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Adderall Side Effects

Adderall side effects range from common, mild issues such as loss of appetite, nausea and insomnia to more serious but rare issues such as seizures, heart attack and psychiatric disorders. The drug has a black box warning for a high potential for abuse, and Adderall misuse may lead to cardiovascular events and sudden death.

Adderall
Adderall Side Effects Facts
  1. Common, Mild Side Effects Stomachache, decreased appetite and nervousness
  2. Rarer, Serious Side Effects Severe hypertension, cardiovascular problems (stroke, heart attack), psychiatric adverse events, seizures, serotonin syndrome, peripheral vasculopathy (including Raynaud’s Phenomenon), vision problems
  3. Boxed Warning High potential for abuse, misuse may lead to sudden death and serious cardiovascular problems.

According to the U.S. Food and Drug Administration’s Adverse Event Reporting System (FAERS), there have been 6145 reports of adverse events related to brand name Adderall and Adderall XR from 1994 to March 31, 2020. Of those cases 3,251 were serious and included 202 deaths.

Most of these FAERS reports were from 2018 and 2019. Because FAERS data is voluntary, the FDA cannot gauge how often these side effects occur or if they were caused by Adderall.

Ten of the most reported FAERS side effects include:
  • Fatigue
  • Feeling abnormal
  • Insomnia
  • Anxiety
  • Depression
  • Headache
  • Weight loss
  • Nausea
  • Decreased appetite
  • Aggression

The prescribing information for Adderall immediate-release tablets doesn’t provide clinical trial data for frequency of side effects. When the FDA originally approved the drug in the 1990s for ADHD, the agency approved the drug without clinical trials in children, according to a PLoS One review by Florence T. Bourgeois and colleagues at Boston Children’s Hospital and Harvard Medical School.

Most of the clinical trial data on side effects comes from the prescribing information for Adderall XR.

There is no consistent clinical trial data on whether side effects are different for men and women or how long side effects last. Some of these side effects may lessen as the body adjusts to the medication; this is different for everyone. Most of these adverse events stop after stopping Adderall treatment.

The types of side effects experienced by people taking Adderall are slightly different depending on their age and if they have any preexisting health problems.

Common Side Effects

The most common side effects for immediate release Adderall are stomachache, decreased appetite and nervousness, according to the Adderall Medication Guide.

Studies aren’t clear on whether side effects increase with the amount of Adderall people take, but researchers have found that the drug’s overall incidence of side effects is low and similar to other stimulants, according to a Canadian article published in the Paediatrics & Child Health journal.

The prescribing information for Adderall XR defines common side effects as those that occurred in five percent or more of people in clinical trials. These trials included 1,315 participants. Of those participants, 635 were pediatric patients, 350 were adolescent patients, and 248 were adult patients. The trials also included 82 healthy adults.

The most common side effects across all age groups were loss of appetite and insomnia.

Children ages 6 to 12:
  • Loss of appetite
  • Insomnia
  • Abdominal pain
  • Rapid, exaggerated changes in mood (emotional lability)
  • Vomiting
  • Nervousness
  • Nausea
  • Fever
Adolescents ages 13 to 17:
  • Loss of appetite
  • Insomnia
  • Abdominal pain
  • Weight loss
  • Nervousness
Adults
  • Dry mouth
  • Loss of appetite
  • Insomnia
  • Headache
  • Weight loss
  • Nausea
  • Anxiety
  • Agitation
  • Dizziness
  • Tachycardia
  • Diarrhea
  • Abnormal weakness or lack of energy (asthenia)
  • Urinary tract infections

Other Side Effects

Adderall XR’s drug label lists several other side effects reported with the drug’s use, but the exact number of people who have experienced them is unknown.

  • Blurred vision
  • Changes in sex drive
  • Constipation
  • Depression
  • Dermatillomania, repeated picking at the skin
  • Frequent or prolonged and painful erections
  • Hair loss
  • Heart palpitations
  • Impotence
  • Irritability
  • Movement disorders (dyskinesia)
  • Overstimulation
  • Restlessness
  • Rhabdomyolysis
  • Skin rashes, including Stevens-Johnson Syndrome and toxic epidermal necrolysis
  • Tics
  • Tremors
  • Unpleasant taste

Warnings and Serious Side Effects

Adderall and Adderall XR have been associated with allergic reactions and other serious side effects, some fatal. These side effects are generally rarer.

Serious Cardiovascular Reactions

Because stimulants such as Adderall can increase heart rate and blood pressure, they may cause cardiovascular problems such as heart attack and stroke, especially in people with preexisting heart issues or high blood pressure.

Strokes, heart attacks and sudden death have been reported with stimulant drugs, including Adderall, according to the prescribing information.

Adults taking Adderall are at greater risk for these side effects than children. Cardiovascular risk factors for adults taking stimulants for ADHD may increase with each passing decade of life, according to a case study published by A. Sinha and colleagues in Case Reports in Cardiology.

Adderall Increases Blood Pressure and Heart Rate

Stimulants including Adderall can increase a person’s blood pressure by two to four millimeters of mercury and heart rate by about three to six beats per minute, according to the Adderall XR prescribing information. Some people may even have larger increases.

People with pre-existing hypertension, arrhythmias or previous heart attacks should be careful when taking Adderall. Patients who develop chest pain, unexplained dizziness or other symptoms of heart problems should seek medical attention and be evaluated.

Psychiatric Side Effects

People who take Adderall may experience new or worsening psychotic or manic symptoms such as hallucinations and delusional thinking. Other mental health symptoms can include panic attacks, severe anxiety, mania and paranoia.

If these symptoms occur, medical providers should consider discontinuing Adderall treatment.

Studies have compared amphetamines such as Adderall with methylphenidate, commonly known as Ritalin, and found that Adderall may cause more severe insomnia, proneness to crying, irritability, anxiety, nightmares and sadness/unhappiness, according to Dr. Steven M. Berman and colleagues in Molecular Psychiatry.

Suppression of Growth in Children

Adderall may interfere with the growth of children. If they don’t grow or gain weight as expected, they may have to stop treatment.

In Adderall XR trials, adolescents lost one to three pounds in four weeks of therapy. Larger doses produced greater weight loss.

Seizures

Some scientific evidence connects stimulants to seizures. People with a history of seizures — and very rarely those with no prior history — have had seizures while taking stimulants, according to Adderall XR’s drug label.

But data presented by Isabell Brikell at a meeting of the European College of Neuropsychopharmacology looked at medical records of 38,247 people with epilepsy — 4,418 with ADHD — and found that ADHD medications don’t increase seizure risk in these patients.

Adderall XR’s label suggests stopping medication if patients have seizures.

Peripheral Vasculopathy and Raynaud's Phenomenon

Adderall XR is associated with peripheral vasculopathy, a circulation disorder that lessens blood flow to the blood vessels in the arms, legs and feet.

Raynaud’s phenomenon is a related disease also connected to stimulant use that causes blood vessels to narrow in response to cold or stress. It usually affects the fingers and toes. Affected areas turn white or blue from lack of blood flow. When blood flow returns it causes tingles or throbbing. In severe cases, it can cause tissue death or sores.

Symptoms are usually mild and improve after stopping treatment.

Serotonin Syndrome

Serotonin syndrome is a potentially life-threatening reaction that occurs when people take amphetamines with other drugs that affect serotonin-based neurotransmitters. These drugs include antidepressants and St. John’s Wort.

Symptoms of serotonin syndrome include hallucinations, delirium, agitation, blood pressure problems, heart arrhythmias, flushing, dizziness, seizures, vomiting, nausea and tremors.

If symptoms of serotonin syndrome occur, see your medical provider right away. They will help you stop your Adderall treatment.

Long-Term Effects of Adderall

Long-term side effects of Adderall include weight loss, stunted growth in children and possible complications from high blood pressure. Usually, these side effects stop once treatment stops.

Some studies show long-term Adderall use may cause adverse psychological effects and changes in the brain.

Some evidence suggests that long-term use of ADHD medications like Adderall may potentially damage a part of the brain called the nucleus accumbens, Dr. Leonard Sax wrote in an article for Time magazine. This part of the brain is responsible for drive and motivation. Some studies show this part of the brain shrinks after long-term stimulant use. But Sax couldn’t say whether it was long-term or short-term damage.

Sax wrote that he witnessed children in his practice — mostly boys — lose drive and motivation after being on these drugs long-term.

Adderall Withdrawal
Stopping Adderall suddenly can cause a person to have withdrawal symptoms. These include vivid, unpleasant dreams, sleeping too much or too little, increased appetite, fatigue, unhappy mood and slow thought processes and physical movements.
Source: Adderall XR Prescribing Information

Is Adderall Addictive?

Adderall is a controlled substance, meaning it is highly addictive and prone to misuse. The Drug Enforcement Administration classifies it as a Schedule II substance, along with oxycodone and cocaine.

Because it sharpens focus, the drug became popular among young professionals and students as a productivity and study aid. It’s also abused along with alcohol for recreational purposes.

According to the Centers for Disease Control and Prevention, about 1 in 5 students have abused Adderall.

Abuse of Adderall can manifest serious side effects. People with prolonged exposure to high doses of amphetamines may develop auditory and tactile hallucinations which may be misdiagnosed as schizophrenia. The most severe forms of psychosis occur with “binge” use throughout the day for several days.

Adderall abuse can also lead to cardiovascular problems, such as heart attacks and even sudden death.

Signs of Adderall abuse include:
  • Abdominal pain
  • Aggression
  • Anxiety
  • Decreased appetite
  • Dilated pupils
  • Excessive sweating
  • Hostility
  • Hyperactivity
  • Increased blood pressure
  • Increased heart rate
  • Insomnia
  • Loss of coordination
  • Psychosis
  • Quicker breathing
  • Restlessness
  • Skin flushing
  • Suicidal or homicidal thoughts
  • Tremors
  • Vomiting

Please seek the advice of a medical professional before making health care decisions.

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Michelle Llamas, Senior Content Writer
Written By Michelle Llamas Senior Writer

Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for seven years. She specializes in fluoroquinolone antibiotics and products that affect women’s health such as Essure birth control, transvaginal mesh and talcum powder. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include:

  • American Medical Writers Association (AMWA) Engage Committee and Membership Committee member
  • Centers for Disease Control and Prevention (CDC) Health Literacy certificates
  • Original works published or cited in The Lancet, British Journal of Clinical Pharmacology and the Journal for Palliative Medicine
Edited By

16 Cited Research Articles

  1. Berman, S.M. et al. (2009). Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/
  2. Bourgeois, F.T., Kim, J.M. & Mandl, K.D. (2014). Premarket Safety and Efficacy Studies for ADHD Medications in Children. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090185/
  3. James, S.D. (2010, November 5). Adderall Abuse Alters Brain, Claims a Young Life. Retrieved from https://abcnews.go.com/Health/MindMoodNews/adderall-psychosis-suicide-college-students-abuse-study-drug/story?id=12066619
  4. Jancin, B. (2017, September 29). ADHD meds don’t raise seizure risk in epilepsy patients. Retrieved from mdedge.com/neurology/article/148350/epilepsy-seizures/adhd-meds-dont-raise-seizure-risk-epilepsy-patients
  5. Sax, L. (2012, June 9). A.D.H.D. Drugs Have Long-Term Risks. Retrieved from https://www.nytimes.com/roomfordebate/2012/06/09/fewer-prescriptions-for-adhd-less-drug-abuse/adhd-drugs-have-long-term-risks
  6. Sax, L. (2016, January 4). 6 Questions to Ask Yourself Before Putting Your Kid on ADHD Medication. Retrieved from https://time.com/4163195/6-questions-to-ask-yourself-before-putting-your-kid-on-adhd-medication/
  7. Sax, L. (n.d.). Stimulants. Retrieved form https://www.leonardsax.com/stimulants.htm
  8. ScienceDirect. (n.d.). Amphetamines. Retrieved from https://www.sciencedirect.com/topics/neuroscience/amphetamines
  9. Shire U.S. Manufacturing. (2019). Adderall XR Medication Guide. Retrieved from https://dailymed.nlm.nih.gov/dailymed/medguide.cfm?setid=aff45863-ffe1-4d4f-8acf-c7081512a6c0
  10. Sichilima, T. & Rieder, M.J. (2009). Adderall and cardiovascular risk: A therapeutic dilemma. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690554/
  11. Sinha, A. et al. (2016). Adult ADHD Medications and Their Cardiovascular Implications. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992783/
  12. U.S. Food and Drug Administration. (2019, December 24). FDA Adverse Event Reporting System (FAERS) Public Dashboard. Retrieved from https://www.fda.gov/drugs/questions-and-answers-fdas-adverse-event-reporting-system-faers/fda-adverse-event-reporting-system-faers-public-dashboard
  13. U.S. National Library of Medicine. (2019). ADDERALL dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate tablet. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f22635fe-821d-4cde-aa12-419f8b53db81
  14. U.S. National Library of Medicine. (2019). ADDERALL Medication Guide. Retrieved from https://dailymed.nlm.nih.gov/dailymed/medguide.cfm?setid=f22635fe-821d-4cde-aa12-419f8b53db81
  15. U.S. National Library of Medicine. (2019). ADDERALL XR- dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate and amphetamine aspartate capsule, extended release. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=aff45863-ffe1-4d4f-8acf-c7081512a6c0&audience=consumer#S5.1
  16. U.S. National Library of Medicine. (n.d.). Raynaud's Disease. Retrieved from https://medlineplus.gov/raynaudsdisease.html
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