Does Adderall cause dilated pupils? (+3 tips)

In this article, we will explore whether Adderall can cause pupil dilation or not, what is the link between Adderall and pupil dilation, what factors may influence Adderall-induced pupil dilation and what to do if Adderall causes pupil dilation.

Does Adderall cause dilated pupils?

Yes, Adderall (amphetamine+dextroamphetamine) can cause dilated pupils as a side effect in some cases. Adderall is known to show this side effect as result of its stimulatory effects on the central nervous system. Adderall is usually prescribed for patients having attention deficit hyperactivity disorder (ADHD) or for narcolepsy (1).

Adderall shows its stimulatory effects by increasing the levels of neurotransmitters present in brain cells. These neurotransmitters are mainly dopamine and norepinephrine. These neurotransmitters affect the eyes causing the pupils to dilate and increase in size. These side effects caused by Adderall are not permanent. They usually appear in the time when the body is trying to adjust to its effects.

If you are taking Adderall and experience pupil dilation with the sympathetic effects of the drug then it is advised to contact your healthcare provider to get the guidance. 

How does Adderall cause dilated pupils?

Adderall causes pupil dilation by stimulating the central nervous system as a result of increasing the levels of certain neurotransmitters(2). Adderall is a stimulant drug that consists of a combination of stimulatory chemicals i.e., amphetamine and dextroamphetamine. These components of Adderall increase the levels of dopamine and norepinephrine in the brain. These neurotransmitters stimulate various physiological processes in the body.

The iris muscles regulate the size of pupils in the eye. There are receptors on the iris muscles and norepinephrine binds to these receptors. alpha-1 adrenergic receptors are mainly responsible for mediating the effect of norepinephrine on the iris muscles (3).

The binding of norepinephrine to these receptors leads to a series of signalling events that cause the iris sphincter to relax causing the dilation of the pupil (4). 

What factors may contribute to Adderall-induced pupil dilation?

Adderall-induced pupil dilation may be influenced by various factors. These factors may include:


Higher doses may lead to a higher risk of side effects. If the dose of Adderall is higher then the effects of the norepinephrine will be stronger on the alpha-1 receptors leading to an increased risk of pupil dilation and more pronounced effects.  

Individual sensitivity

The effects of Adderall may differ in different individuals. This variation is because of individual differences among patients. These differences are attributed to their genetic predisposition, metabolic rate, age and gender. 

Duration of use

If Adderall is used for a longer term then the side effects such as pupil dilation may be more persistent and frequent. This may occur due to adaptations of the sympathetic nervous system that may lead to receptor sensitivity. 

Concurrent medications

If you are taking concurrent medications such as decongestants and antidepressants, both of which have similar effects on norepinephrine levels as that of Adderall, can lead to an increased incidence of pupil dilation. 

Underlying eye conditions

If you have a preexisting medical condition such as glaucoma and cataracts then the effect of Adderall on the pupil size may be more pronounced. Such individuals are more susceptible to experiencing the side effects related to eyes after taking Adderall. 


Dehydration can cause the thickening of the blood and reduced flow that may lead to decreased clearance of norepinephrine from the synaptic cleft which may cause pupil dilation for a longer period of time. 

What to do if Adderall causes dilated pupils?

If you are taking Adderall and experience side effects such as appellation, then the immediate step should be to inform your doctor about this. 

Consulting healthcare professional

Your healthcare provider will perform a thorough exam and determine the exact cause of pupil dilation in the eyes. They will help you assess the severity and intensity of the effect and the required treatment plan for it. 

Your doctor may alter your dosing regimen, lowering the dose or frequency of taking Adderall if higher doses are the reason for the side effects. A few tips may also help you manage this side effect while taking Adderall. These tips may include:

  • Protect your eyes from sunlight, and use sunglasses when going out into the sun. 


  • Use artificial tears or lubricating eye drops as dryness may also cause the dilation of the pupil.


  • Topical eye drops or systemic medications such as pilocarpine (5), physostigmine (6), and pyridostigmine can also help to treat the condition as they constrict the pupil in the eye.


  • Avoid caffeine and alcohol while taking Adderall. Both these circumstances have stimulatory effects and the effects of these may add up to the effects of Adderall leading to worsening the symptoms. 

If the effect of Adderall is persistent and intense then your doctor may suggest an alternative medication to you to avoid the side effects and improve the therapeutic efficiency of the drug. 

Alternatives to Adderall

If you are taking Adderall and Adderall-induced pupil dilation becomes a concern for you then there are certain other alternative medications that may help you with your condition of ADHD or narcolepsy. This effect of Adderall may be experienced by some patients but not everyone may experience it. The alternative medications may include the following (7).

In my opinion, pupil dilation can be experienced by patients taking Adderall to treat conditions like ADHD or narcolepsy. This side effect is due to the stimulatory effect of this drug on the central nervous system. Consulting your healthcare provider is essential in treating such conditions.

There are some over-the-counter eye drops that may help treat this side effect but if the side effect persists, then your healthcare provider may assess and analyze your condition and tailor your treatment plan according to your needs.

The modifications may include altering the dosing regimen, prescribing the medication for symptomatic treatment or altering Adderall with some other medication that may help with your ADHD or narcolepsy as well. 


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Shoar, N. S. (2023, May 23). Dextroamphetamine-Amphetamine. StatPearls – NCBI Bookshelf.


Koss MC. Studies on the mechanism of amphetamine mydriasis in the cat. J Pharmacol Exp Ther. 1980 Apr;213(1):49-53. PMID: 7359369.


Mathôt S. (2018). Pupillometry: Psychology, Physiology, and Function. Journal of cognition, 1(1), 16.


Preuschoff, K., ‘t Hart, B. M., & Einhäuser, W. (2011). Pupil Dilation Signals Surprise: Evidence for Noradrenaline’s Role in Decision Making. Frontiers in neuroscience, 5, 115.


Emina M. O. (2010). Aging and topical pilocarpine concentrations effects on pupil size and tear flow rate [Efectos del envejecimiento y de las concentraciones de pilocarpina tópica sobre el tamaño pupilar y la tasa de secreción lagrimal]. Journal of Optometry, 3(2), 102–106.


Silveira R, Stjernschantz J. Vascular effects of acetylcholinesterase inhibitors in the rabbit eye: a study with fasciculin and physostigmine. J Ocul Pharmacol. 1992 Summer;8(2):129-37. doi: 10.1089/jop.1992.8.129. PMID: 1506754.


In Brief: Alternatives to Adderall | The Medical Letter Inc. (n.d.).,their%20onset%20of%20action%20occurs