From the Guidelines
The typical initial dosage of Adderall for ADHD in adults is 5 to 10 mg once or twice daily, usually starting with a morning dose. This dosage is based on the principle of starting with a low dose and gradually increasing it to achieve optimal symptom control while minimizing side effects, as suggested in the practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults 1. The medication should be taken early in the day to avoid sleep disturbances.
Key Considerations
- The dose may be gradually increased by 5-10 mg weekly based on response and tolerability, with a maximum recommended daily dose of 40 mg for amphetamines, as indicated in the study 1.
- Adderall is available in immediate-release (taken 2-3 times daily) and extended-release (XR) formulations (taken once daily), with the XR version often preferred for convenience and more consistent coverage throughout the day.
- Patients should take Adderall consistently, with or without food, though some find taking it with food helps reduce stomach upset.
- The medication works by increasing dopamine and norepinephrine levels in the brain, which improves attention, focus, and impulse control.
- Common side effects include decreased appetite, insomnia, dry mouth, and increased heart rate or blood pressure, which should be monitored regularly by a healthcare provider, as emphasized in the practice parameter 1.
Monitoring and Adjustment
- Follow-up assessment should include evaluation of target symptoms of ADHD, asked regularly of the patient, and may be supplemented by the use of self-rating scales, as suggested in the study 1.
- Side effects should be systematically assessed by asking specific questions of patients about known side effects, and weighing the patient at each visit provides an objective measure of loss of appetite.
- The titration phase of stimulant initiation covers the period of dose adjustment and often requires 2 to 4 weeks, with contact maintained on a weekly basis by telephone, and follow-up appointments should be made at least monthly until the patient’s symptoms have been stabilized 1.
From the Research
Typical Initial Dosage of Adderall for ADHD in Adults
- The typical initial dosage of Adderall for ADHD in adults is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, the studies discuss the efficacy and tolerability of various stimulant medications, including lisdexamfetamine, mixed amphetamine salts, methylphenidate, and modafinil, in the treatment of ADHD in adults 3, 4, 5.
- A meta-analysis of randomized, double-blind, placebo-controlled trials found that lisdexamfetamine, mixed amphetamine salts, and methylphenidate were effective in reducing ADHD symptoms in adults, with lisdexamfetamine having the largest effect size 5.
- The studies suggest that the dosage of stimulant medications should be individualized based on the patient's response and tolerability, but do not provide specific guidance on the initial dosage of Adderall for ADHD in adults 3, 4, 5, 6.
Available Dosage Information
- A study on the pharmacological and clinical assessment of stimulant prodrugs, including lisdexamfetamine, notes that a wide selection of dosages and linear pharmacokinetics are essential for the treatment of ADHD, but does not provide specific information on the initial dosage of Adderall 3.
- Another study on the efficacy, acceptability, and tolerability of lisdexamfetamine, mixed amphetamine salts, methylphenidate, and modafinil in the treatment of ADHD in adults found that the dosages used in the included trials varied, but does not provide information on the typical initial dosage of Adderall 5.