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Last Updated: 21.06.23

Adderall, Stimulants & Modafinil for ADHD: Short- & Long-​​Term Effects

Huberman delves into the mechanics of ADHD medications like Adderall, Ritalin, and Vyvanse, explaining how they enhance focus and reduce hyperactivity. He explores brain circuits, the roles of dopamine and norepinephrine, and the potential long-​​term effects on health. This episode is invaluable for individuals with ADHD, parents, and those seeking insights into ADHD medication mechanisms.

Key Takeaways

High level takeaways from the episode.

Adderall, Ritalin, Vivance, Modafinil, Rmodafinil, and Guanfacine

  • Improve symptoms of ADHD
  • Commonly used without prescription for focus and recreational purposes 
    • Up to 80% of college-​​age young adults have used these drugs at some point

Stimulant medications increase activity in the prefrontal cortex

  • This helps suppress other brain areas and improve focus
  • Research is ongoing to determine if ADHD meds predispose individuals to addiction

ADHD: not a deficit in prefrontal cortical function, but in its ability to communicate with other brain areas

  • Background chatter becomes very loud 
    • Default Mode Network remains active even when trying to attend to things

Most drugs for ADHD are stimulants or sympathomimetics

  • Resemble the activation of the sympathetic nervous system (alertness and arousal)

Adderall and Vivance: commonly prescribed for ADHD, similar to methamphetamine but less potent.

Dmphetamine: potent, mainly works on receptors in the brain.

Lmphetamine: less potent, increases blood pressure and heart rate (peripheral effects).

Adderall: combination of amphetamine salts (3:1 ratio of D‑amphetamine to L‑amphetamine)

  • Increases activity of two neurochemicals: dopamine and norepinephrine (noradrenaline)
    • Dopamine: increases motivation, pursuit, and mood
    • Norepinephrine: increases attention and focus

Vivance contains only Dmphetamine, attached to an amino acid called Lysine.

Vivance (time-​​release dexadrine) is effective in treating ADHD

  • Slow absorption prevents abuse
  • Effects last 12–18 hours depending on metabolism

Adderall has a quicker time course (6–8 hours).

Ritalin (methylphenidate) increases dopamine and norepinephrine, but not as potent as Adderall or Vivance

  • Shorter half-​​life (4–6 hours)

Too much dopamine can cause issues with focus and attention

  • Proper balance of dopamine and norepinephrine is crucial for effective treatment

Dramatic elevation in dopamine and norepinephrine promotes neuroplasticity at specific synapses.

ADHD medications designed to help the brain networks responsible for focus undergo neuroplasticity

  • Strengthen synapses involved for more efficient functioning later on, even after cessation of the drug

Children with ADHD who are treated with appropriate doses of drugs like Adderall, Ritalin, or Vyvanse fare better in childhood and later in life

  • Improved performance in school and focus
  • Lower risk of illicit drug use and addiction in adulthood

Early treatment with ADHD medications leads to increased dopamine transmission in the forebrain later in life

  • Normalization of neural circuits over time

A well-​​qualified psychiatrist will:

  • Conduct a careful diagnostic evaluation
  • Prescribe appropriate pharmacologic treatments
  • Be aware of and prescribe behavioral treatments
  • Provide nutritional guidelines and supplementation recommendations
  • Update treatments as the child matures

For individuals 25 years or younger who have taken ADHD medications, it may be beneficial to discuss tapering off the drugs with their psychiatrist

  • Tapering should be done gradually to avoid withdrawal symptoms

Variation in dosage response may be due to genetic differences in enzymes that metabolize drugs in the brain and body.

No simple test to predict drug response; best approach is to start with the lowest effective dose and increase as necessary.

Combining alcohol with sympathomimetics (e.g., Adderall, Ritalin) is more detrimental to the brain and body than taking the drugs alone.

Few studies on the long-​​term effects of ADHD medications on endocrine or hormone systems.

Long-​​term increase in sympathetic nervous system activity likely increases cortisol levels.

ADHD medications can inhibit sleep

  • Long duration release of d‑amphetamine (Vivance) can cause trouble falling asleep

Sympathomimetic drugs can disrupt the endocrine system

  • Chronic elevations in cortisol can suppress testosterone and estrogen levels
  • This can lead to reductions in libido, muscle and bone mass, and other aspects of testosterone-​​related psychology and bodily biology

It is unclear whether individuals become addicted to ADHD medications themselves.

Having a first relative with schizophrenia or bipolar disorder increases the likelihood of psychotic episodes when taking sympathomimetic drugs.

Potently increasing dopamine in a person with a predisposition to psychotic episodes can shift the system toward greater propensity for psychosis.

Methylphenidate (Ritalin) has a lower potential for inducing psychosis compared to amphetamine-​​type ADHD drugs.

Vyvanse (long-​​release d‑amphetamine) has fewer psychotic episodes and less abuse/​​addictive potential

  • Not perfectly safe, but highlights the importance of dopamine and norepinephrine release kinetics

Original clinical literature suggested that ADHD drugs should not be taken every single day

  • Designed for use during the school week with weekends off or during the school year with summer breaks

Modafinil (Provigil) and Armodafinil (Nuvigil) are non-​​amphetamine treatments for ADHD

  • Used to treat daytime sleepiness issues related to narcolepsy, dementia, post-​​surgery anesthesia, traumatic head injury, and stroke

Side effects of Modafinil, Amodafinil: can include decreased appetite, runny nose, headache, and skin rashes

  • Stevens-​​Johnson Syndrome, a rare and potentially fatal skin condition, has been associated with Modafinil use

Bupropion (Wellbutrin) and Guanfacine are considered atypical treatments for ADHD

  • Guanfacine is a non-​​stimulant medication that works on the noradrenergic system by stimulating the alpha-​​2A receptor


We recommend using this distillation as a supplemental resource to the source material.

  • Adderall, Stimulants & Modafinil for ADHD: Short- & Long-​​Term Effects 

    Huberman Lab

    Huberman explores ADHD medications’ effects on focus, hyperactivity, and long-​​term health. The variation in individual response and potential side effects are discussed.

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