Adderall: Pharmacological Treatment for ADHD

In the pharmacological treatment of ADHD, Adderall stands out as a highly effective stimulant medication. Discover its benefits and contraindications.

Written and verified by the psychologist Elena Sanz.

Last update: 03 September, 2024

Attention deficit hyperactivity disorder (ADHD) makes it difficult for the sufferer to organize and control their impulses. It also leads them to experience high levels of restlessness. In order to reduce these symptoms and improve daily functioning, certain drugs can be prescribed. One of the best-known and most common is Adderall.

This medication combines amphetamines and dextroamphetamine. These are two stimulants that have proven to be effective in the treatment of ADHD in children and adults. However, it should be remembered that it’s a prescribed drug and must be subject to medical supervision. Otherwise, it could involve significant risks.

Adderall

One of the most widespread and accepted explanations regarding the neurobiology of ADHD is known as the catecholaminergic hypothesis (Clark et al., 1987). It proposes that sufferers of this disorder present an alteration in the functioning of certain neurotransmitters in the brain (mainly dopamine and norepinephrine).

More specifically, there appears to be a deficit in certain brain areas. Their hypoactivation is related to the symptoms of ADHD. Stimulant medications, such as Adderall, activate this catecholaminergic system, exhibiting improvement in about 80 percent of cases (Aboitiz et al., 2012).

Adderall is an amphetamine that stimulates the central nervous system. It does so by blocking the reuptake of dopamine, norepinephrine, and serotonin and increasing their availability in the synaptic gap. Therefore, it manages to reduce the symptoms of inattention, impulsivity, and hyperactivity.

Its uses and effectiveness

Adderall was first introduced in 1996 by Richwood Pharmaceuticals. They offered it as a rapid-release capsule for the treatment of ADHD in school-age children.

Since then, its use has spread. Moreover, research supports its effectiveness in improving the symptoms of the disorder, as confirmed in an article published in the Journal of Attention Disorders. However, it’s also used in the treatment of conditions such as narcolepsy, as it helps improve wakefulness.

The original version of Adderall is an immediate-released drug. Its effects last for about four to six hours and it must be taken several times a day. There’s also another format called Adderall XR. Despite containing the same components, it’s a prolonged-release capsule. Its effects are slower, but last up to twelve hours and only one dose is taken daily.

Whether a patient opts for one or the other depends on their particular case. For example, some people may forget to take a second Adderall tablet during the day or experience more adverse reactions. Adderall XR is more tolerable for sufferers with hypertension, as reported in a clinical trial published in The Journal of Clinical Psychiatry.

How to take Adderall for treating ADHD

The dosage of this medicine is individualized. It needs to be adjusted over time, according to each patient. However, as stated in an article published in the JCCC Honors Journal, there are other considerations.

Adderall is administered orally and is absorbed through the gastrointestinal tract. In the case of the immediate release format, it’s taken in two or three doses a day, separated by four-six hours. It can be taken with or without food. It’s not recommended that the maximum daily dose exceed 40 mg, but up to 60 mg may be initially required.

On the other hand, the extended-release formulation is taken only once a day, in the morning, with or without food. The maximum recommended daily dose shouldn’t exceed 30 mg.

Adderall must always be taken under prescription. The treatment usually commences with low doses that increase depending on the patient’s tolerance. The duration of treatment also depends on the patient and any decrease in its use should always be guided and supervised by a professional. Withdrawal should always be gradual.

Warnings and side-effects

Despite its effectiveness, Adderall is a drug with certain risks. Here are some considerations reviewed by Drug Enquirer.

• It has side effects such as sleep and appetite disturbances, headaches, depression, and even suicidal ideation. If not used properly, anxiety disorders, psychosis, and sexual dysfunction can also occur. It also generates or worsens tachycardia and hypertension.
• One of the main risks associated with Adderall is its addictive potential. The patient may develop dependence and tolerance, needing increasingly higher doses of the drug to function normally. Withdrawal symptoms include fatigue, panic attacks, depression, and nightmares.
• Using Adderall for non-medical purposes is carried out in different settings. For example, among university students or athletes. This is because the drug stimulates attention, concentration, and physical performance. But, taking it without a prescription and without having ADHD is high risk, due to the adverse side effects it may generate.
• Regarding contraindications, Adderall shouldn’t be used by individuals with high blood pressure, heart problems, insomnia, or nervousness. It’s also contraindicated in patients with Tourette syndrome or those taking monoamine oxidase inhibitors.

A drug to be taken with caution

The efficacy of Adderall in the treatment of ADHD is unquestionable, which is why it’s used as a first-line drug. That said, its risks and side effects shouldn’t be overlooked. Moreover, it’s essential that a health professional supervise its use at all times.

Finally, it’s worth remembering that there are other alternatives available, such as non-stimulant medications or psychotherapy. Both of these can be extremely useful in improving the symptoms of ADHD.