What is Adderall?

Adderall is an FDA-approved prescription drug that is often given to patients with ADHD (Attention Deficit Hyperactivity Disorder) for managing impulsive behavior and hyperactivity. Adderall is also prescribed in patients with sleep disorders like narcolepsy (1). It is also used in obesity to decrease body fat.

Adderall is an amphetamine that helps 70 to 80 percent of children and 70 percent of adults with ADHD, but it has a high potential for risky behavior as well. Risky behavior includes using the drug to stay up to study late at night or to increase attention and focus (2).

Types of Adderall

Adderall contains both amphetamine and dextroamphetamine. Various types of Adderall formulations made by pharmaceutical companies include the following

Adderall – Immediate-release formulation available in oral tablet form.
Adderall XR – Extended-release formulation available in capsule form.
Mydayis – Extended-release formulation available in capsule form.

How Does Adderall Work in the Body?

Adderall is a central nervous system stimulant drug that produces its effect by increasing serotonin, dopamine, and norepinephrine in the body. It also inhibits the enzyme monoamine oxidase (MAO) which results in inhibition of metabolism of monoamine neurotransmitters (3).

People with ADHD have a lack of dopamine in their brain’s frontal lobe or “reward center”. Hence, they seek activities that release dopamine in the frontal lobes. By stimulating the central nervous system, Adderall increases the available dopamine to the frontal cortex and helps with the symptoms of ADHD.

Normal Doses of Adderall

The dose of Adderall depends on the patient and his symptoms. But generally, the dose lies somewhere between 5 mg to 40 mg and it is not exceeded beyond 60 mg (4).

ADHD: 5 to 40 mg Adderall is given in one to three doses with 4 to 6-hour intervals.
Narcolepsy: 5 to 60 mg of Adderall in one to three doses is given. The morning dose is 10 mg.
Obesity: 15 to 30 mg of Adderall is given 30 to 60 minutes before meals, divided into one to three doses (3).

Prolonged use of Adderall should be avoided and its dose should be tapered off.

Adderall Misuse and Abuse:

Although many people take Adderall on prescription only, it is a highly abused and misused drug. In 2017, people who misused Adderall above age 12 became 5.2 million (5). People who abuse Adderall either take it from someone else’s prescription or obtain it illegally. Adderall is also abused by students to increase attention span and focus while studying. Adults may take the drug to improve their performance at work.

How Long Does Adderall Last in the Body?

Adderall is a drug absorbed by the gastrointestinal tract. It is either metabolized in the liver or moves through the urine unchanged. Its elimination half-life is 9 to 11 hours.

An immediate-release formulation of Adderall stays for about 4 to 6 hours in the body. The extended-release version stays for about 24 hours in the body. The time Adderall stays in the body varies depending on the dose taken.

Adderall works throughout the body and hence, can be detected in different body parts.

Blood: Adderall stays in the blood for up to 46 hours after it is taken. Blood tests can detect Adderall early after its last dose.
Urine: Adderall is eliminated from the body via urine. Hence, urine has particularly higher concentrations of Adderall which can be detected by urine tests. Adderall can be detected in urine 72 to 96 hours after its last dose. At a cut-off value of 1000 ng/L drug test stays positive for up to five days (7).
Saliva: Adderall detection window in saliva is up to 20 to 50 hours after its last dose.
Hair: Although hair follicle testing is not common, Adderall stays in the hair the longest. Adderall concentrations test positive in the hair for up to three months after its last use.

Factors Affecting Adderall Stay in the Body:

A number of factors decide how long Adderall stays in the body.

Body Composition:

People with more body fat require larger doses of Adderall for it to be effective. Some studies suggest that Adderall clears off faster from the bodies of people who weigh more (6).

Metabolism:

Metabolism varies in people depending upon their age, gender, medications they are taking, physical activity, half-life of Adderall, and weight. Metabolism affects the duration of stay of drug in the body. The faster the metabolism, the faster the clearance of drugs from the body and vice versa.

Dose of Adderall:

High doses of Adderall stay in the body longer than low doses. Moreover, intermediate and extended-release formulations of Adderall also have different speeds of release and metabolism. Frequency of use also affects Adderall’s stay in the body.

Age:

In older people, drug metabolism slows down due to changes in liver, kidney, and body composition. As a result, Adderall stays longer in the body.

Body Systems:

Adderall is absorbed by the gastrointestinal tract, metabolized by the liver, and excreted by the kidney. If there is a problem in GIT, liver, or kidney function, Adderall will take longer to clear out.

Does Adderall Build Up in the Body?

Taking Adderall at higher doses for a prolonged period can cause its buildup in the body leading to reduced effectiveness in treating the symptoms of ADHD. In such cases, the doctor might increase the dosage of the drug slightly. Build-up and tolerance can also be a sign of substance use disorder if a person is using Adderall as a recreational drug.

Is Adderall Dangerous?

As long as Adderall is taken according to prescription and without misuse and recreational activities, it is safe and effective in treating mental health problems like ADHD. Overuse and prolonged use of Adderall can cause a myriad of symptoms which vary in different people (8).

Mild Side Effects of Adderall:

Anxiety
Panic attacks
Change in sex drive
Frequent urination
Restlessness
Difficulty in sleeping
Dizziness
Decreased appetite
Gastrointestinal issues
Headache
Dry mouth

Serious Side Effects of Adderall:

Increased ventilation
Irregular heartbeat
Difficulty in breathing
Numbness in limbs
Mania
Fits or seizures
Paranoia
Aggression

Is Adderall Addictive?

Addiction and dependency on Adderall can take place if a person takes more than the prescribed dosage for an extended period. Hence, doctors prescribe Adderall in the lowest possible dosages.

Misuse of prescription medications can cause a condition called “Substance Use Disorder (SUD)” which takes the shape of addiction in many cases. SUD is developed when a stimulant drug is used so much that it starts affecting the health of the user and the person fails at meeting the responsibilities in school and at work.

Symptoms of Adderall Addiction

People on Adderall usually feel euphoric after taking the drug. As time passes the action of drugs starts fading due to the development of tolerance in the body. When tolerance develops, the person using it increases the dose.

People on Adderall drug abuse show “drug seeking” behavior.

They spend a lot of time and money trying to find the drug.
They start shedding responsibilities of life.
They are socially withdrawn.
They manipulate or crush Adderall to increase its effects.
They do not care about self-grooming and self-care.

Withdrawal from Adderall

The body gets so dependent on Adderall after a length of time that if an addicted person does not take it, he shows withdrawal symptoms. These include;

Fast heart rate
Sleeplessness
Decrease body weight
Dizziness
Suicidal thoughts
Dry mouth
Depression
High blood pressure
Panic attacks
Seizures
Fatigue
Strong cravings

Adderall Overdose

Since a person addicted to Adderall increases the dose now and then, the chances of overdose are increased. Overdose can cause

Nausea
Tremors
Vomiting
Fever
Fainting
Chest pain
Heart attack
Fast breathing

How Adderall Addiction is Diagnosed?

If you notice that you need higher doses of Adderall for it to produce an effect or you experience any symptoms of withdrawal and addiction mentioned above, please consult your doctor.

The doctor will take a detailed history including the frequency of Adderall use, history of use, any other medications you are using, and other relevant questions. He will make a diagnosis of substance abuse based on the Diagnostic and Statistical Manual of Mental Disorders.

If the diagnosis is confirmed, the doctor might refer you to a rehabilitation center.

Adderall Addiction Treatment

Treatment options for drug abuse include a combination of pharmacological management and behavioral therapies. There are no effective medicines to help with Adderall addiction treatment (9). The treatment is focused on supervising the person as he goes through withdrawal because it is an uncomfortable experience. The withdrawal symptoms can last for a few days to a few weeks. The doctor will refer the patient to an inpatient or outpatient detox treatment center or rehabilitation center.

Medical professionals focus on tapering off the Adderall dose in the treatment programs instead of leaving it once and for all. Doctors manage the withdrawal symptoms and the patient undergoes psychotherapy or behavioral therapy to make it easier for him.

Once remission is done, an aftercare treatment plan is made by the doctor to ensure that the patient does not go back to addiction. Aftercare includes continued psychotherapy by licensed therapists.

Conclusion

Adderall is a CNS stimulant drug that can be abused if prescription guidelines are not followed. Adderall stays in the body for different periods, generally from 48-72 hours in blood. Blood tests, saliva tests, tests from hair follicles, and urine tests can help diagnose the presence of Adderall in the body. To prevent Adderall addiction, follow the guidelines of your doctor and the prescription label on the drug. If you or your loved one is struggling with Adderall misuse, get help now.

References

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Advokat C, Scheithauer M. Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers. Front Neurosci. 2013 May 29;7:82. doi: 10.3389/fnins.2013.00082. PMID: 23754970; PMCID: PMC3666055.
Martin D, Le JK. Amphetamine. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556103/
Gautam M, Prabhakar D. Stimulant Formulations for the Treatment of Attention-Deficit/Hyperactivity Disorder. Prim Care Companion CNS Disord. 2018 Dec 27;20(6):18r02345. doi: 10.4088/PCC.18r02345. PMID: 30605269.
PREVALENCE ESTIMATES, Values P, SAMPLE SIZES. National survey on drug use and health: Detailed tables [Internet]. Samhsa.gov. [cited 2023 Oct 25]. Available from: https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf
Brill MJ, Diepstraten J, van Rongen A, van Kralingen S, van den Anker JN, Knibbe CA. Impact of obesity on drug metabolism and elimination in adults and children. Clin Pharmacokinet. 2012 May 1585(5):277-304. doi: 10.2165/11599410-000000000-00000. PMID: 22448619.
Vandevenne M, Vandenbussche H, Verstraete A. Detection time of drugs of abuse in urine. Acta Clin Belg. 2000 Nov-Dec;55(6):323-33. doi: 10.1080/17843286.2000.11754319. PMID: 11484423.
Fitzgerald KT, Bronstein AC. Adderall® (amphetamine-dextroamphetamine) toxicity. Top Companion Anim Med. 2013 Feb;28(1):2-7. doi: 10.1053/j.tcam.2013.03.002. PMID: 23796480.
Siefried KJ, Acheson LS, Lintzeris N, Ezard N. Pharmacological Treatment of Methamphetamine/Amphetamine Dependence: A Systematic Review. CNS Drugs. 2020 Apr;34(4):337-365. doi: 10.1007/s40263-020-00711-x. PMID: 32185696; PMCID: PMC7125061.

How Long Does Adderall Stay in Your System?