Adderall is a “Schedule II Substance” which means it has a “high potential for abuse” and “may lead to severe psychological or physical dependence,” and so the federal government sets limits on the amount that may be manufactured each year. (21 USC Sec. 812)
The Food and Drug Administration (FDA) requires the following “black box” warning on all methylphenidate drugs, including Ritalin, which means that medical studies indicate Ritalin carries a significant risk of serious, or even life-threatening, adverse effects.
Adderall and Adderall XR are powerful blends of four amphetamines that include Dexedrine and Benzedrine.
Each ADDERALL XR Tablet Contains
Dextroamphetamine Sulfate USP
Amphetamine Sulfate USP
Attention deficit disorder
How Amphetamines Work
When we are stressed or under threat, the central nervous system prepares us for physical action by creating particular physiological changes. Amphetamines prompt the brain to initiate this ‘fight or flight’ response. These changes include:
The release of adrenalin and other stress hormones
Increased heart rate and blood pressure
Redirected blood flow into the muscles and away from the gut
In small doses amphetamines can banish tiredness and make the user feel alert and refreshed. However, the burst of energy comes at a price. A “speed crash” always follows the high and may leave the person feeling nauseous, irritable, depressed and extremely exhausted.
Do Not Use If
You have not tried other psychotherapy, have high blood pressure or any form of heart disease, are very nervous or have severe insomnia, have a history of addiction to drugs or alcohol, or have Tourette syndrome. Do not combine with monoamine oxidase inhibitors.
Common Side Effects
Loss of appetite
Difficulty falling asleep (insomnia)
Nervousness including agitation, anxiety and irritability
Less Common Side Effects
High blood pressure
Rapid pulse rate
Tolerance (constant need to raise the dose)
Feelings of suspicion and paranoia
Visual hallucinations (seeing things that are not there)
Dermatoses (infected or diseased skin)
Urinary tract infection
Infection or viral infection
Elevated ALT enzyme levels in the blood (signaling liver damage)
Overdose Side Effects
Amphetamines have been extensively abused. Extreme psychological dependence and severe social disability have resulted. Abuse of amphetamines may cause a sudden heart attack even in those with no signs of heart disease. Symptoms of overdose that require immediate medical assistance include:
Hyperreflexia (overactive reflexes, which can include twitching or spasms)
Symptoms of depression
Seizures or abnormal EEGs
High blood pressure
Rapid heart beat
Swelling of hands/feet/ankles (for example, numbing of the fingertips)
Unexplained muscle pain
Lower abdominal pain
Rhabdomyolysis and kidney damage
Chronic abuse can manifest itself as psychosis, often indistinguishable from schizophrenia
Amphetamine-Induced Anxiety Disorder
The onset of amphetamine-induced anxiety disorder can occur during amphetamine use or withdrawal, according to best-selling psychiatry text, Kaplan and Sadock's Synopsis of Psychiatry citing the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.
“Amphetamine, as with cocaine, can induce symptoms similar to those seen in obsessive disorder, panic disorder, and phobic disorders,” states Synopsis of Psychiatry.
Induction of schizophrenic-like states in children on prescribed doses of stimulant medications, including Adderall, have been observed, though not as well documented as with amphetamine abusers, according to The Journal of the American Board of Family Medicine in an article entitled, “Adderall-Induced Psychosis in an Adolescent.”
Amphetamine-Induced Sexual Dysfunction
Referring again to American Psychiatric Association’s Manual of Mental Disorders, Synopsis of Psychiatry states: “High doses and long-term use of amphetamines are associated with erectile disorder and other sexual dysfunctions.”
Dependence, Tolerance and Withdrawal
It is possible to build up a tolerance to amphetamines, which means the person using the drug needs to take larger doses to achieve the same effect. Over time, the body might come to depend on amphetamines just to function normally. The person craves the drug and their psychological dependence makes them panic if access is denied, even temporarily.
Withdrawal symptoms can include tiredness, panic attacks, crankiness, extreme hunger, depression and nightmares. Some people experience a pattern of “binge crash” characterized by using continuously for several days without sleep, followed by a period of heavy sleeping.
If It Doesn't Work
The drug should be stopped gradually. Withdrawal symptoms are psychological and stopping suddenly can cause extreme fatigue and severe, even suicidal, depression in adult patients.
If It Does Work
“In the treatment of ADHD for children and young adults, Adderall XR is now prescribed frequently, often as a first-line drug. This is, in my opinion, a very serious mistake,” states Jack M. Gorman, M.D., professor of psychiatry at Columbia University and deputy director of the New York State Psychiatric Institute. “Adderall is now abused throughout college campuses, where it is bought, sold, stolen, borrowed, snorted and injected. It is a very powerful drug that undoubtedly works for ADHD, but there are alternatives with less abuse potential that should be tried first.”
Young Abusers Risk Fatal Heart Vessel Condition
In a study published in the American Heart Journal, researchers scanned the medical records of nearly 31 million patients nationwide, ages 18 to 49, and found amphetamine abusers faced 3.3 times the risk of developing a torn aorta.
An aortic tear (a tear in the largest artery in the body, also called aortic dissection) is a medical emergency and can quickly lead to death, even with optimal treatment. Complications include rupture, heart attack, permanent kidney failure, stroke and death, according to the National Library of Medicine at the National Institutes of Health. If torn completely open, there is massive and rapid blood loss and an 80 percent mortality rate. Half of patients die before they even reach the hospital.
The torn heart vessel brings on “the most horrible chest pain imaginable,” states a cardiologist at San Francisco General Hospital and the University of California, San Francisco, David Waters, in Science News, reporting on the Journal's study. Patients say, ‘I think I'm going to die,’ and they’re right, he said.
20 Sudden Deaths Linked to Adderall XR
as reported by Associated Press (February 10, 2005)
Adderall XR, a widely used drug for attention deficit hyperactivity disorder, was pulled off the market in Canada after regulators linked the drug to 20 sudden deaths and 12 strokes. Fourteen of the deaths and two of the 12 strokes were in children.
The adverse reactions were not associated with overdose, misuse or abuse of Adderall XR, Canadian regulators said.
The U.S. Food and Drug Administration issued a public health advisory to alert providers to the withdrawal. But the agency also said it had evaluated the same reports as Canadian regulators and did not think the data warranted pulling the drug from the U.S. market.
Westover AN, Nakonezny PA. “Aortic dissection in young adults who abuse amphetamines.” Am Heart J 2010; 160:315-321.
Seppa N. “Amphetamine abusers face blood vessel risk,” Science News, Web ed. Aug. 23, 2010: sciencenews .org.
National Institutes of Health. “Aortic dissection: Aortic aneurysm - dissecting” PubMed Health, produced by the National Center for Biotechnology Information, a division of the National Library of Medicine at the National Institutes of Health, dated 5/4/2010: ncbi.nlm.nih .gov/pubmedhealth/ PMH0001233/
Isselbacher, EM; Eagle KA, Zipes DP, et al. “Diseases of the aorta”. In Braunwald. Heart disease: a textbook of cardiovascular medicine (5th ed.). Philadelphia: WB Saunders, pp. 1546:81, 1997.
Drug Enforcement Administration, US Department of Justice. “Amphetamines,” Drugs of Abuse Publication. National Drug Intelligence Center, 2005 ed.
Drug Enforcement Administration, US Department of Justice. “Drug Fact Sheet: Amphetamines,” undated, retrieved January 5, 2013: justice .gov/dea/ druginfo/ drug_data_sheets/ Amphetamines.pdf.
National Institute of Mental Health. Medications. Bethesda, MD: National Institute of Mental Health,
National Institutes of Health, US Department of Health and Human Services; NIH Publication No. 02-3929, 2007 ed.: nimh.nih .gov/health/ publications/ medications/ medications.pdf.
Australian Drug Foundation, Victorian Minister for Health. “Amphetamines Fact Sheet,” 2007 ed.: betterhealth.vic .gov .au/ bhcv2/bhcarticles.nsf /pages/Amphetamines.
High-Fructose Corn Syrup May Hurt Cognition and Memory
Los Angeles, CA—A recent study from the University of California Los Angeles (UCLA) brings new evidence about how high-fructose corn syrup (HFCS) may effect the brain. Researchers measured HFCS influence on insulin signaling, synaptic plasticity in the brain, and behavior. They concluded that HFCS consumption impaired cognitive ability and provided evidence of how HFCS may have more of an effect than previously known on cognition and memory.
ABOVE: Barnes JN, Joyner MJ. “Sugar highs and lows: the impact of diet on cognitive function.” J Physiol 590.12, 2831 (2012). Agrawal R, Gomez-Pinilla F. “Metabolic syndrome in the brain: Deficiency in omega-3-fatty acid exacerbates dysfunctions in insulin receptor signaling and cognition.” J Physiol 590, 2485-2499 (2012).