Amphetamine/Dextroamphetamine Side Effects: What to Expect and When to Call Your Doctor

Amphetamine/Dextroamphetamine — sold under brand names like Adderall and Adderall XR — is one of the most commonly prescribed medications for ADHD. Like all medications, it comes with potential side effects. Most are mild and manageable, but some require immediate medical attention.

This guide covers what to expect when you start taking Amphetamine/Dextroamphetamine, which side effects are normal, and which ones mean you should call your doctor right away.

What Is Amphetamine/Dextroamphetamine?

Amphetamine/Dextroamphetamine is a central nervous system (CNS) stimulant that works by increasing dopamine and norepinephrine levels in the brain. It's FDA-approved for treating ADHD in adults and children (age 3+) and narcolepsy. It's a Schedule II controlled substance, meaning it has medical value but also carries a risk of dependence.

For a full overview of the medication, see our guide: What Is Amphetamine/Dextroamphetamine?

Common Side Effects

These side effects are reported frequently in clinical trials and by patients. They're generally mild and often improve after the first few weeks of treatment:

• Decreased appetite — This is the most common side effect. Many people notice they're simply not hungry, especially during the hours when the medication is active.
• Insomnia or trouble falling asleep — Stimulants can make it hard to wind down at night, particularly if taken too late in the day.
• Dry mouth — A frequent complaint that can usually be managed by staying hydrated.
• Headache — Especially common during the first week or two of treatment.
• Stomach pain or nausea — Taking the medication with food can help reduce this.
• Weight loss — Related to decreased appetite. This can be significant in children and should be monitored.
• Anxiety or nervousness — Some people feel jittery or on edge, especially at higher doses.
• Irritability — Can occur as the medication wears off (sometimes called a "crash").
• Increased heart rate — A mild increase in resting heart rate is common.
• Dizziness — Usually mild and temporary.

Most of these side effects are dose-related. If they're bothersome, your doctor may lower your dose or adjust the timing of when you take it.

Serious Side Effects

The following side effects are less common but require medical attention. Contact your doctor right away — or call 911 if severe — if you experience any of these:

• Cardiovascular events — Chest pain, shortness of breath, fainting, or an irregular heartbeat could indicate a serious cardiac issue. The FDA boxed warning for Amphetamine/Dextroamphetamine notes the risk of heart attack, stroke, and sudden death, especially in people with pre-existing heart conditions.
• Psychotic symptoms or mania — New or worsening hallucinations, delusions, paranoia, or manic behavior. This is more common in children and adolescents but can occur at any age.
• Seizures — Amphetamines may lower the seizure threshold. If you have a seizure for the first time, seek emergency care.
• Serotonin syndrome — If you take Amphetamine/Dextroamphetamine along with certain other medications (like SSRIs or SNRIs), you may be at risk for serotonin syndrome. Symptoms include agitation, confusion, rapid heartbeat, high blood pressure, dilated pupils, muscle twitching, and high fever.
• Peripheral vasculopathy (Raynaud's phenomenon) — Unexplained wounds on fingers or toes, or fingers/toes that feel cold, numb, or change color. This is a sign of poor blood circulation.
• Severe hypertension — A significant spike in blood pressure that may cause severe headache, blurred vision, or nosebleeds.

Side Effects in Specific Populations

Children and Adolescents

In addition to the side effects above, children taking Amphetamine/Dextroamphetamine should be monitored for:

• Growth suppression — Long-term stimulant use may slow height and weight gain. Your child's doctor should track growth at every visit.
• Mood changes — Watch for increased tearfulness, emotional flatness, or personality changes.

Pregnancy and Breastfeeding

Amphetamine/Dextroamphetamine is classified as Pregnancy Category C. It may increase the risk of premature birth and low birth weight. The drug is also excreted in breast milk, so breastfeeding is not recommended while taking it. Talk to your doctor if you're pregnant, planning to become pregnant, or breastfeeding.

Older Adults

Elderly patients may be more sensitive to cardiovascular side effects. Blood pressure and heart rate should be monitored closely.

How to Manage Common Side Effects

Here are practical strategies for dealing with the most common issues:

• For decreased appetite: Eat a good breakfast before your first dose. Have calorie-dense snacks available. Schedule a larger meal for the evening when the medication wears off.
• For insomnia: Take your medication as early as possible. Avoid the immediate-release version after 2-3 PM. If you're on the extended-release (XR), take it first thing in the morning. Maintain good sleep hygiene — no screens, cool room, consistent bedtime.
• For dry mouth: Drink water regularly. Sugar-free gum or lozenges can help stimulate saliva. Avoid excessive caffeine, which can make it worse.
• For headaches: Stay hydrated and eat regular meals. Over-the-counter pain relievers like Acetaminophen (Tylenol) are generally safe, but check with your doctor.
• For anxiety or jitteriness: This may indicate the dose is too high. Talk to your doctor about adjusting your dose.
• For irritability during the "crash": Some patients find that overlapping doses (with doctor approval) or switching to an extended-release formulation smooths out the transition.

Final Thoughts

Side effects are a normal part of starting any new medication, and Amphetamine/Dextroamphetamine is no exception. The good news is that most common side effects are mild and tend to improve over time. The key is staying in close contact with your doctor, especially during the first few weeks.

If you're having trouble filling your prescription due to the ongoing shortage, Medfinder can help you find pharmacies with Amphetamine/Dextroamphetamine in stock near you.