ADDERALL XR (amphetamine-dextroamphetamine)
ADDERALL XR is a mixed salt amphetamine approved by the FDA for treatment of Attention Deficit Hyperactivity Disorder. Mixed salt amphetamines have been studied and used clinically to treat ADHD since the 1930’s.
Amphetamines, as a class of stimulants, increase activity of the brain’s natural stimulants, Dopamine and Norepinephrine. Dopamine regulates interest, motivation, energy, concentration, pleasure seeking and movement. Norepinephrine regulates alertness, focus, energy, and vigilance. Adderall’s effects on Norepinephrine are about equal to its Dopamine effect.
ADDERALL XR comes in 5, 10, 15, 30, 25, and 30 mg slow release capsules. The cost is the same for all 6 sizes. Total duration of effect for the XR form is 7-12 hours. Half of the dose is absorbed immediately, and takes effect in about 30 minutes. Half is absorbed in 4 hours.
ADDERALL tablets (scored) come in 5, 7.5, 10, 12.5, 15, 20, and 30 mg sizes. Duration of action for the tablets is 3 ½ – 6 hours. Tablets are more likely to have rebound side effects, and doses are more likely to be missed or delayed.
Unlike most prescriptions, ADDERALL cannot be called into the pharmacy. By state regulations all stimulants require written prescriptions, which MUST BE FILLED WITHIN SEVEN DAYS. This means a prescription written on Monday must be filled by Sunday.
HOW TO TAKE ADDERALL XR
GUIDELINES
DOSING
- STARTING DOSE is 10mg in am for adults, 5mg in am for children.
- Increase dose by 10mg every 1-4 days until symptoms are under control.
- Dosing needs to be individualized for optimal benefit but is in the 20-90 mg range for most people. Maximum total daily dose is usually 2/3’s body weight in pounds. (Do not go above prescribed dose without doctor’s approval.)
- Higher doses last longer and can be effective up to 10-12 hours.
- If nervousness or over-stimulation occurs, always REDUCE the dose.
SWITCHING FROM ADDERALL TABLETS TO CAPSULES (XR)
If switching from ADDERALL tablets to capsules (XR), total the daily dose of tablets in mg and take half as often. For example, if currently taking 30mg tablets twice daily, switch to 60mg XR in am (two 30mg XR capsules). If taking 15mg 4x per day, take 30mg XR twice per day.
MANAGING SIDE EFFECTS
Most side effects are mild and occur mainly in the first two weeks of starting medication. In studies, very few people stop medication due to side effects. If side effects are experienced to a bothersome degree, decrease the dose.
| Side Effect | Children <13 | Adolescents | Adults |
| Decreased appetite | • | • | • |
| Insomnia | • | • | • |
| Emotional lability | • | ||
| Abdominal pain | • | • | |
| Weight loss | • | • | |
| Dry mouth | • | ||
| Headache | • |
May aggravate tics.
Side effects that peak around 6 hours from dose are most likely due to the medication. Dose needs to be reduced.
Irritability and tiredness/fatigue that occurs more than 6 hours after last dose are more likely due to medication wearing off (rebound effect). Dosing may need to be adjusted by adding an extra dose or by increasing the dose.
Many side effects are well controlled by Tenex (Guanfacine).
APPETITE SUPPRESSION
Eat a good breakfast 15-30 minutes after the morning dose. A nighttime snack such as ice cream is also recommended. Appetite usually improves over time, but if not, other methods of management can be used. Weight loss is common especially in people who are overweight. This is usually not due to appetite decrease but to a decreased tendency to eat due to boredom or stress.
Tenex may help taken a.m., evening, or both.
Remeron (Mirtazapine) helps sleep and appetite. Start very low (7.5 mg or lower). Remeron can cause morning drowsiness, especially when first starting.
SLEEP DISTURBANCE
First, shift dose to earlier in the day. If earlier does not work, take dose LATER in day. This may be caused by a “rebound” of ADD symptoms. Sometimes, medications that provide normal sleep are needed.
NOTE: Blood pressure should be monitored especially if any of the following is used on a regular basis with Adderall. Tenex is the first treatment option since it directly counteracts the effects of Adderall and these medications on blood pressure.
- Caffeine-large amounts
- Appetite suppressants
- Thyroid
- Some asthma meds
- Wellbutrin XL
- Effexor XR
- Tricyclics
- Cymbalta
For full information, see package insert or prescribing information.
6 thoughts on “How To Take Adderall (Amphetamine-Dextroamphetamine)”
Bernadette,
I had the same reaction to taking daily adderall (I am an adult). Taking it every day made me feel increasingly manic and psychotic. I am going to try SR but just know your son isn’t the only one!
Hi Bernadette,
Jim has no idea what he’s talking about. Amphetamine salts “adderall” is a psycho-stimulant, classified as a hallucinogen. If taken in too high of doses it can induce psychosis.
Best,
Jess
Been taking adderall xr for 4 years now & it’s losing it’s effectiveness. What can you recommend I do/take to increase it’s effectiveness? Recently tried magnesium & a slight change in it’s effectiveness, but not enough to substantiate. Also, can bipolar meds (i.e. Depakote) affect it’s effectiveness? Thanks. – Mike
Bernadette,
I am 22 and have been taking Adderall XR for 5 years with holidays in the summer. The drug has no psychoactive ingredient and cannot cause hallucinations as you have described. You may want to see a neuro-psychologist and figure out what is really going on with your son. As much as it may cost, it is better to be properly evaluated by a professional than let the problem persist.
I was on Concerta for a long time. I just switched to Adderall, and it works ok. I think I need a larger dose. No one should ever get paranoid on ADD meds. The reason people with ADD get anxiety in the first place is due to lack of ability to “hold it together”. Perhaps the mixture of the types of amphetamine are not right for your son. Also, I have had good results with Dexedrine.
Good Luck!
Namaste, Dana
I am not sure that this posting will help but i am 24 M and a college student. I felt inclined, through my own experiences, during 1 year and 3 months of Adderall and Dextroamphetmine ; prescribed by my doctor for ADHD combined type. So that maybe my insight through this and being well versed in scientific subject matter.
Anyhow, how long and what dosage did your son sustain?
What type of Adderall?
There are two Mixed Amphetamine Salts (Immediate release) or Adderall XR( which is M.A.S coupled with a patented drug release formulary), (It is supposed to release half of the drug at once and then the other half releases 4 hours later.)
Was there any indication of abuse? Large amounts of Adderall can induce what is know to be (Amphetamine induced psychosis.) This sounds like what happened to your son as it disappeared after Adderall was discontinued.
Did he sleep enough? If not, (assuming there arent any coexisting sleep problems) then the dosing was faulty, it was abused, or your son just wasnt meant to take Adderall.
My suggestion:
I am not a professional and therefore my opinion should be a thought provoker only.
Start dose low Adderall XR maybe 10-20 mg in the morning. At or towards bedtime a banana and a snack is good. go from there. Hallucinations are more common with immediate release adderall.
There is also Concerta? It may likely eliminate delusions if dose is correct.
The mainstays of routine when taking Adderall etc are to: eat nutritiously, sleep regularly, exercise judiciously and check your heart yearly.
Hopefully this helps.