From the FDA Drug Label
Amphetamines may interfere with urinary steroid determinations.
The FDA drug label does not answer the question about the relationship between amphetamine-based ADHD medications and hyperandrogenism, as it only mentions interference with urinary steroid determinations, but does not provide direct information on hyperandrogenism. 1
From the Research
Amphetamine-based ADHD medications do not directly cause hyperandrogenism, though they may occasionally influence hormonal balance through indirect mechanisms. Common ADHD stimulants like Adderall (mixed amphetamine salts), Vyvanse (lisdexamfetamine), and Dexedrine (dextroamphetamine) primarily affect dopamine and norepinephrine neurotransmission rather than directly altering androgen levels. However, these medications can potentially influence stress hormones like cortisol, which may indirectly affect the hypothalamic-pituitary-adrenal axis that regulates various hormones including androgens. Some patients report menstrual irregularities while taking stimulants, but this is not typically due to hyperandrogenism. If a patient develops symptoms of hyperandrogenism (excessive hair growth, acne, irregular periods) while taking amphetamine-based medications, they should consult their healthcare provider for evaluation, as these symptoms more likely indicate an underlying condition like polycystic ovary syndrome (PCOS) rather than a medication side effect 2. Laboratory testing of androgen levels can help determine if hyperandrogenism is present and identify its cause. Patients should not discontinue their ADHD medication without medical consultation, as proper management typically involves treating both conditions separately rather than assuming a causal relationship. The most recent study on the pharmacogenetic impact on the pharmacokinetics of ADHD medications found that atomoxetine is predominantly metabolized by cytochrome p450 2D6 (CYP2D6), while methylphenidate is metabolized by carboxylesterase 1 (CES1) 2. However, this study does not provide direct evidence on the relationship between amphetamine-based ADHD medications and hyperandrogenism. Other studies have shown that stimulant therapy of ADHD has long-term beneficial effects and is well tolerated, but they do not address the specific question of hyperandrogenism 3. In conclusion, the current evidence suggests that amphetamine-based ADHD medications are not a direct cause of hyperandrogenism, and any symptoms of hyperandrogenism should be evaluated and treated separately. It is essential to consider the pharmacogenetic profile of each patient when prescribing ADHD medications, as it can affect the pharmacokinetics of the medication 2. Healthcare providers should be aware of the potential indirect effects of amphetamine-based medications on hormonal balance and monitor patients for any symptoms of hyperandrogenism. Further studies are needed to fully understand the relationship between amphetamine-based ADHD medications and hyperandrogenism.