Adderall Overdose: Signs, Symptoms, & Treatment

Can You Overdose on Adderall?

Yes, you can overdose on Adderall. Patients should rarely need doses of more than 40 mg/day. In some cases, doses up to 60 mg/day may be necessary in some patients, but the side effects are more serious and more frequent with these higher doses, so therapy should be monitored closely in these patients.¹

Some people take more Adderall than their provider prescribed to help increase confidence, feel intense excitement, or increase the happiness they experience. Adderall can temporarily have these effects because it briefly increases the activity of the body’s neurotransmitters that cause these effects. While that can be beneficial for people who have a deficiency in these neurotransmitters, excessive neurotransmitter activity is dangerous for the heart, blood vessels, and mental health.

Patients taking more Adderall than prescribed can develop a condition called amphetamine use disorder (AUD). Unfortunately, AUD is common. AUD is usually characterized by repeated periods of intense use with occasional sobriety and relapse.^2,3

Taking Adderall with other substances and medications can increase the risk of overdose. Please make sure your provider and pharmacist are aware of all the medications you are taking.

When Should You Seek Immediate Help for an Adderall Overdose?

Serious symptoms of Adderall overdose include difficulty breathing, chest pain, irregular heartbeat, cough, and coughing up blood. If there are any signs of these symptoms, please see a provider immediately. If a person has taken more Adderall than what they have been prescribed, and they are exhibiting overdose symptoms, they should seek out immediate medical attention. Call the Poison Control Center at 1-800-222-1222 to reach the poison specialists, even if the person seems OK.^2,5

Symptoms of an Adderall Overdose

Misuse of stimulants like Adderall can mean taking the medication at a dose higher than prescribed, taking someone else’s medicine, and taking medicine only for the non-medically indicated effect it causes, for example, to get high. The transition from appropriate use to compulsive use (irresistible urge) of Adderall can be very fast. It takes an average of 50 days from the first day of drug use to the first drug craving. It takes an average of 85 days from the first day of drug use to compulsive use. The misuse of Adderall can lead to psychosis (loss of reality), anger, paranoia, heart, nerve, and stomach problems. These issues could lead to a heart attack, seizures, and death.^2,3 Call your doctor if you experience these symptoms, even if they are common.

Common symptoms of an Adderall overdose include:^1,4,6

• Confusion
• Headaches
• Restlessness
• Tremor
• Fast breathing
• Muscle pain or weakness
• Fatigue and depression
• Nausea and/or vomiting
• Diarrhea
• Stomach cramps

Serious symptoms of Adderall overdose include:^2,6

• Tremors
• Panic
• Delusions
• Paranoia
• Compulsive and repetitive movement
• Brain bleed
• Kidney failure
• Elevated/low blood potassium
• Extremely elevated core body temperature
• Forceful behavior
• Hallucinations
• Irregular heartbeat
• High or low blood pressure

Call your doctor if you have these symptoms. If misuse or abuse is suspected in a person, seek help from the care team immediately.

What Dosage of Adderall Could Be Fatal?

An Adderall dose powerful enough to cause death is about 820mg for a 90-pound person and about 1400mg for a 150-pound person. This is 15-25 times the standard dose.¹ The overdose effects depend on the drug release (fast acting or long-acting), the amount involved.^5,6

A child who mistakenly gets his low-dose Adderall twice might not need treatment. On the other hand, if the pills contain a lot of medicine, even a double dose might be too much for that child. The same is true for a child who takes a sibling’s medicine. A single low-dose pill might not have fatal consequences, while a higher dose might require immediate treatment. It is never a good idea to take someone else’s medicine. Even a “normal” dose could cause harmful effects or interact with other drugs one is taking.⁵

What Can Cause an Adderall Overdose?

Recreational Adderall use someimtes involves much higher doses, leading to possible misuse and overdose. A person may begin using Adderall in this way at an earlier age if they have experienced mood disorders, psychotic disorders, anxiety disorders, or trauma early in life.^2,6 Some evidence suggests that cannabis (marijuana, weed, pot) use among adolescents may increase the chance of starting other drugs like Adderall.²

Taking More Than the Prescribed Dosage

Taking more than the prescribed dose of Adderall can happen. This can be accidental or on purpose. People may like the way they feel on Adderall and they may think taking more of the medication may enhance these positive effects (to get “high”). This is dangerous.³

Taking Adderall with Other Substances

There is an increased risk of overdose when taking Adderall with other substances. A drug interaction is a reaction between two (or more) drugs or between a drug and a food, beverage, or supplement. Taking a drug while having certain medical conditions can also cause a drug interaction. Medication must be used properly to help avoid unwanted fatal effects and other serious side effects.

Substances that can increase the risk of an Adderall overdose when used together include:

• Alcohol: Drinking alcohol with Adderall can cause your heart to work harder. This raises your risk of developing heart problems like chest pain and heart attacks.

Taking Adderall with Other Medications

When Adderall is taken with other medications, the risk and severity of overdose increases. Adderall and other amphetamines contribute significantly to opioid (e.g. strong pain medications) death statistics. Amphetamines also present in 63% of opioid deaths. Serotonin syndrome, a potentially life-threatening reaction, may occur when amphetamines are used with other drugs that increase serotonin in the body.

Serotonin syndrome symptoms may include:⁴

• Agitation, hallucinations, delirium, and coma
• Fast heart rate, irregular blood pressure, dizziness, excessive sweating, reddening of the face, high body temperature
• Tremor, stiffness, twitching, jerking, lack of coordination
• Seizures
• Nausea, vomiting, diarrhea

Medications that can increase the risk of an Adderall overdose when taken together include:^{1,4,7,8,9,10,11,12,13,14}

• Tricyclic Antidepressants: These antidepressants systematically increase epinephrine, an effect of Adderall, can increase effects impacting the heart.
• Serotonergic Drugs (Lexapro, Zoloft, Prozac): Serotonergic drugs affect levels of the chemical messenger serotonin. These include antidepressants such as Lexapro, Zoloft, & Prozac. Using Adderall with serotonergic drugs increases the risk of serotonin syndrome.
• MAO Inhibitors (Phenelzine, Selegiline): Using MAOIs and Adderall can cause serious effects requiring medical attention, such as high blood pressure, stroke, heart attack, and even death. It is not safe to take Adderall® within 14 days after stopping an MAOI.
• Antihistamines (such as Benadryl): If you are using antihistamines to help you sleep, Adderall will likely counteract the drowsiness of antihistamines
• CYP2D6 Inhibitors (such as amitriptyline, risperidone): Using Adderall and CYP2D6 inhibitors may increase the amount of Adderall in your body and increase the risk of serotonin syndrome.
• Alkalizing Agents (acetazolamide, bicarbonate, and thiazide diuretics): Alkalizing agents increase the risk of Adderall toxicity by boosting the effects of Adderall in your body.

Always tell your providers and pharmacists about every medication you take to avoid overdose. If there are interacting medications, your provider or pharmacist may suggest changing some of your medication doses to avoid unwanted side effects.

Can an Adderall Overdose Cause Complications?

Amphetamine use disorder (AUD) is a serious and relapsing condition. Some of the complications from AUD are irreversible. Those who do not engage in treatment post-AUD or post-overdose only show 5-year remission (full recovery) rates of up to 30%. Those who engage in treatment, 61% relapse within the first 12 months, and another 14% relapse during years 2-5.²

In severe cases, sometimes people will experience a brain bleed or stroke that could require surgery. Prolonged illness, disease, and death from the use of stimulants like Adderall and opioids together have been increasing over the past two decades.

Any long-lasting effects around one’s ability to think and reason or mental or emotional symptoms from Adderall toxicity appear to be relatively small. Death is less common with Adderall overdose alone and more common when Adderall is used with other substances or medications. Most patients needing emergency care also had other substances in their system.^16,17

Can You Become Addicted to Adderall?

Adderall is extensively abused and some people experience Adderall addiction. Tolerance, extreme psychological dependence, and severe social disability can occur with abuse and misuse. Patients will increase the dosage to levels many times higher than recommended by their provider. Abruptly stopping Adderall following long-term use of Adderall at a high dosage results in extreme tiredness, mental depression, and changes in sleep patterns.⁴

Seeking Professional Help for an Adderall Overdose

If you or someone you know have overdosed on Adderall or other stimulants, call 911 or Poison Control at 1-800-222-1222 to get further evaluation.^1,5

Here is information important to share when seeking treatment for an Adderall overdose:

• Current signs and symptoms
• Prescribed dosage amount
• Other medications you take, including over-the-counter medications and herbals
• When the medication was most likely taken last
• The estimated amount of medication taken
• Intentional or accidental

Adderall Overdose Treatment

One should always call Poison Control if there is a suspected overdose, but the following situations require immediate emergency department evaluation: abuse/neglect, attempted suicide, severely altered mental status, and extremely high dose ingestion (Poison Control will assess the dose with the patient’s weight). Hospital admission may be necessary for symptoms lasting more than a few days or complications requiring intensive care. Discharge can be considered once the patient has no symptoms for six hours following ingestion of a short-acting stimulant like Adderall or 12 hours after ingestion of a longer-acting stimulant like Adderall XR.¹⁸

Emergency treatment for an overdose on Adderall might include:^{3,18,19,20,21,22}

• There is no antidote for Adderall toxicity, but activated charcoal 25g can prevent absorption if administered within one hour of taking Adderall.
• Monitor vital signs
• Provide supportive care for symptoms (medications, behavioral therapies, ice baths)
• Motivational incentives for positive behaviors

Next Steps After an Adderall Overdose

After an overdose occurs it is important to identify the cause of the overdose and take action to prevent this from happening again. Accidentally taking or giving additional doses, recreational use, or self-harm can be potential causes. To take the best next steps, patients should be evaluated by a psychiatrist. To prevent additional intentional overdoses, therapy or counseling should be provided for underlying conditions such as depression or substance use disorders. It is important to have closer monitoring and regular check-ins with your healthcare team.^23,24

If the Overdose on Adderall was Unintentional

Adderall can be restarted once a person has completed treatment for the overdose. Weekly pill boxes can be used to prevent taking too much by accident. Parents and caregivers of children taking Adderall should store the medication out of reach of children and communicate who is going to give the dose that day.²³

Next steps to consider after an unintentional Adderall overdose include:

• Taking medication as prescribed: This can prevent overdoses and reduces the risk of interactions with other medications. Do not take other medications at doses not prescribed to you.
• Consulting with your psychiatrist: Consult a psychiatrist regarding your dosage, med interactions, etc, to prevent accidental overdose again.
• Storing medication securely: Do not store it in an area readily accessible by children or pets. Do not allow other people access.

If the Overdose on Adderall was Intentional

After recovering from an overdose it is important to seek therapy to address root causes. Talk with your psychiatrist to determine if re-starting Adderall is right for you or if you may benefit from starting a different medication. If restarting Adderall, careful monitoring, possible medication restrictions, and open communication between the patient, family, and the healthcare team will be needed. Atomoxetine is a non-stimulant alternative that can be used to treat ADHD and is used in patients with substance and mental health concerns.^24,25,26

Next steps to consider after an intentional Adderall overdose include:^24,25,26

• Seek psychotherapy: Psychotherapy is important to address treating symptoms that may trigger suicidal thoughts and self-harm behaviors.
• Consult your psychiatrist: Non-controlled, non-stimulant alternatives for ADHD treatment exist and may be beneficial. If your provider continues you on Adderall, they can help prevent future instances by restricting or controlling your supply.
• Avoid misusing substances: Illicit drugs or substances can interact with your medication and should not be taken.
• Get support: Family and friends can provide support and monitoring. It may be beneficial to keep open communication with them and your providers.