Psychiatrist Questions Adderall

What should I watch for when Adderall Xr 10 mg medication has stopped

My granddaughter was prescribed Adderall XR 10 mg per day by her doctor and has been on it for a few years. He had a family emergency and has ceased his practice and I cannot find her another doctor. The ER and clinics will not prescribe it and she wants to discontinue using it as well but I want her to do it safely. Right now, I have no help except what I can find on the internet. She is 14 years old and has been taking Adderall for about 5 yrs and she also takes Clonidine HCI 0.1 mg daily. Any help you can give on what to look for or what things I can do to help her cope , what to look for, etc. would be greatly appreciated.

Female | 14 years old
Medications: Adderal Xr 10mg, ClonidineHCI 0.1 mg once a day
Conditions: Fetal Alcohol/hearing loss

9 Answers

There can be rebound hypertension briefly stopping the clonidine, but it's a low dose, withdrawal from Adderall is tiredness and hunger for a few days. No danger.
Must be tapered down gradually, then stopped. It will prevent withdrawal.
At her age, the adderall is a small dose and it was the extended release so she only gets a little at a time. With it stopped suddenly she may be irritable for 3-4 days then again become hyperactive or easily distracted. Keep a close eye on her school performance, if her grades plunge she may need the meds more than she thinks.
Stopping Adderall 10 mg XL should not have any adverse reactions in and of itself because it is out of the system within 24 hours anyway. However, you may expect to see a return of the original symptoms for which it was prescribed -- poor time management, forgetfulness, distractibility, restlessness, figidiness, etc. A positive may be the return of appetite and easier ability to fall asleep.

Cassandra M. Klyman, M.D.
I assume this was correctly prescribed since she has continued to take it. It’s used to control ADD, so stopping it will probably mean a return of symptoms. That’s hard to measure in a 14-year-old girl because life is fairly chaotic for them anyway. If her grades start falling or she starts getting in trouble, then she needs medicine. I hear you, none available. Next best is support, extra understanding. She shouldn’t have much in the way of w/d sxs, that drug is gone quickly. The clonidine may no longer be needed, as it’s usually there to counter
insomnia. But if there’s a doctor who will prescribe that, ask their opinion. I feel for you, I had to leave practice on short notice once and my patients paid the price. We need more psychiatrists.

Good luck.
Adderall Xr 10 mg is not a high dose, however, usually what happens is that patients start feeling very lethargic, lacking motivation, desire to do anything, hard to get out of bed, etc. It can look like depression, but it's not. I'm not sure where you are at, but sometimes, if you go to an urgent care or an emergency room, they can provide you with a supply until you find someone for her.
it is not clear from the question if she wants to discontinue one or both. Usually, discontinuing stimulants like Adderall-XR is relatively easy, as it wouldn't usually cause any adverse, withdrawal effects, but the actual symptoms for which it has been used may return after some time. On the other hand, clonidine should be tapered off gradually, decreasing the dose by 0.025 mg per week. However, the best option (ideally) would have been to get it done under the supervision of a healthcare professional, and it's a very unfortunate situation that she will have to do it on her own, with your help.
If she has been taking the Adderall daily, I suggest you work with a family doctor who can gradually reduce the dose rather than abruptly stop it. There will be a worsening of inattention, so she will need help limiting visual and auditory distractions when she is studying. Giving her frequent breaks - 5-minute breaks after 30 mins of reading, for example - can also be helpful. The clonidine also has to be slowly tapered by a doctor. Abrupt stopping can cause a rebound elevation of blood pressure.
Stopping her Adderal Rx should not do anything, but her ADD/ADHD will come back into full gear. In the past, we used to give them coffee to help provide some of the stimulant effects of Adderal or any other stimulants. You might want to try that.