Long-term Adderall use?

[my-cat-is-adhd]

Just started Adderall XR 10mg once a day (I sometimes do it twice a day because it wears off after 7-10 hours). While this drug is obviously amazing for the short-term, I question the wisdom in taking it at all. Won't I become dependent on the positive affects of this medication after a few months and become deeply saddened when I want to stop? I mean, at what point do we stop taking it? Is Adderall designed to be taken for life? I really don't understand why a doctor would prescribe this unless they intended it to be a long-term medication. Yet it is so effective at the same time. So to summarize:

1. Is Adderall intended to be a long-term drug? If so, up to how long can people take it for?
2. Will the effects of the drug eventually weaken to where I have to take higher dosages? And if so, at what point do we just stop upping the dose?
3. Will this drug likely have long-term negative effects on either my mental or physical health?
4. My libido has shot up like mad on this medication. Why doesn't the literature talk about this more. Is this a rare side effect or something?


Thanks.

[fnord]

increase in libido is a common effect of most stimulants.as to the long term effects im not completely sure i think i heard long term heavy stimulant abuse can make ones heart increase in size,but dosent that just mean one could love other even more?

[coldkate]

Originally Posted by my-cat-is-adhd

Just started Adderall XR 10mg once a day (I sometimes do it twice a day because it wears off after 7-10 hours). While this drug is obviously amazing for the short-term, I question the wisdom in taking it at all. Won't I become dependent on the positive affects of this medication after a few months and become deeply saddened when I want to stop? I mean, at what point do we stop taking it? Is Adderall designed to be taken for life? I really don't understand why a doctor would prescribe this unless they intended it to be a long-term medication. Yet it is so effective at the same time. So to summarize:

1. Is Adderall intended to be a long-term drug? If so, up to how long can people take it for?
2. Will the effects of the drug eventually weaken to where I have to take higher dosages? And if so, at what point do we just stop upping the dose?
3. Will this drug likely have long-term negative effects on either my mental or physical health?
4. My libido has shot up like mad on this medication. Why doesn't the literature talk about this more. Is this a rare side effect or something?


Thanks.

1- no. and i don't know. it doesn't make sense to me at all. it seems as if ADHD or w/e is being treated goes away over time, which doesn't happen..
2- yes. i guess the max dosage. i think that's 80mg? idk.
3- yes.
4- idk, and no it's not a rare side effect, i have it too.

my doc is reminding me how i'm going to be having to stop the adderall at some point. i'm a psych major and this still makes no sense to me. why prescribe a seriously addictive medication for short-term therapy that doesn't cure a condition, but treats the symptoms? to get off of it...horrible withdrawal, etc. i don't know. not looking forward to it. but yeah i tried to answer the q's.

[jazzmetalguitar]

Originally Posted by my-cat-is-adhd

1. Is Adderall intended to be a long-term drug? If so, up to how long can people take it for?

To SWIM's knowledge, Adderall is not meant to be a long-term drug in all cases. Physicians are supposed to reevaluate the need for the medication every once in awhile to ensure it should be re-prescribed. However, it is believed that the doses prescribed for ADD/ADHD can safely be continued as long as the drug is needed.

Originally Posted by my-cat-is-adhd

2. Will the effects of the drug eventually weaken to where I have to take higher dosages? And if so, at what point do we just stop upping the dose?

Yes. Amphetamines cause dopamine receptors to be stimulated more by keeping the dopamine in the synapse and preventing its breakdown. When the receptors become more stimulated over a period of time they readjust to be not as stimulated by the same amount of dopamine and, in addition, the number of receptors in decreased. This is tolerance and if it was caught, yes, you don't actually become tolerant to the drug, but your own dopamine.

BTW....2-4% of a studied population is generally considered a rarer side effect. Most people don't get this, though almost all would at higher doses.

Due to this, the dosage must be increased to get the same effect. However, it seems to be a trend that in treatment of ADD/ADHD this tolerance stops growing at about a 30mg dose (although higher doses are available for special cases), though the euphoria sought by some can be tolerant infinitesimally. For SWIY, this means there is little to worry about. Though the dose may go up, it will not be forever.

Originally Posted by my-cat-is-adhd

3. Will this drug likely have long-term negative effects on either my mental or physical health?

Long-term use of the drug is not yet fully understood, but likely the doses aren't enough to cause serious heart damage, though pills in general are not great for the liver. The effects SWIM described on the dopamine system will cause a misbalance when the drug is stopped after long-term use, however, unless damaged by high doses or chronic abuse the dopamine system readjusts very well to what was "normal."

Originally Posted by my-cat-is-adhd

4. My libido has shot up like mad on this medication. Why doesn't the literature talk about this more. Is this a rare side effect or something?

The links between amphetamine and libido are not well known, however, SWIM theorizes this because amphetamine targets the same dopaminergic areas as sex, addiction, etc. (hence the smokers increase of cigarettes while on amps, impulsive behavior, and such)

Originally Posted by coldkate

my doc is reminding me how i'm going to be having to stop the adderall at some point. i'm a psych major and this still makes no sense to me. why prescribe a seriously addictive medication for short-term therapy that doesn't cure a condition, but treats the symptoms? to get off of it...horrible withdrawal, etc. i don't know. not looking forward to it. but yeah i tried to answer the q's.

SWIM doesn't describe amphetamines as highly addictive by any means (though chronic insufflation usage can provoke such due to such high dosing and serum levels), though methampethamines are a different story and different chemical. The withdrawal can be eased in many ways because it is mostly due only to the dopamine tolerance. And as far as prescribing treatment that doesn't cure? That is what all medicine is for the most part.

[realitybias]

Everyone else before me seems to have given good info, but there is something that I think a few people got wrong.

Tolerance to dopamine does happen, but dopamine is not the only neurotransmitter that is affected by amphetamine. Norepinephrine is also affected by amphetamine. What seems to happen is this: The recreational effects are tolerated, but the cognitive improvement from them remains.

This calls for a little lesson in human anatomy and neurology.

Norepinephrine is usually excitory, and dopamine is usually inhibitory. The autonomic nervous system is controlled by parasympathetic and sympathetic neurons. Parasympathetic neurons are what are active whenever you are calm, relaxed, sedated. You begin to salivate, you digest your food, blood flow to the skin is high, homeostasis is the most important goal, your pupils constrict. Sympathetic neurons are what are active whenever you have your ass on the line. Your body is focused more on the challenge at hand, and its main evolutionary purpose is survival. Your pupils dilate to see more of your surroundings. Your stomach stops digesting food, your muscles react faster, your heart rate increases, and blood is shunted more to your muscles and internal organs, especially the brain, rather than the skin. The sympathetic system is often named the "fight or flight" response.

Taking amphetamines activates the sympathetic nervous system more than the parasympathetic nervous system, and we "abuse" our evolutionary nature by creating a false sense of the need for survival, say, when swimmers use it to take a test or clean the house. The body builds tolerance to dopamine's mood enhancing effects, but norepinephrine is very closely related to adrenalin and epinephrine, which the (as long as it is in high enough concentrations) will ALWAYS activate the sympathetic nervous system, so the therapeutic effects never go away.

[jazzmetalguitar]

Originally Posted by realitybias

The body builds tolerance to dopamine's mood enhancing effects, but norepinephrine is very closely related to adrenalin and epinephrine, which the (as long as it is in high enough concentrations) will ALWAYS activate the sympathetic nervous system, so the therapeutic effects never go away.

...but amphetamine doesn't increase levels of norepinephrine. It inhibits the synapses' ability to reuptake the neurotransmitter, just as it does with dopamine. Given that the catecholaminergic synthesis path doesn't occur in the synapses, the increase of concentration at that location means nothing for epinephrine. Thus, epinephrine has nothing to do with this and norepinephrine has the same down-regulation and tolerance issues as dopamine.

Otherwise, your info was quite accurate and SWIM was in fault for not taking norepinephrine into account. The tolerance to norepinephrine develops much more slowly (though SWIM is not sure how well it repairs, though the dopaminergic system repairs rather well), but tolerance is still there. Nonetheless, norepinephrine plays key roles itself in amphetamines mechanisms, hence drugs, such as Strattera, which only act upon norepinephrine.

[realitybias]

Jazz, I was not meaning to sound like I was saying that amphetamine increased levels of norepinephrine. When I say available in high concentrations, I am speaking aobut concentrations between neurotransmitters. I think the confusion comes from fuzzy grammar, and I just should not have mentioned epinephrine (the whole second half of that was suposed to describe norepinephrine).

You are spot on with norepinephrine, and I was just trying to figure out a reason why the focus-enhancing effects seem to never go away (and in fact, many users report a sensitization to the focus-enhancing effects, despite tolerance to other effects with time).

[wendel]

I worried about the same things the thread starter is.

It's debatable whether ADD is actually a real thing. It sad that young kids are often given stimulants, but they do often do their job in making the child easier to manage. Doctors don't really know about the effects of long-term use.

That being said, I just an Adderall prescription, and I quite fond of it. It seems to make life easier for now. But no, I don't want to be taking it for life. Hopefully I only need it for my present situation and environment, or I learn from the drug and do what I should without it. But I am a bit worried about tolerance and becoming dependent on it, and what it might be doing to my body.