Adderall and Adderall XR for ADHD

What Should You Know About the Dosage and Side Effects of Adderall?

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What is Adderall and Adderall XR?

Like Ritalin, Adderall is a stimulant, but instead of being made of methylphenidate, Adderall is a mixture of different amphetamine salts. It can help to reduce or improve the symptoms of ADHD, including having a short attention span and/or being hyperactive and impulsive.

Adderall is a short acting stimulant and is generally given twice a day.

Adderall XR is a long acting form of this stimulant that can be given just once a day, so that children don't have to take a lunch time dose.

It usually lasts 10-12 hours in many children.

Dosage and Age

As with other stimulants, the usual philosophy is to start with a low dosage and then work your way up as needed, either until it is working well or the child is having intolerable side effects.

In general, the dosage of Adderall is about 1/2 that of methylphenidate (Ritalin) containing products, so 20mg of Ritalin would be about equivalent to 10mg of Adderall.

Adderall is approved for use in children over age 3 years. It is generally started at a dose of 2.5mg in children under age 5 and gradually increased as necessary. Older children often start with a 5mg dose. These double scored tablets are available in sizes of 5mg, 7.5mg, 10mg, 12.5mg, 15mg, 20mg, 25mg and 30mg.

Adderall XR (extended release) is approved for children over age 6 and it is available as a once a day capsule. It is available in sizes of 5mg, 10mg, 15mg, 20mg, 25mg and 30mg.

Converting from Adderall to Adderall XR

For children switching from regular Adderall to Adderall XR, you usually just add up the dosage they take throughout the day and that is their single dose of Adderall XR. So kids taking 10mg of Adderall twice a day would take one Adderall XR 20mg in the morning.

Side Effects

Although generally well tolerated, the main side effects of Adderall and Adderall XR include:

  • Anorexia (loss of appetite) - A decreased appetite is common, but can sometimes be improved if dinner is served later in the evening, further after the dose of medication.
  • Insomnia (difficulty sleeping) - Difficulty falling asleep is a common side effect, especially early on when taking Adderall, or if your child takes the second dose of short acting Adderall too late in the day.  Be careful to limit other causes of insomnia such as sodas with caffeine. Check out these bedtime routine dos and don'ts for hints on making this side effect a little easier to cope with.
  • Nausea.
  • Headaches.
  • Dry mouth.
  • Weight loss - You will want to monitor your child's weight on Adderall and let your pediatrician know if this should drop or if your child doesn't appear to be gaining weight as you would expect.
  • Emotional lability - Moodiness and irritability are fairly common side effects for children on Adderall.
  • Increased tics - You don't need to worry that Adderall is causing tics, as some medications can, but it can cause tics that you otherwise wouldn't notice to be more apparent.
  • Abdominal pain (stomachache).
  • Depression.

Coping with Side Effects

Many children have mild side effects, and some of these may improve with time.

If side effects don't improve with time, your Pediatrician may have to lower your child's dosage or consider changing to another medication, such as Vyvance, Concerta, or Strattera.

Contraindications - Reasons Not to Take Adderall

You should not take Adderall if you have a heart defect or other heart problems, including high blood pressure, and heart or blood vessel disease, an overactive thyroid, glaucoma, or a history of drug abuse.

If side effects don't improve with time, your Pediatrician may have to lower your child's dosage or consider changing to another ADHD medication, such as Vyvance, Concerta, or Strattera.

The FDA is conducting ongoing studies to look at possible links between Adderall and other stimulants and an increased of sudden death, especially in children with preexisting heart problems.

A final caution is about abuse of Adderall.  If your child is using Adderall  it's important to monitor her use.  It's common now in high school (and even middle school) for children to "share" their Adderall with their peers, and many children have been caught selling their pills as well.  Since Adderall is touted in the high school and college crowd as a "cognitive enhancer" the children who could pressure your child may not be the same ones you would expect to be involved with buying and selling drugs.

Sources:

U.S. Food and Drug Administration. Communication about an Ongoing Safety Review of Stimulant Medications used in Children with Attention-Deficit/Hyperactivity Disorder (ADHD). 08/15/13. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm165858.htm

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