The Advanced Guide to Adderall Withdrawal

Published 2016-11-02 05:00:00 -0400 by Michael | adderall withdrawal

adderall withdrawal - the advanced guide

1. Acceptance

Come to grips with the fact that you’re withdrawing from Adderall. Assume that you’ll need more downtime than normal and that you won’t be as peppy or productive.

If you’re in school or have a challenging job, do whatever you can to temporarily decrease your workload. Treat yourself like you’re sick from the flu: you need rest, Netflix, and delicious food.

Much pain can be avoided by not trying to overextend yourself when you’re in the midst of withdrawal.

Replenish Electrolytes

Adderall tends to deplete electrolytes like sodium, potassium, and magnesium. The mechanism has to do with the fact that amphetamines are potent diuretics. Drinking gatorade can help replenish these lost solutes.

Eat Well

You’re bound to experience some rebound hunger, because Adderall is a potent appetite suppressant. Avoid eating excess carbohydrates, which can destabilize your blood sugar. Load up on antioxidant-rich fruits and vegetables: 1. Blueberries 2. Avocados 3. Kale

The more colorful the vegetable or fruit, the better. There’s actually a correlation between the color of foods and their antioxidant content.

Other neuroprotective, brain foods: - Chocolate - increases blood flow in the brain * Curcumin - derived from the spice turmeric in curries, neuroprotective antioxidant * Coffee and tea - both contain a cocktail of antioxidants. The major downside to coffee is the presence of acrylamide. For tea, the downside is fluoride.

Managing Temptations

Do you have an addictive personality?

If so, you may be tempted to reinstate Adderall even though you made a commitment to stop it. This cycle of drug use, euphoria, discontinuation, withdrawal, craving and then finally reinstatement is what makes addiction such a challenging adversary.

Managing impulses during withdrawal are especially challenging since Adderall withdrawal can cause impulsivity!

You can manage the itch to redose by playing a little game with yourself. Every time you have an unwanted impulse, ask yourself if you survive the next fifteen minutes without it. 15 minutes later, repeat this process. The idea is to break up the withdrawal period into bite-sized chunks, thus making it psychologically more manageable.
  1. Exercise. Excerise is key, but is also difficult during withdrawal because your dopamine receptors have been sucked dry. You’re not motivated, you lack energy, so how can you exercise?

The key is to decrease the psychological barrier to entry. Start small, by telling yourself that you’re just going to put on your gym clothes. Then just take a walk around the block. The key is to “trick yourself” into taking one step at a time and avoid imagining all the steps at once which can be overwhelming.

Can You Go Through Withdrawal With Adderall?

Stopping Adderall (mixed amphetamine salts) often results in a withdrawal syndrome. I have personally experienced Adderall withdrawal and I can attest to its unpleasantness. But Adderall withdrawal is not as difficult than withdrawal from opioids, benzodiazepines, or alcohol. Unlike alcohol withdrawal, Adderall withdrawal can’t kill you.

Amphetamine withdrawal symptoms are opposing manifestations of the drug.

Adderall suppresses appetite while enhancing energy, concentration, and mood. Thus, it’s not surprising that withdrawal can cause anergy, impaired concentration, and depressed mood.

What factors affect the severity of Adderall withdrawal:

  • The duration of use
  • The average dose
  • The pattern of use (Adderall binges vs. “stable”, therapeutic use)
  • Individual neurophysiology and genetics
  • Other environmental factors (e.g., dehydration).

Can A Person Become Addicted to Adderall?

Long-term use of Adderall at therapeutic doses for the treatment of ADHD is unlikely to result in addiction. But addiction is a serious risk with heavy recreational use of amphetamines.

Adderall use results in both psychological and physiological dependence.

The addictive potential of Adderall is extremely well-studied. The major players in amphetamine addiction are:

  • deltaFosB
  • CREB
  • NF-kB

These are transcription factors.

Transcription factors are proteins that bind DNA to regulate gene expression.

DeltaFosB plays a complex role in addiction of many different forms, from gambling to tobacco addiction. CREB is an integral part of learning and memory. NF-kB is a pro-inflammatory transcription factor.

The fact that Adderall addiction and withdrawal involves these transcription factors is important. It tells you that your neurophysiology has been altered at the level of gene transcription. It takes time for these adaptations to normalize.

Dopamine and DAT

Adderall’s abuse potential is attributed to its capacity to release dopamine and norepinephrine in spades.

Amphetamines are dopamine-releasing agents. Dopamine is parceled in vesicles inside neurons, and released via exocytosis in response to inputs.

Normally dopamine release is a tightly regulated phenomena; your brain is a self-regulating homeostatic system that titrates dopamine release to control arousal, motivation, task salience, etc.

Adderall binds the dopamine transporter (DAT) causing it to run in reverse.

Normally, DAT moves dopamine outside the cell into the cytoplasm where it’s meant to be stored in vesicles. When amphetamine is bound to DAT, dopamine is pumped backwards. This depletes dopamine stories and down-regulates dopamine receptors.

Amphetamine use is self-reinforcing because it directly releases dopamine. Over time, your brain adapts to a “new normal” - elevated dopamine levels. Once the drug is withdrawn your brain is left high and dry with no catecholamines (dopamine, norepinephrine).

How Long Do The Effects of Adderall XR Last?

Adderall Withdrawal Timeline

The timeline of Adderall withdrawal is variable. Based on a literature search, the average withdrawal period is 1 week, but withdrawal symptoms can persist up to 4 weeks. These are averages and don’t necessarily apply to your situation.

As a rule, psychological withdrawal outlasts physiological withdrawal.

Psychological withdrawal is the pattern of habits and associations you’ve developed around your Adderall use. It’s that nagging thought that you need Adderall to study effectively. Or that itch to take Adderall with your morning coffee.

Physiological withdrawal is pattern of changes your brain undergoes when Adderall is removed. These adaptations reverse quite quickly - in less than a week.

Withdrawal is Not Always Withdrawal

Sometimes what you think are withdrawal symptoms are actually just a re-emergence of the original condition. For example, if you take Adderall for ADHD and abruptly stop it - you might experience withdrawal symptoms. But if they press there’s a good chance that your underlying ADHD has just been unmasked.

How to Taper Off Of Adderall

What’s a good tapering schedule for Adderall?

It’s recommended to decrease your dose by 25% or 1/4 every week.

Here’s an example:

Maintenance Dose Week 1 Week 2 Week 3 Week 4
20 mg 10mg 5mg 2.5mg 0 mg

For some, these tapering schedule may be too aggressive. If you know that you’re sensitive to medication you can shave off as little as 10% from your maintenance dose per week.

It can be practically difficult to remove 2mg from a 20mg pill of Adderall IR. The workaround is to dissolve Adderall in a solvent so that you can titrate the dose.

Fatigue and Adderall Withdrawal

If you’ve been on a high-dose of Adderall for a long time, there’s no question that you’re going to experience fatigue if you discontinue it.

The bad news is that it can be challenging to cope with your daily responsibilities when you’re tired beyond belief. The good news is that your current state is just temporary. There are a lot of strategies you can use to manage fatigue.

  • Decrease your workload (if possible).
  • Embrace lethargy and sleep as much as you can - your brain needs it.
  • If you’re fatigue doesn’t get better, you might want to use a wakefulness enhancer like modafinil. Modafinil increase arousal but it lacks abuse potential.

Adderall Headaches

Headaches are a well-known side effect of Adderall. Adderall withdrawal can also cause headaches.

Headaches in general are poorly understood. The brain itself lacks nociception - there are no pain receptors in the central nervous system. Headaches therefore arise from pain signals in the neck and the blood vessels outside of the brain.

Adderall induced headaches should be treated differently than other headaches. Some things to consider:

  • Adderall is hypertensive (it increases your blood pressure). Doing things to lower your blood pressure and dilate your blood vessels can help. Take a bath, eat some chocolate, go for a run. All of these activities will reverse amphetamine-induced vasoconstriction.
Chocolate releases nitric oxide (NO). NO is a gaseous neurotransmitter that dilates blood vessels.
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