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Does Adderall help with OCD?

Adderall may intensify OCD symptoms due to its stimulant effects. Learn about safer, proven options for managing OCD.
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By | Updated on Dec. 10, 2024 Medically reviewed by Chad Shaffer, MD
Person organizing items on desk. Does Adderall help with OCD?

Key takeaways

  • In most cases, Adderall is not a viable option for people with OCD—and no other mental health disorders—as it can worsen OCD symptoms.

  • For people who have both ADHD and OCD, however, Adderall might be an effective option.

  • Adderall is also a controlled substance and comes with the risk of various side effects, interactions, addiction, and withdrawal.

  • Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and psychotherapy like CBT are much more common and effective treatments.

In this article:

Persistent thoughts. Repetitive behaviors. Intrusive urges. The signs of obsessive-compulsive disorder (OCD) can be frustrating and anxiety-inducing. It can manifest at any age, and even though approximately 1 in 40 adults will develop OCD at some point in their lives, there are treatment options available.

Is Adderall one of them? It’s complicated. There are specific cases when it might help, but sometimes it can actually worsen OCD symptoms. We’ve got all the important information for both situations below—including side effects and Adderall alternatives. 

Does Adderall help with OCD?

For someone with just OCD and no other mental health conditions, Adderall isn’t typically helpful. In fact, research shows that stimulant medications like Adderall or Ritalin can actually exacerbate OCD symptoms. 

This might happen when OCD is misdiagnosed as attention-deficit hyperactivity disorder (ADHD), according to the International OCD Foundation. Both conditions can affect attention and focus, have some similar symptoms, and affect the brain’s frontostriatal system, so it can be difficult to get an accurate diagnosis. But while OCD stimulates activity in this system, ADHD reduces it, which is why Adderall isn’t always a solution for OCD on its own and can compound the problem. However, according to psychiatrist Dr. Cooper Stone, DO, “The overwhelming majority of patients with OCD will have a co-occurring psychiatric disorder,” and “among those co-occurring conditions, ADHD is among the most common. As a result, Adderall (and other stimulants) can be extremely effective and helpful in treating symptoms of ADHD.”

“Adderall is a stimulant that targets the frontal striatal area of the brain. ADHD and OCD happen because of abnormalities in that area but from different spectrums,” Dr. David Hendricks, MD, assistant medical director at Mountainside adds. “To treat these co-occurring conditions together, It’s important to treat the ADHD first, before tackling the OCD.”

The International OCD Foundation says some research suggests that one out of five children and one out of twelve adults who have ADHD also have OCD—and these ADHD patients could benefit from Adderall treatment. Certain case studies have shown that psychostimulants may improve both ADHD symptoms and OCD for these patients, although there’s still a risk that it could worsen the obsessive-compulsive symptoms. 

Why you shouldn’t take Adderall for OCD

Here are the biggest reasons why Adderall isn’t a viable choice for people with obsessive-compulsive disorder by itself. 

It can make symptoms worse

Adderall isn’t FDA-approved for OCD treatment, and doctors don’t prescribe it off-label either. That’s largely because Adderall’s effects on the body can worsen the symptoms of OCD. “The intrusive and unwanted obsessions associated with OCD can be a source of great anxiety and distress, which can be worsened by Adderall,” Dr. Stone says. “The reason for this is that Adderall, being a stimulant, can commonly cause or contribute to anxiety as a side effect, thereby worsening the experience of the underlying condition.”

Specifically, it boosts the brain’s levels of dopamine and norepinephrine and affects the frontostriatal system, which is already overactive in people with OCD. Adderall use also increases focus, which might cause individuals to fixate on OCD-related intrusive thoughts. 

Side effects

Besides exacerbating symptoms, the use of Adderall also comes with the risk of various side effects. Some of the most common Adderall side effects include:

  • Decreased appetite
  • Dry mouth
  • Trouble sleeping
  • Stomach ache
  • Headache
  • Nervousness
  • Weight loss
  • Mood swings
  • Anxiety
  • Agitation
  • Nausea
  • Vomiting
  • Dizziness
  • Diarrhea
  • Fast heartbeat (tachycardia)
  • Lack of energy
  • Constipation

Additionally, in rare cases, it can cause serious adverse effects like heart issues, aggression, seizures, eyesight changes, and serotonin syndrome. 

Addiction and withdrawal

Despite its popularity as a “study drug” on college campuses, Adderall is not something you want to take on a whim. It’s a Schedule II controlled substance, which puts it into the same category as cocaine, oxycodone, and fentanyl. Per Dr. Hendricks, it “can quickly cause physical dependency if not taken as prescribed by a healthcare provider.” And that dependency can be worse for people with OCD, who have a higher risk of addiction. “In fact, research shows that in people with OCD, 24.8 percent have a co-occurring alcohol use disorder while 11.4 percent have an opioid use disorder,” Dr. Hendricks says. 

He continues: “For people who have a previous history of substance abuse or someone at high risk, I strongly recommend prescribing non-stimulant medications like Wellbutrin, which can aid in treating ADHD.”

Where there’s addiction, there’s also withdrawal, and Adderall withdrawal symptoms include depression, fatigue, increased appetite, agitation, slowness, or sleep issues. 

Drug interactions

Anyone taking (or planning on taking) any other medications, drugs, or supplements simultaneously with Adderall should consult a healthcare provider first since it has several interactions, including:

This is not a complete list of possible drug interactions with Adderall.

Adderall alternatives for OCD

Adderall has plenty of alternatives, and the most common medications prescribed for OCD management include:

  • Selective serotonin reuptake inhibitors (SSRIs): Antidepressant drugs like Prozac, Zoloft, Lexapro, and Paxil increase the amount of serotonin available to your brain. It’s unclear how, exactly, SSRIs influence OCD, but studies have demonstrated their effectiveness in treating it. 
  • Tricyclic antidepressants (TCAs): TCAs work by increasing serotonin and norepinephrine in the brain, and the most common one prescribed for OCD is clomipramine. In studies, it has shown safety and effectiveness in reducing OCD symptoms. 
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs): These are similar to SSRIs, but they also increase norepinephrine levels. The Journal of Clinical Psychiatry published a study that said SNRIs could be an effective alternative to SSRIs for OCD, but additional studies may be necessary. 
  • Atypical antipsychotics: These medicines act on the brain’s dopamine and serotonin receptors, and the main atypical antipsychotic prescribed for OCD is Abilify (aripiprazole). This is technically an off-label use, but research shows that it’s effective as part of a larger treatment plan. 

Aside from medication, certain types of psychotherapy might also work well for treating OCD. In fact, they’re often considered a first-line treatment. According to Dr. Stone, “The benefit of this approach is that it will not expose the patient to any medication side effects or run the risk of interacting with any other medications that may already be prescribed.” Popular non-medication treatments include:

  • Cognitive behavioral therapy (CBT): This type of therapy focuses on raising our awareness of negative thought processes, behaviors, and actions, so we can change our responses—and research has demonstrated its effectiveness in treating OCD.
  • Exposure and response prevention therapy (ERP): Another model that has shown great promise in studies, ERP is a type of CBT developed specifically for OCD. It involves slowly exposing the patient to situations or stimuli that may trigger compulsive responses.  
  • Acceptance and commitment therapy (ACT): Another type of CBT, ACT focuses on noting and accepting specific obsessive thoughts and feelings as they arise, and it might also be an effective treatment for OCD. 

But sometimes, the best treatment is a combination. “For those with more severe or disabling symptoms, it is typically recommended that medications and therapy be started simultaneously,” Dr. Stone says. “This is more effective than either treatment modality used alone.” 

Of course, the prescribing doctor will make the call on which treatment is best for a particular patient.  

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