Adderall is the brand name of a prescription drug primarily used to treat attention-deficit/hyperactivity disorder (ADHD). It is also approved for the treatment of a sleep disorder called narcolepsy. Adderall contains a mixture of stimulant drugs, including dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate. Several stimulant drugs are similar to Adderall but there are important differences. Examples include methylphenidate, amphetamine and methamphetamine. Adderall and similar stimulant medications should only be used as directed and recommended by your doctor.
Stimulant Medications and ADHD
ADHD is a common disorder that interferes with daily functioning due to difficulty staying focused and impulsiveness. Five to 11 percent of U.S. children have ADHD, according to the Centers for Disease Control and Prevention. The condition also affects approximately 4 percent of the adult population, reports the National Institute of Mental Health. Research strongly supports use of stimulant medications to control ADHD symptoms, along with behavioral therapy.
Stimulant medicines provide daytime benefits but often interfere with sleep. Duration of action is an important difference among stimulant medications. A dose of a short-acting stimulant is effective for 3 to 5 hours. Intermediate-acting drugs remain effective for 4 to 8 hours, and long-acting medicines for 8 to 12 hours. An afternoon dose of a short-acting drug sometimes proves problematic. Long-acting medications may be preferred over short-acting drugs in this situation. Individual response to different stimulant medications also varies, so switching from one drug to another is sometimes necessary to maximize benefits and minimize side effects.
Methylphenidate is the most widely used stimulant medication for ADHD. The drug is available in short-acting forms (Ritalin, Methylin, Focalin), intermediate-acting forms (Ritalin SR, Methylin ER, Metadate ER) and long-act brands (Concerta, Metadate CD, Ritalin LA, Focalin XR). Methylphenidate is also available as a skin patch (Daytrana). The patch is a long-acting form of the drug. An advantage of the patch is that it can be taken off early if there are sleep problems.
Amphetamine and Related Medications
Amphetamine and a more powerful form called dextroamphetamine are also effective stimulants for ADHD. Amphetamine is available in both short-acting (Evekeo) and long-acting forms (Dyanavel XR, Adzenys XR). Dextroamphetamine is also available in short-acting (Dexedrine) and long-acting (Dexedrine Spansule) varieties. As previously noted, Adderall contains a mixture of amphetamine and dextroamphetamine. Adderall is short-acting while extended-release Adderall XR is long-acting.
Lisdexamfetamine (Vyvanse) is converted into dextroamphetamine in the body. This long-acting stimulant offers the potential advantage of fewer or less severe side effects compared to similar stimulant drugs due to gradual conversion of lisdexamfetamine into dextroamphetamine. Short-acting methamphetamine hydrochloride (Desoxyn) is another stimulant medication sometimes prescribed to treat ADHD if other stimulant drugs are not effective.
Nonstimulant Medications for ADHD
Atomoxetine (Strattera) is a long-acting nonstimulant drug that may be prescribed for children and adults with ADHD who do not respond well to stimulant drugs or experience intolerable side effects. Atomoxetine does not interfere with sleep like stimulant drugs but may not be as effective as stimulants for controlling ADHD symptoms.
A few other nonstimulant medications are also sometimes used to treat ADHD, particularly in people with accompanying conditions that often coexist with ADHD -- such as tics, sleep problems or aggression. Extended-release guanfacine (Intuniv) and clonidine (Kapvay) can be used alone or in combination with a stimulant drug for ADHD. These medications might be good options for children with weight loss or persistent sleep problems due to a stimulant drug.
Side Effects and Precautions
Adderall and similar stimulant drugs are controlled substances that are only available with a prescription. These drugs can be addictive and should be used only as directed by your doctor. Lisdexamfetamine may have a lower risk of addiction than other stimulant medications. Nonstimulant medications are not controlled substances and are typically not associated with addiction, although there appears to be a low risk of dependence with atomoxetine.
Common side effects of Adderall and other stimulant medications include loss of appetite, weight loss, sleep disturbances, headaches, irritability and nausea. Tell your doctor if you have high blood pressure or heart problems before taking any stimulant medication. Seek emergency medical care in the case of accidental or intentional stimulant overdose.
Reviewed and revised by: Tina M. St. John, M.D.