Adderall (amphetamine/dextroamphetamine): uses, side effects, and what to expect

Talkiatry psychiatrists who treat ADHD are frequently asked about Adderall, and for good reason: it is one of the most commonly prescribed medications in its class. Adderall is a central nervous system stimulant used primarily for ADHD, and whether it is the right fit depends on a thorough evaluation with your psychiatrist.

Key takeaways

• Adderall (amphetamine/dextroamphetamine) is a central nervous system stimulant prescribed mainly for ADHD and narcolepsy.
• It works by increasing dopamine, norepinephrine, and, to a lesser extent, serotonin activity in the brain, which supports attention, focus, and impulse control.
• Many people notice effects within 30 to 60 minutes of taking it.
• Adderall is a Schedule II controlled substance, and it can affect appetite and sleep, especially when starting treatment.

What is Adderall?

Adderall is the brand name for amphetamine/dextroamphetamine, also known as mixed amphetamine salts. It belongs to a class of medications called central nervous system stimulants. Adderall is most commonly prescribed to treat attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. It is one of several ADHD medications your psychiatrist may consider.

What does Adderall treat?

Adderall is FDA-approved to treat two conditions.

On-label uses

• Attention-deficit/hyperactivity disorder (ADHD)
• Narcolepsy

How does Adderall work?

Your brain relies on chemical messengers called neurotransmitters to send signals between nerve cells. In people with ADHD, certain neurotransmitters, especially dopamine and norepinephrine, may not be active enough in the areas of the brain that handle focus and impulse control. Adderall increases the availability of these neurotransmitters, helping those brain circuits work more effectively.

• It increases dopamine and norepinephrine activity in the brain. Adderall quickly boosts the availability of these neurotransmitters, which are important for attention, motivation, and alertness.
• It strengthens focus and attention networks. By increasing these signals, the medication helps the brain's executive function systems stay engaged with tasks.
• It improves attention and impulse control. For people with ADHD, this can make it easier to concentrate, stay organized, and manage distractions.

3 things a Talkiatry psychiatrist wants you to know about Adderall

• It works quickly, but the first few weeks involve some fine-tuning. The speed of onset is one reason stimulants are often a first-line option for ADHD. Still, finding the right dose, formulation, and timing takes a bit of back and forth with your psychiatrist, so expect a few check-ins early on.
• It can affect appetite and sleep. Some people experience reduced appetite, trouble falling asleep, or feeling jittery, especially when starting or adjusting doses. These side effects often improve over time, and your psychiatrist can help you manage them with scheduling or dose adjustments, along with strategies for improving sleep and coping with anxiety.
• It's a controlled medication. Because stimulants can be misused, Adderall is carefully prescribed and monitored by clinicians. Taking it exactly as directed is important.

Other things worth knowing: Supply can vary. At times, there may be nationwide shortages of stimulant medications like Adderall. If this happens, your psychiatrist can send your prescription to a different pharmacy or help you explore alternative treatment options.

Common side effects of Adderall

Most side effects of amphetamine/dextroamphetamine are mild and tend to improve as your body adjusts. Common side effects include:¹

• Nervousness or restlessness
• Headache
• Dry mouth
• Constipation or diarrhea
• Nausea
• Decreased appetite and weight loss
• Trouble sleeping

Talk to your psychiatrist if any of these feel persistent, severe, or get in the way of your day.

Serious side effects of Adderall and when to seek help

Serious side effects are less common but require prompt medical attention. Contact your psychiatrist or seek emergency care if you experience any of the following:¹

• Fast, pounding, or irregular heartbeat
• Slow or difficult speech; dizziness; weakness or numbness in an arm or leg
• Seizures or new motor or verbal tics
• Depression, hallucinations (seeing or hearing things that do not exist), or believing things that are not true
• Serotonin syndrome symptoms: agitation, fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
• Mania (frenzied or abnormally excited mood)
• Paleness or blue color of fingers or toes; unexplained wounds, pain, numbness, burning, or tingling in hands or feet (most relevant for people with Raynaud's phenomenon)
• Signs of severe allergic reaction: rash; hives; swelling of eyes, face, tongue, or throat; difficulty breathing or swallowing; blistering or peeling skin
• Chest pain, shortness of breath, or fainting

Call your psychiatrist right away or seek emergency care if you experience any of these symptoms.

Serious heart-related side effects of Adderall

This medication may cause sudden death in children and teenagers with heart defects or serious heart problems, and may cause sudden death, heart attack, or stroke in adults with heart defects or serious heart problems. Overuse may lead to serious heart problems.¹ If you have a history of cardiac conditions, or a family history of cardiac conditions or sudden cardiac death, it’s best to consult with a cardiologist before starting Adderall.

What to watch for when starting Adderall

When you first start taking amphetamine/dextroamphetamine, there are a few things to keep in mind:¹

• When starting a new medication, it's best to see how it affects you before driving or operating machinery.
• Adderall should not be taken in the late afternoon or evening, as it may cause difficulty falling or staying asleep.
• Your prescriber will likely start with a low dose and increase gradually, no more often than once per week.
• This medication should be used as part of a comprehensive ADHD treatment program, which may include counseling and special education.
• Do not stop taking this medication abruptly without talking to your prescriber, especially after extended use. Sudden discontinuation may cause severe depression and extreme tiredness.

What to do if you miss a dose of Adderall

If you miss a morning dose of the extended-release capsule, skip the missed dose and take your next dose at the regular time the next day. Do not take a dose later in the day, and do not take a double dose to make up for a missed one.¹

Who should talk to a psychiatrist before taking Adderall

Some health conditions, medications, and life situations change how Adderall is prescribed. Tell your psychiatrist if any of the following apply to you:¹

• You have allergies to amphetamine, dextroamphetamine, or other stimulant medications
• You are taking or have recently stopped taking MAO inhibitors (such as isocarboxazid, phenelzine, selegiline, or tranylcypromine) within the past two weeks
• You have glaucoma, hyperthyroidism, or significant feelings of anxiety, tension, or agitation
• You have a personal or family history of irregular heartbeat, heart defects, high blood pressure, hardening of the arteries, heart or blood vessel disease, or sudden cardiac death in a family member
• You have a history of depression, bipolar disorder, mania, motor or verbal tics, Tourette's syndrome, or suicidal thoughts or attempts
• You have a history of mental illness, seizures, abnormal EEG, or liver or kidney disease
• You are pregnant, planning to become pregnant, or breastfeeding
• You are 65 years of age or older
• You have a personal or family history of alcohol misuse, street drug use, or prescription medication overuse