What are the side effects of Adderall (amphetamine and dextroamphetamine)?

From the Guidelines

Adderall can cause several side effects, including decreased appetite, weight loss, dry mouth, headache, stomach pain, nausea, difficulty sleeping, increased heart rate, and elevated blood pressure, as reported in a 2019 study 1.

Common Side Effects

• Decreased appetite
• Weight loss
• Dry mouth
• Headache
• Stomach pain
• Nausea
• Difficulty sleeping
• Increased heart rate
• Elevated blood pressure These side effects are typically associated with the use of stimulants, such as Adderall, which works by increasing levels of neurotransmitters like dopamine and norepinephrine in the brain 1.

Serious Side Effects

More serious but less common side effects may include:

• Cardiovascular problems like heart palpitations or chest pain
• Psychiatric effects such as hallucinations or paranoia
• Rarely, seizures Long-term use can potentially lead to psychological dependence.

Management of Side Effects

If you're taking Adderall and experiencing concerning side effects, don't stop the medication abruptly but consult your healthcare provider promptly 1. They may adjust your dosage, recommend taking the medication earlier in the day to reduce sleep issues, suggest staying hydrated to minimize dry mouth, or potentially switch you to an alternative medication if side effects are severe or persistent.

Monitoring and Follow-up

Regular monitoring of vital signs, including blood pressure and pulse, is recommended, especially in adults, who should have their blood pressure and pulse checked on a quarterly basis 1. Children should have their vital signs checked annually during their routine physical examination.

Individualized Treatment

The treatment regimen should be individualized, taking into account the patient's response to the medication, potential side effects, and other factors, such as comorbidities and concomitant medications 1.

From the FDA Drug Label

ADVERSE REACTIONS Cardiovascular: Palpitations, tachycardia, elevation of blood pressure. There have been isolated reports of cardiomyopathy associated with chronic amphetamine use. Central Nervous System: Psychotic episodes at recommended doses (rare), overstimulation, restlessness, dizziness, insomnia, euphoria, dyskinesia. dysphoria, tremor, headache, exacerbation of motor and phonic tics and Tourette's syndrome. Gastrointestinal: Dryness of the mouth, unpleasant taste, diarrhea, constipation, other gastrointestinal disturbances. Anorexia and weight loss may occur as undesirable effects. Allergic: Urticaria. Endocrine: Impotence, changes in libido. The common side effects of Adderall include:

• Cardiovascular issues such as palpitations, tachycardia, and elevation of blood pressure
• Central Nervous System problems like psychotic episodes, overstimulation, restlessness, and insomnia
• Gastrointestinal issues including dryness of the mouth, diarrhea, and constipation
• Allergic reactions like urticaria
• Endocrine changes such as impotence and changes in libido 2

From the Research

Adderall Side Effects

Adderall is a medication that contains amphetamines, which are used to treat attention deficit hyperactivity disorder (ADHD) [ 3 ]. The side effects of Adderall can be significant, and several studies have investigated these effects.

• Common side effects:
  • Increased heart rate and blood pressure [ 4 ]
  • Insomnia and sleep disturbances
  • Anxiety and agitation
  • Dry mouth and decreased appetite
• Less common side effects:
  • Psychotic episodes and hallucinations [ 5 ]
  • Suicidal thoughts and behaviors [ 5 ]
  • Cardiovascular problems, such as coronary artery dissection [ 6 ]
  • Growth retardation and self-destructive behavior [ 6 ]
• Rare but serious side effects:
  • Sudden death, although this is extremely rare [ 4 ]
  • Precocious puberty, which has been linked to methylphenidate but may also be a concern with amphetamines [ 5 ]
  • Liver damage and elevated liver enzymes, which has been associated with atomoxetine but may also be a concern with amphetamines [ 5 ]

Comparison to Other ADHD Medications

Adderall has been compared to other ADHD medications, such as methylphenidate and atomoxetine, in terms of its safety profile [ 5 ]. While all three medications have been associated with significant side effects, the specific risks and benefits of each medication can vary.

• Methylphenidate:
  • Associated with dyskinesia, myocardial infarction, and hypertension [ 6 ]
  • May have a higher risk of suicidal thoughts and behaviors compared to amphetamines [ 6 ]
• Atomoxetine:
  • Linked to hostility and aggression, taste and smell disorders, and elevated liver enzymes [ 5 ]
  • May have a higher risk of cardiovascular problems compared to amphetamines [ 6 ]

Importance of Monitoring and Individualized Treatment

Given the potential side effects of Adderall and other ADHD medications, it is essential to closely monitor patients and adjust treatment plans as needed [ 7 ]. Individualized treatment approaches can help minimize risks and maximize benefits for patients with ADHD.