Decreased Appetite, Insomnia, and More: 11 Adderall Side Effects You Should Know About

ADHD (attention-deficit/hyperactivity disorder) is a condition that affects your focus and attention span. But ADHD symptoms can show up differently from person to person. It’s often diagnosed during childhood, but many people (especially women) aren’t diagnosed until adulthood.

Stimulants are considered first-choice ADHD medications for all ages. One example is Adderall (mixed amphetamine salts). In fact, Adderall is the most commonly prescribed ADHD medication. It’s also used to treat narcolepsy.

Here, we’ll cover 11 Adderall side effects and how to prevent or manage them.

Adderall side effects at a glance

Adderall and Adderall XR (the extended-release form) cause similar side effects, which are usually mild. Serious side effects are rare. Still, they’re possible, especially if you take Adderall long term.

Common but mild side effects:

• Headache

• Dizziness

• Dry mouth

• Lowered appetite

• Weight loss

• Insomnia (trouble sleeping)

• Mood changes, including nervousness, anxiety, and agitation

• Low energy

• Nausea or vomiting

• Diarrhea

• Urinary tract infections

• Small heart rate or blood pressure increase

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Rare but serious side effects:

• New or worsening heart problems, including high blood pressure

• Seizures

• Priapism (erections lasting 4 or more hours)

• Extreme mood changes

• Growth delays in children or teens

• Worsening of tics

• Vision problems

• Serotonin syndrome

• Raynaud’s phenomenon (abnormal blood flow to fingers and toes)

Adderall also has a boxed warning for dependence and misuse. This is the FDA’s strictest warning for medications. Taking Adderall exactly as prescribed can help minimize your risk of misuse.

1. Increased blood pressure

Adderall causes an average blood pressure increase of 2 to 4 mmHg. This usually isn’t a concern, but it may be more of a problem if you have high blood pressure already. Additionally, if you take blood pressure-lowering medications, Adderall can counteract their effects.

Although blood pressure may increase slightly after you take Adderall, it should go down after the medication wears off. Still, it’s a good idea to have your blood pressure under control before starting Adderall. Several lifestyle changes can help, like exercising for at least 30 minutes most days and following a low-sodium, nutrient-dense eating pattern like the DASH diet.

If your prescriber is concerned about high blood pressure from Adderall, they may recommend a nonstimulant medication to treat your ADHD instead of Adderall. So ask them what the best ADHD medication option for you is.

EXPERT PICKS: WHAT TO READ NEXT

• Adderall IR vs. Adderall XR: Learn about the short- and long-acting forms of Adderall, including how long they last, how they’re taken, and whether it’s OK to combine them.

• Adderall interactions: Adderall interacts with many medications, supplements, and common substances like caffeine and alcohol.

• Nonstimulant options for ADHD: Although stimulant medications are first-choice options for attention-deficit hyperactivity disorder, nonstimulant medications are a good option for some people.

2. Insomnia

Stimulants like Adderall increase norepinephrine and dopamine to improve focus. But it also makes it harder to fall asleep.

Insomnia from Adderall may be more likely when you first start the medication. Taking your Adderall dose first thing in the morning can help you avoid nighttime sleep troubles. If your prescriber recommends two or three doses a day, try to avoid taking doses in the evening. Your prescriber can tell you how many doses you should take per day and how far apart to take them (typically 4 to 6 hours).

Not getting enough sleep has negative consequences, including worsening ADHD symptoms. A lower Adderall dose may help improve sleep problems, but don’t make any changes without talking to your prescriber.

3. Decreased appetite

Adderall can suppress your appetite. If you find yourself skipping meals, eating less, or losing a significant amount of weight while taking Adderall, tell your prescriber.

For children and teens, tell their prescriber if they have a decreased appetite or weight loss. Over time, a lower appetite may contribute to growth problems (more on this below).

If you find yourself eating less after starting Adderall, ask your prescriber about timing your doses around meals. For example, eating a meal before taking an Adderall dose may help maintain your appetite. This may be especially easy to do in the morning before you take your first Adderall dose. Additionally, eating a later dinner or bedtime snack (when Adderall is expected to have worn off) may also help you maintain your usual food intake. Your prescriber may also recommend a lower Adderall dose.

4. Dry mouth

Dry mouth is another possible Adderall side effect. But it may improve as your body adjusts to the medication.

If you experience dry mouth, try sipping cool water or sucking on ice chips throughout the day. You can also try chewing sugar-free gum or over-the-counter (OTC) saliva substitutes. But if a dry mouth is still bothering you weeks later, tell your healthcare team. Gum infections and dental problems are more likely if your mouth doesn’t have enough saliva.

5. Stomach problems

Nausea, vomiting, and stomach pain can occur with Adderall. Diarrhea is also possible. But these side effects may improve as your body adjusts to Adderall.

Adderall can be taken with or without food, but taking it with food may help nausea. You can also ask your prescriber or pharmacist about OTC medications to help gastrointestinal symptoms.

6. Headache

Headaches are common, and they may be more common in people with ADHD. Adderall can also cause headaches, especially in adults.

Taking an OTC pain-relief medication, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol), may help treat headaches in the short term. But tell your or your child’s care team about headaches that don’t improve while taking Adderall. Describing your headaches, and noting when they occur, may help your prescriber figure out if they’re related to Adderall or something else.

7. Heart problems

If you have certain heart conditions, Adderall may not be the best medication for you. This is because even small increases in blood pressure or heart rate can put extra stress on the heart. But there are some heart risks to consider even if you have a healthy heart.

Some research shows a small increased risk of cardiomyopathy in people who take stimulants compared with those who don’t. And the longer you take these medications, the greater your risk. But it’s important to note that the increased risk is very small overall. Researchers estimate that 1 in 500 people may develop cardiomyopathy when stimulants are taken continuously for 10 years.

If you have a history of heart problems, make sure your prescriber knows before starting Adderall. This will help them decide if this is a safe medication for you or if you might benefit from another type of ADHD medication.

8. Seizures

Adderall may increase the risk of seizures in people who have them. It may also cause seizures in people who’ve never had them, but this is extremely rare.

Make sure your care team knows if you have ever had a seizure. They can evaluate whether Adderall is safe to take if you’ve had a seizure in the past. And if you have a seizure while taking Adderall and it’s determined to be the cause, your prescriber will likely stop the medication and consider another ADHD medication option.

9. Mood changes

Adderall might ramp up feelings of anxiety, nervousness, or agitation. But it’s also possible that Adderall improves your mood as it helps you function better in your day-to-day life. For parents or caregivers of a child taking Adderall, it may be hard to tell what’s happening when their moods change.

Close to 4 out of 5 children and adolescents with ADHD have another behavioral, developmental, or mental health condition. So it might be tricky to tell if a mood change is an Adderall side effect or due to another condition, such as anxiety or depression.

If you experience mood changes, your care team can help figure out the cause and adjust your medications if needed. Rarely, mental health emergencies have occurred in people taking Adderall. This includes the emergence of psychotic symptoms (like hallucinations) or mania (periods of high energy). Get immediate help for any severe mood changes.

10. Slowed growth

The research is mixed, but it’s possible that Adderall may slow down your child’s growth over time. One potential cause is lowered appetite and weight loss that can occur with Adderall use. But slowed growth may occur even without appetite changes.

Effects on growth may be more likely if your child is taking a higher dose for a longer period of time. If growth changes occur, there may be ways to manage them that don’t always include stopping Adderall completely, especially if it’s working well for your child. For example, a lower Adderall dosage or treatment break (“drug holiday”) can help maintain their growth. Keep your child’s care team informed if you notice any weight loss or appetite changes during Adderall treatment.

11. Dependence and misuse

Adderall is a controlled substance. This means dependence and misuse are possible, raising the risk of stimulant use disorder and overdose.

Taking Adderall exactly as prescribed, and using the lowest dose needed, will help minimize the risk of misuse. Additionally, parents and caregivers should supervise their kids’ medication and keep it stored securely. And tell your prescriber right away if you or your child is taking more Adderall than what’s prescribed. This is a sign of misuse, and it can lead to a wide range of health issues including heart problems.

If you or someone you know struggles with substance use, help is available. Call the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 to learn about resources in your area.

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Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Renad Abu-Sawwa, PharmD, BCPPS

Renad Abu-Sawwa, PharmD, BCPPS, is an associate professor and associate discipline director of clinical pharmacology at Rush Medical College with a practice site as a clinical pharmacy specialist practitioner at RUSH Children's Hospital in the Pediatric Epilepsy Clinic.

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