If you have lupus, chances are you’re all too familiar with bone-deep fatigue that might seem to seep into your brain and cause brain fog. In the search for relief, MyLupusTeam members have asked about using medications such as Adderall to reduce lupus fatigue and help lift brain fog.

Although Adderall is a particularly well-known medication, it’s just one of many stimulants. These drugs stimulate the central nervous system (CNS), which can make you feel more alert physically and mentally. In this article, we’ll discuss how stimulant medications work and whether they might help with lupus fatigue and brain fog.

Dosing of Adderall

Dextroamphetamine and amphetamine is available in two main formulations — extended-release (Adderall XR) and immediate-release (Adderall). The extended-release product is designed to release the medication slowly over a longer period. The immediate-release type begins working quickly to alleviate symptoms.

The extended-release form is usually taken once in the morning. The immediate-release formulation may be taken two or three times a day, four to six hours apart. The medication generally shouldn’t be taken in the late afternoon or evening because it can make it difficult to fall or stay asleep.

Dosing is individualized based on the condition being treated, how well the medication works, and any side effects. Your doctor will determine the appropriate dose for you.

Doctors often start dextroamphetamine and amphetamine at a lower dose and may gradually adjust it. This process, called titration, helps find a dose that works while limiting side effects.

How Common Are Lupus Fatigue and Brain Fog?

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

In addition, 70 percent to 80 percent of people with lupus experience brain fog, sometimes called “lupus fog,” at some point in their lives. Brain fog can affect memory, concentration, and other thinking skills.

Symptoms can vary from person to person. Some people with lupus have a hard time remembering details or juggling tasks. Others have trouble finding the right words during a conversation or keeping up when someone else is talking.

Can Adderall Help With Lupus Symptoms?

Some symptoms that MyLupusTeam members report, such as fatigue and trouble concentrating, may overlap with symptoms that stimulants are used to treat in other conditions. However, these medications aren’t an established or standard treatment for lupus-related fatigue or brain fog.

No medications are approved specifically to treat lupus fog.

What MyLupusTeam Members Say

MyLupusTeam members have discussed whether dextroamphetamine and amphetamine might help relieve 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 reported positive experiences:

• “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 reported that this medication didn’t help their lupus fatigue:

• “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 manage lupus fatigue. “I currently take Adderall XR to help with my fatigue symptoms, but I was also diagnosed long ago with ADHD,” one member wrote. “I’m lucky to have both a great psychiatrist and rheumatologist that work with each other.”

As these comments show, medications can affect people differently, and what works for one person may not work for another.

What Should You Know About the Evidence and Risks of Adderall for Lupus Fatigue?

Evidence supporting the use of stimulants for lupus fatigue and cognitive symptoms is limited. For example, one published report described two people with lupus-associated fatigue who were treated with modafinil, a different stimulant. This evidence doesn’t show that dextroamphetamine and amphetamine are effective for lupus fatigue or brain fog.

Stimulants such as dextroamphetamine and amphetamine can increase your heart rate and affect your blood pressure. This may be especially important to consider because lupus can affect the heart and blood vessels and increase the risk of heart problems. Your healthcare provider can help you weigh the potential benefits and risks based on your health history.

What Should You Consider if You’re Taking Adderall?

Dextroamphetamine and amphetamine 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 may limit how much of a stimulant you can receive at one time. For instance, you may be limited to a 30-day supply before you can get a refill.

There have also been shortages of Adderall. Some mixed amphetamine salts products have limited availability. If you take dextroamphetamine and amphetamine or are considering it, your doctor can help you plan for possible supply issues.

Possible Side Effects

Before starting a new medication, it’s also important to understand its possible side effects. Commonly reported side effects of stimulants include:

• Trouble sleeping
• Headache
• Weight loss
• Upset stomach
• Loss of appetite
• Faster heart rate
• Increased blood pressure
• Delayed growth in children and adolescents, which is usually temporary and doesn’t appear to affect final height
• Mood changes

Some people may notice a rebound effect as a stimulant wears off. Symptoms can briefly become more intense, which may include feeling more tired.

Rarely, dextroamphetamine and amphetamine can cause more serious side effects, such as hallucinations, seizures, changes in vision, or difficulty breathing. Get medical help right away if you develop a serious or unusual symptom.

How Does Adderall Compare With Vyvanse?

Both Adderall and Vyvanse are prescription stimulants approved by the FDA to treat ADHD. Unlike Adderall, Vyvanse is available only as a long-acting medication and doesn’t have an immediate-release form.

Vyvanse is also approved to treat moderate to severe binge eating disorder in adults. It also comes in a chewable tablet for people who have trouble swallowing pills.

Both medications can have similar side effects. Your doctor can help determine whether either medication is appropriate for you based on your health history and symptoms.

Talk With Your Doctor About Lupus Fatigue and Brain Fog

If you have extreme fatigue or brain fog that interferes with your daily life, talk with your doctor or rheumatologist. They can work with you to find out what’s causing your symptoms. Possible causes include lack of sleep, side effects from lupus medications, or another health condition.

Your doctor can help address possible causes and discuss which treatments may be appropriate for you. This may include discussing whether a stimulant could help with your symptoms.

You can also take steps to manage some of your symptoms and improve your quality of life. The Lupus Foundation of America suggests healthy habits such as getting regular exercise and eating a healthy diet to manage fatigue. Getting enough sleep may also help with fatigue, brain fog, and focus.