“Down in the dumps” doesn’t touch the level of misery some experience when they’re depressed. According to the National Institute of Mental Health, the NIMH, major depression is the leading cause of disability in the United States in people ages 15 to 44. In severe cases when conventional medical treatments for depression don’t boost patients from their depths of despair, physicians consider using off-label or second-line remedies for much longed-for relief.
Depression has reached near-epidemic percentages. According to the NIMH, 9.5 percent of the adult U.S. population has a mood disorder, and 14.8 million American adults experience major depression in a given year. Depression often co-occurs with anxiety disorders and substance use. In 2006, 33,300 people died by suicide in the U.S. Over 90 percent of people who commit suicide have a diagnosable mental disorder, most commonly major depression or substance use. Those so depressed they lose hope for recovery may find symptomatic relief with Adderall.
Emotional stress, not taking prescribed antidepressants as scheduled and underlying physical or other mental health problems may incite treatment-resistant depression, depressive symptoms that persist and/or re-occur despite standard treatments, according to the Mayo Clinic. Atypical depression, often characterized by increased desire to sleep and physical listlessness, may defy customary treatment. Although difficulty sleeping, restlessness, irritability and overeating sometimes typify depression, the NIMH notes that people also may feel hopeless, lose interest in activities once enjoyed, experience fatigue, decreased energy, feelings of guilt and worthlessness, physical pain and thoughts of suicide when they’re depressed. This leaves them feeling sluggish and unproductive, often perpetuating their depression.
Although not labeled for use in depression, Adderall, a stimulant used to treat attention deficit/hyperactivity disorder, is also prescribed for narcolepsy, a condition characterized by overwhelming daytime drowsiness and sudden attacks of sleep. According to the 2010 "Nursing Physician Desk Reference," as a stimulant, Adderall modifies norepinephrine in certain areas of the brain and promotes energy and alertness. When severe despondency characterizes depression, Adderall can help restore vigor and attentiveness. Although it is not an antidepressant, it may be prescribed to augment one to reduce or alleviate incapacitating lethargy.
Adderall is not an antidepressant and should not be used as a replacement for one. According to the National Institute of Health, when taken for a period of time, a tolerance to Adderall may develop, necessitating increased doses to have the same desired effect. For this reason, misuse of and addiction to Adderall is possible. Because it effectively alleviates lethargy, some eventually find it difficult to feel well without it. Regular and ongoing use of Adderall followed by suddenly stopping it can actually trigger depression and severe fatigue. Adderall potentially interacts with many medications including a type of antidepressants called mono amine oxidase inhibitors, blood thinners, alpha blockers, antacids, antihistamines, anti-convulsants and pain killers, among others. Information about use of other medications with Adderall should be shared with the prescribing physician to promote safety.
The FDA has issued a warning for anyone taking stimulants like Adderall. A review of research indicated that children and adolescents with pre-existing cardiac problems who took stimulants were at increased risk for cardiac events like stroke, heart attack and sudden death. The same reviews illustrated that there was a very small chance that people taking stimulants may lose touch with reality, such as hearing voices, seeing things or becoming manic. The risks and benefits of taking Adderall for depression should be weighed very carefully with the prescribing physician.