The Food and Drug Administration (FDA) requires the following “black box” warning on all amphetamine drugs, including Adderall, which means that medical studies indicate Adderall carries a significant risk of serious, or even life-threatening, adverse effects.
Behaviors resulting from amphetamine intoxication such as withdrawal from others, experiencing hallucinations, paranoia, delirium perhaps occurring with violence and stereotyped behaviors such as repeatedly assembling and dissembling electronic equipment may resemble symptoms of schizophrenia. But a skilled clinician should be able to make the proper diagnosis.
Adderall (as with all amphetamines) works by initiating the acute stress response (“fight or flight” response). The central nervous system prepares the body for physical action by creating physiological changes as if it were stressed or under threat. These changes include:
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.
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.
Adderall has been extensively abused. Extreme psychological dependence and severe social disability have resulted. Abuse of Adderall may cause a sudden heart attack even in those with no signs of heart disease. Symptoms of overdose that require immediate medical assistance include:
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.”
The 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.”
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.
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.
“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.”
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.
The NY Times, in an op-ed article by L. Alan Sroufe, a professor emeritus of psychology at the University of Minnesota's Institute of Child Development, stated the following:
“Attention-deficit drugs increase concentration in the short term, which is why they work so well for college students cramming for exams. But when given to children over long periods of time, they neither improve school achievement nor reduce behavior problems. The drugs can also have serious side effects... Many parents who take their children off the drugs find that behavior worsens, which most likely confirms their belief that the drugs work. But the behavior worsens because the children's bodies have become adapted to the drug. Adults may have similar reactions if they suddenly cut back on coffee, or stop smoking.”
Parents might want to consider another approach.
|Adderall||amphetamine plus dextroamphetamine
|Adderall XR||amphetamine plus dextroamphetamine
|Biphetamine||amphetamine plus dextroamphetamine|
[immediate release, bubblegum flavor]
with lysine (lisdexamfetamine)
The following have been reported with use of ADDERALL XR and other stimulant medicines.
1. Heart-related problems:
Tell your doctor if you or your child have any heart problems, heart defects, high blood pressure, or a family history of these problems. Your doctor should check you or your child carefully for heart problems before starting ADDERALL XR.
Your doctor should check you or your child's blood pressure and heart rate regularly during treatment with ADDERALL XR.
Call your doctor right away if you or your child has any signs of heart problems such as chest pain, shortness of breath, or fainting while taking ADDERALL XR.
2. Mental (Psychiatric) problems:
Children and Teenagers
Tell your doctor about any mental problems you or your child have, or about a family history of suicide, bipolar illness, or depression.
Call your doctor right away if you or your child have any new or worsening mental symptoms or problems while taking ADDERALL XR, especially seeing or hearing things that are not real, believing things that are not real, or are suspicious.
Stimulant drugs may have subtle impacts on cognitive and intellectual processes. Both parents and researchers have noticed that children taking Ritalin sometimes answer questions in ways that seem overly compliant or narrow, suggesting the drug might restrict creative thinking. One study found hyperactive children taking Ritalin offered less varied answers to open-ended questions.
The psycho-stimulants help students bear down on their work, but with odd effects. One college student says he spends “too much time researching a paper rather than actually writing it.” Another student looked back at papers he'd written while on Adderall and found them verbose: “I'd produce two pages on something that could be said in a couple of sentences.”
All these questions need proper scientific answers, but for now much of the discussion is taking place furtively, among an increasing number of Americans who are performing daily experiments on their own brains (or their children's brains).