Adderall Interactions

Adderall (mixed amphetamine salts) raises synaptic norepinephrine, dopamine, and to a lesser extent serotonin. St. John's Wort inhibits reuptake of those same monoamines. Together they can push the serotonergic system far enough to risk serotonin syndrome and can add cardiovascular strain. Separately, St. John's Wort strongly induces the CYP3A4 enzyme and P-glycoprotein, which can blunt the effect of many co-taken medicines.

Caffeine and the amphetamine salts in Adderall are both sympathomimetic stimulants. Taking them together adds their effects, so heart rate, blood pressure, jitteriness and trouble sleeping tend to be more pronounced than with either alone.

Energy drinks deliver caffeine alongside other stimulant ingredients such as taurine and guarana, producing additive sympathomimetic effects on top of the amphetamine salts in Adderall. Both raise heart rate, blood pressure, and adrenergic activity, which can bring on palpitations, elevated blood pressure, anxiety, and insomnia, and in rare cases more serious heart rhythm disturbances.