Adderall Side Effects

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.

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.

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.

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.

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 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 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.