By: Sumaiya Chowdhury, PharmD Candidate c/o 2026, Daniyal Khan, PharmD Candidate c/o 2027, Wajiha Uddin, PharmD Candidate c/o 2027 & Riha Chowdhury, PharmD Candidate c/o 2027
Abstract
Adderall is a prescription drug used to treat individuals diagnosed with attention deficit hyperactivity disorder (ADHD) and narcolepsy². However, the illegal use of Adderall has been observed among college students who have not been prescribed this medication for either one of these diagnoses. This may be due to the high pressure and stress caused by academic demands¹. This is confirmed by double blind, placebo-controlled crossover pilot study conducted in 2018 on Adderall use in college students³. Pilot studies are categorized as a smaller research project conducted before starting the original large-scale study³. The goal of the pilot study is to see if Adderall has the ability to increase the cognitive abilities of the college students using this medication in order to be able to focus more or to see if there actually are no benefits of using this medication on students without ADHD.
What is Adderall?
Adderall is FDA indicated for the treatment of narcolepsy and ADHD. It does this by enhancing the release of norepinephrine, dopamine, and serotonin into the synaptic region while preventing their absorption. When taken as prescribed, Adderall can help manage the symptoms of ADHD such as inattention, hyperactivity, and impulsivity. By raising dopamine and norepinephrine levels in the brain, Adderall helps lessen the symptoms of ADHD by enhancing focus, reducing impulsivity, and lowering hyperactivity. However, abuse can have detrimental effects. Although some people don’t think Adderall is addictive, it can become very habit-forming, especially if taken excessively or without a prescription. Many people believe it is safe to use as needed, however it can be risky to take several doses without a doctor’s supervision. Loss of appetite, weight loss, stomach pain, headache, nausea, dizziness, anxiety, and difficulty sleeping are possible adverse effects. Adults should start taking Adderall pills at a dose of 5 mg once or twice a day, with a doctor adjusting the dosage as necessary. According to studies, Adderall’s effects on neurocognition are negligible at lower dosages, such as 10 mg, and are still comparatively minor even at 30 mg. Adderall improves attention by helping the brain stay focused on tasks for longer periods and reducing distractibility. It also enhances working memory, making it easier to hold and use information in the short term. Additionally, Adderall supports better decision-making by increasing impulse control and improving the brain’s ability to plan and respond thoughtfully, rather than reacting impulsively.
The Experiment
The study consisted of healthy young college students ranging in age from 18 to 30 without a history of ADHD, with a normal EKG, and with no chronic medical conditions requiring medications in the last six months. This exclusion criteria does not apply to female participants on antibiotics or birth control. All participants were expected to complete pre-assessment neurocognitive tests and baseline testing of heart rate and blood pressure. Each participant then underwent two randomized, double-blind sessions. In one session, the participants were either given a 30 mg oral dose of amphetamine mixed salts or a placebo of dextrose each session. Following administration, the participants fasted for 2 hours and repeated a neurocognitive assessment between 90- and 210-minutes post-consumption, while autonomic activity was remeasured every 30 minutes. The neurocognitive assessment includes attention tasks, memory tasks, and executive function tasks. A DEQ (Drug Effects Questionnaire) was also administered to provide a subjective perspective, and both a PA (Positive Activation) and NA (Negative Activation) scale were used to measure the emotions felt by the participants. After the first session, a 5–7-day washout period was observed before the experiment was repeated in a second session.
Discussion
The study exhibited mixed results. In terms of neurocognitive performance measures, the Adderall and placebo sessions were not significantly different. Participants exhibited impaired working memory performance, reduced response variability, a “worsening of participants’ ratings of their own past cognitive ability,” but an improvement in attention skills³. However, Adderall exhibited substantial effects on autonomic activity; there was an increase in heart rate, systolic and diastolic blood pressure, feeling the drug’s effect, feeling high, and positive activation (PA). This effect on autonomic activity does not correlate with an improvement in cognitive performance. Some limitations include a small sample size, the potential drug effects not being analyzed after the peak period, and low power for detecting small to moderate effects but high power for large effects. Overall, Adderall is shown to improve attention but cannot enhance academic performance.
Conclusion
As more individuals use stimulants such as Adderall outside of its intended medical context, the consequences are growing more concerning. The growing issue of non-medical use is contributed by informal channels, which are often the ones supplying college students with access to Adderall. These informal channels are peer-to-peer diversion, dark web markets, social media forums, and as plain as taking it from a relative’s medication cabinet⁴. Among college students in particular, there is a growing misconception that Adderall is safe to use off label and can help with increased concentration and cognitive function or can be used recreationally for weight loss or partying. Through the misuse of stimulants like Adderall, symptoms of ADHD and anxiety have become prominently high. Although healthy individuals can have slight cognitive benefits, the side effects like daydreaming, sadness, heightened anxiety, and irritability, showcase that the behavioral risks of using Adderall without a prescription make it an unwise choice.
References
- DeSantis, Alan D., and Audrey Curtis Hane. “Adderall is Definitely Not a Drug: Justifications for the Illegal Use of ADHD Stimulants.” Substance Use & Misuse, vol. 45, no. 1-2, 2010, pp. 31-46. https://www.tandfonline.com/doi/10.3109/10826080902858334.
- Ahmann, Elizabeth, et al. “Placebo-Controlled Evaluation of Amphetamine Mixture—Dextroamphetamine Salts and Amphetamine Salts (Adderall): Efficacy Rate and Side Effects.” Pediatrics, vol. 107, no. 1, 2001, e10. https://publications.aap.org/pediatrics/article/107/1/e10/66525.
- Weyandt, Lisa L., et al. “Neurocognitive, Autonomic, and Mood Effects of Adderall: A Pilot Study of Healthy College Students.” Frontiers in Psychology, vol. 9, 2018, article 2326. https://pmc.ncbi.nlm.nih.gov/articles/PMC6165228.
- Lakhan, S. E., & Kirchgessner, A. (2012). Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: Misuse, cognitive impact, and adverse effects. Brain and Behavior, 2(5), 661–677.https://pmc.ncbi.nlm.nih.gov/articles/PMC3489818/
