Adderall causes a stimulation of the neurotransmitters norepinephrine and dopamine in the brain, which increase blood pressure and heart rate, says Levine. That increased blood flow to your brain is what gives people better focus on Adderall.

But, if too much is taken or someone has a history of heart disease, a spike in heart rate and blood pressure can be dangerous. “We typically don’t recommend this drug for people with heart issues, and anyone taking it should have their blood pressure checked regularly by their doctor,” says Levine. Adderall could lead to heart attacks if not taken properly or by someone at a higher risk.

Because Adderall causes increased blood pressure, that could potentially cause damage to the kidneys over time, says Levine. High levels of blood flowing through and around the kidneys can cause narrowing and hardening of the arteries located there. This is why it’s especially important for people with any heart issues to avoid stimulants or make sure their doctor is monitoring their BP levels, as it could have even more implications over time.

Adderall makes the brain release more epinephrine, a hormone that makes you feel less hungry, says Levine. “It takes away your desire to eat, but it’s only temporary,” she says. “People find that when the Adderall wears off, they’re usually ravenous.”

If you take Adderall frequently and often lose your appetite, you may eat smaller portions that cause your stomach to shrink, says Levine, so weight loss could occur in that way. But, this isn’t a healthy or sustainable way to lose weight.

Like any stimulant, Adderall can mess with sleep habits and make it difficult for some adults to fall asleep, says Levine. How much you’re taking and when can also have an effect on your ability to fall asleep, so certain tweaks to the dosing instructions can make a difference.

While some people may experience a mood boost on Adderall, others may feel edgy, restless, or easily agitated on the drug, says Levine. Some people may experience mood shifts when they’re on the drug too, and feel uneasy as the effects are wearing off. It’s important to monitor these changes as they could be a sign that there’s another or different issue than ADHD at play, like depression, says Levine.

Because Adderall makes you feel more awake and alert, it’s difficult to tell how drunk you’re getting when you have alcohol. “It increases your tolerance, so it can be dangerous in that you feel more sober than you really are,” says Levine. “People need to be more careful with drinking because of this.”

Adderall itself does not have chemically addictive properties, but it can cause dependence, says Levine. “It’s desirable to addictive personalities,” she says. “And the positive effects are something you can become dependent on.”

She recommends people take days off from the drug every once in a while to clear their system of it and reduce the chance of dependence. “It’s not like an anti-depressant where it needs to be taken every day to work properly. You only need to take Adderall when you feel like you need it.”