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Does Adderall help with anxiety and depression?

Medically reviewed by Carmen Pope, BPharm. Last updated on July 22, 2024.

Official Answer by Drugs.com

Although Adderall is only FDA-approved for the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy, it has been used rarely and off-label to treat depression that has not responded to other treatments. However, this is controversial and there is a lack of good quality evidence to support its use. There is no evidence that Adderall helps with anxiety and in many people with pre-existing mood disorders, Adderall can make depression and/or anxiety worse.

The history of Adderall use for depression

Adderall is a combination of mixed amphetamine salts, and amphetamine was first synthesized in the late 1800s, although it was not used clinically until 1927. By the 1930s, it was found to alleviate hyperactive syndrome in children, and for the next 20 years, it was used to treat conditions such as depression, obsessive-compulsive disorders, and schizophrenia.

But by the 1950s, antidepressants had been discovered, and these largely replaced amphetamines as a treatment for mood disorders. Increasing abuse of amphetamines in the 1960s reduced their use even further.

Nowadays, using psychostimulants such as Adderall for the treatment of depression is not very common and has been criticized by some experts. But some centers, such as the Zurich Psychiatric University Hospital in Switzerland have used amphetamines and methylphenidate to treat severe treatment-resistant depression since the 1930s, especially in people who also have prominent fatigue and apathy.

A retrospective study that looked back on the records of 65 people with treatment-resistant depression who were treated with psychostimulants (17 treated with amphetamines, 35 with methylphenidate, and 13 treated with both amphetamines and methylphenidate, for an average duration of 10 years) at the Zurich hospital reported:

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Bottomline

Adderall in combination with antidepressants or other mood-stabilizing agents may help improve energy, mood, and activity levels in people with very hard-to-treat depression. However, this is an off-label use, and good quality trials to support this benefit are lacking; evidence mainly comes from specialist psychiatric hospitals and retrospective surveys. Some authors have reported a lack of effect or even deterioration following the addition of psychostimulants to people with depression. There is no evidence that Adderall helps with anxiety, and it may make it worse.

References
  • Adderall (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate) [Package Insert]. Revised 03/2020. Teva Pharmaceuticals USA, Inc. https://www.drugs.com/pro/adderall.html
  • Stotz G, Woggon B, Angst J. Psychostimulants in the therapy of treatment-resistant depression Review of the literature and findings from a retrospective study in 65 depressed patients. Dialogues Clin Neurosci. 1999;1(3):165-174. doi:10.31887/DCNS.1999.1.3/gstotz
  • Malhi GS, Byrow Y, Bassett D, Boyce P, Hopwood M, Lyndon W, Mulder R, Porter R, Singh A, Murray G. Stimulants for depression: On the up and up? Aust N Z J Psychiatry. 2016 Mar;50(3):203-7. doi: 10.1177/0004867416634208. PMID: 26906078.

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