Adderall is not an MAOI. It is classified by the FDA as a central nervous system stimulant, and it works through a completely different mechanism than monoamine oxidase inhibitors. The two drug classes should never be combined, which is likely why this question comes up so often.
How Adderall Actually Works
Adderall is a mix of amphetamine salts prescribed for ADHD and narcolepsy. It increases levels of dopamine and norepinephrine in the brain by doing two things: pushing more of these chemical messengers out of nerve cells and blocking those cells from reabsorbing them. The net effect is more dopamine and norepinephrine available in the spaces between neurons, which improves focus and attention.
MAOIs work in an entirely different way. Rather than releasing neurotransmitters or blocking their reuptake, MAOIs disable an enzyme called monoamine oxidase, which is responsible for breaking down dopamine, norepinephrine, and serotonin. By shutting down that cleanup enzyme, MAOIs let these chemicals accumulate naturally. MAOIs are primarily prescribed for depression, not ADHD. The ones currently approved in the U.S. include isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Emsam), which is applied as a skin patch.
A Technical Nuance Worth Knowing
Interestingly, amphetamines do have a weak, secondary ability to inhibit the monoamine oxidase enzyme. Research published in Drug Target Insights describes amphetamines as “relatively potent, non-selective MAO inhibitors” but immediately clarifies that this inhibition is weak compared with actual MAOIs and is reversible. This property has not attracted much scientific interest precisely because the effect is so minor relative to amphetamine’s primary actions of releasing and blocking reuptake of neurotransmitters.
So while amphetamines technically touch the same enzyme that MAOIs target, the effect is too small to define the drug’s class or its therapeutic purpose. Calling Adderall an MAOI based on this would be like calling coffee a sleep aid because it contains trace amounts of compounds that promote relaxation. The dominant effect is what defines the drug.
Why Adderall and MAOIs Cannot Be Combined
The FDA lists MAOIs as a hard contraindication for Adderall. Both drug classes increase the same neurotransmitters, but they do it through different routes. When you take them together, those effects stack. An MAOI prevents the body from breaking down dopamine and norepinephrine while Adderall simultaneously floods the brain with more of them. The result can be a dangerous, uncontrolled spike in blood pressure known as a hypertensive crisis.
This is not a theoretical concern. A case documented by Cleveland Clinic described a patient on both tranylcypromine (an MAOI) and dextroamphetamine whose blood pressure surged to over 230/100 mmHg during a hypertensive emergency. Symptoms included chest pain radiating to the jaw, heart palpitations, and a pounding headache. Potential outcomes of a hypertensive crisis include stroke, heart attack, kidney failure, and death.
Not all MAOIs carry the same level of risk. Tranylcypromine appears to pose a greater danger of spiking blood pressure when paired with stimulants than phenelzine does. But the general rule from the FDA is clear: do not take Adderall while on any MAOI.
The 14-Day Washout Period
If you’re switching from an MAOI to Adderall (or the reverse), the FDA requires a minimum 14-day gap between stopping one and starting the other. This applies to all MAOIs, including less obvious ones like linezolid (an antibiotic) and intravenous methylene blue, both of which have MAOI activity. The two-week window exists because MAOIs disable the monoamine oxidase enzyme irreversibly in most cases, meaning your body needs time to produce entirely new enzyme before it’s safe to introduce a stimulant.
This washout period is not flexible. Even at the tail end of 14 days, residual MAOI effects can still be present. If you’re prescribed both types of medication at different points in your treatment, the timing of the transition matters as much as the drugs themselves.