Many millions of people worldwide will suffer from a mental health disorder at some point in their lifetime. Adderall and Xanax are drugs used to treat serious mental health conditions. Taking them together without proper diagnosis and supervision by a physician can lead to unwanted results, potential addiction, and a high risk of overdose.

Doctors commonly prescribe stimulants such as Adderall (amphetamine and dextroamphetamine) for ADHD (Attention Deficit Hyperactivity Disorder) to help control hyperactivity, impulsiveness and to prolong attention span in affected individuals. But sometimes, due to the high dosage, or inherently reduced drug metabolism of the affected person (based on their genetic profile), Adderall can accumulate in the person’s body, resulting in undesirable side effects that demand further treatment. In such situations, the anti-anxiety drug Xanax (Alprazolam) may be prescribed. It is important to understand how these medications work and interact before taking these two drugs together.

Adderall, prescribed for ADHD, induces the release of large amounts of dopamine, resulting in feelings of pleasure, concentration and motivation. The process of dopamine stimulation is dose-dependent. However, a common side effect of amphetamine is anxiety, and higher doses lead to more anxiety. Reduced amphetamine metabolism by liver enzymes may also lead to anxiety attacks in certain individuals.

Xanax, a benzodiazepine prescribed for anxiety and panic disorders, enhances the effects of GABA, a neurotransmitter that inhibits activity in the brain to promote calmness. The effect of Xanax is directly proportional to the dose taken. It may also cause undesirable side effects, such as drowsiness, depression and speech impairment. Prolonged use may affect memory and alertness. Benzodiazepines also have a high risk of addiction and are a leading cause of drug overdose deaths.

Adderall and Xanax are both controlled substances because of their potential for addiction and abuse.

When do people take adderall and xanax together?

• ADHD patients suffering anxiety from high clinical doses of Adderall might be prescribed Xanax to balance its side effects.
• Long-term users of Xanax may benefit from Adderall to bring back some alertness and focus.
• Adderall and Xanax, taken together recreationally, is a common example of drug abuse.

Adderall and Xanax have antagonistic effects on each other. They are prescribed by physicians to control two competing mental health disorders. Patients should carefully follow their treating physician’s recommendations when these two drugs are taken together. Combined use of Adderall and Xanax can make both medications less effective and may interact in harmful ways.

Adderall is a stimulant, and its intended effect is to make the user feel more focused and awake. However, in people who suffer from anxiety or panic disorder, Adderall can exacerbate these conditions. Adderall may also affect sleep patterns. In contrast, Xanax is a sedative, reducing anxiety, stress, and excitement levels. Therefore, Xanax can counteract the effects of Adderall. Unfortunately, Xanax can also cause fatigue and make it harder to concentrate.

Studies have shown that combining Adderall and Xanax not only increases the risk of impairment in body movements, memory and brain activity but that people on these two drugs have a higher propensity for road accidents. Unprescribed use of these drugs together can be dangerous and addictive. These medications should only be taken under the supervision of a healthcare practitioner.

How to minimize the risk of taking either of these medications

How well a person’s body metabolizes these medications is based mainly on genetics. We are all different and unique in our genetic makeup. Which drug will help and which can cause adverse side effects is largely dependent on our drug metabolism genes. Pillcheck, a pharmacogenetic test, can analyze your drug metabolism genes to help your healthcare provider identify appropriate dosage and risk of side effects for Adderall and Xanax. The test assesses over fifty medications used to treat mental health disorders. It can help your physician select appropriate treatment for anxiety and ADHD and reduce the risk of adverse side effects and addiction.

References

FDA. (2016, September). Xanax alprazolam tablets, USP. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018276s052lbl.pdf

FDA. (2007, March). Adderall (CII). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf

Mills, K. C., Spruill, S. E., Kanne, R. W., Parkman, K. M., & Zhang, Y. (2001). The influence of stimulants, sedatives, and fatigue on tunnel vision: risk factors for driving and piloting. Human factors, 43(2), 310-327

Greenblatt, D. J., Harmatz, J. S., Dorsey, C., & Shader, R. I. (1988). Comparative single‐dose kinetics and dynamics of lorazepam, alprazolam, prazepam, and placebo. Clinical Pharmacology & Therapeutics, 44(3), 326-334.

Kilic, C., Curran, H. V., Noshirvani, H., Marks, I. M., & BA, M. (1999). Long-term effects of alprazolam on memory: a 3•5 year follow-up of agoraphobia/panic patients. Psychological medicine, 29(1), 225-231.

Mintzer, M. Z., & Griffiths, R. R. (2007). A triazolam/amphetamine dose–effect interaction study: dissociation of effects on memory versus arousal. Psychopharmacology, 192(3), 425-440.

Márcia Carvalho, Helena Carmo, Vera Marisa Costa, João Paulo Capela, Helena Pontes, Fernando Remião, Félix Carvalho, Maria de Lourdes Bastos; Toxicity of amphetamines: an update. Archives of Toxicology, August 2012,  (86): 8, 1167–1231,D Sulzer, MS Sonders, NW Poulsen, A Galli  Mechanisms of neurotransmitter release by amphetamines: a review.  Prog Neurobiol. 2005 Apr;75(6):406-33.

P Glue, A Fang, K Gandelma Pharmacokinetics of an extended release formulation of alprazolam (Xanax XR) in healthy normal adolescent and adult volunteers.  Am J Ther. 2006 Sep-Oct;13(5):418-22.