Why is Adderall working inconsistently? Sometimes works great, sometimes does nothing, sometimes makes symptoms worse

[Zoe5267]

Hello, I have been recently diagnosed with combined type ADHD and have been taking Adderall for about two months.

I had a diagnosis from a psychiatrist but I also did the full five hour neuropsychological testing and it came back with very high scores for ADHD. Including a significantly lower score on working memory compared to the other sections of the IQ test.

I started with 10 mg instant release Adderall which seemed to have no effect except making it a little bit harder to study the first week. I felt like I couldn’t think as well. 10 mg of Adderall extended release did nothing but two 10 mg pills did. I noticed that I was able to enjoy vacation and relax with family and enjoy their company. Usually I am rigid and distracted and find it hard to pay attention for very long when somebody is speaking. Or I’ll have to be doing something else at the same time. On the 20 XR I was able to play games and even play

With my daughter which is usually very hard because it doesn’t keep my attention and I just start thinking of everything else I have to do. I was able to stay engaged at a three day conference which required sitting still for most of the day which would’ve been a nightmare before.

7.5 mg instant release twice a day worked very well but it would only work for about four or five days and then it would either do nothing or my symptoms would be worse. It was like it was borrowing focus and alertness and emotional stability only to have to pay them back later in the week. The first couple of weekends this happened I just felt tired and had all of my usual ADD symptoms. But then wone weekend I felt totally crazy. I had severe brain fog and was reacting to everything and crying. I felt very confused and sad. And lightheaded.

This was the point that the doctor said well that sounds like what happens whensomebody who doesn’t have ADHD takes the medicine.

He decided to try me on Ridellan 5 mg twice a day and then increase it in a few days if there are no side effects.

So my question is has anybody had a similar experience and then found a different class of stimulants that works for them? Because I think he is right to suspect that, but the diagnostic process was very thorough. It seemed like the Adderall was sometimes making my working memory worse even though it was low in the first place. I had trouble taking tests for school. I felt even slower than usual and misread questions.

And if it were the case that I actually didn’t have ADHD, why would the medication work the majority of the time to make me feel much more stable and eliminate ADHD symptoms and then suddenly not work or make me feel crazy?

I also tried 20 mg extended release in one single capsule which made me feel super anxious and made my jaw very tense. This seemed very strange because I had previously taken two 10 mg capsules extended release. Perhaps it was a different generic manufacturer?

The other factors that I considered were: Menstrual hormones, and outside stressors such as school and moving houses. Any thoughts?

[mrturner8341]

I was diagnosed at the age of 34 and have used Adderall XR and IR successfully in the past four years. At the beginning of last year I noticed some inconsistency in the meds performance throughout the day that had not happened before. I thought back to anything that changed and started working with my PCP with bloodwork, etc. I now know the Liletta IUD I had implanted 18 months ago was causing progestrin suppression. I had the IUD removed on Monday of this week. I can feel an immediate improvement. My OBGYN did not seem aware of the connection and the adhd support sites I found the information on said it is very common for ADHD females to have to educate their OBGYN on this matter as it has not been looked at until recent years in the field of medicine. He did a FSH check on my estrogen levels and said they were in the lower range and the IUD could be suppressing my estrogen too much. This was creating intense menopause symptoms among other things. If you feel that you had successfully found a dosage that was working for you and you suspect the possibility of hormone imbalance, I would personally start there. Here is a link I found helpful.

chadd.org/adhd-weekly/chang...

[Zoe5267 in reply to mrturner8341]

Very interesting! I have an IUD but it is the non-hormonal copper wire one—Paraguard. I suspected it was making me have more emotional periods even though the doctor said, “no, that can’t happen, because it’s non-hormonal.” But it definitely causes physiological changes and the body is a single system. So why not? I will look into it. Thanks so much!

[DuckDogMom]

I took Concerta for several years with fabulous results - when it became available as a generic it still worked for a while and then all the sudden it didn't. I talked with my pharmacist who told me that initially the same manufacturer made both the brand and the generic, but now there were other manufacturers making the generic and they didn't use the same delivery system (it's patented) and that could be why I was getting inconsistent results. My insurance won't cover brand if generic is available so now I am taking Vyvanse but it's not as effective as Concerta was. I don't know if Adderall has a generic so I don't know if that could be what is going on with you. I do know some people do better on one class of stimulants than another (I think the two classes are methylphenidates and amphetamines) and some people don't do well with stimulants at all and have to take other types of meds. I had the tense jaw the first few weeks I was on Concerta and then it went away - I haven't had it with Vyvanse. And I agree - hormones are also a factor.

[Zoe5267 in reply to DuckDogMom]

Good to know; yes, Adderall has a lot of generics as well. I just checked my bottles and found 3 different manufacturers. That’s crazy that they’re allowed so much variance.

[Gentlemanly_ink]

Hi - one thing I've experienced with generic amphetamine salts (XR) is that the meds produced by one manufacturer may not give similar results for the same dosage of the same meds for another. I discussed this with both a pharmacist and psychiatrist and they agreed the poor results I was having could have related to this variance. So, if you're on a steady medication / dose, it might be worth tracking the manufacturer for each filled Rx - it's right on the bottles I get from my pharmacy.

[Zoe5267 in reply to Gentlemanly_ink]

Ok thanks, I will definitely bring this up with the doc!

[PJTJ in reply to Zoe5267]

I second this- the generic had very different effects for me. Also second a response above- hormones seem to have a huge potential variation in symptoms but vastly ignored by many doctors. Not surprising and very frustrating.

[caringdoc2]

research info regarding medication and dosing, Check Dr. Dodson research.

I went through medical school with undiagnosed ADHD. was diagnosed in my 50 , with the right medication and correct dosing it was like night and day. You need to do your research, you can find the correct medication.