Can you develop an Adderall tolerance?

[SuzanneRhoden]

About 10 years ago, at age 45, I was diagnosed with ADHD. It seems that I was the only one in my life that was surprised. I was given Adderall and the change in focus was amazing! The weight loss was an added benefit and for the first time in my life ate "normally" without slipping meals or dieting and lost from 235 down to 180. I felt so much better. Then about 5 years ago, it stopped. My weight began to slowly creep back up and no matter what I do, I can't lose it. I am now at 210. I have read about resetting your system for Adderall tolerance. I teach, so I took a break from it for 2 months in the summer, but nothing changed. I know it isn't a weight loss drug, however I really miss that side effect.

[Ripplex]

Yes I've been on and off adderall because your body does build up a tolerance to it. So I have to switch between adderall and Vyvanse once the dosage amount gets to high. I've only noticed the weight loss when I first started taking adderall years ago now it seems like that affect has no effect on me anymore. But I have kids now and that seems to remind me to eat more. As when I didn't have kids and I was on adderall the thought of food never seemed to cross my mind. You might want to give vyvanse a try it's more expensive than adderall but I feel that I can get more things accomplished when I'm on it as were adderall is like running on a hamster wheel all the time especially with your thoughts. Hope this helps

[BatWoman87]

Thanks to both Suzanne and Ripplex for your insight. I am newly diagnosed (33), have a weight problem and am using Noom, slowly but successfully (for now!). Your experiences are really helpful for me to understand and anticipate in advance of starting medication.

[minutiaepast]

This can happen to some people with long term use, yes. There are ways to work through it without ceasing treatment periodically.

Adderall and other amphetamines dump dopamine and serotonin into the limbic system of the brain. Dopamine is responsible for the reward seeking and attention management aspects of stimulant therapy.

1. L-Tyrosine (or the n-acerylated version), a precursor to dopamine, and a supplement available OTC.

It's been suggested by doctors and patients alike that it can help with providing more base materials to build up those neurotransmitters, thusly allowing your medication to dump more of them, and in turn, increasing binding frequency/signalling.

2. Flaxseed oil or omega-3 fish oil with a high EPA dosage or EPA:DHA ratio e.g. 300mg each, or 3:1. Often touted for 'general health,' and available in stores everywhere OTC.

The EPA in it also acts on the brain to modulate serotonin. Serotonin, well known for improving mood, I believe does so in part through modulation of dopaminergic systems in the brain. That is, increasing serotonin signalling will cause more dopamine to be released.

The mechanism for this isn't the same as with amphetamines, but rather indirect. This could be useful with L-Tyrosine for those who are experiencing dopamine desensitization, which is speculated to underpin tolerance in long term use, at least in part.

Finally, non-conventional advice I have is related to that desensitization. A contributing homeostatic mechanism is reduced receptor density.

3. Naltrexone is an opioid antagonist most known for helping those with addiction. A less common use is at very low doses wherein it produces paradoxical effects.

Instead of persistently blocking opioid receptors, it glances them so minutely that this somehow causes the opposite effect! These neurons will start _releasing_ endorphins, apparently realising there is an imbalance finally.

It just so happens that there are also dopamine receptors on the same neuronal projections that are similarly effected, but also, critically, something amazing happens here... the signalling potential when activating receptors are bound to is reset, allowing opioid and stimulant medication to work better.

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I've personally tried all of these and can attest to their effects. I would _not_ recommend adding all of them at once though.

The most helpful here would be the low-dose naltrexone, however, it's by rx only. It's also little known, and you'll probably have to educate your psychiatrist on it, as they won't know of this use case. Mine didn't, but was perfectly happy to prescribe it once he understood the theory behind it, and figured it'd do no harm.

Unfortunately, a normal pharmacy isn't going to carry the dosages you'll be taking, and it will have to be sent to a compounding pharmacy to be custom made. This isn't covered by insurance.

A month supply ran me around $65. I titrated up from 1mg up to 4mg by 1mg at a time, every 2 weeks, and then left myself there for a month, finally reaching maximal effects and stabilization. (Likely, I could have tapered down and discontinued it at that point, but I was also taking it for seasonal depression, and won't be doing that for a few more weeks

The reason I wouldn't recommend taking these all together is due to the potential for side effects. You might wind up as you were when initially starting stimulant therapy.

To make this as comfortable as possible, it's always best to slowly titrate from a low dose. L-Tyrosine (non-acetylated) is often sold in 500mg capsules. I started at 100mg by opening the capsule and weighing out the equivalent of 100mg in another capsule, and similarly took that for a week before increasing by 100mg thereafter and each subsequent week. A little can go a long way, though I am a pretty sensitive person to dopamine activity due to low-active COMT genotype [1].

Timing is also important. I'm not sure why taking it in the later afternoon helped reduce side effects, as I'd figure that it building up through the night would still result in it getting dumped the next morning, but that's how it happened for me. Play around with it and see what works for you!

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While I'd love to say to talk to your doctor about all this, it's my experience that doctors don't really know anything beyond the standard rote stuff they're taught in medical school. None of this is, and is rather experimental as far as treatment effectiveness alterations go.

So while it _could_ be useful to run weird ideas like these by them to ensure you aren't doing something dangerous, I find that 100% of the time they have nothing to say and no insight to add, thus my confidence in their abilities to actually solve my problems is extremely limited.

I thank them for giving me access to important medication, but even that feels like a waste of time from a efficiency perspective when I've done more research than they have on my conditions and the medications I use to treat them.

That said, if you're not a drug research nerd like I am, you absolutely should talk to them about a supplement stack you intend to take when also on powerful psychoactives that affect the same brain subsystems.)

~erin

1. healthunlocked.com/adult-ad...