What You Should Know About Adderall XR Side Effects

Adderall XR is one of the most commonly prescribed medications for ADHD, and like all medications, it comes with potential side effects. Most are mild and manageable, but some require immediate medical attention.

This guide covers the most common and serious side effects of Adderall XR based on FDA labeling, what to watch for in specific populations, and practical tips for managing side effects so you can get the most from your treatment.

What Is Adderall XR?

Adderall XR is an extended-release capsule containing a combination of amphetamine and dextroamphetamine. It's classified as a Schedule II controlled substance and is FDA-approved to treat ADHD in patients aged 6 and older. The "XR" stands for extended-release, meaning it's designed to work throughout the day with a single morning dose.

To understand how this medication produces its effects — and its side effects — you can read more about how Adderall XR works.

Common Side Effects

The following side effects are the most frequently reported in clinical trials. They're usually mild to moderate and may improve as your body adjusts to the medication over the first few weeks:

• Decreased appetite — This is the most commonly reported side effect. Many people notice they simply don't feel hungry, especially during the day while the medication is active.
• Insomnia or trouble falling asleep — Because Adderall XR is a stimulant that lasts most of the day, it can interfere with sleep, particularly if taken too late in the day.
• Dry mouth — A common stimulant side effect. Staying hydrated and chewing sugar-free gum can help.
• Headache — Usually mild and tends to improve over time.
• Stomach pain or nausea — Taking the medication with food may help reduce stomach-related side effects.
• Weight loss — Often related to decreased appetite. Your doctor may monitor your weight, especially in children and adolescents.
• Nervousness or anxiety — Some people feel jittery or on edge, particularly at higher doses.
• Dizziness — Usually mild and more common when first starting the medication.
• Irritability — Can occur as the medication wears off (sometimes called a "crash" or rebound effect).
• Increased heart rate — Stimulants can raise your heart rate by 5–10 beats per minute on average.

Most of these side effects are dose-dependent, meaning they may improve if your doctor lowers your dose.

Serious Side Effects

While less common, Adderall XR can cause serious side effects that need immediate medical attention. Contact your doctor right away — or go to the emergency room — if you experience any of the following:

Cardiovascular Events

Adderall XR carries an FDA boxed warning about serious cardiovascular risks. Stimulants can increase blood pressure and heart rate, and in rare cases have been associated with:

• Heart attack
• Stroke
• Sudden death (primarily in patients with pre-existing heart conditions)

When to call your doctor: Chest pain, shortness of breath, fainting, or a rapid or irregular heartbeat.

Psychiatric Symptoms

In some patients, Adderall XR can trigger or worsen psychiatric symptoms, including:

• New or worsening psychosis (hallucinations, delusions)
• Mania or manic episodes
• Aggressive behavior
• Paranoia

When to call your doctor: Hearing or seeing things that aren't there, extreme mood swings, or unusual aggression.

Peripheral Vasculopathy (Raynaud's Phenomenon)

Stimulants can affect blood circulation to the fingers and toes, causing them to feel numb, cold, or change color (pale, blue, or red).

When to call your doctor: Unexplained wounds on fingers or toes, or skin color changes in your extremities.

Serotonin Syndrome

If you take Adderall XR with serotonergic medications (like SSRIs, SNRIs, or triptans), there's a risk of serotonin syndrome — a potentially life-threatening condition.

When to call your doctor or go to the ER: Agitation, rapid heartbeat, high fever, muscle twitching, diarrhea, or loss of coordination.

Seizures

Stimulants may lower the seizure threshold. This risk is higher in people with a history of seizures.

Growth Suppression in Children

Long-term stimulant use may slow growth in children. Your child's doctor should monitor height and weight regularly. Growth typically catches up when the medication is stopped.

Side Effects in Specific Populations

Children and Adolescents

Children may be more sensitive to appetite suppression and growth effects. Weight loss, stomach pain, and insomnia are among the most common side effects in younger patients. Parents should watch for mood changes, irritability, or signs of depression.

Pregnancy and Breastfeeding

Adderall XR is not recommended during pregnancy. Amphetamines may cause premature birth, low birth weight, and withdrawal symptoms in newborns. If you're pregnant or planning to become pregnant, talk to your doctor about alternative treatment options. Adderall XR can also pass into breast milk, so use caution while breastfeeding.

Older Adults

ADHD treatment in older adults is becoming more common, but cardiovascular risks may be higher in this population. Blood pressure and heart rate should be monitored closely.

How to Manage Common Side Effects

Here are practical tips for dealing with the most common Adderall XR side effects:

• Appetite loss: Eat a good breakfast before your dose kicks in. Schedule meals and snacks even if you're not hungry. Focus on calorie-dense, nutritious foods.
• Insomnia: Take your dose first thing in the morning. Avoid caffeine, especially in the afternoon. Practice good sleep hygiene (consistent bedtime, dark room, no screens before bed).
• Dry mouth: Drink plenty of water throughout the day. Sugar-free gum or lozenges can stimulate saliva production.
• Headaches: Stay hydrated and eat regularly. Over-the-counter pain relievers like Acetaminophen or Ibuprofen can help — but check with your doctor first.
• Irritability or crash: This often happens as the medication wears off in the evening. Your doctor might adjust timing or add a small immediate-release dose.
• Increased heart rate: Limit caffeine intake. If your resting heart rate stays above 100 bpm, let your doctor know.

If side effects are persistent or interfere with your daily life, don't stop taking Adderall XR on your own. Talk to your doctor — they can adjust your dose or explore alternative medications.

A Note on Dependence and Withdrawal

Adderall XR is a Schedule II controlled substance with a high potential for abuse and dependence. If you've been taking it regularly and want to stop, do not quit abruptly. Your doctor will help you taper off gradually to avoid withdrawal symptoms like fatigue, depression, and sleep disturbances.

Final Thoughts

Most people who take Adderall XR experience mild, manageable side effects — especially after the first few weeks. The key is to stay in close communication with your doctor, report anything unusual, and never adjust your dose without medical guidance.

If you're having trouble finding Adderall XR at your pharmacy due to the ongoing shortage, Medfinder can help you locate pharmacies with stock near you.