Ask an Expert

Can Adderall and other drugs used to treat ADHD cause depression?

Understanding stimulant medications and other possible factors 

Steven G. Dickstein, MD

Pediatric Psychopharmacologist, formerly with the ADHD and Disruptive Behavior Disorders Center
Child Mind Institute

Q:  I have a 15-year-old son diagnosed with ADD.  He is taking 20 mg of Adderall XR. Does Adderall or other drugs used to treat ADD cause depression? I was also told by my son's psychiatrist that medications like Adderall have been prescribed for depression. What can you tell me?

A:  Adderall in general is not used to treat depression. It has been found to be effective for treating kids and adults with ADHD.

It is possible that a child who has been prescribed Adderall which is mixed amphetamine salts for ADHD might begin exhibiting sad or listless behavior. There are a few explanations for this reaction. When a stimulant dose is too high for a child he may begin to look sedated or unlike himself. If this happens his psychiatrist needs to work with the family to adjust the prescription until they find the right dose. But a small percentage of children—about five percent—can become very dysphoric and even depressed-seeming on a mixed amphetamine. Their emotional reaction will end when they stop taking the medication. Again, this is a small percentage of children.

However, if your child does get depressed on amphetamine, you always have the option to try a different medication. There are two kinds of stimulants that doctors use to treat ADHD, amphetamine and methylphenidate. Sometimes a person may have side effects on one kind of stimulant but respond very well to the other. So if a child has a poor response or side effect to amphetamine, then his doctor should consider prescribing a methylphenidate based medication.

Doctors also work to think carefully about their diagnosis, because some symptoms of depression can look a lot like ADHD. Depression makes it difficult to concentrate and can result in struggles at school, for example. It's helpful to consider how long you've been seeing symptoms. Starting at a young age, kids with ADHD present a chronic history of difficulty focusing and paying attention whereas depression symptoms are more episodic. And, of course, kids with depression experience a lot more sadness, guilt, feelings of hopelessness, and sleep problems.

For kids who have been correctly diagnosed with ADHD, it is possible that they also develop depression. Kids with ADHD are actually at a higher risk for developing major depressive disorder. It's not completely clear why but it could be because they have more problems early in life, such as having trouble at school, trouble getting along with parents and trouble with peers which may lead to developing poor self-esteem. The good news is that kids can be safely treated for both disorders at the same time. Generally doctors begin treating the primary disorder first and then add treatment for the second later.

Published: March 23, 2012

Leave a Comment 1
View All Comments (1)

Please SIGN IN or REGISTER to post a comment.

dklein37263572 · Mar 27 2012 Report

A clarification that the term "depression" is ambiguous and often used differently would be helpful. That simple ADHD is a forerunner for clinical diagnosable depression is not supported by longest study. Important , since the counterproductive claim has become popular that ADHD is a form of bipolar spectrum (whatever that is). Otherwise ,fine article. Don Klein MD

Please help us improve the Symptom Checker!

Click here to share your thoughts about using the tool.