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. intermittent) use as 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 the obvious issues with it causing insomnia due to the stimulant effects.
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
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.
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.
- 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. ToxNET
- Overview of Sodium's Role in the Body. Merck
- Effects of Amphetamine and Its Isomers on Excretion of Sodium and Water in the Rat. SAGE