Mindpath Health’s Zishan Khan, MD, discusses youth and gender-affirming care. See highlights below or read the full article with sources here. 

Attention-deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed mental health conditions in children ages 3 to 17, affecting approximately 9.4% of young people in the U.S., according to a report by the Centers for Disease Control and Prevention. If you or your child has been diagnosed with ADHD, your doctor may prescribe medication as part of your treatment plan—Adderall being a common option. 

What Is Adderall—And What Is It Prescribed for?

Adderall is a prescription medication that contains a combination of amphetamine and dextroamphetamine—two central nervous system (CNS) stimulants that work by altering the chemicals, such as dopamine and norepinephrine, in the brain. It’s commonly prescribed to reduce the symptoms of attention-deficit/hyperactivity disorder (ADHD), which is characterized by symptoms including inattention, hyperactivity and impulsivity. It’s also indicated for narcolepsy, a chronic neurological condition that can affect the brain’s ability to regulate sleep-wake cycles. 

Dopamine plays an important role in feelings of reward, while norepinephrine increases heart rate, blood pressure and breathing—ultimately affecting your attention and alertness. As a result, Adderall can help you feel more awake and motivated when taken as prescribed. 

Zishan Khan, M.D., a board-certified psychiatrist and regional medical director at Mindpath Health in Frisco, Texas, explains that some health care providers may also prescribe Adderall to treat other medical conditions, known as off-label prescribing. A common off-label use of Adderall includes using it to treat depression. 

While the boost of dopamine may increase feelings of euphoria, energy levels and working memory in the short term, taking Adderall without a prescription or in ways other than prescribed can cause emotional and physical side effects. Instead, she urges students to develop study skills that focus on learning and retaining the information. 

Age Requirements for Adderall

Adderall is not recommended for children under 3 years of age, while Adderall XR (an extended release form of the medication) is not recommended for children under 6 years of age. 

The American Academy of Pediatrics recommends parent training in behavior management as the first line of treatment for ADHD (before medication is prescribed) for children younger than 6 and recommends medication and behavior therapy for older children. 

“Every child and situation is different, and there are absolutely cases that warrant prescribing Adderall as young as 3 or 4 years old,” notes Dr. Khan. However, he urges that caution must be taken, and that just because Adderall is FDA approved for children 3 years of age and older, not all 3 year olds can tolerate the side effects. Young children are more likely to experience appetite suppression and growth restriction as a result of taking Adderall than a teenager or an adult would be, he says. 

A Warning About Stimulant Misuse

It’s worth noting that Adderall is an amphetamine medication, which is categorized as a stimulant. The Food and Drug Administration (FDA) warns that stimulants carry a high potential of abuse. 

Misuse of amphetamines may cause serious health effects, including cardiovascular events and even sudden death. It’s important to only use this medication under the close supervision of your doctor, and to make sure you follow prescribing directions closely if you are giving it to your child. 

Some signs of stimulant addiction and dependency include: 

  • Inability to reduce doses or stop use 
  • Difficulty completing normal functions without use 
  • Difficulty falling and staying asleep, even when you’re tired 
  • Severely reduced appetite 
  • Increased tolerance and requiring higher doses to feel the same effects 
  • Experiencing withdrawal symptoms with reduced dose, including difficulty sleeping, trembling, anxiety or depression 

How Adderall Is Administered

Adderall is available in tablet form, while Adderall XR is available in capsule form. Strengths range from 5 milligrams to 30 milligrams per tablet/capsule. Your dosage will vary based on how your body reacts to the medication. In most cases, your doctor will start you on a lower dose initially to see how you respond and then adjust on a weekly basis until the desired result is achieved. 

For the treatment of ADHD, an initial dose is taken in the morning with or without food. Although Adderall XR is only taken once per day, short acting Adderall can be taken two to three times per day with four to six hours between doses. In most cases, the total dosage will not exceed 40 milligrams per day, but dosage should be determined by your doctor. 

Adderall and Pregnancy

Adderall is classified as a Category C drug for pregnancy, due to the lack of adequate studies in pregnant women. Inform your doctor if you are pregnant, as some research suggests that taking Adderall while pregnant may cause birth defects, according to the CDC. Additional research has found that dexamphetamine, one of the ingredients in Adderall, can transfer into breast milk. 

The risk and benefit ratio of untreated ADHD versus the medication’s effects on the unborn child have to be carefully monitored by your practitioner. It’s important to work with your doctor to consider the risks before you start taking Adderall if you are pregnant or breastfeeding. 

Adderall Side Effects, Risks and What to Know Before Use

Like other medications, individuals who take Adderall may experience some side effects. Common side effects of Adderall include: 

  • Stomachache 
  • Decreased appetite and weight loss 
  • Difficulty sleeping 

Rare side effects that warrant a call to your doctor include: 

  • Significant increase in blood pressure 
  • Significant increase in heart rate 
  • Severe anxiety, panic attacks, delusions or hallucinations 
  • Severe muscle pain or weakness 
  • Signs of dehydration 
  • Prolonged or painful erection 
  • Changes of feeling or color in fingers and toes 

Prior to taking Adderall, it’s important to inform your doctor of your medical history, including any medications that you are currently taking. Tell your doctor if you, or a member of your family, have a history that includes: 

  • Mental health issues, such as bipolar disorder or depression 
  • Heart-related problems, such as heart defects 
  • Cardiovascular disease 
  • High blood pressure 
  • Hyperthyroidism 
  • Glaucoma 
  • History of drug abuse 

When taken in addition to Adderall, certain medications can interact and cause serious side effects. Inform your health care provider of all prescription and nonprescription medications, vitamins and herbal supplements that you are taking, especially: 

  • Blood pressure medication 
  • Anti-depression medication, including MAOIs 
  • Blood thinners 
  • Decongestant cold or allergy medications 
  • Stomach acid medicine 
  • Seizure medication 

Adderall is a Schedule II controlled substance, due to its risk of misuse and abuse. It’s important that you take your medication as prescribed by your health care provider to reduce your risk of unwanted side effects or overdose. 

Adderall Alternatives

While Adderall may be effective in the treatment of ADHD and narcolepsy, it’s not for everyone. There are alternatives that may work better for some individuals, according to Dr. Elia. These include: 

  • Other stimulant medications, such as methylphenidate 
  • Non-stimulant medications, such as atomoxetine, clonidine or guanfacine 
  • Trigeminal nerve stimulation (TNS) 
  • Transcranial magnetic stimulation (TMS) 
  • Behavior therapy 

Regardless of the treatment path you choose, it’s important to discuss all your options with your doctor. They will help educate you on all of your treatment options, as well as the potential risks for each, so that you can make the right decision for you and your situation. 

Zishan Khan, MD

Frisco, TX

Dr. Zishan Khan is board-certified in child, adolescent, and adult psychiatry. Dr. Khan primarily treats children, adolescents, and young adults suffering from ADHD, anxiety, depression, and behavioral issues that often keep them from reaching their full potential. He works with patients of various cultural and professional backgrounds, helping people improve their lives and conquer their struggles. He prides himself on ... Read Full Bio »

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