Mixing Adderall and Alcohol? You Could Experience More ADHD Symptoms

If you or a loved one has been prescribed Adderall, it is important to know the dangers associated with drinking alcohol while taking it.

Adderall also has a high potential for misuse, so it is important to know the side effects and signs of overdose.1

In this article:

Why Do Adderall and Alcohol Interact?

The term “drug interaction” refers to when two or more drugs or substances are present in your body and one or more of them affects the others such that:2

  1. They don’t work as they should
  2. Unexpected side effects occur
  3. An overdose of a chemical could be present in the body

Adderall (amphetamine/dextroamphetamine) is commonly prescribed for attention-deficit/hyperactivity disorder (ADHD). It is also prescribed for narcolepsy, a neurological disorder where the brain cannot control the sleep-wake cycle.1

Adderall is prescribed for ADHD because it can help to increase attentiveness. Adderall may be prescribed to help mitigate behavioral issues in adolescents with ADHD. Therefore, it may seem surprising that it is actually a stimulant.3

The name is slightly misleading as Adderall does not increase your energy or “stimulate” you, but rather, it works to enhance brain processes. In this case, Adderall enhances the brain processes related to attention, concentration, cognitive performance and processing, focus, and short-term memory. These effects are why Adderall can also be prescribed for narcolepsy, even though “calming” ADHD and helping someone stay awake seem like they would be opposing goals. Adderall stimulates the brain processes related to alertness and cognitive performance to help individuals with narcolepsy stay awake during the day.4

Adderall is administered in tablet form and is typically prescribed to take once or twice daily. Given the high potential for misuse, doctors usually prescribe Adderall at the smallest dosage and slowly increase it as needed.1

Side Effects of Adderall

Adderall can have side effects—even if you take it as prescribed and without alcohol. Potential side effects include:1,4

  • Irritability
  • Nervousness
  • Shakiness
  • Stomachache
  • Decreased appetite
  • Disturbances in heart rhythm
  • Nighttime sleep disruption

If you take Adderall for an extended period and then stop abruptly, you can experience extreme fatigue and depression.1 Inform your doctor of these or any other side effects that you experience while taking Adderall.

Adderall Overdose

You can overdose on Adderall even if you do not drink alcohol while taking it. Signs of an Adderall overdose include:1

  • Restlessness
  • Tremor
  • Confusion
  • Hallucinations
  • Panic states
  • Overactive reflexes
  • Rapid respiration
  • Aggressive behavior
  • Change in blood pressure
  • Irregular heartbeat
  • Gastrointestinal problems such as nausea, vomiting, diarrhea, and abdominal cramps
  • Hyperpyrexia, or a fever of 106 degrees or higher
  • Rhabdomyolysis, or breakdown of muscle tissue that releases a kidney-damaging protein into the blood

If you or a loved one experiences any of these symptoms, get immediate medical attention.

Adderall Addiction

Taking Adderall for long periods could lead to psychological dependence and addiction, particularly if you take a higher dose than prescribed, you take someone else’s Adderall, or you misuse an as-needed Adderall prescription.

Adderall and Alcohol

Unlike Adderall, alcohol is a depressant. Central nervous system depressants slow down processes in the brain. This effect is why many people feel sleepy, physically drained, or disoriented after the initial buzz of using alcohol.5

Combining any depressant with a stimulant can cause them to counteract each other or mask each other’s effects. When you use alcohol with your Adderall prescription, your Adderall may not work as it is meant to. This type of interaction can occur even if you do not use alcohol at the same time as taking your Adderall.3

There is also a risk that you will feel decreased effects of alcohol due to the neurochemical stimulation of your Adderall. This interaction places you at higher risk of serious alcohol misuse and alcohol overdose.3

You do not have to take medication when you drink alcohol for the substances to interact. You may experience a decreased effect of your Adderall or additional side effects whenever you mix alcohol and Adderall. These risks are present even if, for example, you take the medication once per day in the morning and then drink alcohol at night.6

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What Are the Short-Term Effects of Combining Adderall and Alcohol?

The negative side effects of both Adderall and alcohol could be enhanced when they are taking together. Some possible short-term effects include:3

  • Nausea
  • Vomiting
  • Dehydration
  • Aggressiveness
  • Slower reaction time
  • Lack of motor coordination
  • Problems with visual perception
  • Cardiovascular problems
  • Increased chance of engaging in impulsive or risky behavior

If someone uses Adderall to counteract the effects of alcohol to have a longer period of time to use alcohol, this misuse could lead to consuming heavier amounts of alcohol. When the stimulant effects of Adderall block the depressant effects of alcohol, the body’s warning signs of intoxication can be masked. This can make it easier to drink even more and then, seemingly suddenly, develop alcohol poisoning.3

What Are the Long-Term Effects of Combining Adderall and Alcohol?

A couple of the long-term risks of regularly combining Adderall and alcohol include:3

  • Cardiovascular Disease—Cardiovascular disease can develop due to a range of complex factors. When you combine alcohol and Adderall, you are more likely to have accelerated heart rate, irregular heartbeat, or increased blood pressure. These side effects overburden your heart muscle and can lead to specific types of cardiovascular disease, such as alcoholic cardiomyopathy.
  • Mental Health Issues—Alcohol can reduce the efficacy of Adderall, such that you have a harder time focusing, the reason you are probably taking Adderall in the first place. You may experience more severe versions of symptoms you have had in the past. You may also develop additional mental health symptoms as combining the two substances also increases the likelihood of experiencing depression or anxiety.

What Does This Mean for Me?

If you have an Adderall prescription, it is recommended that you follow these guidelines.

Do Not Stop Taking Your Adderall to Use Alcohol

Take your Adderall consistently to ensure that it works as effectively as possible. Suddenly stopping any prescription medication is not recommended. If you are taking Adderall for ADHD, some research suggests that if you stop your medication to use alcohol you may be at higher risk for impulsive behavior when using alcohol.8 This means that if you have untreated ADHD, you are more likely to behave in ways that are potentially risky to your interpersonal relationships, physical safety, or health while intoxicated.

Take Adderall Only as Instructed by Your Doctor

Given the risk for misuse and serious side effects associated with Adderall, it is important to take the medication only as prescribed. You have a high risk of addiction and overdose if you take it in larger doses than needed.1

Seek Treatment for Substance Misuse or Addiction

If you feel concerned about your use of alcohol, Adderall, or both, seek substance misuse treatment. This treatment may include rehab, counseling, or therapy. Therapy for alcohol misuse can help you control your alcohol use so that it does not  interfere with your ADHD or narcolepsy treatment. Treatment often includes a combination of medication and psychotherapy for those with both ADHD and a substance use disorder.9

Regularly Consult with Your Care Team

Talk with your doctor about your symptoms, including if you are struggling with misuse of alcohol in addition to ADHD or narcolepsy. Your doctor may suggest the possibility of medication that can improve your symptoms and reduce heavy drinking.10

Do not make changes to your medication regimen without first consulting with your doctor. Your doctor will be able to evaluate how long you might need the medication, if you can take breaks from the medication so that your body does not build up a tolerance, etc.1

It is also important that you inform your doctor if you have:1

  • Any allergies to medications
  • Any other medications you are taking, including over-the-counter medications
  • Any history or family history of medical or mental health problems
  • Any heart problems or heart defects as these combined with Adderall could lead to stroke, heart attack, or sudden death

Do Not Allow Anyone Else to Use Your Adderall

Adderall is a federally controlled substance. Providing your Adderall to anyone else facilitates their misuse as any non-prescription Adderall use is considered misuse. After you give the Adderall to another person, you do not know if they will engage in additional risky behaviors such as mixing it with other substances. Giving away or selling Adderall is also against the law.1

If you are concerned about your alcohol or stimulant use or that of a loved one, please call 800-948-8417 Info iconCalls are forwarded to paid advertisers for 24/7 help.

Resources

  1. US Food and Drug Administration. (2017). Label for Adderall.
  2. S. Food and Drug Administration. (2013). Drug Interactions: What You Should Know.
  3. Columbia University. (2018). Adderall: Health risks when combined with alcohol? Go Ask Alice!
  4. National Institutes of Health. (2014). Narcolepsy Fact Sheet. National Institute of Neurological Disorders and Stroke.
  5. Doweiko, H.E. (2006). Alcohol. In Concepts of Chemical Dependency. (6th ed. pp 197-212). United States: Thomson Brooks/Cole.
  6. National Institutes of Health. (2014). Harmful Interactions.
  7. Sharma, J., de Castro, C., Chatterjee, P., & Pinto, R. (2013). Acute myocardial infarction induced by concurrent use of Adderall and alcohol in an adolescent. Pediatric Emergency Care, 29(1), 84-88.
  8. Weafer, J., Fillmore, M. T., & Milich, R. (2009). Increased sensitivity to the disinhibiting effects of alcohol in adults with ADHD. Experimental and Clinical Psychopharmacology, 17(2), 113–121.
  9. Crunelle, C.L., van den Brink, W., Moggi, F., Konstenius, M., Franck, J., Levin, F.R., van de Glind, G., Demetrovics, Z., Coetzee, C., Luderer, M., Schellekens, A., & Matthys, F. (2018). International consensus statement on screening, diagnosis and treatment of substance use disorder patients with comorbid attention deficit/hyperactivity disorder. European Addiction Research, 24, 43-51.
  10. Wilens, T.E., Adler, L.A., Weiss, M.D., Michelson, D., Ramsey, J.L., Moore, R.J., Renard, D., Brady, K.T., Trzepacz, P.T., Schuh, L.M., Ahrbecker, L.M., Levine, L.R. (2008). Atomoxetine treatment of adults with ADHD and comorbid alcohol use disorders. Drug and Alcohol Dependence, 96(1-2), 145-154.
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