If you have lupus, chances are you’re all too familiar with bone-deep fatigue that might seem to seep into your brain, making it as hard to think clearly as it is to muster energy. In the search to address both issues, MyLupusTeam members have asked about using medications like Adderall to reduce lupus fatigue and help lift their brain fog.

Although Adderall is a particularly well-known medication, it’s just one of a class of stimulants — drugs that rev up the body’s systems, perking you up physically and mentally. Other commonly used stimulants include:

• Methylphenidate hydrochloride (sold under brand names such as Concerta and Ritalin)
• Dexmethylphenidate hydrochloride (Focalin and Focalin XR)
• Lisdexamfetamine dimesylate (Vyvanse)

Like Adderall, each of these medications might be prescribed off-label — or used to treat a condition for which it hasn’t been approved by the U.S. Food and Drug Administration (FDA) — to help manage lupus fatigue.

In this article, we’ll discuss how stimulant medications like Adderall work and how they might help combat your symptoms. We’ll also cover some logistical information about getting an Adderall prescription and other concerns members may have.

What Is Adderall?

Adderall is a prescription drug that consists of two active ingredients — dextroamphetamine and amphetamine. It’s approved by the FDA to treat attention deficit/hyperactivity disorder (ADHD) and narcolepsy. The combination of dextroamphetamine and amphetamine is also available under the brand name Mydayis and as generics.

Both children and adults can have ADHD, which causes difficulty concentrating, trouble controlling impulsive behaviors, or excessive activity. Narcolepsy is a condition that makes you extremely drowsy, causing you to fall asleep suddenly throughout the day.

Adderall is a type of medication known as a central nervous system (CNS) stimulant. It boosts levels of brain chemicals called neurotransmitters, like dopamine and norepinephrine. Together, higher levels of these chemicals help reduce drowsiness and improve concentration and motivation.

Dosing of Adderall

There are two main formulations of Adderall — extended-release (Adderall XR) and immediate-release (Adderall). The extended-release product slowly delivers a steady amount of medicine throughout the day, whereas the immediate-release type begins working quickly to alleviate symptoms.

The recommended extended-release dosing is usually once in the morning, and the immediate-release formulation is taken once in the morning and once in the early afternoon. It’s best to avoid taking this medication in the evening, as it can cause insomnia. The dose of Adderall you’re prescribed may depend on your symptoms and their severity. Most adults start with a daily dose of 20 milligrams of Adderall XR or 5 milligrams of Adderall, which might be gradually titrated (increased to reach the maximum dose that works or doesn’t cause side effects).

Lupus Fatigue and Brain Fog

If you find yourself with little to no energy as you attempt to get through the day, you’re not alone. Between 67 percent and 90 percent of people with systemic lupus erythematosus (SLE) report fatigue as a symptom. Many people with lupus experience chronic fatigue — constant exhaustion that rest doesn’t relieve.

In addition, 70 percent to 80 percent of people living with lupus also experience brain fog or “lupus fog” — cognitive impairment that affects your memory and ability to concentrate. Different people experience different symptoms: Some people with lupus have a hard time remembering things or juggling tasks, while others have difficulty finding the right words during a conversation or can’t keep up when someone else is talking.

Adderall for Lupus Symptoms

Many of the symptoms experienced by MyLupusTeam members appear to overlap with those that can be treated by stimulants like Adderall. A few have asked other members if they take this medication and how it might alleviate fatigue or brain fog.

One member wrote, “Adderall for memory — I read an article that explains how it has helped lupus fog. Is anyone using it and if so, what are your results?” Some members replied with positive reports:

• “I take 20 milligrams twice a day, and it actually does help me be normal and not all over the place.”
• “Adderall has changed my life. I’ve been able to go back to college and get a full-time job after graduating.”

Others have had less luck taking Adderall while living with lupus. Members shared experiences such as these:

• “I’ve been on Adderall … for my ADHD inattentive type for over four years. The fatigue the last two years has been ridiculous, so Adderall may not help at all.”
• “I’ve been on Adderall for about four years because my physicians noticed I was a bit scatterbrained. I take the recommended dosage, and I’m not sure it works for me, and it doesn’t give me energy!”

Members also responded to another post asking about ways to deal with lupus fatigue. “I currently take Adderall XR to help with my fatigue symptoms, but I was also diagnosed long ago with ADHD. I’m lucky to have both a great psychiatrist and rheumatologist that work with each other,” wrote one member. Another shared, “I take 5 milligrams of Adderall daily for fatigue. It works so much better than Provigil (a narcolepsy medication), which is all I was offered before. It’s been a game changer.”

While many MyLupusTeam members have noted that Adderall helps their fatigue and focus, it’s important to note that this medication affects everyone differently. What works for one person may not work for you.

Adderall is not FDA-approved to treat lupus-related fatigue or brain fog, but it’s used off-label to treat brain fog caused by other conditions, including multiple sclerosis. You can ask your doctor or rheumatologist about getting a prescription, but they may suggest trying other treatments first. If you have ADHD or narcolepsy in addition to lupus, a medication like Adderall may help treat some of your symptoms.

Considerations for Taking Adderall

According to the U.S. Drug Enforcement Administration, Adderall is a controlled substance. This means it has the potential to be misused or lead to a substance use disorder. Depending on where you live, state laws might limit how much of a stimulant like Adderall you can receive, such as just one 30-day supply at a time.

There are also growing concerns about Adderall shortages. In October 2022, the FDA released a statement on the insufficient supply, and manufacturers are still experiencing delays. If you are taking Adderall or are interested in starting a prescription, your doctor may work with you to change your treatment plan.

Side Effects of Adderall

Before starting a new medication, it’s also important to be aware of the potential unwanted effects. Stimulants come with a long list of commonly reported side effects, which include:

• Trouble sleeping
• Headache
• Upset stomach
• Loss of appetite
• Faster heart rate
• Increased blood pressure
• Delayed growth (most often seen in adolescents)
• Mood changes, including irritability and rage
• Psychosis or hallucinations

You also may experience a rebound effect after a dose wears off, which can make you “crash” and feel even more fatigued.

Talk to Your Doctor About Lupus Fatigue and Brain Fog

If you’re experiencing extreme fatigue or brain fog that interferes with your daily life, talk to your doctor or rheumatologist. They can work with you to find out what’s causing your symptoms — whether it’s a lack of sleep, side effects from your lupus medications, or another health condition — and address the problem. They’ll also explain the benefits and risks of taking Adderall or another stimulant drug.

You can also take extra steps to help alleviate some of your symptoms and improve your quality of life. The Lupus Foundation of America suggests adopting healthy habits like getting regular exercise and eating a healthy diet to help fight fatigue. Getting a good night’s sleep consistently can also help clear brain fog and improve your focus.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 222,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you take a stimulant such as Adderall along with your lupus medications? Has this drug helped treat your fatigue or brain fog? Share your experience in the comments below, or start a conversation by posting on your Activities page.