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 possible side effects of Adderall (amphetamine and dextroamphetamine) 60 mg daily in an 84-year-old patient may include:
- Cardiovascular side effects such as palpitations, tachycardia, and elevation of blood pressure
- Central Nervous System side effects such as psychotic episodes, overstimulation, restlessness, dizziness, insomnia, and euphoria
- Gastrointestinal side effects such as dryness of the mouth, unpleasant taste, diarrhea, constipation, and other gastrointestinal disturbances
- Allergic reactions such as urticaria
- Endocrine side effects such as impotence and changes in libido 1
From the Research
Adderall (amphetamine and dextroamphetamine) at 60 mg daily is generally not recommended for an 84-year-old patient due to significant safety concerns, as it may increase the risk of adverse cardiovascular events, such as stroke or heart attack, and worsen existing conditions like anxiety, glaucoma, or hyperthyroidism 2. This dose is particularly high for an elderly individual and carries substantial risks. Common side effects in this age group include:
- Increased blood pressure
- Irregular heartbeat
- Heart palpitations
- Elevated risk of cardiovascular events such as stroke or heart attack Elderly patients may experience more pronounced neurological effects including:
- Confusion
- Agitation
- Hallucinations
- Delirium Sleep disturbances, decreased appetite, weight loss, and dry mouth are also common concerns. The medication may worsen existing conditions like anxiety, glaucoma, or hyperthyroidism. Age-related changes in kidney and liver function can lead to higher blood levels of the medication, intensifying side effects. Additionally, drug interactions are a serious concern as many elderly patients take multiple medications. If Adderall treatment is absolutely necessary, it should be started at a much lower dose (typically 5-10 mg daily) with careful monitoring and gradual adjustments based on response and tolerability, as daily oral amphetamines increase blood pressure, heart rate, and withdrawals due to adverse effects, with these effects observed across all time points, including shorter and longer durations of use 2.