4 ms·

There are non-amphetamine medications available now that might work for your brother, and cognitive-behavioural therapy can really help too.

s5300 4y ago
While this is true, it is also true that Amphetamine is the Powerhouse of the Cell
- Shared404 4y ago
  angry mitochondria sounds play in the background
DannyBee 4y ago
+1 After 30+ years, I have found the non-amphetamine medications work a lot more consistently and helpfully than the amphetamine ones. The one downside is that if your brother also ends up on SSRI's, he won't be able to use most of the non-amphetamine medications until he is done with SSRI's.
- PragmaticPulp 4y ago
  > After 30+ years, I have found the non-amphetamine medications work a lot more consistently and helpfully than the amphetamine ones. I've watched a lot of friends go through the same cycle: Initial excitement from an Adderall prescription which gradually gives way to tolerance and a mismatch between reality and their perceptions of Adderall as a miracle pill. The non-stimulant medications have worked wonders for a lot of people I know. The catch (and it's a big one) is that they generally don't work immediately. In fact, they can be kind of unenjoyable for the first weeks or months while they begin to work. This is the exact opposite timeline of stimulants, which puts a lot of people off. If you can gradually titrate up and you're willing to give it a multi-month trial before ruling it out, the non-stimulant medications can actually be quite good. Some times better than the stimulants at controlling impulses and improving cognition, even. First-time stimulant users can easily get sidetracked by focusing too much on distractions. The other catch is that it's hard to objectively evaluate the positive changes when they happen gradually over the course of a month. A lot of Straterra (Atomoxetine) users will think the medication isn't working, but when you ask them to objectively walk through their daily routines and work performance they realize they've improved tremendously. For others, they don't realize the benefits until the quit the medication and lose the positives, at which point they're back for round 2 of titration.
  - DannyBee 4y ago
    Yes, exactly this. Straterra/others are interesting in that way. As you say, you don't get the immediate on/off feeling you do with amphetamines, which makes sense because of how it acts, but is a weird thing for those not used to it. Having had to switch on and off it a few times over 30 years for various medication complexities, as you say, you notice a few days later when it's gone.
treeman79 4y ago
Any recommendations? I took one that you take at night. It slightly improved my focus during day. But would leave me sleepy all day. Even with taking it before bed.
- thethethethe 4y ago
  Wellbutrin worked wonders for me. Works immediately, similar to amphetamines and is easy to obtain legitimately.
  - chimeracoder 4y ago
    > is easy to obtain legitimately. Depends on the country. In Europe, it's not so easy. In the UK, the last I checked, it was contraindicated for long-term use, meaning it could be used for smoking cessation but not for long-term ADHD treatment. > similar to amphetamines Wellbutrin has a very different mechanism of action, and a different effectiveness profile. I wouldn't say it's "similar to amphetamines" in any clinical sense.
    - thethethethe 4y ago
      I was just saying it is similar on the sense that it works right away and has a noticeable effect, unlike other depression meds that people take, like SSRIs which take months to kick in
    - professor_meow 4y ago
      > In the UK, the last I checked, it was contraindicated for long-term use, meaning it could be used for smoking cessation but not for long-term ADHD treatment. It is not a typical treatment, but a psychiatrist in the UK does have the discretion to prescribe Bupropion off-label. In my own n=1 experience, as a fourth option, only after unsatisfactory trials of more traditional stimulants and Atomoxetine.
  - jstarfish 4y ago
    A counterpoint from my own experience: For me it was like rediscovering caffeine for the first time, which lasted about six months altogether. Then the positive effects waned and it became a self-inflicted case of acid reflux. Would never describe it as being similar to amphetamines. The most praise I can give it is as "an antidepressant that kinda sorta works."

s5300 4y ago

While this is true, it is also true that Amphetamine is the Powerhouse of the Cell

Shared404 4y ago
angry mitochondria sounds play in the background

DannyBee 4y ago

+1 After 30+ years, I have found the non-amphetamine medications work a lot more consistently and helpfully than the amphetamine ones. The one downside is that if your brother also ends up on SSRI's, he won't be able to use most of the non-amphetamine medications until he is done with SSRI's.

PragmaticPulp 4y ago
> After 30+ years, I have found the non-amphetamine medications work a lot more consistently and helpfully than the amphetamine ones. I've watched a lot of friends go through the same cycle: Initial excitement from an Adderall prescription which gradually gives way to tolerance and a mismatch between reality and their perceptions of Adderall as a miracle pill. The non-stimulant medications have worked wonders for a lot of people I know. The catch (and it's a big one) is that they generally don't work immediately. In fact, they can be kind of unenjoyable for the first weeks or months while they begin to work. This is the exact opposite timeline of stimulants, which puts a lot of people off. If you can gradually titrate up and you're willing to give it a multi-month trial before ruling it out, the non-stimulant medications can actually be quite good. Some times better than the stimulants at controlling impulses and improving cognition, even. First-time stimulant users can easily get sidetracked by focusing too much on distractions. The other catch is that it's hard to objectively evaluate the positive changes when they happen gradually over the course of a month. A lot of Straterra (Atomoxetine) users will think the medication isn't working, but when you ask them to objectively walk through their daily routines and work performance they realize they've improved tremendously. For others, they don't realize the benefits until the quit the medication and lose the positives, at which point they're back for round 2 of titration.
- DannyBee 4y ago
  Yes, exactly this. Straterra/others are interesting in that way. As you say, you don't get the immediate on/off feeling you do with amphetamines, which makes sense because of how it acts, but is a weird thing for those not used to it. Having had to switch on and off it a few times over 30 years for various medication complexities, as you say, you notice a few days later when it's gone.

treeman79 4y ago

Any recommendations? I took one that you take at night. It slightly improved my focus during day. But would leave me sleepy all day. Even with taking it before bed.

thethethethe 4y ago
Wellbutrin worked wonders for me. Works immediately, similar to amphetamines and is easy to obtain legitimately.
- chimeracoder 4y ago
  > is easy to obtain legitimately. Depends on the country. In Europe, it's not so easy. In the UK, the last I checked, it was contraindicated for long-term use, meaning it could be used for smoking cessation but not for long-term ADHD treatment. > similar to amphetamines Wellbutrin has a very different mechanism of action, and a different effectiveness profile. I wouldn't say it's "similar to amphetamines" in any clinical sense.
  - thethethethe 4y ago
    I was just saying it is similar on the sense that it works right away and has a noticeable effect, unlike other depression meds that people take, like SSRIs which take months to kick in
  - professor_meow 4y ago
    > In the UK, the last I checked, it was contraindicated for long-term use, meaning it could be used for smoking cessation but not for long-term ADHD treatment. It is not a typical treatment, but a psychiatrist in the UK does have the discretion to prescribe Bupropion off-label. In my own n=1 experience, as a fourth option, only after unsatisfactory trials of more traditional stimulants and Atomoxetine.
- jstarfish 4y ago
  A counterpoint from my own experience: For me it was like rediscovering caffeine for the first time, which lasted about six months altogether. Then the positive effects waned and it became a self-inflicted case of acid reflux. Would never describe it as being similar to amphetamines. The most praise I can give it is as "an antidepressant that kinda sorta works."