Narcolepsy adderall: Uses, side effects, and dosage
Uses, side effects, and dosage
Adderall is a prescription medication that doctors commonly prescribe to treat attention deficit hyperactivity disorder, or ADHD. Adderall can also help treat narcolepsy, which is a sleep disorder.
In this article, we outline the uses, side effects, dosage, and risks of Adderall. We also list some alternative medications for ADHD and narcolepsy.
Share on PinterestA doctor may prescribe Adderall to treat ADHD.
Image credit: DMTrott, 2010
Adderall is a prescription medication that contains two stimulant drugs: amphetamine and dextroamphetamine.
Stimulant drugs increase the activity of certain brain chemicals.
Amphetamine and dextroamphetamine increase the availability of norepinephrine and dopamine in the brain. Together, these brain chemicals play a vital role in wakefulness and attention.
Adderall is available as either an oral tablet under the brand name Adderall or an extended-release oral tablet under the brand name Adderall XR.
The Food and Drug Administration (FDA) have approved Adderall for the treatment of ADHD and narcolepsy.
ADHD is a condition that usually appears in childhood or early adolescence. Characteristic symptoms include hyperactivity, impulsiveness, and difficulty paying attention.
Research shows that these symptoms are partly the result of decreased dopamine activity in the brain. Dopamine is a brain chemical that plays an important role in movement, motivation, and attention.
Adderall increases the availability of dopamine in the brain, helping alleviate ADHD symptoms.
Narcolepsy is a chronic sleep disorder that causes the following symptoms:
- excessive daytime sleepiness
- sleep attacks, in which a person experiences sudden overwhelming sleepiness
- sleep paralysis
- disrupted nighttime sleep
- cataplexy, or sudden muscle weakness that occurs in response to strong emotion
Narcolepsy may stem from the death of a particular type of brain cell. These cells produce the chemical hypocretin, which is essential for regulating the sleeping and waking cycle.
Stimulant medications, such as Adderall, boost the levels of a brain chemical called norepinephrine, which helps promote wakefulness.
Taking stimulants at the start of the day can promote daytime wakefulness, which may also help a person sleep better at night.
Share on PinterestCommon side effects of Adderall include headaches, dizziness, and anxiety.
Common side effects of Adderall include:
- difficulty sleeping
- decreased appetite
Children taking stimulant medications such as Adderall may also experience:
- temporarily delayed growth
- moodiness and irritability
In some cases, Adderall may cause more serious side effects. People should phone a doctor right away if they notice the following symptoms in themselves or a child in their care while taking Adderall:
- blurred vision
- increased blood pressure and heart rate
- chest pain
- shortness of breath
- cognitive impairments
- delusional thinking
- racing thoughts
People who feel as though they are experiencing a medical emergency should phone 911 or the emergency number in their area.
The risk of serious side effects is higher among people with certain preexisting medical conditions, such as:
- heart problems or heart defects
- a history of stroke or heart attack
- high blood pressure
- circulatory problems
- depression or anxiety
- bipolar disorder
- drug misuse or addiction
- recent use of monoamine oxidase inhibitors
- an allergy or hypersensitivity to stimulant drugs
While Adderall is a safe treatment option for many people, there are several possible risks. These include or relate to:
Pregnancy and breastfeeding
According to the FDA, there are no adequate, well-controlled studies investigating the effects of Adderall use during pregnancy.
It is possible that infants who have exposure to amphetamines during gestation are at increased risk of:
- premature birth
- low birth weight
- amphetamine withdrawal symptoms
According to the FDA, doctors should only prescribe Adderall during pregnancy if the likely benefit justifies the potential risks.
As the body excretes amphetamines in breast milk, people who take these drugs should avoid breastfeeding and talk to a doctor about either changing medications or using formula.
Infants who ingest amphetamines through breast milk may experience side effects.
Tolerance and drug dependence
Adderall is a schedule II controlled substance, meaning that it has a high potential to lead to dependence and abuse.
Long-term use of prescription stimulants such as Adderall can lead to tolerance, which is when a person needs increasing amounts of a drug for it to be effective.
In some cases, people who take large doses of Adderall for an extended period may become physically dependent on the drug. They might experience withdrawal symptoms when they stop taking the drug.
A person can minimize the symptoms of withdrawal by gradually reducing the dosage over time.
The dosage depends on which condition Adderall is treating and the age of the person taking it.
As a treatment for ADHD
The FDA do not recommend Adderall for children under 3 years of age.
Children aged 3–5 years should begin with a starting dosage of 2.5 milligrams (mg) per day. If necessary, a doctor may increase the daily dose by 2.5 mg at weekly intervals to establish the minimum effective dosage.
For children aged 6 years or above, the recommended starting dosage is 5 mg once or twice per day. The doctor may increase the daily dose by 5 mg each week until they find a dosage that works.
For adults with ADHD, the starting dosage of Adderall is 5 mg once or twice per day. If necessary, a doctor may then increase the daily dose by 5 mg at weekly intervals.
The recommended maximum daily dose (MDD) for adults with ADHD is 40 mg.
As a treatment for narcolepsy
Although it is rare, narcolepsy can sometimes occur in children under the age of 12 years.
For children 6–12 years in age, a doctor may prescribe Adderall at an initial dosage of 5 mg per day. They may increase the daily dose by 5 mg each week, stopping when they find the optimal dosage.
For children and adults aged 12 years and above, the FDA recommend a starting dosage of 10 mg per day. A doctor may raise the daily dose by 10 mg each week if necessary.
The MDD for adults with narcolepsy is 60 mg per day. A person will need to divide this amount into two or three smaller doses and take them throughout the day, rather than taking all 60 mg at once.
If Adderall is ineffective or causes intolerable side effects, a doctor may recommend a different medication.
Other medications for ADHD
Share on PinterestA doctor may prescribe other medications for ADHD, such as Vyvanse, Ritalin, or Focalin.
Besides amphetamine, other stimulants may help treat ADHD. The following are suitable for use in children:
- lisdexamfetamine (Vyvanse)
- methylphenidate (Ritalin)
- dexmethylphenidate (Focalin)
Stimulant drugs may not work for some people, or they may cause intolerable side effects. In these cases, a doctor may prescribe one of the following nonstimulant drugs instead:
- guanfacine (Tenex)
- clonidine (Catapres)
- atomoxetine (Strattera)
Other medications for narcolepsy
Stimulants, antidepressants, and lifestyle changes may all be useful in treating the symptoms of narcolepsy.
Some examples of each include:
- stimulants: methylphenidate (Ritalin) and modafinil (Provigil)
- antidepressants: fluoxetine (Prozac) and sertraline (Zoloft)
- lifestyle changes: taking short naps and exercising daily
Doctors may sometimes also prescribe the central nervous system depressant sodium oxybate (Xyrem) to treat cataplexy and excessive daytime sleepiness.
Adderall is a prescription medication that contains the stimulants amphetamine and dextroamphetamine. These drugs can be effective in treating the symptoms of ADHD and narcolepsy.
A doctor will not prescribe Adderall without first taking a detailed medical history to be sure that a person has the correct diagnosis.
Adderall can cause a range of side effects. It may not be suitable for people with certain medical conditions.
People who are taking Adderall should talk to a doctor if they have concerns about the side effects or risks of the drug. The doctor may adjust the dosage or recommend an alternative medication if necessary.
9 Things To Consider Before Taking Adderall for Narcolepsy or ADHD – Sleep doctors Ft. Myers, Bonita Springs, Cape Coral, Lehigh, Estero
9 Things To Consider Before Taking Adderall for Narcolepsy or ADHD
Table of Contents
Prescription medications like Adderall are commonly used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy, but in recent years, doctors have been criticized for overprescribing and abuse rates have skyrocketed. Adderall belongs to the group of medicines known as central nervous system (CNS) stimulants. The Centers for Disease Control and Prevention reports an estimated 16.4 million children, ranging from ages 4 to 17, have been diagnosed with ADHD at some point in their lives. Around two-thirds of these children and adolescents are prescribed stimulant ADHD medications such as Adderall.
How does Adderall affect narcolepsy?
Since the 1930s, amphetamines have been used to improve alertness in narcolepsy and other conditions. These medications are among the most effective for reducing sleepiness, but side effects are moderately common.
A large variety of amphetamines are clinically available, and individuals may respond better to one than to another. Some of the most common are dextroamphetamine (Dexedrine) and a mixture of amphetamines and dextroamphetamine (Adderall). Methylphenidate (Ritalin, Concerta, Metadate, and Methylin) is closely related to the amphetamines and has similar benefits and side effects.
All these medications improve alertness by increasing brain levels of dopamine. To a lesser degree they can also increase brain levels of two other wake-promoting chemicals, serotonin and norepinephrine.
Is Adderall FDA approved for narcolepsy?
Adderall is indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) and Narcolepsy.The effectiveness of Adderall for long-term use has not been systematically evaluated in controlled trials.
Therefore, the physician who elects to use Adderall for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient.
What is the dosing for Adderall in narcolepsy?
Usual dose 5 mg to 60 mg per day in divided doses, depending on the individual patient response. Narcolepsy seldom occurs in children under 12 years of age; however, when it does, dextroamphetamine sulfate may be used. The suggested initial dose for patients aged 6-12 is 5 mg daily; daily dose may be raised in increments of 5 mg at weekly intervals until optimal response is obtained. In patients 12 years of age and older, start with 10 mg daily; daily dosage may be raised in increments of 10 mg at weekly intervals until optimal response is obtained. If bothersome adverse reactions appear (e.g., insomnia or anorexia), dosage should be reduced. Give the first dose on awakening; additional doses (1 or 2) at intervals of 4 to 6 hours.
Does Adderall make you last longer in bed?
Erectile dysfunction (ED) is a potential side effect for men taking Adderall. Some men report a decreased interest in sex and difficulty getting and keeping an erection.
Can Adderall cause extreme fatigue?
If you take Adderall to help manage your ADHD, you may have noticed a surprising side effect. You might feel really calm or sleepy. Or you may have low energy, also known as fatigue. It’s rare, but it happens.
What happens if you take Adderall without ADHD?
In people who don’t have ADHD, users may experience feelings of euphoria and increased energy levels, as well as possible dangerous physical and emotional side effects. Adderall should be considered an addictive drug.
Does Adderall help with depression?
Though Adderall can instantly improve your mood, it is not a treatment for depression. Using Adderall for long periods of time (prescribed or not) can cause many serious physical and mental health issues, so even if you are diagnosed with ADHD and prescribed Adderall, you should be extremely cautious when taking it.
Why is Adderall not working anymore?
Adderall can be very effective in treating ADHD or narcolepsy symptoms but for a significant number of patients, medications are not helpful. In fact, as many as 30% of children with ADHD do not respond to stimulants or cannot tolerate the side effects. And 1 in 3 adults with ADHD do not improve on standard medications. It could be due to several reasons: the dosage may be incorrect; adherence may be an issue; co-existing disorders may impede the medications effectiveness or the patient may have another medical condition producing narcolepsy or ADHD-like symptoms.
Who should not take adderall?
Adderall should not be taken if you or your child:
Have heart disease or hardening of the arteries
Have moderate to severe high blood pressure
Have an eye problem called glaucoma
Are very anxious, tense, or agitated
Have a history of drug abuse
Are taking or have taken within the past 14 days an anti-depression medicine called a monoamine oxidase inhibitor or MAOI.
Are sensitive to, allergic to, or had a reaction to other stimulant medicines
ADDERALL® IS NOT RECOMMENDED FOR USE IN CHILDREN LESS THAN 3 YEARS OLD
adhd icd 10
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Dr. Imtiaz Ahmad is a highly qualified physician, Board Certified in Pulmonary and Sleep Medicine. He has been actively serving the community of Lee County, Florida since 2004, with a strong focus on a proactive healthcare approach. Dr. Ahmad has received advanced training from some of the most prestigious institutions, including Harvard University, Cornell University, State University of New York at Brooklyn, and the University of Mississippi. SOMNAS is a medical facility that is committed to improving and maintaining the health of patients with sleep disorders. The expert team at SOMNAS is known for their compassionate and high-quality care. They offer unparalleled treatment and care to patients on the Gulf Coast of Florida, ensuring a better and healthier life for them.
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Narcolepsy is a disease of the central nervous system characterized by complex sleep disorders that have 4 main manifestations:
- Sudden daytime sleepiness and attacks of sudden falling asleep
- Cataplexy (attacks of sudden weakness)
- Sleep paralysis
- Hypnagogic (when falling asleep) and hypnapompic (when waking up) hallucinations
The prevalence of narcolepsy is 5-7 per 10,000 people. Narcolepsy usually develops between the ages of 20 and 50, and is more common in men. The hereditary nature of the disease is assumed. Narcolepsy can manifest itself, especially at the beginning of the disease, with only one of the above symptoms. Over time, the picture of the disease may change due to the addition of other symptoms of narcolepsy.
The characteristic manifestations of narcolepsy are detailed below:
- Abrupt daytime sleepiness and sudden daytime sleep attacks are usually the first symptoms of narcolepsy. The drowsiness is so severe that the patients fall asleep in spite of the extreme reluctance to do so, or in the most unsuitable environment. After waking up, patients feel cheerful and energized. However, after a few hours, severe drowsiness develops again. This is especially dangerous if a person is associated with professions that require increased attention.
- Cataplexy is an attack of sudden weakness on the background of strong positive or negative emotions (laughter, surprise, sexual intercourse, crying, anger). Weakness is due to a sharp loss of muscle tone. The attack can develop so quickly that in some cases, the patient may fall and be injured. The duration of an attack ranges from a few seconds to several minutes. Sleep may follow.
- Hypnagogic (during the period of falling asleep) and hypnapompic (during the period of awakening) hallucinations are vivid acoustic or visual visions similar to a dream that occur during falling asleep or waking up. They are also called “waking dreams”, as a person realizes that he is not yet sleeping, but is already beginning to dream. Usually these visions are accompanied by fear and anxiety.
- Sleep paralysis is a condition characterized by complete immobility upon awakening. The person is fully conscious and adequately assesses the situation, but cannot move. Only the ability to blink and move the eyes is preserved. Sleep paralysis is more common in the morning, but can occur in the evening and at night. This situation can be very frightening, especially in the case of frightening hallucinations against the background of immobility.
An accurate diagnosis is possible only on the basis of a consultation with a somnologist and polysomnography.
If you or your relatives want to have a good rest during sleep, we are waiting for you in the department of somnology of the Medical and Diagnostic Center of the International Institute of Biological Systems named after S.M. Berezina.
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what is it, symptoms, treatment, causes of daytime sleepiness
This disease is treated by Somnologist
The information provided on this page should not be used for self-treatment or self-diagnosis. If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment.
- Symptoms of narcolepsy
- Narcolepsy treatment
- Prognosis and prevention
What is narcolepsy?
Narcolepsy is a pathological condition characterized by the inability to control sleep and wakefulness. Sudden onset of excessive daytime sleepiness and other symptoms of narcolepsy can occur at any time, even in situations that require extreme concentration, such as driving.
The risk group for the development of narcolepsy is men, the frequency of cases is 1 in 2 thousand people. But there is an opinion that the prevalence is higher due to the fact that not all patients do not seek medical help and treatment.
description of the clinical observation. Remizevich R.S., Kurasov E.S. Bulletin of the National Medical and Surgical Center. N. I. Pirogova, Volume 8, No. 4, 2013. pp. 141-145 – not a fatal pathology, but accidents still happen during attacks.
The exact causes of narcolepsy are unknown, although it has been established that heredity plays a role, as well as a lack of the neurotransmitter orexin, which is responsible for wakefulness.
REM sleep literally invades the periods of wakefulness and the transition to sleep. Symptoms of narcolepsy are associated with a sharp loss of muscle tone, the appearance of vivid visions, which are just characteristic of the phase of REM sleep.
It was not possible to establish the exact reasons for the decrease in the production of the neurotransmitter, but the predisposing factors for the development of the pathology were identified:
- serious craniocerebral injuries and their consequences;
- infectious diseases affecting the nervous system Source:
Autonomic disorders in narcolepsy (review of foreign literature). Golokov V.A., Nikolaeva T.Ya., Schneider N.A., Kantimirova E.A. Medical Almanac No. 5(45), 2016. pp. 165-168;
- pronounced hormonal changes;
- autoimmune diseases;
- chronic stress and severe emotional upheavals;
- nervous and physical exhaustion.
As a rule, the development of a disease requires the combined action of several factors at once. Great importance in the mechanism of the development of the state is given to the work of immunity. An immune response is launched, as a result of which its own cells are mistakenly destroyed, which leads to the onset of symptoms.
Symptoms of narcolepsy
The most common symptom is increased daytime sleepiness, as well as persistent sleep disturbances at night. This creates inconvenience, spoils the quality of life, affects success in work and social relations.
Over time, the clinical picture changes, other signs join:
- The first and most common symptom is sudden falling asleep during the day. Drowsiness is severe, patients fall asleep against their will, even in unsuitable surroundings. But after waking up, they feel a surge of strength, there is no drowsiness. This state can be deceptive – after a short time they fall asleep again. At the same time, waking up the patient is no more difficult than during normal sleep.
- Cataplexy Source:
Narcolepsy with prepubertal onset cataplexy. Gromova D.O., Zinovieva O.E., Rogovina E. G., Poluektov M.G. Neurological journal No. 4, 2012. pp. 22-27 – sudden muscle weakness after strong emotional outbursts. The resulting weakness can be explained by a sharp loss of muscle tone, which often ends in injuries associated with a fall. The duration of the attack varies and lasts up to several minutes, followed by falling asleep.
- Hallucinations on falling asleep and waking up. They are characterized as vivid acoustic or visual visions, which correspond to REM sleep. This state is sometimes called “waking sleep”, and the patient himself does not realize that he is sleeping and dreaming. This is a dangerous condition that creates confusion between reality and dream.
- Sleep paralysis is a condition characterized by the inability to move after waking up, but the ability to breathe and blink remains. The patient is conscious, understands where he is. Most often, sleep paralysis is formed in the morning, less often in the evening and at night. Sleep paralysis is aggravated by hallucinations without the ability to move. The condition goes away after a few minutes.
Only 10% of patients present with all symptoms at once. Usually first appear in young people, with no previous diseases. Although they can be associated with strong emotional upheavals or chronic stress. After the first onset of symptoms, narcolepsy is permanent, but does not affect life expectancy.
In clinical practice, it is customary to distinguish 2 types of narcolepsy:
- the first occurs due to orexin deficiency, cataplexy is characteristic. Source:
Narcolepsy-cataplexy. Vasilchenko T.S., Gabdrakipova A.A. Bulletin of Science and Education No. 24(78), 2020. pp. 53-55;
- the second is characterized by a normal level of the neurotransmitter and cataplexy does not occur.
The main thing is to detect the pathology in time to prevent risks to the patient’s physical health and harm to others. The patient cannot control narcolepsy, attacks occur even at the time of hard work and maximum concentration of attention, as well as performing tasks that involve risks to health and even life.
When visiting a doctor, the symptoms that characterize the diagnosis are studied in detail. The doctor is interested in:
- the patient’s complaints, when the attack first occurred and how long it lasted, what symptoms are present;
- neurological examination data, some tests;
- results of additional examination methods to confirm the diagnosis.
These include polysomnography. Source:
Problems in the differential diagnosis of epileptic seizures and narcolepsy (clinical observation). Dmitrenko D.V., Alekseeva O.V., Sapronova M.R., Usoltseva A.A., Areshkina I.G. Bulletin of the North-Eastern Federal University. M. K. Ammosova. Series: Medical Sciences No. 4(13), 2018. pp. 44-51 with EEG data. This method of examination allows you to objectively assess the activity of the brain and sleep phases. The survey continues throughout the night. Electrodes are placed on the patient’s head, which fix the indicators and give them out in the form of curves – the doctor analyzes the data.
Additionally, CT and MRI are recommended to assess brain function and condition. In some cases, it may be necessary to analyze the cerebrospinal fluid, which is aimed at determining the concentration of orexin.
Treatment tactics are determined by the data obtained during the examination. This takes into account the severity of concomitant pathology, acquired diseases.
Treatment of narcolepsy
Drug treatment prescribed by specialists is constant, but the number of drugs depends on the clinical picture and the characteristics of the manifestation of the disease. Doctors usually prescribe:
- sleeping pills to help normalize night sleep;
- means to combat daytime sleepiness.
Other recommendations are added to medications – lifestyle changes that help control symptoms. Patients with narcolepsy are recommended:
- strictly observe the daily routine: go to bed and get up at the same time, regardless of holidays and weekends;
- give up alcohol completely and stop smoking;
- Minimize your intake of coffee, soft drinks, energy drinks, and junk food;
- introduce a short daytime nap into your schedule;
- lead an active lifestyle, play sports, for example, exercise therapy, yoga.
Prognosis and prevention
Unfortunately, there is no cure for narcolepsy. All treatment is aimed at controlling and maximizing symptom relief. After the course of treatment, the patient returns to his usual way of life, although there are still some restrictions.
There are some prohibitions for all narcolepsy patients. They are forbidden to drive a car, as well as to occupy positions related to hazardous industries, for example, to work with machine tools, in large factories, etc. After all, an attack can happen at any moment, regardless of what a person is doing.
- Narcolepsy-cataplexy. Vasilchenko T.S., Gabdrakipova A.A. Bulletin of Science and Education No. 24(78), 2020. p.53-55
- Narcolepsy with cataplexy with onset in prepubertal age. Gromova D.O., Zinovieva O.E., Rogovina E.G., Poluektov M.G. Neurological journal №4, 2012. pp.22-27
- Modern ideas about narcolepsy with a description of clinical observation.