Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN
Written By: Phillippe Greenough
Article Updated: 11/22/2021
Number of References: 6 Sources
There is a common misconception that because a drug is prescribed by a doctor, it must be safe and there is no risk. This is simply not the case. Adderall is an amphetamine drug and can be very addictive, even when taken as prescribed. The withdrawal symptoms, while primarily psychological, can nevertheless be extremely uncomfortable and long-lasting. In addition, chronic Adderall use can create or amplify a variety of psychological disorders that become apparent during Adderall withdrawal. We take an in-depth look at the symptoms of Adderall withdrawal, how these are produced in the brain and the average timeline for withdrawal.
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The timeline for Adderall withdrawal is usually extended over several months, although the symptoms will gradually reduce over time. This experience may last between a few weeks or several months depending on the person. While the early days will be the most intense, these symptoms usually reach manageable, but still unpleasant, levels around 1 to 2 weeks after ceasing Adderall use. There are certain variables that can affect this timeline, but we will take a look at a common and general timeline for illustration.
While Adderall does not produce a classic “acute” withdrawal syndrome, the experience is certainly more intense in the time immediately after someone ceases Adderall use. This is due to the severe downregulation which has occurred that had been balanced out by repeatedly using Adderall. Once Adderall use has ceased, there can be an extreme deficit of neurotransmitters in the brain, and this results in a plummeting mood, energy level, outlook, and ability to concentrate.
These symptoms will begin in a very intense fashion through the Adderall crash and gradually reduce with time. The fact that Adderall withdrawal maintains similar symptoms throughout, albeit of varying intensity, is why it is considered to lack a classical acute/post-acute distinction. Some symptoms may resolve quicker than others, but there is no clear delineation between distinct phases. The intensity of withdrawal symptoms as well as withdrawal duration can vary quite a bit between people as we will examine further.
A general overview of the Adderall withdrawal timeline may look something like this:
Adderall withdrawal symptoms will typically begin a day or two after someone last used the drug. These will be most severe in the first day or two, leaving someone completely drained emotionally, mentally, and physically. Around the middle of the first week, hypersomnia may transform into insomnia, with someone being exhausted but still unable to sleep.
Some symptoms of Adderall withdrawal that are common during the first week may include:
The second week typically shows some marked improvement in the severity of symptoms, although all are frequently still present. Cravings for Adderall and depression will still be present, but anxiety may reduce slightly. Anxiety is most commonly manifest as social anxieties during Adderall withdrawal, and this may become more apparent around the second week as overall anxiety may become more directed towards social anxiety.
Some of the common Adderall withdrawal symptoms that may persist into the second week can include:
While these are usually some of the same symptoms as during the first week, these are usually on their way to resolution by now.
The third week of Adderall withdrawal may show some progress in the severity of the symptoms. Sleep issues will typically resolve around the third week and appetite may return to normal as well. While this is still an uncomfortable time, it may be the first time someone sees light at the end of the tunnel, so to speak. Thinking may begin to clear up and fatigue or lethargy may begin to lift as well. Cravings and depression will probably linger for several weeks, or possibly even months, but will gradually improve as time passes. There have been cases of cognitive issues such as slow or disorganized thinking persisting for up to a year, but this is rare.
While these symptoms may still be present, they are often much less severe than during the first 2 weeks. These symptoms will continue to resolve over time, but they may persist for some time.
The symptoms of Adderall withdrawal can vary both in intensity and duration between individuals. Some of these factors are predetermined at birth, but others are influenced by the choices someone makes and technically within the control of an Adderall user.
Some of the factors which heavily contribute to the intensity and duration of withdrawal from Adderall include:
There is certainly a genetic component to addiction as evidenced by the fact that it tends to run in families. If someone has close family members who suffer from addiction, they have a higher chance of exhibiting additive patterns themselves. This can affect both the intensity and duration of Adderall withdrawal, albeit in an indirect manner. Having a genetic predisposition for addiction means that it will take someone less time, or even smaller amounts used to develop tolerance and then dependence. In this way, someone with a genetic predisposition for addiction may experience worse withdrawal symptoms than someone who had no family history and no such predisposition, even if they used the same amounts of Adderall for the same amount of time. This can also contribute to worse cravings once Adderall use is stopped.
The amounts the Adderall someone used as well as the length of time they used contributes in the strongest and most direct manner to Adderall withdrawal intensity. Withdrawal is a direct result of neurotransmitter downregulation. The more Adderall someone does, the greater the degree of downregulation. The greater the degree of downregulation, the worse someone will feel when they do quit using Adderall. Likewise, the longer someone uses Adderall, the more complete this downregulation becomes, thus the longer it takes to reverse and the more protracted the experience of withdrawal.
If someone had experienced Adderall withdrawal before, and in particular suffered psychotic symptoms, they will be more likely to experience psychotic symptoms the next time they undergo Adderall withdrawal. Additionally, people with co-occurring mental health issues such as schizophrenia are at a much greater risk of experiencing psychotic episodes during Adderall withdrawal. Finally, if someone were to be suffering from depression or anxiety before Adderall addiction, then the depression and anxiety during Adderall withdrawal would be much more severe than it would otherwise.
To get a better understanding of Adderall withdrawal, it will be useful to know some of the specifics of Adderall addiction. Adderall works by affecting the function of 3 major neurotransmitters in the brain. The greatest effect by far is on the neurotransmitter dopamine. Dopamine is a major excitatory neurotransmitter that helps to amplify and strengthen nerve signals in the brain. Serotonin and norepinephrine are also affected, but to a lesser degree than dopamine. Serotonin is a mood enhancer and mood-regulating neurotransmitter while norepinephrine is both a hormone and neurotransmitter which regulates adrenaline function.
Adderall increases levels of all of these neurotransmitters, but to different degrees and through slightly different means. Dopamine receives the greatest boost, both through increased production as well as reuptake inhibition. Reuptake is the brain’s recycling process that sweeps up neurotransmitters after they have been used while also removing them from the synaptic cleft. Reuptake inhibition reduces these recycling and clearing processes which lead to greatly increased levels and an increased duration of stimulation. Serotonin and norepinephrine also undergo reuptake inhibition, but may not have production levels increased to the degree that dopamine experiences.
The surge of dopamine produced through Adderall use is directly responsible for the euphoria and pleasure and is partially for the increased energy. Increased levels of serotonin result in mood elevation and can boost the subjective pleasure felt from the flood of dopamine. Norepinephrine is most responsible for physical stimulation including increased heart rate, blood pressure, and blood sugar levels since it also acts as a hormone in the blood. When these 3 neurotransmitters are released in the levels and manner produced through Adderall use, someone is likely to feel very good, upbeat, full of energy, and extremely confident and capable.
The symptoms of Adderall withdrawal are the exact opposite of the “high” that Adderall produces. Due to chronic stimulation of these neurotransmitters, the brain will alter its responses to them through a process called downregulation. This is an attempt to maintain balance which can be disrupted through continuously heightened levels of these neurotransmitters. The immediate result is that tolerance begins to build, as higher levels of these neurotransmitters are needed to produce the same result. After a time dependence develops, where the brain will begin to be unbalanced when someone has not used Adderall. This will amplify through continuous use and the withdrawal symptoms will worsen over time.
The Adderall withdrawal symptoms are very unpleasant and require medical help if someone is to comfortably make it through the withdrawal and detox process. Adderall detox centers can offer medical supervision, medications, and therapeutic techniques that have proven most effective at treating this condition and helping someone into the journey of recovery. Entering one of these detoxes can greatly increase the chances of making it through Adderall withdrawal and begin to build a life after Adderall addiction.
There are several other stimulant drugs that can produce uncomfortable or even dangerous withdrawal symptoms. We have more in-depth withdrawal guides for drugs such as:
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