8 ms·

Fellow ADHD person: Get diagnosed and get a low-dose of meds. It helps _a lot_. You will likely hate the feeling they give you for the first week (you will gen

Fellow ADHD person: Get diagnosed and get a low-dose of meds. It helps _a lot_. You will likely hate the feeling they give you for the first week (you will genuinely feel high even on 10mg Adderall XR), along with nightmares and night sweats but after a few weeks, you'll suddenly be productive at a very normal level. I don't feel strung out nor is it some addiction. Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you. Even with an addictive personality, it's very easy to avoid over-doing it (hint: only take it as prescribed). Medication is intended as a stop-gap to build a system so you won't need high doses forever. If you go into thinking meds are all that needs to be done, you are going about it wrong. You need to build a system and reflect on how to improve your baseline productivity and keep yourself on rails (planners, calendars, checking your work, reviewing work with a fresh mind before sending out, etc). Additionally, it does help if you like what you are doing. I'd imagine ADHD is much easier to maintain if you are self-employed or have a large leeway to define how work gets done or what work gets done. If you are in a command-and-control / top-down power structure, you need to leave; you'll never thrive there and will ultimately get tossed out. Lastly, caffeine does help from my testing, especially caffeine combined with L-Theanine. I used to take 100mg of HVMN "Sprint" pills as a test whether I had ADHD; it helped quite a bit. It didn't make me jittery and it let me focus much better.

sneak 6y ago
Counter-anecdata here: meds aren't always the best option for people. Don't bias toward taking amphetamines as the parent comment instructs you to do. There are serious negative long-term effects from taking amphetamines regularly. Such advice as above is very one-size-fits-all, and in my view is thus really bad advice. > Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you. You can ignore those people because they're wrong, amphetamine is not methamphetamine. But do not ignore the people who tell you that even normal amphetamines (adderall) are not harmless. They cause harm, even at low doses. The harm they cause may be mitigated by the benefit they bring; it may also be extremely difficult to estimate their harm in advance. Ceasing regular use of amphetamines for some people can result in subsequent YEARS of oversleeping, lethargy, and depression from dopamine receptor downregulation. > I don't feel strung out nor is it some addiction. Amphetamines are a highly addictive substance, if you are taking them every day it is likely that your body has developed at least some physical dependence upon them. Addiction doesn't make itself known until you stop.
- birdyrooster 6y ago
  Kidney damage? What effects?
- hombre_fatal 6y ago
  We're talking about ADHD though, not someone looking to just pull some all-nighters or cram on a Sunday night. When I realized there was a low dose medication that could basically cure me of ADHD (thus cure me of underperformance, procrastinating my ambitions, low professional self-esteem), the choice was obvious. Know what also does harm? Underperformance, procrastinating my ambitions, low professional self-esteem. Far worse than any side-effect from amphetamine. And I'd take on much worse harms if they would cure my ADHD like amphetamine does. Edit: lol, when I started my reply to you, your comment was two sentences long. Take it easy. Btw, I'm in my mid-30s and I've been taking amphetamine since I was 18. Perfect bill of health. Though, granted, there's plenty of life left.
  - sneak 6y ago
    Stimulant addictions are one of the most common functional addictions. I don't think most people would consider someone servicing an active physical dependency to have a "perfect bill of health", even if you are totally free from disease.
    - q3k 6y ago
      > someone servicing an active physical dependency to have a "perfect bill of health" Is taking immunosuppressants also a physical dependency or a functional addiction?
    - borski 6y ago
      You are making assumptions the parent did not imply. You can be on ADHD meds and not be addicted to them, ffs. I am on low-dose adderall xr on days that I need it and I have never had an issue. Everyone is different, but to imply that the adderall has caused an “active physical dependency” is no different from stating that too many people drink caffeine (except that because I only take it as needed it’s not even a fair comparison). You’d be right, but it does not do significant harm, especially given how therapeutic the right drug can be in the right doses. Can it do significant harm? Sure. So can Ibuprofen.
birdyrooster 6y ago
Seconded on L-Theanine, definitely helps if I get jitters. I usually avoid caffeine bc of this, since the adderall at a correct dose seems to work great but socially it’s hard to avoid caffeine.
- madamelic 6y ago
  I love soda too much to kick caffeine entirely. Never got on the coffee train thankfully. I've tried to kick caffeine multiple times but always fall back during stress. I just can't find another (cheap) drink I enjoy sipping on. My harm reduction is a Soda Stream, which at least lowers my overall sugar intake. I don't understand sparkling water, I've tried it and it is less enticing than plain water.
- rejectfinite 6y ago
  L-Theanine is sadly not sold in Sweden in tablets. I have tried to find. As Tea really has a very calming effect on me.
schoolornot 6y ago
I'm still not sold on the medication and prefer to follow strict routines + good diet + exercise. To me, it's obvious who is taking ADHD pills. People are almost zombie like or they space out, or even on low-doses they almost can't "keep up" in conversation or meetings. Not being drugged and finding coping mechanisms has allowed me to plow through multiple degrees and find career success, albeit at the cost of "other things", relationships, social skills, health, etc. I'm not going to risk my livelihood when life is good-enough atm.
- madamelic 6y ago
  Good for you, I am glad you have found something that works for you. It is inappropriate and rude to assume what others need. I am the complete opposite of what you assume on Adderall, I am more verbose, my thoughts are more coherent and I can keep up with meetings because I can actually pay attention to them. The first time my spouse heard me conduct an interview after medications, he told me how much more cohesive, steady and assured my speaking was. It helps no one, not even yourself, to tear down someone else because they are using a different solution than you.
- q3k 6y ago
  > People are almost zombie like or they space out, or even on low-doses they almost can't "keep up" in conversation or meetings. What you describe sounds more like symptoms of untreated ADHD rather than treated ADHD.
  - borski 6y ago
    This is exactly what I was thinking.
  - novok 6y ago
    Or sleep deprivation...
    - aidenn0 6y ago
      People who are sleep deprived will actually have many of the symptoms of ADHD; poor subjective sense of time, difficulty focusing, &c.
imesh 6y ago
> I don't feel strung out nor is it some addiction. Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you. Even with an addictive personality, it's very easy to avoid over-doing it (hint: only take it as prescribed). Low dose meth does work pretty similar to Adderall. Everyone who does meth does not become a meth addict. Most don't. But the people who become meth addicts are the same people who end up using adderall like methheads. Which is why I personally don't have an Adderall prescription. Because if I have a bottle of Adderall I'm going to attempt a prescribed dose on day one and start snorting it by day three.
- falcolas 6y ago
  To paraphrase, "I think adderall is kinda like meth, so it's obviously addictive." The fuck? Adderall is one of many medical options for treating ADHD. Not all of which are stimulants. And some of which are chemically designed so they can't be abused (like Vyvance). EDIT: The OP pulled the "in my opinion" phrasing from their post, but I'm going leave mine as-is. There's a lot of anecdote based FUD about ADHD meds going on in these threads, and it makes me mad. My above thoughts stand.
  - driverdan 6y ago
    Adderall is 100% addictive and is like meth but with less bio-availability and neurotoxicity. All stimulants are addictive and you will have physical side effects from discontinuing use.
    - username90 6y ago
      > All stimulants are addictive and you will have physical side effects from discontinuing use. I love those side effects though. It is so nice to stop taking them and feel cozy and rest for a few days. The best description I have for it is that it feels like when you get home from a hard days work and are tired and go sit down in your sofa and just relax. Just that the feeling lasts for days! Awesome, right? I hate being on the meds and I never take them when I don't work, but I have to take them to do any kind of work requiring focus like for example filling out a form.
krrrh 6y ago
> caffeine does help from my testing, especially caffeine combined with L-Theanine. One thing that made me look into adderall was finding out I was a slow metabolizer of caffeine via 23andme, and was consuming an unhealthy level of caffeine. I did some research and determined that the health risks of low doses of adderall were smaller than those of high doses of caffeine. Scott Alexander’s review of the research on Adderall are also worth reading: https://slatestarcodex.com/2017/12/28/adderall-risks-much-more-than-you-wanted-to-know/ https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...
- madamelic 6y ago
  >the health risks of low doses of adderall were smaller than those of high doses of caffeine. I hadn't seen that before, so thank you! I ran into this same thing accidentally, I was regularly 'overdosing' on caffeine by drinking 300 - 400mg of caffeine per day in college. The safe dosage is ~200mg for an adult if I recall, but I can only do about 100 - 125mg absolute max or my heart starts pounding. I am not sure if this lowered limit is due to 'abuse' or if I also have different caffeine metabolization. I will have to take a look at my data.
  - krrrh 6y ago
    Yeah, without diving back into it myself right now, the health effects of caffeine are quite different depending on a single SNP. For fast metabolizers some doses of caffeine above 300mg/day can actually have net positive effects on cardiac health, while the opposite is true for slow metabolizers. I got into a habit of 400mg+ doses per day and the cumulative effect that had on sleep quality alone was a good reason to find an alternative. I completely agree with your comments about looking for opportunities to use medication to bootstrap into better habits around exercise, mindfulness, and building better systems and habits.
  - rejectfinite 6y ago
    >The safe dosage is ~200mg for an adult if I recall No? It is 400mg https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20045678 https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...
falcolas 6y ago
> caffeine does help from my testing My doctor put it this way: Caffeine triggers a useful dopamine response, but the side effects are strong at "useful" levels. Ritalin and Adderall provide a stronger dopamine response with fewer side effects at "useful" levels. They're all stimulants, but the magnitude of the useful vs. non-useful effects differs.
- nxc18 6y ago
  For me it’s ~300mg caffeine to almost be as good as 10mg Ritalin, but I have to re-dose the caffeine often. Think a gram or more a day. Both have an impact on cardiovascular health, but my impression is that Ritalin and the like are much safer than what people self-medicate with.
aidenn0 6y ago
> Get diagnosed and get a low-dose of meds. It helps _a lot_. You will likely hate the feeling they give you for the first week (you will genuinely feel high even on 10mg Adderall XR), along with nightmares and night sweats but after a few weeks, you'll suddenly be productive at a very normal level. I wonder if I could have persisted long enough with Adderall to find a theraputic effect if it had been during lockdown. 10mg of Adderall made me unsafe to drive to work (I would suddenly get the subjective sense that my car was completely still and instead all the parked cars on the side of the road were hurtling at me at 25 mph). My doctor actually started me on a higher dose (15 or 20mg maybe?) because I needed such a high dose of Ritalin to get a theraputic effect (and at that high of a dose it greatly impacted my sleep). I took it exactly once and I didn't feel tired for 36 hours and was completely non-productive. For the first time I finally understood what all that clinical language describing the symptoms of a manic episode were all about. Vyvanse did not feel nearly as bad subjectively, but my wife insisted I change meds because I was (in her words) "an asshole" while on it. Finally settled in on 20-30mg of Focalin a day. The year of titrating the doses of each medication was hell. And then when we finally figured it out, my company switched insurers I had to change the pill sizes (not total quantity) to get it covered with the new insurance. The one thing I'd like to add is that diet for me made a huge difference. I might as well not be taking the meds if I have a carb-heavy breakfast. Prior to taking the meds I had quit eating breakfast altogether because I felt like such crap around lunchtime if I ate breakfast. Obviously taking stimulants on an empty stomach is not a great idea, and my psychiatrist helped me out to go for a breakfast that doesn't provoke such a strong insulin response.
- madamelic 6y ago
  > (swapping meds for a year) Definitely feel you there. It's the worst part about psychiatric drugs and why I've bailed on almost everyone I've ever been on. It's that initial hump and having to struggle through ~two weeks of hell. My partner has run the gamut so he constantly assured me it was normal and that I'd be fine. >The one thing I'd like to add is that diet for me made a huge difference. I might as well not be taking the meds if I have a carb-heavy breakfast. Prior to taking the meds I had quit eating breakfast altogether because I felt like such crap around lunchtime if I ate breakfast. Obviously taking stimulants on an empty stomach is not a great idea, and my psychiatrist helped me out to go for a breakfast that doesn't provoke such a strong insulin response. Diet is my next interest but haven't gotten tools perfected to track the variables that I think will be affected (productivity, happiness, energy and sleep). I am vaguely on the train of diet affecting productivity but my daily lunch is a McDouble and large caffeine-free soda to sip on so... non-conclusive currently. I also skip breakfast because of the same reasons (too heavy + no good breakfast foods, even 30-in-30 always slows me down) I have found that many 'healthy' foods make me feel sick or worsen productivity so I am tentatively sticking to my weird diet for now. I have suspicions I may have food allergies and that could be causing it.
disabled 6y ago
> Lastly, caffeine does help from my testing, especially caffeine combined with L-Theanine. I used to take 100mg of HVMN "Sprint" pills as a test whether I had ADHD; it helped quite a bit. It didn't make me jittery and it let me focus much better. Caffeine is an adenosine A2A receptor antagonist. See: https://en.wikipedia.org/wiki/Adenosine_A2A_receptor_antagonist#Caffeine https://en.wikipedia.org/wiki/Adenosine_A2A_receptor_antagon... You may want to check out this paper, Adenosine A2Areceptor as potential therapeutic target in neuropsychiatric disorders: https://scihubtw.tw/10.1016/j.phrs.2019.104338 https://scihubtw.tw/10.1016/j.phrs.2019.104338 Caffeine has a problem though: > Moreover, considering that caffeine has a half-life of 2.5-4.5 hours [137]the once-a-day schedule of administration used in clinical trials in ADHD patients could be insufficient to antagonize A2AR throughout the day; thus, in future trials different administration schedules should be used or, as an alternative, selective A2AR antagonists could be tested in animal models of ADHD. In particular, it would be interesting to test the efficacy of the A2AR antagonist istradefylline in view of its approval for the treatment of Parkinson’s disease in Japan [138]. Ironically, I just started taking Nourianz (istradefylline) (link: https://www.nourianz.com/ https://www.nourianz.com/) as a last-resort drug for my severe restless legs syndrome, which has been going phenomenally well. I also have ADHD combined type (inattention and hyperactivity), and fairly severely. Anyways, I have been taking the the istradefylline for a week now, and it has made a tremendous difference in many of my ADHD symptoms. In addition, it greatly increased my sense of wellbeing within 1-2 hours of initially taking it, and it has been sustained for the entire week. I hope you find this interesting! I take Vyvanse for my ADHD. Thanks to istradefylline I can now focus seamlessly and without effort. I can just "lock in" to whatever I want to do. Before, it would require some static force ("friction") to be able to "lock in" my concentration to do the task. I can also just focus, without hyperfocusing. It now comes naturally to me. I also no longer find myself pacing around the house aimlessly. I also do not randomly get up from my seat or fidget hardcore. I can also lock back into a flow state without effort if I am disrupted.
ryandrake 6y ago
This is a super-edge-case but if you happen to want to be a pilot (either small planes all the way up to airlines), the FAA considers ADHD and other attention-deficit conditions to be disqualifying. If you're taking medication for ADHD or similar conditions and want to be a pilot, you're dead in the water until you get off them and can show that you don't have some kind of attention difficulty. FYI!
- jacques_chester 6y ago
  Personally, as a person with ADHD, I am fine with that restriction.
- renewiltord 6y ago
  Fascinating, but appears to make sense. Hopefully, some day we will be able to quantify the difference so that people like me (who do worry that they can't stay on top of all the details in a plane) are excluded from flying¹ while other people who have a similar condition to mine but are capable of flying are allowed to do so. ¹ As much as I want to.
- madamelic 6y ago
  Almost any medical condition disqualifies you. Almost any medication taken regularly does too. I am interested in getting my private pilot's license and I _should_ be able to get a Class 3 Medical from what I've seen, but that will be a bit away so I have time. What I've seen and heard from others is to just lie. Seems like many have gotten to the point of realizing trying to do it right is only going to put you in months of bureaucracy and spend thousands proving your viability. The FAA needs to figure out how to either commission studies to reduce their list of disqualifications or streamline the process of appealing your medical certification.
  - danaliv 6y ago
    Most common medical history items fall under something called CACI: Conditions AMEs Can Issue. (Yes, that's an acronym in an acronym. Welcome to the FAA. AME is the doctor you see for your flight physical, which you probably already know, but other readers might not.) The vast majority of folks walk out of their flight physicals with a medical certificate thanks to CACI. ADHD does not fall under CACI, and will trigger a deferral to the FAA. The FAA will then refer the applicant to a HIMS AME. (Human Intervention Motivation Study.) HIMS is really about substance abuse, not ADHD, but it's doing double-duty now for things like ADHD and the four conditionally approvable SSRIs. ADHD can also trigger expensive neurocognitive tests ("CogScreen"). So ADHD really is in a separate class of conditions when it comes to getting a medical certificate. Current use of stimulants is a denial no matter what. As a flight instructor I think this is completely bonkers. The nature of ADHD is such that if it keeps a person from being able to fly safely, that will show up during training as a failure to meet performance standards. It's completely different from something like a heart condition, where a pilot will fly just fine until suddenly their heart stops. I've taught lots of folks with ADHD diagnoses; almost all of them did great, and the few that didn't were very obviously not able to handle the airplane.
justasidenote2 6y ago
I'm working on ADHD diagnosis now and my doctor was kind enough to let me begin taking Ritalin and then switch to Vyvanse. Medication is literally, demonstrably changing my life for the better. I used to drink multiple cups of coffee a day and felt like it was almost baseline requirement just to attempt to focus. Actual ADHD medication makes coffee almost obsolete. The first time I took Ritalin it was almost scary to realize how chaotic my mind was minute-to-minute, every day without fail. Suddenly the noise all went away. It feels like I can actually create coherent sentences. I stop getting overwhelmed by asynchronous communications (Slack, email). The "volume" of every single distraction that used to monopolize my attention gets turned way down. Yeah, I still get distracted -- but now it's a conscious choice to either let that distraction take precedent or to re-focus to the task at hand. The day to day benefits are great, but the big picture / life-style benefits are the most appreciated. In general my anxiety and stress management is honestly 10x better. I've gone from being stressed over my career choice every week to finally feeling like I can thrive. I stop getting irritated by the most innocuous things someone might say or do. I stop waking up anxious every weekend trying to process the million things I need to get done just to exist and make forward progress in my life. I could go on and on and on about how "real" ADHD is, without even having a formal diagnosis yet. I'm sure the discussions in this thread regarding the utility and risks of these medications sounds intriguing if you don't have ADHD and already know how to sit still and focus at will. But anyone who doesn't have our experience should understand this shit is honestly helping people live their lives for the better. My only regret is I didn't know sooner.
- madamelic 6y ago
  >My only regret is I didn't know sooner. Yep! Always scored 90th percentile in standardized tests (how? no clue.), curious, the lot... just couldn't care about homework or listening in class. I struggled through 5.5 years of college then years later snapped out of the mindset of "just having to try harder". My parents knew... they had me diagnosed as a kid, but were scared off of stimulants by their church. I try not to think about what my life could've been.
  - core-questions 6y ago
renewiltord 6y ago
How strange. My initial dose made me feel almost sleepy. I'm usually high-energy at night time, but now I go to bed before midnight.
User23 6y ago
> Ignore the people screaming about Adderall being "literal meth" Just a fun fact: Literal meth is called deoxyephedrine when it's prescribed for ADHD. Anyone that was awake for intro Chem will know why.

sneak 6y ago

Counter-anecdata here: meds aren't always the best option for people. Don't bias toward taking amphetamines as the parent comment instructs you to do. There are serious negative long-term effects from taking amphetamines regularly. Such advice as above is very one-size-fits-all, and in my view is thus really bad advice. > Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you. You can ignore those people because they're wrong, amphetamine is not methamphetamine. But do not ignore the people who tell you that even normal amphetamines (adderall) are not harmless. They cause harm, even at low doses. The harm they cause may be mitigated by the benefit they bring; it may also be extremely difficult to estimate their harm in advance. Ceasing regular use of amphetamines for some people can result in subsequent YEARS of oversleeping, lethargy, and depression from dopamine receptor downregulation. > I don't feel strung out nor is it some addiction. Amphetamines are a highly addictive substance, if you are taking them every day it is likely that your body has developed at least some physical dependence upon them. Addiction doesn't make itself known until you stop.

birdyrooster 6y ago
Kidney damage? What effects?
hombre_fatal 6y ago
We're talking about ADHD though, not someone looking to just pull some all-nighters or cram on a Sunday night. When I realized there was a low dose medication that could basically cure me of ADHD (thus cure me of underperformance, procrastinating my ambitions, low professional self-esteem), the choice was obvious. Know what also does harm? Underperformance, procrastinating my ambitions, low professional self-esteem. Far worse than any side-effect from amphetamine. And I'd take on much worse harms if they would cure my ADHD like amphetamine does. Edit: lol, when I started my reply to you, your comment was two sentences long. Take it easy. Btw, I'm in my mid-30s and I've been taking amphetamine since I was 18. Perfect bill of health. Though, granted, there's plenty of life left.
- sneak 6y ago
  Stimulant addictions are one of the most common functional addictions. I don't think most people would consider someone servicing an active physical dependency to have a "perfect bill of health", even if you are totally free from disease.
  - q3k 6y ago
    > someone servicing an active physical dependency to have a "perfect bill of health" Is taking immunosuppressants also a physical dependency or a functional addiction?
  - borski 6y ago
    You are making assumptions the parent did not imply. You can be on ADHD meds and not be addicted to them, ffs. I am on low-dose adderall xr on days that I need it and I have never had an issue. Everyone is different, but to imply that the adderall has caused an “active physical dependency” is no different from stating that too many people drink caffeine (except that because I only take it as needed it’s not even a fair comparison). You’d be right, but it does not do significant harm, especially given how therapeutic the right drug can be in the right doses. Can it do significant harm? Sure. So can Ibuprofen.

birdyrooster 6y ago

Seconded on L-Theanine, definitely helps if I get jitters. I usually avoid caffeine bc of this, since the adderall at a correct dose seems to work great but socially it’s hard to avoid caffeine.

madamelic 6y ago
I love soda too much to kick caffeine entirely. Never got on the coffee train thankfully. I've tried to kick caffeine multiple times but always fall back during stress. I just can't find another (cheap) drink I enjoy sipping on. My harm reduction is a Soda Stream, which at least lowers my overall sugar intake. I don't understand sparkling water, I've tried it and it is less enticing than plain water.
rejectfinite 6y ago
L-Theanine is sadly not sold in Sweden in tablets. I have tried to find. As Tea really has a very calming effect on me.

schoolornot 6y ago

I'm still not sold on the medication and prefer to follow strict routines + good diet + exercise. To me, it's obvious who is taking ADHD pills. People are almost zombie like or they space out, or even on low-doses they almost can't "keep up" in conversation or meetings. Not being drugged and finding coping mechanisms has allowed me to plow through multiple degrees and find career success, albeit at the cost of "other things", relationships, social skills, health, etc. I'm not going to risk my livelihood when life is good-enough atm.

madamelic 6y ago
Good for you, I am glad you have found something that works for you. It is inappropriate and rude to assume what others need. I am the complete opposite of what you assume on Adderall, I am more verbose, my thoughts are more coherent and I can keep up with meetings because I can actually pay attention to them. The first time my spouse heard me conduct an interview after medications, he told me how much more cohesive, steady and assured my speaking was. It helps no one, not even yourself, to tear down someone else because they are using a different solution than you.
q3k 6y ago
> People are almost zombie like or they space out, or even on low-doses they almost can't "keep up" in conversation or meetings. What you describe sounds more like symptoms of untreated ADHD rather than treated ADHD.
- borski 6y ago
  This is exactly what I was thinking.
- novok 6y ago
  Or sleep deprivation...
  - aidenn0 6y ago
    People who are sleep deprived will actually have many of the symptoms of ADHD; poor subjective sense of time, difficulty focusing, &c.

imesh 6y ago

> I don't feel strung out nor is it some addiction. Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you. Even with an addictive personality, it's very easy to avoid over-doing it (hint: only take it as prescribed). Low dose meth does work pretty similar to Adderall. Everyone who does meth does not become a meth addict. Most don't. But the people who become meth addicts are the same people who end up using adderall like methheads. Which is why I personally don't have an Adderall prescription. Because if I have a bottle of Adderall I'm going to attempt a prescribed dose on day one and start snorting it by day three.

falcolas 6y ago
To paraphrase, "I think adderall is kinda like meth, so it's obviously addictive." The fuck? Adderall is one of many medical options for treating ADHD. Not all of which are stimulants. And some of which are chemically designed so they can't be abused (like Vyvance). EDIT: The OP pulled the "in my opinion" phrasing from their post, but I'm going leave mine as-is. There's a lot of anecdote based FUD about ADHD meds going on in these threads, and it makes me mad. My above thoughts stand.
- driverdan 6y ago
  Adderall is 100% addictive and is like meth but with less bio-availability and neurotoxicity. All stimulants are addictive and you will have physical side effects from discontinuing use.
  - username90 6y ago
    > All stimulants are addictive and you will have physical side effects from discontinuing use. I love those side effects though. It is so nice to stop taking them and feel cozy and rest for a few days. The best description I have for it is that it feels like when you get home from a hard days work and are tired and go sit down in your sofa and just relax. Just that the feeling lasts for days! Awesome, right? I hate being on the meds and I never take them when I don't work, but I have to take them to do any kind of work requiring focus like for example filling out a form.

krrrh 6y ago

> caffeine does help from my testing, especially caffeine combined with L-Theanine. One thing that made me look into adderall was finding out I was a slow metabolizer of caffeine via 23andme, and was consuming an unhealthy level of caffeine. I did some research and determined that the health risks of low doses of adderall were smaller than those of high doses of caffeine. Scott Alexander’s review of the research on Adderall are also worth reading: https://slatestarcodex.com/2017/12/28/adderall-risks-much-more-than-you-wanted-to-know/ https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...

madamelic 6y ago
>the health risks of low doses of adderall were smaller than those of high doses of caffeine. I hadn't seen that before, so thank you! I ran into this same thing accidentally, I was regularly 'overdosing' on caffeine by drinking 300 - 400mg of caffeine per day in college. The safe dosage is ~200mg for an adult if I recall, but I can only do about 100 - 125mg absolute max or my heart starts pounding. I am not sure if this lowered limit is due to 'abuse' or if I also have different caffeine metabolization. I will have to take a look at my data.
- krrrh 6y ago
  Yeah, without diving back into it myself right now, the health effects of caffeine are quite different depending on a single SNP. For fast metabolizers some doses of caffeine above 300mg/day can actually have net positive effects on cardiac health, while the opposite is true for slow metabolizers. I got into a habit of 400mg+ doses per day and the cumulative effect that had on sleep quality alone was a good reason to find an alternative. I completely agree with your comments about looking for opportunities to use medication to bootstrap into better habits around exercise, mindfulness, and building better systems and habits.
- rejectfinite 6y ago
  >The safe dosage is ~200mg for an adult if I recall No? It is 400mg https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20045678 https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...

falcolas 6y ago

> caffeine does help from my testing My doctor put it this way: Caffeine triggers a useful dopamine response, but the side effects are strong at "useful" levels. Ritalin and Adderall provide a stronger dopamine response with fewer side effects at "useful" levels. They're all stimulants, but the magnitude of the useful vs. non-useful effects differs.

nxc18 6y ago
For me it’s ~300mg caffeine to almost be as good as 10mg Ritalin, but I have to re-dose the caffeine often. Think a gram or more a day. Both have an impact on cardiovascular health, but my impression is that Ritalin and the like are much safer than what people self-medicate with.

aidenn0 6y ago

> Get diagnosed and get a low-dose of meds. It helps _a lot_. You will likely hate the feeling they give you for the first week (you will genuinely feel high even on 10mg Adderall XR), along with nightmares and night sweats but after a few weeks, you'll suddenly be productive at a very normal level. I wonder if I could have persisted long enough with Adderall to find a theraputic effect if it had been during lockdown. 10mg of Adderall made me unsafe to drive to work (I would suddenly get the subjective sense that my car was completely still and instead all the parked cars on the side of the road were hurtling at me at 25 mph). My doctor actually started me on a higher dose (15 or 20mg maybe?) because I needed such a high dose of Ritalin to get a theraputic effect (and at that high of a dose it greatly impacted my sleep). I took it exactly once and I didn't feel tired for 36 hours and was completely non-productive. For the first time I finally understood what all that clinical language describing the symptoms of a manic episode were all about. Vyvanse did not feel nearly as bad subjectively, but my wife insisted I change meds because I was (in her words) "an asshole" while on it. Finally settled in on 20-30mg of Focalin a day. The year of titrating the doses of each medication was hell. And then when we finally figured it out, my company switched insurers I had to change the pill sizes (not total quantity) to get it covered with the new insurance. The one thing I'd like to add is that diet for me made a huge difference. I might as well not be taking the meds if I have a carb-heavy breakfast. Prior to taking the meds I had quit eating breakfast altogether because I felt like such crap around lunchtime if I ate breakfast. Obviously taking stimulants on an empty stomach is not a great idea, and my psychiatrist helped me out to go for a breakfast that doesn't provoke such a strong insulin response.

madamelic 6y ago
> (swapping meds for a year) Definitely feel you there. It's the worst part about psychiatric drugs and why I've bailed on almost everyone I've ever been on. It's that initial hump and having to struggle through ~two weeks of hell. My partner has run the gamut so he constantly assured me it was normal and that I'd be fine. >The one thing I'd like to add is that diet for me made a huge difference. I might as well not be taking the meds if I have a carb-heavy breakfast. Prior to taking the meds I had quit eating breakfast altogether because I felt like such crap around lunchtime if I ate breakfast. Obviously taking stimulants on an empty stomach is not a great idea, and my psychiatrist helped me out to go for a breakfast that doesn't provoke such a strong insulin response. Diet is my next interest but haven't gotten tools perfected to track the variables that I think will be affected (productivity, happiness, energy and sleep). I am vaguely on the train of diet affecting productivity but my daily lunch is a McDouble and large caffeine-free soda to sip on so... non-conclusive currently. I also skip breakfast because of the same reasons (too heavy + no good breakfast foods, even 30-in-30 always slows me down) I have found that many 'healthy' foods make me feel sick or worsen productivity so I am tentatively sticking to my weird diet for now. I have suspicions I may have food allergies and that could be causing it.

disabled 6y ago

> Lastly, caffeine does help from my testing, especially caffeine combined with L-Theanine. I used to take 100mg of HVMN "Sprint" pills as a test whether I had ADHD; it helped quite a bit. It didn't make me jittery and it let me focus much better. Caffeine is an adenosine A2A receptor antagonist. See: https://en.wikipedia.org/wiki/Adenosine_A2A_receptor_antagonist#Caffeine https://en.wikipedia.org/wiki/Adenosine_A2A_receptor_antagon... You may want to check out this paper, Adenosine A2Areceptor as potential therapeutic target in neuropsychiatric disorders: https://scihubtw.tw/10.1016/j.phrs.2019.104338 https://scihubtw.tw/10.1016/j.phrs.2019.104338 Caffeine has a problem though: > Moreover, considering that caffeine has a half-life of 2.5-4.5 hours [137]the once-a-day schedule of administration used in clinical trials in ADHD patients could be insufficient to antagonize A2AR throughout the day; thus, in future trials different administration schedules should be used or, as an alternative, selective A2AR antagonists could be tested in animal models of ADHD. In particular, it would be interesting to test the efficacy of the A2AR antagonist istradefylline in view of its approval for the treatment of Parkinson’s disease in Japan [138]. Ironically, I just started taking Nourianz (istradefylline) (link: https://www.nourianz.com/ https://www.nourianz.com/) as a last-resort drug for my severe restless legs syndrome, which has been going phenomenally well. I also have ADHD combined type (inattention and hyperactivity), and fairly severely. Anyways, I have been taking the the istradefylline for a week now, and it has made a tremendous difference in many of my ADHD symptoms. In addition, it greatly increased my sense of wellbeing within 1-2 hours of initially taking it, and it has been sustained for the entire week. I hope you find this interesting! I take Vyvanse for my ADHD. Thanks to istradefylline I can now focus seamlessly and without effort. I can just "lock in" to whatever I want to do. Before, it would require some static force ("friction") to be able to "lock in" my concentration to do the task. I can also just focus, without hyperfocusing. It now comes naturally to me. I also no longer find myself pacing around the house aimlessly. I also do not randomly get up from my seat or fidget hardcore. I can also lock back into a flow state without effort if I am disrupted.

ryandrake 6y ago

This is a super-edge-case but if you happen to want to be a pilot (either small planes all the way up to airlines), the FAA considers ADHD and other attention-deficit conditions to be disqualifying. If you're taking medication for ADHD or similar conditions and want to be a pilot, you're dead in the water until you get off them and can show that you don't have some kind of attention difficulty. FYI!

jacques_chester 6y ago
Personally, as a person with ADHD, I am fine with that restriction.
renewiltord 6y ago
Fascinating, but appears to make sense. Hopefully, some day we will be able to quantify the difference so that people like me (who do worry that they can't stay on top of all the details in a plane) are excluded from flying¹ while other people who have a similar condition to mine but are capable of flying are allowed to do so. ¹ As much as I want to.
madamelic 6y ago
Almost any medical condition disqualifies you. Almost any medication taken regularly does too. I am interested in getting my private pilot's license and I _should_ be able to get a Class 3 Medical from what I've seen, but that will be a bit away so I have time. What I've seen and heard from others is to just lie. Seems like many have gotten to the point of realizing trying to do it right is only going to put you in months of bureaucracy and spend thousands proving your viability. The FAA needs to figure out how to either commission studies to reduce their list of disqualifications or streamline the process of appealing your medical certification.
- danaliv 6y ago
  Most common medical history items fall under something called CACI: Conditions AMEs Can Issue. (Yes, that's an acronym in an acronym. Welcome to the FAA. AME is the doctor you see for your flight physical, which you probably already know, but other readers might not.) The vast majority of folks walk out of their flight physicals with a medical certificate thanks to CACI. ADHD does not fall under CACI, and will trigger a deferral to the FAA. The FAA will then refer the applicant to a HIMS AME. (Human Intervention Motivation Study.) HIMS is really about substance abuse, not ADHD, but it's doing double-duty now for things like ADHD and the four conditionally approvable SSRIs. ADHD can also trigger expensive neurocognitive tests ("CogScreen"). So ADHD really is in a separate class of conditions when it comes to getting a medical certificate. Current use of stimulants is a denial no matter what. As a flight instructor I think this is completely bonkers. The nature of ADHD is such that if it keeps a person from being able to fly safely, that will show up during training as a failure to meet performance standards. It's completely different from something like a heart condition, where a pilot will fly just fine until suddenly their heart stops. I've taught lots of folks with ADHD diagnoses; almost all of them did great, and the few that didn't were very obviously not able to handle the airplane.

justasidenote2 6y ago

I'm working on ADHD diagnosis now and my doctor was kind enough to let me begin taking Ritalin and then switch to Vyvanse. Medication is literally, demonstrably changing my life for the better. I used to drink multiple cups of coffee a day and felt like it was almost baseline requirement just to attempt to focus. Actual ADHD medication makes coffee almost obsolete. The first time I took Ritalin it was almost scary to realize how chaotic my mind was minute-to-minute, every day without fail. Suddenly the noise all went away. It feels like I can actually create coherent sentences. I stop getting overwhelmed by asynchronous communications (Slack, email). The "volume" of every single distraction that used to monopolize my attention gets turned way down. Yeah, I still get distracted -- but now it's a conscious choice to either let that distraction take precedent or to re-focus to the task at hand. The day to day benefits are great, but the big picture / life-style benefits are the most appreciated. In general my anxiety and stress management is honestly 10x better. I've gone from being stressed over my career choice every week to finally feeling like I can thrive. I stop getting irritated by the most innocuous things someone might say or do. I stop waking up anxious every weekend trying to process the million things I need to get done just to exist and make forward progress in my life. I could go on and on and on about how "real" ADHD is, without even having a formal diagnosis yet. I'm sure the discussions in this thread regarding the utility and risks of these medications sounds intriguing if you don't have ADHD and already know how to sit still and focus at will. But anyone who doesn't have our experience should understand this shit is honestly helping people live their lives for the better. My only regret is I didn't know sooner.

madamelic 6y ago
>My only regret is I didn't know sooner. Yep! Always scored 90th percentile in standardized tests (how? no clue.), curious, the lot... just couldn't care about homework or listening in class. I struggled through 5.5 years of college then years later snapped out of the mindset of "just having to try harder". My parents knew... they had me diagnosed as a kid, but were scared off of stimulants by their church. I try not to think about what my life could've been.
- core-questions 6y ago

renewiltord 6y ago

How strange. My initial dose made me feel almost sleepy. I'm usually high-energy at night time, but now I go to bed before midnight.

User23 6y ago

> Ignore the people screaming about Adderall being "literal meth" Just a fun fact: Literal meth is called deoxyephedrine when it's prescribed for ADHD. Anyone that was awake for intro Chem will know why.