Dear Alice,

I am a teenage girl currently taking Adderall (20 mg) to treat my ADHD. My question: does taking this medication affect sexual wantings or behavior? I am supposed to start taking it at 7:00am so it will wear out at about 9:00 or 9:30pm. Since I go out later at night, my medicine is usually worn off before I engage in any kind of sexual activity. But sometimes on weekends I wake up late and have to take it at later times such as 12:00 or 1:00pm. Since then it will not wear off until after I go out, would being on Adderall affect my sexual behavior? I feel like I am less "horny" when on Adderall and sex is worse because of the lack of my desires. Does this have anything to do with my medicine or is it just a coincidence?

Dear Reader,

You're right that medications may sometimes have unanticipated side effects — and your lack of libido may not just be a coincidence. One of Adderall’s (generic name: amphetamine-dextroamphetamine) known side effects is a potential decrease in sexual drive. It’s helpful to note, however, that both the efficacy and side effects of any prescription medication may vary depending on how and when you take it. While it's possible that the drug is impacting your sex drive, there may be other factors that contribute to fluctuations in your sex drive. So, it might be worth it to talk with your health care provider about the specific effects of amphetamine-dextroamphetamine for you, especially if you’re considering altering your medication regimen.

As you may already know, amphetamine-dextroamphetamine is an amphetamine often used to treat attention-deficit/hyperactivity disorder (ADHD). Amphetamines are stimulants that have been shown to help with the symptoms of ADHD. They work by increasing the amount of certain neurotransmitters (such as dopamine, serotonin, and norepinephrine) that help regulate mood and behavior. When taken over a long-term period, amphetamine-dextroamphetamine builds up in the system and the brain develops a tolerance for and reliance on it. And while there are benefits, amphetamine-dextroamphetamine's potential side effects include:

  • Headache
  • Diarrhea
  • Constipation
  • Loss of appetite
  • Stomach pain
  • Nausea
  • Vomiting
  • Weight loss
  • Diminished sex drive
  • Impotence

So, it's possible that your medication intake may be related to your lower sex drive. However, given that amphetamine-dextroamphetamine builds up in a person’s body over time, taking it (or not taking it) doesn't necessarily work like an on/off switch for libido. It's meant to be taken over longer periods of time in order to provide consistent levels of neurotransmitters, rather than "wearing off" after a short period of time. Therefore, it’s not likely that a few hours difference in when you take the drug could lead to wide swings in sexual drive. That being said, it's most effective and safest for amphetamine-dextroamphetamine to be taken consistently at the same time every day. If you want to alter your medication schedule or dosage to fit your lifestyle more appropriately, consider speaking with your health care provider about your options. Changing or skipping a dose without consulting them may jeopardize your health, so they can provide the most appropriate guidance for you to ensure that you get the medication you need.

Also, it might be a helpful to think about other medications you may be taking or habits you have on the weekends. For example, some people report sexual side effects from using hormonal birth control, antidepressiants or anti-anxiety medications, and from alcohol or other drug use. It especially may be wise to exercise caution when taking amphetamine-dextroamphetamine and drinking alcohol as their mixed effects include potential over-drinking and a disturbed sleep schedule, as amphetamine-dextroamphetamine can decrease the depressive effects of alcohol. Do you regularly drink alcohol on the weekends? Do you take any medications other than amphetamine-dextroamphetamine that may affect your libido? If any of these factors play a role in your life, you might want to consider discussing their impact with a health care provider or a mental health professional. Keeping a journal of when you take amphetamine-dextroamphetamine or any other medications or substances and when you experience lower sex drive may also help you and your provider pinpoint a pattern and make a plan of action.

Good luck figuring out what is impacting your sex drive!

Alice!

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