ADHD and Addictions

[rmsmi28]

A couple of quick questions: First, has anyone ever had an issue where they feel that their doctor has them on too low a dosage and refuses to increase it claiming that anything above my dosage increases my chances of developing side effects? I am currently on 30 mgs (which, to be fair is, several milligrams more than the 5 that she started me out on) of Adderall XR and have not really felt any benefit from the medication. Standing at 6'4" and weighing a little over 300lbs, I feel that this dosage is much too low, especially considering that really has not been a general over all improvement. While I understand that the medication is not designed to make my symptoms completely disappear, I did think that it would reduce them even just a little. Trying other medications is not feasible at this time as my insurance will only cover the cost of the Adderall.

My second question relates to ADHD and addictions. In addition to my recent ADHD diagnosis, I also suffer from depression and anxiety. When my therapist and I talked about my recent diagnosis, she asked me if I was addicted to anything, especially anything outside of the normal addictions (i.e. drugs and/or alcohol) as these are often common comorbities associated with ADHD. After mulling over the question for a bit I realized that I definitely was. I had several: porn, masturbation, food, and the internet. Has any of you here had any similar experiences or addictions and if so, what did you do to either quit them altogether, or at least reduce the frequency with which you engaged them?

Thanks for listening and I look forward to your responses.

[Gettingittogether]

Yes, people with ADHD are very susceptible to addictions of all kinds. Also depression untreated can lead to addictions.

Sounds like you need to be treated for depression ... and addiction ... and sounds like you need to switch meds ... Your doctor is basically right: at a certain level you tend to get side effects and if you're not feeling like Adderall XR at 30mg isn't working, then it's smart for a provider to not go beyond that. Personally, I used to get sleep problems at 30mg Adderall ... though that doesn't happy for all people.

But try out different meds ... What does your provider suggest? You can try out the Ritalin class of meds (methylphenidate) ... or other amphetamine meds like Dexedrine and Vyvanse ... You probably need to be going to therapy ... as well ....since you have a lot going on, therapy makes is much easier to take on the range of problems you are facing.

Good luck.

[rmsmi28 in reply to Gettingittogether]

Thanks for the reply. I appreciate it. They suggested some strategies for trying to manage my symptoms, such as having a reward system in place where I reward myself for staying on task for a specific length of time. Sometimes these work, but not very often. I have also found that they do not work very well when I am trying to organize and write the chapters for my dissertation. This is especially apparent when I find myself going back and changing the opening of the chapter for the umpteenth time. I really do not want to up my meds considering that I am wary of the side effects as well as possible interactions with my other medications. Directly referencing my dissertation she suggested that I take sometime away from it, but I have already delayed this to the point where I cannot do so anymore as my timeframe allotted by the Graduate School expires next spring.

As for other medications for ADHD, I am stuck with Adderall as that is the only medication my insurance will cover, the rest I have to pay out of pocket, which would not be an issue if I was still teaching, but in my program they do not assign you classes to teach so that you can spend your time working on your dissertation, although they still expect you to pay your tuition (even one credit costs close to $2000) but that is another issue altogether.

[BlessedLady]

You can change doctors. But based on your history. another doctor might be as cautious as your current one. There are other medications for ADHD that are not drugs of concern.

[rmsmi28 in reply to BlessedLady]

Thanks for the reply. I appreciate it. I understand why they are being cautious and I appreciate it. Moreover, it took me months to find this doctor and so I really do not want to change doctors at this time. (Ideally, I would love to switch insurances, but that would incur another $1500 fee on my tuition bill.) Moreover, my insurance is the only one the insurance will cover. Trying to find a therapist that will help me with my addictions is turning into another nightmare.

I have tried some of the strategies that my doctor has suggested and they work for awhile before I grow frustrated with them and myself. Moreover, in some instance they are really hard to implement, especially when trying to organize and write my dissertation chapters. If you have any strategies, I am more than willing to listen.

[Funkatdelic]

Hello,

I'm in agreement with the others. There are a lot of "comorbidities" (fantastic word, rite?!) with ADHD and addiction is a biggie. Which can also loop in to your question about your meds. Most ADHD medication is a "controlled" substance (where I'm from, anyway), so it makes sense that your doctor would be concerned in you have a tendency to self "medicate" (even if it's not with what we'd typically consider "medication") and/ or use other "escape" strategies to try to deal. I would hope that any other doctor would also be hesitant to just up your meds.

I don't have insurance so have to pay out of pocket for my meds. It sucks, but I realised I had to subcontract so much work out because I was incapable of doing it, that the money to pay for the meds was less per month than what I was loosing in work. I was also taking a huge hit on my relationships and self esteem, so I also suggest that your sanity/ mental health is worth the dollars.

I have a friend who first tried Biphentin and it wasn't working for him, so he switched to Concerta and he swears by it even though they are the same drug (methylphenidate). Apparently they release the methylphenidate differently.

My doctor started me on two weeks at a time with my meds, so I wasn't shelling out an entire month's worth right away. You might consider this strategy.

How much is ADHD effecting your life? Relationships? Your work (or potential for work)? How much is that worth to you?

[BlessedLady in reply to Funkatdelic]

Have you tried Prescription Discount Cards? A friend of mine paid $60 for Dextroamphetamine with one. Without it her medication would have cost $260 and up. Her pharmacist looked for the one that saved her the most.

[rmsmi28 in reply to BlessedLady]

Thanks. To be honest, I never even heard of them before but are definitely something worth looking into. Thanks for the suggestion.

[Francescatya]

My addictions vary. When I quit heavy drinking last year I felt liberated. Then the honeymoon period ended. I drink now although I only have a couple a week, and I don’t binge drink anymore. But now I have a shopping addiction, particularly online shopping. I had to return something yesterday and I was almost relieved, I felt like I got a second chance to rethink that somewhat impulsive purchase. On The flip side I’ve become sort of addicted to my hobbies (music creation) and I hyperfocus intensely on playing my bass for example. It’s always something.

[wtfadhd]

good morning rmsmi28,

The only thing all of us ADHDers have in common is that our brains do not create dopamine….. and that creates total havoc on our lives because we then try to create it for ourselves by trying whatever we might like based on our individual wiring n situation( swimming, gambling, eating, self deprivation, drugs, religion, cleaning, bideo games, tobacco, sex with self, sex with others, lol) you get the point.

what was your medical providers point about asking if you had other addictions? ?!?!?! when you listed off tons of other addictions- that was a HUGE indicator that your brain is just not getting enough dopamine on 30mg. in terms of meds, the sweet spot for each of us is when the dosage is correct n we can finally focus on productivity vs constantly in a state of starving for dopamine n doing dumb shit to create it.

also- 60 mg of Adderall xr is the recommended max dose. you are only 1/2 way there, sorry u r struggling🥲. advocate for yourself.

[Hidden]

Change providers, go outside, exercise and stop feeling guilty for who you are. One more thing quit mulling over it. I know it makes you feel bad and invalidated but put on your sun glasses and ride out into the sunset like a badass. Everything will work out.

[Hominid711]

My first reply was censored. Probably the word 🪱🌾⚒️Anyway, these are not addictions but at worst compulsions. At best a good and healthy way to reduce tension. Masturporn at least.

Increased Adderal helps with weight and an SSRI or SNRI with depression/anxiety and reducing libid0 if that's what you want.

[Hominid711]

Something else I read in a medical journal:

"The bioavailability of Vyvanse is greater once it is digested; it becomes 100 percent dextromethorphan, a potent amphetamine stimulant. Adderall, in contrast, is only 75 percent dextromethorphan."

Which means 70mg Vyvanse/Elvanse (the usual maximum dose) is equivalent to 52.5mg Adderall.

Tell that your doctor!

And ask for 50mg Adderall XR.