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Key takeaways
Adderall is a stimulant medication commonly prescribed for ADHD, but over time, you might feel like it’s not working as well.
Consider factors that may be contributing to Adderall not working as well, such as lifestyle changes like stress or a new environment, as well as the timing of medication in relation to your symptoms.
Always consult your healthcare provider to discuss any concerns and explore dosage adjustments, formulation changes, or alternative treatments if necessary.
Adderall (amphetamine/dextroamphetamine) is a brand-name prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Adderall is generally used in combination with other treatment methods, such as behavioral therapy and educational interventions. In some cases, people who take Adderall may notice that after some time, it feels like the medicine is not working as well as it used to. There could be several reasons for this. The good news, though, is that there are some things you can do about it. Continue reading to learn more about what to do when your ADHD medicine is no longer working.
Why is my Adderall not working?
Let’s explore seven reasons why Adderall may not be working.
1. Incorrect dose
When you start taking an ADHD medication like Adderall, your healthcare provider will monitor you closely. They may suggest gradual increases in dosage until you get to an effective dose. However, after some time at the correct dose, you may check in with your healthcare provider less frequently. If your medicine is not working well, you may need a dosage adjustment. If it’s been some time since you have discussed your dose of medicine with your healthcare provider, call them. Sometimes, a slight tweak in the dose might be all you need to make you feel better.
2. Formulation or timing issues
There are various types of ADHD drugs, and many have several formulations. For example, Adderall is an immediate-release drug. Because it does not last more than a few hours in the body, people generally have to take it two or three times daily to be effective. However, there is also an extended-release form of Adderall, called Adderall XR, that lasts longer in the body. Therefore, it only needs to be taken once daily.
Some individuals take both formulations, such as a dose of Adderall XR in the morning and an immediate-release Adderall dose later in the day if needed. You may be taking the appropriate formulation, but the timing might not be optimal. For example, maybe you are taking your medicine too early, and it is wearing off when you still need it to work. Have a conversation with your healthcare provider or pharmacist regarding formulation and timing issues.
3. Missing doses
Are you (or your child) taking the prescribed ADHD medication exactly as directed? It can be all too easy to forget a dose here and there or otherwise not take it exactly as recommended by a healthcare provider, especially if you find the side effects of your ADHD medication to be bothersome. If you think missing doses could be an issue, you may want to set a reminder or use an app to remind you to take your medicine daily.
If you are skipping doses due to side effects, consult your healthcare provider for medical advice. A short supply of Adderall due to an Adderall shortage could also cause dosing disruptions. Calling other pharmacies may help if you are having difficulty getting your prescription filled at your local pharmacy.
4. Lifestyle factors
The American Academy of Pediatrics (AAP) recommends taking a look at lifestyle factors if you feel ADHD medication is not working. Experts note that lifestyle changes like school transitions can play a role. For example, students who took an ADHD medication in middle school and found it effective may feel like the medicine is not working as well once they get to high school. However, this may also be because high school brings much more work and new social dynamics, among other issues. In these cases, it may seem like the medicine is not working, but it may instead be a new problem that needs to be addressed.
5. Other medical conditions
The AAP notes that in addition to lifestyle factors, a new medical condition may arise. For example, the patient may be experiencing new symptoms of anxiety or depression that they were not previously experiencing. The Centers for Disease Control and Prevention (CDC) notes that many children with ADHD also have other medical conditions. Adult ADHD patients may also have more than one condition that needs to be treated. Some common conditions that people with an ADHD diagnosis may also have include:
- Anxiety disorders
- Depression
- Mood disorders
- Autism spectrum disorder
- Disruptive behavior disorders
- Tic disorder
- Substance abuse disorder
You can always consult your healthcare provider, who can diagnose other conditions and recommend appropriate treatment.
6. Tolerance
As noted in the prescribing information, Adderall can cause tolerance. Tolerance means that after taking a drug for some time, you will not respond as much as you did at first, and you will need higher doses of the medicine to produce the same effect that you used to have at a lower dose. One study found that almost 25% of people developed a tolerance to stimulant medication in days to weeks. Long-term studies have found that many people respond less to medicine over time. If you think you may be tolerant of your medication, check in with your healthcare provider for medical advice.
7. A different drug may be better suited for you.
In some cases, it may simply come down to trying a different medication under the supervision of your healthcare provider. For example, although Adderall may be very effective in treating ADHD for some, others may do better with a different type of medication. Adderall is a central nervous system (CNS) stimulant.
There are two types of stimulants: amphetamines like Adderall and Vyvanse and methylphenidate like Ritalin and Concerta. Non-stimulant medications, such as Strattera (atomoxetine), Intuniv (guanfacine), Kapvay (clonidine), and Qelbree (viloxazine), are also prescribed to treat ADHD.
When comparing stimulants, methylphenidate-type drugs are often preferred in younger children between the ages of 4 and 6. With this age group, medication is typically only prescribed after behavioral interventions. Methylphenidate may also be better for older children and adolescents, while amphetamines may be preferred in adults. However, the best drug can only be determined by your healthcare provider.
How to know if Adderall is working
We talked about reasons that Adderall may not be working. Now, how do you know if Adderall is working? Adderall works by increasing levels of the neurotransmitters (chemical messengers) dopamine and norepinephrine, which helps with symptoms of ADHD such as impulsivity and hyperactivity.
Experts note that Adderall may not help every ADHD symptom, but you will know that the medicine works when some symptoms improve, such as focusing on and completing a task or feeling like you are performing better at work or school. As stated above, keeping in close contact with your healthcare provider is important, as they can guide you through any necessary dosage increases, helping you find the most effective dose for your symptoms.
Steps to take when Adderall is no longer working
If you feel like Adderall is no longer working for you or your child, consider the points above. For example, could a lifestyle change be contributing to symptoms? Is there another mental health condition occurring at the same time? Is the medication taken at the optimal times?
You may also want to start a journal, jotting down the times that you took your medication and noting things like how your ADHD symptoms responded as well as when you felt like the medicine started to wear off.
Next, or at any point, you will want to contact the healthcare provider. Only the healthcare provider can determine the best treatment for you or your child, taking into account many individual factors that will determine the best course of treatment.
It is important to note that some medical conditions, such as depression, may cause suicidal thoughts and behaviors. If you have any thoughts of harming yourself, you should immediately get emergency medical help. You can call 911 and go to the nearest emergency room or call 988 for the Suicide and Crisis Lifeline.
The bottom line
If you feel like Adderall is not working for you or your child, take note of the considerations above and see if any are applicable. You or your child may need a dosage change, a different medication, or a check-up to see if another medical condition may have arisen. Consult with the healthcare provider to understand why the medicine is not the right match, and work with your provider to take the next steps in finding the most appropriate treatment.
Sources
- Treatment of ADHD, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
- Stimulant and related medications: U.S. Food and Drug Administration-approved indications and dosages for use in adults, Centers for Medicare & Medicaid Services
- Adderall, DailyMed (2024)
- Adderall XR, DailyMed (2023)
- Look at life circumstances when ADHD medications stop working, American Academy of Pediatrics (2019)
- Not just ADHD? Helping children with multiple concerns, Centers for Disease Control and Prevention (2024)
- Tolerance to stimulant medication for Attention Deficit Hyperactivity Disorder: Literature review and case report, Brain Sciences (2022)
- 6 things to know about Adderall, Lee Health (2020)
- Ritalin vs. Adderall: Comparing common ADHD medications, Cleveland Clinic (2023)
- Non-stimulant medications available for ADHD treatment, American Academy of Pediatrics (2021)
- Clinical care of ADHD, Centers for Disease Control and Prevention (2024)
- Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: A systematic review and network meta-analysis, Lancet Psychiatry (2018)