From the Guidelines
Adderall (amphetamine and dextroamphetamine) can cause several side effects, including decreased appetite, weight loss, dry mouth, headache, stomach pain, nausea, dizziness, trouble sleeping, nervousness, and irritability, as well as more serious effects like increased blood pressure and heart rate, and psychiatric symptoms such as mood changes and hallucinations, as noted in a 2019 study published in Pediatrics 1.
Common Side Effects
- Decreased appetite
- Weight loss
- Dry mouth
- Headache
- Stomach pain
- Nausea
- Dizziness
- Trouble sleeping (insomnia)
- Nervousness
- Irritability These side effects are commonly observed in patients taking Adderall, and they can vary in severity depending on the individual and the dosage, as discussed in the study by Wolraich et al. 1.
Serious Side Effects
- Increased blood pressure and heart rate, which can lead to cardiovascular problems such as heart attack or stroke in some individuals, particularly those with pre-existing heart conditions
- Psychiatric side effects, including mood changes, agitation, aggression, and in rare cases, psychosis or hallucinations
- Long-term use may lead to physical dependence and withdrawal symptoms when stopping the medication
- Children taking Adderall might experience slowed growth The study published in Pediatrics in 2019 highlights the importance of monitoring patients for these serious side effects, especially those with a history of cardiac symptoms or cardiovascular disease 1.
Special Considerations
- The medication carries a risk of misuse and addiction due to its stimulant properties
- Side effects typically depend on dosage, individual sensitivity, and duration of use
- If experiencing concerning side effects, patients should consult their healthcare provider rather than stopping the medication abruptly, as this could lead to withdrawal symptoms As noted in the 2019 study, clinicians should carefully evaluate the benefits and risks of Adderall treatment, particularly in children and adolescents, and monitor patients closely for potential side effects 1.
From the FDA Drug Label
Long-Term Suppression of Growth ... suggests that consistently medicated children (i.e., treatment for 7 days per week throughout the year) have a temporary slowing in growth rate ... Seizures There is some clinical evidence that stimulants may lower the convulsive threshold in patients with prior history of seizures, in patients with prior EEG abnormalities in absence of seizures, and, very rarely, in patients without a history of seizures and no prior EEG evidence of seizures. Peripheral Vasculopathy, including Raynaud's phenomenon Stimulants, including amphetamine sulfate, used to treat ADHD are associated with peripheral vasculopathy, including Raynaud's phenomenon. Serotonin Syndrome Serotonin syndrome, a potentially life-threatening reaction, may occur when amphetamines are used in combination with other drugs that affect the serotonergic neurotransmitter systems... Visual Disturbance Difficulties with accommodation and blurring of vision have been reported with stimulant treatment. Symptoms Manifestations of acute overdosage with amphetamines include restlessness, tremor, hyperreflexia, rhabdomyolysis, rapid respiration, hyperpyrexia, confusion, assaultiveness, hallucinations, panic states.
The side effects of Adderall (amphetamine and dextroamphetamine) include:
- Long-term growth suppression in children
- Seizures, especially in patients with a history of seizures or EEG abnormalities
- Peripheral vasculopathy, including Raynaud's phenomenon
- Serotonin syndrome, a potentially life-threatening reaction, when used with other serotonergic drugs
- Visual disturbances, such as difficulties with accommodation and blurring of vision
- Overdose symptoms, including restlessness, tremor, hyperreflexia, rhabdomyolysis, rapid respiration, hyperpyrexia, confusion, assaultiveness, hallucinations, and panic states 2 2
From the Research
Side Effects of Adderall
The side effects of Adderall, a medication containing amphetamine and dextroamphetamine, can be significant. According to the studies, some of the possible side effects include:
- Neurological effects such as mydriasis, tremor, agitation, hyperreflexia, combative behavior, confusion, hallucinations, delirium, anxiety, paranoia, movement disorders, and seizures 3
- Cardiovascular effects, including increased heart rate and blood pressure 3, 4
- Gastrointestinal effects, such as abdominal pain, decreased appetite, vomiting, and nausea 5
- Renal, muscle, and pulmonary effects can also occur, although these are less common 3
Serious Side Effects
In rare cases, Adderall can cause serious side effects, including:
- Acute myocardial infarction, particularly when used in conjunction with alcohol 4
- Suicidal ideation, as noted in the black-box warning for atomoxetine, although this is not directly related to Adderall 5
- Serious liver injury, as reported in postmarketing data for atomoxetine, although this is not directly related to Adderall 5
Comparison to Other Medications
Adderall has been compared to other medications, such as Ritalin, in terms of efficacy and time-course. Studies have shown that Adderall can produce greater improvement than Ritalin, particularly at lower doses, and can have a longer duration of action 6. However, the side effect profiles of the two medications are similar, with both producing low and comparable levels of clinically significant side effects 6.
Excretion Profile
The excretion profile of amphetamine following administration of Adderall has been studied, with results showing that peak amphetamine concentrations can range from 2645 to 5948 ng/mL, and samples containing > or = 500 ng/mL of amphetamine can be seen up to 47:30 h post dose 7. The presence of the l-enantiomer in Adderall can help differentiate it from other preparations of amphetamine, such as dexedrine, which contains only the d-enantiomer 7.