How to Recognize and Respond to an Adderall Overdose

Can You Overdose on Adderall? 

You can overdose on Adderall if you take more than the prescribed amount. Misusing Adderall also can increase the risk of an overdose. According to research, overdose by psychostimulant medications, including Adderall, is rising.²

Contact your doctor if you’re abusing or overdosing on Adderall. Medication delivery should be interrupted if there is a resurgence of behavioral problems that require prolonged treatment.

What is Adderall?

Adderall is a prescription drug approved by the Food and Drug Administration (FDA). It treats attention deficit hyperactivity disorder (ADHD) and narcolepsy.

The drug is made by combining amphetamine and dextroamphetamine. Adderall affects the central nervous system (CNS) and works by increasing dopamine, serotonin, and norepinephrine levels.¹ 

Adderall brings the brain from a state of overstimulation to a normal state of stimulation. This improves your focus and reduces impulsivity. 

How Much Adderall Can Lead to an Overdose?

No defined dosage of Adderall causes an overdose because people respond to Adderall’s effects differently. In rare occurrences, an overdose may occur even at low dosages.

The FDA has determined 70mg daily to be the maximum safe dose for most ADHD medications. Anything above that can lead to an overdose.

When you use Adderall regularly, it may result in a higher tolerance. This can cause you to take a higher dose to achieve the desired effect ("high.")

Signs of an Adderall Overdose

Adderall overdose can result in mild to severe symptoms.⁴ The symptoms may vary from one person to the next.

Mild symptoms include:

• Headache
• Nausea
• Vomiting
• Diarrhea
• Blurry vision
• Rapid breathing
• Fatigue
• Dark red or brown urine
• Confusion
• Hyperreactivity
• Stomach pain

Severe symptoms include:

• Hallucinations
• Aggressiveness
• Panic attacks
• Tremors
• Heart attack
• High blood pressure
• High fever (106.7 °F/41.5 °C or higher)
• Muscle breakdown (rhabdomyolysis)
• Fainting (loss of consciousness)
• Possible death

Factors that Affect The Severity of Symptoms

The severity of symptoms depends on the following factors:

• The amount taken
• Your body chemistry and sensitivity to stimulants
• Whether you mixed Adderall with another drug

If you or your child is experiencing a combination of such symptoms after taking Adderall, call your doctor or the National Poison Center at 1-800-222-1222. For emergency treatment, dial 911.

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What to Do if You Overdose on Adderall

If you suspect someone is having an Adderall overdose, seek emergency medical services or call 911 for immediate assistance. Don’t try to sleep it off or make yourself vomit without consulting a healthcare professional.

If you're watching over someone who has overdosed on Adderall, do the following as you wait for help to arrive:

• Place the victim in a calm environment
• Cool them down using ice packs or a fan
• Find out the victim's age
• Find out how much Adderall they consumed
• Find out any possible allergies to other medications
• Find out their history of drug use
• Find out if they mixed Adderall with alcohol or other drugs

Adderall overdose can be deadly, especially if taken with other illegal drugs. Whatever the case, be honest with the doctors and first responders. They need all the information they can get to minimize the effects of the overdose or save the victim's life.

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Treatment for Adderall Overdose

There are many ways doctors can treat an overdose. An Adderall overdose doesn’t have a particular medication or therapy. 

Instead, the doctor must provide supportive care and address emerging symptoms or issues. Treatment may include:

• Managing uncontrolled hypertension with IV medications such as phentolamine (Regitine) or dopamine (Intropin)
• Using activated charcoal or gastric lavage to help the person's system eliminate the drug⁸
• Benzodiazepines can address cardiovascular and CNS toxicity, seizures, agitation, anxiety, and psychotic symptoms.
• Administering nitrates to reduce chest pain associated with Adderall overdose
• Administering medication to lower blood pressure

How to Prevent Adderall Overdose 

The most effective way to avoid an Adderall overdose is by adhering to the prescription instruction given by your doctor. Adderall is classified as a Schedule II substance, which means it has a high potential for abuse and dependence.

Here are a few ways to prevent an Adderall overdose:

• Only take Adderall when prescribed for you by a physician with legitimate indications for use and an honest medication history, including prescribed, OTC, and non-prescribed drug use
• Avoid using Adderall for leisure or entertainment purposes
• Avoid using Adderall to improve academic performance
• If it’s your first time using Adderall, lower your dose so your body can adjust
• If you forget to take your dose, don’t take a second dose to compensate

To ensure you don't forget to take your daily dose, take it at the same time each day. Set a daily reminder if you need to. If you're in doubt about how to take a prescription for Adderall safely, reach out to your doctor for professional advice.

Treatment for Adderall Misuse & Addiction

Like other drugs, Adderall addiction can be treated. Inpatient and outpatient rehab facilities exist nationwide, offering effective addiction recovery programs.

• Inpatient rehab: These treatment facilities require people to stay within the facility for the period of their treatment (30 to 90 days) and provide access to immediate medical care 24x7
• Outpatient rehab: These facilities offer flexibility for people to live and sleep at home  while attending rehab and participating in ongoing treatment

Substance abuse treatment programs for Adderall addiction may include:

• Medical detox: To help eliminate the drug while minimizing the risk of severe withdrawal symptoms
• Group therapy: To enable interaction with other victims and professional therapists
• 12-step programs: A support group designed to help you learn how to build a life without drugs
• Aftercare (extended care): This is required after the completion of therapy to prevent relapse and ensure full recovery

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Can Adderall Interact With Other Drugs?

The risk of Adderall overdose increases if you’re engaged in alcohol or substance use while taking Adderall. 

Adderall and Alcohol Interaction

Adderall might make it difficult for people to feel the effects of alcohol, leading them to drink more than they would otherwise. This increased consumption increases the likelihood of:⁵

• Extreme intoxication or Alcohol poisoning
• Kidney 
• Liver failure
• Any or all of the common ill effects from excess alcohol ingestion (injury, poor judgment, undesired legal encounters)

Furthermore, alcohol and Adderall may harm the heart and cardiovascular system, raising the risk of: 

• Cardiac arrhythmias
• Heart attacks
• High blood pressure
• Stroke

Adderall Interaction With Other Prescription Drugs

Adderall can interact with other drugs, leading to negative side effects. You should always discuss any drugs you’re taking with your doctor.

These include: 

• Over-the-counter medicines, particularly cold or flu medications such as decongestants
• Vitamins
• Other nutritional supplements

Doing so will help your doctor select the appropriate medication and dose to limit your risk of a drug interaction. Prescription drugs that can interact with Adderall include:

Adrenergic Blockers

Adderall can lessen the effectiveness of adrenergic blockers, otherwise known as alpha-blockers. Adrenergic blockers are a type of blood pressure medication that lowers blood pressure

These include:

• Doxazosin
• Prazosin
• Terazosin

Serotonergic Drugs

Taking Serotonergic drugs alongside Adderall can increase the amount of serotonin in your body, leading to serotonin syndrome.⁶ Serotonin is a neurotransmitter that affects your emotions and motor functions.

Serotonergic drugs include:

• Serotonin and Norepinephrine reuptake inhibitors (SNRIs)
• Selective serotonin reuptake inhibitors (SSRIs). 

Tricyclic Antidepressants

Adderall can increase the potency of these drugs. This can increase the risk of cardiovascular side effects.

These include:

• Amitriptyline
• Amoxapine
• Desipramine (Norpramin)

Antacids

Antacids can enhance the absorption rate of Adderall. This can increase the risk of an overdose.

Antacids include:

• Aluminum hydroxide gel
• Calcium carbonate
• Magnesium hydroxide 

CYP2D6 Inhibitors

Mixing these inhibitors with Adderall can also increase the risk of serotonin syndrome.⁷ CYP2D6 inhibitors include:

• Benadryl
• Cymbalta
• Paxil
• Prozac 

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs can decrease the metabolism of Adderal, making it stay in your body longer. This can lead to side effects like:

• Abnormally high blood pressure
• High fever
• Metabolic acidosis

MAOIs that interact with Adderall include:

• Isocarboxazid (Marplan)
• Phenelzine (Nardil)
• Selegiline (Emsam)

Antihistamines

Adderall can weaken the sedative effects of antihistamines when mixed. These include:

• Chlorpheniramine (Chlor-Trimeton)
• Clemastine (Tavist)
• Diphenhydramine (Benadryl)

Proton Pump Inhibitors

Proton pump inhibitors can affect Adderall’s effects. You should let your doctor know if you’re taking both of these drugs. They’ll monitor the interaction of these drugs closely.

These include:

• Lansoprazole (Prevacid)
• Lansoprazole (Prevacid)
• Omeprazole (Prilosec)

Seizure Medication

When used alongside Adderall, it may cause an anticonvulsant effect. Medications like phenobarbital and phenytoin can interact with Adderall.

Types of Adderall

Adderall comes in two main forms: 

• Adderall: Comes in 5, 7.5, 10, 12.5, 15, 20, and 30 mg capsules 
• Adderall XR: Comes in 5, 10, 15, 20, 25, and 30 mg capsules

These drugs have the same active ingredients but are absorbed differently in the body.³ 

Adderall XR is an extended-release variant of Adderall. This means the pill breaks down slowly, and the active ingredients are delivered throughout the day. For this reason, it's taken just once a day.

What’s the Normal Prescribed Dosage of Adderall? 

The amount of Adderall you take daily depends on the condition the medication is treating. All amphetamines are typically prescribed at the lowest effective dosage.

Your response to Adderall will determine the appropriate dosage for you. Generally, the safe Adderall dosage is as follows:

• Adderall for children should be 2.5mg daily
• Adderall for adults should be 5mg once or twice a day
• Adderall XR for children should be 10mg daily
• Adderall XR for adults should be 20mg daily 

Your doctor may raise the dosage each week to ensure effectiveness. However, it’s rare for children to exceed a dosage of 40mg a day. Some adults can take up to 60mg a day and still be safe (i.e., have the desired clinical effects with acceptable side effects.)

Summary

Adderall is commonly used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. However, it's classified as a Schedule II drug, meaning it has a high potential for misuse and dependence.

If you take more than the prescribed dose, you’ll likely experience an overdose. The risk of an overdose may increase when you take the drug with alcohol or other drugs or if you take Adderall that wasn’t prescribed for you by a physician.

You can prevent an Adderall overdose by strictly following your prescription instructions. If you or someone you know has overdosed on Adderall, seek immediate medical attention.

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