Unwanted Adderall XR side effects, how to make them go away?
September 15, 2013 8:15 AM   Subscribe

Asking for a friend: This is a question for people who have experience with Adderall. I just went on Adderall XR 20 mg about 5 days ago. I have very bad ADD and the Adderall is definitely helping with that so far. I am however concerned with some of the side effects that I am experiencing.

For example, I have consistently cold hands and also am getting a bit of muscle tension in my jaw/shoulders. Besides that, the Adderall is working great for my ADD symptoms so I would not like to go off the drug - I am getting things done and functioning like a normal person for the first time in my life!!

I am a late-20s male, and weigh about 175 pounds. Do these side effects go away with time? If that is not the case, do you think it would be a good idea to lower the dose a bit (to, say, 15mg)? Has anyone done so and had the side effects decrease?

I know you guys are not doctors (well, maybe some of you are). I would just like to hear some personal anecdotes regarding this.
posted by Thanquol180 to Health & Fitness (16 answers total) 1 user marked this as a favorite
Two things you might try. Lowering the dose a bit. And using Vyvance instead. (My son, were he here, would add, "marijuana helps take some of the edge off.")
posted by Obscure Reference at 8:29 AM on September 15, 2013 [3 favorites]

1. Many report that the side effects do lessen or go away with time. 2. I had unpleasant side effects with Adderall, so I switched to Ritalin (actually, concerta, which is extended release Ritalin) which was better for me.
posted by lunasol at 8:38 AM on September 15, 2013

I had many, many fewer side effects (for me, dry mouth and sweating) with the non-time release stimulant. It also allowed me to regulate my own dosage, truly taking it "as needed." The time release uniformly made me feel physically terrible. So you might try that.
posted by decathecting at 8:42 AM on September 15, 2013 [2 favorites]

Response by poster: One point I forgot to mention: I have already tried Concerta, which just made me feel weird. Have not tried any other ADD meds.
posted by Thanquol180 at 9:02 AM on September 15, 2013

I would try a lower dosage. The XR also comes in 10mg and 15mg.
posted by elizardbits at 9:21 AM on September 15, 2013

IANAD. My husband is slightly older than you and weighs a bit more (around 200 lbs.) and started out on Adderall XR 10mg about two months ago. He had side effects of jitteriness and loss of appetite for about a week, and then those faded out. I would definitely thing it would be worthwhile to call your doctor and see about lowering the dose for now and going back up as needed once your body is used to the medication. Also, check in with your doctor about those specific side effects to see if she/he has any suggestions. If they're fairly common, other patients may have developed good ways to cope that she/he can share with you. Good luck!
posted by epj at 9:33 AM on September 15, 2013

I would second starting with a lower dosage, and then slowly increase to 20 over a month or so if you feel like you need to.

I have also found that taking pure Dexedrine (the primary amphetamine salt in Adderall) is much better in terms of side effects.
posted by St. Sorryass at 11:18 AM on September 15, 2013

1: cut down on caffeine.
2: quit smoking if you do.
3: spread the dose out over the day. eg, 15 in the am and the rest of the capsule around lunch time.
posted by gjc at 11:19 AM on September 15, 2013

If you want to try out lowering the dose but they give you the 20mg capsules, you can open the capsules up and divide up the little balls. So if you have 20mg capsules and you want to try out 15mg without having to go get a different prescription, take 3 pills, open them all up and put them in a little cup or something and divide it into 4 equal piles, then save those 4 piles separately in some way where they won't get mixed up.

Unfortunately I've never experienced side effects from Adderall or Concerta, so I don't have any experience in trying to fix them.
posted by 0x006DB0 at 12:23 PM on September 15, 2013

Are you taking it with meals? If not, try taking it on a full stomach and see if that helps.
posted by Jacqueline at 3:02 PM on September 15, 2013

Adderall causes vascular constriction - which might be what's making you chilly. Taking other vasoconstrictors like caffeine, nicotine, pseudoephedrine etc. on top of the Adderall might make it worse. Jaw tension usually often fades. I still notice it from time to time when I am stressed or cranky, but it's pretty easy for me to relax when I'm aware of it. Just keep an eye out for teeth grinding. My experience and non-expert-not-a-medical-professional-opinion is that the side effects you're experiencing probably aren't dangerous unless you have heart or hypertension problems.

It's unlikely that anything bad will happen if you lower your dose or stay at 20mg for awhile longer. Obviously you could loose could some therapeutic value at lower doses. This can be a good thing if it helps you a. calibrate the dose you need to function the way you want and b. weigh cost/benefits. Starting low and building up as necessary might also minimize side effects.

5 days probably isn't enough time to get an accurate read on how it will affect you long term. The nice thing about Adderall is that, at least for me, almost all of the side effects faded and are easily managed with minor adjustments in dosage and habits.

Below are some other side effects I've noticed. Most disappeared or faded considerably. The ones that remain are minor nuisances and are well worth it. Me: 120 lbs, lady. I've been at 20mg 2x per day approx 4-6 hours apart for about a year.

* Dry mouth (due to it being both a vasoconstrictor and a salt): drink more water. Moisturizing mouthwash can help too.
* Insomnia: dose either too high or taken too late in the day. Adjust one at a time to get an accurate idea of which is which. I can't take XR because of this.
* Reduced appetite: food seems gross to me unless I eat before taking the meds. I still have to force myself to eat snacks to maintain blood sugar. It's kind of annoying.
* Unusual crabbiness/irritability: dose might be too high, might mean being tired/hungry without feeling tired/hungry since stimulants mask both.
* Subtle, weird warm-zingy feeling on my skin: have no idea what causes this, does not bother me. Might be another dose too high indicator.
* I seem to hyper-focus more - which does cause some functional problems. Unfortunately it's so damn pleasurable that I sometimes have a hard time summoning the desire to do anything about it without a strong motivator or external reminder.
*Some mood up/down ticks as it kicks in/wears off. This subsided without losing the main benefits. 10-15 min. brisk exercise helps quite a lot. Definitely talk to your doctor if you experience distressing/pronounced mood crashes.
*Some smokers notice increased cravings for nicotine. I did, had a harder time quitting and needed to take an Adderall break in the early days.

Happy tinkering.
posted by space_cookie at 3:42 PM on September 15, 2013

I had to try 2-3 different ADD drugs to find one that had an effectiveness/side effects balance that worked well for me, and ended up with a smaller-than-standard dosage as well. I still get tight jaw muscles and have a hard time transitioning off the drug without the very strategy Obscure Reference's son suggests.
posted by croutonsupafreak at 4:12 PM on September 15, 2013

I adjusted some over time, but my experience on Adderall got about a million times better when I got an Inderal prescription to go with it, even though my blood pressure is ordinarily fine. I'm on the IR, not the XR, but I suspect it would be similar. I still have occasional insomnia problems but I've mostly adapted, and I make a point of eating a solid breakfast because I know I'm going to skip lunch nine times out of ten.

The big issue I had for awhile was that I went from having mild, slightly annoying acid reflux to it being absolutely horrible, and that didn't improve until I stopped trying to cope with more Tums and actually started taking Prevacid.
posted by Sequence at 4:39 PM on September 15, 2013

I have terrible ADD, too. Everyone is different when it comes to psychotropic medicines. I'm having good luck with Vyvanse right now after Concerta and then Focalin stopped working after couple of years each. (They are different forms of Ritalin, which you said didn't work for you.) I've been taking Vyvanse for a couple of years.

Like any stimulant, you'll build a tolerance to the drug after a while. This may make your side effects get better or maybe even go away at the same dose. For me, with the Vyvanse, my heart rate was too fast at first. It's still a little fast, but better than it was. I also had problems with dry mouth, which has disappeared. It also made me crave nicotine more, though I am back down to a little less than a pack of cigarettes a day now.

Unfortunately, the tolerance also caused the medicine to not work as well over time. I'm maxed out on the dose for Vyvanse now, so my doctor added some Straterra (which isn't a stimulant) and it seems to be working better again.

I haven't smoked pot in almost 20 years, so I can't speak to how helpful/unhelpful that would be.

IANAD, YMMV, etc. Good luck.
posted by double block and bleed at 5:49 PM on September 15, 2013

Response by poster: Hi everyone. I just asked the doctor to lower the dose and he agreed. I'm not sure if he's taking me down to 15 or 10 mg, and I don't really care at the moment. I will post in a couple of weeks or so to let you guys/gals know how the reduced dose works out.
posted by Thanquol180 at 5:23 PM on September 16, 2013 [1 favorite]

Response by poster: Okay, so the doctor took me to 10mg which lowered the side effects but definitely wasn't enough symptom-controlling-wise; it would poop out after about 5 hours and I would feel like a zombie for the rest of the day. That never happened with the 20mg. I'm going to be taking 15mg strength starting today - hopefully that is my sweet spot!
posted by Thanquol180 at 5:36 AM on October 8, 2013

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