Adderall is a common stimulant medication for the treatment of ADHD. Used in the right doses, it can help people with ADHD manage typical symptoms like concentration issues and hyperactivity. But how does Adderall actually work?
Let’s explore the mechanism of Adderall and other stimulant medications to see what it does in ADHD brains and how it affects your mental, emotional, and physical state.
⚕️ Disclaimer: This article is for informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. The information provided does not replace the guidance of a healthcare professional. Always seek the advice of a qualified healthcare provider regarding questions you have about a medical condition or medications. Use this information at your discretion. The editors and writers associated with this article cannot be held liable for any errors or consequences resulting from its use.
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- Adderall is an amphetamine-based stimulant medication.
- ADHD brains have less dopamine and norepinephrine neurotransmitters, and Adderall increases the availability of these.
- Adderall has physical, mental, and cognitive effects that can help manage ADHD symptoms, but it also comes with negative side effects.
How do Adderall and other stimulants affect brain chemistry?
ADHD is likely caused by disruptions in neurotransmitter systems, leading to lower levels of dopamine and norepinephrine (aka noradrenaline) in ADHD brains.1
Stimulant medications like Adderall increase dopamine and norepinephrine activity, which helps alleviate common ADHD symptoms, such as distractibility, impulsive behavior, and emotional reactivity.2
Stimulants increase dopamine and norepinephrine levels in ADHD brains
ADHD brains have lower levels of dopamine and norepinephrine, two important brain chemicals (neurotransmitters) that send signals to different parts of the brain and body.
Dopamine is involved in the brain’s reward system and helps with motivation, attention, and goal-directed action.
Norepinephrine plays a part in alertness, mood, and memory.
Typically, after transporting a message, neurotransmitters are collected back into the cell by transporter proteins in a process called “reuptake.”
Stimulant medications work by inhibiting these transporters, preventing them from removing dopamine and norepinephrine molecules so they can be active for longer.1
Additionally, amphetamine-based medication like Adderall has been shown to reverse the action of dopamine transporters, leading to an even greater release of dopamine.3
🧠 Want to know more about the ADHD brain? Check out our deep dive into the neuroanatomy of ADHD.
Amphetamine enantiomers: levoamphetamine and dextroamphetamine
Levoamphetamine and dextroamphetamine are enantiomers. This means that even though they have the same elements, their molecular structures are mirror images of each other. Both are psychostimulants: They increase central nervous system (CNS) activity by raising dopamine and norepinephrine levels, which play key roles in motivation, pleasure, and focus. Dextroamphetamine is more potent than levoamphetamine.4
Adderall: enantiomers work better together
Adderall is a combination of the two enantiomers: 25% levoamphetamine salts and 75% dextroamphetamine salts.
When combined, the two amphetamines are synergistic: They enhance each other’s effects, leading to a stronger and longer-lasting response.
How does Adderall affect the brain and body?
Emotional and cognitive effects
Dopamine isn’t just a “happiness chemical.” It directly affects how different parts of the brain perform, including reward responses. This is why dysregulation of the dopamine system in the brain affects everyday life for ADHDers. Increased dopamine levels can lead to higher motivation, better emotional regulation, and a general improvement in mood.
Norepinephrine increases alertness and attention and helps regulate sleep, memory, and mood.
Adderall increases the amount of neurotransmitters in the brain, stimulating the cognitive faculties of ADHDers so they can perform at a “normal” level for a while.
Positive effects of Adderall
The extent of effects felt depends on dosage and each individual’s pre-existing conditions.
In general, positive effects for ADHDers include:
- Mood stability
- Greater alertness
- Increased focus
- Decreased hyperactivity
- Improved executive functions, including:5
- Working memory
- Cognitive flexibility (switching focus)
- Attentional control
- Impulse control
Negative effects of Adderall
You can also experience some adverse effects from taking Adderall, such as:6
- Slowed speech
- ‘Adderall crash,’ aka medication rebound: worsened ADHD symptoms when the medication wears off
More severe but less common side effects include hallucinations and seizures. For people with comorbid anxiety, Adderall can also worsen their symptoms.
In some cases, Adderall may worsen tics or tic disorders, although this isn’t the case for most people.
As Adderall increases focus, it can help ADHDers perform physical tasks with greater accuracy and speed.
Adderall affects the respiratory and circulatory systems. Like other stimulants, Adderall constricts your blood vessels, which can increase your blood pressure and heart rate.
Other physical side effects of Adderall include:
- Lower appetite
- Teeth grinding
- Bladder pain, pain during urination, or bloody or cloudy urine
- Lower back or side pain
- Nausea or vomiting
Is Adderall right for you?
Adderall is a stimulant medication and won’t suit everyone. The decision to take Adderall is between you and your doctor and will take into consideration any pre-existing conditions or concerns you have.
For those with depression or anxiety, Adderall may help, or it may make some symptoms worse.
Adderall can also affect the blood by increasing blood glucose levels, which can make you feel more energetic, but it may not be a good fit for someone with diabetes.
Adderall may increase the risk of stroke and heart attack in some adults with pre-existing conditions due to its physical effects. If you have a pre-existing lung or heart condition, Adderall may not be the right medication for you. For people with anxiety or heart conditions, non-stimulant ADHD medications can be an alternative.
You may also want to consider pharmacogenetics to find out how different drugs work for you.
Adderall is often misused as a drug (often by non-ADHDers or in non-prescribed doses). It is known to carry a relatively high risk of addiction, and long-term use may lead to dependence. If someone has a history of substance use disorder, a medical practitioner may advise against using Adderall.
If you experience any adverse effects mentioned in this article or others not mentioned here, it is best to speak to a medical practitioner to see if you might benefit from alternative treatment.
💊 Learn more about common and rare side effects of different ADHD medications here.
It’s important to remember that everyone responds to treatments differently, depending on their individual genetic makeup, underlying or comorbid conditions, lifestyle, etc. There are many things we are still learning about amphetamines and ADHD. So, consulting with a medical professional who knows about your specific situation and understands the ins and outs of ADHD medication options is crucial to getting the support you need.
1 Neuroscience & Behavioral Reviews | The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities (2018)
2 Curr Dev Disord Rep | Neurobiology of ADHD: A Review (2019)
3 Brain Sci. | Precision Medicine Care in ADHD: The Case for Neural Excitation and Inhibition (2021)
4 JCCC Honors Journal | An Analysis of ADHD Drugs: Ritalin and Adderall (2011)
5 Pharmacy | Neurocognitive, Autonomic, and Mood Effects of Adderall: A Pilot Study of Healthy College Students (2018)
6 Pharmacology & Therapeutics | Evidence-based pharmacological treatment options for ADHD in children and adolescents (2022)