What is the starting dose of Adderall XR (amphetamine and dextroamphetamine) for adult Attention Deficit Hyperactivity Disorder (ADHD)?

Starting Dose of Adderall XR for Adult ADHD

The recommended starting dose of Adderall XR for adults with ADHD is 10 mg once daily in the morning. 1

Dosing Guidelines

• Adderall XR (amphetamine mixed salts extended-release) should be initiated at 10 mg taken once daily in the morning 1
• After starting at 10 mg, the dose can be titrated by 5 mg weekly increments based on response and tolerability 1
• Maximum recommended daily dose is 50 mg for adults 1
• Dosing should occur in the morning (qam) to minimize sleep disturbances 1

Titration Protocol

• Week 1: Start with 10 mg once daily in the morning 1
• Week 2 and beyond: Increase by 5 mg weekly as needed for symptom control 1
• Titration should continue until optimal symptom control is achieved or side effects become problematic 1
• Clinical response should be assessed using standardized ADHD rating scales to guide dose adjustments 1

Evidence Quality and Considerations

• The 10 mg starting dose recommendation comes from the most recent clinical guidelines (2024) published in the American Journal of Obstetrics and Gynecology 1
• Clinical trials have demonstrated efficacy of Adderall XR at doses ranging from 10-60 mg daily for adult ADHD 2
• Long-term studies (up to 24 months) have shown sustained efficacy with doses titrated from 20-60 mg/day 3

Monitoring During Initiation

• Monitor for common side effects including dry mouth, insomnia, decreased appetite, headache, and nervousness 3
• Assess vital signs (blood pressure, pulse) at baseline and with each dose increase 1
• Evaluate both therapeutic effects and side effects before each dose increase 1

Special Considerations

• Adults with severe ADHD symptoms may require higher doses (up to 50 mg daily), but should still start at 10 mg 2
• The extended-release formulation provides approximately 12 hours of symptom control with once-daily dosing 2
• If inadequate response occurs with Adderall XR despite appropriate titration, consider switching to an alternative stimulant 1

Common Pitfalls to Avoid

• Starting at too high a dose can lead to unnecessary side effects and decreased medication adherence 1
• Failure to systematically assess both benefits and side effects during titration 1
• Not allowing sufficient time between dose increases (minimum one week) to evaluate response 1
• Overlooking the importance of morning administration to minimize sleep disturbances 1