Adderall For Fatigue

Question:
What are the guidelines for taking Adderall for fatigue? I am taking 60mg a day but that is not enough. My doctor has no problem with increasing my dosage to 70mg or 80mg but insurance denied it. All I can find are policies on ADD/ADHD but nothing on fatigue due to MS?

Answer:
Believe it or not there are no good studies demonstrating that Adderall is beneficial for MS related fatigue. The main problem is that fatigue means different things to different people and requires a detailed approach to evaluation and management. In my experience, people with “brain fog”, processing speed problems, and excessive sleepiness during the day may be the people most likely to benefit from stimulants but you rarely know until the medicine is tried and some will simply not tolerate or benefit from stimulants. Please refer to a blog I wrote on this subject READ MORE

To directly answer your question, if I believe that Adderall is a good choice for an individual after an in depth evaluation, I generally do not go beyond a maximum of 60 mg per day (usually 30 mg twice a day). I usually try a sustained release formulation of Adderall or go directly to a sustained release methyphenidate in this circumstance. After you’ve read the blog on fatigue, why not set aside an entire visit with your doctor for an evaluation of your fatigue complaints?

Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego