Adderall: Indications and Mechanisms
Adderall is a combination of two stimulants, amphetamine and dextroamphetamine. It treats ADHD by stimulating the central nervous system and increasing the levels of norepinephrine and dopamine, two critical hormones regulating cognitive functions and activity [1, 2]. Dopamine is also responsible for developing addictions, because it increases wanting for items, making Adderall a tightly controlled prescription drug.
Adderall helps individuals with ADHD improve focus and concentration and manage hyperactivity. It is often prescribed as part of a comprehensive treatment program that may include psychological or behavioural therapy.
In people with narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and falling asleep throughout the day, Adderall helps increase wakefulness and alertness during the day [1, 3]. This is thanks to the effects of Adderall on norepinephrine, which works by increasing excitation in the pre-frontal part of the brain. Increasing excitation in the prefrontal brain increases one’s executive function and control.
Adderall comes in two forms: Adderall and Adderall XR. The former can be used in adults and children ages 3 years and older, while the latter is used in adults and children ages 6 years and older. However, it's important to note that Adderall XR is not used to treat narcolepsy [1].
Semaglutide: Mechanisms and Indications
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist, a peptide hormone that is released from the intestine and acts on the brain to increase satiety. Semaglutide reduces the emptying of your stomach, making you physically full for longer and reducing blood sugar spikes. This makes semaglutide a popular peptide for weight loss [4, 5, 6].
When it binds to cells in the pancreas, Semaglutide stimulates the production of insulin, a hormone released from the pancreas that lowers blood sugar after a meal by stimulating sugar uptake into cells, muscles, and the liver.
Semaglutide is available in both oral and subcutaneous (under the skin) injectable forms. These formulations are available under multiple names, for example, Wegovy and Ozempic from Novo Nordisk.
Adderall and Semaglutide
Adderall and Semaglutide: Two Different Weight Loss Pills?
Amphetamines, one of the active ingredients in Adderall and tesla pills, were the original class of drugs used in weight loss in the 20th century [7]. This is because they could stimulate the noradrenergic and dopaminergic systems, increasing arousal and activity levels, suppressing appetite and reducing cravings for highly palatable foods by stimulating the brain's reward centres.
Therefore, Adderall has some historical overlap of being used for the same conditions semaglutide is currently indicated for. Indeed, phentermine, a weight loss drug like similarly to semaglutide, has pharmacology closer to Adderall than Semaglutide or dulaglutide.
Adderall and Semaglutide: Side Effects
Amphetamines, such as those preceding Adderall, were discontinued for weight loss due to the high incidence of side effects, risk of dependence, increasing blood pressure, severe anorexia and motor disturbance, for example, dyskinesia [8]. This is due to the noradrenergic and dopaminergic effects of Adderall in the brain.
In contrast, semaglutide mimics the effects of GLP-1, which can cause gastrointestinal side effects, including nausea, diarrhoea, and abdominal pain [6]. More severe side effects of semaglutide include pancreatitis and kidney problems, which is because semaglutide binds to these areas to promote insulin release [9].
Lastly, the combination of Adderall and Semaglutide has no known interactions, but drug interactions may sometimes be surprising, for example, Adderall can interact with kratom. Make sure to consult with your healthcare provider.
Adderall and Semaglutide: Link with ADHD?
The link between semaglutide and ADHD is not as strong as the link between Adderall and weight loss. Nonetheless, semaglutide increases levels of insulin in the body and brain. Insulin is considered to have a pro-cognitive role in the brain, where it can protect against cognitive decline in conditions like Frontotemporal Dementia, Alzheimer’s Disease, or Parkinson’s Disease [10, 11]. Therefore, semaglutide could, in theory, help ADHD patients by improving their cognitive functions, such as attention and focus.
Summary: Adderall and Semaglutide
To summarise the complex interplay between Adderall and Semaglutide, there are surprising overlaps between the plausible indications of these two medications. For one, Adderall does cause weight loss, albeit with higher side effects than semaglutide and is therefore not FDA-approved for weight loss. Second, semaglutide may improve cognition by increasing insulin levels, although this effect is yet to be studied in patients with ADHD. The side effect profiles of Adderall and Semaglutide are also different due to different pharmacological targets.