Adderall is a stimulant containing amphetamine and dextroamphetamine. It is used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. There are side effects that both men and women experience when taking Adderall. Women taking Adderall to treat their ADHD symptoms should be aware of the potential serious side effects and limitations.
Table of Contents
Key Points
- Adderall is a combination of amphetamine and dextroamphetamine used to treat ADHD and narcolepsy.
- Adderall has numerous side effects that women can experience. Some of the side effects are unique to women.
- Ongoing research continues to explore how hormonal fluctuations impact the symptoms of ADHD and medication effectiveness in women.
- Adderall does have a risk for misuse.
- Lifestyle choices can help decrease Adderall’s side effects.
How Adderall Works
Adderall is the brand name of the drugs amphetamine and dextroamphetamine. It is a central nervous system (CNS) stimulant that improves attention and reduces restlessness in people who struggle with concentration and are easily distracted. Adderall does this by increasing the neurotransmitters dopamine, norepinephrine, and, to a lesser extent – serotonin in the brain. The Food and Drug Administration approved Adderall XR for the treatment of ADHD in adults in 2008.[1]
The effects of Adderall can be felt within 45-60 minutes of taking it. For immediate-release tablets, the peak effects are at the 2-3 hour mark, and the total effectiveness time is 4-6 hours. Immediate-release tablets are usually taken multiple times a day. For extended-release tablets, the peak is reached at 4-7 hours and lasts 12 hours. Extended-release tablets are usually only taken once a day. [2]
Side Effects of Adderall
Common side effects of Adderall include: [3]
- stomach pain
- loss of appetite
- weight loss
- mood changes
- feeling nervous
- fast heart rate
- headache
- dizziness
- insomnia
- dry mouth
Serious side effects of Adderall include: [4]
- signs of heart problems: chest pain, trouble breathing, feeling like you may pass out. These could be signs of a heart attack.
- signs of psychosis: hallucinations, new behavior problems, aggression, hostility, paranoia
- signs of circulation problems: numbness, pain, cold feeling, unexplained wounds, changes in the skin color of your fingers or toes
- a seizure or convulsions
- muscle twitches and tics
- changes in vision
If you experience any serious side effects, contact your healthcare provider immediately.
Adderall Considerations for Women
ADHD, Adderall, and the Menstrual Cycle
Research has been slow at addressing the difference in symptoms and treatment for ADHD in girls and women.[5] New studies are exploring how the menstrual cycle and changing hormone levels may impact the effectiveness of stimulant medication for ADHD treatment in women and girls.
Many women with ADHD report a significant decrease in their well-being in their premenstrual week.[6] They report increased irritability, fatigue, and generally worse mood, including anxiety and depressed mood. They also report a worsening in their ADHD symptoms during their premenstrual week. Some women report their ADHD medication is less effective or even ineffective during their premenstrual week and the first few days of starting menstruation.
Research on the impact hormones play in ADHD symptoms and treatment thus far shows that estrogen seems to aid in the effectiveness of stimulants, while progesterone likely decreases it.[7]
One group of doctors studied increasing their patients’ ADHD medications during their premenstrual week and the first few days of their period. Their patients reported decreased focus, concentration, productivity, and brain fog before increasing the ADHD medications. They also struggled with self-control, which resulted in arguments, binge eating, and impulsive behaviors. All the women in the study reported improved premenstrual mood and improved ADHD symptoms, as well as better concentration, focus, productivity, and improved capabilities of managing emotions with increased ADHD medications.[8]
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Pregnancy
Studies have found that Adderall is the most prescribed medication for ADHD among women. The number of pregnant women taking ADHD medications has been on the rise. For most pregnant women, exposure to the fetus happens during the first trimester, as most women discontinued their ADHD medication use after that.
Research on the impact of Adderall and other ADHD medications on the fetus is limited, but ongoing studies are attempting to understand potential risks better. However, a few studies have identified an increased risk for the following congenital malformations: [9]
- Gastroschisis: a hole in the abdominal wall that causes the intestines or organs to be outside the body and have no covering membrane. The herniated organs may sometimes be covered by fibrous material.
- Omphalocele: a defect in the abdominal wall where the intestines or organs are outside the body, usually through the belly button, and are covered by a thin, often translucent membrane.
- Transverse limb deficiency: a missing arm, leg, or digits that appear as if amputated.
- Congenital heart defects.
Babies born to mothers who were dependent on amphetamines during their pregnancy are at a higher risk for premature birth, lower birth rate, and experiencing withdrawal symptoms.[10]
Breastfeeding
Adderall is excreted into breast milk; therefore, women are advised to consult with their healthcare provider to weigh the risks and benefits of continuing Adderall while breastfeeding. Limited research exists on the impact Adderall in breast milk has on infants’ neurological development. There is also some evidence that Adderall may reduce milk production in breastfeeding mothers, particularly those who are already struggling with milk production.
Weight Loss
Adderall has the side effect of weight loss for some people. This is due to Adderall’s side effect of suppressing appetite and increasing how quickly you burn calories. This has led to Adderall being misused as a weight loss drug. However, Adderall is not approved by the FDA as a weight loss medication.
Cardiac Health
There has been a link between stimulants, including Adderall, and cardiovascular events such as heart attacks.[11] If you have a heart condition or a family history of heart disease, you should talk to your doctor and complete a cardiac assessment before taking Adderall.
Low Libido
Low libido and decreased interest in sex are reported side effects of Adderall in women.[12] Discuss with your healthcare provider your decrease in sexual desire and what options there may be. This may include adjusting your medication or stopping Adderall.
What Women Can Do
Adderall can be an effective treatment for ADHD. Adderall does have serious side effects, and women are more likely to experience changes in how they process Adderall due to their hormonal cycle. Women taking Adderall should closely monitor their symptoms and hormonal cycle changes and discuss any concerns with their healthcare provider. Should they notice changes in their ADHD symptoms despite taking their Adderall as prescribed, they should contact their healthcare provider immediately.
Frequently Asked Questions
Is Adderall safe for women?
Adderall can be safe when used as prescribed under close supervision by a healthcare professional, but it is important to be aware of potential side effects and risks. If you experience any side effects, contact your healthcare provider immediately. It may be beneficial to track your mood, ADHD symptoms, and menstrual cycle. If you identify any changes in medication effectiveness that appear to be menstrual cycle-based, you may discuss this with your healthcare provider.
How can I manage Adderall side effects?
Many of Adderall’s side effects can be managed through lifestyle choices.[13] Examples include:
- Sleep: Many people with ADHD struggle with sleep, and adding a stimulant like Adderall can make insomnia worse. Having good sleep habits like going to bed and getting up at the same time, limiting caffeine intake, limiting screen time before bedtime, and not taking your Adderall after 5 p.m.
- Alcohol: Alcohol can affect how your body processes Adderall. This may exacerbate some side effects.
- Antidepressants: Some antidepressants (Wellbutrin, Prozac, Cymbalta, and Effexor) can increase Adderall’s side effects. If you are on an antidepressant, you should discuss this with your doctor before starting Adderall.
- Dry Mouth: A frequent side effect of Adderall is dry mouth. You can increase your water intake throughout the day, chew gum, use a dry mouth-specific mouthwash, use a humidifier, and avoid antihistamines, which will worsen dry mouth.
Can you overdose on Adderall?
Yes, you can overdose on Adderall. Overdose symptoms include [14]
- agitation, confusion
- blurred vision, temporary blindness
- change in consciousness, loss of consciousness
- chest pain or discomfort
- dark urine, diarrhea
- dizziness, faintness, or lightheadedness
- Fast or slow heartbeat, pounding or irregular heartbeat or pulse, heart palpitations
fever - headache, inability to speak
- muscle cramps, spasms, pain, or stiffness
- nausea, vomiting
- overactive reflexes
- pain or discomfort in the arms, jaw, back, or neck, or weakness in an arm or leg on one side of the body
- pale, clammy skin
- pounding in the ears
- seeing, hearing, or feeling things that are not there, nervousness
- seizures
- shivering, sweating
- slurred speech
- talking or acting with uncontrollable excitement
- trembling or shaking
- trouble breathing
- unusual tiredness or weakness
Call your doctor right away if you notice these symptoms.
Is Adderall addictive?
Adderall is classified as a Schedule II controlled substance because it has a high risk of misuse/abuse.[15] Signs of misuse and addiction include taking someone else’s prescription, taking a higher amount of Adderall than prescribed, taking Adderall more frequently than prescribed, and ingesting Adderall other than prescribed (injecting, snorting, smoking).
Sources
[1,11,15] Martin, D., Le, J.K. (2023) Amphetamine. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK556103/ on April 12, 2024.
[2] Berman, S.M., Kuczensk, R., McCracken, J.T., London, E.D. (2009) Potential adverse effects of amphetamine treatment on brain and behavior: a review. Mol Psychiatry. 2009 Feb;14(2):123-42. doi: 10.1038/mp.2008.90. Epub 2008 Aug 12. Erratum in: Mol Psychiatry. 2010 Nov;15(11):1121.
[3, 4] Drugs.com. (2023, August 23). Adderall: Uses, dosage, side effects & warnings. Drugs.com. Retrieved from https://www.drugs.com/adderall.html on April 12, 2024.
[5,6,7,8] de Jong, M., Wynchank, D.S.M.R., van Andel, E., Beekman, A.T.F., Kooij, J.J.S. (2023). Female-specific pharmacotherapy in ADHD: premenstrual adjustment of psychostimulant dosage. Front Psychiatry. 2023 Dec 13;14:1306194. doi: 10.3389/fpsyt.2023.1306194.
[9]Anderson, K. N., Dutton, A. C., Broussard, C. S., Farr, S. L., Lind, J. N., Visser, S. N., Ailes, E. C., Shapira, S. K., Reefhuis, J., & Tinker, S. C. (2020). ADHD Medication Use During Pregnancy and Risk for Selected Birth Defects: National Birth Defects Prevention Study, 1998-2011. Journal of Attention Disorders, 24(3), 479-489. https://doi.org/10.1177/1087054718759753
[10] Drugs.com (2023, Sept. 13) Amphetamine / dextroamphetamine Pregnancy and Breastfeeding Warnings. Retrieved from https://www.drugs.com/pregnancy/amphetamine-dextroamphetamine.html on April 12, 2024.
[12] Mayo Clinic (2023). Can low libido be treated? Retrieved from https://mcpress.mayoclinic.org/women-health/treatment-for-low-libido/ on April 12, 2024.
[13] WebMD (2022) Adderall Side Effects. Retrieved from https://www.webmd.com/add-adhd/adderall-side-effects on April 12, 2024.
[14] Mayo Clinic (2024) Dextroamphetamine And Amphetamine (Oral Route). Retrieved from https://www.mayoclinic.org/drugs-supplements/dextroamphetamine-and-amphetamine-oral-route/precautions/drg-20071758 on April 12, 2024.
