Adderall Withdrawal Symptoms and Treatment

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Adderall is in a class of drugs called stimulants, which stimulate your central nervous system. As with most drugs of abuse, Adderall withdrawal symptoms can appear if usage stops suddenly.

Adderall Withdrawal Symptoms

In many ways, Adderall withdrawal is the reverse of a stimulant high. Symptoms include:¹

• Increased appetite
• Nightmares
• Sleep problems (too much or too little)
• Fatigue
• Mental and physical slowing and agitation
• Unpleasant mood

Considering that as many as 9% of school-age children and up to 35% of college-age young adults use non-prescription amphetamines, the risk for withdrawal is high in this specific population.¹

Every person who goes through Adderall withdrawal has a different experience regarding how long it takes and what it feels like. A lot has to do with how long your history of Adderall use is and how much you took. People who get the most severe withdrawals are usually those who have used higher doses over longer periods of time.²

The Adderall withdrawal timeline can begin a few hours after taking your last dose and can last several days or even weeks. Depressive and other mood symptoms usually resolve within a week.¹

If you or a loved one has been misusing Adderall for a significant amount of time or in excessive doses, you may want to seek medical care to assist in your withdrawal to assist you in maintaining abstinence.

Who Is at Risk for Adderall Withdrawal Symptoms?

Adderall and stimulants like it are classified as Schedule II drugs, which means they have a high potential for severe physical and psychological dependence.³ Adderall manufacturing is restricted and regulated, and you need a new prescription for every refill. ³

The stimulant regulation change highlighted their risk for misuse and the long- and short-term side effects, like psychosis and paranoia. The only two FDA-approved uses were narcolepsy and “hyperkinetic disorder of childhood,” which is known as ADHD.⁴ Adderall is still often prescribed for off-label uses at the discretion of the prescriber.

Anyone who uses Adderall for a long time and stops using cold turkey is at risk of experiencing Adderall withdrawal symptoms.

Youth and Adderall

Many children are treated with Adderall or other stimulants, with some negative consequences. More than 1 out of every 10 children is diagnosed with ADHD. Of those, two-thirds are prescribed ADHD medication.⁶

A major concern with Adderall addiction and withdrawal is the number of children and adolescents affected.⁶ ADHD is a brain development disorder where people are impaired by inattention and hyperactivity to the extent that it disrupts their day-to-day function.⁷ Unless a parent or provider carefully administers medical to children, they can be at risk of misusing their medication which can lead to dependency or heightened side effects.

Adderall Tolerance and Sensitivity

Building up a tolerance means that more Adderall is needed to achieve the same high.¹ The danger of this is that some people will increase their dose of Adderall, risking the more severe side effects of high doses, or even resort to smoking or injecting street analogs of Adderall.

Most people who develop stimulant use disorder experience either tolerance or sensitivity to the drug. Sensitivity is less common and refers to individuals who repeatedly use the drug and experience an enhanced effect over time with the same dose.

Overall, an increased tolerance often means a higher risk for misuse, making adjusting behavior more challenging and withdrawal symptoms much more likely.

Adderall Withdrawal Treatment

The type of treatment you receive for Adderall withdrawal will depend on the extent of your use. In milder cases of withdrawal and overuse, the first line for treatment is group therapy and counseling. Some people are put in intensive outpatient treatment as well, where they spend a significant amount of time each day in treatment, receiving counseling and oversight.

Cognitive-behavioral therapy (CBT) and motivational interviewing help you learn coping skills that can assist you in staying abstinent in the future. This usually lasts 6-8 weeks.

For more severe cases of withdrawal, you may be prescribed medication to assist you in maintaining abstinence. Medications vary among providers and depend on your specific needs. Many of the medications used for Adderall withdrawal mimic the effects of Adderall to a milder extent.

Ways to Prevent Adderall Withdrawal and Misuse

If you are concerned about addiction and have been prescribed Adderall or another stimulant, it may be wise to consider the following to prevent the hazards of Adderall addiction.

• Get a second opinion to confirm your diagnosis
• Have a conversation with your provider about alternative treatments, such as behavioral therapy and non-narcotic medications
• Share your concerns with your provider about addiction and withdrawal

If you think you have become addicted to Adderall or other stimulants, treatment usually involves phases:

• Detoxification
• Inpatient or intense outpatient rehab
• Aftercare (support groups, counseling, sober living, medical care)

Depending on the extent of your dependence on Adderall, you may need all or only some of the steps in this process. It’s important first to be assessed individually to determine your treatment needs. You can also contact 800-681-1058 (Who Answers?) to get help for your Adderall addiction or speak with a treatment advisor. The help is available, and recovery is possible.

The Dangers of Adderall Withdrawal and Misuse

People who do not have ADHD but take Adderall and drugs like it can experience an overload of brain chemicals that create a euphoric or high feeling, similar to that of cocaine, ecstasy, or speed.⁵ This response is what creates the cycle of addiction to Adderall for many people. A major health concern is that some people that start with prescription Adderall “graduate” to smoking or injecting more dangerous “upper” street drugs.⁸

The high of stimulant use involves:¹

• Feeling friendly and talkative
• Feeling restless
• Anxiety
• Vigor
• Interest in, and awareness of, others
• Repetitive behavior
• Impaired judgment

After repeated use, chronic intoxication of stimulants can lead to:¹

• Heart problems
• Social withdrawal
• Nausea and vomiting
• Dilated pupils
• Seizures
• Confusion
• Weakness
• Ears ringing
• Psychosis

The greater extent to which a person experiences Adderall intoxication, the more likely they are to go through Adderall withdrawal that requires medical intervention.⁴

Stimulant Use Disorder

Addiction to Adderall, cocaine, crystal meth, speed, and other stimulants are considered “stimulant use disorder” by the American Psychiatric Association.² Stimulant use disorder is defined by a person having at least some of the following experiences related to stimulants within a one-year period:¹

• Taking larger amounts than intended, or over a longer period of time
• Persistent, unsuccessful efforts to cut down on use
• A lot of time spent getting, using, or recovering from it
• Failure to meet personal or work responsibilities as a result of use
• Cravings
• Continuing use even after problems related to use
• Dangerous situations
• Relationship problems
• Needing more to achieve the same high
• Taking it to avoid withdrawal
• Experiencing withdrawal

It can take as little as a week to develop stimulant use disorder, although it doesn’t always happen that quickly.¹

What Is Adderall Medically Used For?

Adderall and other prescription stimulants cause wakefulness and a pleasurable feeling for many people. Medically, they are approved to treat Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy, a sleep disorder.

These medications also have some less common off-label uses. Many people take Adderall (or similar drugs) recreationally or to self-medicate. Adderall is a controlled substance, meaning the government oversees its distribution to limit overproduction and overuse.

Similar drugs to Adderall include:

• Methylphenidate (Ritalin, Concerta)
• Dextroamphetamine (Dexedrine)
• Sibutramine hydrochloride monohydrate (Meridia)
• Lisdexamfetamine (Vyvanse)

Adderall Use vs. Mental Illness

It is important to disclose your Adderall or other stimulant use to your provider because toxicity and withdrawal can both closely resemble psychiatric illness. In high doses, Adderall and other stimulant toxicity can look like generalized anxiety disorder, panic disorder, or psychosis, while withdrawal can resemble a depressive episode. Treatment for Adderall overuse and psychiatric illness is very different.

Safety Measures for Adderall Prescribers

Many people in the medical community have come to recognize the danger of Adderall and other prescription stimulants. Doctors use several tactics to help protect their patients and communities from the legal and health hazards of misuse and diversion:⁶

• Writing up contracts having patients promise to use them as directed and not to divert
• Limiting the number of pills patients get at a time
• Offering extended-release Adderall instead of pills with rapid onset
• Considering non-stimulant alternatives for relevant conditions
• Recommending substance abuse treatment if warranted

ADHD and Substance Use Disorder

Doctors are concerned that some patients fake ADHD symptoms to get a prescription.⁶ In fact, there is a lot of overlap between the symptoms of ADHD and substance use disorder, so prescribers need to be able to tell the difference. The similarities between substance use disorder (SUD) and ADHD include:⁵

• Impulsivity
• Unstable moods
• Emotional imbalance
• Inability to delay gratification

Not surprisingly, many people have both ADHD and SUD. These people tend to have a harder time abstaining from addictive substances, more hospitalizations, and many other risks. If you are prescribed Adderall for a medical condition and a history of addiction, it’s important to find prescribers that understand your specific needs and how to avoid the risks of these concurrent conditions.

References

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). 2013.
2. Schwarz, Alan (14 December 2013). “The Selling of Attention Deficit Disorder”. The New York Times. ISSN 0362-4331.
3. List of Controlled Substances. (n.d.). US Drug Enforcement Agency & Department of Justice.
4. Rasmussen N. (2008). America’s first amphetamine epidemic 1929-1971: a quantitative and qualitative retrospective with implications for the present. American journal of public health, 98(6), 974–985.
5. Varga, M. D. (2012). Adderall abuse on college campuses: a comprehensive literature review. Journal of evidence-based social work, 9(3), 293-313.
6. Colaneri, N., Keim, S., & Adesman, A. (2017). Physician practices to prevent ADHD stimulant diversion and misuse. Journal of substance abuse treatment, 74, 26-34.
7. Perugi, G., Pallucchini, A., Rizzato, S., De Rossi, P., Sani, G., Maremmani, A. G., … & Maremmani, I. (2019). Pharmacotherapeutic strategies for the treatment of attention-deficit hyperactivity (ADHD) disorder with comorbid substance-use disorder (SUD). Expert opinion on pharmacotherapy, 20(3), 343-355.
8. Rasmussen, N. (2015). Amphetamine-type stimulants: the early history of their medical and non-medical uses. International review of neurobiology, 120, 9-25.