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ADHD Medications and Alcohol Interactions

Written by L. Anderson, PharmD on Nov 7, 2017.

Attention deficit hyperactivity disorder (ADHD) can affect both adults, teens, and children. Symptoms can include:

  • Trouble paying attention
  • Restlessness
  • Hyperactivity
  • Impulsive behavior

Children can have difficulties with homework, may be disruptive in the classroom setting, and have trouble getting along with others. Adult ADHD can lead to unstable relationships, poor work performance, and a low self-esteem. Genetics and the environment both appear to have a causative role in ADHD.

Treatments for ADHD typically involve medication, education, training and counseling. A combination of these is often the most effective treatment. These treatments can relieve many symptoms of ADHD, but ADHD is a lifelong condition that can be managed but not cured.

Amphetamine containing medicines and methylphenidate have a high risk for abuse and can cause physical and psychological dependence. A healthcare provider should review a patient’s history for signs of alcohol abuse or drug abuse before and during treatment with stimulants. A history of abuse may suggest greater risk for abuse with stimulants. Teenagers and young adults may be especially at risk of alcohol and drug interactions with ADHD medications if they drink: according to the CDC, most people younger than age 21 who drink report binge drinking, usually on multiple occasions.

Stimulant medications, such as methylphenidate (Ritalin) and the mixed amphetamine salts (Adderall XR, Mydayis) are often used as treatment options for ADHD, but other classes are available and may be used in combination. Stimulants, used for decades for the treatment of ADHD, are effective in roughly 80 percent of patients. The central alpha agonists such as clonidine (Kapvay, Intuniv) or guanfacine (Intuniv) are other options, as is atomoxetine (Strattera), a selective norepinephrine reuptake inhibitor. Alcohol and ADHD medications may cause certain interactions.

ADHD Medication and Alcohol:

  • In general, you should not use alcohol or medications that contain alcohol while taking a stimulant. Certain stimulants can cause a variety of central nervous system side effects when mixed with alcohol. Dizziness, drowsiness, impaired concentration or coordination, anxiety, and seizures may occur. Driving or operating equipment may be hazardous.
  • If you have a history of drug or alcohol abuse, inform your healthcare provider.
  • In certain long-acting stimulants used for ADHD, such as methylphenidate, use with alcohol may cause the medication to be released too quickly and lead to dangerous side effects and overdose.
  • An elevated risk for heart problems (rapid heart rate, chest pain, heart attack) may occur when alcohol is mixed with the amphetamine derivatives (amphetamine, dextroamphetamine, lisdexamfetamine). Avoid alcohol with amphetamine derivatives, especially if you have a history of heart disease.
  • Central alpha agonists, such as clonidine or guanfacine used in ADHD treatment should be avoided with alcohol. The combination can increase the risk of central nervous system depression, and aggravate low blood pressure, dizziness, fainting, or injuries from falls.
  • Alcohol is not listed as a possible interaction in the atomoxetine (Strattera) package labeling.

Common ADHD Medications*

Generic Name Common Brand Names
amphetamine Adsenzys ER, Adzenys XR-ODT Dyanavel XR, Evekeo
amphetamine/dextroamphetamine Adderall, Adderall XR, Mydayis
atomoxetine Strattera
clonidine Kapvay
dexmethylphenidate Focalin, Focalin XR
dextroamphetamine Dexedrine Spansule, Zenzedi
lisdexamphetamine Vyvanse
methamphetamine Desoxyn
guanfacine ER Intuniv
Methylphenidate, methylphenidate ER Aptensio ER, Cotempla XR, Cotempla XR-ODT, Concerta, Daytrana, Metadate CD, Methylin, Quillichew ER, Quillivant ER, Ritalin, Ritalin SR

*Note: This is not a complete list; always check with your pharmacist for possible drug-alcohol interactions.

Further information

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

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