thesis drug adderall

• Program Finder
• Admissions Services
• Course Directory
• Academic Calendar
• Hybrid Campus
• Lecture Series
• Convocation
• Strategy and Development
• Implementation and Impact
• Integrity and Oversight
• In the School
• In the Field
• In Baltimore
• Resources for Practitioners
• Articles & News Releases
• In The News
• Statements & Announcements
• At a Glance
• Student Life
• Strategic Priorities
• Inclusion, Diversity, Anti-Racism, and Equity (IDARE)
• What is Public Health?

Adderall Misuse Rising Among Young Adults

Prescriptions for the stimulant unchanged, but study finds more nonmedical use and emergency room visits among adults.

While the number of prescriptions for the stimulant Adderall has remained unchanged among young adults, misuse and emergency room visits related to the drug have risen dramatically in this group, new Johns Hopkins Bloomberg School of Public Health research suggests.

Anecdotal evidence had suggested the most severe problem of Adderall misuse was among older children and adolescents, but the new research – published Feb. 16 in The Journal of Clinical Psychiatry – finds otherwise. The study examined trends from 2006 through 2011 and found that it is mainly 18-to-25-year-olds who are inappropriately taking Adderall without a prescription, primarily getting the medication from family and friends and without a physician recommendation or prescription.

“The growing problem is among young adults,” says study co-author Ramin Mojtabai, MD, MPH, PhD, a professor of mental health at the Bloomberg School.  “In college, especially, these drugs are used as study-aid medication to help students stay up all night and cram. Our sense is that a sizeable proportion of those who use them believe these medications make them smarter and more capable of studying. We need to educate this group that there could be serious adverse effects from taking these drugs and we don’t know much at all about their long-term health effects.”

Says first author Lian-Yu Chen, MD, who received her PhD in 2014 from the Bloomberg School: “The number of prescriptions for Adderall has fallen and yet we are seeing more medical problems from its use. This suggests that the main driver of misuse and emergency room visits related to the drug is the result of diversion, people taking medication that is legitimately prescribed to someone else. Physicians need to be much more aware of what is happening and take steps to prevent it from continuing.”

Adderall, the brand name for dextroamphetamine-amphetamine, does improve focus, Mojtabai says, but it can also cause sleep disruption and serious cardiovascular side effects, such as high blood pressure and stroke. It also increases the risk for mental health problems, including depression, bipolar disorder and unusual behaviors including aggressive or hostile behavior. There is little research on long-term effects. In 2006, the Food and Drug Administration (FDA) put a black box warning on dextroamphetamine-amphetamine due to cardiovascular risks. It is prescribed for conditions such as attention deficit/hyperactivity disorder and narcolepsy.

For their study, the researchers examined three separate sets of data: the National Survey on Drug Use and Health, a population survey of substance use; the Drug Abuse Warning Network, a survey of emergency department visits; and the National Disease and Therapeutic Index, a survey of office-based practices including prescribing.

They found that in adults, over the six-year study period, treatment visits involving Adderall were unchanged, while non-medical use of Adderall (that is, taking the drug without it being prescribed) rose 67 percent and emergency room visits went up 156 percent. Over the same period, in adolescents, treatment visits involving Adderall went down, nonmedical use was stable and emergency room visits declined by 54 percent. The trends for methylphenidate, sold under the brand name Ritalin among others, and another prescription stimulant prescribed for attention-deficit/hyperactivity disorder, were unchanged over the period.

Meanwhile, the major source for nonmedical use of Adderall was family or friends; two-thirds of those family or friends obtained it by prescription.

The researchers found that of all Adderall nonmedical use, from age 12 and up, 60 percent of it was among 18-to-25-year-olds.

Mojtabai says that from a public health perspective, drugs like Adderall should be monitored in the same way that prescription painkillers have started to be monitored in recent years. He says prescriptions should be entered into a database that a physician could check before writing a prescription to make sure the patient isn’t receiving multiple medications from multiple physicians, a warning sign of diversion or abuse.

He also says it would be helpful to institute informational campaigns for young adults explaining the adverse effects associated with the drug. “Many of these college students think stimulants like Adderall are harmless study aids,” he says. “But there can be serious health risks and they need to be more aware.”

“Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants” was written by Lian-Yu Chen, MD, PhD; Rosa M. Crum, MD, MPH; Eric C. Strain, MD; G. Caleb Alexander, MD, MS; Christopher Kaufmann, MHS; and Ramin Mojtabai, MD, MPH, PhD.

This study was supported by the National Institutes of Health’s National Institute on Drug Abuse (K24 DA023186), the Agency for Healthcare Research and Quality (RO1 HS01899600 and a National Research Service Award (F31AG044052).

Alexander is Chair of the FDA’s Peripheral and Central Nervous System Advisory Committee, serves as a paid consultant to IMS Health, and serves on an IMS Health scientific advisory board. This arrangement has been reviewed and approved by Johns Hopkins University in accordance with its conflict of interest policies. Mojtabai has received consulting fees and research grants from Bristol-Myers Squibb and Lundbeck.

Media contacts for the Johns Hopkins Bloomberg School of Public Health: Stephanie Desmon at 410-955-7619 or  [email protected]  and Barbara Benham at 410-614-6029 or  [email protected] .

Adderall abuse on college campuses: a comprehensive literature review

Affiliation.

• 1 Department of University Housing, The University of Tennessee, Knoxville, TN 37916, USA. [email protected]
• PMID: 22694135
• DOI: 10.1080/15433714.2010.525402

Prescription stimulant abuse has dramatically increased over the past 10 years, but the amount of research regarding college students and illicit prescription stimulant use is still very limited. This has important implications for college mental health professionals and higher education administrators. In this comprehensive literature review the author explores factors contributing to illicit use, self-medication, and recreational use of controlled prescription stimulants; discusses the potential consequences for those students abusing stimulants; and provides recommendations for educating, combating, and assisting students who illicitly use prescriptions stimulants on college campuses.

Publication types

• Amphetamine-Related Disorders / epidemiology*
• Amphetamine-Related Disorders / psychology
• Amphetamines / administration & dosage*
• Attention Deficit Disorder with Hyperactivity / drug therapy
• Central Nervous System Stimulants / administration & dosage*
• Educational Status
• Methylphenidate / administration & dosage
• Self Medication
• Socioeconomic Factors
• Universities / statistics & numerical data*
• Amphetamines
• Central Nervous System Stimulants
• Methylphenidate

'Study drugs' set the stage for other drug use and mental health decline

Adderall abuse primes college students for alcohol, cannabis and more.

Taking "study drugs" like Adderall without a diagnosis is not only dangerous in itself, but can lead to other drug use and a decline in mental health, according to new research from Binghamton University, State University of New York.

Attention Deficit Hyperactivity Disorder (ADHD) medications are frequently used illicitly by college students as a study aid, but it's unknown what psychoactive substances are likely to be abused along with these drugs. To explore this issue, a team of Binghamton researchers led by Associate Professor of Health and Wellness Studies Lina Begdache, conducted a study of 702 undergraduate college students from across the U.S., asking about the most commonly used drugs used by students -- including ADHD medications, cannabis, nicotine, alcohol, MDMA, and ecstasy -- as well as questions on academic performance and physical and mental distress.

The researchers found several associations indicating that using one substance may lead to using others -- as if the brain becomes primed for further substance use.

"Substance use promotes the release of the neurotransmitter dopamine, which is responsible for the initial euphoria and feelings of pleasure. These sensations act as a positive reinforcement for further substance use," said Begdache. "The continuous activation of the limbic system through drug use leads to dependence, in a sense that this substance is no longer producing pleasurable feelings. Individuals have to either increase the dose or resort to something more potent."

The researchers found that using one substance was associated with generally poorer mental health and lower resilience to stress. Also, low frequency of use was negatively associated with mental distress, which potentially becomes a positive reinforcement for further use.

"Since the human brain continues developing into a person's mid/late 20s, substance use during young adulthood may have a strong negative impact on the quality of brain maturity and cognitive function," said Begdache. "Additionally, those individuals are likely to continue using substances later in life, which means they are at risk of mental health decline as well. Our findings also indicated that substance use is linked to lower resilience to adversity. So we can speculate that the rise in mental health ailments may be mediated by a lower resilience to adversity, which impacts mood."

Begdache said that these findings are important because many students may use study drugs not knowing their detrimental effects on the brain.

"Since these are prescribed medications to promote focus in individuals who actually have ADHD, students may think that they are safe to use and that the drug may give them an academic edge," she said.

Begdache leads the Binghamton Student Managed Adderall Research Team (B-SMART), which investigates the harmful effects of Adderall abuse on college students and is conducting further studies. She believes that college campuses need to take a stranger stance on educating their students about the dangers of drug use on the developing brain.

"The repeated feedback we receive from students is that they wish they knew this information earlier. Lack of education and peer pressure are the main drivers," said Begdache. "College campuses are struggling to deal with the mental health decline of their students. A preventative approach is more cost-effective and may likely improve the quality of life of their students in the future."

The paper, "Association between ADHD Medication, Cannabis, and Nicotine Use, Mental Distress, and Other Psychoactive Substances," was published in the International Journal of Psychological and Behavioral Sciences .

• Mental Health Research
• Teen Health
• Controlled Substances
• Mental Health
• Disorders and Syndromes
• Educational Policy
• Education and Employment
• STEM Education
• Controversy about ADHD
• Psychopharmacology
• Psychopathology
• Pharmaceutical company
• Personalized medicine
• Health science
• Drug discovery
• Epidemiology

Story Source:

Materials provided by Binghamton University . Original written by John Brhel. Note: Content may be edited for style and length.

Journal Reference :

• Nicole Scott, Emily Dwyer, Cara Patrissy, Samantha Bonventre, Lina Begdache. Association between ADHD Medication, Cannabis, and Nicotine Use, Mental Distress, and Other Psychoactive Substances . International Journal of Psychological and Behavioral Sciences , 2024; 18 (1): 62-71 [ abstract ]

Cite This Page :

Explore More

• Leafhopper Inspires Invisibility Devices
• AI Meet AI: Talk to Each Other
• Managing Anger: Breathe, Don't Vent
• Tanks of the Triassic
• Holographic Message Encoded in Simple Plastic
• Maybe Our Universe Has No Dark Matter
• A New World of 2D Material Is Opening Up
• Best Way to Memorize Stuff? It Depends...
• Chimp: Persistence of Mother-Child Play
• High-Speed Microscale 3D Printing

Trending Topics

Strange & offbeat.

Taking 'Study Drugs' Like Adderall Could Be Gateway to More Drug Abuse

Taking 'Study Drugs' Like Adderall Could Be Gateway to More Drug Abuse

By Carole Tanzer Miller HealthDay Reporter

THURSDAY, March 14, 2024 (HealthDay News) -- College students who use drugs like Adderall to help them focus on their studies may be setting themselves up for trouble.

Researchers asked 700 undergraduates across the United States about drugs commonly used by students — including ADHD medications like Adderall, cannabis, nicotine, alcohol, MDMA and ecstasy. They also asked about students' academic performance and physical and mental distress.

They found that using one substance appears to prime the brain for using others.

Lead author Lina Begdache , an associate professor of health and wellness studies at Binghamton University, State University of New York, said the finding is important because many students use these so-called "study drugs" without understanding how they affect the brain.

U.S. Cities With the Most Homelessness

Adderall is a medication prescribed to help people with attention-deficit hyperactivity disorder (ADHD) focus.

"Since these are prescribed medications to promote focus in individuals who actually have ADHD, students may think that they are safe to use and that the drug may give them an academic edge," she said in a university news release.

Instead of an edge, students may find one substance leads to another, Begdache warned. 

Researchers linked use of one substance to generally poorer mental health and lower ability to fight off stress. And less frequent use led to mental distress — potentially promoting continued use.

The findings were published recently in the International Journal of Psychological and Behavioral Sciences .

"Substance use promotes the release of the neurotransmitter dopamine, which is responsible for the initial euphoria and feelings of pleasure," Bedache said. "The continuous activation of the limbic system through drug use leads to dependence, in a sense that this substance is no longer producing pleasurable feelings, individuals have to either increase the dose or resort to something more potent."

Begdache leads the Binghamton Student Managed Adderall Research Team, which is investigating the harmful effects of Adderall abuse on college students. 

"The repeated feedback we receive from students is that they wish they knew this information earlier," she said. "Lack of education and peer pressure are the main drivers."

More information

Hazelden Betty Ford Foundation has more about adderall abuse .

SOURCE: Binghamton University, news release, March 11, 2024

Copyright © 2024 HealthDay . All rights reserved.

Join the Conversation

Tags: drug abuse , psychology , addiction

Best Countries

Health News Bulletin

Stay informed on the latest news on health and COVID-19 from the editors at U.S. News & World Report.

Sign in to manage your newsletters »

Sign up to receive the latest updates from U.S News & World Report and our trusted partners and sponsors. By clicking submit, you are agreeing to our Terms and Conditions & Privacy Policy .

You May Also Like

The 10 worst presidents.

U.S. News Staff Feb. 23, 2024

Cartoons on President Donald Trump

Feb. 1, 2017, at 1:24 p.m.

Photos: Obama Behind the Scenes

April 8, 2022

Photos: Who Supports Joe Biden?

March 11, 2020

Biden Anxious to Shore Up Swing States

Susan Milligan March 18, 2024

What to Know About the Looming Shutdown

Lauren Camera March 18, 2024

The Week in Cartoons Mar. 18-22

March 18, 2024, at 3:05 p.m.

March Madness: Fed, Budget Spell Upset

Tim Smart March 18, 2024

Trump’s Strategy of Delay Is Working

Lauren Camera March 15, 2024

Judge: Willis Can Stay on Trump Case

Thesis Nootropic Review - Do Personalized Nootropics Work? I Found Out.

O dds are if you hadn’t heard about nootropics before the early 2010s, you’ve heard about them now. Nootropics burst onto the scene around that time, and they’ve been trending ever since. Why? Well, with bold claims of making you feel more focused, calmer, and even smarter , it’s no wonder that these unique supplements have been catching people’s attention. Especially after the toll of the pandemic on all of our mental wellbeing…

If you’re dealing with brain fog, fatigue, and poor productivity, nootropics probably sound enticing. But, finding natural, effective, no-nonsense nootropics in today’s crowded wellness market can seem like a steep order. 

That’s where Thesis comes in. Takethesis.com is an online brand that’s been a leader in personalized nootropics for years. With all-natural supplement blends that they claim are rooted in science, Thesis promises to bring a new meaning to the term “smart drugs”. 

But as someone who’s always reserved a healthy level of skepticism around the efficacy of supplements in general, I decided to try Thesis nootropics firsthand to see what the hype was all about. In this review, I’ll share my experience with Thesis, including my honest reaction after taking their formulas for greater focus, confidence, logic, and more.

Curious if Thesis can introduce you to the valuable world of nootropics, without the BS? Keep reading to learn what’s inside Thesis ‘ supplements and whether or not their nootropic blends had any effect on my brain.

What are nootropics?

Any natural or synthetic substance that can positively affect cognition, focus, memory, and other mental faculties, and sometimes your mood, is considered a nootropic.

Prescription stimulants like Adderall for ADHD are included as well. And while prescription drugs work for many, they typically exhibit a high instance of unwanted side effects. Natural remedies that boost mental performance, including organic supplements and dietary changes, are generally more sustainable over the long term. In fact, many ADHD patients first discover nootropics after seeking healthier alternatives to Adderall and other pharmaceuticals.

Read our full comparison of nootropics vs Adderall for more details on the key differences.

Source: Thesis

How long have nootropics been around?

The use of nootropics first became widespread in the 70s, when  Piracetam first became widely known as a treatment for motion sickness, then later was found to boost cognitive performance. This spurred more of an effort toward discovering and developing more nootropics . It’s since become a thriving market, especially after the global pandemic wreaked havoc on mental health and left many with persistent brain fog. Today, the internet is awash with countless brain-boosting products available to consumers without prescription, and most don’t have FDA approval or much clinical data to support their claims.

While we love having options, the wide range of (unproven) nootropic supplements available today makes it hard to know which could work for you. There are dozens of brands, each offering various different nootropic blends, all claiming to be the best in class. Should you really be expected to try them all?

Thesis is on a mission to solve this conundrum. The company emerged to not only offer great quality and transparency around their blends, but also to recognize patients’ need for personalized recommendations from experts.

Let’s dive in to see what nootropics Thesis offers, and how the support they offer differs from typical supplement companies.

What are Thesis nootropics?

Thesis (rebranded from FindMyFormula.com) is a longstanding nootropics company with an impressive customer base of over 500,000 users. Having been in the space for years, Thesis has developed a comprehensive data set of nootropics research that dwarfs those of their competitors. I found this data-driven pitch compelling, and thus decided that I’d give Thesis a shot as my first foray into the world of nootropics in general.

1. How Thesis works

To get started, complete Thesis’ online questionnaire . They only ask for basic info – you don’t have to share specific lab tests or detailed medical history. Next, the Thesis algorithm will process your answers to recommend one or more nootropic blends best suited to your needs, which will be shipped to your house within 1-3 business days. 

Thesis recommends you sample their nootropic blends for a month before selecting ones that you believe work the best for you. Of course, you don’t have to stick with just one – and many Thesis customers opt to continue taking two or more blends for varied nootropic benefits as desired. Customer’s purchase data then funnels back to bolster Thesis’s algorithm, further strengthening the reliability of its recommendation engine. Pretty cool, I must admit.

2. What makes Thesis unique

Thesis’ personalized nootropic recommendation algorithm, paired with the ability to try out four unique nootropic blends before selecting your go-to formula, is what defines the Thesis process. They spare you from the difficult, time-intensive testing of individual nootropics on your own, which could easily take months (and cost a serious amount of $). By first paring down your options to the supplements that are most likely to work for you, Thesis takes the legwork out of trying nootropics. 

Plus, when you become a Thesis customer, you’ll also get access to a nootropics expert. This coach is available for consultation at any time to help you optimize your nootropics routine so that you get the most out of these specialized supplements. This includes keeping track of your progress, as well as answering any and all questions you may have about the science supporting each ingredient.

What’s inside Thesis’s unique nootropic blends?

At this point, you’re probably wondering what nootropic blends Thesis has to offer, and what secret sauce ingredients lie within. Thesis currently has six different formulations, each designed to target specific needs:

After filling out Thesis’ online questionnaire, I was recommended all but their Creativity blend . Below, I’ll outline the key nootropic ingredients inside each, as well as review my own personal experience in experimenting with them for the first time.

Energy formula Ingedients

Thesis’ Energy formula is designed to boost energy, fight fatigue, and improve mental stamina. Its ingredients include:

• Choline, for learning and memory
• NAC, for detoxification
• NALT, to support nerve cell communication
• Sabroxy®, for a dopamine boost and heightened memory
• TeaCrine®, for improved motivation, energy, and cognitive function
• Zynamite®, for mental and physical energy
• Caffeine, for energy and alertness
• L-Theanine, for an improved stress response

Review of Thesis energy – did it work for me?

Keep in mind that the power of placebo is well documented, as is the tremendous bias in self-reporting of any kind. These two factors, in combination with the day-to-day choppiness of life in general, make it hard to objectively determine how well supplements of any kind work for a given individual, much less the general population at large. 

That said, putting those caveats aside for sec, I took Thesis’ energy blend for 6 days straight, and I definitely felt more ALERT. The results were noticeable and fairly instant – I felt more alive and energetic within the first hour of taking the four recommended pills , and the feeling generally continued late into the afternoon. 

Fearful that my morning cup of coffee might overshadow or confound the nootropic’s effects, my routine was to take Thesis’ energy formula first thing in the morning with just a glass of water. It could just be the pill’s healthy dose of caffeine (or again, perhaps just placebo?), but regardless, I no longer craved coffee. Thesis’ Energy nootropics jolted me to full attention and kept my energy high for hours. If you’re looking for a caffeine replacement, or perhaps just an extra boost after a night of poor sleep, I definitely recommend Thesis’ blend for higher energy. Here’s what they pills look like up close:

The one downside? I ended up trying Thesis Energy with coffee one morning and felt pretty jittery. Of course, caffeine (and nootropics!) affect everyone differently, so if you’re eager to give these a shot, try them with and without your normal dose of coffee or tea to see how you feel. For me, I only needed one, not both, but it’s worth testing to find out what works for you!

Clarity formula ingredients

Do you find yourself often feeling foggy or forgetful? If so, Thesis’s Clarity formula may be worth a try. Formulated for increased focus and attention span, the Clarity nootropics are designed to help you more easily enter a flow state. 

What ingredients are inside Thesis’ Clarity? Their unique formula contains:

• 7,8-DHF, for neural communication, neurogenesis, and neuroprotection
• Alpha GPC, for memory, neurogenesis, and neuroprotection
• Epicatechin, for improved mood, blood flow, and neuroprotection
• Lion’s Mane, for improved memory consolidation and neuroprotection
• L-Theanine, for a better response to stress

Review of Thesis clarity – my personal experience

In my next phase of experimentation with Thesis nootropics, I decided to sample the Clarity blend for 6 days straight. Note that these six days did not overlap with days I took other nootropics, as I wanted to document my reaction to their blends independently, rather than seeing how I felt taking all of them together at once.

Although the benefits of Thesis’ Clarity blend were admittedly less immediate and noticeable than those I experienced with their Energy blend, I can honestly report that on the days I took Clarity, I found it easy to maintain a state of mental flow for longer . I generally don’t struggle to enter flow and engage deeply with my work, and this remained true while taking Thesis Clarity. What was different for me, however, was the duration of my flow, and I did my best to document these benefits closely through journaling.

To try and make my process as scientific as possible, at lunch each day I recorded how long I was able to stay focused that AM, and then again at dinner, noting how long I had been able to focus in that afternoon. Upon comparing my notes from the week I took Clarity vs the week I didn’t take anything at all, some clear benefits emerged. Overall, I was able to stay in a state of flow for ~35% longer with Thesis Clarity , although I’d be careful not to assume similar results too broadly for a couple of key reasons.

For one, placebo could very much be to blame given that I wanted to be more focused, and thus that desire alone could be to blame for my positive results. There’s also a small sample bias. Having only taken Clarity for one week, my self-reported data is a long way from “scientific significance”. 

That said, nootropics and supplements are all about how you feel, and the end conclusion remains the same: I felt focused for longer when taking Thesis’ recommended blend for Clarity. If you find yourself being overly fidgety, forgetful, or disengaged at work, I recommend you give Thesis Clarity a shot.

Motivation formula ingredients

The Motivation formula is intended to boost willpower and productivity while reducing procrastination. This formula from Thesis includes the following nootropic ingredients:

• Artichoke extract, for stress management and circulation
• Dynamine®, for crash-free energy and a mood boost
• Forskolin, for improved cognitive function
• L-Phenylalanine, for mood, attention, and motivation
• B12, for energy and nerve wellness
• Theanine, for an improved stress response

Review of Thesis Motivation – does it actually work?

Although I consider myself highly motivated, we all have days when we feel kind of “meh”. Rather than sampling Thesis’ Motivation nootropic every day for six days in a row, as I had with other blends, I instead opted to only experiment with them on days I woke up feeling noticeably uninspired. Interestingly, but perhaps not so surprisingly, these mostly fell on Mondays, although I felt less inclined to face my responsibilities on other days as well.

So, on these days of lower motivation when I took Thesis’ recommended Motivation nootropics, how did they make me feel? Honestly, I’m not sure. When reviewing my journal entries, I don’t notice any strong signs that the Thesis’ Motivation nootropics helped me significantly. It’s possible they acted in more subtle or slower ways because, by the afternoon, my notes indicate that I always felt fully engaged and motivated with whatever I was doing. But I must admit, I felt no sudden rush of motivation or anything super perceptible about Thesis’ nootropics for Motivation.

This may be because I didn’t adequately measure my personal motivation level while journaling. It could also be that on cherry-picking days I felt less motivated and heavily on biased my experience. For instance, I wonder if my results would have been more pronounced if I took Motivation consistently every day? Ultimately, I should probably test Thesis’ Motivation blend more before drawing any hard conclusions. And again, it’s worth noting that everyone’s body is quite different. While I don’t struggle with day-to-day motivation, others clearly do, and thus might see more noticeable results than I did.

Creativity formula ingedients

Thesis’s Creativity formula is designed to spark inspiration, improve verbal fluency, and provide a boost of confidence. It contains:

• Agmatine, for stress management
• Alpha GPC, support for memory, neuroprotection, and neurogenesis
• Ginseng, for learning and memory
• Ashwagandha, to promote calm in stressful settings
• Zembrin®, for mood regulation and blood flow to the brain
• Caffeine, for energy

My review of thesis creativity

Unfortunately, Thesis didn’t recommend this formula to me, so I can’t comment on its efficacy. That said, it’s one of Thesis’ most popular formulations, and thus seems to work for thousands of happy customers. I’ll update this section when I have a chance to try it first-hand.

Confidence formula ingredients

Confidence is the newest nootropic blend from Thesis. It contains ingredients to target stress and insecurities while fostering a sense of self-assurance. The idea behind the Confidence blend is that it will help users to feel more sure of themselves and stay in the present.

The Confidence nootropic ingredients include:

• Magnesium L-threonate

Ashwagandha

Review of thesis confidence – does it work.

Even the most self-assured among us crave more confidence. That’s because it’s attractive and infectious. As Thesis’ newest nootropic blend, Confidence is recommended for “high-pressure situations” when you want to “expand your comfort zone”, so I decided to reserve mine for situations in which I was meeting new people, which often, for me, means anticipatory social anxiety.

Recording how I felt two hours before leaving to meet new folks (both for business and pleasure), and then comparing that to my notes from just one hour before each meeting, a clear pattern emerged. In all cases, I reported feeling more relaxed and ready for new encounters after taking Thesis nootropics .

Absent any supplements whatsoever, my typical levels of social anxiety generally increase steadily up until the moment I see people. Generally, I turn to meditation to try to remedy that in the short term. However, that didn’t appear to be the case the 6 times I sampled Thesis’ confidence formula, although it’s unclear why. Perhaps it’s a placebo effect. But in any event, I was encouraged to keep trying Thesis Confidence nootropics before performative moments of all kinds.

Do Thesis nootropics really work?

I didn’t expect any nootropics to have a significant perceptible impact on my mood or cognition, yet 3 of the 4 blends that I tried brought real benefits. In case you missed it, I chronicled my experience trying various nootropic blends from Thesis above. Overall, I have to say I was pretty impressed with their results. 

For me, Thesis’ Energy and Confidence blends worked the best. Clarity also helped me maintain flow for longer during the workday, but I didn’t notice any strong effects from their Motivation supplements. Of course, I don’t know for sure that the nootropics are directly responsible for the benefits I perceived after trialing each variety 6 times. It could have just been placebo effect or some other internal bias altering my perception of reality. But honestly, does it really matter? The effects were very positive, and for the most part, perceptible, too. That’s a win-win!

That said, everyone responds differently to nutrients, which explains why you should maintain a healthy dose of skepticism about how well nootropic blends might work for you. How can something as simple as an herb really make you feel happier, more focused, and more productive? You won’t know unless you try them for yourself and pay close attention to how you feel.

Since my initial exploration, several members of my team have tried Thesis nootropics as well. While we all agree that you likely won’t feel as stark of a mental difference from all natural nootropics as you would with synthetic prescription drugs, but we all experienced a noticeable, positive effect on mood, memory, energy, and focus. This corroborating evidence – albeit self-reported – reassured me that perhaps my experience wasn’t all placebo after all.

What’s it like to talk to a Thesis nootropic coach?

After trying Thesis supplements, I was eager to chat with their team of expert nootropic coaches to discuss my experience. Naturally, I wanted to know if what I felt was “normal”, as well as how to further optimize the benefits I felt by making adjustments. I know there are lots of telehealth platforms on the market and having a coach with the knowledge of something that I knew less about made me much more comfortable.

I was able to schedule a call within just a few days and chatted with someone named Cindy with a degree in neurobiology. She was able to explain how the various nootropics I had tried likely contributed to my experience and offered a few recommendations around what to try next given my individual results.

Ultimately, I not only enjoyed the conversation but felt like I had clear next steps. It was reassuring to know I could get advice again at any time in the future. This is an amazingly personal feature that makes Thesis stand out against other nootropic brands.

What active ingredients does Thesis include in their compounds?

Each ingredient included in Thesis’s formulations is backed by science, which you can find right on their website. There are ways to test for any deficiencies  that you might have, which can also help you decide which supplements would benefit you. Here’s an overview:

Synapsa® (Bacopa monnieri plant)

Bacopa has been shown to boost memory recall and be neuroprotective. 

TAU (uridine)

The body uses uridine to create choline (a cognitive enhancer), construct nerve cell membranes, and help prevent neuron damage. 

7,8-DHF (dihydroxyflavone)

Studies indicate that 7,8-DHF can help protect against brain damage and neurological decline. 

Choline supports nerve health, cerebral metabolism, and the function of neurotransmitters. It also has been shown to have neuroprotective benefits, preserving the health of your brain. 

When it’s taken regularly, DHA has been shown to boost memory and reaction time. 

Ashwagandha root helps regulate the body’s response to cortisol, the “ stress hormone”. 

The active components of GS15-4 Panax Ginseng have been found to boost memory formation and learning. 

NALT (N-Acetyl-L-Tyrosine)

NALT can increase alertness, energy, and cognitive function . 

Artichoke extract

Artichoke extract is rich in antioxidants that can boost your overall bodily function and offer protection against stress and toxins. 

NAC boosts levels of glutathione, which can reduce oxidative stress and help naturally detoxify the body. 

Methylcobalamin, a form of vitamin B12, is used in Thesis supplements to improve nerve health and energy levels. 

Lion’s Mane mushrooms

Lion’s Mane mushrooms can enhance your mood and quality of sleep while reducing stress levels.

There are a total of 28 ingredients found in Thesis nootropic blends . Others not listed above include alpha GPC, Zembrin®, phosphatidylserine, forskolin, Sabroxy®, TeaCrine®, agmatine, epicatechin, alpha GPC, Dynamine®, L-theanine, Zynamite®, L-Phenylalanine, theobromine, ginkgo Biloba, and caffeine. 

How much do Thesis nootropics cost?

For a one-time purchase, Thesis costs $119 for a one-month supply . This isn’t the most economical way to try their nootropics, though. Instead, we’d recommend signing up for a subscription , which costs $79 for a one-month supply, and will force you to properly test Thesis over a longer period for more credible results.

Thesis offers a 30-day money-back guarantee, which eliminates the risk of trying them out. If you’re not sold after a month, you can simply get your investment back – no questions asked. 

Thesis alternatives: How does Thesis compare to other nootropic brands?

Of course, Thesis is far from the only nootropic company in town. How does it stack up vs alternatives? Take a look for yourself:

Thesis Nootropic reviews: What are customers saying?

Before diving into nootropics with Thesis, we knew that you’d want to read what other customers are praising or complaining about in their reviews. Here’s what we found online:

Source: Facebook

Source: Reddit

The verdict: Are Thesis nootropics legit?

Armed with all of the information, including my own personal journey trying their nootropics for the first time, and a comparison of Thesis vs other popular alternatives… should you give Thesis a shot?

While Thesis is pricier than its competitors, we believe that their personalized approach is ultimately worth it for the value. For one, Thesis offers you access to an expert nootropics coach, who can seriously enhance your experience with the supplements and guide you on your journey to optimal mental performance.

Additionally, Thesis has done the heavy lifting of finding legitimate ingredients that are backed by reputable science and are more transparent with their ingredients and dosage than other brands. If we’re comparing to taking it upon yourself to test out individual nootropics on your own, Thesis will save you a ton of time.

Plus, the company’s unique blends pair ingredients that complement each other, and you won’t find these formulations anywhere else. They are custom formulas based on your individual needs, and you can try them for 30 days risk-free thanks to their money-back guarantee.

When push comes to shove, we’d recommend Thesis to anyone who’s interested in testing nootropics for the first time and doesn’t know where to start, as well as more experienced wellness enthusiasts looking to make nootropics a regular part of their self-care routine. For greater focus, energy, motivation, and a major mood boost, nootropics from Thesis worked for me, and with thousands of happy customers, it’s reasonable to assume their blends can work wonders for anyone willing to experiment under the guidance of one of their coaches. Of course, you’ll never know unless you try it out for yourself. Just don’t forget to use our promo code FINVSFIN for 10% off at checkout.

Remember to always consult with your doctor before starting a new supplement to ensure it’s right for you.

Have you tried out nootropics? Let us know about your experience and result in the comments below!

Frequently Asked Questions (FAQ)

For a one-time purchase, Thesis costs $119 for a  one-month supply . This isn’t the most economical way to try their nootropics, though. Instead, we’d recommend signing up for a  subscription , which costs $79 for a one-month supply, and will force you to properly test Thesis over a longer period for more credible results.

Discover more innovative mental health startups

Plushcare anxiety review: is it legit for therapy online.

Home › Mental Health › Plushcare Anxiety Review Rating: 4.5 / 5 ★★★★★ 4.5/5 Telehealth platforms, like PlushCare, allow you to prioritize your mental health in a more convenient and affordable way. With PlushCare’s online platform, you won’t have to rearrange your schedule, worry about transportation, or leave home to connect with a therapist or doctor, even if you may need a prescription. You can arrange an appointment when it’s convenient for you, including same-day bookings.  Let’s review Plushcare’s approach, pricing, and alternatives for fast, convenient anxiety and depression treatment online. PlushCare Anxiety Pros + Cons ProsIntegration of medication and therapy –

Klarity Anxiety Review – Pros, Cons, Alternatives, & More

Affecting over 40 million American adults each year, anxiety is one of the most common mental health conditions. Regardless of the type of anxiety condition, they are all highly treatable, with many individuals experiencing symptom reduction or relief with appropriate treatment.   Finding treatment, booking an appointment, and traveling to an office for support may feel overwhelming and exhausting, making online mental health platforms, like Klarity, incredibly useful. The platform connects you with practitioners all over the country who aim to provide you with the best telepsychiatry treatment possible.     In this review, we explore what Klarity is, including its

Circle Medical ADHD Review – Is It Legit For ADHD Meds Online?

ADHD can interfere with your quality of life and disrupt your work schedule. We know how busy life can get, and sometimes, it may feel impossible to make the time to see an in-person care provider. Plus, the steps to find appropriate support may feel overwhelming. The good news? You can get an ADHD diagnosis and treatment all online, thanks to telemedicine. Circle Medical is a primary care practice that offers online appointments and care, including ADHD assessments and treatment. We review Circle Medical in-depth – specifically their ADHD treatment (although they can treat many other conditions, online or in

How to Get Prescribed Adderall Online

Difficulty focusing, impulsivity, disorganization, trouble planning ahead…we all have scattered thoughts and trouble motivating ourselves from time to time, but if you’re distracted too regularly to the point where your ability to perform daily life is impacted, you may very well have ADHD. Check out this in-depth roadmap of how to get prescription meds for Adderall online.

TruBrain Sleep Review – Is It the Best Nootropic Drink for Better Sleep?

Nootropics, or “smart drugs,” are substances that may boost cognitive function, including learning and focus. However, some nootropics also aim to enhance sleep.    TruBrain’s Sleep Drinks are a fast-acting formula that support deep, restorative sleep, according to the company.   Learn more about this 1 ounce sleep shot, including its ingredients, how it compares to other sleep nootropics, and its potential benefits.     TruBrain Pros and Cons   Pros Cons Non-groggy: Optimizes sleep and may help you feel clear-headed in the morning Easy: No prep involved; simply enjoy ~30mins before getting ready for bed Convenient: The individual ingredients

Stasis Review – Can It Really Eliminate the Negative Effects of Stimulants?

Stimulants, like Adderall, may be incredibly useful for some people in managing symptoms associated with ADHD. Unfortunately, they may also come with side effects, such as decreased sleep and appetite, as well as increased heart rate and blood pressure. A severe side effect called neurotoxicity, which describes changes to the nervous system’s typical activity after exposure to a toxic substance, is also possible.    Some supplements, such as Stasis daily supplements, are aiming to combat these side effects by replenishing certain nutrients that stimulants may deplete from your body temporarily. When taken correctly and under the guidance of your healthcare

Adderall: 7 things you should know

Medically reviewed by Carmen Pope, BPharm . Last updated on April 4, 2023.

1. How it works

• Adderall is a combination of four different amphetamine salts: dextroamphetamine saccharate, dextroamphetamine sulfate, amphetamine aspartate, and amphetamine sulfate.
• Experts aren't sure exactly how Adderall works in Attention Deficit Hyperactivity Disorder (ADHD) but suggest it blocks the reuptake of the neurotransmitters, dopamine, and norepinephrine, which increases their concentration in the neuronal synapse (the space between two nerves).
• Adderall belongs to the group of medicines known as central nervous system (CNS) stimulants.
• Used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) to increase attention and decrease hyperactivity and impulsiveness.
• May be given to increase alertness in people with the sleep disorder, narcolepsy.
• When given for ADHD, Adderall should be used in conjunction with other treatment options, such as psychotherapy, education about the disorder, and social integration advice.
• FDA approved for children over the age of three.
• Adderall is available as a generic under the name mixed amphetamine salts (which may be abbreviated to MAS or M. amphet salts).

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Insomnia (inability to sleep), headache, dry mouth, loss of appetite, nervousness, and nausea are the most common side effects.
• May also cause heart palpitations, constipation and other GI disturbances, weight loss, changes in libido, alopecia (hair loss), elevated blood pressure and muscle twitching, stiffness, or tightness.
• High potential for dependence especially when administered for long periods of time.
• High potential for abuse. May be sought after by drug abusers or people with addiction disorders. Misuse may cause sudden death or cardiovascular events. Overdosage has resulted in psychosis which is indistinguishable from schizophrenia.
• May exacerbate pre-existing psychiatric disorders such as bipolar disorder, psychotic disorder, or mania; and increase anxiety, tension, and agitation.
• May impair judgment or reaction skills; exercise caution before driving or operating machinery until the full effects of Adderall are known.
• Reports indicate some temporary slowing of growth may occur when regular Adderall is given to children aged 7 through 10 years. Doctors should monitor height and weight and consider treatment interruption if growth suppression is suspected.
• May increase the risk of seizures and peripheral circulatory problems and cause visual problems.
• May not be suitable for people with certain heart conditions, as the risk of sudden death is increased even with usual dosages. May also not be suitable for people with thyroid disease, glaucoma, psychiatric disease, a history of drug abuse or agitation, a tic disorder, seizures, liver or kidney disease, or circulation problems.
• May interact with a number of other drugs including other antidepressants, medications used to treat heart disease, blood thinners, decongestants, tramadol, and proton pump inhibitors.
• Interaction or overdosage may cause serotonin syndrome (symptoms include mental status changes [such as agitation, hallucinations, coma, delirium]), fast heart rate, dizziness, flushing, muscle tremor or rigidity, and stomach symptoms (including nausea, vomiting, and diarrhea).
• Extreme fatigue and depression have been reported when Adderall has been stopped suddenly, particularly in those who have been taking more than the recommended dose.
• Rare cases of priapism (painful erections more than 6 hours in duration) have been reported.
• Adderall should not be used during pregnancy unless the potential benefit justifies the risk. There are no well-controlled studies investigating its use in humans during pregnancy. Case reports document severe congenital bone deformity and other birth defects; animal studies have reported long-term neurochemical and behavioral alterations in pups exposed to amphetamines in utero.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Adderall is a combination of four different amphetamine salts and may be used to improve attention, focus, or reduce impulsive behaviors in children over the age of 3 and adults with ADHD. It can also be used to treat narcolepsy. Adderall is potentially addictive and can cause insomnia.

• Take in the morning if using once daily. If using twice daily, avoid late evening dosages to reduce the risk of insomnia.
• May be taken with or without food.
• Take exactly as directed by your doctor and never increase the dosage without his or her advice.
• Ensure your child partakes in other psychological, educational, or social treatment measures as recommended by your doctor as these are also an important part of ADHD treatment.
• Do not suddenly stop taking Adderall, unless it is an emergency. Sudden discontinuation may precipitate a withdrawal reaction. Symptoms include extreme tiredness, depression, or agitation.
• Seek medical advice if symptoms persist or worsen despite treatment, or if psychotic symptoms (such as hearing voices or signs of paranoia) or hallucinations develop.
• Seek urgent medical help if you experience chest pain, shortness of breath, or fainting while taking Adderall or other worrying symptoms such as unexplained nausea or vomiting, a fast heartbeat, agitation, hallucinations, coma, delirium, flushing, muscle tremor, or rigidity.
• Do not drive or operate machinery if Adderall impairs your judgment or reaction skills. Alcohol may contribute to these effects and should be avoided.
• Seek medical advice if any new numbness, pain, skin color change, sensitivity, or unexplained wounds occur in your fingers or toes.
• Keep out of reach of children and pets. Keep your medicine in a safe, private storage area, out of view of any person that may illegally misuse it.
• Do not use if pregnant or breastfeeding unless specifically recommended by your doctor.

6. Response and effectiveness

• Parent training in behavior management and/or behavioral classroom interventions should be used before medicines to treat ADHD.
• Effective at improving symptoms such as attention and focus and reducing impulsive behaviors.
• Small trials have reported similar effectiveness to Vyvanse. One study reported that both seemed equally effective at improving attention-span, rule-following, and interactions with peers and adults for classroom-based behavior in a group of children with ADHD. Similar results were reported in a trial of 18 adults with ADHD. It took about two hours for Adderall to start working and three hours for Vyvanse, and the effects of each drug lasted for approximately 16 hours. Side effects such as decreased appetite, insomnia, and abdominal symptoms are common to most ADHD treatments.
• Peak concentrations are reached within three hours following a single dose.
• Not all the hepatic enzymes involved in the metabolism of Adderall have been defined; however, CYP2D6 is known to be one of the enzymes responsible, which means that variations may occur in the way different individuals metabolize Adderall. Many other drugs rely on CYP2D6 for metabolism and may interact with Adderall.

7. Interactions

Medicines that interact with Adderall may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Adderall. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Adderall include:

• anticoagulants (blood thinners), such as warfarin, or other drugs that have blood-thinning effects such as aspirin or NSAIDs
• anticonvulsants, such as phenytoin, phenobarbital, or primidone
• antidepressants, such as tricyclic antidepressants (eg, amitriptyline), monoamine oxidase inhibitors (eg, isocarboxazid, phenelzine, and tranylcypromine), or SSRIs (eg, fluoxetine, sertraline)
• antipsychotics (such as butyrophenones, phenothiazines, or thioxanthenes) and atypical antipsychotics (eg, olanzapine, quetiapine, ziprasidone)
• any medication that may cause drowsiness, such as benzodiazepines (eg, diazepam, lorazepam), first-generation antihistamines (such as doxylamine or promethazine), metoclopramide, or opioids (such as codeine, morphine)
• beta-blockers, such as atenolol, labetalol, or metoprolol
• cold, flu, or allergy medications that contain decongestants such as phenylephrine or pseudoephedrine
• diuretics such as furosemide
• medications that increase or decrease the pH of the stomach or urinary tracts, such as PPIs (eg, omeprazole, pantoprazole), sodium bicarbonate, acetazolamide, ascorbic acid, or ammonium chloride
• medications that inhibit CYP2D6 enzymes
• heart medications such as doxazosin, prazosin, clonidine, or methyldopa
• HIV medications (fosamprenavir, ritonavir)
• other medications that affect serotonin, such as amphetamines, fentanyl, lithium, tramadol, triptans (eg, almotriptan, eletriptan, or sumatriptan), or St. John's Wort
• propoxyphene.

Avoid drinking alcohol or taking illegal or recreational drugs while taking Adderall.

Note that this list is not all-inclusive and includes only common medications that may interact with Adderall. You should refer to the prescribing information for Adderall for a complete list of interactions.

More about Adderall (amphetamine / dextroamphetamine)

• Check interactions
• Compare alternatives
• Pricing & coupons
• Reviews (492)
• Drug images
• Latest FDA alerts (5)
• Side effects
• Dosage information
• During pregnancy
• Generic availability
• Support group
• Drug class: CNS stimulants
• En español

Patient resources

• Adderall drug information

Other brands

Professional resources.

• Adderall prescribing information
• Amphetamine (AHFS Monograph)

Other formulations

• Adderall XR

Related treatment guides

• Adderall (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate) [Package Insert]. Revised 02/2022. Teva Pharmaceuticals USA, Inc. https://www.drugs.com/pro/adderall.html
• Biederman J, Boellner SW, Childress A, Lopez FA, Krishnan S, Zhang Y. Lisdexamfetamine dimesylate and mixed amphetamine salts extended-release in children with ADHD: a double-blind, placebo-controlled, crossover analog classroom study. Biol Psychiatry. 2007 Nov 1;62(9):970-6. doi: 10.1016/j.biopsych.2007.04.015. Epub 2007 Jul 12. PMID: 17631866.
• Briars L, Todd T. A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder. J Pediatr Pharmacol Ther. 2016;21(3):192-206. doi:10.5863/1551-6776-21.3.192

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Adderall only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2024 Drugs.com. Revision date: April 4, 2023.

Medical Disclaimer

Xywav , Sunosi , Vyvanse , methylphenidate , Concerta , atomoxetine , Ritalin , Strattera , modafinil , dextroamphetamine

• Taking 'Study Drugs' Like Adderall Could Be Gateway to More Drug Abuse

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Psychol Res Behav Manag

Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants

Lisa l weyandt.

Department of Psychology, University of Rhode Island, Kingston, RI, USA

Danielle R Oster

Marisa e marraccini, bergljot gyda gudmundsdottir, bailey a munro, brynheld martinez zavras.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that cause functional impairment. Recent research indicates that symptoms persist into adulthood in the majority of cases, with prevalence estimates of approximately 5% in the school age population and 2.5%–4% in the adult population. Although students with ADHD are at greater risk for academic underachievement and psychosocial problems, increasing numbers of students with ADHD are graduating from high school and pursuing higher education. Stimulant medications are considered the first line of pharmacotherapy for individuals with ADHD, including college students. Although preliminary evidence indicates that prescription stimulants are safe and effective for college students with ADHD when used as prescribed, very few controlled studies have been conducted concerning the efficacy of prescription stimulants with college students. In addition, misuse of prescription stimulants has become a serious problem on college campuses across the US and has been recently documented in other countries as well. The purpose of the present systematic review was to investigate the efficacy of prescription stimulants for adolescents and young adults with ADHD and the nonmedical use and misuse of prescription stimulants. Results revealed that both prostimulant and stimulant medications, including lisdexamfetamine dimesylate, methylphenidate, amphetamines, and mixed-amphetamine salts, are effective at reducing ADHD symptoms in adolescents and adults with ADHD. Findings also suggest that individuals with ADHD may have higher rates of stimulant misuse than individuals without the disorder, and characteristics such as sex, race, use of illicit drugs, and academic performance are associated with misuse of stimulant medications. Results also indicate that individuals both with and without ADHD are more likely to misuse short-acting agents than long-acting agents. These findings have implications for intervention, prevention, and future research.

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that cause functional impairment. 1 Previously, ADHD was believed to be primarily a disorder of childhood that would be outgrown with the onset of puberty. Recent research, however, indicates that symptoms persist into adulthood in the majority of cases, with prevalence estimates of approximately 5% in the school age population and 2.5%–4% in the adult population. 1 – 4 Academic problems are prevalent among children and adolescents with ADHD and are associated with inattention and difficulty remaining seated, following directions, and completing assignments. 5 In addition, children and adolescents with ADHD often demonstrate disruptive, defiant, and hostile behavior. 6 , 7 Given these academic and behavioral difficulties, children and adolescents with ADHD are more likely than their non-ADHD peers to receive lower grades, fall behind academically, receive special education services, repeat grades, and drop out of high school and are less likely to pursue college. 5 , 8 Research suggests, however, that the symptoms of ADHD are often manifested differently in adolescence compared with in childhood. For example, symptoms of hyperactivity tend to decrease in adolescence relative to childhood and instead may be manifested as symptoms of cognitive or internal restlessness. 9 – 11 Adolescents with ADHD, however, continue to demonstrate similar levels of impairment as younger children with ADHD, including academic underachievement and difficulties with peers and social relationships, as well as various high-risk behaviors, including reckless driving and sexual behavior and substance use. 12

Despite these impairments, students with ADHD are increasingly graduating from high school and attending college. 13 However, information is lacking concerning the exact prevalence of ADHD among college students, due to privacy protection for students with disabilities under the Americans with Disabilities Act of 1990 and because many college students who meet diagnostic criteria for ADHD may not have been diagnosed with the disorder. 14 , 15 Therefore, more information is sorely needed regarding the prevalence of the disorder in the college population and its impact on student functioning. Several investigations have examined the prevalence of ADHD and the functioning of college students with ADHD symptomatology, most of which have relied on student self-report. For example, Weyandt et al 16 conducted the first study assessing ADHD symptomatology among college students and found that approximately 2.5%–8.7% of participants reported significant ADHD symptoms, depending on the criteria employed. More recent estimates are similar to those of Weyandt et al, indicating that approximately 2%–10% of college students have significant ADHD symptoms and that approximately 50% of students who receive disability services do so because of ADHD. 15 , 17 – 19

In terms of the academic and psychosocial functioning of college students with ADHD, Norwalk et al 20 found that students with ADHD had greater difficulty with college adjustment and poorer study habits and study skills than students without the disorder. Similarly, Shaw-Zirt et al 21 found that college students with ADHD, matched with non-ADHD peers on age, sex, and grade point average (GPA) (a measure of academic performance), reported poorer academic, social, and emotional adjustment than non-ADHD participants. Other studies have revealed that college students with ADHD tend to have lower GPAs, higher rates of academic probation, and poorer test-taking strategies and are less likely to graduate from college. 2 , 22 – 24 Self-reported psychological distress also appears to be more common among college students with ADHD than among those without the disorder, including poorer self-esteem and increased levels of depression and anxiety. 21 , 25 – 27 Collectively, these findings indicate that students with ADHD and elevated ADHD symptomatology are beset by various challenges in the college environment. To improve the outcomes of college students with ADHD, proper identification of the disorder is crucial so that effective prevention and intervention strategies may be developed and implemented.

Medical and nonmedical use of prescription stimulants

Pharmacotherapy is the primary treatment option for children, adolescents, and adults with ADHD, including college students. 28 , 29 US Food and Drug Administration (FDA)-approved medications for ADHD include 1) stimulants such as methylphenidate (MPH) (eg, Ritalin [Novartis International AG, Basel, Switzerland], Concerta [Janssen Pharmaceuticals Inc., Titusville, NJ, USA]), dextroamphetamine (D-AMP) (eg, Adderall [Shire plc, Dublin, Ireland], Dexedrine [GlaxoSmithKline plc, London, UK]), and lisdexamfetamine dimesylate (LDX) (eg, Vyvanse [Shire Inc., Wayne, PA, USA]), a prostimulant; and 2) nonstimulants (eg, atomoxetine, [Strattera; Eli Lilly and Company, Indianapolis, IN, USA]).

Nonstimulants (eg, atomoxetine) have been demonstrated to be safe and effective for improving ADHD symptoms among children, adolescents, and adults. 30 – 33 Nonstimulants have been found to be effective for individuals who do not respond to stimulants and have also been recommended for treating patients with ADHD who have comorbid substance use disorder (SUD). Nonstimulants, unlike stimulants, primarily affect the norepinephrine neurotransmitter system rather than the dopaminergic system and consequently have a lower potential for abuse than stimulant medications. Stimulant medications, however, remain the first line of pharmacotherapy for individuals with ADHD. 28 , 29 , 32 An extensive body of literature attests that stimulant medication, when used as prescribed, is safe and efficacious for improving attention and decreasing hyperactivity and impulsivity symptoms. 34 – 42 Although individuals with ADHD may greatly benefit from prescription stimulant medication, given their abuse potential when not taken as prescribed, prescription stimulants have been classified as schedule II medications by the FDA. A schedule II classification indicates that although the medication has been approved for medical use, it has a high potential for abuse, which, in turn, may lead to physiological and/or psychological dependence. 43

Numerous studies have documented that the nonmedical use of prescription stimulants, defined here as the use of stimulant medication in the absence of a valid prescription and use of prescription stimulants other than as prescribed, is a growing problem on college campuses, and college students typically report that stimulant medication is easy to obtain on campus. 44 – 52 Indeed, large numbers of students claim to have engaged in the nonmedical use of prescription stimulants, which is reflected in lifetime prevalence rates of prescription stimulant misuse ranging from 5% to nearly 34% of students. 53 , 54 Researchers have speculated that this increase may, in part, be explained by increasing numbers of college students receiving stimulant medication treatment for ADHD who may be distributing their medication to their peers, who may, in turn, misuse it. 44 , 49 Due to the significant health risks associated with the nonmedical use of prescription stimulants, this behavior poses a serious public health issue. 55 Consequently, studies have attempted to elucidate the characteristics of prescription stimulant misuse as well as risk and protective factors associated with this behavior.

The most commonly reported and the most strongly endorsed reason for taking prescription stimulants nonmedically is to improve attention and alertness while studying, taking exams, and writing papers: ie, cognitive and academic enhancement. 44 , 45 , 49 , 52 , 53 Research has also identified several risk factors for stimulant misuse, including demographic variables such as sex, ethnicity, and psychological risk factors, such as depressive symptomatology and symptoms of inattention. The identification of malleable predictors such as the academic and psychosocial functioning of students is particularly important for prevention and intervention strategies for prescription stimulant misuse. 56 – 58

Purpose of the present study

Given the positive association between psychological factors, ADHD symptoms, and the nonmedical use of prescription stimulants, and that college students report misusing stimulants primarily to enhance their cognitive and academic functioning, it is highly plausible that, by doing so, students are trying to compensate for the struggles they encounter in the college environment. In fact, some researchers have hypothesized that college students may be using prescription stimulants nonmedically as a coping strategy to treat ADHD symptoms: ie, to “self-medicate”. 49 , 57 Although preliminary evidence indicates that prescription stimulants are safe and effective for college students with ADHD when used as prescribed, very few controlled studies have been conducted on the efficacy of prescription stimulants for college student functioning specifically. 37 The question that arises, then, is whether the medical use of prescription stimulants leads to reductions in symptoms and improved academic and psychosocial outcomes. Further, is the medical use of prescription stimulants associated with increased nonmedical use of these medications? What is the scope of prescription stimulant misuse among college students? Are certain types of medications associated with greater potential for misuse than others? Answers to these questions will greatly inform both the treatment of ADHD among college students and prevention and intervention efforts aimed at reducing the nonmedical use of prescription stimulants on college campuses.

The present study attempted to answer these questions by conducting a systematic review of the literature concerning studies that investigated 1) the efficacy of prescription stimulants for adolescents and adults, including college students, with ADHD and 2) the nonmedical use and misuse of prescription stimulants.

Search and retrieval

A systematic literature review was conducted according to Okoli and Schabram’s 59 eight-step guide. Accordingly, all researchers were trained in the protocol for searching and identifying relevant articles. Although the first study to identify stimulant misuse was conducted in 2000 by Babcock and Byrne, 46 a substantial number of studies addressing stimulant misuse appeared in 2002. Therefore, we attempted to identify and retrieve all empirical studies published after 2002 that examined the efficacy of stimulants and nonstimulants and stimulant misuse with adolescents and adults. The search and retrieval process included a comprehensive search of the following bibliographic databases: PsycINFO, PsycARTICLES ® , MEDLINE, and ScienceDirect. Keywords and eligibility criteria were established separately for each subject. In order to identify and retrieve empirical studies that examined the efficacy of stimulants among adolescents and adults, the following keywords were used: “efficacy” + “stimulants”, “efficacy” + “Ritalin”, “efficacy” + “Adderall”, “efficacy” + “Concerta”, “ADHD” + “Ritalin”, “ADHD” + “Adderall”, and “ADHD” + “Concerta”. Keywords used to identify research examining the efficacy of nonstimulants and prostimulants among adolescents and adults included the following: “efficacy” + “nonstimulants”, “efficacy” + “Strattera”, “efficacy” + “Vyvanse”, and “efficacy” + “prostimulant”. Finally, keywords used to identify research examining stimulant misuse among adolescents and adults were: “prescription stimulant” + “misuse”, “prescription stimulant” + “illicit”, “methylphenidate” + “misuse”, “methylphenidate” + “illicit”, “prescription stimulants” + “nonmedical”, and “methylphenidate” + “nonmedical”.

Eligibility criteria

Studies for all search subjects were selected for review based on the following criteria.

• The study was published in English.
• The study was published no earlier than 2002.
• The study included a minimum sample size of 20 subjects.
• The study used an original dataset (meta-analyses and reviews were excluded).
• The study was relational, experimental, or quasiexperimental.
• The study could be conducted worldwide.
• The sample included adolescents (ie, participants with a mean age of ≥12 years) and/or adults. Note that studies including both children and adolescents were included if the mean age of participants was ≥12 years. Studies that did not report the participants’ mean age and included samples with a majority of participants aged <12 years were excluded.
• The sample included human subjects only and included no special groups except for persons with ADHD and learning disabilities.
• The study used only FDA-approved medication for ADHD.
• Eligibility criteria were established specifically for research examining the efficacy of stimulants, prostimulants, and nonstimulants.
• The sample included a control group (guanfacine studies were excluded, as well as studies examining efficacy of nicotinic agonists).

The search process resulted in identifying 2,103 sources, of which 76 met eligibility criteria. Specifically, nine studies examined the efficacy of LDX, 14 explored the efficacy of MPH, three assessed the efficacy of amphetamine (AMPH), three explored the efficacy of both MPH and AMPH in adolescents and adults, and 47 examined stimulant misuse among adolescents and adults. Although included in the initial search process, no studies examining the efficacy of nonstimulants met eligibility criteria for the present review.

Efficacy of prostimulants for adolescents and adults

As seen in Table 1 , all of the included studies (n=9) demonstrated a significant improvement in the measured outcomes from LDX compared with placebo. Six of the nine included studies reported effect sizes, all of which (based on Cohen’s estimates of small, medium, and large) reported medium to large LDX-related effects for improvement in ADHD and related symptoms. 35 , 37 , 60 – 64 Although the majority of studies examined LDX effects among adults, only one study examined its efficacy among a sample of adolescents. Specifically, Findling et al 65 reported that at varying doses (30, 50, and 70 mg/day), LDX was more effective at treating ADHD than placebo. Regarding adults with ADHD, improvements from LDX have been reported for quality of life, performance productivity, and executive function. 35 , 64 , 66 Large effects from LDX on improved executive function were also demonstrated in college students with and without ADHD. 37 Furthermore, LDX was associated with reduced ADHD symptoms compared with placebo in a sample of college students and two different samples of adults. 37 , 61 , 62 Although higher doses of LDX related to greater improvement in the reduction of ADHD symptoms in two studies, in one study differences between doses were not observed. 37 , 61 , 62 The maintenance of efficacy of LDX compared with placebo during a 2-week randomized withdrawal phase was also demonstrated to be effective in a sample of adults with ADHD. 67 Finally, findings suggest that LDX may be effective for treating individuals with comorbid ADHD and depression or SUD and in reducing ADHD symptoms. 63

Studies investigating the efficacy of lisdexamfetamine dimesylate (LDX) for adolescents and adults (N=9)

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; ADHD-RS, ADHD Rating Scale; ADHD-RS-IV, ADHD Rating Scale IV; AIM-A, ADHD Impact Module for Adults; BRIEF-A, Behavior Rating Inventory of Executive Function-Adults; CGI-I, Clinical Global Impression-Improvement; CGI-S, Clinical Global Impression-Severity; CI, confidence interval; d , Cohen’s d ; EF, executive function; GEC, Global Exeuctive Composite; LDX, lisdexamfetamine dimesylate; PERMP-A, Permanent Product Measure of Performance-Attempted; PERMP-C, Permanent Product Measure of Performance-Correct; YQOL-R, Youth QOL-Research Version.

The most common side effects reported by participants in studies investigating the efficacy of LDX included a decreased appetite, weight loss, dry mouth, insomnia, nausea, diarrhea, dizziness, headache, nasal congestion, feeling jittery, and anxiety. Mild to moderate adverse treatment-related effects were generally reported by 5% or fewer treatment group participants and included insomnia, tachycardia, irritability, fatigue, increased blood pressure/hypertension, upper respiratory tract infections, anxiety, decreased libido, and dyspnea. No deaths were reported in any of the studies. The results of most LDX studies led to the conclusion that the drug has a safety profile consistent with previous studies and other long-acting stimulants.

Efficacy of MPH and AMPH for adolescents and adults

Although research examining the efficacy of LDX is in its early stages, numerous studies have examined the efficacy of MPH, AMPH, and mixed amphetamine salts (MAS). The included research studies examined the effects of these stimulants among samples of adolescents (n=5), one of which also included children, and adults (n=15) (see Table 2 ). The vast majority of studies (n=14) specifically examined the effects of some form of MPH, whereas three studies examined MAS, and the remaining studies (n=3) examined a combination of MPH and MAS or AMPH. Regardless of the medication examined, all of the included studies reported statistically significant positive effects for stimulant medication compared with placebo, and effect sizes ranging from small to large based on Cohen’s estimates of effect size. 60 A total of 14 out of 20 included studies reported effect sizes. Of the studies reporting effect sizes for positive effects from stimulant medication, most effect sizes ranged from medium to large, with two studies reporting small to medium effects. 40 , 68 – 77 One study reported effect sizes regarding the interaction effects of differences between sex and medication dose, with no significant interactions found. Effect sizes ranged from very small (partial η2 as low as 0.00) to small. 78

Studies investigating the efficacy of methylphenidate (MPH) and/or amphetamine for adolescents and adults (N=20)

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; ADHD-RS, ADHD Rating Scale; ADHD-RS-IV, ADHD Rating Scale IV; AIM-A, ADHD Impact Module for Adults; CAARS, Conners’ Adult Attention Deficit Disorder Scale; CAARS:S:L, Conners’ Adult ADHD Rating Scale: Self-report: Long; CGI-I, Clinical Global Impression-Improvement; CGI-S, Clinical Global Impression-Severity; CI, confidence interval; d , Cohen’s d ; d-MPH-ER, dexmethylphenidate extended release; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; OROS, osmotic release oral system; MAS, mixed amphetamine salts; MAS-ER, mixed amphetamine salts extended release; MLR, multilayer release; MPH, methylphenidate; MPD-ER, methylphenidate extended release; MPH-LA, methylphenidate long acting; QOL, quality of life; SADS-E, Schedule for Affective Disorders and Schizophrenia - Epidemiologic version; SDS, Sheehan Disability Scale; SCID-I, Structural Clinical Interview for DSM-IV; se-AMPH-ER, extended-release amphetamine salts; TOVA, test of variables of attention; WRAADDS, Wender–Reimherr Adult Attention Deficit Disorder Scale; XR, extended release.

Studies assessing the effects of MPH, dextroamphetamine extended release (d-MPH-ER), MPH long-acting or extended release (MPH-ER), multilayer-release MPH, and MAS, including triple-bead MAS and MAS extended release (MAS-ER), have demonstrated reductions in ADHD symptoms among adult samples. 34 , 40 , 69 – 72 , 74 – 76 , 79 – 82 For example, Biederman et al 83 reported that adults with ADHD taking osmotic release oral system (OROS)-MPH, compared with those taking a placebo, demonstrated reduced symptoms of inattention and hyperactivity/impulsivity specifically. Adolescents taking MAS-ER and MPH-ER have also been shown to demonstrate reduced ADHD symptoms. 73 , 84

Regarding the effective dose for improvements in ADHD symptoms, doses of MPH-ER of 36–108 mg/day and 40–80 mg/day have been shown to be effective. 34 , 40 Similarly, two studies reported that higher doses of MPH-ER and d-MPH-ER were more effective than lower doses at reducing ADHD symptoms among adults with ADHD. 70 , 74 Among adolescents, higher doses, compared with lower doses, of d-MPH-ER and MAS-ER have also been shown to relate to improvement of ADHD symptoms. 75 Rösler et al, 76 however, reported that even at low to moderate doses (10–60 mg/day), MPH-ER was effective at reducing ADHD symptoms and that these effects were sustained during a 24-week follow-up.

In addition to ADHD symptoms, studies have shown that MPH and MPH-ER may improve cognition and emotional symptoms, and triple-bead MAS may enhance executive functions and quality of life among adults. 68 , 77 , 81 For example, Rösler et al 77 reported on a multicenter 24-week study and found that among a sample of adults with ADHD, taking MPH-ER was associated with improvement in emotional symptoms, obsessive–compulsive symptoms, and problems with self-concept. Among adolescents, one study reported that within a sample of 35 adolescents, those taking either OROS-MPH or amphetamine extended release (AMPH-ER) (Adderall XR) demonstrated improved neuropsychological functioning compared with those taking placebo. 85 Finally, MPH-ER and AMPH-ER have been demonstrated to be equally effective at improving symptoms among male and female adolescents with ADHD. 78

Regarding side effects in studies investigating the efficacy of D-AMP and MPH, participants most commonly reported decreased appetite, weight loss, headache, insomnia, abdominal pain, dizziness, nervousness, emotional lability, and dry mouth. Approximately half of the studies (n=12) found that a majority of participants reported at least one side effect; however, mild to moderate adverse treatment-related effects were generally reported by ≤5% treatment group participants and included decreased weight, insomnia, tachycardia, palpitation, irritability, fatigue, increased blood pressure/hypertension, and anxiety. No deaths were reported in any of the studies. The results of most stimulant studies led to the conclusion that the drug has a safety profile consistent with previous research. 86

Stimulant misuse among adolescents and adults

The efficacy of prescription stimulants among adolescents and adults with ADHD has been well documented, but the effects of these medications among populations without ADHD are unclear. Despite a lack of empirical evidence of stimulant effectiveness in individuals without ADHD, numerous studies have documented the misuse of prescription stimulants among college students without the disorder. Indeed, the present review retrieved more research studies pertaining to stimulant misuse (n=47) than the combined number of included studies assessing the efficacy of LDX, MPH, AMP, and MAS combined (see Table 3 ). The primary foci of the retrieved studies examining stimulant misuse varied. For example, some studies reported on prevalence rate estimates, others examined characteristics of individuals most susceptible to stimulant misuse, and others reported primarily on student opinions, such as ethical implications of stimulant misuse. Most of the studies, however, reported on some combination of these factors. Therefore, a systematic assessment and inclusion of effect sizes was beyond the scope of the present article.

Illicit stimulant use and misuse by adolescents and adults (n=47)

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; GPA, grade point average; LA, long acting; MPH, methylphenidate; OROS, osmotic release oral system; PCP, primary care physician; SD, standard deviation; UPPS-P, urgency, premeditation, perseverance, sensation seeking, and positive urgency; XR, extended release.

The studies reviewed indicate that prescription stimulant misuse is a growing problem across adolescent and adult populations. Estimates of lifetime prevalence range from 7.1% to 29% among adults, 5.3% to 55% among college students, and 1.7% to 4.5% among adolescents. 53 , 87 – 92 Although estimates of stimulant misuse prevalence appear to be relatively low among general adolescent samples, estimates of stimulant misuse among adolescents using other substances (23%–31%) and among adolescents and adults receiving treatment for ADHD (14%) are much higher. 91 – 97 Estimates of lifetime stimulant misuse also appear to increase as adolescents reach higher grade levels. For example, among high school seniors, McCabe and West 98 reported that nearly 10% admitted to using prescription stimulants nonmedically at least once. Similarly, lifetime prevalence estimates in college have been shown to grow as students reach their final years of school. Garnier-Dykstra et al 56 reported that although only 13.3% of first year students reported stimulant misuse, by their fourth year 31% reported misuse.

In addition to college level, lifetime estimates of stimulant misuse may vary according to several other variables. For example, prevalence of stimulant misuse specifically for cognitive enhancement was estimated to be <2% in a sample of preuniversity (students preparing to attend university) and university students in Germany, but prevalence estimates of stimulant misuse for the purpose of weight loss has been reported to be nearly 12%. 99 , 100 Studies assessing stimulant misuse among general samples of college students have reported rates between approximately 8% and 34%. 54 , 101 , 102 Much higher estimates of stimulant misuse have been reported among samples of college students with ADHD (43%) or with prescriptions for stimulant medication (45.2%). The highest estimates of prevalence of stimulant misuse among college students (55%), however, have been reported among a sample of fraternity members. 90 , 103 , 104

Among medical students, lifetime prevalence estimates for engaging in prescription stimulant misuse have ranged between 9%–10% and 18%. 105 – 107 Moderate lifetime prevalence estimates of stimulant misuse have also been reported among undergraduate and graduate health care students (11%), dental and dental hygiene students (12.4%), and general samples including both undergraduate and graduate students (16.2%–17.5%). 50 , 108 – 110

Compared with adolescents and college students, very few studies have addressed prevalence estimates of stimulant misuse among adults aged ≥18 years outside of the university setting. Novak et al 87 reported that 2% of the 4,297 adults sampled indicated that they had engaged in nonmedical use of ADHD medications in the past year and 7.1% in their lifetime. Pilkinton and Cannatella 88 reported similar rates (7.1%) for lifetime prevalence estimates among a sample of both adolescents and adults. However, estimates of stimulant misuse prevalence among adults with prescriptions for stimulant medications have yielded much higher rates (29%), similar to adolescent populations. 89 Finally, Lensing et al 111 explored physician and adult patient agreement regarding prescription stimulant misuse and diversion and found that <1% of physicians suspected their patients of diversion and <2% of the adults themselves reported diversion of prescription stimulants, yielding a high level of agreement between the two.

Studies examining characteristics of students engaging in stimulant misuse have yielded relatively consistent findings regarding sex and race/ethnicity. Although multiple studies reported that male students have indicated higher rates of lifetime stimulant misuse than female students in university settings, several studies have also failed to find differences between males and females among college students and high school senior students. 44 , 52 , 98 , 99 , 101 , 105 , 107 , 110 , 112 These conflicting findings may be due to differences in measurement. For example, although Franke et al 99 reported sex differences in lifetime prevalence of stimulant misuse for cognitive enhancement, the researchers did not find differences across males and females in past year or past month stimulant misuse. On the other hand, the vast majority of studies examining racial and ethnic differences related to stimulant misuse have reported that young adults, college students, and adults who are white are more likely to misuse stimulants than students of other races and ethnicities. 49 , 53 , 88 , 91 , 98 , 99 , 101 , 113 Only one study reported that there were no differences in ethnicity regarding prevalence of stimulant misuse; however, <12% (n=37) of the study’s sample included students of color, limiting statistical power and thus conclusions regarding differences in prevalence among ethnic differences. 52

Interestingly, studies examining characteristics of adolescents who partake in nonmedical stimulant use indicate that students without plans to attend college have been shown to report a higher prevalence of stimulant misuse than those who plan to attend college, and adolescents who report prescription stimulant misuse may be less likely to attend school. 94 , 96 However, college students appear to be particularly vulnerable to stimulant misuse, and members of fraternities and sororities have reported higher rates of misuse than students unaffiliated with Greek organizations. 47 , 101 , 114 One of the reviewed studies found that college students who are upper classmen or live off-campus may be more likely to engage in nonmedical stimulant use. 90 Additional correlates of stimulant misuse among college students have included affiliation with a Jewish religion, perceiving stimulant use as normative, and engaging in problematic weight loss strategies. 100 , 101 , 115 Weight loss, however, may not be unique to college students, as adolescent prescription stimulant misusers have been found to be more likely to have an eating disorder than students who did not misuse stimulants. 96 Finally, all types of students (adolescents, adults, and medical) performing worse academically appear to be more likely to engage in nonmedical prescription stimulant use. 56 , 99 , 101 , 105 Indeed, this review found that the most commonly reported reasons university students take prescription stimulants are related to academics, and studies suggest that during periods of high academic stress, college students may be more likely to use prescription stimulants, as indicated by self-report measures and by measurements of stimulant levels in campus wastewater samples. 49 , 54 , 56 , 105 , 108 , 110 , 113 , 115

It is not surprising, then, that procrastination and difficulty with time management have also been shown to relate to stimulant misuse among college students. 115 Further, stimulant misuse among college students has been shown to relate to higher levels of hyperactivity, sensation seeking, depression, internal restlessness, and psychological distress and lower levels of premeditation. 44 , 58 , 104 , 114 , 116 ADHD diagnoses and symptoms may also relate to stimulant misuse. Adolescents, college students, and adults diagnosed with ADHD have reported higher levels of prescription stimulant misuse than students without ADHD, and ADHD symptoms have been shown to correlate with nonmedical use of prescription stimulants. 57 , 84 , 95 , 117 It is important to note, however, that studies suggest that the vast majority of individuals with ADHD do not misuse or divert their stimulant medications. 84

The studies included in the present review also indicate that in addition to ADHD, diagnoses of conduct disorder and SUD are associated with increased nonmedical prescription stimulant use and diversion in adolescents and adults. 84 Illicit drug use among adolescent and university students is also associated with misuse of prescription stimulants. 52 , 56 , 90 , 91 , 93 , 98 , 101 , 103 , 104 , 107 , 115 , 118 , 119

Several studies in the current review assessed student perspectives on prescription stimulant misuse, and findings revealed that students’ opinions on the ethical implications of taking illicit prescription stimulant medications to enhance academic outcomes are mixed. For example, Bossaer et al 108 reported that health care students were split between considering stimulant misuse to be academically dishonest and proffering unfair academic advantages. Similarly, half of the medical students sampled by Emanuel et al 107 perceived stimulant misuse to be a problem, but 20% did not. Students who report engaging in stimulant misuse, however, may feel less conflicted regarding ethical implications. For example, Judson and Langdon 48 reported that compared with nonillicit users, illicit users demonstrated fewer concerns regarding the safety and ethics of using stimulant medication.

Whether or not students consider their decision to engage in stimulant misuse to be ethical, students misusing stimulants appear to expect positive outcomes. 107 , 116 Indeed, students who have reported taking stimulant medications illicitly have endorsed feeling a reduction in fatigue and improvement in cognition and memory after taking prescription stimulants. 54 The present findings also indicate that students who misuse tend to perceive the benefits as outweighing the risks, despite the fact that little is known about the physiological and cognitive effects of prescription stimulant medications among populations without ADHD. 49 Two of the reviewed studies suggest that individuals misusing stimulants may be more likely to take short-acting agents than long-acting agents. Wilens et al 84 and Bright, 97 for example, reported that adolescents and adults were more likely to misuse short-acting agents than long-acting agents, suggesting that immediate-release agents have more potential for abuse. Results were mixed regarding the most commonly misused fast-acting stimulant, with Ritalin (MPH) more likely to be misused than Adderall among adults, but nearly 12% of college students reported misusing Adderall compared with 8.5% misusing Ritalin. 88 , 115

Effectiveness of ADHD treatment options

Studies included in this review revealed that the medical use of prescription stimulants is efficacious in reducing ADHD symptoms and may improve cognitive and psychosocial outcomes in individuals diagnosed with ADHD. Specifically, research investigating LDX in comparison with placebo consistently found LDX efficacious across 30, 50, and 70 mg/day. Two studies, however, found that higher doses related to greater improvements in overall functioning. 37 , 62 Most notably, the present findings support that LDX is effective for reducing ADHD symptomatology across different ages. 37 , 61 , 62 Among adults with ADHD, LDX was also found to positively affect executive functions, quality of life, and performance productivity. 35 , 64 , 66 Additionally, LDX has been found to be effective in reducing ADHD symptoms with individuals with comorbid depression and SUD. 63 Although these results are encouraging, it is important to note that most studies did report negative side effects from LDX, such as decreased appetite, weight loss, and nasal congestion. More severe side effects, however, including tachycardia, increased blood pressure/hypertension, and anxiety, were reported by <5% of the included study samples, and no individuals died while participating in these studies.

Similar to those investigating LDX, studies examining the efficacy of MPH and D-AMP consistently found such treatment options to be associated with fewer ADHD symptoms compared with placebo. These positive effects were found among long-acting and short-acting stimulant medications, and one study reported similar effects for both males and females. 78 Although higher doses generally proved to be more effective at reducing ADHD symptoms, low to moderate doses of stimulants may also be effective at reducing ADHD symptomatology. 70 , 74 , 76 Such treatment options examined in this review were associated with enhanced cognitive performance, executive functioning, and quality of life and fewer emotional symptoms. 68 , 77 , 81 Although MPH and D-AMP have proved to be efficacious in treating ADHD symptomatology, it is important to consider their side effects that are similar to LDX: decreased appetite, weight loss, headache, insomnia, abdominal pain, dizziness, nervousness, emotional lability, and dry mouth. Although rare, more severe side effects of these medications have included psychosis, seizures, and cardiac events such as tachycardia, hypertension, myocardial infarction, and sudden death. 120

Overall, however, these results are consistent with the child literature indicating that prostimulant and stimulant medications, when used as prescribed, are a safe and efficacious treatment option for improving attention and decreasing hyperactivity and impulsivity symptoms. 23 , 34 – 38 , 40 – 42 What remains less clear, however, is whether these medications affect academic and work-related outcomes of adolescents and adults without ADHD. Although one study reported improvements in measured cognition from MPH and another found that students who misuse stimulant medication perceive positive academic effects, 54 , 68 none of the studies included in the present review examined changes in quality of work or student grade or productivity after taking stimulant medications. Given that cognitive enhancement-related reasons are considered the primary motivation for college students misusing prescription stimulant medications, future research examining the effects of prescription stimulants on direct measures of academic success (eg, studying and concentration, grade performance, quality of writing, and reading comprehension) is warranted.

An additional area that warrants attention concerns the efficacy of nonstimulant medication for the reduction of ADHD symptoms and any potential effects for cognitive enhancement. The present review was unable to identify any studies examining nonstimulant efficacy among adults and adolescents meeting the required eligibility criteria. Given the lower abuse potential associated with nonstimulant medication, use of these medications among populations more susceptible to diversion and misuse may be prudent. 32 Such a recommendation, however, is contingent on a demonstration of the efficacy of nonstimulants among adolescent and adult populations most at risk for stimulant abuse. 32

Finally, although prescription stimulant medication is considered the front line of pharmacotherapy for ADHD treatment in adolescents and adults, these drugs have significant diversion and misuse potential. 43 In fact, the present review revealed that the medical use of prescription stimulants is associated with increased stimulant misuse among students with ADHD, with one study reporting misuse rates of 62.8% among participants with a valid prescription. 104

Stimulant misuse

Results from the present review indicate that a significant percentage of adolescents and adults are engaging in nonmedical stimulant misuse, which is consistent with previous research examining college students specifically. 45 Results revealed lifetime prevalence rates of stimulant misuse ranging from 1.7% to 55%, with reports varying across the population being examined. 90 , 91 A limitation of this body of literature is the dearth of studies investigating the prevalence of prescription stimulant misuse among college students outside of the US, which impedes cross-cultural comparisons regarding prescription stimulant misuse.

Similar to previous studies examining the nonmedical use of stimulants, the present review revealed that estimates vary according to numerous variables. For example, one trend that has emerged is that as individuals reach higher grade levels, they misuse at greater rates. 56 , 98 Although increased exposure to prescription stimulants may be one reason students report higher prevalence rates of stimulants as they increase in age, these findings suggest that prescription stimulants may also be misused more frequently as coursework becomes more challenging and academic success becomes more difficult to obtain. Indeed, as indicated in this review, academic performance has been reported as the primary motive for this behavior. A critical finding, however, is that prescription stimulant misuse has been found to be negatively associated with academic performance. 44 , 90 , 101 For example, Arria et al 121 reported that college freshmen who used prescription stimulants nonmedically had poorer study skills (eg, skipped classes more often and spent less time studying and more time socializing) and poorer academic performance (GPA) in high school and college than students who did not endorse stimulant misuse. 51

Despite the negative relationship between academic performance and stimulant misuse, most students who endorse the nonmedical use of stimulants perceive them as effective and helpful for enhancing their academic performance. 49 For example, Weyandt et al 44 found that >20% of students in their sample agreed or strongly agreed that the occasional nonmedical use of prescription stimulants is harmless. Additionally, stimulant misusers may be less concerned about the safety and ethical implications of stimulant misuse compared with students who do not misuse stimulants. 48 Findings suggest, however, that general student populations are conflicted about the ethical implications of stimulant misuse.

Although individuals without ADHD have endorsed positive effects from misusing stimulant medication, to date only one study has explored the effects of Adderall on college students without ADHD, and this study, in general, did not find enhancement of cognitive abilities, despite the students’ impression that it was improving their performance. 122 Similar performance-enhancing impressions have been made of MPH, and have led to the popularity of its use among adolescents and college students with and without ADHD. 123 In addition, the present review suggests that adolescents and adults are more likely to misuse short-acting or immediate-release agents compared with long-acting agents. 84 , 97 Consistent with previous studies, the present review suggests that students who are white, affiliated with a fraternity or sorority, engaging in other illicit drugs, and male, are more likely to misuse prescription stimulants. 47 , 49 , 56 , 57 , 84 , 89 , 92 , 94 , 96 , 101 , 102 , 113 , 118 , 124 Although some of the studies reported no sex differences, recently Weyandt et al 45 reported on the effect sizes of sex differences in studies examining stimulant misuse. Cohen’s d effects ranged from 0.88 to 5.38, suggesting that males are misusing at greater rates than females. 109 , 110 , 125

Implications

Pharmacotherapy is the principal choice of treatment for ADHD among children, adolescents, college students, and adults. 28 , 29 Because stimulants are the most frequently prescribed drug for college students with ADHD, and most college students with ADHD take prescription stimulants, more double-blind, placebo-controlled studies examining the effectiveness of these medications in college students are warranted. 22 It is important to note, however, that there is recent evidence that prostimulants may also be effective at improving symptoms in individuals with ADHD. 28

The present review provides evidence that college students with ADHD and those with a stimulant prescription are taking part in greater levels of stimulant misuse compared with those without the disorder. 103 , 104 Although individuals with ADHD may greatly benefit from stimulant medication, these prescription medications have significant abuse potential when they are not used as prescribed. 43 All prescription stimulants that are used to treat ADHD are controlled substances; however, abuse liability varies based on the delivery system in which the medication activates. 126 For example, Svetlov et al 123 reported that although MPH and AMPH have similar psychopharmacological effects, they do have different neurochemical mechanisms of action. Such differences are essential to consider, as MPH appears to have less rewarding abilities, lowering its chances of dependence, especially when taken as prescribed. A second example includes the requirement of enzymatic hydrolysis for LDX before its therapeutic effects are achieved, which results in a slow increase of D-AMP levels, potentially lowering its use for diversion or misuse. 37 , 127 Indeed, recent research has examined the effects of LDX in a group of stimulant abusers who did not have ADHD, and found that intravenous doses of LDX had greater abuse-related disliking compared with placebo. 127 Specifically, Jasinski and Krishnan 127 administered 100 mg of LDX and 40 mg of D-AMP to individuals, also reporting that intravenous doses of D-AMP have significantly more abuse-related liking effects compared with placebo. Additionally, because of its chemical properties, LDX cannot be ground or dissolved into a short-acting stimulant, which has been the stimulant of choice for stimulant misusers. Given the demonstrated effects of LDX on improving ADHD symptomology, as well as executive function, and its demonstrated greater abuse-related disliking, LDX may be the ADHD medication of choice for college students with ADHD who are at risk for stimulant misuse. 37 , 127 LDX may also be a good choice for prescribers working with the college student population to help prevent stimulant diversion among valid prescription holders and misuse among college students without ADHD. Results of this review also suggest that health care providers should inform their patients of the health and legal risks associated with the misuse of prescription medications, and monitor the use of these medications on a frequent basis. Lastly, health care providers involved in prescribing ADHD-related medications should be thoroughly trained in the proper assessment, diagnosis, and treatment of ADHD to ensure diagnostic accuracy and treatment effectiveness.

In addition to educating prescribers about the rates of misuse and diversion, as well as the variables associated with stimulant misuse, it is critical that prevention and intervention efforts be made amongst health care providers and educators at the middle school, high school, and higher education levels. Further efforts should target particularly higher-risk college populations such as fraternities and sororities. Information regarding the potential side effects of stimulant medications taken at varying doses and by different methods (eg, snorting or injecting), in addition to side effects resulting from the ingestion of medication as prescribed, should be made available to students in particular. Students should also be informed of the dangers of coingestion of prescription stimulants with other substances (eg, alcohol and cocaine), and particular emphasis should be placed on maintaining security of their medication (eg, lockboxes). Students who are misusing prescription stimulants without medical guidance are placing themselves at health and psychological risk, in addition to legal consequences for buying, selling, and diverting their medications. 120

The inclusion of a psychoeducational component that focuses on inaccurate perceptions of safety surrounding nonmedical prescription stimulant use would be beneficial to intervention as well. Students who are at risk for stimulant misuse with academic problems can be provided with various support, such as tutoring and structured environments for studying and work completion. This additional support may encourage a school culture of clear expectations, educational support, and effective study habits, rather than competitiveness. For individuals who have been misusing stimulants or are inclined to misuse, it is imperative to discuss the motivating factors and determine any possibly undiscovered psychological, social, and/or emotional problems related to misuse or the desire to misuse. By pinpointing and addressing the core cause of stimulant use, students can be provided with the resources that will directly provide them with benefits and alternative methods to meet their specific needs. Thus, students should be educated about the potential side effects and risks associated with prescription stimulant misuse, as well as encouraged to access campus resources for academic and psychological support. 45 , 47

Results from the present review support that both stimulant and prostimulant medications (including LDX, MPH, AMPH, and MAS), when used as prescribed, are safe and effective options for reducing ADHD symptoms in adolescents and adults with ADHD. Preliminary studies also suggest that prescription stimulants may improve psychosocial outcomes (eg, quality of life, self-concept, and obsessive– compulsive symptoms) for those with ADHD. Research explicitly examining effects of prescription stimulants on academic and cognitive functioning in students without ADHD is sorely limited, yet the current review revealed that alarmingly high percentages of adolescents and adults are engaging in nonmedical prescription stimulant use primarily for cognitive enhancement. Results of the present review also revealed a higher rate of prescription stimulant misuse among individuals with ADHD compared with individuals without the disorder, and that short-acting agents are more likely to be misused than long-acting agents. These findings emphasize the need for additional research concerning the misuse of prescription stimulants and have direct implications for prevention and intervention efforts to reduce prescription stimulant misuse among adolescents and young adults.

Acknowledgments

Research reported in this publication was supported by the National Center for Research Resources of the National Institutes of Health under Award Number G20RR030883. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors report no conflicts of interest in this work.

• Bipolar Disorder
• Therapy Center
• When To See a Therapist
• Types of Therapy
• Best Online Therapy
• Best Couples Therapy
• Best Family Therapy
• Managing Stress
• Sleep and Dreaming
• Understanding Emotions
• Self-Improvement
• Healthy Relationships
• Student Resources
• Personality Types
• Verywell Mind Insights
• 2023 Verywell Mind 25
• Mental Health in the Classroom
• Editorial Process
• Meet Our Review Board
• Crisis Support

Vyvanse vs. Adderall: Similarities and Differences

John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH).

 Verywell /  Theresa Chiechi

• Vyvanse vs. Adderall
• Effectiveness
• Side Effects
• Differences
• Which Drug Is Best?

Vyvanse (lisdexamfetamine) and Adderall (amphetamine and dextroamphetamine) are stimulant medications prescribed to treat attention-deficit/hyperactivity disorder (ADHD).

However, there are several differences between the two medications. The effects of Vyvanse generally last longer than the effects of Adderall; Vyvanse has a slower absorption rate than Adderall. Adderall also has a higher potential to be misused than Vyvanse.

Both drugs work by acting on the central nervous system, which boosts the availability of neurotransmitters in the brain. With increased amounts of dopamine and norepinephrine, it is easier to pay attention and focus. In addition, hyperactivity and impulsive behavior are reduced.

Vyvanse vs. Adderall: Key Facts

Vyvanse and Adderall are two different medications. However, because they are both stimulant medications from the same drug family (amphetamine), they may be confused as being the same medication. Here are some facts about the two drugs to shed light on their similarities and differences.

Adderall is a brand name for a drug that contains dextroamphetamine and amphetamine . It is available in two formulas: Adderall IR (immediate-release) and Adderall XR (extended-release). Adderall IR is short-acting. Typically, when a person is prescribed this immediate-release version, they would take it two or three times a day.

Adderall XR was approved by the FDA in 2001 and may be prescribed to people 6 years and older. Adderall IR is also approved to treat narcolepsy.

Vyvanse is a brand name for a drug that contains lisdexamfetamine. When lisdexamfetamine enters the body, it is converted to dextroamphetamine. It is available in one formula that was approved by the FDA in 2007 for people 6 years and older.  In addition to treating ADHD, Vyvanse is approved to treat binge eating disorder .

Effectiveness of Vyvanse vs. Adderall

Both Vyvanse and Adderall are effective for treating ADHD. There is little comparative research to suggest that one is better than the other.

The two medications do differ in terms of how long they last. This can be a deciding factor for many people and can impact how effective the medication is for controlling symptoms.

• The immediate-release form of Adderall lasts for around three to four hours. However, people may be able to take a dose two to three times per day. The extended-release form is taken once per day but lasts for 10 to 12 hours.
• One dose of Vyvanse can last up to 14 hours, which means that it can often be taken in the morning and last all day.

Some people taking Adderall XR may find that they need to take other medications to help control their symptoms.

Side Effects of Vyvanse vs. Adderall

As Vyvanse and Adderall are both amphetamine-type stimulant medications, the side effects of each drug are similar and include:

• Abdominal pain
• Affect lability
• Appetite loss
• Increased heart rate
• Irritability
• Jitteriness
• Nervousness
• Sleep problems
• Weight loss

More serious but rarer side effects include increased heart rate, high blood pressure, shortness of breath, hallucinations, and paranoia. If you experience these or any other side effects, contact a doctor as soon as possible.

There are some additional side effects that need to be considered. Men might experience erectile dysfunction (ED) when taking an amphetamine. Although you might feel embarrassed to talk about this with a doctor, they will be able to work with you to help resolve this issue.

Precautions

People with certain conditions should not take Vyvanse or Adderall. For example, you should not take either of these medications if you have:

• Bipolar disorder
• Cardiovascular disease
• High blood pressure
• Hyperthyroidism
• Liver problems

Adderall and Vyvanse both could be unsafe during pregnancy, and they are not recommended while breastfeeding. If you are pregnant, planning to become pregnant, or breastfeeding, talk with your prescribing doctor.

Since both medications are amphetamines that can be addicting, you should also not use them if you have a history of substance abuse.

Drug Interactions

There is also a risk of drug interactions that can occur if you combine Adderall or Vyvanse with another substance. Medications that you should avoid while taking these ADHD medications include:

• Antidepressants
• Antipsychotics
• Blood pressure medications
• Cold or allergy medications containing antihistamines or decongestants
• Monoamine oxidase inhibitors (MAOIs)
• Opioid pain medications

Other things that can interact with and affect the actions of Vyvanse and Adderall include alcohol, caffeine, and foods or beverages containing ascorbic acid.

Remember to inform your prescribing doctor about any other prescriptions, over-the-counter medications, and natural supplements you might be taking.

Differences of Vyvanse vs. Adderall

While Vyvanse and Adderall share a number of similarities, there are some important differences between the two medications. These differences can play a role in determining which medication is right for you. 

Slower absorption rate; starts working in 1 to 2 hours

Effects last 14 hours

Lower risk of abuse since cannot be inhaled or injected

No generic available until after 2023

Faster absorption rate; starts working in 30 minutes

Effects last 4 hours for Adderall IR, 10 to 12 hours for Adderall XR

More potential for abuse

Generic available

Immediate (IR) and extended (XR) versions for flexibility

Absorption Rate

Perhaps the biggest distinction between Adderall and Vyvanse is that Vyvanse is a prodrug. This means that it needs to be taken orally in order to be metabolized by the body’s enzymes to become effective.

The effects of Adderall start to work within 30 minutes. In contrast, Vyvanse takes approximately one to two hours to take effect.

Vyvanse is often described as "smoother" than Adderall. One of the reasons for this is that—because it has a slower absorption rate—there is not a "kick" or "jolt" to the system when the medication starts to work.

Medication Rebound

In addition, there is less medication rebound when Vyvanse starts to wear off. Since Adderall is available in both intermediate and extended versions, it allows for great flexibility in how it can be taken. For example, a person might be prescribed Adderall XR to take daily and have Adderall IR to take when a more immediate effect is needed or when it is beneficial to have the medication wear off before bedtime.

Vyvanse and Adderall are Schedule II drugs, which means there is a potential for abuse and dependency. Both are approved to take orally. Since Vyvanse needs to be converted in the body, it can't be inhaled or injected as a way to become high, so it is less likely to be misused than Adderall and other stimulant medications. Always store your medications safely and away from other people.

Forms and Dosages

Adderall IR is available in tablets ranging from 5 to 30 milligrams (mg). Adderall XR is available in six different doses ranging from 5mg to 30mg. Vyvanse is available in capsules and chewable tablets of several strengths in doses from 10mg to 70mg.

Doctors usually prescribe a lower dose when you first start taking a medication and gradually increase it until they find the right therapeutic dose for you and your symptoms.

Adderall and Vyvanse are both brand names and a month’s supply without insurance can cost from around $150 to $400 depending on the frequency and dose. Adderall is available in generic versions (called mixed amphetamine salts), which can be considerably cheaper. Some people find that generic versions of Adderall are not as effective for them as the brand version.

Vyvanse is not available in generic form. Online pharmacies might advertise generic forms of Vyvanse but take care: Generic Vyvanse has not been approved , giving it the potential to be unsafe.

The fact that Vyvanse is not available as a generic may impact a person's decision about which drug to use. Generic drugs tend to be much less expensive than brand-name medications.

Which Drug Is Right For You?

If you are wondering which ADHD medication is best for you or your child, talk through the options with your healthcare provider. Finding the optimal medication often involves some back and forth with your doctor as each person responds differently.

When you start taking a new medication, monitor how it makes you feel, including side effects. Then inform your prescribing doctor so they can make the necessary adjustments if needed.

Some of the key factors that might go into deciding which one is right for you are how long the medication lasts and how much it costs. After trying one medication, you might find that it is not working as well as expected, and you may want to switch. Each person is different, so go off of how you feel and work with your doctor to come up with the right approach.

A Word From Verywell

Because Vyvanse and Adderall are similar medications in many ways, the choice really comes down to what works best for you. Both are effective for managing symptoms of ADHD, but it may take some trial-and-error to find the medication and dose that works best.

It is also important to remember that while these are among the most popular options for treating ADHD, they are not the only ones. There are also other options available, which you should discuss with your doctor if you feel like neither Vyvanse nor Adderall is right for your needs.

Wolraich ML, Hagan JF Jr, Allan C, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents [published correction appears in Pediatrics. 2020 Mar;145(3):].  Pediatrics . 2019;144(4):e20192528. doi:10.1542/peds.2019-2528

Purushothaman P. What’s new with stimulants? . Child Adolesc Psychopharmacol News . 2013;18(4):1-8. doi:10.1521/capn.2013.18.4.1

Food and Drug Administration (FDA). Adderall XR (mixed salts of a single-entity amphetamine product) extended release capsules .

Food and Drug Administration (FDA). Adderall (dextroamphetamine saccharate, amphetamine, dextroamphetamine sulfate, and amphetamine sulfate) tablets .

Food and Drug Administration (FDA). Vyvanse (lisdexamfetamine dimesylate) capsules .

Drug Enforcement Administration. Drug scheduling .

By Jacqueline Sinfield Jacqueline Sinfield is an ADHD coach, and the author of "Untapped Brilliance, How to Reach Your Full Potential As An Adult With ADHD."