Adderall

US Brand Name: Adderall
A link here will take you to the official website for the drug.
Generic Name: amphetamine salts: dextroamphetamine saccharate, dextroamphetamine sulfate USP, amphetamine aspartate and amphetamine sulfate USP.What is Adderall / Adderall XR?: Adderall is a stimulant specifically a cocktail of amphetamine salts.
Read up on these sections if you haven’t done so already, because they cover a lot of information about multiple medications that I’m not going to repeat on many pages. I’m just autistic that way about not repeating myself.
Other Forms: Extended Release (XR)
What are the FDA Approved Uses of Adderall / Aderall XR:
Adderall was approved in February 1996 to treat Attention deficit hyperactivity disorder in children.
Immediate-release Adderall is also approved for narcolepsy and exogenous obesity.
Adderall XR was approved in August of 2004 to treat ADHD in adults.
Off-Label Uses of Adderall: Depression. Probably others, stay tuned for studies and more potential off-label uses.

Adderall’s pros and cons:
Pros: A tried and true way to treat ADD/ADHD and narcolepsy.
Like most amphetamines it doesn’t have much in the way of side effects, fewer than the methylphenidates (Ritalin, Focalin, Concerta).
Cons: Those triplicate prescriptions are a pain in the ass to deal with.
If you have any history of drug abuse, the odds are you’ll never get an Adderall prescription no matter how much you’ve cleaned up your act and how helpful it will be to you.
Because it’s an amphetamine it might be a little too much fun to use for some people.

Adderall’s Typical Side Effects: The usual for stimulants –  headache, nausea, dry mouth, sweating, insomnia, constipation, weight loss, heart palpitations, raised blood pressure, dizziness, horniness.  Generally everything clears up up after a couple weeks except the constipation, weight loss, increased blood pressure and increased libido.  So unless you have blood pressure issues and/or real problems with being too thin and/or too horny already I’m sure you can live with the typical side effects.

For tips on how to cope with these side effects, please see our side effects page.
These aren’t all the side effects possible, just the most popular ones.

Adderall’s Not So Common Side Effects:  Triggering a manic reaction.  More often than not this happens when someone is misdiagnosed as only having ADD/ADHD when they are also bipolar.  Although you won’t find “manic reaction” as a side effect anywhere in the PI sheet, you’ll find every symptom of mania listed instead.  This is a great CYA (Cover Your Ass) move by Shire for the doctors prescribing it.  Hey, it doesn’t trigger mania, it just causes a bunch of symptoms that are like mania!  I had one person write me  about her  bipolar disorder that was in complete remission for 14 yearsgetting completely hosed by an Adderall prescription from a doctor who must have been convinced she only had ADD/ADHD.  Other not-so-common side effects are tics, twitches and exacerbation or unmasking of Tourette’s or similar syndromes, depression and screwing with your menstrual cycle.
These may or may not happen to you don’t, so don’t be surprised one way or the other.

Adderall’s Freaky Rare Side Effects: Amphetamines don’t have much in the way of freaky rare side effects.  I may dig up something on PubMed later.  The closest thing I can find is the combination of increased libido and impotence.
You aren’t going to get these. I promise.

Adderall’s Suicide Risk:  All psychiatric and neurological meds have a potential suicide risk.  I’ll get back to you on the specifics with Adderall.

Interesting Stuff Your Doctor Probably Won’t Tell You: Since ADD/ADHD is pretty much part of being bipolar, in some cases there really isn’t anything wrong in taking Adderall if you’re bipolar and taking a good mood stabilizer of some kind.  The problem is if you’re taking lithium don’t expect to lose any weight.  Or stay awake for that matter.  In fact, Adderall may not work at all when combined with lithium.  So if lithium is the mood stabilizer that works for you, you’re stuck with your ADD/ADHD symptoms if Strattera(atomoxetine) and/or Provigil (modafinil) didn’t cut it for you.

Mixing booze and Adderall, or any stimulant, is a really bad idea.  Not only do you increase the chances of having a seizure of some kind (even if you’ve never had one before), but you just don’t feel quite so drunk.  So you have another.  And another.  And another.  Until you’re a lot thinker than you’re drunk, and still insist on driving home, what do you mean it’s not your car?

Your doctor, or at least your pharmacist should tell you not to wash down your Adderall with orange juice or any other fruit juices.  Those severely lower the absorption of amphetamines.  You can drink fruit juice at other times of the day, just not around when you’re taking your speed.

Adderall’s Dosage and How to Take Adderall: With all stimulants the drug companies and I are in full agreement – start at the lowest possible dosage and see what works!  Here it is, right in the PI sheet, “Regardless of indication, amphetamines should be administered at the lowest effective dosage and dosage should be individually adjusted. Late evening doses should be avoided because of the resulting insomnia.”  At least that is how it used to read.  Now that has been watered down a bit.

Adderall was originally approved for childhood ADD/ADHD and all the guidelines were just for kids, so they would start you out at 5mg once or twice a day.  With the XR version that would be one 10mg capsule a day.  And I’m really down with that method.  Now the PI sheet has adults starting at 20mg a day no matter what.  You know, they make 10mg capsules andeverything costs the same, so why not start at 10mg a day and see how that goes at first?  It’s easier to deal with having to take more Adderall if it’s not working well enough than to deal with the side effects of having had too much to start with.  The maximum dosage for an adult is 60mg a day.  For kids it’s 30mg a day.

For narcolepsy – as above.  Start with the lowest dosage possible.  By 60mg a day it’ll either work or it won’t or the side effects will suck too much.

For depression – using amphetamines is pretty radical, but not unheard of.  They are sometimes the only thing that will work.  Good luck in finding a doctor who will actually work with you along these lines if you need to go this route.  Again you should start at the lowest possible dosage.  I don’t have a clue if the maximum dosage is lower than 60mg a day or not.

How Long Adderall Takes to Work: You should start feeling results within hours of taking your first dose.  Now you might not get over your ADD/ADHD or narcolepsy symptoms immediately, but you’ll certainly feel something.  This is all part of the art of psychopharmacology combined with whatever therapy you’re getting and coping skills you’re learning.  It’ll all be a matter of finding the right dosage and learning to work with this med.  Presuming it’s the right med for you in the first place.

How to Stop Taking Adderall: Your doctor should be recommending that you reduce your dosage by 10-20mg a day every three days if you need to discontinue it, if not more slowly than that.     For more information, please see the page on how to safely stop taking these crazy meds.   You shouldn’t be tapering off any faster than that unless it’s an emergency.

So if you’re at 60mg a day you take 50mg a day for three days, then 40mg a day for the next three days and so forth until done.
If you’ve worked your way up to a particular dosage, it’s usually best to spend this many days at the next lowest dosage before going down the next lowest dosage before that and so forth. This is the least sucky way to avoid problems when stopping any psychiatric medication. Presuming you have the option of slowly tapering off them.

Average Time to Clear Out of Your System:  Three days to get clean.

How Adderall Works In Your Brain: I’ll be getting back to you on this.

Chances Adderall Will Work and How Adderall Compares to Other Meds:   I’ll be getting back to you on this as well.

Adderall’s Half-Life: 10-13 hours for adults, 9-11 hours for children.

Days to Reach a Steady State: Shire didn’t publish anything in the PI sheet.  They did state that the pharmacokinetics are linear.  So I’ll use Dr. Julien’s rule of thumb from A Primer of Drug Action (see the bibliography) of six times the half-life, or somewhere around three days.
When you’re fully saturated with the medication and less prone to peaks and valleys of effects. You still might have peaks of effect after taking many meds, but with a lot of the meds you’ll have fewer valleys after this point. In theory anyway.

Comments: I’ll have more later.  For now I can tell you that Mouse has found Adderall to be less effective than Abbott’s version of Desoxyn.  As for Ovation’s there were too many dosage issues with both meds for a good comparison. The immediate-release version gave her migraines, but she’s able to tolerate the extended-release version with periods of melancholia and greater lack of motivation.  Eventually she was able to figure out a dosing schedule with the immediate-release version that works for her.  And the headache thing is just too unpredictable to tell what is causing them

 

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