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Maintain focus and Support attention

Fight fatigue and Build mental stamina

Maintain willpower and Support productivity

Support memory and Promote deep thinking

Verbal fluency and Maintain confidence

Feelings of calm and Positive outlook

• GMP Certified
• Gluten Free
• Promote Energy
• Fight Fatigue
• Build Mental Stamina

TeaCrine® has been shown to increase energy, motivation, and concentration.

• Maintain Focus
• Support Attention
• Enter Flow State

Alpha-GPC has been shown to support healthy cognitive function and physical performance.

• Maintain Willpower
• Manage Procrastination
• Support Productivity

CDT (Dynamine® ) has been shown to help with cognitive control and reaction time during mentally demanding tasks.

• Support Memory
• Promote Deep Thinking
• Maintain Processing Speed

Synapsa® has been shown to significantly improve working memory.

• Spark Inspiration
• Support Verbal Fluency
• Manage Stress

KSM-66® Ashwagandha has been shown to significantly reduce stress and anxiety.

• Encourage calm state
• Support mental flexibility
• Promote positive outloook

Zembrin® has been shown to improve in mood and disposition.

Nootropics aren’t one size fits all

We formulate potent nutrient compounds to enhance mental performance and make personalized recommendations based on your goals and unique brain chemistry

Your Personalized Thesis Journey

1. take the quiz.

Tell us about yourself and your goals. We’ll use your answers to determine your baseline and build your recommendations.

2. Get Your Starter Kit

You’ll sample 4 blends over the course of the month to understand what you can accomplish with each formulation.

3. Optimize with a Coach

Check in with your wellness coach and our nootropics experts to customise your blends based on your experience so far.

A powerful, natural way to boost your cognition

Thesis can help you.

• Raise your energy level
• Feel more motivated
• Clear brain fog
• Increase focus

We’ve Helped Over 500,000 People Find Their Formula

“Motivation gets me going during my six days in a row at work, and Clarity keeps my mind sharp and alert so I’m performing at my best . Creativity does just as it says -- I love this one for when I’m doing the Reading Comprehension and/or Arguments section of LSAT prep; I truly feel like it gives me an edge.”

Britney’S BLENDS

"I did feel different since day one. I got more motivated and had an overall better mood. [Thesis] has been a game changer for me."

Ondrej's BLENDS

“I always feel energized and focus without the afternoon crash that I typically experience with coffee. I can get hours of work done and stay motivated all day.”

Renee’S BLENDS

"For someone who has struggled with attention and staying awake, [Thesis has] been life saving."

Trish's BLENDS

Trusted by experts

Dr. gabrielle lyon.

Functional Medicine & Nutritional Sciences

“I work with CEOs, celebrities, and other top performers in my practice. Thesis is what I recommend and take personally for focus and cognition. I even used it to help me nail my first TedX talk.”

Gabrielle’s blends

Professional Basketball Player & Mental Health Advocate

“With a busy life on and off the court, Thesis gives me energy and focus to get through the longest days and keep me sharp.”

Kevin's blends

Ultra-endurance Athlete & Nutrition Advocate

"Thesis has provided a substantial benefit to my ability to focus. Creativity works best for me — I take it 30 mins before a podcast or writing and it helps get me into the zone."

RICH’s blends

Pure and effective ingredients

Potent active ingredients.

Quality counts when supplementing, and only the active ingredients in a blend make an impact.

Clinically Studied Dosage

We only use nutrients that have been proven to safely deliver desired effects in clinical trials.

All ingredients in each batch are tested with a third party lab to ensure optimal potency and purity.

“ The Thesis process was developed by systematically testing different combinations of high quality ingredients. We made the process of finding the right nootropics quicker & safer.”

DAN FREED CEO & Founder, Thesis

Our research and product development teams review clinical studies and information on safety, side effects, and any potential interactions for each ingredient being considered for a Thesis blend.

Each ingredient goes through two rounds of internal testing, in which members of our research and product development team share feedback on individual ingredients.

The research and product development team reviews existing clinical literature about synergistic benefits between ingredients and integrates it as we continue to formulate, developing 2-4 blends to move forward to Phase 3 testing.

We test each prospective blend internally, as members of our research and product development team try each of the blends before we move forward to Beta testing.

Next, we test multiple iterations of each blend with a group of 100 Thesis beta group customers and collect quantitative and qualitative feedback to help us refine the final blend.

We finalize our winning blend (based on the Alpha and Beta test feedback) by completing a final round of safety testing by our third party lab partners before we release it. Ongoing safety testing occurs with each batch of production.

After the blend undergoes third party lab testing for safety, we launch a limited release to 5,000 customers to help us gather additional feedback and work through our supply chain process

Once a blend passes the limited release phase, we launch full production in a cGMP facility and release it to all customers.

The Thesis Story

As long as I can remember, people thought I was stupid, lazy, or unmotivated. I started to believe it. In school, I would read the same page over and over again, without absorbing anything. At 16, I dropped out of high school and went to work at a sandwich shop.

Fast-forward ten years — I scored in the 99th percentile on the GMAT and earned Master’s degrees from Yale and INSEAD. Nootropics turned everything around for me, and helped me form the positive habits that I built my success on. Once I balanced my brain chemistry, I could perform like never before.

I take Energy to get me going in the morning and Motivation to power through long afternoons.

DAN’s blends

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Sheridan is a writer from Hamilton, Ontario. She has a passion for writing about what she loves and learning new things along the way. Her topics of expertise include skincare and beauty, home decor, and DIYing.

Table of Contents

About Thesis Nootropics

Hands up if you guzzle five coffees a day to stay awake, have tried all the supplements in the book desperate to improve your headspace, and aren’t interested in prescribed medications. Designed to increase focus , Thesis nootropics might be for you. 

Thesis offers a customized blend of ingredients designed to optimize your cognitive function , with personalized details that tackle your specific needs. Nootropics boost brain performance in the same way a stimulant would, without the common negative effects. 

A study published in the Journal of Alzheimer’s Disease found that nootropics may help improve cognitive function in people with Alzheimer’s disease.

Interested in finding out more about the brand and how it works? Leaf through our Thesis Nootropics review. We’ll be your guide through the company and the process, as well as details on the treatments, highlights from customer reviews, answers to important FAQs, and more, to help you decide if it’s worth the try.

Pros and Cons

• Multiple cognitive benefits: Thesis Nootropics offers a variety of blends that cater to multiple aspects of cognitive function.
• Long-term effects: On top of short term benefits for daily life, Thesis nootropics ingredients are designed to impact the brain in the long-term.
• Personalized recommendations: Thesis Nootropics makes personalized recommendations based on your goals and unique brain chemistry.
• Potential side effects: The most common side effects to watch out for when you start taking Thesis Nootropics include heartburn, headaches, confusion, dizziness, loss of appetite, and digestive issues.
• Need to stop taking if issues arise: If you experience a headache or an upset stomach that won’t go away while taking their nootropics, Thesis recommends that you stop taking them.

What is Thesis Nootropics?

Nootropics are nutrient compounds and substances that are known to improve brain performance , such as caffeine and creatine. They help with issues that affect motivation, creativity, mood, memory, focus, and cognitive processing.

Nootropics are the ideal addition to an already healthy lifestyle that consists of exercise, proper nutrition, and enjoyable activities.  Thesis nootropics are carefully formulated to target specific needs, ranging from energy to creativity. The brand focuses on safety, ensuring that all supplements adhere to FDA guidelines and go through multiple clinical trials. 

How Thesis Nootropics Works

With all that being said, you may be wondering how Thesis provides users with an option that is specific to their needs. Fortunately, the process is simple and hassle free. Here’s how it works:

• Take the Thesis nootropics quiz
• Answer questions about your basic information
• Receive personalized recommendations 
• Get your starter kit for $120 , or $79 monthly when you subscribe 

After that, you’ll select one formula to take each week, taking one day off in between each different option. You’ll also track your results in the daily journal over the month to see how they affect your daily life. 

From there, it operates as a subscription service. Users will be able to optimize their next shipment by telling the brand which formulas worked best.

If you don’t like any of the blends in your box, let the company know and they’ll switch it for something that’s a better fit for your lifestyle, genetics, and goals.

Thesis Nootropics Ingredients

Thesis Nootropics is a brand that offers personalized nootropics designed to enhance cognitive function and overall brain health. Their blends contain a variety of ingredients that are carefully chosen for their cognitive-boosting properties. Here are some of the key ingredients in Thesis Nootropics:

• Cognizin (Citicoline) : Cognizin is a type of choline that is known for its ability to enhance cognitive function, including memory and focus.
• L-Theanine : L-Theanine is an amino acid that is found in green tea, and is known for its ability to promote relaxation and reduce stress and anxiety.
• Lion’s Mane Mushroom : Lion’s Mane Mushroom is a type of medicinal mushroom that is believed to have cognitive-boosting properties, including improved memory and focus.
• Rhodiola Rosea : Rhodiola Rosea is an adaptogenic herb that is known for its ability to reduce stress and fatigue, and improve mental clarity and cognitive function.
• Ashwagandha : Ashwagandha is an adaptogenic herb that is known for its ability to reduce stress and anxiety, and improve memory and cognitive function.
• Phosphatidylserine : Phosphatidylserine is a type of phospholipid that is found in high concentrations in the brain, and is believed to support cognitive function, including memory and focus³
• Alpha-GPC : Alpha-GPC is a type of choline that is known for its ability to enhance cognitive function, including memory and focus.
• TAU (uridine): TAU is a blend of uridine, choline, and DHA, which is believed to support brain health and cognitive function.
• Artichoke extract : Artichoke extract is believed to enhance cognitive function by increasing levels of acetylcholine, a neurotransmitter that is important for memory and learning.
• Dynamine : Dynamine is a type of alkaloid that is believed to enhance cognitive function by increasing levels of dopamine, a neurotransmitter that is important for mood and motivation.

Overall, the ingredients in Thesis Nootropics are carefully chosen for their cognitive-boosting properties, and are designed to work together to enhance overall brain health and cognitive function.

Thesis Nootropics Health Benefits

Thesis Nootropics is a brand that offers personalized nootropics designed to enhance cognitive function and overall brain health. Their blends contain a variety of ingredients that are carefully chosen for their cognitive-boosting properties, and offer numerous health benefits. Here are some of the health benefits of Thesis Nootropics:

• Increased cognitive energy : One of the key benefits of Thesis Nootropics is increased cognitive energy, which can help improve productivity, mental alertness, and motivation, as it contains cognizin .
• Enhanced mental clarity : Another benefit of Thesis Nootropics is enhanced mental clarity,given from Lion’s Mane Mushroom which can help reduce brain fog and improve focus.
• Improved memory and learning abilities : Thesis Nootropics contains ingredients that are believed to improve memory and learning abilities, like Phosphatidylserine , which can help users retain information more effectively.
• Elevated mood : Thesis Nootropics may help elevate mood and reduce symptoms of anxiety and depression, thanks to ingredients like L-Theanine and Ashwagandha .
• Lowered stress levels : The adaptogenic herbs in Thesis Nootropics, such as Rhodiola Rosea and Ashwagandha , are known for their ability to lower stress levels and promote relaxation.
• Boosted focus : Thesis Nootropics contains ingredients like Alpha-GPC and Artichoke extract , which are believed to boost focus and concentration.

While Thesis Nootropics offers numerous health benefits, it’s important to note that the long-term effects of nootropics are not yet fully understood and more research is needed.

3 Thesis Nootropics Bestsellers

Thesis energy review.

If you’re constantly struggling to keep up with the demands of your busy life, it might be time to try a natural energy booster like Thesis Energy. This powerful nootropic blend is specifically designed to increase energy, overcome fatigue, and build mental stamina.

Thesis Energy is caffeine-free, making it a great option for those who are sensitive to caffeine or looking for a natural alternative to traditional energy drinks. The Energy formulation is designed to help improve focus and mental clarity, increase cognitive energy, and reduce fatigue. Whether you’re facing a busy day at work, recovering after a night of poor sleep, or gearing up for an intense workout, Thesis Energy can help you power through.

Each ingredient in Thesis Energy is carefully chosen for its energy-boosting properties. The specific ingredients can vary depending on your needs, but they work together to help increase energy, improve mental clarity, and reduce fatigue.

To get the most out of Thesis Energy, take it every morning on an empty stomach. You can also take it again after lunch if you need an extra boost. It’s designed to help you tackle busy, hectic days, recover from poor sleep, and power through intense workouts.

If you’re tired of relying on coffee and energy drinks to get through the day, it might be time to give Thesis Energy a try. Check availability and start boosting your energy naturally today!

Thesis Creativity

If you’re someone who struggles with creativity or finds yourself feeling stuck in your creative endeavors, Thesis Creativity may be worth considering. This nootropic supplement is designed to help spark inspiration, enhance verbal fluency, and boost confidence in your own great ideas.

So what’s in Thesis Creativity? The ingredients may vary depending on your specific needs, but these ingredients work together to support stress management, memory function, mood regulation, and energy production.

By supporting stress management, memory function, and mood regulation, Thesis Creativity can help free up mental space for more creative thinking. Additionally, the caffeine and L-theanine combo can provide a boost of energy and focus without the jitters and crash that can come with caffeine alone.

To get the most out of Thesis Creativity, it is recommended to take it every morning on an empty stomach and again after lunch if you need an extra boost. This nootropic blend is particularly helpful for brainstorming and creative thinking, writing and creative projects, and public speaking and social situations.

As with any nootropic supplement, it’s important to note that the long-term effects of Thesis Creativity are not yet fully understood and more research is needed. It’s always a good idea to speak with a healthcare professional before adding any new supplements to your routine.

In summary, if you’re looking for a little extra help in the creativity department, Thesis Creativity may be a valuable addition to your nootropic lineup. Its unique blend of ingredients can help support mental clarity, mood regulation, and energy production, making it a valuable tool for any creative individual.

Thesis Logic

If you’ve been having trouble with your memory lately, such as forgetting what you had for lunch yesterday or struggling to recall common words, then Thesis Logic may be just what you need. This formula is designed to help enhance your processing speed, boost your memory, and deepen your thinking.

Thesis Logic is caffeine-free, making it a great option for those who are sensitive to caffeine. The formula is ideal for use during deep, focused work, complex problem-solving, research projects, and completing tedious tasks.

Taking Thesis Logic is easy – simply take it every morning on an empty stomach, and take it again after lunch if you need an extra boost. By incorporating Thesis Logic into your daily routine, you may notice improvements in your cognitive function and overall mental performance.

Who Is Thesis Nootropics For? 

Thesis nootropics are designed for a number of different specific needs, including anyone who wants to focus better, have more energy, and maintain mental clarity. All in all, the products are specifically formulated to improve day to day life and target your specific needs .

Thesis Nootropics Side Effects

While Thesis nootropics are designed to enhance cognitive performance and provide a range of benefits, it’s important to be aware of the potential side effects that can occur. As with any supplement, individual reactions can vary, and some people may experience side effects while others may not.

Some of the potential side effects of Thesis nootropics include:

• Insomnia : Some nootropics contain caffeine or other stimulants that can disrupt sleep patterns and lead to difficulty falling asleep or staying asleep.
• Blurry vision : Certain nootropics, such as those containing alpha GPC, have been linked to temporary blurry vision.
• High blood pressure : Stimulant-based nootropics can increase blood pressure, which can be dangerous for people with hypertension or other heart conditions.
• Fast heart rate : Similarly, stimulants can also increase heart rate, leading to palpitations or a rapid pulse.
• Circulation problem s: Certain nootropics, such as vinpocetine, can affect blood flow and circulation, leading to issues like dizziness, nausea, or headaches.
• Addiction : Some nootropics, such as those containing racetams, have been associated with the potential for addiction or dependence if used long-term.

It’s important to remember that not all nootropics will produce these side effects, and the severity of any reactions will depend on individual factors such as dosage, duration of use, and underlying health conditions. However, it’s always wise to discuss any potential risks with a healthcare professional before starting any new supplement regimen.

Additionally, it’s important to follow dosage instructions carefully and not to exceed recommended amounts, as this can increase the risk of side effects. By being mindful of potential risks and using nootropics responsibly, users can reap the benefits of these supplements without experiencing adverse effects.

Thesis Nootropics Reviews: What Do Customers Think?

At this point in our Thesis nootropics review, it’s time to turn to what customers are saying. So, we sourced testimonials from the brand’s website, Reddit, and ZenMasterWellness. And spoiler alert, the Thesis nootropics reviews we came across have nothing but good things to say.

On takethesis.com , the brand earns 4.4/5 stars out of 7,956 reviews. One patron describes their particular blend as the perfect alternative to prescription meds :

“ I have been off stimulants for months now and these formulas are far superior. My husband and daughter both noticed the change and said I have been more productive, focused, less anxious, and more “thinking outside the box”. I have tried for years to get off stims and nothing would work .”

On Reddit, many reviewers share similar sentiments about how effective the products are. One buyer shares that they tried tons of different nootropics on the market, and Thesis stands out amongst the crowd . 

On ZenMasterWellness, one reviewer states that their blend provided the exact results they were looking for :

“ They offer notable improvements to how well I’m able to focus, stay on task, and grind when it’s time to grind. In practice, this usually looks like a clearer mind and an improved ability to just… chill. With the Clarity and Creativity blends, in particular, I just feel leveled out .”

Backed by clinical trials and real customer experiences, Thesis stands out in the world of nootropics and supplements. The personalized selections prove effective, while the quality ingredients live up to expectations. 

Is Thesis Nootropics Legit?

If you’re wondering if this brand offers products that are too good to be true, this Thesis nootropics review is here to say that it is the real deal .

The brand is backed by numerous clinical trials, which highlight how 86% of customers reported improvements in a wide range of cognitive challenges, while 89% noticed an improvement in their ability to reduce stress and maintain energy.

Is Thesis Nootropics Worth It?

Thesis is an appealing choice in the world of nootropics because it provides a completely customized selection based on your needs and goals. Plus, the ingredients are potent and ensure the best effects—and you only end up paying for the benefits you actually need.

With that in mind, this Thesis nootropics review deems the brand worth the try.

Alternatives

Here are some alternatives to Thesis Nootropics that you might find interesting:

• Mind Lab Pro – This nootropic supplement is designed to improve cognitive function and mental performance. It contains 11 ingredients that work together to enhance memory, focus, and overall brain health.
• Thorne Supplements : If you’re looking for high-quality, science-based supplements, Thorne is a great choice. Their products are designed with the latest research in mind and are rigorously tested for quality and purity. Some of their popular offerings include multivitamins, protein powders, and omega-3 supplements.
• WeAreFeel Supplements : WeAreFeel is a supplement brand that offers a variety of products designed to support different aspects of your health. Their supplements are vegan-friendly and free from artificial colors, flavors, and preservatives. Some of their popular offerings include multivitamins, probiotics, and omega-3 supplements.
• Neuro Gum : If you’re looking for a quick and easy way to boost your focus and energy levels, Neuro Gum is a great option. This gum is infused with caffeine and other natural ingredients that can help improve mental clarity and alertness. Plus, it’s sugar-free and comes in a variety of delicious flavors.
• Neuriva Plus : Neuriva Plus is a brain supplement that’s designed to improve memory, focus, and cognitive performance. It contains a blend of natural ingredients, including coffee fruit extract and phosphatidylserine, that have been shown to support brain health. If you’re looking for a natural way to boost your cognitive function, Neuriva Plus is worth considering.

Thesis Nootropics Promotions & Discounts 

There aren’t currently any Thesis promos or discounts available. That being said, if you subscribe for recurring shipments of your recommended products, you’ll save $40 monthly .

Where to Buy Thesis Nootropics

At the time of this Thesis nootropics review, the products are exclusively available on the brand’s website, takethesis.com .

Is Thesis Nootropics vegan?  

Thesis nootropics are made with only vegan ingredients . That being said, while the brand has taken precautions to protect against cross contamination, the products are not certified vegan.

Is Thesis Nootropics gluten-free? 

On top of being vegan, Thesis products are made without gluten, eggs, or nuts . Again, while the brand strives to protect users against cross contamination, the products are not certified gluten free. 

What is Thesis Nootropics’ Shipping Policy?

If you’re anxiously awaiting your order from this Thesis nootropics review, you’ll be happy to hear that the company offers speedy shipping, sending orders out within 1 business day. After that, packages should arrive within only 1-3 business days . Costs are calculated at checkout.

At this time, Thesis is not able to offer international shipping. This Thesis nootropics review recommends following the brand on social media and signing up for the newsletter to stay up to date with shipping policies. 

What is Thesis Nootropics’ Return Policy?

If you find that your Thesis formula isn’t working out, the company requests that you contact them to make changes and adjustments to ensure you are able to receive the proper help.

If you would still like to make a return, follow these simple steps for a refund:

• Submit your refund request
• Ship the items back within 30 days of the original delivery
• Send an email with your tracking number to the brand
• Return any remaining product in their original packaging to: 

Thesis Returns 902 Broadway

6th Floor New York, NY 

Once your return has been received, a refund will be processed and email confirmation will be sent. It’s also important to note that the brand can only refund one month’s supply per customer and return shipping is the customer’s responsibility. 

How to Contact Thesis Nootropics

We hope you enjoyed this Thesis nootropics review! If you have any further questions about the brand or its products, you can contact them using the following methods:

• Call 1 (646) 647-3599
• Email [email protected]

902 Broadway Floor 6 New York, NY 10010

If you’re looking for other ways to boost your productivity via supplements, check out these other brands we’ve reviewed:

Thorne Supplements Review

WeAreFeel Supplements Review

Neuro Gum Review

Neuriva Plus Review

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Adderall Misuse Rising Among Young Adults

Prescriptions for the stimulant unchanged, but study finds more nonmedical use and emergency room visits among adults.

While the number of prescriptions for the stimulant Adderall has remained unchanged among young adults, misuse and emergency room visits related to the drug have risen dramatically in this group, new Johns Hopkins Bloomberg School of Public Health research suggests.

Anecdotal evidence had suggested the most severe problem of Adderall misuse was among older children and adolescents, but the new research – published Feb. 16 in The Journal of Clinical Psychiatry – finds otherwise. The study examined trends from 2006 through 2011 and found that it is mainly 18-to-25-year-olds who are inappropriately taking Adderall without a prescription, primarily getting the medication from family and friends and without a physician recommendation or prescription.

“The growing problem is among young adults,” says study co-author Ramin Mojtabai, MD, MPH, PhD, a professor of mental health at the Bloomberg School.  “In college, especially, these drugs are used as study-aid medication to help students stay up all night and cram. Our sense is that a sizeable proportion of those who use them believe these medications make them smarter and more capable of studying. We need to educate this group that there could be serious adverse effects from taking these drugs and we don’t know much at all about their long-term health effects.”

Says first author Lian-Yu Chen, MD, who received her PhD in 2014 from the Bloomberg School: “The number of prescriptions for Adderall has fallen and yet we are seeing more medical problems from its use. This suggests that the main driver of misuse and emergency room visits related to the drug is the result of diversion, people taking medication that is legitimately prescribed to someone else. Physicians need to be much more aware of what is happening and take steps to prevent it from continuing.”

Adderall, the brand name for dextroamphetamine-amphetamine, does improve focus, Mojtabai says, but it can also cause sleep disruption and serious cardiovascular side effects, such as high blood pressure and stroke. It also increases the risk for mental health problems, including depression, bipolar disorder and unusual behaviors including aggressive or hostile behavior. There is little research on long-term effects. In 2006, the Food and Drug Administration (FDA) put a black box warning on dextroamphetamine-amphetamine due to cardiovascular risks. It is prescribed for conditions such as attention deficit/hyperactivity disorder and narcolepsy.

For their study, the researchers examined three separate sets of data: the National Survey on Drug Use and Health, a population survey of substance use; the Drug Abuse Warning Network, a survey of emergency department visits; and the National Disease and Therapeutic Index, a survey of office-based practices including prescribing.

They found that in adults, over the six-year study period, treatment visits involving Adderall were unchanged, while non-medical use of Adderall (that is, taking the drug without it being prescribed) rose 67 percent and emergency room visits went up 156 percent. Over the same period, in adolescents, treatment visits involving Adderall went down, nonmedical use was stable and emergency room visits declined by 54 percent. The trends for methylphenidate, sold under the brand name Ritalin among others, and another prescription stimulant prescribed for attention-deficit/hyperactivity disorder, were unchanged over the period.

Meanwhile, the major source for nonmedical use of Adderall was family or friends; two-thirds of those family or friends obtained it by prescription.

The researchers found that of all Adderall nonmedical use, from age 12 and up, 60 percent of it was among 18-to-25-year-olds.

Mojtabai says that from a public health perspective, drugs like Adderall should be monitored in the same way that prescription painkillers have started to be monitored in recent years. He says prescriptions should be entered into a database that a physician could check before writing a prescription to make sure the patient isn’t receiving multiple medications from multiple physicians, a warning sign of diversion or abuse.

He also says it would be helpful to institute informational campaigns for young adults explaining the adverse effects associated with the drug. “Many of these college students think stimulants like Adderall are harmless study aids,” he says. “But there can be serious health risks and they need to be more aware.”

“Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants” was written by Lian-Yu Chen, MD, PhD; Rosa M. Crum, MD, MPH; Eric C. Strain, MD; G. Caleb Alexander, MD, MS; Christopher Kaufmann, MHS; and Ramin Mojtabai, MD, MPH, PhD.

This study was supported by the National Institutes of Health’s National Institute on Drug Abuse (K24 DA023186), the Agency for Healthcare Research and Quality (RO1 HS01899600 and a National Research Service Award (F31AG044052).

Alexander is Chair of the FDA’s Peripheral and Central Nervous System Advisory Committee, serves as a paid consultant to IMS Health, and serves on an IMS Health scientific advisory board. This arrangement has been reviewed and approved by Johns Hopkins University in accordance with its conflict of interest policies. Mojtabai has received consulting fees and research grants from Bristol-Myers Squibb and Lundbeck.

Media contacts for the Johns Hopkins Bloomberg School of Public Health: Stephanie Desmon at 410-955-7619 or  [email protected]  and Barbara Benham at 410-614-6029 or  [email protected] .

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Can Adderall Help Relieve Anxiety?

• Why It Won't Help Anxiety?
• Can It Worsen Anxiety?

ADHD and Depression

• Adderall for Depression

Treatments for Anxiety Disorders and Depression

Attention deficit hyperactivity disorder (ADHD) is often associated with mental health conditions, including depression and anxiety. A 2021 study showed that adults with ADHD were 4 times more likely to also have generalized anxiety disorder (GAD) compared with people without ADHD.

Adderall (amphetamine and dexamphetamine mixed salts) is a commonly prescribed ADHD medication. It can be used in adults and children age 3 years and older.

If you have both ADHD and anxiety, you may want to know if Adderall helps with anxiety. While Adderall may make you feel less anxious due to the relief from ADHD symptoms, Adderall does not directly treat anxiety-related symptoms. In some cases, it can even make it worse.

This article will take a closer look at how Adderall might affect anxiety, the link between ADHD and mental health conditions, and what other treatments may help with anxiety and depression.

Getty Images / Bloomberg  / Contributor

Why Adderall Won't Directly Help With Anxiety

Generalized anxiety disorder is a mental health condition characterized by excessive worrying that interferes with the person's social functioning and enjoyment of life. Anxiety may also cause other symptoms, such as restlessness, tiredness, and trouble concentrating.

ADHD medications , such as Adderall, may help with certain anxiety symptoms, including restlessness and decreased focus.

However, Adderall doesn't treat anxiety. So, you may still have other symptoms of anxiety even after taking Adderall.

How Adderall Works

Adderall is a stimulant medication. This means that it works by activating your central nervous system (CNS) . The CNS is made up of your brain and spinal cord. Adderall and other stimulant drugs increase the amount of the chemicals norepinephrine and dopamine in your brain.

Higher norepinephrine levels in your brain help reduce impulsive behavior and improve focus. Dopamine helps with memory, movement control, and motivation to complete tasks.

ADHD and Anxiety Disorders

There is a strong link between ADHD and anxiety , and research suggests that some childhood symptoms of ADHD may bring on anxiety symptoms later in life. This is because living with unregulated ADHD symptoms can be stressful and, in turn, bring on anxious feelings.

Adderall helps to relieve symptoms of ADHD, such as restlessness or impulsive behavior. As these symptoms improve, you may feel less social anxiety and worry less about your ability to concentrate on essential tasks.

However, Adderall may also worsen anxiety.

Which ADHD Medication Is Best for Anxiety?

While Adderall and other stimulant medications may not be the best option for people with ADHD and anxiety, other non-stimulant drugs may help with ADHD symptoms without worsening anxiety.

Examples of nonstimulant medications used to treat ADHD include:

• Strattera (atomoxetine)
• Intuniv (guanfacine)
• Qelbree (viloxazine)

Although non-stimulants are not considered a first choice for ADHD treatment, studies have shown that Strattera can effectively improve symptoms of both ADHD and anxiety.

If Adderall Does Not Help Anxiety, Can It Make It Worse?

It is possible that Adderall may make anxiety worse. This is because stimulant medications, such as Adderall, may have side effects that resemble symptoms of anxiety.

These include:

• Nervousness
• Trouble sleeping
• Restlessness
• Irritability
• Increased heart rate

If you already have these symptoms, taking Adderall may worsen them.

Why You Shouldn't Stop Taking Adderall Suddenly

If you notice your anxiety symptoms worsening while on Adderall, do not stop taking your medication without first speaking to a healthcare professional.

Adderall is a stimulant that may cause physical dependence if taken long term. With physical dependence, your body needs to have a certain medication or substance to function as usual. If you develop physical dependence on a drug, you may have withdrawal symptoms if you stop taking the drug suddenly.

Stopping Adderall suddenly after you've been taking the medication for a while may cause withdrawal symptoms. These can include:

• Depression or depressed mood
• Fatigue (extreme tiredness)
• Unpleasant dreams
• Sleeping too little or too much
• Increased appetite
• Sluggishness

Due to this risk, you shouldn't stop taking Adderall suddenly.

If you and your healthcare provider decide to stop your Adderall treatment, they'll likely decrease your dosage gradually before you completely stop taking the medication. Doing so can reduce your risk of having withdrawal symptoms after stopping Adderall.

As with anxiety, depression has also been associated with ADHD . Studies have shown that adults with ADHD are more likely to have depression compared with those without ADHD.

Teens with ADHD are also more likely to have depression than teens without ADHD.

Additionally, the risk for developing depression is about 6 times higher during the first year of ADHD diagnosis.

Off-Label Use of Adderall for Depression

For some people, currently approved depression medications may not work well enough to treat their condition. Healthcare providers sometimes refer to this type of depression as treatment-resistant or difficult-to-treat depression.

If two or more different depression medications do not work well enough to relieve depression symptoms or keep them from coming back, healthcare providers may try off-label treatments.

Using medications off-label means prescribing a medication to treat a condition or at a dose different from what the drug was approved to treat.

Stimulant medications, including Adderall, have been used off-label to treat depression that does not improve with antidepressants approved by the Food and Drug Administration (FDA).

When Adderall and other stimulants are prescribed for depression, they are typically used along with an approved antidepressant.

Adderall Precautions

It's important to keep in mind that Adderall can interact with certain antidepressants.

For example, you should not take Adderall along with or within 14 days of stopping an antidepressant called monoamine oxidase inhibitor (MAOI) . Doing so may lead to dangerously high blood pressure that may result in stroke, heart attack, or even death.

Examples of MAOIs include:

• Nardil (phenelzine)
• Parnate (tranylcypromine)
• Marplan (isocarboxazid)

In addition, Adderall should be used cautiously with SSRIs and SNRIs. This is because Adderall, SSRIs, and SNRIs can increase serotonin levels in your body. Taking more than one drug that increases serotonin may cause serotonin to build up in your body. Having very high serotonin levels can lead to a condition called serotonin syndrome .

With serotonin syndrome, you may have symptoms such as:

• Anxiety or restlessness
• Tremor or shivering
• High blood pressure (hypertension) and rapid heartbeat
• Nausea or vomiting
• Problems with coordination

Serotonin syndrome can be fatal if left untreated. Be sure to seek emergency medical attention immediately if you have symptoms of serotonin syndrome while taking Adderall.

Help Is Available

If you or someone you know are having suicidal thoughts, dial  988  to contact the  988 Suicide & Crisis Lifeline  and connect with a trained counselor. If you or a loved one are in immediate danger, call  911 . For more mental health resources, see the  National Helpline Database .

Treatments for anxiety and depression typically involve using a combination of methods. These can include psychotherapy (talk therapy), medication, or both.

Psychotherapy

Cognitive behavioral therapy (CBT) is a type of psychotherapy commonly used to treat both anxiety and depression.

With CBT, you learn to change the way you think, behave, and react to situations in a way that helps improve your depression and anxiety.

Medication for Anxiety and Depression

Sometimes, psychotherapy alone is not enough to treat anxiety and depression. In this case, healthcare providers may prescribe medication along with psychotherapy as part of your treatment.

Medications typically prescribed to treat anxiety include:

• Benzodiazepines, such as Xanax (alprazolam) and Ativan (lorazepam)
• Certain antidepressants, such as Zoloft (sertraline) and Lexapro (escitalopram)

Medications commonly used to treat depression include:

• Selective serotonin reuptake inhibitors (SSRIs), such as Zoloft and Lexapro
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) , such as Cymbalta (duloxetine) and Effexor XR (venlafaxine)
• Wellbutrin (bupropion)

A Word From Verywell

Adderall's effectiveness can vary based on individual responses and factors, including age, heart health, and risk of high blood pressure. It's important to note that Adderall doesn't directly treat anxiety or depression. For individuals with ADHD and anxiety, a combination of approaches such as therapy, medication, or both may be necessary.

Studies have shown that people living with ADHD are more likely to also have depression or an anxiety disorder vs. people who don't have ADHD.

Adderall is a stimulant medication commonly prescribed to treat ADHD in adults and some children. It works by increasing norepinephrine and dopamine in your brain.

Although Adderall may indirectly alleviate some anxiety symptoms, some side effects of the medication may actually make anxiety worse.

In some cases, Adderall can be prescribed off-label to treat depression. However, it is not the first-choice therapy for this condition.

If you have ADHD with another mental health condition, your healthcare provider can tell you more about the best treatment option for your condition.

Fuller-Thomson E, Carrique L, MacNeil A. Generalized anxiety disorder among adults with attention deficit hyperactivity disorder . J Affect Disord . 2022;299:707-714. doi:10.1016/j.jad.2021.10.020.

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Marques A, Marconcin P, Werneck AO, et al. Bidirectional association between physical activity and dopamine across adulthood—a systematic review .  Brain Sciences . 2021;11(7):829. doi:10.3390/brainsci11070829

National Institute of Mental Health. Attention-deficit/hyperactivity disorder in adults: what you need to know .

Nazarova VA, Sokolov AV, Chubarev VN, et al. Treatment of ADHD: drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials .  Front Pharmacol . 2022;13:1066988. doi:10.3389/fphar.2022.1066988

Villas-Boas CB, Chierrito D, Fernandez-Llimos F, et al.  Pharmacological treatment of attention-deficit hyperactivity disorder comorbid with an anxiety disorder: a systematic review . International Clinical Psychopharmacology 2019. 34(2):p 57-64. doi:10.1097/YIC.0000000000000243

Griffiths KR, Leikauf JE, Tsang TW, et al. Response inhibition and emotional cognition improved by atomoxetine in children and adolescents with ADHD: The ACTION randomized controlled trial . Journal of Psychiatric Research. 2018;102:57-64. doi.org/10.1016/j.jpsychires.2018.03.009.

National Institutes of Health. DailyMed. Adderall XR label .

National Institutes of Health. DailyMed. Label: Adderall XR- dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate and amphetamine aspartate capsule, extended release .

Lohr WD, Wanta JW, Baker M, et al. Intentional discontinuation of psychostimulants used to treat ADHD in youth: A review and analysis .  Front Psychiatry . 2021;12:642798. doi:10.3389/fpsyt.2021.642798

Bron TI, Bijlenga D, Verduijn J, et al.  Prevalence of ADHD symptoms across clinical stages of major depressive disorder .  J Affect Disord . 2016;197:29-35. doi:10.1016/j.jad.2016.02.053

Powell V, Riglin L, Hammerton G, et al.  What explains the link between childhood ADHD and adolescent depression? Investigating the role of peer relationships and academic attainment .  Eur Child Adolesc Psychiatry . 2020;29(11):1581-1591. doi:10.1007/s00787-019-01463-w

Riglin L, Leppert B, Dardani C, et al.  ADHD and depression: investigating a causal explanation .  Psychol Med . 2021;51(11):1890-1897. doi:10.1017/S0033291720000665

Voineskos D, Daskalakis ZJ, Blumberger DM.  Management of treatment-resistant depression: challenges and strategies .  NDT . 2020;16:221-234. doi:10.2147/NDT.S198774

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By Rosanna Sutherby, PharmD Rosanna Sutherby, PharmD, is a freelance medical writer and community pharmacist with over 20 years of experience in medication review, counseling, and immunization.

"Adderall is definitely not a drug": justifications for the illegal use of ADHD stimulants

Affiliation.

• 1 Department of Communication, University of Kentucky, Lexington, Kentucky, USA.
• PMID: 20025437
• DOI: 10.3109/10826080902858334

In-depth interviews were conducted in 2007 with 175 undergraduate students (94 males, 81 females, 13 non-Caucasian) at a large, public southeastern research university located in an urban area in the United States. Our primary goal was to identify how these students conceive of Attention Deficit Hyperactivity Disorder (ADHD) stimulants and their illegal use. We discovered that these students frame stimulant use as both physically harmless and morally acceptable. Specifically, these students justify their drug use through the use of four recurring prostimulant arguments: 1) comparison-and-contrast, 2) all-things-in-moderation, 3) self-medicating, and 4) minimization arguments. We discuss limitations to the study and conclude by suggesting five strategies for prevention researchers that would directly target these four arguments.

• Amphetamines / administration & dosage*
• Attention Deficit Disorder with Hyperactivity / drug therapy
• Central Nervous System Stimulants / administration & dosage*
• Health Knowledge, Attitudes, Practice
• Self Administration
• Substance-Related Disorders / prevention & control
• Substance-Related Disorders / psychology*
• Universities
• Amphetamines
• Central Nervous System Stimulants

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Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants

Lisa l weyandt.

Department of Psychology, University of Rhode Island, Kingston, RI, USA

Danielle R Oster

Marisa e marraccini, bergljot gyda gudmundsdottir, bailey a munro, brynheld martinez zavras.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that cause functional impairment. Recent research indicates that symptoms persist into adulthood in the majority of cases, with prevalence estimates of approximately 5% in the school age population and 2.5%–4% in the adult population. Although students with ADHD are at greater risk for academic underachievement and psychosocial problems, increasing numbers of students with ADHD are graduating from high school and pursuing higher education. Stimulant medications are considered the first line of pharmacotherapy for individuals with ADHD, including college students. Although preliminary evidence indicates that prescription stimulants are safe and effective for college students with ADHD when used as prescribed, very few controlled studies have been conducted concerning the efficacy of prescription stimulants with college students. In addition, misuse of prescription stimulants has become a serious problem on college campuses across the US and has been recently documented in other countries as well. The purpose of the present systematic review was to investigate the efficacy of prescription stimulants for adolescents and young adults with ADHD and the nonmedical use and misuse of prescription stimulants. Results revealed that both prostimulant and stimulant medications, including lisdexamfetamine dimesylate, methylphenidate, amphetamines, and mixed-amphetamine salts, are effective at reducing ADHD symptoms in adolescents and adults with ADHD. Findings also suggest that individuals with ADHD may have higher rates of stimulant misuse than individuals without the disorder, and characteristics such as sex, race, use of illicit drugs, and academic performance are associated with misuse of stimulant medications. Results also indicate that individuals both with and without ADHD are more likely to misuse short-acting agents than long-acting agents. These findings have implications for intervention, prevention, and future research.

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that cause functional impairment. 1 Previously, ADHD was believed to be primarily a disorder of childhood that would be outgrown with the onset of puberty. Recent research, however, indicates that symptoms persist into adulthood in the majority of cases, with prevalence estimates of approximately 5% in the school age population and 2.5%–4% in the adult population. 1 – 4 Academic problems are prevalent among children and adolescents with ADHD and are associated with inattention and difficulty remaining seated, following directions, and completing assignments. 5 In addition, children and adolescents with ADHD often demonstrate disruptive, defiant, and hostile behavior. 6 , 7 Given these academic and behavioral difficulties, children and adolescents with ADHD are more likely than their non-ADHD peers to receive lower grades, fall behind academically, receive special education services, repeat grades, and drop out of high school and are less likely to pursue college. 5 , 8 Research suggests, however, that the symptoms of ADHD are often manifested differently in adolescence compared with in childhood. For example, symptoms of hyperactivity tend to decrease in adolescence relative to childhood and instead may be manifested as symptoms of cognitive or internal restlessness. 9 – 11 Adolescents with ADHD, however, continue to demonstrate similar levels of impairment as younger children with ADHD, including academic underachievement and difficulties with peers and social relationships, as well as various high-risk behaviors, including reckless driving and sexual behavior and substance use. 12

Despite these impairments, students with ADHD are increasingly graduating from high school and attending college. 13 However, information is lacking concerning the exact prevalence of ADHD among college students, due to privacy protection for students with disabilities under the Americans with Disabilities Act of 1990 and because many college students who meet diagnostic criteria for ADHD may not have been diagnosed with the disorder. 14 , 15 Therefore, more information is sorely needed regarding the prevalence of the disorder in the college population and its impact on student functioning. Several investigations have examined the prevalence of ADHD and the functioning of college students with ADHD symptomatology, most of which have relied on student self-report. For example, Weyandt et al 16 conducted the first study assessing ADHD symptomatology among college students and found that approximately 2.5%–8.7% of participants reported significant ADHD symptoms, depending on the criteria employed. More recent estimates are similar to those of Weyandt et al, indicating that approximately 2%–10% of college students have significant ADHD symptoms and that approximately 50% of students who receive disability services do so because of ADHD. 15 , 17 – 19

In terms of the academic and psychosocial functioning of college students with ADHD, Norwalk et al 20 found that students with ADHD had greater difficulty with college adjustment and poorer study habits and study skills than students without the disorder. Similarly, Shaw-Zirt et al 21 found that college students with ADHD, matched with non-ADHD peers on age, sex, and grade point average (GPA) (a measure of academic performance), reported poorer academic, social, and emotional adjustment than non-ADHD participants. Other studies have revealed that college students with ADHD tend to have lower GPAs, higher rates of academic probation, and poorer test-taking strategies and are less likely to graduate from college. 2 , 22 – 24 Self-reported psychological distress also appears to be more common among college students with ADHD than among those without the disorder, including poorer self-esteem and increased levels of depression and anxiety. 21 , 25 – 27 Collectively, these findings indicate that students with ADHD and elevated ADHD symptomatology are beset by various challenges in the college environment. To improve the outcomes of college students with ADHD, proper identification of the disorder is crucial so that effective prevention and intervention strategies may be developed and implemented.

Medical and nonmedical use of prescription stimulants

Pharmacotherapy is the primary treatment option for children, adolescents, and adults with ADHD, including college students. 28 , 29 US Food and Drug Administration (FDA)-approved medications for ADHD include 1) stimulants such as methylphenidate (MPH) (eg, Ritalin [Novartis International AG, Basel, Switzerland], Concerta [Janssen Pharmaceuticals Inc., Titusville, NJ, USA]), dextroamphetamine (D-AMP) (eg, Adderall [Shire plc, Dublin, Ireland], Dexedrine [GlaxoSmithKline plc, London, UK]), and lisdexamfetamine dimesylate (LDX) (eg, Vyvanse [Shire Inc., Wayne, PA, USA]), a prostimulant; and 2) nonstimulants (eg, atomoxetine, [Strattera; Eli Lilly and Company, Indianapolis, IN, USA]).

Nonstimulants (eg, atomoxetine) have been demonstrated to be safe and effective for improving ADHD symptoms among children, adolescents, and adults. 30 – 33 Nonstimulants have been found to be effective for individuals who do not respond to stimulants and have also been recommended for treating patients with ADHD who have comorbid substance use disorder (SUD). Nonstimulants, unlike stimulants, primarily affect the norepinephrine neurotransmitter system rather than the dopaminergic system and consequently have a lower potential for abuse than stimulant medications. Stimulant medications, however, remain the first line of pharmacotherapy for individuals with ADHD. 28 , 29 , 32 An extensive body of literature attests that stimulant medication, when used as prescribed, is safe and efficacious for improving attention and decreasing hyperactivity and impulsivity symptoms. 34 – 42 Although individuals with ADHD may greatly benefit from prescription stimulant medication, given their abuse potential when not taken as prescribed, prescription stimulants have been classified as schedule II medications by the FDA. A schedule II classification indicates that although the medication has been approved for medical use, it has a high potential for abuse, which, in turn, may lead to physiological and/or psychological dependence. 43

Numerous studies have documented that the nonmedical use of prescription stimulants, defined here as the use of stimulant medication in the absence of a valid prescription and use of prescription stimulants other than as prescribed, is a growing problem on college campuses, and college students typically report that stimulant medication is easy to obtain on campus. 44 – 52 Indeed, large numbers of students claim to have engaged in the nonmedical use of prescription stimulants, which is reflected in lifetime prevalence rates of prescription stimulant misuse ranging from 5% to nearly 34% of students. 53 , 54 Researchers have speculated that this increase may, in part, be explained by increasing numbers of college students receiving stimulant medication treatment for ADHD who may be distributing their medication to their peers, who may, in turn, misuse it. 44 , 49 Due to the significant health risks associated with the nonmedical use of prescription stimulants, this behavior poses a serious public health issue. 55 Consequently, studies have attempted to elucidate the characteristics of prescription stimulant misuse as well as risk and protective factors associated with this behavior.

The most commonly reported and the most strongly endorsed reason for taking prescription stimulants nonmedically is to improve attention and alertness while studying, taking exams, and writing papers: ie, cognitive and academic enhancement. 44 , 45 , 49 , 52 , 53 Research has also identified several risk factors for stimulant misuse, including demographic variables such as sex, ethnicity, and psychological risk factors, such as depressive symptomatology and symptoms of inattention. The identification of malleable predictors such as the academic and psychosocial functioning of students is particularly important for prevention and intervention strategies for prescription stimulant misuse. 56 – 58

Purpose of the present study

Given the positive association between psychological factors, ADHD symptoms, and the nonmedical use of prescription stimulants, and that college students report misusing stimulants primarily to enhance their cognitive and academic functioning, it is highly plausible that, by doing so, students are trying to compensate for the struggles they encounter in the college environment. In fact, some researchers have hypothesized that college students may be using prescription stimulants nonmedically as a coping strategy to treat ADHD symptoms: ie, to “self-medicate”. 49 , 57 Although preliminary evidence indicates that prescription stimulants are safe and effective for college students with ADHD when used as prescribed, very few controlled studies have been conducted on the efficacy of prescription stimulants for college student functioning specifically. 37 The question that arises, then, is whether the medical use of prescription stimulants leads to reductions in symptoms and improved academic and psychosocial outcomes. Further, is the medical use of prescription stimulants associated with increased nonmedical use of these medications? What is the scope of prescription stimulant misuse among college students? Are certain types of medications associated with greater potential for misuse than others? Answers to these questions will greatly inform both the treatment of ADHD among college students and prevention and intervention efforts aimed at reducing the nonmedical use of prescription stimulants on college campuses.

The present study attempted to answer these questions by conducting a systematic review of the literature concerning studies that investigated 1) the efficacy of prescription stimulants for adolescents and adults, including college students, with ADHD and 2) the nonmedical use and misuse of prescription stimulants.

Search and retrieval

A systematic literature review was conducted according to Okoli and Schabram’s 59 eight-step guide. Accordingly, all researchers were trained in the protocol for searching and identifying relevant articles. Although the first study to identify stimulant misuse was conducted in 2000 by Babcock and Byrne, 46 a substantial number of studies addressing stimulant misuse appeared in 2002. Therefore, we attempted to identify and retrieve all empirical studies published after 2002 that examined the efficacy of stimulants and nonstimulants and stimulant misuse with adolescents and adults. The search and retrieval process included a comprehensive search of the following bibliographic databases: PsycINFO, PsycARTICLES ® , MEDLINE, and ScienceDirect. Keywords and eligibility criteria were established separately for each subject. In order to identify and retrieve empirical studies that examined the efficacy of stimulants among adolescents and adults, the following keywords were used: “efficacy” + “stimulants”, “efficacy” + “Ritalin”, “efficacy” + “Adderall”, “efficacy” + “Concerta”, “ADHD” + “Ritalin”, “ADHD” + “Adderall”, and “ADHD” + “Concerta”. Keywords used to identify research examining the efficacy of nonstimulants and prostimulants among adolescents and adults included the following: “efficacy” + “nonstimulants”, “efficacy” + “Strattera”, “efficacy” + “Vyvanse”, and “efficacy” + “prostimulant”. Finally, keywords used to identify research examining stimulant misuse among adolescents and adults were: “prescription stimulant” + “misuse”, “prescription stimulant” + “illicit”, “methylphenidate” + “misuse”, “methylphenidate” + “illicit”, “prescription stimulants” + “nonmedical”, and “methylphenidate” + “nonmedical”.

Eligibility criteria

Studies for all search subjects were selected for review based on the following criteria.

• The study was published in English.
• The study was published no earlier than 2002.
• The study included a minimum sample size of 20 subjects.
• The study used an original dataset (meta-analyses and reviews were excluded).
• The study was relational, experimental, or quasiexperimental.
• The study could be conducted worldwide.
• The sample included adolescents (ie, participants with a mean age of ≥12 years) and/or adults. Note that studies including both children and adolescents were included if the mean age of participants was ≥12 years. Studies that did not report the participants’ mean age and included samples with a majority of participants aged <12 years were excluded.
• The sample included human subjects only and included no special groups except for persons with ADHD and learning disabilities.
• The study used only FDA-approved medication for ADHD.
• Eligibility criteria were established specifically for research examining the efficacy of stimulants, prostimulants, and nonstimulants.
• The sample included a control group (guanfacine studies were excluded, as well as studies examining efficacy of nicotinic agonists).

The search process resulted in identifying 2,103 sources, of which 76 met eligibility criteria. Specifically, nine studies examined the efficacy of LDX, 14 explored the efficacy of MPH, three assessed the efficacy of amphetamine (AMPH), three explored the efficacy of both MPH and AMPH in adolescents and adults, and 47 examined stimulant misuse among adolescents and adults. Although included in the initial search process, no studies examining the efficacy of nonstimulants met eligibility criteria for the present review.

Efficacy of prostimulants for adolescents and adults

As seen in Table 1 , all of the included studies (n=9) demonstrated a significant improvement in the measured outcomes from LDX compared with placebo. Six of the nine included studies reported effect sizes, all of which (based on Cohen’s estimates of small, medium, and large) reported medium to large LDX-related effects for improvement in ADHD and related symptoms. 35 , 37 , 60 – 64 Although the majority of studies examined LDX effects among adults, only one study examined its efficacy among a sample of adolescents. Specifically, Findling et al 65 reported that at varying doses (30, 50, and 70 mg/day), LDX was more effective at treating ADHD than placebo. Regarding adults with ADHD, improvements from LDX have been reported for quality of life, performance productivity, and executive function. 35 , 64 , 66 Large effects from LDX on improved executive function were also demonstrated in college students with and without ADHD. 37 Furthermore, LDX was associated with reduced ADHD symptoms compared with placebo in a sample of college students and two different samples of adults. 37 , 61 , 62 Although higher doses of LDX related to greater improvement in the reduction of ADHD symptoms in two studies, in one study differences between doses were not observed. 37 , 61 , 62 The maintenance of efficacy of LDX compared with placebo during a 2-week randomized withdrawal phase was also demonstrated to be effective in a sample of adults with ADHD. 67 Finally, findings suggest that LDX may be effective for treating individuals with comorbid ADHD and depression or SUD and in reducing ADHD symptoms. 63

Studies investigating the efficacy of lisdexamfetamine dimesylate (LDX) for adolescents and adults (N=9)

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; ADHD-RS, ADHD Rating Scale; ADHD-RS-IV, ADHD Rating Scale IV; AIM-A, ADHD Impact Module for Adults; BRIEF-A, Behavior Rating Inventory of Executive Function-Adults; CGI-I, Clinical Global Impression-Improvement; CGI-S, Clinical Global Impression-Severity; CI, confidence interval; d , Cohen’s d ; EF, executive function; GEC, Global Exeuctive Composite; LDX, lisdexamfetamine dimesylate; PERMP-A, Permanent Product Measure of Performance-Attempted; PERMP-C, Permanent Product Measure of Performance-Correct; YQOL-R, Youth QOL-Research Version.

The most common side effects reported by participants in studies investigating the efficacy of LDX included a decreased appetite, weight loss, dry mouth, insomnia, nausea, diarrhea, dizziness, headache, nasal congestion, feeling jittery, and anxiety. Mild to moderate adverse treatment-related effects were generally reported by 5% or fewer treatment group participants and included insomnia, tachycardia, irritability, fatigue, increased blood pressure/hypertension, upper respiratory tract infections, anxiety, decreased libido, and dyspnea. No deaths were reported in any of the studies. The results of most LDX studies led to the conclusion that the drug has a safety profile consistent with previous studies and other long-acting stimulants.

Efficacy of MPH and AMPH for adolescents and adults

Although research examining the efficacy of LDX is in its early stages, numerous studies have examined the efficacy of MPH, AMPH, and mixed amphetamine salts (MAS). The included research studies examined the effects of these stimulants among samples of adolescents (n=5), one of which also included children, and adults (n=15) (see Table 2 ). The vast majority of studies (n=14) specifically examined the effects of some form of MPH, whereas three studies examined MAS, and the remaining studies (n=3) examined a combination of MPH and MAS or AMPH. Regardless of the medication examined, all of the included studies reported statistically significant positive effects for stimulant medication compared with placebo, and effect sizes ranging from small to large based on Cohen’s estimates of effect size. 60 A total of 14 out of 20 included studies reported effect sizes. Of the studies reporting effect sizes for positive effects from stimulant medication, most effect sizes ranged from medium to large, with two studies reporting small to medium effects. 40 , 68 – 77 One study reported effect sizes regarding the interaction effects of differences between sex and medication dose, with no significant interactions found. Effect sizes ranged from very small (partial η2 as low as 0.00) to small. 78

Studies investigating the efficacy of methylphenidate (MPH) and/or amphetamine for adolescents and adults (N=20)

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; ADHD-RS, ADHD Rating Scale; ADHD-RS-IV, ADHD Rating Scale IV; AIM-A, ADHD Impact Module for Adults; CAARS, Conners’ Adult Attention Deficit Disorder Scale; CAARS:S:L, Conners’ Adult ADHD Rating Scale: Self-report: Long; CGI-I, Clinical Global Impression-Improvement; CGI-S, Clinical Global Impression-Severity; CI, confidence interval; d , Cohen’s d ; d-MPH-ER, dexmethylphenidate extended release; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; OROS, osmotic release oral system; MAS, mixed amphetamine salts; MAS-ER, mixed amphetamine salts extended release; MLR, multilayer release; MPH, methylphenidate; MPD-ER, methylphenidate extended release; MPH-LA, methylphenidate long acting; QOL, quality of life; SADS-E, Schedule for Affective Disorders and Schizophrenia - Epidemiologic version; SDS, Sheehan Disability Scale; SCID-I, Structural Clinical Interview for DSM-IV; se-AMPH-ER, extended-release amphetamine salts; TOVA, test of variables of attention; WRAADDS, Wender–Reimherr Adult Attention Deficit Disorder Scale; XR, extended release.

Studies assessing the effects of MPH, dextroamphetamine extended release (d-MPH-ER), MPH long-acting or extended release (MPH-ER), multilayer-release MPH, and MAS, including triple-bead MAS and MAS extended release (MAS-ER), have demonstrated reductions in ADHD symptoms among adult samples. 34 , 40 , 69 – 72 , 74 – 76 , 79 – 82 For example, Biederman et al 83 reported that adults with ADHD taking osmotic release oral system (OROS)-MPH, compared with those taking a placebo, demonstrated reduced symptoms of inattention and hyperactivity/impulsivity specifically. Adolescents taking MAS-ER and MPH-ER have also been shown to demonstrate reduced ADHD symptoms. 73 , 84

Regarding the effective dose for improvements in ADHD symptoms, doses of MPH-ER of 36–108 mg/day and 40–80 mg/day have been shown to be effective. 34 , 40 Similarly, two studies reported that higher doses of MPH-ER and d-MPH-ER were more effective than lower doses at reducing ADHD symptoms among adults with ADHD. 70 , 74 Among adolescents, higher doses, compared with lower doses, of d-MPH-ER and MAS-ER have also been shown to relate to improvement of ADHD symptoms. 75 Rösler et al, 76 however, reported that even at low to moderate doses (10–60 mg/day), MPH-ER was effective at reducing ADHD symptoms and that these effects were sustained during a 24-week follow-up.

In addition to ADHD symptoms, studies have shown that MPH and MPH-ER may improve cognition and emotional symptoms, and triple-bead MAS may enhance executive functions and quality of life among adults. 68 , 77 , 81 For example, Rösler et al 77 reported on a multicenter 24-week study and found that among a sample of adults with ADHD, taking MPH-ER was associated with improvement in emotional symptoms, obsessive–compulsive symptoms, and problems with self-concept. Among adolescents, one study reported that within a sample of 35 adolescents, those taking either OROS-MPH or amphetamine extended release (AMPH-ER) (Adderall XR) demonstrated improved neuropsychological functioning compared with those taking placebo. 85 Finally, MPH-ER and AMPH-ER have been demonstrated to be equally effective at improving symptoms among male and female adolescents with ADHD. 78

Regarding side effects in studies investigating the efficacy of D-AMP and MPH, participants most commonly reported decreased appetite, weight loss, headache, insomnia, abdominal pain, dizziness, nervousness, emotional lability, and dry mouth. Approximately half of the studies (n=12) found that a majority of participants reported at least one side effect; however, mild to moderate adverse treatment-related effects were generally reported by ≤5% treatment group participants and included decreased weight, insomnia, tachycardia, palpitation, irritability, fatigue, increased blood pressure/hypertension, and anxiety. No deaths were reported in any of the studies. The results of most stimulant studies led to the conclusion that the drug has a safety profile consistent with previous research. 86

Stimulant misuse among adolescents and adults

The efficacy of prescription stimulants among adolescents and adults with ADHD has been well documented, but the effects of these medications among populations without ADHD are unclear. Despite a lack of empirical evidence of stimulant effectiveness in individuals without ADHD, numerous studies have documented the misuse of prescription stimulants among college students without the disorder. Indeed, the present review retrieved more research studies pertaining to stimulant misuse (n=47) than the combined number of included studies assessing the efficacy of LDX, MPH, AMP, and MAS combined (see Table 3 ). The primary foci of the retrieved studies examining stimulant misuse varied. For example, some studies reported on prevalence rate estimates, others examined characteristics of individuals most susceptible to stimulant misuse, and others reported primarily on student opinions, such as ethical implications of stimulant misuse. Most of the studies, however, reported on some combination of these factors. Therefore, a systematic assessment and inclusion of effect sizes was beyond the scope of the present article.

Illicit stimulant use and misuse by adolescents and adults (n=47)

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; GPA, grade point average; LA, long acting; MPH, methylphenidate; OROS, osmotic release oral system; PCP, primary care physician; SD, standard deviation; UPPS-P, urgency, premeditation, perseverance, sensation seeking, and positive urgency; XR, extended release.

The studies reviewed indicate that prescription stimulant misuse is a growing problem across adolescent and adult populations. Estimates of lifetime prevalence range from 7.1% to 29% among adults, 5.3% to 55% among college students, and 1.7% to 4.5% among adolescents. 53 , 87 – 92 Although estimates of stimulant misuse prevalence appear to be relatively low among general adolescent samples, estimates of stimulant misuse among adolescents using other substances (23%–31%) and among adolescents and adults receiving treatment for ADHD (14%) are much higher. 91 – 97 Estimates of lifetime stimulant misuse also appear to increase as adolescents reach higher grade levels. For example, among high school seniors, McCabe and West 98 reported that nearly 10% admitted to using prescription stimulants nonmedically at least once. Similarly, lifetime prevalence estimates in college have been shown to grow as students reach their final years of school. Garnier-Dykstra et al 56 reported that although only 13.3% of first year students reported stimulant misuse, by their fourth year 31% reported misuse.

In addition to college level, lifetime estimates of stimulant misuse may vary according to several other variables. For example, prevalence of stimulant misuse specifically for cognitive enhancement was estimated to be <2% in a sample of preuniversity (students preparing to attend university) and university students in Germany, but prevalence estimates of stimulant misuse for the purpose of weight loss has been reported to be nearly 12%. 99 , 100 Studies assessing stimulant misuse among general samples of college students have reported rates between approximately 8% and 34%. 54 , 101 , 102 Much higher estimates of stimulant misuse have been reported among samples of college students with ADHD (43%) or with prescriptions for stimulant medication (45.2%). The highest estimates of prevalence of stimulant misuse among college students (55%), however, have been reported among a sample of fraternity members. 90 , 103 , 104

Among medical students, lifetime prevalence estimates for engaging in prescription stimulant misuse have ranged between 9%–10% and 18%. 105 – 107 Moderate lifetime prevalence estimates of stimulant misuse have also been reported among undergraduate and graduate health care students (11%), dental and dental hygiene students (12.4%), and general samples including both undergraduate and graduate students (16.2%–17.5%). 50 , 108 – 110

Compared with adolescents and college students, very few studies have addressed prevalence estimates of stimulant misuse among adults aged ≥18 years outside of the university setting. Novak et al 87 reported that 2% of the 4,297 adults sampled indicated that they had engaged in nonmedical use of ADHD medications in the past year and 7.1% in their lifetime. Pilkinton and Cannatella 88 reported similar rates (7.1%) for lifetime prevalence estimates among a sample of both adolescents and adults. However, estimates of stimulant misuse prevalence among adults with prescriptions for stimulant medications have yielded much higher rates (29%), similar to adolescent populations. 89 Finally, Lensing et al 111 explored physician and adult patient agreement regarding prescription stimulant misuse and diversion and found that <1% of physicians suspected their patients of diversion and <2% of the adults themselves reported diversion of prescription stimulants, yielding a high level of agreement between the two.

Studies examining characteristics of students engaging in stimulant misuse have yielded relatively consistent findings regarding sex and race/ethnicity. Although multiple studies reported that male students have indicated higher rates of lifetime stimulant misuse than female students in university settings, several studies have also failed to find differences between males and females among college students and high school senior students. 44 , 52 , 98 , 99 , 101 , 105 , 107 , 110 , 112 These conflicting findings may be due to differences in measurement. For example, although Franke et al 99 reported sex differences in lifetime prevalence of stimulant misuse for cognitive enhancement, the researchers did not find differences across males and females in past year or past month stimulant misuse. On the other hand, the vast majority of studies examining racial and ethnic differences related to stimulant misuse have reported that young adults, college students, and adults who are white are more likely to misuse stimulants than students of other races and ethnicities. 49 , 53 , 88 , 91 , 98 , 99 , 101 , 113 Only one study reported that there were no differences in ethnicity regarding prevalence of stimulant misuse; however, <12% (n=37) of the study’s sample included students of color, limiting statistical power and thus conclusions regarding differences in prevalence among ethnic differences. 52

Interestingly, studies examining characteristics of adolescents who partake in nonmedical stimulant use indicate that students without plans to attend college have been shown to report a higher prevalence of stimulant misuse than those who plan to attend college, and adolescents who report prescription stimulant misuse may be less likely to attend school. 94 , 96 However, college students appear to be particularly vulnerable to stimulant misuse, and members of fraternities and sororities have reported higher rates of misuse than students unaffiliated with Greek organizations. 47 , 101 , 114 One of the reviewed studies found that college students who are upper classmen or live off-campus may be more likely to engage in nonmedical stimulant use. 90 Additional correlates of stimulant misuse among college students have included affiliation with a Jewish religion, perceiving stimulant use as normative, and engaging in problematic weight loss strategies. 100 , 101 , 115 Weight loss, however, may not be unique to college students, as adolescent prescription stimulant misusers have been found to be more likely to have an eating disorder than students who did not misuse stimulants. 96 Finally, all types of students (adolescents, adults, and medical) performing worse academically appear to be more likely to engage in nonmedical prescription stimulant use. 56 , 99 , 101 , 105 Indeed, this review found that the most commonly reported reasons university students take prescription stimulants are related to academics, and studies suggest that during periods of high academic stress, college students may be more likely to use prescription stimulants, as indicated by self-report measures and by measurements of stimulant levels in campus wastewater samples. 49 , 54 , 56 , 105 , 108 , 110 , 113 , 115

It is not surprising, then, that procrastination and difficulty with time management have also been shown to relate to stimulant misuse among college students. 115 Further, stimulant misuse among college students has been shown to relate to higher levels of hyperactivity, sensation seeking, depression, internal restlessness, and psychological distress and lower levels of premeditation. 44 , 58 , 104 , 114 , 116 ADHD diagnoses and symptoms may also relate to stimulant misuse. Adolescents, college students, and adults diagnosed with ADHD have reported higher levels of prescription stimulant misuse than students without ADHD, and ADHD symptoms have been shown to correlate with nonmedical use of prescription stimulants. 57 , 84 , 95 , 117 It is important to note, however, that studies suggest that the vast majority of individuals with ADHD do not misuse or divert their stimulant medications. 84

The studies included in the present review also indicate that in addition to ADHD, diagnoses of conduct disorder and SUD are associated with increased nonmedical prescription stimulant use and diversion in adolescents and adults. 84 Illicit drug use among adolescent and university students is also associated with misuse of prescription stimulants. 52 , 56 , 90 , 91 , 93 , 98 , 101 , 103 , 104 , 107 , 115 , 118 , 119

Several studies in the current review assessed student perspectives on prescription stimulant misuse, and findings revealed that students’ opinions on the ethical implications of taking illicit prescription stimulant medications to enhance academic outcomes are mixed. For example, Bossaer et al 108 reported that health care students were split between considering stimulant misuse to be academically dishonest and proffering unfair academic advantages. Similarly, half of the medical students sampled by Emanuel et al 107 perceived stimulant misuse to be a problem, but 20% did not. Students who report engaging in stimulant misuse, however, may feel less conflicted regarding ethical implications. For example, Judson and Langdon 48 reported that compared with nonillicit users, illicit users demonstrated fewer concerns regarding the safety and ethics of using stimulant medication.

Whether or not students consider their decision to engage in stimulant misuse to be ethical, students misusing stimulants appear to expect positive outcomes. 107 , 116 Indeed, students who have reported taking stimulant medications illicitly have endorsed feeling a reduction in fatigue and improvement in cognition and memory after taking prescription stimulants. 54 The present findings also indicate that students who misuse tend to perceive the benefits as outweighing the risks, despite the fact that little is known about the physiological and cognitive effects of prescription stimulant medications among populations without ADHD. 49 Two of the reviewed studies suggest that individuals misusing stimulants may be more likely to take short-acting agents than long-acting agents. Wilens et al 84 and Bright, 97 for example, reported that adolescents and adults were more likely to misuse short-acting agents than long-acting agents, suggesting that immediate-release agents have more potential for abuse. Results were mixed regarding the most commonly misused fast-acting stimulant, with Ritalin (MPH) more likely to be misused than Adderall among adults, but nearly 12% of college students reported misusing Adderall compared with 8.5% misusing Ritalin. 88 , 115

Effectiveness of ADHD treatment options

Studies included in this review revealed that the medical use of prescription stimulants is efficacious in reducing ADHD symptoms and may improve cognitive and psychosocial outcomes in individuals diagnosed with ADHD. Specifically, research investigating LDX in comparison with placebo consistently found LDX efficacious across 30, 50, and 70 mg/day. Two studies, however, found that higher doses related to greater improvements in overall functioning. 37 , 62 Most notably, the present findings support that LDX is effective for reducing ADHD symptomatology across different ages. 37 , 61 , 62 Among adults with ADHD, LDX was also found to positively affect executive functions, quality of life, and performance productivity. 35 , 64 , 66 Additionally, LDX has been found to be effective in reducing ADHD symptoms with individuals with comorbid depression and SUD. 63 Although these results are encouraging, it is important to note that most studies did report negative side effects from LDX, such as decreased appetite, weight loss, and nasal congestion. More severe side effects, however, including tachycardia, increased blood pressure/hypertension, and anxiety, were reported by <5% of the included study samples, and no individuals died while participating in these studies.

Similar to those investigating LDX, studies examining the efficacy of MPH and D-AMP consistently found such treatment options to be associated with fewer ADHD symptoms compared with placebo. These positive effects were found among long-acting and short-acting stimulant medications, and one study reported similar effects for both males and females. 78 Although higher doses generally proved to be more effective at reducing ADHD symptoms, low to moderate doses of stimulants may also be effective at reducing ADHD symptomatology. 70 , 74 , 76 Such treatment options examined in this review were associated with enhanced cognitive performance, executive functioning, and quality of life and fewer emotional symptoms. 68 , 77 , 81 Although MPH and D-AMP have proved to be efficacious in treating ADHD symptomatology, it is important to consider their side effects that are similar to LDX: decreased appetite, weight loss, headache, insomnia, abdominal pain, dizziness, nervousness, emotional lability, and dry mouth. Although rare, more severe side effects of these medications have included psychosis, seizures, and cardiac events such as tachycardia, hypertension, myocardial infarction, and sudden death. 120

Overall, however, these results are consistent with the child literature indicating that prostimulant and stimulant medications, when used as prescribed, are a safe and efficacious treatment option for improving attention and decreasing hyperactivity and impulsivity symptoms. 23 , 34 – 38 , 40 – 42 What remains less clear, however, is whether these medications affect academic and work-related outcomes of adolescents and adults without ADHD. Although one study reported improvements in measured cognition from MPH and another found that students who misuse stimulant medication perceive positive academic effects, 54 , 68 none of the studies included in the present review examined changes in quality of work or student grade or productivity after taking stimulant medications. Given that cognitive enhancement-related reasons are considered the primary motivation for college students misusing prescription stimulant medications, future research examining the effects of prescription stimulants on direct measures of academic success (eg, studying and concentration, grade performance, quality of writing, and reading comprehension) is warranted.

An additional area that warrants attention concerns the efficacy of nonstimulant medication for the reduction of ADHD symptoms and any potential effects for cognitive enhancement. The present review was unable to identify any studies examining nonstimulant efficacy among adults and adolescents meeting the required eligibility criteria. Given the lower abuse potential associated with nonstimulant medication, use of these medications among populations more susceptible to diversion and misuse may be prudent. 32 Such a recommendation, however, is contingent on a demonstration of the efficacy of nonstimulants among adolescent and adult populations most at risk for stimulant abuse. 32

Finally, although prescription stimulant medication is considered the front line of pharmacotherapy for ADHD treatment in adolescents and adults, these drugs have significant diversion and misuse potential. 43 In fact, the present review revealed that the medical use of prescription stimulants is associated with increased stimulant misuse among students with ADHD, with one study reporting misuse rates of 62.8% among participants with a valid prescription. 104

Stimulant misuse

Results from the present review indicate that a significant percentage of adolescents and adults are engaging in nonmedical stimulant misuse, which is consistent with previous research examining college students specifically. 45 Results revealed lifetime prevalence rates of stimulant misuse ranging from 1.7% to 55%, with reports varying across the population being examined. 90 , 91 A limitation of this body of literature is the dearth of studies investigating the prevalence of prescription stimulant misuse among college students outside of the US, which impedes cross-cultural comparisons regarding prescription stimulant misuse.

Similar to previous studies examining the nonmedical use of stimulants, the present review revealed that estimates vary according to numerous variables. For example, one trend that has emerged is that as individuals reach higher grade levels, they misuse at greater rates. 56 , 98 Although increased exposure to prescription stimulants may be one reason students report higher prevalence rates of stimulants as they increase in age, these findings suggest that prescription stimulants may also be misused more frequently as coursework becomes more challenging and academic success becomes more difficult to obtain. Indeed, as indicated in this review, academic performance has been reported as the primary motive for this behavior. A critical finding, however, is that prescription stimulant misuse has been found to be negatively associated with academic performance. 44 , 90 , 101 For example, Arria et al 121 reported that college freshmen who used prescription stimulants nonmedically had poorer study skills (eg, skipped classes more often and spent less time studying and more time socializing) and poorer academic performance (GPA) in high school and college than students who did not endorse stimulant misuse. 51

Despite the negative relationship between academic performance and stimulant misuse, most students who endorse the nonmedical use of stimulants perceive them as effective and helpful for enhancing their academic performance. 49 For example, Weyandt et al 44 found that >20% of students in their sample agreed or strongly agreed that the occasional nonmedical use of prescription stimulants is harmless. Additionally, stimulant misusers may be less concerned about the safety and ethical implications of stimulant misuse compared with students who do not misuse stimulants. 48 Findings suggest, however, that general student populations are conflicted about the ethical implications of stimulant misuse.

Although individuals without ADHD have endorsed positive effects from misusing stimulant medication, to date only one study has explored the effects of Adderall on college students without ADHD, and this study, in general, did not find enhancement of cognitive abilities, despite the students’ impression that it was improving their performance. 122 Similar performance-enhancing impressions have been made of MPH, and have led to the popularity of its use among adolescents and college students with and without ADHD. 123 In addition, the present review suggests that adolescents and adults are more likely to misuse short-acting or immediate-release agents compared with long-acting agents. 84 , 97 Consistent with previous studies, the present review suggests that students who are white, affiliated with a fraternity or sorority, engaging in other illicit drugs, and male, are more likely to misuse prescription stimulants. 47 , 49 , 56 , 57 , 84 , 89 , 92 , 94 , 96 , 101 , 102 , 113 , 118 , 124 Although some of the studies reported no sex differences, recently Weyandt et al 45 reported on the effect sizes of sex differences in studies examining stimulant misuse. Cohen’s d effects ranged from 0.88 to 5.38, suggesting that males are misusing at greater rates than females. 109 , 110 , 125

Implications

Pharmacotherapy is the principal choice of treatment for ADHD among children, adolescents, college students, and adults. 28 , 29 Because stimulants are the most frequently prescribed drug for college students with ADHD, and most college students with ADHD take prescription stimulants, more double-blind, placebo-controlled studies examining the effectiveness of these medications in college students are warranted. 22 It is important to note, however, that there is recent evidence that prostimulants may also be effective at improving symptoms in individuals with ADHD. 28

The present review provides evidence that college students with ADHD and those with a stimulant prescription are taking part in greater levels of stimulant misuse compared with those without the disorder. 103 , 104 Although individuals with ADHD may greatly benefit from stimulant medication, these prescription medications have significant abuse potential when they are not used as prescribed. 43 All prescription stimulants that are used to treat ADHD are controlled substances; however, abuse liability varies based on the delivery system in which the medication activates. 126 For example, Svetlov et al 123 reported that although MPH and AMPH have similar psychopharmacological effects, they do have different neurochemical mechanisms of action. Such differences are essential to consider, as MPH appears to have less rewarding abilities, lowering its chances of dependence, especially when taken as prescribed. A second example includes the requirement of enzymatic hydrolysis for LDX before its therapeutic effects are achieved, which results in a slow increase of D-AMP levels, potentially lowering its use for diversion or misuse. 37 , 127 Indeed, recent research has examined the effects of LDX in a group of stimulant abusers who did not have ADHD, and found that intravenous doses of LDX had greater abuse-related disliking compared with placebo. 127 Specifically, Jasinski and Krishnan 127 administered 100 mg of LDX and 40 mg of D-AMP to individuals, also reporting that intravenous doses of D-AMP have significantly more abuse-related liking effects compared with placebo. Additionally, because of its chemical properties, LDX cannot be ground or dissolved into a short-acting stimulant, which has been the stimulant of choice for stimulant misusers. Given the demonstrated effects of LDX on improving ADHD symptomology, as well as executive function, and its demonstrated greater abuse-related disliking, LDX may be the ADHD medication of choice for college students with ADHD who are at risk for stimulant misuse. 37 , 127 LDX may also be a good choice for prescribers working with the college student population to help prevent stimulant diversion among valid prescription holders and misuse among college students without ADHD. Results of this review also suggest that health care providers should inform their patients of the health and legal risks associated with the misuse of prescription medications, and monitor the use of these medications on a frequent basis. Lastly, health care providers involved in prescribing ADHD-related medications should be thoroughly trained in the proper assessment, diagnosis, and treatment of ADHD to ensure diagnostic accuracy and treatment effectiveness.

In addition to educating prescribers about the rates of misuse and diversion, as well as the variables associated with stimulant misuse, it is critical that prevention and intervention efforts be made amongst health care providers and educators at the middle school, high school, and higher education levels. Further efforts should target particularly higher-risk college populations such as fraternities and sororities. Information regarding the potential side effects of stimulant medications taken at varying doses and by different methods (eg, snorting or injecting), in addition to side effects resulting from the ingestion of medication as prescribed, should be made available to students in particular. Students should also be informed of the dangers of coingestion of prescription stimulants with other substances (eg, alcohol and cocaine), and particular emphasis should be placed on maintaining security of their medication (eg, lockboxes). Students who are misusing prescription stimulants without medical guidance are placing themselves at health and psychological risk, in addition to legal consequences for buying, selling, and diverting their medications. 120

The inclusion of a psychoeducational component that focuses on inaccurate perceptions of safety surrounding nonmedical prescription stimulant use would be beneficial to intervention as well. Students who are at risk for stimulant misuse with academic problems can be provided with various support, such as tutoring and structured environments for studying and work completion. This additional support may encourage a school culture of clear expectations, educational support, and effective study habits, rather than competitiveness. For individuals who have been misusing stimulants or are inclined to misuse, it is imperative to discuss the motivating factors and determine any possibly undiscovered psychological, social, and/or emotional problems related to misuse or the desire to misuse. By pinpointing and addressing the core cause of stimulant use, students can be provided with the resources that will directly provide them with benefits and alternative methods to meet their specific needs. Thus, students should be educated about the potential side effects and risks associated with prescription stimulant misuse, as well as encouraged to access campus resources for academic and psychological support. 45 , 47

Results from the present review support that both stimulant and prostimulant medications (including LDX, MPH, AMPH, and MAS), when used as prescribed, are safe and effective options for reducing ADHD symptoms in adolescents and adults with ADHD. Preliminary studies also suggest that prescription stimulants may improve psychosocial outcomes (eg, quality of life, self-concept, and obsessive– compulsive symptoms) for those with ADHD. Research explicitly examining effects of prescription stimulants on academic and cognitive functioning in students without ADHD is sorely limited, yet the current review revealed that alarmingly high percentages of adolescents and adults are engaging in nonmedical prescription stimulant use primarily for cognitive enhancement. Results of the present review also revealed a higher rate of prescription stimulant misuse among individuals with ADHD compared with individuals without the disorder, and that short-acting agents are more likely to be misused than long-acting agents. These findings emphasize the need for additional research concerning the misuse of prescription stimulants and have direct implications for prevention and intervention efforts to reduce prescription stimulant misuse among adolescents and young adults.

Acknowledgments

Research reported in this publication was supported by the National Center for Research Resources of the National Institutes of Health under Award Number G20RR030883. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors report no conflicts of interest in this work.

Adderall: 7 things you should know

Medically reviewed by Carmen Pope, BPharm . Last updated on April 4, 2023.

1. How it works

• Adderall is a combination of four different amphetamine salts: dextroamphetamine saccharate, dextroamphetamine sulfate, amphetamine aspartate, and amphetamine sulfate.
• Experts aren't sure exactly how Adderall works in Attention Deficit Hyperactivity Disorder (ADHD) but suggest it blocks the reuptake of the neurotransmitters, dopamine, and norepinephrine, which increases their concentration in the neuronal synapse (the space between two nerves).
• Adderall belongs to the group of medicines known as central nervous system (CNS) stimulants.
• Used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) to increase attention and decrease hyperactivity and impulsiveness.
• May be given to increase alertness in people with the sleep disorder, narcolepsy.
• When given for ADHD, Adderall should be used in conjunction with other treatment options, such as psychotherapy, education about the disorder, and social integration advice.
• FDA approved for children over the age of three.
• Adderall is available as a generic under the name mixed amphetamine salts (which may be abbreviated to MAS or M. amphet salts).

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Insomnia (inability to sleep), headache, dry mouth, loss of appetite, nervousness, and nausea are the most common side effects.
• May also cause heart palpitations, constipation and other GI disturbances, weight loss, changes in libido, alopecia (hair loss), elevated blood pressure and muscle twitching, stiffness, or tightness.
• High potential for dependence especially when administered for long periods of time.
• High potential for abuse. May be sought after by drug abusers or people with addiction disorders. Misuse may cause sudden death or cardiovascular events. Overdosage has resulted in psychosis which is indistinguishable from schizophrenia.
• May exacerbate pre-existing psychiatric disorders such as bipolar disorder, psychotic disorder, or mania; and increase anxiety, tension, and agitation.
• May impair judgment or reaction skills; exercise caution before driving or operating machinery until the full effects of Adderall are known.
• Reports indicate some temporary slowing of growth may occur when regular Adderall is given to children aged 7 through 10 years. Doctors should monitor height and weight and consider treatment interruption if growth suppression is suspected.
• May increase the risk of seizures and peripheral circulatory problems and cause visual problems.
• May not be suitable for people with certain heart conditions, as the risk of sudden death is increased even with usual dosages. May also not be suitable for people with thyroid disease, glaucoma, psychiatric disease, a history of drug abuse or agitation, a tic disorder, seizures, liver or kidney disease, or circulation problems.
• May interact with a number of other drugs including other antidepressants, medications used to treat heart disease, blood thinners, decongestants, tramadol, and proton pump inhibitors.
• Interaction or overdosage may cause serotonin syndrome (symptoms include mental status changes [such as agitation, hallucinations, coma, delirium]), fast heart rate, dizziness, flushing, muscle tremor or rigidity, and stomach symptoms (including nausea, vomiting, and diarrhea).
• Extreme fatigue and depression have been reported when Adderall has been stopped suddenly, particularly in those who have been taking more than the recommended dose.
• Rare cases of priapism (painful erections more than 6 hours in duration) have been reported.
• Adderall should not be used during pregnancy unless the potential benefit justifies the risk. There are no well-controlled studies investigating its use in humans during pregnancy. Case reports document severe congenital bone deformity and other birth defects; animal studies have reported long-term neurochemical and behavioral alterations in pups exposed to amphetamines in utero.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Adderall is a combination of four different amphetamine salts and may be used to improve attention, focus, or reduce impulsive behaviors in children over the age of 3 and adults with ADHD. It can also be used to treat narcolepsy. Adderall is potentially addictive and can cause insomnia.

• Take in the morning if using once daily. If using twice daily, avoid late evening dosages to reduce the risk of insomnia.
• May be taken with or without food.
• Take exactly as directed by your doctor and never increase the dosage without his or her advice.
• Ensure your child partakes in other psychological, educational, or social treatment measures as recommended by your doctor as these are also an important part of ADHD treatment.
• Do not suddenly stop taking Adderall, unless it is an emergency. Sudden discontinuation may precipitate a withdrawal reaction. Symptoms include extreme tiredness, depression, or agitation.
• Seek medical advice if symptoms persist or worsen despite treatment, or if psychotic symptoms (such as hearing voices or signs of paranoia) or hallucinations develop.
• Seek urgent medical help if you experience chest pain, shortness of breath, or fainting while taking Adderall or other worrying symptoms such as unexplained nausea or vomiting, a fast heartbeat, agitation, hallucinations, coma, delirium, flushing, muscle tremor, or rigidity.
• Do not drive or operate machinery if Adderall impairs your judgment or reaction skills. Alcohol may contribute to these effects and should be avoided.
• Seek medical advice if any new numbness, pain, skin color change, sensitivity, or unexplained wounds occur in your fingers or toes.
• Keep out of reach of children and pets. Keep your medicine in a safe, private storage area, out of view of any person that may illegally misuse it.
• Do not use if pregnant or breastfeeding unless specifically recommended by your doctor.

6. Response and effectiveness

• Parent training in behavior management and/or behavioral classroom interventions should be used before medicines to treat ADHD.
• Effective at improving symptoms such as attention and focus and reducing impulsive behaviors.
• Small trials have reported similar effectiveness to Vyvanse. One study reported that both seemed equally effective at improving attention-span, rule-following, and interactions with peers and adults for classroom-based behavior in a group of children with ADHD. Similar results were reported in a trial of 18 adults with ADHD. It took about two hours for Adderall to start working and three hours for Vyvanse, and the effects of each drug lasted for approximately 16 hours. Side effects such as decreased appetite, insomnia, and abdominal symptoms are common to most ADHD treatments.
• Peak concentrations are reached within three hours following a single dose.
• Not all the hepatic enzymes involved in the metabolism of Adderall have been defined; however, CYP2D6 is known to be one of the enzymes responsible, which means that variations may occur in the way different individuals metabolize Adderall. Many other drugs rely on CYP2D6 for metabolism and may interact with Adderall.

7. Interactions

Medicines that interact with Adderall may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Adderall. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Adderall include:

• anticoagulants (blood thinners), such as warfarin, or other drugs that have blood-thinning effects such as aspirin or NSAIDs
• anticonvulsants, such as phenytoin, phenobarbital, or primidone
• antidepressants, such as tricyclic antidepressants (eg, amitriptyline), monoamine oxidase inhibitors (eg, isocarboxazid, phenelzine, and tranylcypromine), or SSRIs (eg, fluoxetine, sertraline)
• antipsychotics (such as butyrophenones, phenothiazines, or thioxanthenes) and atypical antipsychotics (eg, olanzapine, quetiapine, ziprasidone)
• any medication that may cause drowsiness, such as benzodiazepines (eg, diazepam, lorazepam), first-generation antihistamines (such as doxylamine or promethazine), metoclopramide, or opioids (such as codeine, morphine)
• beta-blockers, such as atenolol, labetalol, or metoprolol
• cold, flu, or allergy medications that contain decongestants such as phenylephrine or pseudoephedrine
• diuretics such as furosemide
• medications that increase or decrease the pH of the stomach or urinary tracts, such as PPIs (eg, omeprazole, pantoprazole), sodium bicarbonate, acetazolamide, ascorbic acid, or ammonium chloride
• medications that inhibit CYP2D6 enzymes
• heart medications such as doxazosin, prazosin, clonidine, or methyldopa
• HIV medications (fosamprenavir, ritonavir)
• other medications that affect serotonin, such as amphetamines, fentanyl, lithium, tramadol, triptans (eg, almotriptan, eletriptan, or sumatriptan), or St. John's Wort
• propoxyphene.

Avoid drinking alcohol or taking illegal or recreational drugs while taking Adderall.

Note that this list is not all-inclusive and includes only common medications that may interact with Adderall. You should refer to the prescribing information for Adderall for a complete list of interactions.

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• Adderall (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate) [Package Insert]. Revised 02/2022. Teva Pharmaceuticals USA, Inc. https://www.drugs.com/pro/adderall.html
• Biederman J, Boellner SW, Childress A, Lopez FA, Krishnan S, Zhang Y. Lisdexamfetamine dimesylate and mixed amphetamine salts extended-release in children with ADHD: a double-blind, placebo-controlled, crossover analog classroom study. Biol Psychiatry. 2007 Nov 1;62(9):970-6. doi: 10.1016/j.biopsych.2007.04.015. Epub 2007 Jul 12. PMID: 17631866.
• Briars L, Todd T. A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder. J Pediatr Pharmacol Ther. 2016;21(3):192-206. doi:10.5863/1551-6776-21.3.192

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Adderall only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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• Taking 'Study Drugs' Like Adderall Could Be Gateway to More Drug Abuse

'Hyped up on Adderall': Internet pokes fun at Jill Biden after she claims her husband Joe Biden is 'calm' and 'steady'

W ASHINGTON, DC: First lady Jill Biden was met with severe backlash on social media on Wednesday, May 29, following an interview where she stated that President Joe Biden is "calm" and "steady" in contrast to former President Donald Trump who represents "chaos."

"We have a choice, this is what I'm out there saying. We have a choice we can have my husband who is calm, and steady and strong and has character and integrity or we have the other choice, which is chaotic," Jill Biden told 'Good Morning America' on Wednesday, May 29. "We have to decide. Democracy or chaos," she further said.

Conservatives criticized Jill Biden for referring to Joe Biden as 'calm'

Conservatives who were dubious of Biden's portrayal as "calm" and "steady" quickly criticized the comment on social media. "This doesn't work this time. Does anything feel calm?" conservative commentator Stephen L Miller posted on X, according to Fox News . 

"Narrator: He's incredibly weak, has a history of anger problems, and has so little integrity that he can't give a simple speech without telling multiple, already-debunked lies," Red State writer Bonchie posted on X.

Joe Biden is often criticized for losing his temper in recent years

Biden has received a lot of flak for appearing to have lost his temper recently. He seemed to refer to an Iowa man as "fat" and a "damn liar" in 2019. Later on, he denied calling him fat, arguing that he was speaking of "facts."

Joe Biden accused of calling Donald Trump names in private

Numerous reports have surfaced since Biden assumed office regarding his propensity for furious outbursts at employees and other people when he is not in the spotlight. He had called former President Trump a "sick " and a " a*****e," according to a report from last year. "No one is safe," one administration official told the outlet.

Typically, Biden's strategies took the shape of "angry interrogations" until it was clear to everyone else in the room that they were stumped for an answer. Staff reportedly dubbed it "stump the chump" because it became so routine.

NBC News previously claimed that Joe Biden is growing anxious and angry about his reelection bid

In response to an NBC News report in March claiming that Biden is becoming more nervous and irate over his reelection campaign, the White House pushed back.

"There's a report that when President Biden was told his handling of the war between Israel and Hamas was starting to affect his poll numbers, the quote is he began to shout and swear. So when he does that, is he shouting and swearing about Netanyahu or about Hamas or about his poll numbers?" Fox News' White House correspondent Peter Doocy asked National Security Adviser Jake Sullivan.

"This is the ‘when did you stop beating your spouse' question because I don't think he ever did that," Sullivan responded. "Excuse me?" Doocy interjected, before Sullivan continued, "Well you use that as the premise of your question, which is when he does that. He – I've never seen him do that shout or swear in response to that. So from my perspective, that particular report is not correct."

Joe Biden's anger was on display in February

In February, Biden's fury was evident in his response to a special counsel report regarding his improper handling of classified materials. He referred to certain claims as "plain wrong."

"There's even reference that I don't remember when my son died. How the hell dare he raise that? Frankly, when I was asked the question, I thought to myself it wasn't any of their damned business," he said. "I am well-meaning, and I'm an elderly man and I know what the hell I'm doing," he added.

He also was not keen on some questions from reporters. "My memory is so bad, I let you speak," he snapped at Doocy.

Internet mocks Joe Biden saying he is 'hyped up on Adderall'

Netizens did not tsake mich long before they started making fun of Jill Biden based on remarks on Joe Biden. One X user wrote, "He's either comatose or hyped up on Adderall. Nothing in between," referring to the president. Another user penned, "Don't mind Jill. She will literally do or say anything to keep her seat in power. Even if it means parading me around in a full diaper and slobbing all over myself." 

"Either she doesn't know her husband or she is as big of a liar as him," said one user and another asked, "What do expect from someone who calls herself a doctor but isn't?" "And some pictures of her she's starting to look just like her husband. I'm worried that she's the one that's making the decisions and telling him what to do or what to say. Then we really be in trouble," said one user. 

This article contains remarks made on the Internet by individual people and organizations. MEAWW cannot confirm them independently and does not support claims or opinions being made online.