Does Adderall Make You Pee More?

In our latest question and answer, the pharmacist discusses how Adderall and related amphetamines can cause you to go to the bathroom more often.

Question

Can Adderall cause diuretic effects in higher than prescribed doses? I feel like I am going to the bathroom more often and feel that Adderall is to blame. Also, how can Adderall interfere with heart medications (medications indicated for A-fib, beta-blockers, etc.). Thank you doc(s)!

Asked by Berry On Jul 18, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Jul 18, 2022
Last updated May 02, 2024

Key points

  • Short-term use of Adderall is associated with an increase in urination (i.e. having to go pee).
  • Long-term use, however, can cause urinary retention.

Answer

Yes, Adderall (amphetamine salts) does have mild diuretic effects and may make you go to the bathroom more often than usual. However, this effect typically only occurs with acute (i.e. short-term) us. Chronic administration of Adderall is associated with urinary retention.

Adderall And Water Balance

The exact mechanism behind Adderall and related products causing an increase in urination (i.e. 'making you pee more') isn't well know but there are a few theories.

  • Several animal and human studies have shown that Adderall can increase sodium excretion. Our bodies work hard to maintain the appropriate balance between sodium and water. When sodium excretion is increased, water often follows to maintain this balance.
  • Studies have also shown that Adderall can decrease the excretion of aldosterone, a steroid hormone with many biological functions, one of which is to signal the kidneys to retain sodium. A decrease in aldosterone may be responsible for the subsequent increase in sodium excretion.

Interestingly enough, chronic or consistent administration of Adderall is associated with decreased urination and urinary retention. In fact, the prescribing information for Adderall does list 'impaired urination' as a potential side effect. This may be due to Adderall increasing bladder sphincter tone (contraction).

Due to the long-term administration of Adderall and related amphetamine products being associated with urinary retention, there have been studies that evaluated its use to decrease bed-wetting (nocturnal enuresis) in children and adolescents. However, it hasn't been shown to be overly effective and there are obvious issues with it causing insomnia due to the stimulant effects.

Additional Information

In regard to your question regarding Adderall with heart medications, the concern lies with the heart conditions themselves. Adderall is contraindicated in individuals with symptomatic cardiac disease.

Adderall is well associated with adverse cardiovascular effects, such as:

  • Increased heart rate
  • Increased blood pressure
  • Palpitations

The concern is that Adderall can exacerbate underlying heart conditions or diseases.

Per the prescribing information for Adderall:

"Sudden death has been reported with usual doses of CNS stimulants in children and adolescents with structural cardiac abnormalities or other serious heart problems; sudden death, stroke, and myocardial infarction have been reported in adults taking CNS stimulants at usual doses. Stimulant drugs should not be used in patients with known structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious heart problems."

Just how much of an increased cardiovascular risk there is with Adderall isn't known.

In fact, one study published in the New England Journal of Medicine did not find an increased risk of serious cardiovascular events in users vs. non-users, even in those with underlying cardiovascular disease (10). Nevertheless, the study concluded that while the risk of cardiovascular adverse events is low, an overall increase in risk can't be ruled out.

It would be prudent to discuss the use of Adderall or any stimulant medication with your doctor before use.

References

  • Adderall XR Prescribing Information, AccessFDA
  • Drugs for nocturnal enuresis in children (other than desmopressin and tricyclics), PubMed
  • Urinary Retention in Adults: Diagnosis and Initial Management., AAFP
  • A mechanistic study on urine retention in d-amphetamine addicts, PubMed
  • Amphetamine Monograph, PubChem

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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