The Side Effects of Adderall

Adderall is an amphetamine that is mainly prescribed to treat the symptoms of ADHD, but it can also be used to treat depression and narcolepsy. It has two primary forms: extended release and instant release.⁽⁷⁾

It has many side effects, positive and negative; some side effects can be life-threatening, especially when it comes to prolonged use.

This guide goes over the many side effects of Adderall, including:

– Short term and long term side effects
– Positive and negative side effects
– Side effects on different systems of the body
– Side effects on pregnancy and fetuses
– Withdrawal side effects
– Signs and symptoms of overdose
– Side effects of taking Adderall with alcohol
– Side effects of drug interaction
– Less common side effects

Positive Side Effects of Adderall

Adderall is a stimulant that works by changing the amounts of certain chemicals in the brain, specifically norepinephrine, serotonin, and dopamine. These chemicals are responsible for boosting attentiveness and energy.⁽⁷⁾

The most positive side effect of Adderall is said, by users, to be mood elevation. Due to the increase of norepinephrine, serotonin, and dopamine in the brain, those who use Adderall may experience a restructuring of their brain chemistry, which can make them feel more attentive or focused.

Some evidence even suggests that the stimulation provided by the increase of these chemicals in the brain could lead to an increase in the size of certain areas of the brain that control attention, motivation, and focus.⁽¹⁰⁾

Taking Adderall might help someone increase his or her:

– Attention span
– Ability to focus
– Ability to function with clarity
– Organizational and listening skills

It may also help to control behavior problems and reduce hyperactivity.^{(1, 13)}

Despite all of these positive side effects, Adderall also has adverse side effects, some of which could be severe or potentially fatal.

Side Effects on the Gastro-Intestinal System

Adderall may cause several issues within the digestive tract, including, but not limited to:

– Bladder pain
– Difficulty urinating or bloody urine
– Constipation
– Diarrhea
– Dry mouth
– Bad taste in the mouth

One reason someone who is taking Adderall might have these issues mentioned above is that Adderall increases the amount of sugar released into the body. This increase in sugar could cause abdominal pain and constipation or could cause one to have bouts of nausea, vomiting, and diarrhea.⁽¹¹⁾

Another reason one might have gastrointestinal issues is that Adderall use causes the muscles in the digestive tract to slow down, resulting in backups.⁽¹²⁾

The bladder pain, difficulty urinating, and bloody urine can all also be signs of a Urinary Tract Infection (UTI), which, in some cases, can be an Adderall side effect.

The kidneys and liver can also be affected by Adderall. Heavy use of the drug over an extended period may cause urination to be painful, or may even lead to acute renal failure. Long term side effects on the liver include:

– Increased ALT enzyme levels
– Liver damage
– Hepatitis A, B, or C ⁽⁴⁾

Side Effects on Metabolism

Adderall suppresses the appetite, which may lead to weight loss. If not monitored, the weight loss could become severe and unhealthy, which could cause one to develop an eating disorder such as anorexia, or to become malnourished. Malnutrition can have many effects on one’s body and vital organs. ⁽¹²⁾

Loss of appetite does not only cause weight loss. It can also cause the stunting or slowing of growth in children. Amphetamines have long since been connected to slow weight gain, and the reduced calorie intake as a result of the loss of appetite may be the reason. ⁽⁵⁾

The weight loss and slow growth are supposed to be temporary side-effects that should subside with time as the body adjusts to the medication and appetite returns. ⁽¹¹⁾ The appetite suppression that Adderall causes makes it an attractive weight-loss drug to some people, but it is not used as a treatment for weight loss anymore due to its high abuse potential. ⁽⁵⁾

Side Effects on the Cardiovascular System

Adderall can have many different effects on the cardiovascular system. While most of these are relatively harmless for those who use Adderall as prescribed, long term use or abuse can heighten these effects and lead to damaging or weakening of the cardiovascular system in those who abuse it. Organs or other parts of the cardiovascular system that could be affected include:

– The heart
– The lungs
– The arteries
– The veins

As a result of how the drug interacts with the body, the previously mentioned parts of the cardiovascular system are forced to work harder. Working harder may cause them to become strained from long-term use. ⁽¹²⁾

The Heart

Adderall increases heart rate and raises blood pressure in those who use it. This increase in heart rate and blood pressure, in some cases, could cause other serious heart-related conditions to arise, especially in those who are abusing Adderall. Some of these circumstances are listed below:

– Hypertension (high blood pressure)
– Tachycardia (fast heartbeat)
– Irregular heart rate
– Chest pain/pain in the left arm
– Heart palpitations
– Fainting
– Cardiomyopathy

Some of the symptoms listed above could also be signifiers of a heart attack or stroke. Those who are taking Adderall and think they might be having a heart attack or stroke are encouraged to contact their doctor immediately. ⁽¹¹⁾ The most common cardiovascular problems reported by Adderall users are hypertension and tachycardia.

Adderall consumption can also lead to a serious condition known as an aortic dissection, also known as an aortic tear, although it is seen most commonly in those who abuse Adderall. Studies have shown that of the approximately 31 million patients taking Adderall across the nation, the risk of having an aortic dissection is three times more likely in those who are abusing it than in those who aren’t. ⁽³⁾

Those who have underlying heart conditions or heart defects or have a family history of underlying heart conditions should talk to their doctor to figure out if Adderall is right for them, as it could raise their chances of having more serious side effects such as heart attack, stroke, seizures, or even sudden cardiac death. ⁽¹²⁾

The Lungs

Adderall can also cause lung problems. Signs of lung damage due to prolonged, unprescribed use of Adderall include:

– Reduced lung capacity
– Shortness of breath
– Irregular respiration rates
– Breathing trouble ⁽⁴⁾

The Arteries and Veins

Stimulants cause arteries and veins to constrict, which may interfere with circulation. Some symptoms that someone might have restricted blood flow include:

– Tingling or numbness in the fingers, toes, hands, or feet
– The fingers and toes may hurt or feel numb
– The skin of the fingers and toes may turn red or blue ⁽¹¹⁾

Extended use of Adderall could also cause collapsed blood vessels, coronary artery disease, or septicemia (blood poisoning). ⁽⁴⁾

Side Effects on the Nervous System

Because amphetamines deal with chemicals in the brain that are responsible for energy levels, certain neurological symptoms can result from using Adderall. But these neurological symptoms can be better or worse depending on if the user is taking the drug as prescribed or is abusing it.

Short term neurological side effects

For those who are taking it as prescribed, nervousness, restlessness, and headaches are common neurological side effects of Adderall. Those who take it may also have trouble getting to sleep or staying asleep at night, which is why doctors often recommend patients to take it in the morning. ⁽¹¹⁾

Insomnia, coupled with the malnutrition from weight loss, may cause the body and brain to have trouble functioning at normal levels. ⁽¹²⁾

Mood and behavior changes are also common Adderall side effects. Such changes include:

– Agitation or aggression
– Mood swings
– Depression
– Abnormal thoughts or thoughts of suicide ⁽⁶⁾

Uncontrolled movements, dizziness, slowed speech, damaged nerve cells, and changes in vision are also possible side effects of Adderall. Symptoms of Tourette’s syndrome, such as phonic or motor tics, could become worse through the ingestion of amphetamines. ⁽⁸⁾ Those who have Tourette’s are encouraged to ask their doctors if amphetamines are right for them.

In rare cases, severe neurological side effects may occur. Anyone experiencing these side effects is asked to contact his or her doctor immediately:

– Consistent, high fevers
– Weakness or numbness of the limbs
– Swelling of the face, tongue, or throat
– Uncontrollable shaking, tics, or seizures
– Hallucinations and paranoia

By taking Adderall, any of the neurological symptoms mentioned in this section can become worse if preexisting mental health conditions are present, or the preexisting mental health conditions can be made worse. ⁽¹¹⁾

Long term neurological side effects

While Adderall has some pretty serious side effects for those who use it correctly, it can have even worse side effects for those who don’t use it properly. As already stated, Adderall increases the presence of dopamine, norepinephrine, serotonin, and other neurotransmitters in the brain. It is made to help people with ADHD, who have lower concentrations of these chemicals.

In a normal brain, however, the increase of these chemicals can lead to several psychological problems, such as:

– Anxiety
– Paranoia
– Mania
– Having auditory or visual hallucinations

Long-term side effects of Adderall also include drastic changes in one’s personality. Mood swings can escalate to the point that the user seems to have bipolar disorder or an entirely different personality. Excessive use of the drug can also lead to hostility and depression. ⁽¹³⁾

Those who use it as prescribed often report feelings of euphoria, high energy, or invigoration. These feelings are very similar to the high that cocaine users feel. ⁽⁷⁾ It is no wonder, then, that many people are attracted to this drug for its heightened sense of euphoria, also known as “the feel-good feeling.”

Those who abuse Adderall over an extended period might also experience the following side effects:

– Difficulty sleeping or staying asleep
– Decreased ability to concentrate
– Little or no motivation
– Increased lethargy or fatigue
– Aggressiveness
– Suicidal thoughts
– Panic attacks
– Heart disease
– Tremors

In some cases, Adderall, like other stimulants, can cause psychosis and symptoms that resemble those of schizophrenia, such as paranoid delusions and hallucinations, and mood and behavior disturbances have been reported. Anxiety attacks and panic attacks are also effects of long-term Adderall abuse, and can also be symptoms of Adderall withdrawal.

Any or all of these aforementioned neurological symptoms may be worsened by Adderall if someone who has a family history of mental illness or has a mental disorder him or herself. On the reverse side, the mental disorder or its symptoms could also become worse by taking Adderall. ⁽⁹⁾

Side Effects on the Endocrine System

In adults, Adderall can affect sexual drive or performance. One might have a decreased interest in having sex, an inability to have or keep an erection. ⁽⁶⁾

To the opposite extreme, the use of Adderall might increase the risk of priapism, which is a persistent, painful erection that lasts more than four hours and usually occurs without any sexual stimulation. If not treated right away, the condition could lead to permanent scarring or even erectile dysfunction. ⁽³⁾

Women may experience abdominal cramps that are worse than normal during their menstrual cycles. ⁽²⁾

Side Effects on the Skin

Adderall can sometimes cause a minor allergic reaction. An allergic reaction can present itself in many different ways. It can affect the skin, which would result in:

– Itching or irritation
– Hives or a rash
– Blistering or peeling skin ⁽¹¹⁾

In rare cases, Adderall can cause a severe allergic reaction. A serious allergic reaction might be accompanied by intense itching or rash, swelling of the tongue, throat, or face, dizziness, and trouble breathing. ⁽¹⁾

Side Effects on Pregnancy and Fetuses

While the study of the side effects of Adderall on pregnant women and their fetuses is still largely unexplored, there has been indications that prenatal exposure to amphetamines can result in long-term neurological and behavioral problems. These issues include:

– Learning and memory deficits
– Altered motor skills
– Changes in sexual function

Babies who are born to mothers who were dependent on amphetamines during pregnancy are more likely to have:

– Increased risk of being born prematurely
– Low birth weight
– Amphetamine withdrawal symptoms

Pregnant women should only be prescribed amphetamines if the potential risks to the fetus are outweighed by the potential benefits. Mothers who are taking Adderall or other types of amphetamines should not nurse because amphetamines can be excreted in human milk. ⁽⁸⁾

Side Effects of Withdrawal

Amphetamines have a high addiction rate, but when those who are addicted to Adderall abruptly stop taking Adderall, they can experience many unpleasant side effects, both mental and physical.

As abusers of Adderall become dependent on the drug, the brain reduces its natural production of norepinephrine, serotonin, and dopamine. Abrupt cessation of the drug, consequently, results in excessively low levels of these chemicals in the brain which can lead to depression, fatigue, and thoughts of suicide. Changes in sleep patterns also can occur. ⁽⁸⁾

Other side effects of withdrawal include:

– Irritability and jitteriness
– Changes in appetite
– Extreme tiredness
– Drug cravings
– Drastic mood changes
– Changes in behavior

Heart rate, blood pressure, and body temperature are also affected by withdrawal symptoms. ⁽¹²⁾ But the emotional side effects of withdrawal, like the drastic mood changes, are possibly the most noticeable, because the longer the user abuses the drug, the more pronounced the mood swings may become when the user or someone else removes the drug from the body. ⁽⁹⁾

Signs and Symptoms of an Overdose

As the brain develops a dependency on Adderall, it also builds up a tolerance to the drug, which causes the user to seek higher doses to achieve the same results. This increasing of dosage amplifies Adderall’s side effects and can lead to an overdose. ⁽⁷⁾

There are many symptoms and signs that someone has overdosed. In acute overdose cases, signs and symptoms might include:

– Restlessness
– Tremors
– Overresponsive reflexes
– Rapid breathing
– Confusion or combativeness
– Hallucinations
– Panic states
– Swelling of hands, feet, or ankles
– Sweating
– Dehydration

Fatigue and depression often follow the restlessness, panic states, and over-responsive reflexes; in other words: the high is followed by the crash.

Adverse neurological effects of overdose include:

– Personality changes
– Signs of depression
– Seizures
– Abnormal EEGs
– Unexplained muscle pain
– Delusions
– Persistent headaches ^{(1, 3)}

Overdoses have astronomical effects on the cardiovascular and gastrointestinal systems. It can cause someone to have a sudden massive heart attack, even if he or she has no history or had no prior signs of having heart disease. Other side effects of an overdose on these systems include:

– Arrhythmias or rapid heartbeats
– Hypertension
– Hypotension (low blood pressure)
– Circulatory collapse
– Nausea or vomiting
– Diarrhea
– Abdominal cramps
– Kidney damage or failure

Overdoses can lead to fatal poisoning, which is usually preceded by convulsions and coma. ^{(3, 8)} If an observer sees signs of an overdose on amphetamines, he or she is encouraged to consult a certified Poisoned Control Center for current advice.

Getting over an addiction or an overdose of Adderall can take time, but it is possible to reverse all the side effects, and neurotransmitter levels can return to normal levels. Medical detox is the safest way to get over an Adderall addiction. ⁽¹²⁾

Side Effects of Adderall Used with Alcohol

Adderall has some serious side effects just by itself, but when one decides to take it with alcohol, it can create further complications. Alcohol is a depressant, meaning it shuts the body down. Adderall, on the other hand, as a stimulant, wires the body up.

Slurred speech and lethargy are signs that someone has ingested too much alcohol, but when that person is also on Adderall, the drug can mask those warning signs. ⁽⁷⁾ Because Adderall keeps users awake, it can shut off the cues from the body that tell people that they’ve had too much to drink, which can lead to a potentially dangerous situation called alcohol poisoning. ⁽¹²⁾

Other possible side effects of consuming alcohol with Adderall are:

– Dehydration (both Adderall and alcohol have dehydrating properties)
– Possible intensification of psychological issues associated with Adderall withdrawal ⁽⁷⁾

Side Effects from Drug Interactions

Abusing Adderall or taking it with alcohol can increase one’s risk for serious side effects, but drug interactions can increase the chances further. Certain drugs interacting with Adderall could alter how one or both medications work.

Monoamine oxidase (MAO) inhibitors, for example, slow down the rate at which one’s body can metabolize amphetamines, which makes the amphetamines more potent. The change in potency could lead to headaches and signs of hypertensive crisis. Toxic neurological effects can also occur, which could be potentially fatal. ⁽⁸⁾ It is recommended that one stop taking MAO inhibitors two weeks before starting Adderall. ⁽¹⁾

Other drugs that can alter the effectiveness of Adderall include those that are used to treat:

– Heartburn (antacids such as Pepcid, Prilosec, and Zantac)
– Depression
– High or low blood pressure
– Cholesterol levels (such as blood thinners)
– Colds or allergies (especially medicines that contain decongestants)
– Various mental illnesses
– Severe pain (narcotics)
– Seizures ⁽²⁾

Those to whom Adderall is prescribed should check the labels on all their current medications, whether they are prescription meds or not, as some could contain ingredients that, like Adderall, raise heart rate and blood pressure. Adderall could also interfere with certain medical tests, such as blood and urine steroid levels and scans for Parkinson’s disease, which could come back as false positives. ⁽¹⁾

Aside from drug interactions that can make taking Adderall dangerous, other medical conditions or a family history of certain medical conditions can also make it dangerous to take Adderall. No one should take Adderall if he or she is allergic to any other kind of stimulant medicine. One should also not take Adderall if he or she currently has or has a family history of any of the following:

– Hypertension (even if it is not severe)
– Heart disease
– Coronary artery disease
– Overactive thyroids
– Glaucoma
– Anxiety
– Drug or alcohol addiction
– Any mental disorders such as depression, bipolar disorder, psychosis, or suicidal thoughts or actions
– Tourette’s syndrome
– Epilepsy
– Abnormal EEGs
– Blood circulation problems

Adderall and other stimulants have been known to cause sudden cardiac death. Taking Adderall can be extremely dangerous if one or anybody in one’s family has or has had any of the following:

– Heart problems
– Congenital heart defects
– High blood pressure
– Heart disease or sudden cardiac death ⁽²⁾

Less Common Side Effects

There are other side effects besides all of the ones listed up to this point that can occur from taking Adderall, but their reported frequency is unknown. These side effects include:

– Symptoms that resemble the cold or the flu
– A cough or hoarseness
– Confusion
– Having difficulty speaking or swallowing
– Inability to move certain muscles, such as arms, legs, or those on the face
– Double vision
– Joint or muscle pain
– Inability or decreased ability to control the bladder
– Muscle cramps, spasms, or stiffness
– Skin lesions
– Sores, ulcers, or white spots in or on the mouth or lips
– Sweating
– Swelling in the feet or lower legs
– Feeling suspicious or paranoid
– Infected or diseased skin ^{(3, 7)}

Conclusion

Adderall is not a drug that one should take lightly. It is highly addictive, which can lead to dependence, overdose, and withdrawal. It has an array of side effects, both good and bad. These side effects can be mostly useful one takes the drug exactly as prescribed and under doctor supervision, and most of the side effects are time-limited, meaning they should subside once the body gets used to the drug.

There are a lot of things to consider before taking Adderall, but whether the risks of taking it outweigh the benefits or vice versa is up to the consumers.

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