Key takeaways:
Adderall (mixed amphetamine salts) is a medication that treats attention deficit-hyperactivity disorder (ADHD) and narcolepsy. It has possible short-term and long-term side effects.
Long-term effects of Adderall may include dependence and misuse, heart problems, and slowed growth in children. However, Adderall is generally well tolerated and long-term risks aren’t common.
We don’t have a lot of research on whether Adderall side effects are different in men versus women. But in general, women are considered more likely to experience medication side effects.
Attention deficit-hyperactivity disorder (ADHD) affects about 11% of children and adolescents and up to 6% of adults in the U.S. Using stimulant medications, such as Adderall (mixed amphetamine salts), to treat ADHD is common. Adderall is also used to treat narcolepsy.
Like all medications, Adderall has risks to be aware of. Particularly, long-term effects of Adderall may be a concern if you or your child take Adderall. Here, we’ll cover five potential long-term effects of Adderall and ways to minimize your risks. Additionally, we’ll answer several common Adderall FAQs.
1. Misuse
Stimulant medications like Adderall are controlled substances. Controlled substances are strictly regulated because of their potential for dependence and misuse. There’s also restrictions on how they’re prescribed and refilled.
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Long-term Adderall use can lead to both physical dependence and misuse. Physical dependence describes a tolerance to Adderall. Tolerance is the need to use Adderall in greater amounts over time to achieve the desired effect. If you’re dependent on Adderall, you may also experience withdrawal symptoms if you miss a dose or don’t take Adderall for a while. Symptoms may include anxiety, irritability, and trouble concentrating.
Dependence is different from misuse. Misuse refers to taking Adderall for any reason other than why it's prescribed, or taking more than the prescribed amount. Misuse often causes difficulties with relationships, responsibilities, and your health. And using more Adderall than what’s prescribed can lead to health problems, including high blood pressure and other heart problems.
To avoid Adderall misuse, only take it exactly as prescribed. Use the lowest dose possible, and check in with your prescriber frequently about whether continuing Adderall long-term is a good idea for you.
If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.
2. Heart problems
Adderall may increase your heart rate and blood pressure. But the research on whether this has long-term effects are mixed. And the studies that look at Adderall’s effects on the heart are called observational studies. These studies can’t establish cause-and-effect relationships. They can only look at whether two things are correlated.
One review of 19 studies —including close to 4 million adults and children taking ADHD medications — found that stimulants don’t increase your risk of heart problems. This was true even in people who had an existing heart-related condition. In this review, participants were followed for anywhere between 4 months to 9.5 years.
Another study of close to 300,000 adults and children found that taking stimulants for ADHD did increase your risk of heart problems, especially high blood pressure and peripheral arterial disease. This study only looked at people who didn’t have an existing heart condition. Participants were monitored for up to 14 years.
Despite mixed study results, it’s important to let your prescriber know if you have an existing heart condition — including high blood pressure (hypertension), heart disease, and irregular heartbeat (arrhythmia) — before starting Adderall. They can help you decide whether it’s safe to take it.
3. Mental health problems
There have been reports of psychosis (i.e. delusions or hallucinations) in children taking stimulant medications for ADHD. As a result, stimulant medication labels state that stimulants may cause psychotic symptoms. This can occur in people with or without a history of mental health issues. Adderall’s label also warns that new mental health problems, such as mania and aggressive behavior, can also occur.
ADHD medication options: There are several medication options for ADHD, including stimulant and non-stimulant options. Depending on your health history and preferences, one option may be better for you than another.
Adderall FAQs: Get the answer to several frequently asked questions about Adderall and other prescription stimulants.
Stopping Adderall: Some people may stop Adderall temporarily or they may stop taking it for good. Learn about how three people felt after stopping Adderall.
This warning is supported by a 2019 study of over 200,000 teens and young adults. In the study, prescription stimulant use increased the risk of developing new psychoses. And the risk was two times higher with Adderall compared to methylphenidate (Ritalin), another stimulant that treats ADHD. Still, the risk of developing new mental health problems due to Adderall was low.
People with a history of certain mental health conditions, such as schizophrenia, may be more likely to experience psychosis while taking Adderall. So make sure your prescriber has your full health history before starting this medication. If you experience changes in your mood or behavior while taking Adderall, let your prescriber know immediately.
4. Slowed growth
Prescription stimulants, like Adderall, could slow down growth in children. But the research on this is mixed.
One study looked at over 400 children and young adults aged 7 to 21 years old taking prescription stimulants. The study followed participants for an average of 6 years and found that growth slowed with Adderall use. And higher stimulant doses caused more slowing of growth. What’s more, this study showed that growth didn’t fully normalize over time.
Another large study looked at over 800 participants who were between 7 to 10 years old. The study followed these children for 16 years, and found that long-term stimulant use for ADHD reduced height and increased weight over time. However, inconsistent use of stimulant medications wasn’t associated with slowed growth. This may support the practice of taking planned breaks from prescription stimulants, such as in the summers when children are not in school.
A study of over 300 adults with ADHD who took prescription stimulants as children found that they weren't shorter than adults who didn’t take prescription stimulants.
In general, the difference in height owed to prescription stimulant use is small — less than a couple centimeters (which is less than an inch). And some experts believe that any slowing of growth can be caught early, and Adderall can be stopped if necessary.
If your child takes Adderall, talk to their pediatrician about their growth. Make sure you know how frequently their height and weight should be monitored, and keep up with any necessary appointments. That way, if any changes occur, their pediatrician can catch it early on.
5. Sexual side effects
Research on how Adderall might affect sex drive or sexual function is limited. Of the research we do have, results are mixed. For example, one survey of close to 3,000 college students found that prescription stimulant users were more likely to report a loss of sex drive compared to people who didn’t take prescription stimulants. And men were more likely to report this side effect than women.
But another small study from 2020 had different results. This study looked at 17 men with difficulty achieving orgasm. After taking Adderall, an improvement in sexual satisfaction was reported by eight of the men.
Despite the little research we have on Adderall and sexual problems, the prescribing information for Adderall states that it may cause changes in sex drive and longer-lasting or more frequent erections.
If you experience sexual side effects while taking Adderall, talk to your prescriber. If you’re experiencing an erection that’s painful or longer than 4 hours, seek emergency care. This is a sign you’re experiencing a condition called priapism. This can also happen in children, so make sure you talk to your child about watching out for signs of priapism.
Frequently asked questions about Adderall use
Adderall works by increasing the amount of certain chemicals in the brain. These chemicals — norepinephrine and dopamine — play a role in attention and mood. Norepinephrine has an effect on attention and stress responses in the brain. Dopamine affects things like complex thinking and our reaction to rewarding experiences. Having a higher level of these chemicals in the body can lead to more alertness, energy, and attention.
Like most medications, Adderall can also have short-term side effects. Generally mild, short-term Adderall side effects include:
Short-term increases in blood pressure or heart rate
Dry mouth
Trouble sleeping, especially if you take it at night
Diarrhea or constipation
Headache
Loss of appetite and weight loss
However, more serious short-term side effects can also happen. This includes:
Serious heart problems or sudden death
Circulation problems in fingers and toes
Movement problems and worsening of Tourette’s syndrome
Aggressive behavior
Seizures
Vision problems
If you notice any signs of a serious side effect, such as trouble breathing, chest pain, or seizures, seek emergency care.
In general, women are more likely to report medication side effects than men. This may be due to differences in how the body metabolizes (breaks down) medications, percentage body fat, and social influences. So it’s possible that men and women may experience different Adderall side effects.
However, we don’t have much research on this. In one survey of close to 3,000 young adults taking stimulant medications, women reported nausea, headaches, and loss of appetite more so than men. Women also more frequently experienced dizziness and nervousness. However, people who weren’t taking prescription stimulants also reported some of these side effects. So it’s unclear whether these side effects are due to Adderall itself.
In general, Adderall is a safe and well-tolerated medication option for adults and children with ADHD when taken correctly. But like all medications, side effects are possible. This is especially true if you take it in a way that it isn’t prescribed, such as using more than what’s recommended.
To minimize your risk of Adderall risks, both short-term and long-term, only take Adderall exactly as prescribed. And talk to your prescriber about whether you should take it long-term.
Adderall works by increasing the amount of certain chemicals in the brain. These chemicals — norepinephrine and dopamine — play a role in attention and mood. Norepinephrine has an effect on attention and stress responses in the brain. Dopamine affects things like complex thinking and our reaction to rewarding experiences. Having a higher level of these chemicals in the body can lead to more alertness, energy, and attention.
Like most medications, Adderall can also have short-term side effects. Generally mild, short-term Adderall side effects include:
Short-term increases in blood pressure or heart rate
Dry mouth
Trouble sleeping, especially if you take it at night
Diarrhea or constipation
Headache
Loss of appetite and weight loss
However, more serious short-term side effects can also happen. This includes:
Serious heart problems or sudden death
Circulation problems in fingers and toes
Movement problems and worsening of Tourette’s syndrome
Aggressive behavior
Seizures
Vision problems
If you notice any signs of a serious side effect, such as trouble breathing, chest pain, or seizures, seek emergency care.
In general, women are more likely to report medication side effects than men. This may be due to differences in how the body metabolizes (breaks down) medications, percentage body fat, and social influences. So it’s possible that men and women may experience different Adderall side effects.
However, we don’t have much research on this. In one survey of close to 3,000 young adults taking stimulant medications, women reported nausea, headaches, and loss of appetite more so than men. Women also more frequently experienced dizziness and nervousness. However, people who weren’t taking prescription stimulants also reported some of these side effects. So it’s unclear whether these side effects are due to Adderall itself.
In general, Adderall is a safe and well-tolerated medication option for adults and children with ADHD when taken correctly. But like all medications, side effects are possible. This is especially true if you take it in a way that it isn’t prescribed, such as using more than what’s recommended.
To minimize your risk of Adderall risks, both short-term and long-term, only take Adderall exactly as prescribed. And talk to your prescriber about whether you should take it long-term.
The bottom line
Adderall (mixed amphetamine salts) is a common medication that treats attention deficit-hyperactivity disorder (ADHD). It also treats narcolepsy. But there are risks involved with taking it.
Long-term effects of Adderall may include misuse, heart problems, and severe mood changes. Sexual problems can also occur, and children may experience slowed growth. However, in general, long-term risks aren’t common and Adderall is typically safe when taken as prescribed.
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References
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