ADHD Questions
Questions
What happens if you mix alcohol and ADHD medication?
Charles Li, MD
December 26, 2022
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There have been reports of heart attacks in those who drink and take Adderall.
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Ritalin has been linked to rare cases of mortality from ethylphenidate when taken with alcohol.
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Strattera tends to be a safer medication for those who drink, according to clinical trials.
Mixing ADHD medication and alcohol can lead to health issues, mainly if you are drinking a lot.
While there have not been many studies quantifying the risk, there is a fair amount of evidence showing that drinking and mixing ADHD medication is not risk-free.
Adderall and drinking
There have been several published reports on young individuals who developed heart attacks after drinking and taking Adderall.
Typically, young people, particularly adolescents, are not at significant risk of a heart attack unless they have an undiagnosed heart condition or are taking substances.
Adderall is generally a very safe treatment for ADHD when taken under the supervision of a healthcare professional.
But, as you can see, in the case below, it can lead to heart attacks if it's taken while drinking heavily in rare cases:
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We report a case of acute myocardial infarction in an adolescent without cardiovascular risk factors who took the total prescribed daily dose of Adderall one time while consuming alcohol. The sporadic use of Adderall with alcohol creates a potentially dangerous situation with serious cardiovascular adverse effects.
One of the reasons why this happens might be because Adderall and alcohol are both processed by your liver. When you drink, you may notice that it takes a while to sober up. That is because your liver is working as fast as it can to process all the alcohol.
When you take Adderall and alcohol, your liver gets jammed up and slows down further as it processes both substances. As a result, your body can become exposed to dangerous levels of Adderall:
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In our case, concurrent alcohol use and the sudden double dose of Adderall may have contributed to its toxicity. Alcohol competes with amphetamine for the metabolizing enzymes in the liver, therefore enhancing the bioavailability of amphetamine.
Risks of Ritalin and alcohol
One of the critical risks in mixing Ritalin and alcohol is the creation of ethylphenidate.
Methylphenidate is a molecule that gets generated when your body processes Ritalin and alcohol together.
While it has not been well studied, we do know that it affects the brain.
Additionally, there have been cases of people getting seriously ill or dying because of high levels of ethylphenidate.
It’s not a particularly common phenomenon, but it is an excellent reason to avoid heavy drinking while taking Ritalin.
Strattera and alcohol
Strattera is one of the less risky medications to take with alcohol. According to its prescribing instructions, Strattera has not been linked to changes and how we react to alcohol.
In fact, Strattera is the medication of choice for those with an alcohol use disorder and ADHD.
In a randomized controlled trial, researchers found that Strattera was safe and effective in treating ADHD for those who also have an alcohol use disorder.
While this doesn’t mean that it’s a good thing to go out and binge drink while taking Strattera, it is one of the safer medications you can take for ADHD if you do plan on drinking.