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Prescription medications can be very useful for people that need them, but are susceptible to abuse by people who don’t. Adderall is used effectively by many Americans who follow their doctor’s orders. While there are some side effects, proper use can help you get the most out of your medication.

In an interview with Johns Hopkins Medicine, Doctor of Philosophy and Master of Public Health Dr. Ramin Mojtabai notes a "growing problem" involving young adults who are using Adderall without prescription. The problem, according to Dr. Mojtabai, is that Adderall is being used as a study tool to stay up late and cram for tests and projects. People who take the medication without a prescription might take it improperly and can face serious side effects. That’s why Dr. Mojtabai recommends educating people on the potential harms of Adderall, as well as discussing what it can and can’t do. Much like any other prescription drug, taking Adderall without a prescription is irresponsible and dangerous.

If you’re curious about Adderall, here’s what you need to know about its usage, dosage, and side effects.

Adderall is prescribed for ADHD

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Attention deficit hyperactivity disorder, also known as ADHD, can occur in children and adults. People with ADHD might seem fidgety, have a tough time focusing on tasks, lack control of their behavior, and have trouble staying quiet and still. It can be problematic in places like a classroom or at work where you have to stay quiet and focused on a task. Drugs, such as Adderall and Adderall extended release (XR) are used to treat ADHD (via MedlinePlus).

Adderall is used to treat a wide range of people, from children as young as 3 all the way up to adults. Adderall XR can be used in kids as young as 6 years and adults. Your doctor can help you determine if you have ADHD and if you qualify for Adderall. According to the Centers for Disease Control and Prevention (CDC), your healthcare provider will give you a test from the American Psychiatric Association’s Diagnostic and Statistics Manual, which is the current standard.

Adderall is used to treat narcolepsy

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Another use for Adderall might seem counterintuitive, since it’s typically intended to help people with hyperactivity disorder. It’s also used to treat narcolepsy, which is a condition that causes sleepiness during the daytime and sudden onset of sleep, according to MedlinePlus. For narcolepsy, Adderall can be used in children over 12 years and adults.

Adderall is an amphetamine, which is a type of stimulant. An article from the Division of Sleep Medicine at Harvard Medical School explains that amphetamines have been used since the 1930s to treat the symptoms of narcolepsy. One of the ways these medications work is by increasing dopamine, which will improve alertness. Another way is by increasing serotonin and norepinephrine, both of which are brain chemicals that help you feel awake and alert. That said, there are other medications available that provide similar benefits for people with narcolepsy, such as Ritalin and Concerta.

Adderall increases feel-good chemicals in the brain

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Adderall is the name of a drug, but it’s actually a combination of two ingredients: amphetamine and dextroamphetamine. These chemicals work by targeting your brain and the adrenal gland, which sits on top of your kidneys (via the American Addiction Centers). More specifically, they bind to receptors in your brain for dopamine and norepinephrine, and to epinephrine receptors in the kidney gland. In doing so, Adderall gives you, the user, a feeling of euphoria.

In the brain, norepinephrine and dopamine do a number of important things. A paper published in Frontiers in Molecular Neuroscience explains that both are important for learning and memory processes. According to the authors, these two brain chemicals work in tandem to facilitate learning, which is why Adderall can help children and adults with school and work-related tasks. These chemicals are also important for increasing vigilance and play a crucial role in your brain’s reward system.

How to take Adderall

A collection of pills

Part of responsibly using Adderall is taking it as prescribed. Your doctor or pharmacist should provide you with instructions for proper use, and sticking with those guidelines can help you avoid unwanted side effects. An article from the National Alliance on Mental Illness says that amphetamines, such as Adderall, should be taken once or twice daily, without food.

When you take an Adderall tablet, make sure you swallow it whole. It can have a very unpleasant taste if chewed, and can be irritating for your throat. If you’re taking Adderall XR you might be given something called a sprinkle tablet. You can either swallow these tablets whole or open them and sprinkle the substance on food, such as apple sauce. However, if you choose to sprinkle, make sure you do it on a small amount of food and eat it immediately, without chewing. You shouldn’t chew the substance in the sprinkle tablets.

How to take Adderall XR

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The specific instructions for taking Adderall XR are different from regular Adderall because the effects of the drug are different.

Since Adderall XR is an extended release version of the original medication, you need to time it differently. An article from the Food and Drug Administration (FDA) outlines instructions for properly taking this medication. The FDA recommends taking the pill as soon as you get up in the morning because it slowly releases throughout the day.

You can take this version of Adderall with or without food. Occasionally, your doctor might recommend that you stop taking the medication. They’ll do so to give you another test for ADHD, to see if your symptoms are different than before you started taking the medication. To screen for problems with the medication, your doctor might also suggest regular blood pressure checks, blood tests, and heart evaluations, just to make sure you’re not experiencing side effects.

Mixing alcohol and Adderall could be dangerous

Man sleeping next to glass of alcohol

Students taking Adderall to study is a problem in some colleges, but that’s not the only situation in which Adderall is abused. It also seems to be a party drug (per the University of Iowa Hospitals and Clinics). Worse, since the effects of drinking and taking Adderall have not been properly researched, there could be unknown consequences.

Part of the danger of mixing Adderall and alcohol is that they have competing effects. Alcohol is a depressant, whereas Adderall is a stimulant. This can cause problems because Adderall can mask the effects of alcohol, leading someone to believe that they need to drink more than they really should. The result could be alcohol poisoning.

Mixing the two can also lead to certain cardiovascular problems, such as increased blood pressure. In the long term, mixing alcohol and Adderall can increase your risk for a cardiac event, like a stroke.

Adderall can be addictive

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While Adderall is prescribed for use in people with certain conditions, it can become addictive over time.

The Addiction Center lists common signs of Adderall addiction, such as the need for a larger dose to feel the same effects, as well as the desire to taper your prescription but being unable to do so. Another sign is not being able to function properly without the drug (e.g., not finishing your work and not feeling alert if you don’t take it).

However, there is a difference between dependence and addiction. Developing some form of dependence is normal. A dependence is when someone needs the drug for the physical effects it provides, such as helping with ADHD or narcolepsy. Addiction occurs when someone needs the drug for the mental effects, such as the "high" that a drug can provide. People who are addicted to Adderall will prioritize getting the drug over other things, and can cause them to seek out the drug even if they don’t have a prescription.

Common reasons for Adderall abuse

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Abusing prescription drugs can be dangerous and illegal, so it’s important to be wary of the warning signs of Adderall abuse. Taking Adderall for specific reasons unrelated to its medical purpose can increase the likelihood of abuse, per the Addiction Center.

People who take Adderall for weight loss, for example, is one reason for abuse. Adderall isn’t designed for weight loss, but it acts as an appetite suppressant. Some athletes might take the drug to increase their athletic performance; there are some physical performance benefits, as well as mental performance such as concentration, which can help an athlete. Regardless, taking Adderall for something it isn’t intended for can be considered abuse.

Another method of abuse is taking Adderall in an improper way. For example, crushing an Adderall pill and snorting it is considered abuse. Taking a dose larger than you’re prescribed to get more of an effect from the drug is also considered abuse.

Taking Adderall improperly is dangerous

Man at desk with headphones working

On college campuses, some students get Adderall from their friends or family without a prescription, then use it to try to boost their mental abilities while studying or working on a project. Ironically, it seems that these students might not benefit much from taking the medication (via the University of Iowa Hospitals and Clinics).

The way you take Adderall and your proper dosage will be clearly defined by your doctor or pharmacist. Taking Adderall improperly can increase your risk of side effects (per the American Addiction Centers). Snorting or injecting Adderall, for example, causes the drug to absorb into your bloodstream faster than swallowing and digesting the pills as they’re designed. The quick release of Adderall into your system can provide potent effects, which is dangerous. People who snort or inject Adderall are at an increased risk for drug overdose, as well as developing an addiction.

Taking Adderall more often than you’re prescribed can also lead you to become addicted. Over time, you might feel like you need more Adderall to get the same effects, which leads to a blunted dopamine response. That means if you take too much Adderall or take it too often, you can have trouble feeling pleasure without the drug in your system.

If you or anyone you know is struggling with addiction issues, help is available. Visit the Substance Abuse and Mental Health Services Administration website or contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

Adderall can cause heart problems

Doctor checking man's heart

There are a few serious side effects from taking Adderall that users should be aware of, even though they’re rare. Perhaps the most serious side effects are the ones related to your cardiovascular system. An article from the National Alliance on Mental Illness discusses some of the rare side effects of taking amphetamines such as Adderall. Even if you take it responsibly, you can still develop cardiovascular problems such as high blood pressure and shortness of breath.

If you misuse Adderall, the side effects can be even worse. You might even experience sudden death. People with a heart defect are particularly at risk for serious complications from taking Adderall. Heart defects refer to structural abnormalities of the heart, such as abnormally thick walls. Other people who are at an increased risk for cardiac events include people with uncontrolled high blood pressure.

It’s important to take Adderall properly and with a prescription from your doctor, because they can screen you first to see if you’re at risk for serious side effects.

Common side effects of Adderall use

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Most of the side effects that you might experience on Adderall aren’t serious, although they can be uncomfortable. You can speak to your doctor if you experience any of them, as they might suggest altering your medication.

The Cleveland Clinic lists some of the common side effects of using stimulant therapy such as Adderall. Headache, stomach, and dizziness are just a few examples. Dry mouth and an increase in blood pressure are also common, but not necessarily dangerous.

These symptoms should decrease after a few weeks of taking the drug. When you change your dosage or the type of drug you’re taking, you might experience other changes. Decreased appetite, for example, is fairly common among people who take stimulants. That’s one reason why weight loss is another common side effect. Trouble sleeping and nervousness may also occur. It’s also possible to have an allergic reaction to stimulants, so a skin rash or other allergy symptoms may occur.

What to tell your doctor before you take Adderall

Doctor speaking to patient

When your doctor prescribes you Adderall, they’ll ask you a series of questions to be sure that they’re prescribing the correct dosage and that you’re not at risk for serious side effects. However, you can ask them questions to better prepare yourself for taking the medication and to give them ample information to base their decisions on.

The Cleveland Clinic has some suggestions. For starters, women should tell the healthcare practitioner they’re speaking to if they’re pregnant or planning to get pregnant. Be sure to tell your doctor what medications you’re taking, to make sure that they’re safe to combine. You should also tell them if you’re taking any dietary supplements, herbal medicines, or over-the-counter drugs. Additionally, you should disclose any previous history of mental illness (such as depression or psychosis), or if you were previously addicted to any drugs or alcohol.

Who shouldn’t take Adderall

Woman yelling forcefully

Some people benefit from taking Adderall, but for others, the reward is not worth the risk.

The FDA lists some of the reasons why you should avoid taking Adderall. The first is arteriosclerosis, which is plaque buildup of plaque inside your arteries (via MedlinePlus). People with hyperthyroidism, which is an overactive thyroid gland, should avoid taking Adderall. People in agitated states should also avoid the drug.

If you’re taking another type of drug called a monoamine oxidase inhibitor (MAOI) or are within 14 days of stopping one of those drugs, you shouldn’t take Adderall. These are a type of antidepressant, according to an article published by StatPearls. Taking both these drugs at the same time can cause a dangerous increase in blood pressure. Another potential problem is aggression. This should be screened for before beginning an Adderall treatment, in order to prevent it from getting worse.