Medication and Treatment Reviews

Adderall XR

Generic Name: Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate

Uses

Adderall XR is a once-daily, timed-release stimulant medication primarily is used to treat Attention Deficit Hyperactivity Disorder (ADHD) in children ages 6-12, adolescents, and adults. According to the FDA, Adderall XR is a federally controlled substance (CII) because it can be abused or lead to dependence. It is an amphetamine.

Adderall XR may improve focus for people with inattentive ADHD, and decrease impulsivity and hyperactive behavior, the hallmark symptoms in patients with the condition. It has not been studied in children under the age of 6.

The American Academy of Pediatrics recommends treatment with behavioral therapy before medication for children under the age of 6. For children ages 6 to 11, the AAP says “The primary care clinician should prescribe US Food and Drug Administration–approved medications for ADHD and/or evidence-based parent- and/or teacher-administered behavior therapy as treatment for ADHD, preferably both.” Likewise, the National Institute of Mental Health finds the most successful treatment plans use a combination of ADHD medication, like Adderall XR, and behavior therapies.

Originally, Adderall was developed to treat narcolepsy; it should not be used to treat tiredness or other sleep-related problems without a doctor’s specific instructions and prescription.

How to Use Adderall XR

Before starting or refilling an Adderall XR prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage

As with all medications, follow your Adderall XR prescription instructions exactly. Adderall XR is taken orally, with or without food, once daily. The first dose is typically taken first thing in the morning; it should be taken at the same time each day for the best results.

Capsules should be swallowed whole with water or other liquids. If your child is unable to swallow the capsule, it can be opened and sprinkled over a spoonful of applesauce. Taken this way, the mixture should be swallowed whole without chewing, followed by a drink of water or other liquid. Capsules should never by crushed or chewed.

Capsules are available in 5mg, 10mg, 15mg, 20mg, 25mg and 30mg dosages. The time-release formulation is designed to maintain a steady level of medication in your body throughout the day.

The optimal dosage varies patient by patient; is not determined by age, weight, or height, but rather by how a person metabolizes the medication. Your doctor may adjust your daily dosage by 5mg increments until you or your child experiences the best response — that is, the lowest dosage at which you experience the greatest improvement in symptoms without side effects.

Children ages 6-12 should not exceed 30mg once daily. It is rare that a patient needs to exceed 40mg daily. Taking a high dosage for a prolonged time can result in withdrawal symptoms like fatigue, depression, insomnia, irritability, psychosis, or personality changes. If you or your child exceeds the prescribed dosage, call your doctor or poison control, or seek emergency medical care.

During treatment, your doctor may periodically ask you to stop taking your Adderall XR so that he or she can monitor ADHD symptoms; check vital statistics including blood, heart, and blood pressure; or evaluate height and weight. If any problems are found, your doctor may recommend discontinuing treatment.

Some patients report developing a tolerance to Adderall after long-term usage. If you notice that your dosage is no longer controlling your symptoms, talk to your doctor to plan a course of action.

Side Effects

The most common side effects of Adderall XR are as follows:

Children (ages 6 to 12): Loss of appetite, insomnia, abdominal pain, emotional lability, vomiting, nervousness, nausea, and fever.

Adolescents (ages 13 to 17): Loss of appetite, insomnia, abdominal pain, weight loss, and nervousness.
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Adults: Dry mouth, loss of appetite, insomnia, headache, weight loss, nausea, anxiety, agitation, dizziness, tachycardia, diarrhea, asthenia, and urinary tract infections.

Other serious side effects include slowed growth in children, seizures, and changes in eyesight. Taking Adderall XR may impair your or your teenager’s ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor. Most people taking this medication do not experience any of these side effects.

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Adderall XR. Stimulants can increase blood pressure and heart rate. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting while taking Adderall XR.

Also disclose to your physician all mental health issues including any family history of suicide, bipolar illness, tics, or depression. The drug manufacturer, Shire, recommends evaluating patients for bipolar disorder, tics, and Tourette’s syndrome prior to stimulant administration. Adderall XR may create new or exacerbate existing behavior problems, bipolar illness, or Tourette’s syndrome. It can cause psychotic or manic symptoms in children and teenagers. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including hallucinations or sudden suspicions.

Discuss circulation problems with your doctor before taking Adderall XR, which has been known to cause numbness, coolness, or pain in fingers or toes, including Raynaud’s phenomenon. Report to your doctor any new blood-flow problems, pain, skin color changes, or sensitivities to temperature while taking Adderall XR.

Amphetamines like Adderall XR have a high potential for abuse and addiction, especially among people who do not have ADHD. It is a “Schedule II Stimulant,” a designation that the Drug Enforcement Agency uses for drugs with a high potential for abuse. Other Schedule II drugs include Dexedrine, Ritalin, and cocaine. People with a history of drug abuse should use caution when trying this medication. Taking the medication exactly as prescribed can reduce potential for abuse.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions and Safety

Store Adderall XR in a secure place out of the reach of children, and at room temperature. Do not share your Adderall XR prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

You should not take Adderall XR if you have any of the following conditions:

  • Advanced arteriosclerosis
  • Glaucoma
  • Symptomatic cardiovascular disease
  • Moderate to severe hypertension
  • Hyperthyroidism
  • Known hypersensitivity or idiosyncrasy to the sympathomimetic amines
  • Glaucoma
  • Agitated states
  • History of drug abuse
  • During or within the administration of monoamine oxidase inhibitors (MAOIs)

If you’re thinking of becoming pregnant, discuss the use of Adderall XR with your doctor. Animal studies indicate a potential risk of fetal harm; infants may be born prematurely, with low birth weight, have learning or motor deficits, or experience withdrawal. Adderall XR is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

The effects of Adderall XR on the elderly have not been studied.

Interactions

Before taking Adderall XR, discuss all other active prescription medications with your doctor. Adderall XR can have a dangerous, possibly fatal, interaction with antidepressants including MAOIs.

Exercise caution with medicines including anti-psychotics, lithium, narcotic pain medicines, seizure medications, blood thinners, blood pressure medications, stomach acid medications — like antacids —, and cold or allergy medicines that contain decongestants. Even over-the-counter medications may contain ingredients that raise or lower the level of the medication in your blood to a dangerous level.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Adderall XR before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Sources:
http://www.shirecontent.com/PI/PDFS/AdderallXR_USA_ENG.PDF
http://www.fda.gov/downloads/Drugs/DrugSafety/ucm085819.pdf

11 reviews

  1. We’ve had tremendous success with Adderall 5mg extended release for my daughter. She is 8 years old now but she started it when she was 6. She is normally a happy, feisty, little tornado, but when her medicine wears off about 5pm she gets grouchy and irritable. The doctor gave me a prescription for the regular Adderall 5mg and told me to give it to her around 3:30 pm after school. She didn’t get to sleep until about midnight. So after about a week I dropped the extra pill in the afternoon and deal with the irritability, which has improved some. Her symptoms return immediately when she doesn’t take it. She hasn’t had to progress to a higher dose in over a year and half.

  2. My son (who is 6 ½ years old) is currently taking Adderall XL 20 mg. He tried Medidate and Concerta, both of which worked well, but the dose kept increasing. He has been on Adderall XL 20 mg. for about 6 months now and is doing great. He is a totally different kid on the medicine (focused, much calmer, and responsible). When not on the medicine, you can definitely see the difference (very hyper, giddy, not focused, lack of personal boundaries, etc). Thus, I would say that Adderrall has worked great for him.

  3. My child was diagnosed with comprehensive ADD and was prescribed Adderall. She takes 20mg XR in the morning and 10mg regular in the afternoon. She has been on it for about 2 years now but it doesn’t seem to work as well anymore.

  4. I am a 56-year-old woman and was diagnosed with ADHD and Bipolar II a year ago. One of my biggest problems has been with impulsive talking that seems to have gotten worse since I’ve gotten older. I talked to my doctor about it a couple of weeks ago and she suggested trying Adderall XR 30mg instead of the Concerta ER 54mg I was taking. It really seems to be helping!

  5. My first experience with Adderall XR was horrible. It changed my mood and behavior. I would get angry easier and cry easier. It made me get horrible bad breath, dry mouth, and body odor. I had to switch meds.

  6. I was diagnosed with the inattentive type just before my 40th birthday. I take 20 mg slow release generic Adderall XR. The immediate positive effects were: absence of paralyzing fear and uncertainty about what to do/ how to complete any task; decisiveness; effortlessness of any task or decision; confidence; naturally stay on task without thinking about it; automatic follow through without effort; clear sight – where before I felt I was in a deep fog; assertiveness where timidity and passivity would have been; diminished appetite – where constant hunger was previously; physical body pains relieved; need much less sleep and rest. The negative side effects at first were: dry mouth without ability to drink a lot; diarrhea on day two or three after an afternoon coffee; diminished sensory experience – no longer seeking pleasurable activities or food; feeling ‘amped up’ (like shortness of breath, short temper, cry easily, easily irritated); not as easy as normal to fall asleep, harder to observe my thoughts, less vivid dreams, less ‘awareness’.

  7. I am 30 years old and have ADHD. I have been taking Adderall for approximately 3 years now and the last dose (25 MG XR 24 hour as my doctor states) I received makes me extremely irritable, especially when my concentration gets broken. It seems to be progressing, especially the anxiety.

  8. I’ve had only one side effect taking Adderall IR 20mg: dry mouth. I did get a slight headache at the end of the day when it started to taper off, but nothing that bothered me.
    Now that my doctor has moved me up to 30mg I’ve been experiencing a dull, mild headache all day long. It starts about the time my medicine kicks in and lasts till the drop off headache would normally subside.

  9. I just started Adderall XR on Friday. It worked great this weekend and for the beginning of this week at work. Today, it took 40 minutes to kick in (instead of a half hour), and it stopped working after three and a half hours instead of 10.

  10. 45 year old male diagnosed with ADHD (ADD). Started with 10ml for 30 days…nothing. Increased to 20ml for another 30 day trial…still nothing. Doctor wanted to switch to something else but I asked if we could try 30ml before doing that and so we did. One word…WOW. That did it. Super focused through most of the day. I’m still in my first week with no side effects other than the increased focus. I did wake up with a head ache this morning but not sure if I’m blaming it on the med or my sinus issues. Regardless, I’m certain I’ll be telling the doctor on my next follow up visit we found it!

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