Eli5 how Adderall works
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It’s a CNS stimulant, specifically four amphetamine salts that combine to act on dopamine receptors to improve focus, wakefulness, and cognitive acuity.
Basically legalized speed that’s given in micro doses to help those with low focus and attention bring both up to more normalized levels.
It’s dopamine. Just energy and pleasure for people with normal dopamine levels, but for those with low dopamine to begin with (ADHD), it gets them closer to normal levels, hence producing a calming and focused effect, as opposed to jumping off the wall
With ADHD, you have chronically low levels of certain chemicals (neurotransmitters like dopamine, norepinephrine and serotonin) because your brain is wired a bit differently.
Because of this, your brain is making you frantically search for solutions to said deficiency, hence the hyperactivity, attention issues, and/or issues with executive function in general.
Taking things like Adderall helps bring you back up to regular levels. No chemical deficiency == reduced ADHD symptoms.
It’s also used for narcolepsy, but I don’t know enough about that to comment
Doc here.
While we don’t know the exact reason why stimulants help people with ADHD, it is believed that these people have abnormally low levels of dopamine in the parts of their brain responsible for attention and concentration. Dopamine is a feel-good hormone that is released with rewarding activities like eating and sex. It can also be released by certain stimulatory activities like fidgeting (or, in extreme cases, thrill activities like skydiving — which is why some people literally get addicted to thrill sports). Since people with ADHD can’t eat and have sex all the time, they respond to their lower dopamine levels by engaging in rewarding and impulsive behaviors, which usually come off looking like hyperactivity.
Drugs like Adderall increase the dopamine supply that’s available to the brain. In people with ADHD, it *corrects* the level of dopamine to normal levels. Thus, it improves attention span and, in people with ADHD, reduces the need for self-stimulatory behavior. Too much Adderall, or any Adderall in normal people, will cause hyperactivity due to its effects on the sympathetic nervous system (fight or flight). But in people with ADHD, the proper dosage will, for reasons mentioned, fix the hyperactivity. You reach the happy medium.
Edit: Thanks everyone for the awards! There are a lot of questions on here and I can’t get to all of them. But if you feel you have ADHD and could benefit from medical therapy, definitely talk to your doctor!
Honestly, there is no Eli5 because medical science does not know the answer to this. You will get a lot of answers saying “it raises levels of dopamine” and such, but the truth is that, like with most psychiatric disorders, nobody has a good scientific understanding of what causes ADHD. We have empirical knowledge of what adderall and similar stimulants do at the level of neurotransmission activity – so yes, dopamine and norepinephrine probably play a key role – but we have no consensus theories as to why those neurochemical effects alleviate ADHD.
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A normal Brain gets rewarded (dopemine) for doing normal things in completion. Folding Laundry, answering emails, etc. It’s like preferred member benefits.
ADHD brain does not get the same rewards for doing normal things to completion. so it constantly looks for new things to get new member rewards (learning a new song, reading about a random fact, discovering a new hobby). But new member rewards expire after the trial period so they move onto something new frequently.
Adderall unlocks preferred member benefits (dopemine) in the Adhd brain.
Think of the ADD brain like a chipmunk. Dopamine, the chemical that makes our brain feel happy, is kind of like a delicious nut.
Most chipmunks have gotten really good at planning and organizing their days – so they have their own steady supply of nuts that come to them every day. They have also learned how to balance their day so that they can hunt for an appropriate amount of nuts relative to their needs.
But this chipmunk, for whatever reason, doesn’t have their own steady supply of nuts. So instead of having the ability to plan out their day on other things, like building shelter or working on projects, they must be constantly on the hunt for nuts.
All day, this chipmunk is searching for nuts. It’s basically all it can think about.
Even worse, sometimes our chipmunk gets so hungry that he can’t finish a hunt. One simple obstacle might be enough for him to decide to try to hunt in a different way, go to a different tree, or just give up all together.
As you can imagine, hunting for nuts all day like this is exhausting.
It would free up a ton of energy and time if our chipmunk just had a nut dispenser. Then they could finally focus on other things, like projects or upgrading their little home.
That being said, our chipmunk is much better at hunting for nuts than many other chipmunks.
With the right conditions, they can sometimes build up a huge supply of nuts.
Buuuuuuttt, having so many nuts can make it difficult to balance hunting and living.
Since they aren’t used to balancing their nut intake, if they do happen to have a large supply of nuts they are likely to expend that supply much quicker too.
After all, having that many nuts is exciting! So exciting that it’s distracting! How can our chipmunk *ever* hunt for more nuts when they have *so many* right here.
Or maybe, if our chipmunk *doesn’t* find the nuts they need, they can end up procrastinating the hunt out of discouragement.
They’ll get so stressed and hungry until finally they can’t take it anymore and finally go on a *super hunt* where they might be up well into the night and next day finding hunts at a voracious pace.
Then they get that big pile again, and well…you know the rest.
Adderall (and other Stimulants) act as a sort of Nut Dispenser with exactly the right amount of nuts that our chipmunk needs to dedicate their energy to other tasks. They might still need to hunt for nuts on their own, but they won’t be so preoccupied with it since they can count on a steady supply of them every day.
As a result, our chipmunk feels less anxiety, is more productive, and isn’t so distracted at the thought of finding nuts.
Where other chipmunks might get a nut dispenser and feel good as well, it’s really more nuts than they need.
They can often end up with weird side effects, since these chipmunks don’t really know how handle so many additional nuts in their routines.
They might end up staying awake all night working on their projects or having fun, because they have the nuts to justify it.
But our ADHD chipmunk goes to bed at a consistent time with their nut dispenser, because they feel less stressed, overwhelmed, and anxious overall. Instead of feeling super excited like other chipmunks might with a nut dispenser, they feel calm, focused, and “normal.”
They now have the time and the energy when they need it, and with the ability to balance it all with their own hunt for nuts – not as important or overwhelming as it once was.
I know this is ELI5, but I find overly simplistic explanations to be inaccurate and missing important information. I prefer to just lay things out and try to explain them.
Adderall is a mix of 4 different amphetamine salts. Amphetamine itself is a chiral molecule, which means it has two stereoisomers; an isomer is a form of a molecule that is shaped differently but retains the same chemical formula, and more specifically, a stereoisomer is an isomer whose shape is identical in all ways aside from being mirrored. The best analogy would be your hands; they have the same tendons and bones arranged in the same configuration, but they’re mirrored.
That’s what Adderall IS. What it DOES is it acts as a triple monoamine releaser. Monoamines are neurotransmitters (molecules that brain cells release to send signals to one another), and in this case the “triple” refers to dopamine, serotonin, and norepinephrine. Amphetamine shares structural similarities to these monoamines, and so can be taken into the brain cells by transporter proteins, which usually do the job of collecting extra neurotransmitters and bringing them back into the cell to be reused.
What it does when it gets into the cell is reverse the direction of the transporter proteins, pumping more monoamines out of the cell, causing the cells to send stronger signals to one another. While amphetamine is TECHNICALLY a triple monoamine releaser, it predominantly targets dopamine and norepinephrine with little activity regarding serotonin. A drug like Ritalin/methylphenidate is also a CNS stimulant, but it selectively targets dopamine and norepinephrine transport proteins without any action at serotonin whatsoever. Also, Ritalin is merely a reuptake protein inhibitor and does not cause any release like amphetamine does. Cocaine is yet another stimulant, and it is a triple monoamine reuptake inhibitor, but does not cause release.
What all of THAT does is enhance focus, memory, and motivation because dopamine and norepinephrine are not just neurotransmitters, they’re neuromodulators. A neurotransmitter like glutamate or GABA send a single signal between cells, but neuromodulators can send signals from one region of the brain to another and cause entire cascades of resulting signals depending on which cells are talking to which region. Neurotransmitters are like a bunch of employees sitting in a conference room talking amongst each other, whereas the neuromodulators are like the team leads who come down with a message from corporate and tell everyone at the conference what it is to discuss.
So amphetamine releasing higher levels of dopamine and norepinephrine than normal starts activating the parts of the brain responsible for taking in information and assigning it importance in order to commit it to memory, as well as raising energy levels in order to put thoughts into action and begin taking steps in order to achieve a goal. Say you stumbled upon a nice berry bush in the wild and ate some berries; the sugar causes a release of dopamine, and the dopamine makes your brain start taking notes of where you are, what the bush looks like, how you got here, etc. So that you are more likely to repeat the process in the future and acquire more berries next time you’re hungry. Similarly, say you stumble upon a bear you weren’t expecting and your norepinephrine starts pumping; your respiration and heart rate elevate, and non-time sensitive processes such as digestion are put on hold in order to divert energy towards decision making and physical exertion to get out of danger.
These are naturally occurring examples of the roles these neuromodulators play in our lives and how they developed to serve those roles. Adderall bypasses the need for external stimuli to leverage these chemicals in order meet those same purposes in a world that isn’t as exciting or high stakes for people with ADHD, or for people whose ADHD is bad enough that they struggle to do things they do enjoy.
It’s a very wordy and technical explanation, but I still think most people can understand it and it paints the full picture. Even if it doesn’t fully satisfy you now, your understanding of what I’ve laid out can develop over time and you can reach a more satisfying answer to your question.
Edit: Thank you everyone for the positive feedback! I’m used to getting told “That’s too complicated, no 5 year old would understand that” and having to remind people this sub isn’t for literal 5 year olds.
It may take me a bit because I get burnt out on replying very quickly but if anyone has any further questions, feel free to leave them and I will get back to everyone with as much info as I can. While my knowledge can be extensive, it tends to be very narrow in scope.
I have and have had- at various times, on and off – a script for Adderall. 10-20mg, depending on era.
It’s function is very, very simple. You take the pill, and about 30min later, you’ve got a 2-5 hour window where shit is interesting – whatever you’re doing – and you can just focus like a madman and get shit done. Adderall turns the mundane in to a structured task you want to complete, and makes stuff as boring as Excel like a video game.
Over time it becomes a bit more dull, so you’ve got to demonstrate restraint, but if it works for you it WORKS.
Source – was a sad, 235lb guy who gamed too much as recently as Feb 2023. Got laid off, saw a doctor for Addy, and am now 190lbs, happy as a clam, and living in a clean living space instead of a house I hadn’t cleaned for a year.
Is it speed? Yes, it’s literal amphetamine in pure form. Is that a bad thing? Depends on the person. Adderall has turned my life around multiple times, and I can say with certainty that I’ve never been better off in life while not taking it. Some of us just need that spike in energy and interest, and Adderall exists for a reason.
I have a deep, deep set of family and friends around me who can tell what’s going on with me by the state of my appearance/weight, and condition of my home. All of them agree that Adderall is a godsend, even if they view it as a recreational drug for most. It’s the nudge over the finish line I need to be a healthy, functioning adult.
TL;DR – take addy, get motivation to do all of the shit you neglect that you know matters.
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