What’s the Link Between Adderall and Depression?

Read on to understand when this medication is used for depression and whether it really helps.

Adderall is a stimulant medication that’s most commonly used to treat attention deficit hyperactivity disorder (ADHD) and the sleep disorder narcolepsy.

Sometimes, Adderall and other stimulants are also prescribed to treat depression. But is this medication safe and effective as a depression treatment? The evidence is still unclear.

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How does Adderall work?

Adderall contains two active ingredients, both of which are stimulants: amphetamine and dextroamphetamine.

Adderall works by increasing the amount of neurotransmitters available in your brain — mainly dopamine, norepinephrine, and serotonin. Neurotransmitters are chemical messengers that help your brain carry signals between cells throughout your body.

Here are some of the ways these neurotransmitters affect your brain:

• Dopamine influences motor functioning, pleasure, satisfaction, and motivation.
• Norepinephrine plays a role in alertness, focus, and clarity.
• Serotonin stabilizes mood and emotion and may help regulate hyperactivity and impulsivity.

Adderall is most commonly prescribed to treat ADHD and narcolepsy.

For people with ADHD, increasing the available levels of these neurotransmitters is thought to help:

• maintain focus
• boost motivation to aid in task completion
• reduce hyperactivity and impulse behavior

For people with narcolepsy, boosting these neurotransmitters in the brain can help maintain wakefulness.

Can Adderall be prescribed for depression?

Doctors sometimes prescribe Adderall to people living with depression. This is an off-label use, which means the medication is being used for something other than its approved purpose.

The Food and Drug Administration (FDA) has not approved Adderall as a treatment for depression, so any prescription of Adderall for depression is off-label. But this doesn’t mean that doctors are going rogue — it’s actually fairly common for doctors to prescribe medications for off-label uses in certain cases.

Doctors sometimes prescribe Adderall to people who have treatment-resistant depression if other forms of treatment have failed to relieve their symptoms. They also sometimes prescribe it for people who have both ADHD and depression.

Does Adderall really treat depression?

The short answer is: maybe not.

Results are mixed on whether Adderall and other stimulants can effectively treat depression and other mood disorders. Let’s look at what the research says.

A 2015 review of studies on the use of certain stimulants in adults with depression concluded that stimulants may boost mood, energy, and concentration. They may be particularly effective in people with treatment-resistant unipolar or bipolar depression and people who have significant fatigue or cognitive symptoms.

But the same review notes that relatively few double-blind, placebo-controlled studies (one of the most reliable types of research) have tested the effectiveness of dextroamphetamine (one of Adderall’s active ingredients) for treating depression.

If doctors are seeking stimulant treatment for treatment-resistant depression, the review authors suggest that they first consider modafinil (Provigil) and armodafinil (Nuvigil), which are both stimulant-like medications used to treat narcolepsy.

A 2016 review suggests that stimulants may help improve symptoms of depression but that the improvements may be short-term. The authors also note that there is little evidence from high quality trials to support the effectiveness of stimulants as a treatment for depression.

The authors recommend that stimulants be prescribed for depression and other mental health conditions only after other forms of treatment have failed — and even then, for only limited periods of time.

Finally, a 2017 review reports similar findings to the one from 2016: While some studies may have found that stimulants help improve symptoms in people with major depressive disorder, most of these studies have significant limitations.

The authors of the 2017 review suggest that stimulants could be more effectively tested as a treatment for particular mental health conditions rather than as across-the-board antidepressants. They conclude that the question of using stimulants to treat depression and other mental health conditions has simply not yet been studied enough.

Does Adderall have any risks?

Like any other medication, Adderall can have side effects. These can vary from person to person depending on factors such as age, existing health conditions, and other medications.

Some of the more common side effects are:

• dry mouth
• nausea
• vomiting
• diarrhea
• stomachaches or pain
• headache
• decreased appetite
• weight loss
• blurred vision
• changes in libido
• insomnia
• restlessness
• irritability
• nervousness
• anxiety
• depression

While they’re uncommon, Adderall may cause some serious side effects, including:

• heart problems
• elevated blood pressure
• seizure
• stroke
• slowed or suppressed growth in children

Can Adderall cause depression?

It’s important to note that Adderall may negatively affect your mental health and mood.

In fact, depression is one possible side effect of Adderall. This can look and feel different for each person.

According to the FDA, Adderall may worsen or cause depression symptoms in people with preexisting mental health conditions such as depression, bipolar disorder, psychosis, and mania.

Therefore, the FDA recommends that healthcare professionals carefully evaluate and monitor people who have ADHD and mental health comorbidities before and after prescribing Adderall or other stimulants.

According to the 2015 review mentioned earlier, healthcare professionals should not prescribe Adderall or other stimulants to people who have bipolar disorder and a history of stimulant-induced mania, psychosis, or rapid cycling.

The FDA also cautions that depression can affect people without other mental health conditions. In rare cases, people who don’t have depression before starting to take Adderall can develop symptoms of depression or mania while taking it.

Adderall can also affect mental health in other ways, as it may cause nervousness, anxiety, and irritability.

Are there any risks to taking Adderall and antidepressants?

If you take Adderall along with other medications that affect your serotonin levels, you might experience a reaction called serotonin syndrome.

Medications that boost serotonin levels include antidepressants such as:

• serotonin-norepinephrine reuptake inhibitors
• selective serotonin reuptake inhibitors
• monoamine oxidase inhibitors
• tricyclic or cyclic antidepressants

Serotonin syndrome is a serious reaction caused by having too much serotonin in your body. Most cases are mild, but in severe cases the reaction can be life threatening. Symptoms include:

• agitation
• anxiety
• restlessness
• disorientation
• unusually high body temperature (hyperthermia)
• vomiting
• tremors
• muscle twitches, spasms, or contractions
• dilated pupils
• flushed skin

Serotonin syndrome tends to happen within 24 hours of exposure to a new medication or to higher dosages of an existing medication. If no reaction happens within this time frame, it’s unlikely that serotonin syndrome will develop.

Treatment varies according to the severity of the reaction but includes stopping the medication that brought it on.

Adderall misuse

Adderall is a controlled substance and may pose a risk of misuse and dependence. You should never take it unless your doctor has prescribed it to you.

Adderall misuse can involve regularly and compulsively taking Adderall without a diagnosis or prescription, or it can involve having a prescription for Adderall but taking incorrect dosages, different from the dosage your doctor prescribed.

This is known as stimulant use disorder — continued use of stimulants outside of doctor-prescribed uses despite harm to the user. Stimulant use disorder is not just associated with recreational drugs — it can also occur with prescription medication, especially when that medication is not being used as prescribed.

If you’re experiencing Adderall misuse or other types of stimulant use disorder, reaching out to qualified professionals can be the first step in getting help. This may seem daunting, but you’re not alone and there are lots of organizations that can support you.

The Substance Abuse and Mental Health Services Administration has a free and confidential national helpline that can connect you with local services, assistance, and counseling.

The bottom line

Adderall is a safe and effective medication for treating ADHD and narcolepsy.

Doctors sometimes prescribe Adderall off-label for depression, particularly for people who have treatment-resistant depression. The FDA has not approved Adderall to treat depression, but this is still a common use of the drug.

There is not yet enough evidence to know for sure whether Adderall can effectively treat depression. It may even have negative effects.

If you think you may be experiencing depression, consider talking with a doctor or a mental health professional to get a diagnosis and develop a treatment plan that works for you.

In addition to various types of therapy, treatment for depression can include medication, and there are many FDA-approved antidepressant medications that are clinically proven to offer relief from depression symptoms.