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Healthcare providers prescribe Adderall and generic versions of the drug to treat attention-deficit/hyperactivity disorder (ADHD) and narcolepsy symptoms. Narcolepsy is a sleep disorder marked by extreme daytime drowsiness. Through extensive study over the years, the generics have been deemed to be as safe and effective as brand-name drugs.
However, generic drugs are sometimes perceived by patients and even some healthcare providers as being less effective than the brand-name products they aim to duplicate.
What is Adderall used for?
Adderall is the brand name for a mixture of the drugs amphetamine and dextroamphetamine. It is a prescription-only stimulant, one of several medications for ADHD and narcolepsy treatment.
Stimulants are the primary medications prescribed for ADHD among adults and children ages six and older to treat symptoms of inattention or hyperactivity-impulsivity. Though not without side effects, Adderall and its generic equivalents, which go by the unwieldy name dextroamphetamine-amphetamine, have, after extensive testing, been deemed effective and safe for most patients (Krull, 2020).
These drugs stimulate the brain to release chemicals that improve focus in ADHD patients and help people with narcolepsy stay awake, though scientists don’t fully understand how they work.
People can take these medications as a chewable tablet, a flavored liquid, or a capsule to be swallowed. They can be formulated to act within an hour and last for up to six hours or, with sustained-release formulations, up to 13 hours (Krull, 2020).
Are generic versions identical to brand name Adderall?
Generic versions of Adderall cost less but carry the same general benefits and risks. However, they may not be available in all formulations, such as the longer-lasting, sustained-release variety.
- Contain the same key (active) ingredients
- Have the same strength and dosage
- Perform the same way in the body
However, the FDA defines “same” as “bioequivalence,” a term that refers to the active ingredient in comparable medications. If a generic drug is bioequivalent, it means that the active ingredient in a generic performs in the same manner to the pioneer drug (FDA, 2007). Here’s the thing: The FDA allows for some wiggle-room for that performance of the active ingredients in a generic drug, meaning its performance has to be “approximately the same”, but doesn’t have to be exactly 100% similar to the active ingredient of the pioneer drug.
What’s more, inactive ingredients in a generic drug are not held to the same standard. “Other characteristics, such as colors and flavorings that do not affect the performance, safety, or effectiveness of the generic medicine may be different,” the FDA states (FDA, 2021). In rare cases, this can present problems. A person could have an allergic reaction to an inactive ingredient in a generic medication that does not exist in the branded version, for example (CHADD, 2017).
So while generic versions of Adderall are supposed to work in the same way and provide the same benefit as the brand-name medicine, there’s a chance that they are not 100% identical.
The important role of generic drugs and the differences
One large study found generic drugs differed by about 3.5% in their absorption into the body compared to their branded counterparts (Davit, 2009). Some generics were absorbed slightly more, some slightly less.
According to the FDA, “this amount of difference is expected and clinically acceptable, whether for one batch of brand-name medicine tested against another batch of the same brand or for a generic tested against a brand-name medicine” (FDA, 2009).
Reassuring as that may be, a given generic version of Adderall might slightly differ in terms of bioequivalence and inactive ingredients from the brand–and from each other. Also worth noting: Between one prescription fill and the next, a pharmacy might change the generic variety it sells without notice (CHADD, 2017).
Regardless, some patients and even some healthcare providers might perceive generic drugs as being less effective than the brand-name products they aim to duplicate. So one large independent, non-governmental study of insurance-company records examined outcomes among 3.5 million patients using eight different drugs for various conditions, though not including ADHD. The research, published in the journal PLoS Medicine, found generics to be just as effective (Desai, 2019).
The upshot: While generic drugs are generally considered safe and effective and are a very important cost-saver for people who need them, they are not 100% identical to brand-name drugs. These differences are not medically important, according to the FDA. Armed with this information, you can still seek lower drug prices, but it’s wise to have a conversation with your healthcare provider about the benefits and risks of Adderall versus a generic and then aim to stick with what works.
Adderall side effects
Stimulants like adderall are generally considered safe when used as directed. But common side effects include reduced growth in children, which tends to self-correct over time and is not thought to impact adult height. Other side-effects (Krull, 2020):
- Sleep problems
- Social withdrawal
- Anorexia or weight loss
- Mental/behavior changes (such as agitation, aggression and depression)
Less common side effects include headaches, dizziness, gastrointestinal issues, and heart rate and blood pressure increases. In rare cases, stimulants can cause priapism (a prolonged erection of the penis), psychoses such as hallucinations, delusional thinking, or mania. (Krull, 2020).
The FDA warns that amphetamines like Adderall have a high potential for misuse or abuse of amphetamine may lead to dependency. Misuse of the drug can also cause serious (possibly fatal) heart and blood pressure problems (FDA, 2007).
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) (2017), Exactly Like Brand? Retrieved from: https://chadd.org/attention-article/exactly-like-brand/
- Davit B et al. (2009), Comparing generic and innovator drugs: a review of 12 years of bioequivalence data from the United States Food and Drug Administration. Annals of Pharmacotherapy, Oct;43(10):1583-97. doi: 10.1345/aph.1M141. Epub 2009 Sep 23. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19776300/
- Desai R et al. (2019) Comparative effectiveness of generic and brand-name medication use: A database study of US health insurance claims, PLoS Medicine, March 13, 2019https://doi.org/10.1371/journal.pmed.1002763. Retrieved from https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002763
- Krull K. UpToDate (2020). Pharmacology of drugs used to treat attention deficit hyperactivity disorder in children and adolescents. Retrieved from: https://www.uptodate.com/contents/pharmacology-of-drugs-used-to-treat-attention-deficit-hyperactivity-disorder-in-children-and-adolescents
- U.S. Food & Drug Administration, Generic Drugs: Overview & Basics https://www.fda.gov/drugs/generic-drugs/overview-basics
- U.S. Food & Drug Administration, Generic Drugs: Questions & Answers https://www.fda.gov/drugs/questions-answers/generic-drugs-questions-answers
- U.S. Food and Drug Administration (FDA) (2007). ADDERALL. Retrieved April 26, 2021 from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.