*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Adderall can be used as an off-label medication to treat depression symptoms such as tiredness and distress. However, It is important to note that Adderall may also cause depression as a potential side effect. For those struggling with decision-making and concentration due to depression, Adderall may help improve focus and attention. In some cases, combining Adderall with other antidepressants may be effective in treating severe depression. It can enhance mood, energy level, mental and physical activities, alertness, and social interactions.
If you’re considering Adderall as treatment for depression, online psychiatry platforms such as Circle Medical can be a good place to start. It is a platform that can and will offer assessments and prescription consultation for stimulant medications, which are controlled substances. Their providers can determine if Adderall or another medication may help your symptoms.
Boxed Warning: Amphetamine, dextroamphetamine mixed salts (Adderall) - Risk of medication misuse or abuse
Adderall has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Amphetamines, an active ingredient in Adderall, have a risk of misuse (abuse) which can lead to dependence on the medication, serious heart conditions, and even sudden death.
Adderall is a controlled substance, which means that it’s more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
What Is Adderall & How Does it Work?
Adderall is a widely prescribed drug that contains amphetamine and dextroamphetamine, two brain stimulants that alter the chemicals dopamine and norepinephrine. It is FDA-approved for the treatment of ADHD and narcolepsy.1 Adderall may help people feel more awake and motivated by boosting dopamine (feelings of reward) and norepinephrine (raises heart rate, blood pressure, and breathing). These effects may improve attention and alertness for some who use Adderall.
Adderall is sometimes misused for non-therapeutic reasons, including weight loss and staying awake. However, it can be dangerous when used without a medical indication. Consequently, it results in more emergency room visits, overdoses, and suicides related to nonmedical Adderall use by high school and college students and young adults.2
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Adderall & Depression
Adderall may be a treatment option for individuals with treatment-resistant depression (TRD). When individuals do not respond to first-line depression treatment, they are considered to have TRD. Augmenting their antidepressant with Adderall may help reduce depression symptoms for some people who have TRD.3
However, Adderall is often misused by college students as a study aid, making it one of the most commonly abused substances among full-time college students. Evidence suggests that any use of Adderall increases the risk of depression, and this risk is even higher when it is used without a prescription or at higher-than-recommended doses.4
Adderall for Depression Treatment
Adderall may, at times, be considered an off-label treatment for symptoms of severe major depressive disorder if a person has not had sufficient symptom relief from other treatments. An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may benefit individuals seeking treatment.3
Research has shown that at lower doses, Adderall may relieve depression symptoms for some. Within two or three days of starting therapy, individuals may experience noticeable improvement.
Adderall as a Cause of Depression Symptoms
Adderall may cause depression symptoms for some who take it. For individuals who take high doses of Adderall, quick tolerance and severe withdrawal effects can occur. These effects may include depression symptoms, increased hunger, and agitation after discontinuing the drug. The depression experienced during this time may be more intense and prolonged, and those who stop taking the drug should be closely monitored for signs of suicidality and treated for depression if needed.
When people stop taking Adderall after long-term use, many report a withdrawal syndrome that typically occurs within 24 hours of their last dose. This syndrome involves two phases, the first being an “Adderall crash” that usually lasts for about a week. Symptoms during this period may include increased sleep (2-3 hours more per night), poor sleep quality, frequent awakening, and feeling nervous upon waking up. Additionally, individuals may experience severe depression, decreased energy, loss of interest, and slowed movement.5
Side Effects of Adderall
Adderall can easily pass through the blood-brain barrier and reach its main targets in the brain. Evidence indicates that the effects of Adderall on the neurotransmitters dopamine and norepinephrine play important roles in producing these effects. Most of these side effects are time-limited, resolving rapidly after discontinuing the drug.6
When used in the short term, it can result in various behavioral changes, such as heightened alertness or wakefulness, loss of appetite, and increased activity (repetitive movements). Experiencing a state of high, ecstasy, and pleasurable effects is a risk factor for Adderall abuse. Rarely, severe symptoms such as seizures or psychosis from taking Adderall may occur.
Common Adderall side effects include*:
- Abdominal Pain (stomachache)
- Dry Mouth
- Loss of appetite
- Trouble sleeping
- Headache
- Weight loss
- Nausea
- Anxiety
- Agitation
- Dizziness
- Tachycardia
- Diarrhea
- Weakness
- Urinary tract infections
Severe side effects of Adderall that require immediate medical attention include*:
- Panic attacks
- Psychotic or manic symptoms (hallucinations, delusional thinking, great excitement, and overactivity)
- Seizures
- Serious skin rashes (Stevens-Johnson syndrome, SJS and toxic epidermal necrolysis, TEN)
- Hypersensitivity allergic reactions
- Increases in blood pressure and heart rate
- Stroke
- Heart attack (myocardial infarction)
- Raynaud’s Phenomenon (body feels numb and cool)
- Prolonged or painful erection
Many of these serious side effects can cause death if not treated promptly. It has been observed that sudden deaths related to heart problems were more apparent when treating anxiety disorders with Adderall. However, subsequent studies have produced mixed results, failing to establish a definitive risk of heart attacks. If you experience severe chest pain, breathing difficulties, or fainting while taking Adderall, seek medical assistance immediately. 1
*All medications, including Adderall, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
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Adderall Warnings & Precautions
The Food and Drug Administration (FDA) warns that Adderall carries a high potential for abuse. Its misuse can lead to serious health effects, including cardiovascular (chest pain, high blood pressure, racing heart) problems and sudden death. It’s important to only use this drug under the close supervision of your doctor. If you experience seizures or fainting, immediately seek emergency medical assistance.1
Warnings and precautions for taking Adderall include:
- Heart problems: If you have existing heart problems, taking Adderall is risky because changes in blood pressure or heart rate can be life-threatening. Sudden deaths, stroke, and heart failure may occur.
- Bipolar disorder: The risk of a person with bipolar disorder using Adderall due to possible triggers for mixed or manic episodes is high at regular doses.
- Peripheral vasculopathy (Raynaud’s Phenomenon): Adderall poses an increased risk and potentially exacerbates the blood vessel constriction in fingers and toes. This can limit blood flow to the affected areas and result in color changes, numbness, pain in the fingers and toes, ulceration, and soft tissue breakdown in extreme cases.
- Seizures: Adderall may potentiate the risk of seizures by lowering the convulsive threshold in individuals with controlled seizures. If you begin to have seizures while using this medication, the drug should be discontinued.
- Long-term suppression of growth: Adderall may cause a suppression of growth (about 2 cm less growth in height and 2.7 kg less growth in weight over 3 years in children ages 7 to 10 years). Therefore, growth should be monitored during Adderall treatment. A child who is not growing or gaining weight as expected may need to have their treatment re-evaluated.
- Serotonin syndrome: A potentially life-threatening reaction may occur when Adderall is used in combination with other drugs that affect the serotonergic neurotransmitter systems like monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John’s Wort. Make sure to tell your doctor and pharmacist about all medications, herbs, and supplements that you use.
- Visual disturbance: Adderall may be associated with blurring of vision. It may increase eye pressure if you have glaucoma.
- Tics: Adderall may exacerbate motor and phonic tics and Tourette’s syndrome, characterized by sudden twitches, movements, or sounds that people do repeatedly
Disclaimer: This is not a comprehensive list of warnings and precautions. A doctor or pharmacist should always be consulted about any potential health risks before starting Adderall.
Adderall Withdrawal Symptoms
The prevalence of Adderall withdrawal syndrome is high and with 87.6% of individuals experiencing six or more signs of withdrawal. People who have a higher tolerance for Adderall have a more severe withdrawal. Moreover, if they take a high dose for a long time or use it too frequently, they’re more at risk for withdrawal. Additional factors influencing how an individual reacts after quitting a drug include genetics, age, family history of addiction, and physical and mental health.7
Elderly individuals with extensive Adderall use may experience more severe withdrawal symptoms. Abrupt cessation following prolonged high-dosage administration results in extreme fatigue and mental depression. When people stop taking Adderall, their brain chemistry can be affected, leading to a range of symptoms, some common, some severe, some rare, and some may warrant immediate medical attention.
Drug Interactions With Adderall
Disclaimer: Taking certain medications, herbs, or supplements alongside stimulants can change how they work in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines unless your prescriber has advised you to do so.
Individuals need to discuss Adderall use with their medical providers and disclose all medical conditions, medical history, and medications (prescription and over-the-counter) they may be taking to prevent harmful drug interactions that can occur while taking Adderall. A drug interaction happens when two or more drugs react with each other or when a drug interacts with food, beverage, or supplement. Taking a drug while having certain medical conditions can also cause a drug interaction.1
Medications that can have adverse interactions with Adderall include.
- Monoamine oxidase inhibitors (MAOIs): Adderall typically should not be taken within two weeks of taking MAOIs. It can cause kidney failure, heart attack, and high blood pressure.
- Acidifying agents: Gastrointestinal and urinary acidifying agents lower absorption and make Adderall less effective.
- Antihypertensives: Adderall may reverse the therapeutic blood pressure-lowering effects of antihypertensives.
- Ethosuximide: Adderall may delay intestinal absorption of ethosuximide, thus lowering its effectiveness.
- Haloperidol: Use cautiously as it diminishes the central stimulant effects of Adderall by affecting the liver enzyme.
- Lithium carbonate: It decreases the anorectic and stimulatory effects of Adderall.
- Meperidine: Adderall potentiates the analgesic effect of meperidine.
- Norepinephrine: Both decrease drowsiness but increase blood pressure and heart rate.
- Phenytoin & Phenobarbital: Adderall may delay the absorption of both.
- Propoxyphene: Adderall stimulation is potentiated due to propoxyphene overdose, and dangerous convulsions can occur.
- Tricyclic Antidepressants: Adderall may enhance the risk of serotonin syndrome and heart-related side effects. The provider may consider frequent monitoring, dose adjustment, or alternative therapy.
How to Get Prescribed Adderall
Understanding how to get prescribed Adderall or other depression treatments is a key part of building a treatment plan. Adderall comes in two forms, immediate and sustained release. It is FDA-approved to treat ADHD and narcolepsy (a rare sleep disorder) in adults and children.
Before prescribing the drug, your doctor will likely check your medical history and current medications. They will also assess the risk of abuse before prescribing Adderall and monitor for signs of misuse and dependence while on treatment.8
There are online psychiatry services available, which may be a beneficial option to consider with convenient access to manage ADHD, anxiety, and other psychiatric problems.
See If You Have ADHD - Same Day Appointments
Affordable and accessible ADHD evaluations and treatment, including possible controlled substances medication if clinically appropriate. Diagnosis and prescription over video. Insurance accepted. Same day appointments.
Other Treatments for Depression
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants for mild to moderate depression. These are the first-line antidepressants with the least risk potential and side effects. There are other comparably effective second-generation antidepressants like serotonin-norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, and serotonin modulators that can be considered if SSRIs are not a good fit for you.9
Psychotherapy for Depression
Psychotherapy Is a helpful way for individuals to understand how their thoughts, emotions, and behaviors affect their mood. It teaches healthy coping skills to manage challenging situations in life. There are different types of psychotherapy, and some may be more effective for certain clinical situations. They may be used in combination with medication or other therapies.10
Cognitive behavioral therapy (CBT) for depression is a primary form of therapy for depression. Its goal is to increase self-awareness of one’s thoughts, attitudes, and expectations. CBT helps identify and change false and distressing beliefs. It combines cognitive and behavioral therapies. Cognitive therapy is based on the principle that problems are often caused by people’s attachment to beliefs or situations rather than the events themselves. Changing how people see things is an important step. Behavioral therapy is based on the principle that behaviors can be learned and unlearned. The goal is to identify harmful behavior patterns, work on them, and change them.
Medications for Depression
Antidepressants target certain neurotransmitters to regulate mood and behavior. They are often used in combination with psychotherapy to treat major depression. Studies have shown that combination treatment is more effective than either treatment alone. Many individuals experience improvement within one to two weeks. Selective serotonin reuptake inhibitors (SSRIs) are currently the most widely prescribed antidepressants with the least risk and side effects, making them the first-line treatment for mild to moderate depression.
As the treatment comes to a close, the dose of antidepressants is reduced gradually over several weeks. It is important to consult your doctor before discontinuing the medication, as without medical advice, the risk of returning to depression is high. Psychotherapy may help people develop new coping skills and more adaptive ways of thinking about life problems.11
Brain Stimulation Treatments for Depression
Brain stimulation treatments may be recommended when people do not respond to antidepressants and psychotherapy. One such treatment is transcranial magnetic stimulation (TMS), where a device is placed on the scalp to pass magnetic waves into the brain, inducing small electric currents. These pulsed stimulations can help correct injured cell functioning and promote healing. The Food and Drug Administration (FDA) recommends at least 20 sessions over 4 to 6 weeks, with a frequency of at least five times per week for treatment-resistant depression (TRD). This treatment is safe, well-tolerated, and can lead to mood elevation.12
Another treatment option is electroconvulsive therapy (ECT), where electrodes are placed on the head, and a short burst of electric current is passed through the brain under general anesthesia, inducing a seizure. This seizure causes chemical changes in the brain that can relieve severe depression. It is the fastest way to treat severe symptoms of mental illness, and doctors consider it when drugs or psychotherapy do not improve symptoms or when the severity of symptoms is life-threatening.13
Questions to Ask Your Healthcare Provider About Adderall for Depression
Asking questions about the drug helps people to understand the complete recovery process and avoid harmful drug interactions. Ensure to prepare a list of questions you want to ask the prescribers or psychiatrist, including your overall mental and physical health problems, pregnancy status, and all the current drugs you are taking. Many online psychiatry services are available with convenient online access to mental health care for depression and anxiety problems. Individuals may even change prescribers, get a mental health evaluation, and get customized treatment plans.
Questions to ask your care team when considering using Adderall for depression may include:
- Can I use Adderall along with therapy to treat depression?
- How long will it take for me to adjust to taking Adderall?
- Am I at risk for more severe symptoms if I am already taking other anxiety /depression medications?
- Will a previous history of addiction make me more susceptible to dependency?
- What is the best dosage to ensure fewer side effects?
- Are there drugs I am taking that could have negative interactions?
- When should I reach out to you if I am experiencing side effects?
- Is there anything I should tell my therapist about this new medication?
- How long will it take for the drug to improve my symptoms?
- What should I avoid while taking Adderall?
- What happens if I miss a dose?
- What happens if I overdose with Adderall?
- Are there specific precautions during pregnancy and nursing the baby?
- Are there Adderall alternatives for me to consider if it doesn’t help or has too many side effects?
- Can you take Adderall and Lexapro together?
- Is it safe to take Adderall and Zoloft together?
In My Experience
In my experience, Adderall may be a suitable treatment for some individuals coping with treatment-resistant depression. Adderall misuse is a risk associated with using the medication, but the benefits of symptom relief may outweigh this potential concern.
Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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National Institutes of Health. (n.d.). DailyMed – ADDERALL- dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate tablet. U.S. National Library of Medicine. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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Aberg, S.E., Adler, A., Liu, J., Zuckerman, D. (2022). “Study Drug” Abuse by College Students: What You Need to Know. National Center for Health Research. Retrieved from https://www.center4research.org/study-drug-abuse-college-students/
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Small, T.M., Dhat, S., Faruqui, Z. (2022). Dextroamphetamine-Amphetamine Augmentation in the Treatment of Treatment-Resistant Depression. Cureus, 14(8), e27755. Retrieved from doi: 10.7759/cureus.27755. PMID: 36106259; PMCID: PMC9445411
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McKetina et al (2019). Mental health outcomes associated with of the use of amphetamines: A systematic review and meta-analysis. eClinicalMedicine. 16, P81-97. Retrieved from https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30177-4/
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Shoptaw, S.J., Kao, U., Heinzerling, K., Ling, W. (2009). Treatment for amphetamine withdrawal. Cochrane Database Syst Rev. 2009(2), CD003021. Retrieved from doi: 10.1002/14651858.CD003021.pub2. PMID: 19370579; PMCID: PMC7138250
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Berman, Kuczenski, McCracken, and London. (2009). Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review. 14(2), 123-142. Retrieved from doi:10.1038/mp.2008.90.
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Hart, A.B., de, W. H., Palmer, A.A. (2012). Genetic factors modulating the response to stimulant drugs in humans. Curr Top Behav Neurosci. 12, 537-77. Retrieved from doi: 10.1007/7854_2011_187. PMID: 22261702; PMCID: PMC3388157
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Sharbaf, S.N, Marwaha, R., Molla, M. (2023) Dextroamphetamine-Amphetamine. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK507808/
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Kendrick, T., Taylor, D., Johnson, C.F. (2019). Which first-line antidepressant? Br J Gen Pract. 69 (680), 114-115. Retrieved from doi: 10.3399/bjgp19X701405. PMID: 30819733; PMCID: PMC6400617
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InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). Treatments for depression (2020 Jun 18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK279282/
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Rush, A.J. (2023). Patient education: Depression treatment options for adults (Beyond the Basics). Retrieved from https://www.uptodate.com/contents/depression-treatment-options-for-adults-beyond-the-basics?
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Goegan et al. (2022).Naturalistic Study on the Effects of Electroconvulsive Therapy (ECT) on Depressive Symptoms. Can J Psychiatry. 67(5), 351-360. Retrieved from doi: 10.1177/07067437211064020. Epub 2021 Dec 13. PMID: 34903092; PMCID: PMC9065492
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