The use of stimulants like Adderall for cases of treatment-resistant depression is not very common these days. It is much more common for a psychiatrist to put the patient through the ringer of SSRI, SNRI, Tricyclic, and MAOI classes before they are likely to consider a psychostimulant. This is in part due to the fact that these have not been directly approved by the FDA for “depression.” However, if we take a look at most of the literature surrounding psychostimulants in cases of treatment-resistant depression, it seems to indicate that not only do they work, they work quite effectively.
Psychostimulants for Treatment-Resistant Depression Study
In one study by Stotz et al. (1999), they examined 65 patients that were diagnosed with treatment-resistant depression. When these patients were treated with psychostimulants (amphetamine and methylphenidate) in addition to conventional antidepressants, 38 of these patients showed “significant improvement.” Their energy improved, their mood improved, and they showed increases in overall psychomotor activity.
The best response for these patients was when psychostimulants were used in combination with Tricyclic antidepressants. It should be noted that none of the patients developed drug dependency and risk of side effects was low. The authors of the study suggest that psychostimulants should be considered more in cases of treatment-resistant depression.
Taking Adderall for Treatment-Resistant Depression
Adderall is one of the most common, most potent treatments for cases of depression. Most people that take it experience instant improvements in mood and motor activity. In cases of depression and comorbid ADD or ADHD, this may be the single most effective treatment option. Some things listed below may be a reason people should consider Adderall for their depression.
- Boosted confidence – In many cases, people that take Adderall feel more confident. This is because it acts on dopamine receptors and can make socialization feel more pleasurable. For some people, having more confidence goes a long way towards feeling normal again.
- Increases in energy levels – Depression is associated with low energy, tiredness, and overall mental and physical fatigue. Adderall can help increase your energy in the fact that it is a “stimulant” – it stimulates brain activity.
- Improvement in focus – In cases of depression, most people experience “clouded” thinking and slow motor activity. Adderall helps them improve their focus and concentration so that they can complete tasks. The completion of tasks is rewarding in itself to make the person feel more productive.
- Instant mood improvement – Within hours of taking Adderall, many people feel better. Not only do they not have to wait “4 to 6 weeks” before their antidepressant “kicks in” they feel better right away (read more about why antidepressants take so long to work). This can be a huge plus for someone who is really suicidal. Although some antidepressants do work immediately, most take awhile and Adderall can help pick up the slack.
- Pro social effect – Some people experience a pro-social effect related to Adderall. They feel more social, more outgoing, and want to interact with people. Most stimulants can cause this in one form or another.
Why Adderall isn’t used for “standard” depression
Not everyone should be on Adderall for depression. It is up to you and your psychiatrist to take a look at available options and consider what might work. There are cases where it may seem like a good idea to try Adderall, but some people may have an overall tough experience.
- Addiction potential – The medication can be very addictive for some people. If you have an addictive personality, the medication may make you feel so good, that it will be tough to go through life without it. However, I guess dependence on this medication is better than feeling suicidal 24/7.
- Antidepressant effect fades quickly – The drug is geared mostly towards improving cognition in people with ADD and ADHD. Individuals with depression may notice a mood improvement for the first couple weeks, but this effect may wear off relatively quickly.
- Dependency – Certain people may become dependent on this drug in order to function. Although that’s not necessarily a bad thing, some people may not like the fact that they are essentially hooked. Then again, going from a cloud of major depression to something that actually works probably feels much better.
- Not intended for depression – This is not formally approved by the FDA to treat depression. Studies have shown that it works, but it’s intended to treat attention-deficit disorder. Depression is not what this is primarily used to treat.
- Quickly build up a tolerance – Some people build up a tolerance relatively quickly to Adderall. This requires constantly increasing the dosage and tinkering to find a strength of medication that works. Because this medication is so fast-acting, you can get quickly accustomed to this medication both psychologically and physically.
- Worsening depression during withdrawal – I have personal experience with Adderall to treat my own treatment-resistant depression and I know how coming off this medication can be – very tough. If you have been taking a high dosage and are trying to stop taking it, you may be extremely depressed during withdrawal. However, I tend to think that it’s far easier to come off of Adderall than it is to come off of an SSRI – that’s my experience.
Supplementing Adderall with an SSRI or TCA
It is most common practice to supplement Adderall or another psychostimulant with an SSRI or TCA (tricyclic) antidepressant. Using a stimulant by itself to target depression doesn’t have as high of a success rate and is not formally approved for depression treatment. Star D studies have shown that when used in combination with an antidepressant, this is more effective than either standalone treatment option. It has become a practice to supplement Adderall with an SSRI to help target deep cases of depression.
Psychostimulants for Treatment Resistant Depression
Despite the fact that Adderall has never been directly used as treatment for depression, it may be something to consider if nothing else is working. There is conflicting evidence as to whether the stimulant class really works for cases of depression, but they do work for some people. If nothing else is working and you are at your wits end, they may be something to consider. I think more people are starting to realize how difficult SSRI treatment can be and how powerful SSRI’s really are – especially upon withdrawal. It should also be noted that some people experience that Adderall helps with anxiety too – so it may tackle both depression and anxiety altogether.
Is Adderall safe to take?
Contrary to popular belief, Adderall has been around for a long time and is universally considered one of the safest psychiatric medications. Although people online can paint horror stories regarding addiction and dependence on this drug, it has helped many people. A lot of people that take it for the right reasons don’t experience any major side-effects upon withdrawal. Many people have been taking this drug for years to treat their attention-deficit disorder and they stop with no major side effects.