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Azstarys Addiction: Signs and Side Effects of Azstarys Abuse

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Azstarys can result in dependence over time especially if your are misusing or abusing it

Published: October 31, 2025

Reviewed by Matthew N. Parker, MD

Azstarys is a brand-name medication that is used in the treatment of attention deficit/hyperactivity disorder (ADHD) and contains the active ingredients of dexmethylphenidate and serdexmethylphenidate. The combination of these two stimulants provides both immediate and extended-release effects.

Like other stimulants, Azstarys is considered a Schedule II controlled substance in that it carries a high potential for misuse and abuse. Because of this, Azstarys is currently part of the growing concern over prescription drug misuse and addiction in the United States.

It is important to be aware of the signs and symptoms of Azstarys addiction if you or a loved one has been prescribed this medication, as well as other potential dangers.

Continue reading to learn more about the signs of Azstarys, ADHD stimulant abuse, and CNS (central nervous system) stimulant addiction. Additionally, find information on how to recognize potential side effects, withdrawal symptoms, risk factors, and more.

Why Does Azstarys Lead to Addiction?

Azstarys has powerful neurological effects that can lead to addiction over time, especially when misused or abused.

How Azstarys Works

Azstarys has a dual-component formulation of dexmethylphenidate, which has an immediate release, and serdexmethylphenidate, which provides an extended release of up to 13 hours.

Both work by increasing the amount of dopamine and norepinephrine neurotransmitters in the brain, enhancing both attention and impulse control.

Neurological Effects of Azstarys

The neurological effects of Azstarys are the reason why it is so effective in treating ADHD symptoms. Azstarys increases attention span and also improves working memory, increases alertness and wakefulness, and reduces hyperactivity and impulsivity.

Not all of the neurological effects of Azstarys are positive, however, as it can also cause headaches, dizziness, insomnia, restlessness, increased anxiety, new manic symptoms, and more.

How its Effects can Create a Cycle of Misuse and Reinforce Addictive Behavior

The Azstarys dopamine effects can create a cycle of misuse in that it initially creates positive reinforcement by increasing productivity and focus, giving many individuals a sense of euphoria as well.

Over time, people build up a tolerance and need more of the drug to feel the positive effects of the stimulant reward system. When they attempt to stop, they experience uncomfortable withdrawal symptoms.

When this occurs, they are no longer continuing to use just to experience the positive effects and ADHD drug high again, but also to avoid withdrawal. As their use continues to escalate, it becomes harder and harder to stop.

Azstarys Abuse vs. Azstarys Addiction

Misuse, abuse, and addiction are distinct concepts, although they can be interconnected, with misuse and abuse often leading to addiction over time.

Difference Between Azstarys Misuse vs. Addiction

Misuse typically means only occasionally taking an extra dose or a dose outside of a prescription, and usually only for the specific purpose of increasing focus or energy before an exam or event.

When someone is addicted, they will instead engage in compulsive and harmful use, even after their use has become disruptive in their life or personal relationships. A person in this position likely wants to stop using but has a very hard time stopping.

Key Behavioral Signs that Distinguish Abuse from Addiction

When someone is engaging in recreational use of Azstarys, they may show some behavioral signs, but are generally still in control. They may occasionally take a higher dose than prescribed, use someone else’s prescription occasionally, or only use it before a big exam or when trying to stay awake.

When someone is addicted, on the other hand, they may use compulsively, experience strong cravings for the drug, neglect their responsibilities, and have a strong preoccupation with the drug and obtaining more.

Both ADHD drug misuse and addiction have the potential for serious side effects and medical issues, including heart problems, malnutrition, psychosis, increased risk of overdose, and more.

They can also increase the risk for legal problems, including possession of pills without a prescription, driving under the influence, or doctor shopping and forging prescriptions.

Does Azstarys Cause Dependence?

To understand how Azstarys leads to addiction, it’s essential to first comprehend how it can result in dependence.

Physical Dependence vs. Psychological Addiction

Physical prescription drug dependence occurs when a person’s body becomes physiologically adapted to a substance and needs it to function normally.

Psychological addiction, on the other hand, is a compulsive need or desire to use a substance to experience its rewarding effects, such as euphoria or relaxation.

How Prolonged or High-Dose Use Can Lead to Tolerance and Withdrawal

With a prolonged or high dose of Azstarys, a person’s brain will adjust to the medication over time. In addition to this, their dopamine and norepinephrine receptors become less sensitive.

As this happens, they build up a stimulant tolerance and will need an even higher dose to experience the effects they have become used to. If they try to stop taking the drug suddenly, the withdrawal symptoms will likely be even more amplified as well.

Why Even Prescribed Use Can Result in Dependence Over Time

Azstarys can result in dependence over time, even when it is prescribed by a licensed healthcare provider. This is because the brain and body can build up a tolerance to the drug even when not abused.

Most people who become dependent while prescribed, however, do not develop a stimulant physical addiction because their dosing is controlled and they are still under medical supervision.

Signs of Azstarys Addiction

Recognizing the signs of Azstarys addiction and general stimulant addiction symptoms is not always easy, but can be beneficial in the case that you or a loved one has a current prescription.

Physical Signs

Azstarys addiction can have several physical side effects, ranging from mild to more severe. Because of these effects, Azstarys can be especially dangerous to people who have existing medical conditions like heart disease and other heart problems.

Physical signs of Azstarys addiction include:

  • Rapid weight loss
  • Insomnia
  • Increased heart rate
  • Increased blood pressure
  • Frequent headaches
  • Excessive sweating

Behavioral Signs

Other signs of Azstarys addiction have less to do with physical characteristics and more to do with a person’s behavior and how they act both when using the drug and when they are between doses or trying to stop.

Azstarys abuse behaviors and behavioral signs of Azstarys addiction include:

  • Taking higher doses than prescribed or more often than prescribed
  • Social withdrawal
  • Neglecting responsibilities like school or work
  • Doctor shopping
  • Lying about use
  • Crushing or snorting pills
  • Using Azstarys along with other drugs or alcohol
  • Increased risk-taking behaviors
  • Decline in academic or work performance
  • Financial problems related to drug use
  • Ignoring medical advice

Psychological Signs

There are also additional signs of Azstarys addiction that affect a person emotionally and mentally. It is often these types of symptoms that eventually lead a person to relapse on Azstarys.

Psychological signs of Azstarys addiction include:

  • Strong cravings
  • Obsessive focus
  • Mood swings
  • Loss of control
  • Denial or minimization of the problem

Azstarys Withdrawal Symptoms

Stopping Azstarys, especially if suddenly, can cause uncomfortable withdrawal symptoms in some people. These symptoms, sometimes referred to as stimulant crash symptoms, are why psychological support is so important during detox.

The Withdrawal Experience When Someone Stops Using Azstarys After Dependence

When someone stops using Azstarys suddenly after they have developed a dependence, they are likely to experience stimulant withdrawal symptoms.

These symptoms usually start around 24 hours after the last dose, peak within a few days, and can last several days or several weeks, depending on how long and at what dose the medication was used for.

Common Withdrawal Symptoms

The withdrawal symptoms of Azstarys addiction are not considered life-threatening, but can still be difficult to get through and can oftentimes cause people to relapse.

Common Azstarys withdrawal symptoms include:

  • Fatigue
  • Depression
  • Anxiety
  • Irritability
  • Sleep disturbances and trouble sleeping
  • Strong cravings
  • Difficulty concentrating
  • Increased appetite
  • Headaches
  • Muscle aches

Side Effects of Azstarys Abuse

Azstarys side effects can also cause discomfort in people, and especially in those who are on higher doses or taking the drug more frequently.

It is also important to note that the possible side effects can be especially dangerous in people who have heart defects, hypertension, glaucoma, and Tourette’s syndrome, or in breastfeeding women and people using MAOIs (monoamine oxidase inhibitors).

Potential Side Effects of Azstarys Misuse

The side effects of Azstarys misuse or abuse may start as mild but will likely get worse over time and with continued long-term Azstarys use.

In very rare instances, Azstarys can also cause allergic reactions.

The most common side effects of Azstarys misuse include:

  • Increased heart rate
  • High blood pressure
  • Insomnia
  • Decreased appetite
  • Nausea or vomiting
  • Tremors or twitching
  • Headaches
  • Paranoia or aggression
  • Hallucinations or psychosis
  • Seizures
  • Chest pain
  • Skin rashes or hives
  • Blurred vision
  • Risk of ADHD drug overdose or cardiac arrest
  • Circulation problems
  • Priapism

Risk Factors for Azstarys Addiction

Azstarys addiction can happen to anyone, but is most likely to happen to someone who has a prescription for it. Several factors can put a person at risk for developing Azstarys addiction, especially for those without a prescription.

Key Factors that Increase Vulnerability to Addiction

Key factors that increase a person’s chances of developing Azstarys addiction are often those that involve high amounts of stress and a desire to self-medicate.

Azstarys addiction risk factors include:

  • Family history of substance abuse: A family history of substance use can both expose people to substance use throughout their lives, but can also predispose them to ADHD medication misuse risk through their genetics.
  • Mental health disorders: Comorbid mental health and addiction are common, with conditions like anxiety, depression, and ADHD leading people to self-medicate through substance use.
  • High academic or work-related stress: People may abuse Azstarys if they are under a lot of pressure or stress as a way to increase their energy and improve their performance or productivity levels.
  • Peer pressure: If friends or peers are using Azstarys or other substances, then an individual may be more tempted to experiment or keep using to fit in or gain social approval.
  • Easy access to prescriptions: Having access to prescriptions allows people to misuse medications without barriers and at their discretion, sometimes leading to dependence over time.
  • History of trauma or neglect: If someone has experienced a recent trauma, including abuse or neglect, they may use Azstarys in an attempt to numb themselves or avoid their problems.

Diagnosing Azstarys Addiction

Azstarys addiction can only be officially diagnosed by a healthcare professional. This can usually be done through a series of diagnostic steps and screening tests.

Clinical Process of Identifying Azstarys Addiction

Any time that a substance use disorder is diagnosed, the individual typically goes through a structured process and several interviews of different forms. Once a prescription drug addiction diagnosis has been established, a treatment plan can be made.

Use of DSM-5 Criteria for Stimulant Use Disorder

Mental health professionals often use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria as a means of diagnosing Azstarys addiction or any type of addiction, with the number of matched criteria associated with either a mild, moderate, or severe addiction.

DSM-5 criteria for addiction include:

  • Persistent but unsuccessful desire to cut back or stop using.
  • Strong cravings and desires to use the substance.
  • Giving up important social, occupational, or recreational activities because of substance use.
  • Using the substance in risky situations, such as while driving.
  • Continuing substance use despite knowing it is causing problems in one’s life.

Behavioral Assessments

Behavioral assessments include a clinical interview to gather information about the patient’s substance usage, such as how often they are using and at what dose.

This assessment also includes a review of the patient’s medical and psychiatric history to determine if any co-occurring disorders are present.

Substance Use Screening Tools

Behavioral screening tools and questionnaires may also be used to determine the extent of the patient’s substance use.

These tests may include the Drug Abuse Screening Test (DAST) and others, depending on the person’s age and other factors.

Interviews With the Individual and Family

Input from the individual’s family can also be extremely helpful in some cases, in order to get a better idea of what is going on.

A bad home environment can also be a trigger for substance abuse, and interviews with the family can help determine if this is the case.

Azstarys Addiction FAQs

The following are frequently asked questions about Azstarys and addiction.

Is Azstarys addictive even if taken as prescribed?

Yes, Azstarys does have the potential to be addictive even when taken as prescribed, though it is more likely to become addictive when misused or abused.

Even when someone takes Azstarys as prescribed, their body may still become adjusted to the medication over time, and they may experience withdrawal symptoms as a result if they decide to stop taking it suddenly.

How quickly can someone become addicted to Azstarys?

There is no specific timeline for how long it takes a person to become addicted to Azstarys, as each individual is different and will be affected in unique ways.

Factors that can affect how quickly a person becomes addicted include the size of their dose, method of administration, and whether they have a family history or personal history of substance abuse.

Is Azstarys safer or riskier than other ADHD medications?

Azstarys is not considered safer or riskier than other ADHD medications, and is generally considered very comparable to them in terms of safety and risks.

It is important to note, however, that Azstarys may be easier for some people to tolerate than other ADHD medications and treatment options, as it has a smoother release profile.

Can Azstarys misuse cause permanent harm?

Yes, abusing Azstarys carries with it a lot of risks and can cause serious and even permanent damage.

Some of the more serious risks are for cardiovascular issues, especially in people who have pre-existing heart conditions. These risks include a heart attack, stroke, and sudden death.

Find Help for Yourself or a Loved One with Azstarys Addiction

If you suspect that you or a family member is struggling with an addiction to Azstarys, it is important to seek guidance and support as early as possible.

Also remember that addiction should never be considered a moral failure, and is instead a medical condition – one that can see significant improvement with the right treatment and support.

For a free and confidential addiction help resource that can help you locate rehab centers near you with treatments tailored to your needs, contact us at RehabNet addiction services today.

Help for Azstarys addiction is within your reach, and your recovery journey can begin as soon as today. Call our helpline now for more information.

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