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Coming off medication can be exciting and scary at the same time. If you’re overcoming Adderall abuse, you may be looking forward to a new lease on life. If you’re recovering from mental illness, reducing your need for meds may feel like a new beginning too.
Rapid withdrawal comes with the dreaded Adderall crash, whether you were taking Adderall for medical reasons or are recovering from drug abuse. What is it, and how can we ride the wave to our new Adderall-free tomorrow?
The “crash” stage of Adderall or other amphetamine withdrawal, also known as an Adderall comedown, is the result of going cold turkey from the drug. It is a syndrome involving intensely unpleasant mood changes, such as severe depression, anxiety, panic attacks, irritability and even paranoia. Unfortunately, one study estimates that 87.6% of people suffer at least six symptoms of amphetamine withdrawal [1].
Adderall works by increasing the release of dopamine and noradrenaline, as well as slowing their breakdown. These two neurotransmitters (chemical messengers) are essential for functions including motivation and learning. When you quit Adderall, this support ends, and your noradrenaline and dopamine levels drop rapidly [1].
The time it takes to feel the effects of Adderall withdrawal may depend on the dose you’ve been using and how well your body detoxifies from medications. You can expect to develop symptoms of Adderall withdrawal within the first 24 hours of going cold turkey [1].
The half-life of Adderall may be one way to estimate how long it takes for withdrawal symptoms to appear. A drug’s half-life is the time taken for half of your dose to be removed from your body. The more potent D-amphetamine (Adderall XR) has a half-life somewhere between nine and 11 hours, while it takes 11-13 hours for half of the L-amphetamine dose to be detoxified [2].
The main symptom during an Adderall comedown is negative mood changes, which can include anything from just feeling irritable to depression, anxiety and paranoia. Diagnostic criteria for amphetamine withdrawal also lists insomnia and hypersomnia (sleeping too much); vivid dreams or nightmares; fatigue; increased appetite and disrupted or slowed motor function [3].
It’s important to seek help if you feel like you can’t cope with withdrawal symptoms after Adderall abuse. The depression and paranoia that the Adderall crash features can even lead to suicidal thoughts, with some people attempting suicide or continuing to abuse Adderall [3].
Common Adderall side effects include:
In specific groups or at high doses, there are other symptoms to consider:
High doses of amphetamines can cause severe addiction, personality changes, hyperactivity, irritability, panic attacks, insomnia and even heart attack. A form of psychosis which resembles schizophrenia is the most serious manifestation of long-term amphetamine abuse.
The effects seen at high doses are partly why Adderall is categorized as a controlled substance, and use is not recommended for an extended period [4].
Children with ADHD are commonly prescribed Adderall, or Adderall XR, to manage their symptoms as part of a comprehensive treatment plan. Surveys show that common side effects include stomach ache, loss of appetite and insomnia. These side effects are worse at higher doses of the drug [4].
Additionally, there is a chance that amphetamines such as Adderall could slow growth in children. A reduction of two centimeters (almost one inch) in three years has been documented with use of a similar drug, with no evidence of a rebound [4].
The risk of growth impairment mentioned above has not been studied in teenagers. However, the FDA’s label for Adderall mentions the need to watch out for new manic or psychotic symptoms, along with increased aggression, in both children and teenagers taking the drug [4].
The most common side effects of Adderall include insomnia, poor appetite, nervousness, general overstimulation and fever. You may also have diarrhea or constipation; itching; blurred vision; changes in libido; and at higher doses, muscle damage. In a way, the lifted mood and sharpened focus can be a negative side effect, as it makes abuse more tempting [4].
Adderall is listed in Pregnancy Category C, meaning it is potentially unsafe. Animal studies point to potential risks of taking Adderall in pregnancy, and there is at least one report of birth defects occurring with Adderall use. Adderall is linked to an increased risk of premature birth and low birth weight, as well as withdrawal symptoms after birth [4].
There are two primary causes: a fall in the neurotransmitters dopamine and noradrenaline, and a rise in the stress hormone, cortisol.
Adderall’s ability to keep dopamine and noradrenaline levels high turns down your brain’s production of these neurotransmitters.
When we have enough dopamine and noradrenaline, our neurons receive a signal to stop producing them in order to maintain balance [5]. The abrupt end to this support after large doses or taking the drug for extended periods triggers a steep drop in the levels of these chemicals.
Animal models of Adderall’s effects reveal that cortisol levels rise in the brain when we quit cold turkey. High cortisol keeps us awake, and heightens our perception of stress, leading to insomnia and anxiety [6].
There are several lifestyle tips you can use to help yourself when riding the wave of Adderall withdrawal.
Many people going through the Adderall detox reach for another dose to find temporary relief. It’s best to avoid this temptation, even if you’re considering a smaller dose.
Research shows that abusing Adderall intermittently has extra negative effects that taking the drug regularly doesn’t. Mice on a yo-yo regimen were shown to have higher cortisol levels, which is the main stress hormone [6]. Over time, elevated cortisol can lead to brain shrinkage. Not only is it toxic to neurons, but it also impairs the growth of new neurons [7].
If you can barely scrape together the motivation to get out of bed from intense depression, it pays to have a bottle or tall glass of water by your bedside. Dehydration causes cognitive impairments of its own, and increases cortisol concentration [8].
Boost your brain health long-term as your appetite returns by skipping junk food. Research shows that Mediterranean-style diets, rich in nutritious foods containing polyphenol antioxidants, vitamins, minerals and omega-3 fatty acids are the most protective against cognitive decline. These protect the brain cells by providing anti-inflammatory and antioxidant support [9].
Regular exercise may help to clear out the rise in cortisol that comes with withdrawal from Adderall. However, you should avoid giving it all you’ve got. High-intensity exercise, at 60-80% of your maximum cardio capacity, can increase your cortisol levels [10].
It’s best to stick to low-intensity activity, which is around 40% of your maximum capacity [10]. Yoga, walking and swimming are some gentle forms of exercise that may also help just by keeping your thoughts away from withdrawal symptoms and drug cravings.
Adderall withdrawal is associated with a rise in cortisol, the main stress hormone [11]. If you focus on everything that’s going wrong and how unpleasant your symptoms of withdrawal currently are, you create another stressful stimulus that triggers the production of even more cortisol.
One way to manage stress and reduce your cortisol levels is mindfulness meditation. Research shows that some types of meditation, including OM meditation, can soothe stress and lower cortisol. OM involves observing all of your thoughts and sensations, without forming any attachment or reacting to them [12].
Hours may feel like entire days, but keep in mind that the worst symptoms usually resolve in several days. Remember that this too shall pass.
If you have trouble staying asleep because of your Adderall withdrawal symptoms, it’s best to at least rest your eyes in the dark.
Avoid distracting yourself with your phone or anything that involves light exposure, as this increases cortisol production. Our circadian rhythms, which tell our bodies when to wake up or go to bed, respond to light. Darkness sends a signal to generate more melatonin, the sleep hormone, and keep cortisol levels down [13].
Other stimulants may amplify the symptoms of withdrawal from Adderall, even though they are a tempting way to fight fatigue. Caffeine is undoubtedly the most popular stimulant in the world, but it can cause anxiety, nervousness and insomnia in large amounts [14].
A sudden withdrawal from Adderall could put your mental and physical health in danger. As we mentioned earlier, suicidal thoughts and even suicide attempts are known to appear during the crash phase, as well as psychosis. Seek Adderall addiction treatment if any of these develop, or if you have a history of other mental disorders or substance abuse.
If you’re struggling through withdrawal, certain medications may bring relief. This is not intended to provide medical advice, but to highlight ways of relieving common symptoms.
Antidepressants typically work by slowing the reuptake of serotonin back into brain cells, increasing levels of the neurotransmitter. Serotonin has mood-lifting, yet calming effects. It not only can be depleted in cases of stimulant addiction, but may also reduce cravings for stimulants such as amphetamines [15].
Clinical studies show that antidepressants may be effective for some people going through stimulant withdrawal, but results are mixed [16].
Some muscle relaxants also act as anti-anxiety and sedative medications. This is particularly the case with benzodiazepines, a type of central nervous system depressant which can relieve anxiety, insomnia, and possibly body aches, while giving you an overall relaxed feeling. However, these can be addictive too, so use them with caution and under medical advice [17].
Valium, or diazepam, has been used for decades to relieve anxiety. As withdrawal from amphetamines such as Adderall can cause anxiety, lab research tested diazepam’s effects on withdrawal symptoms. Diazepam was able to reverse the anxiety seen with symptoms of withdrawal from the first dose, meaning it may provide effective relief in humans [18].
Other medications available over-the-counter can help if you have trouble sleeping. Antihistamines have sedating effects by blocking histamine, which is also a stimulating neurotransmitter, while melatonin acts directly as a sleep-promoting hormone [19].
Adderall is a legal, safe form of amphetamine, one of the prescription stimulant medications used to treat Attention Deficit Hyperactivity Disorder (ADHD). The drug is made up of D-amphetamine and L-amphetamine, which are essentially mirror images of the same amphetamine molecule. Mirror images of the same molecule are known and used in the chemistry world for their different properties [20].
In the case of Adderall, D-amphetamine is more potent while L-amphetamine has more staying power. Together, they make a stronger central nervous system stimulant than the dopamine and noradrenaline reuptake inhibitors often prescribed as their alternatives. This is both why Adderall has been prescribed for decades, and why the crash is so infamous among those overcoming Adderall addiction [20].
Natural Adderall alternatives belong to a class of supplements known as nootropics, or cognitive enhancers. The specific type you’re looking for can increase dopamine levels too, but without being overpowering.
Mind Lab Pro provides both direct nutritional support for neurotransmitter production, and a boost from herbal medicines that modulate neurotransmitter and growth factor release.
It features N-acetyl-tyrosine, an efficient precursor to dopamine, and pairs it with vitamins B6, folate and B12. Tyrosine is the amino acid that dopamine is made from, while these three B vitamins are involved in the production of dopamine and other neurotransmitters [21] [22].
Read our comprehensive Mind Lab Pro review here for more information.
Performance Lab Mind is another nootropic supplement centered around tyrosine, but adds nutrients for brain cell membrane production. Citicoline is one such ingredient, which the brain uses for both the cognition-enhancing neurotransmitter, acetylcholine, and as structural support in cell membranes. Unlike regular choline, it won’t be metabolized into the toxic TMAO [23].
See our Performance Lab review for the full verdict.
In a nutshell, what do we need to expect when we stop taking the drug?
Unfortunately, yes, with symptoms more severe at higher doses. A study on 647 people found that almost 88% experienced a crash after suddenly stopping the drugs.
In general, crash symptoms appear within 24 hours after your last dose.
Depression is a common symptom as your levels of dopamine suddenly fall, as it is a key neurotransmitter (chemical messenger) for mood balance.
Adderall does not cause extreme fatigue, but it is a common symptom of a crash.
Depression, anxiety, insomnia, fatigue and more are unfortunately expected symptoms when you quit Adderall cold turkey. Managing these symptoms is possible, however, making addiction treatment easier. Lifestyle modifications such as rest, hydration and exercise, along with nootropic supplements and medications to soothe insomnia and anxiety, can help you ride it out and return to balance.
