management. CNS Drugs. 2013 Jul;27(7):531-43. doi: 10.1007/s40263-013-0084-8. 

Toce MS, Farias M, Bruccoleri R, Brown DW, Burns MM. A Case Report of Reversible Takotsubo Cardiomyopathy after Amphetamine/Dextroamphetamine Ingestion in a 15-Year-Old Adolescent Girl. J Pediatr. 2017 Mar;182:385-388.e3. doi: 10.1016/j.jpeds.2016.11.038. 

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Store medicines up, away, and out of sight of children.
  • Take the prescribed dose at the scheduled time.
  • Avoid using Adderall for recreational or non-medical purposes.
  • Do not share your Adderall with others or take someone else’s Adderall.
  • Consult with a physician or pharmacist or use an online drug interaction checker before taking other medications, herbal supplements, vitamins, caffeine or alcohol with Adderall.
  • Be aware of potential side effects and let your physician know if you think you are experiencing them.
  • Do not abruptly stop taking Adderall, since it may precipitate withdrawal symptoms such as agitation, depression or extreme tiredness. It may be necessary to taper the dose over time.
  • Do not use it if pregnant or breastfeeding unless your doctor feels that benefits outweigh risks.

This Really Happened

An 18-month-old girl swallowed 2-3 of her brother’s Adderall pills. She became agitated and restless, with dystonic movements. She was staring out into space and not responding to her name.  The mother called Poison Control and was told to take her daughter to the emergency department (ED). In the ED, she was hypertensive, with an elevated heart rate and respiratory rate, as well as a mildly elevated temperature. She was awake but restless, irritable, and crying on and off. She was not responding to her mother, the doctors, or the nurses. Urine toxicology screen was positive for amphetamines. Other lab values were normal. She was admitted for observation and started on intravenous fluids. She did not need other treatment. Over the next 8-12 hours, she became responsive and interactive with normal blood pressure, heart rate, and temperature. She was discharged the following day.