Dealing With Adderall Tolerance

What Is Adderall Tolerance?

Adderall tolerance is an example of the biological process where a previously effective prescription medication becomes less effective over time. In some ways, it is in fact a normal, healthy response to taking a drug for a long period. However, a long-term lack of response could indicate serious issues. 

What Causes Adderall Tolerance?

How Adderall works is through an increase of your levels of dopamine, noradrenaline, and certain other neurotransmitters, such as serotonin [1]. Your body responds to this by turning down the production of these neurotransmitters. This is why missing a dose, or Adderall withdrawal, can leave you feeling terrible. 

The vast majority of physiological processes are controlled by negative feedback loops. High levels of substances such as neurotransmitters or hormones will then turn their production down, so they don’t reach dangerously high concentrations. While it’s easy to feel like your body is betraying you, this is a protective response. 

Additionally, with repeated exposure to certain substances, your liver ramps up detoxification. You may remember your first time trying alcohol, and how you were much more sensitive then than now. Or, if you don’t drink often, you’re more sensitive than your friends who drink regularly. This is because the parts of your liver cells that produce detoxification enzymes increase in number, as a specific response to Adderall [2]. 

Research suggests that tolerance is more likely with continuous doses of the drug, instead of occasional high doses. Shorter-term high doses are often used in animal research to test the effects of long-term Adderall use, but continuous smaller doses are more relevant to how we actually take the drug [3]. 

Why Is My Adderall Not Working Anymore?

A gradual, persistent loss of response to Adderall could indicate something more serious. Lab research points to the possibility that real-world doses of the drug may eventually damage dopaminergic neurons. Both dopamine and dopamine transporters significantly declined in primates taking realistic Adderall doses. 

This could stop you from responding to the drug, as you aren’t making enough dopamine for it to work with. However, children seem to be better protected and may not build tolerance through this mechanism. As more children use Adderall than adults, we haven’t picked up this adverse effect yet [4].

Damage to the neurons may be partly caused by high levels of cortisol. If you miss a dose of Adderall, or worse, go through the Adderall crash, cortisol rises in response to the sudden fall in dopamine. Through oxidative stress, cortisol not only damages the neurons you already have but also impairs the growth and development of new ones [5] [6]. 

Research comparing amphetamined drugs (tested with MDMA), Ritalin, and modafinil found that, out of the three prescription stimulants, only the amphetamines raised cortisol. 

While the placebo group’s cortisol levels were only 630nmol/L, those taking MDMA had an average cortisol concentration of 942nmol/L. MDMA is a stronger, illegal amphetamine, but Adderall may have a milder effect [7]. 

Adderall Tolerance Build Up: What To Know

Your body gets used to Adderall sooner than you think, but the most important thing is to stay safe. 

How Long Does It Take for Adderall Tolerance?

The early signs of Adderall tolerance may even start within a few days. A study involving healthy men and women, with no ADHD or other disorder, showed the beginnings of tolerance after only three doses spread over five days. Just one dose significantly increased blinking rate, but after the third, this fell back to levels seen in the placebo group. 

On the other hand, energy (measured as vigor) was higher after three doses than one alone. This means that while you develop a tolerance early, you are unlikely to see any negative effects of this for quite some time [8]. 

Noticeable Adderall tolerance can take weeks or months to appear. A study involving children with ADHD taking Ritalin, another stimulant, showed that the average child needed one or two dosage increases over the course of 10 months. 

For children taking ADHD every day, there was an average of 1.79 dosage increases. However, having an “Adderall holiday” on the weekends reduced this down to 1.61 increases in their dose. 

This means occasionally using the drug as a study pill, or reserving it for the most difficult periods of the semester, is less likely to cause tolerance. If you have ADHD, taking breaks could mean you will reach tolerance to your current dose a little slower, but use caution to avoid Adderall withdrawal symptoms [9]. 

What Adderall Dosage Works Best?

If you need stimulants for medical reasons, do not use larger doses of Adderall than what has been prescribed to you. The upper limit for the drug is set at 40 mg per day for ADHD symptoms, and up to 60 mg per day for narcolepsy. The right dose for you depends on how well you respond to Adderall. Only your doctor can determine this, as it is individual [1]. 

In research revealing tolerance through a loss of dopaminergic neurons, the response of the serotonin system was unchanged. One of the dangers of Adderall is therefore the perceived need to take higher doses because you could be at risk of serotonin syndrome. 

Depending on the severity, serotonin syndrome can involve anything from a faster heart rate and rest under medical supervision, to organ damage and intensive care [10]. 

How To Make Adderall Work Again: 6 Simple Tips

If you’re missing the benefits of Adderall, there are simple ways to make your ADHD drugs work better for you again without turning to Adderall abuse. You may have been eating foods that impair absorption, leading to an easy misunderstanding that the stimulant medications have stopped working. 

On the other hand, there is hope if your dopaminergic systems have been burnt out by stimulant medication use. While impaired dopamine responses have been documented up to three years after quitting the drug, they slowly improve even without intervention [11].