Just need to vent a little bit to people who get it. I am feeling so overwhelmed and frustrated today. After 4 weeks on 10mg Adderall, I told my psychiatrist it's not working for me except for eating issues, and the days I took 20mg I didn't like how it made my body feel. She replied that I need to do a sleep study and we will up the dosage, and she sent me a bunch of insomnia questionnaires to fill out... I was like ??? I asked her to explain the sleep concern, (I had said nothing about sleep issues) then I asked why we'd increase Adderall after I said the increase from 10-20mg didn't make me feel good, could we try a different compound/brand/immediate release? She then replied, here's Vyvance RX, but still do the sleep study.
So I went to pharmacy this morning and was stunned that my total was over $300.... I think the Adderall was like $5. We checked my insurance, same (I just upgraded to more expensive health insurance/better coverage!). I asked them if I could try just 3, they said it would void the rest of the RX, but I said whatever. (I both hope it works and that it doesn't: trying to swallow the reality of paying $300+ on meds every month is.... a lot. ugh). Why wouldn't she have mentioned a possible jump in price? I think maybe she went to Vyvance because it's used for binge eating disorder, but I think other appetite suppressing ADHD stimulants would have been a decent thing to try next. She just didn't even take the time of day to walk me through the options; I'm doing all the research myself.
Someone from the clinic called me a little later to ask about a follow up appointment and so I was able to request a transfer to a different psychiatrist. So I hope to work out a new plan with them as soon as possible. But like, WTF!?
I have crashed so hard emotionally the last couple of days. The last weeks I have only been ok when I am distracting myself for hours and hours on end, obsessively looking for Valentine's day decorations (and spending money)... when I have a TON of work to do. I am self employed so the only one to answer to is myself. I am in therapy. I am on Bupropion. I put a lot of effort into tracking how things are going, reading books, processing - I do the emotional work. I wanted so badly for Adderall to work, and it just didn't help with the emotional dysregulation, the overall mentally chaotic, the inability to do what I need to do. I am living inside a rock tumbler.
Lately, I reviewed my old journals from up to 12 years ago. It's so sad: the same rollercoaster of wanting "peace" "gounding" "stability" "consistency" -- and then having little spurts of "I'm doing good! Let's Keep it going! Please don't mess up this time! Please let it stick" only to plummet back. Part of the reason I sought out an ADHD evaluation was because I've known these things are always something I've battled with, but seeing it in writing, year after year, made me so sad and further hopeless. I know medication can take time, and it's not 100% solved by meds, but days like today I am drowning. It doesn't help to know it takes time.
This article below was enormously useful for me and I feel really sums up what my issues are. I feel like ADHD is all about dysregulation (which is super duper NOT what most people, myself included, think it is). Can't regulate what we tune into, what and how seriously things affect us, etc.
Hi Harriet, Sorry to hear about your struggles. I read the Signs of ADHD article by William Dodson, M.D. that you linked to and thought it was interesting but poorly written, actually incredibly poorly written for someone on an ADHD medical review panel. For example, Dr. Dodson writes "98-99% of adolescents and adults with ADHD acknowledge experiencing RSD" and that "60% experience robust benefits when both [guanfacine and clonidine] are tried." It really frustrated me when people who should be experts just throw out numbers that clearly are almost nonsensical, like 98-99% (why include a range when these numbers are likely based on a single [and uncited] study and then conflate that value with a 60% of the people who experience RSD] to the extent that they would get treatment. Sounds like Dr. Rodson is just trying to get people to try guanfacine and clonidine. Poopers, I read that article and it made me want to try guanfacine - something that I have wanted to try for around a year due to a number of studies that seemed to indicate that it might be helpful in my case. BUT, but but, I don't want to take any more meds, especially when the benefits may not be clear and the costs - as in the case of yours (and mine) $300 Vyvanse indicates. I also was shocked and outraged at the high cost of Vyvanse and then paid out of pocket but found it did little. I have also tried varying doses of Concerta, Adderal, Ritalin, Aptensio XR, and others with minimal benefit. Maybe, I don't have ADHD? But, wow, I was struck that you have been able to journal for the past 12 years, or that you even have a journal 12 years ago. I have tried and tried and tried to journal but I can never seem to get past the second or third page. Again, and again. And, I can't seem to use a calendar or a planner, and I am so incredibly sensitive to any criticism or even positive feedback that I almost certainly have RSD, and sorry, I am ranting as well now too but I just wanted to say that I hope that you are able to get out of the rock tumbler soon. I like the analogy you used as it is amazing how awesome previously rough rocks can look after coming out of a tumbler. Best of luck!
Sorry the article was frustrating! And that your journey on medication has been long and somewhat fruitless. Ugh I can imagine how disheartening that's been. I wonder if you like your psychiatrist and if you could ask about the supplements you mentioned? But I hear you in not wanting a huge med cocktail.
Maybe it'd be more accurate to say I'm trapped in a rock tumbler 😅 waiting for it do actually work and let me out, cleaned up.
Also, journaling has been VERY off and on. It's only 3 books spanning 12 years. But yes, it's valuable to me.
I know that Vyvanse has a good track record, but it is expensive. I don't think that there is a generic form of it, and there might not be for years.
There are other, less expensive ADHD medications. I understand the stimulant meds to be in two families, related to either Adderall or Ritalin. If Adderall didn't work well for your, maybe Ritalin will. (There are generic forms of both, which can help save on cost. Sometimes generics don't work exactly the same as the same dosage of the name brand drug. Sometimes insurance companies are particular.)
There are also non-stimulant meds for ADHD, and med combinations which help many people with ADHD.
I hope that changing psychiatrists goes well for you.
Adderall XR was the first ADHD medication that I started on as well. 10mg met my needs only halfway. 20mg wasn't any more effective and gave me the side effect of tachycardia (elevated heart rate).
I have the ADHD Predominantly Inattentive presentation (no Hyperactive-Impulsive traits at all). I remembered reading somewhere that the non-stimulant medication Strattera (atomoxetine) can be effective for people with the Inattentive presentation, so I asked my doctor to switch my medication. He put me on a generic, which cost me no more than $30 per month on my old health insurance plan (now only about $5 per month on my current health insurance), whereas the brand name Strattera might cost me up to $200 per month. As a bonus, because it's not a controlled substance, I can get a 90-day refill, not just 30-days at a time like Adderall.
Atomoxetine is much more effective for me than Adderall ever was. It addresses all of my ADHD traits (inattentiveness, distractibility, working memory issues, and a variable sense of time).
There's another condition that well-known ADHD researcher Dr. Russell Barkley has talked about called sluggish cognitive tempo (SCT). It presents similarly to Inattentive ADHD, but it's distinct, yet the two conditions are often comorbidities with each other. In addition to ADHD, I meet all the criteria for SCT (by self-assessment).
SCT is not a recognized diagnosis yet (not listed in the DSM-5), but has been studied for the last few decades. According to Dr. Barkley, research shows that it is well-treated with atomoxetine. That may be why I respond so much better to atomoxetine than I did to Adderall XR.
I feel this in my BONES! This week has been an absolute nightmare. I was doing SO GOOD the first few weeks on meds then they just STOPPED working or so I felt. I then asked for an increase from my doctor and it worked for maybe 2 days and then back to it doing nothing other than maybe slightly managing the noise in my head better. I think I had expectations that these meds would be a miracle and they’re really not abs it’s disappointing. I don’t want to keep going up and up for it to just do something for a few days and then not much after. It’s super frustrating process and I feel everything your saying aka hyper focus and just general feelings of being extremely overwhelmed even tho like… there isn’t anything TRUELY stressful in my life rn.
Ugh, I'm sorry! I hear you. Everyone has to be on their own journey, which I know isn't useful at all to hear!! One thing I tried to do was watch the first med (Adderall) throughout my cycle, because hormones can really affect ADHD symptoms and I've read, thus, the medication efficacy. So I am going to try each med for a month-ish (unless I have any terrible side effects obviously.) I do have a difficult time discerning, is today's productivity because of the meds, or just a good day/interesting/urgent thing?? So keeping a journal and having a few questions I can answer each day has been helpful (especially considering the bad memory!).
It's really, really disappointing to go on the rollercoaster of hope and no results from a new med. Some people say it's night and day difference... and I will continue to wish at least some version of that for you and for me! And anyone else starting the med trials.
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