Is It Okay to Skip Doses of Adderall?


Is It Okay to Skip Doses of Adderall?Is It Okay to Skip Doses of Adderall?

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Adulting With ADHD Staff

Millions of Americans don’t take their medications as prescribed by their physicians and health care providers for a variety of reasons. Taking the wrong amount of medication, or none at all can lead to severe consequences in some instances. Adderall is a Schedule II drug according to the Controlled Substance Act based on its use and dependency potential. As such, one should always take caution when taking this drug.

Although physicians prescribe a timetable for taking Adderall, skipping a dose is usually not harmful. However, as is the case with all prescribed medications, you should always consult your physician before altering the dosage or skipping one altogether.

The rest of this article will discuss Adderall and its use as a prescribed medication, possible reasons for skipping a dose, and the potential side-effects. Additionally, this article will explain what steps to take in the event you skip a dose, intentionally or otherwise.

Related: Adderall Doesn’t Work While I’m On My Period

What Is Adderall and What Does It Treat?

Adderall is the brand name for a combination of two central nervous system stimulants: dextroamphetamine, and amphetamine. It belongs to a classification of medications called central nervous system stimulants and works by altering the levels of certain naturally occurring substances in the brain. Other brand names include Adderall XR and Mydayis.

These medications are primarily used in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy, a lifelong nervous system disorder that causes daytime sleepiness and sudden sleep attacks.

The typical use of each brand by age group is as follows:

  • Adderall:  Adults and children over the age of three years
  • Adderall XR: Adults and children over the age of six years
  • Mydayis: Adults and children of 13 years of age and older

Recent studies found that Adderall reduces impulsive behaviors associated with ADHD and improves the ability to focus attention. Additionally, a 2016 study found that between 75 and 80 percent of children who have ADHD saw improved symptoms with the use of psychostimulants like Adderall.

Likewise, psychostimulants are also useful for decreasing daytime drowsiness. Similarly, they increase wakefulness in people diagnosed with narcolepsy.

How Does Adderall Work?

As discussed above, Adderall is a combination of amphetamine and dextroamphetamine. When those drugs reach the brain, they act like the naturally occurring neurotransmitters epinephrine, dopamine, and norepinephrine.

Epinephrine speeds up the sympathetic nervous system, which puts the body into fight-or-flight mode. In turn, this triggers mental alertness, focus, and clarity.

Working alongside epinephrine, norepinephrine increases and sustains that fight-or-flight response.

At the same time, the brain uses dopamine to transmit pleasure from one cell to another across the synaptic gap. I also may help focus the mind, helping it avoid distractions.

Individuals with narcolepsy have inadequate levels of certain neurotransmitters that are responsible for stabilizing mental alertness and wakefulness. The use of Adderall stimulates the brain providing enough energy and focus that patients can get through the daylight hours without falling asleep.

Likewise, the feelings of euphoria resulting from dopamine, and enhanced by epinephrine and norepinephrine, brings the level of stimulation in the brain down to a more manageable level.

What Precautions Are Necessary Before Taking Adderall?

Prescribing physicians usually conduct extensive pre-screening procedures before prescribing Adderall. For example, its use is contraindicated with a variety of other medications. Likewise, pre-existing medical conditions can play a significant role in determining if Adderall is right for patients.

Taking Adderall and Other Medications at the Same Time

Patients considering using Adderall must advise their doctor if they are taking the following medications, or stopped taking them the last 14 days:

  • Isocarboxazid (Marplan), Linezolid (Zyvox), Methylene blue, Phenelzine (Nardil), Selegiline (Eldepryl, Emsam, or Zelapar), Tranylcypromine (Parnate).

Additionally, prescribing doctors need to know if patients are currently taking any of the following medications:

  • Antidepressants, antihistamines, ascorbic acid, buspirone, chlorpromazine; fentanyl, lithium (Lithobid); meperidine (Demerol); methenamine (Hiprex, Urex), quinidine (in Nuedexta), reserpine, ritonavir (Norvir, in Kaletra), sodium bicarbonate, sodium phosphate, and certain thiazide diuretics.

Likewise, patients need to tell their physician any other medications they are taking to include those listed in the chart below.

Alpha-blockers: Alfuzosin (Uroxatral), doxazosin (Cardu), prazosin (Minipress), tamsulosin (Flomax, in Jalyn), and terazosin
Antacid and other medications for heartburn or ulcers:

 

Cimetidine (Tagamet), esomeprazole (Nexium), omeprazole (Prilosec, in Zegerid), and pantoprazole (Protonix)
Anti-seizure medications: Ethosuximide (Zarontin), phenobarbital, and phenytoin (Dilantin, Phenytek)
Beta-blockers: Atenolol (Tenormin), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal, Innopran)
Migraine medications: Almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet), and zolmitriptan (Zomig)
Selective serotonin reuptake inhibitors:

 

Citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Prozac, Pexeva), and sertraline (Zoloft)
Serotonin and norepinephrine reuptake inhibitors:

 

Desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), milnacipran (Savella), and venlafaxine (Effexor)

Pre-existing Conditions Contraindicated with Adderall Use

A variety of pre-existing conditions typically preclude the use of Adderall. Be sure to tell your physician if anyone in your family has or has ever had an irregular heartbeat or suddenly died. Likewise, advise our doctor if you recently suffered a heart attack. Also, tell your physician if you ever had a heart defect, hardening of the arteries, high blood pressure, blood vessel disease, heart disease, or any other heart problems.

Additionally, advise your physician if you or anyone if your family has or has ever suffered from abnormally excited moods, bipolar disorder, depression, had thoughts about or attempted suicide, mania, motor tics, Tourette’s syndrome, or verbal tics.

Also, tell your doctor if you ever suffered from liver or kidney disease, mental illness, seizures, or an abnormal electroencephalogram.

How Should Adderall Be Used?

Adderall is only accessible to patients with a physician’s prescription and is available as an immediate-release (IR) tablet or an extended-release (XR) capsule.

Patients should only take Adderall as directed by their physician. If patients have any questions about taking this medication, they should contact the prescribing doctor.

Adderall should come with a Medication Guide, a paper handout that addresses known issues specific to a particular drug or class of drugs. The Food and Drug Administration requires these guides if the agency determines that:

  • Patients require specific information to prevent serious side-effects;
  • Patient adherence to directions regarding the use of a drug is essential to its usefulness;
  • Patients need data about any known issues with a specific drug.

They should not increase or decrease the dosage. If a patient thinks there is a problem with the amount prescribed, they should check with their doctor.

Likewise, patents should not take Adderall longer than prescribed. If patients take too much of this drug, there is a risk it can become habit-forming.

Dosages typically conform to the following daily schedules:

  • Adderall: Two to three times per day, starting shortly after awakening at four to six-hour intervals, with or without food;
  • Adderall XR: One time a day, shortly after awakening, with or without food;
  • Mydayis: One time a day, shortly after awakening, taken consistently either with food or without food.

Patients should swallow extended-release capsules whole, taking care not to chew or crush them. Individuals experiencing difficulty swallowing the capsules whole can open them and mix the contents with applesauce. However, they should take care to swallow the applesauce whole, taking care not to chew it.

Additionally, patients should avoid taking Adderall in the later afternoon, evening, or at night as it can cause difficulty falling to sleep or insomnia.

What is the Typical Dosage for Adderall?

Adderall is usually prescribed starting at a low dosage, with the amount gradually increased over time.

The proper dosage for Adderall varies depending on the patient and the reason prescribed. Additionally, the amount of medication prescribed depends on the strength of the drug, the number of doses taken per day, and the time allocated between dosages.

Doses of Adderall Typically Prescribed for ADHD

  Adderall caplets Adderall XR extended-release capsules Mydayis extended-release capsules
Adults: 5 milligrams (mg) once or twice per day to begin, taken in the morning.

Doctors may increase the dose in 5 mg increments, weekly, as necessary.

The daily dose usually doesn’t exceed 40 mg per day.

20 (mg) once per day to begin, taken in the morning.

Doctors may increase the dose as necessary.

12.5 mg once per day, taken in the morning right after waking up.

Doctors may increase the dose as necessary.

The daily dose usually doesn’t exceed 40 mg per day in total

Children from 13 to 17 years of age: 10 mg per day, taken in the morning. Doctors may increase the dose as needed. 12.5 mg once per day, taken in the morning.

Doctors may increase the dose as necessary.

The daily dose usually doesn’t exceed 25 mg per day in total.

Children from 6 to 12 years of age: 10 mg per day, taken in the morning.

Doctors may increase the dose as necessary.

The daily dose usually doesn’t exceed 30 mg per day in total.

Doctors must prescribe the use and dose on a case-by-case basis.
Children younger than six years of age: 2.5 mg once a day, taken in the morning. Your doctor may adjust your dosage as needed.

Adderall is not recommended for use by children under three years of age.

Doctors must prescribe the use and dose on a case-by-case basis.

Doses of Adderall Typically Prescribed for Narcolepsy

  Adderall caplets
Adults and children 12 years of age and older:

 

10 milligrams (mg) twice per day to begin, taken in the morning.

 

Doctors may increase the dose as necessary.

Children 6 to 12 years of age: 5 mg once a day, taken in the morning. Your doctor may adjust your dosage as needed.
Children younger than 6 years of age: Adderall is not recommended for children younger than three years of age.

*Note: To create the charts above, we researched and consolidated published data from trusted authorities like the University of Iowa, the University of Utah, and the Mayo Clinic.

What To Do in the Event of an Overdose of Adderall

In the event of an overdose, call the Poison Control Hotline at 1-800-222-1222. If the victim has trouble breathing, had a seizure, or collapses, immediately call 911.

Overdose symptoms include:

  • Aggressive behavior, blurred vision, coma, confusion, dark red-colored urine, depression, diarrhea, dizziness, fainting, fast or irregular heartbeat, feelings of panic, fever, hallucinations, loss of consciousness, muscle weakness or aches, rapid breathing, restlessness, seizures, uncontrollable shaking, upset stomach, vomiting, weakness or fatigue.

Precautions to Take While Using Adderall

Like other medications, there are risks associated with taking Adderall. To minimize them, patients should consider the following precautions:

  • Schedule regular doctor appointments: It is crucial that prescribing physicians monitor progress and make sure this medication is working correctly.
  • Schedule period blood tests: Blood tests are essential to check for any undesired conditions and side-effects.
  • Look for any signs of addiction: symptoms may include a need to increase the dosage to receive the desired effects, a strong desire to continue taking the medication after the termination of the use of Adderall, withdrawal effects after discontinuing the drug’s use.

Likewise, patients should contact their physician if they notice any of the following:

  • Symptoms of cardiac distress: these symptoms can include chest pain, experiencing a fast or irregular heartbeat, or trouble breathing.
  • Unusual changes in behavior: changes may include aggression, agitation, hostility, irritability, and suicidal thoughts or actions.
  • Symptoms of Raynaud Phenomenon (a problem associated with blood circulation in the extremities): symptoms include cold sensations, skin color changes, paleness, unexplained pain, or tingling sensations in the fingers or toes.

What Are Some of the Reasons to Skip Doses of Adderall?

An alarming number of people do not take their medications as prescribed. For example, a study published by the Annals of Internal Medicine found that nearly a third of patients did not even fill their first-time prescriptions.

Another study published by the same journal found that half of the patients taking medications for chronic diseases did not take the drug as prescribed by their physician.

People fail to take medications like Adderall or skip taking doses for a variety of reasons, according to these and other studies. For example, some individuals forget to take them. Others cut back, or skip doses due to undesirable side-effects. Also, some people quit taking medicine if they don’t experience any benefit from taking it.

Additionally, Harvard Medical School reported that millions of people skip taking medications due to their rising costs. Citing a study by the National Center for Health Statistics, Harvard reported that about eight percent of adult Americans didn’t take their medication as prescribed because of the cost.

Additionally, 6 percent of adults under the age of 65 with private health insurance skipped taking medication to save money, and 14 percent without insurance did the same.

Below are some cost-saving tips if the cost is a consideration:

  • Ask your pharmacist or doctor if a suitable generic version is available.
  • If a generic drug isn’t available, ask your pharmacist or doctor if a suitable less-expensive brand name would work.
  • Ask your pharmacist or doctor if there is a difference in price between immediate-release tablets and extended-release capsules.
  • Ask your physician if they have any samples. Some physicians stock up on free samples for patients with financial issues.
  • Shop around for the best price. Prices vary at pharmacies, and some medications are available online at discounted rates.

What Are the Side Effects of Taking Adderall?

Along with its desired effects, a variety of side effects from mild to severe can accompany the use of Adderall. Some side effects require immediate medical attention. Those conditions are broken down into two categories: those that are common and those with an unknown level of incidence.

Adderall Side Effects Requiring Immediate Attention

The following chart shows side effects that require immediate medical attention. Patients experiencing any of these symptoms should contact their physician immediately.

Common Side Effects Unknown Level of Incidence
Agitation, believing things that are not true, bladder pain, bloody or cloudy urine, burning or tingling in the extremities, changes in vision or blurred vision, chills, confusion, cough, depression, diarrhea, difficult or painful urination, difficulty breathing or swallowing, dizziness, fast heartbeat,  fast or irregular heartbeat or pulse, feeling unusually suspicious of others, fever, frequent urge to urinate, a general feeling of discomfort or illness, hallucinations, headache, hives, hoarseness, itching, joint pain, loss of appetite, loss of coordination, lower back or side pain, mania, motor or verbal tics, muscle aches and pains, nausea, paleness or blue coloring of the fingers or toes, rash, runny nose, seizures, severe muscle stiffness or twitching, shivering, slow or difficult speech, sore throat, sweating, swelling of the eyes, teeth grinding, unusual tiredness or weakness, vomiting, weakness or numbness of the extremities. Blistering or loosening of the skin, chest pain or discomfort, dark urine, difficulty with speaking, double vision, inability to move the arms legs, inability to move facial muscles, inability to speak, loss of bladder control, muscle cramps, muscle spasms or jerking of the arms and legs, red skin lesions, red and irritated eyes, skin rash, sores or white spots in the mouth, sudden loss of consciousness, sudden swelling of the feet or legs, tightness in the chest, uncontrolled repeated movements, uncontrolled vocal outbursts, unusual tiredness or weakness.

 

Adderall Side Effects Patients Should Monitor

Additionally, there are side effects that can occur when patients begin taking Adderall. Those symptoms usually fade away as patients’ bodies start adjusting to the medication. However, patients should notify their physician if these symptoms persist or if they have any questions about them.

Common Side Effects Unknown Level of Incidence
Anxiety, dry mouth, headache, loss of strength, nervousness, painful menstrual cramps, stomach pain, weight loss. Constipation, decreased sexual drive, a false sense of well-being, inability to have or keep an erection.

Potential Long-Term Side Effects of Using Adderall

Although Adderall is perfectly safe for long-term use under the direction of a physician, its use may cause changes in the brain. For example, deterioration of dopamine receptors in the brain can occur as the result of long-term use of the drug.

Additionally, if Adderall is abused, long-term effects can become exaggerated.

Potential long term effects of Adderall use may include:

  • Anorexia or unwanted weight loss, damage to the heart muscle, depression, fatigue, irritability and moodiness, severe insomnia, skin rashes, and other similar disorders, symptoms of psychosis such as aggressive behaviors, hallucinations, and feelings of grandeur.

Is It Okay to Skip Doses of Adderall?

Generally speaking, skipping a dose of any medication is not recommended. Serious consequences can result from not taking medicines as prescribed or skipping doses. For example, it can increase the risk of hospitalization for the underlying medical condition.

Most people skipping doses of Adderall do not experience significant consequences. Possible side effects of missing a dose of Adderall can cause fatigue, depressions, and sleep-related problems.

However, Adderall is listed as a Schedule II controlled substance, meaning a high risk of addiction is possible when taking this medication. For that reason, patients should talk to their physicians before they stop taking Adderall. Skipping doses or stopping taking it can result in withdrawal or a crash.

Symptoms can include:

  • Achiness, anxiety, depression, difficulty concentrating, fatigue or lack of energy, hallucinations, headaches, increased appetite, intense cravings for more Adderall, irritability, mood swings, nightmares, panic attacks, sleep-related issues. (Some people alternate between insomnia and sleeping too much.), suicidal thoughts, unhappiness.

Patients should immediately contact their prescribing doctor if they exhibit any symptoms of withdrawal from Adderall after skipping doses.

The duration of withdrawal depends on the dosage and how long a patient has been taking the drug. Additionally, withdrawal time takes longer for people taking Adderall XR than for the faster releasing Adderall. Symptoms typically last from a few days for Adderall to a few weeks for Adderall XR.

Treatment Options for Symptoms Associated With Adderall Withdrawal

Proper diet and exercise can alleviate symptoms of withdrawal from Adderall. Likewise, adequate sleep helps. Individuals experiencing difficulty sleeping can try relaxing an hour or two before bedtime. Additionally, setting the bedroom temperature at a comfortable level can help.

There are no available medications approved for managing the withdrawal from Adderall. However, Aripiprazole, an antipsychotic medication may relieve some of the symptoms associated with withdrawal from amphetamine, one of the two drugs contained in Adderall.

Additionally, doctors can prescribe drugs that can relieve some of the symptoms of withdrawal from Adderall.

Frequently used medications include:

  • Analgesics: to treat minor aches, pains, and headaches;
  • Antidepressants: to relieve significant clinical depression;
  • Benadryl: to aid sleep and to decrease agitation;
  • Trazodone: to treat severe cases of insomnia.

What Should You Do If You Miss a Dose of Adderall?

If you miss taking a dose of Adderall, take it as soon as you possibly can. However, if it is nearly time for another dose, skip taking the missed dose and continue with your regularly scheduled one.

Do not double up on your dose to make up for the missed one.

Resources for Additional Information on Adderall

Finding reliable sources of information regarding Adderall can be challenging with all the misinformation circulating about pharmaceuticals these days. For that reason, we want to conclude this article with a listing of some credible sources of information regarding Adderall.

  • The U.S. Food and Drug Administration Medical Guide for Adderall:  As noted earlier in the article, Medication Guides are handouts that accompany the sale of certain regulated medications. These guides provide detailed information specific to a particular drug or class of drugs. For example, these guides contain FDA-approved guidelines and information regarding the use, potential drug interactions, side effects, and other information to help patients avoid experiencing any potentially severe adverse effects.
  • The FDA Medical Guide for Adderall XR: The current medical guide for extended-release (XR) Adderall capsules (as opposed to the immediate-release caplets listed above).
  • National Institute on Drug Abuse: Prescription Stimulants DrugFacts Sheet: Founded in 1074, the National Institute on Drug Abuse is a part of the National Institutes of Health. It is a federally-owned research institute whose mission is “to advance science on the causes and consequences of drug use… and to apply that knowledge to improve individual and public health.” This fact sheet covers three commonly prescribed stimulants: Adderall, Dexedrine, and Ritalin.
  • Drugs.com, Adderall: Adderall’s listing on Drugs.com, which includes Drug.com’s listing for Adderall broken down by section to include its overview, side effects, dosage, professional data, tips, and interactions. For those unfamiliar with the website, Drugs.com is the largest independent “medicine information website available on the internet. Four independent leading medical information companies power its database to include the American Society of Health-System Pharmacists, IBM Watson Micromedex, Cerner Multum, and Wolters Kluwer Health.
  • Wentworth Institute of Technology, Facts About Adderall: Founded in 1904, the Wentworth Institute of Technology is a private engineering university located in Boston, Massachusetts. This article lists 10 interesting facts about Adderall, 8 risks associated with its use, along with other information directed at college students who have been known to use Adderall to augment study practices.

Final Thoughts

This article covered a lot of information regarding the use of Adderall, its medicinal purposes, and potential side-effects.

If you have questions regarding skipping a dose of Adderall or have an emergency related to its use, don’t hesitate to call your physician, go to the nearest emergency room, or all 911.

DISCLAIMER: The content found in this article was created for informational purposes only. This article is not intended to serve as a substitute for professional medical advice.

If you have any questions regarding the use of Adderall or about skipping a dose, contact a licensed physician or other qualified health care provider. Likewise, do not disregard professional medical advice based on the information written in this article.

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