From the FDA Drug Label
Central Nervous System: ... dyskinesia... The FDA drug label mentions dyskinesia as a possible adverse reaction to amphetamine, which is the active ingredient in Adderall.
- Tardive dyskinesia is a specific type of dyskinesia that is associated with long-term use of certain medications.
- The label does not explicitly state that the dyskinesia is tardive dyskinesia, but it does indicate that dyskinesia can occur with chronic use. Based on this information, it can be inferred that dyskinesia, which may include tardive dyskinesia, has been seen in the setting of long-term amphetamine use 1.
From the Research
Tardive dyskinesia has not been clearly established as a direct side effect of long-term Adderall (amphetamine/dextroamphetamine) use. Tardive dyskinesia is primarily associated with long-term use of dopamine-blocking agents such as antipsychotic medications, not with stimulants like Adderall 2, 3. Adderall works by increasing dopamine and norepinephrine levels in the brain, which is a different mechanism than the dopamine receptor blockade that typically causes tardive dyskinesia. However, Adderall can cause other movement disorders such as tics, tremors, and stereotypic movements, particularly at higher doses or with prolonged use. These movement effects are generally reversible when the medication is reduced or discontinued, unlike true tardive dyskinesia which often persists after medication discontinuation.
Some key points to consider:
- Tardive dyskinesia is a potentially permanent movement disorder resulting from chronic use of dopamine receptor blocking agents (DRBA) 3.
- The pathogenesis of TD is unknown, but there are three main theories proposed: dopamine receptor supersensitivity resulting from chronic dopamine receptor blockade, oxidative stress, and maladaptive synaptic plasticity 3.
- New treatment approaches to persistent TD are available and approved by the US Food and Drug Administration: the vesicular monoamine transporter-2 (VMAT2) inhibitors, deutetrabenazine and valbenazine 2.
- If abnormal movements develop while taking Adderall, it's essential to consult a healthcare provider promptly for evaluation, as dose adjustment or medication change may be necessary.
Given the available evidence, the most recent and highest quality study suggests that tardive dyskinesia is not a direct side effect of long-term Adderall use 4. Therefore, it is crucial to distinguish between stimulant-induced movement disorders and tardive dyskinesia for proper management and treatment decisions.