Adderall Interactions

Adderall (amphetamine/dextroamphetamine) raises synaptic norepinephrine, dopamine, and serotonin. St. John's Wort inhibits serotonin, dopamine, and norepinephrine reuptake. Combined, the serotonergic load can produce serotonin syndrome and a hypertensive response, while St. John's Wort's CYP3A4 induction may also alter amphetamine metabolism.

Caffeine and amphetamine salts are both sympathomimetic stimulants. Combining them raises heart rate and blood pressure, worsens anxiety and insomnia, and increases the risk of palpitations, arrhythmias and panic attacks.

Energy drinks deliver high-dose caffeine (often 80-300 mg per can) plus taurine, guarana, and B vitamins that produce additive sympathomimetic effects on top of the amphetamine salts in Adderall. Both substances raise heart rate, blood pressure, and norepinephrine release, which can precipitate palpitations, hypertension, anxiety, insomnia, and in rare cases tachyarrhythmia or coronary vasospasm.