What is Prednisone?
Prednisone is a corticosteroid that reduces inflammation and overactivity in the immune system. It is a generic prescription medication used to treat various inflammatory conditions and autoimmune disorders in adults and children [1]. Examples of conditions for which one might be prescribed prednisone are severe allergic reactions, Crohn's disease, ulcerative colitis, rheumatoid arthritis, inflammatory bowel disease, and multiple sclerosis.
Prednisone can also supplement corticosteroid hormones when the body cannot produce enough. This can occur when one suffers damage to the adrenal glands or has a genetic predisposition to adrenal insufficiency [1].
Prednisone is an immediate-release tablet that is swallowed and released into the body immediately. It is available as a generic drug and under the brand names Prednisone Intensol and Rayos [1, 2]. It should be taken before 9 a.m. to avoid suppressing the body's natural release of cortisone, the endogenous corticosteroid [3]. A common side effect of taking prednisone is an increase in blood sugar levels and blood pressure, warranting caution if you have a family history of diabetes or cardiovascular disease.
What is Adderall?
Adderall is a prescription medication primarily used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy, a condition characterized by excessive daytime sleepiness. It is the most commonly known brand name for the combination of two central nervous system stimulants, amphetamine and dextroamphetamine [4].
How Does Adderall Work?
Adderall medication works by increasing the levels of dopamine and norepinephrine in your brain. These critical neurotransmitters regulate alertness and attention in the midbrain and prefrontal cortex. Branded Adderall comes in two forms: an immediate-release tablet and an extended-release capsule known as Adderall XR. The immediate-release form releases the drug into your body right away, while the extended-release form slowly releases the drug into your body over a long period of time [4].
Adderall and prednisone are both prescription drugs that must not be taken unless they have been prescribed to you by a healthcare professional.
Prednisone and Adderall
Based on the published, peer-reviewed literature, there is no direct evidence to suggest that Prednisone and Adderall interact with each other when taken together. This may be partially attributed to the target organs of the drugs. Adderall targets the brain, increasing dopamine and norepinephrine, whereas prednisone targets the adrenal glands, stimulating the release of corticosteroids. Interestingly, both Adderall and prednisone were among the top 4 prescription drugs taken by college students in a study from 2003 [5].
The absence of registered drug interactions does not mean that they are safe to combine. Both medications are available only on prescription; therefore, you must inform your healthcare provider before starting a dosing regimen of either drug.
Prednisone Drug Interactions
Prednisone, a corticosteroid, interacts with certain medications such as aspirin, ketoconazole, phenobarbital, phenytoin, rifampin, and warfarin [6].
It is critical not to take prednisone if you have a systemic fungal infection.
Adverse effects and common side effects of prednisone treatment or even toxicity with a higher dose of prednisone include increased aggressive behavior, reduced urination, heart palpitations, swelling of the hands, feet, and fingers, difficulty breathing at rest, or weight gain. Make sure to seek medical attention if you notice any of these symptoms while taking prednisone.
Adderall Drug Interactions
On the other hand, Adderall can interact with certain antidepressants, dietary supplements like St. John's wort and vitamin C, and substances like caffeine [7]. Supplements like St. John's wart can interfere with the elimination of Adderall, leading to insomnia, restlessness, and anxiety.
Can Glucocorticoids and Stimulants Interact?
In humans, acute hydrocortisone pretreatment did not affect any of the physiological, behavioral, or subjective effects of d-amphetamine [8].
Amphetamine administration has been shown to produce a dose-dependent increase in plasma corticosterone [9]. This may imply that taking Adderall could mimic some of the effects of prednisone. Taking Adderall and prednisone together may compound the corticosterone release in the blood. This could increase the risk of experiencing side effects linked to prednisone, such as swelling, aggression, or difficulty breathing [3].
In contrast, Chronic administration of amphetamine can also lead to a significant reduction in the density of glucocorticoid receptors (GR), by approximately 20% [10]. This results in higher corticosterone levels and fewer receptors = sensitization, where your body does not respond to the effects of corticosterone in the blood. This can lead to adrenal depletion, as your adrenal glands try to pump out more corticosterone, resulting in adrenal failure. Based on these severe side effects, combining prescription drugs must be avoided unless advised by a medical professional.
In the context of drug withdrawal, glucocorticoids may play a role in relapse. Preliminary studies in rats suggested that corticosterone drugs like prednisone attenuated withdrawal symptoms resulting from amphetamine drug use. These findings are yet to be validated in humans but indicate an additional role of prednisone in helping with drug use and additional treatments [11].
In conclusion, while glucocorticoids and amphetamines interact in various ways, the exact nature of these interactions and their implications for human health and disease remain fully elucidated.
Summary: Prednisone and Adderall
To summarise, drug interactions, specifically between prednisone and Adderall, have not yet been studied. However, there is abundant evidence to support the interaction of amphetamines and corticosteroids throughout the body, indicating that taking prednisone and Adderall can change the effect of these drugs. Always consult a healthcare provider if you experience any side effects linked to these drugs.