In what way have ADHD meds impacted your life / work / home / relationships etc? Did they exceed or fall short of your expectations?
What advice would you give someone who was starting ADHD meds for the first time? (I’m in the UK, but open to hear about all experiences)
TIA 🙏🏼
My Advice: Keep a journal of your experience. Note any changes (good or bad) and how big the changes are. I did this, and it really helped in follow-up appointments with my doctor.
My Medication Experience:
Adderall XR was only somewhat effective for me. Increasing the dosage didn't increase the benefits, and caused a concerning side effect.
I convinced my doctor to try me on a non-stimulant, Strattera (I'm actually on a generic form of the same medication, atomoxetine). It's been twice as effective as Adderall was for me!
While my ADHD struggles aren't gone, I'd say that they are about 85% reduced from my unmedicated norm.
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I have also learned that I need to keep anxiety and depression under control. They cause my ADHD severity to magnify. I'm on a mild antidepressant right now. It's the second time I've had to be on an SSRI in 3 years, but the first time was only for 3 months, and so far this time it's been a month, but I feel so much better. (I'm in counseling, too, which has also been helpful. And I now more regularly practice mindfulness in the form of breath work.)
--- I've accepted that I'm prone to anxiety, but it can increase quickly in response to stress.
--- The depression is due to Adjustment Disorder, at least that's what my counselor says. (In the last two years, I went through job changes, relationship issues, a divorce, cross-country move, and a lengthy job search... Yeah, I've had a lot of "adjustments" to deal with.)
I also have to get adequate sleep. My ADHD meds can't compensate for my attention issues that are due to lack of sleep. I can still tell they're working, but I don't have my best attention and working memory capacity.
Just seeing this now. Thank you so much for your detailed reply and really useful advice. I’ll go and do just that - record and journal about my symptoms and their intensity/ pattern without meds, in order to compare to the impact of different meds/ doses I’m on in the future.
Wow - that is a LOT of change. I’m glad to read you’re working your way through it with your breath work and anti-depressants.
I think the more I read, the more I understand that pills will only help so much. Though 85% seems like a dream reduction in symptoms to me right now.
Wishing you well 🙏🏼
Yeah, my response to the meds seems pretty miraculous.
So do many other ADHDers self reports of the effect of their meds, like how clear their brains become. With stimulant meds, the change is faster than I experienced, but there's a daily letdown.
The initial ADHD diagnosis that I received is that I have "mild to moderate" ADHD.
My own estimation was that my executive functioning impairment caused me to be significantly less effective than neurotypical peers. It would often cause me to take about 20% longer on complex tasks. It took me up to double the amount of time on memory related tasks, because I could only hold small amounts of information in my head for a short period of time.
Now, I can hold 3 times as much information in my head in working memory, hold that in memory several times longer.
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Let's put it this way:
Before meds, when I had to go to the store for a few things, I could only keep 2 things in mind, and had to repeat those items to myself every 2 minutes. I would also get distracted on almost every turn in the grocery store. I couldn't trust myself to remember any more than 2 things; if I needed even one more related item, I had to write down my list.
After two weeks or so on meds, I did a test...I went shopping for 8 grocery items WITHOUT A LIST. I didn't rehearse my list on the way to the grocery, got everything on my list, DIDN'T GET DISTRACTED, and even remembered that the milk in the fridge was almost gone. So, I got everything on my list, and remembered something else that I needed that I hadn't put on the list.
The benefits at home and work have been tremendous! I don't do twice as much. I maybe do 10-20% more than I used to, but it takes a lot less effort, and I don't have to redo work nearly as much as I used to.
I still have some problems with procrastination, self-motivation, and imposter syndrome. The treatment I'm getting for depression is helping some with those issues, but after decades of having them in my life, I know it well take time and effort on my part to overcome them. ("Pills don't teach skills.")
I long for some of what you’ve described! Having experimented with drugs as a youth - I remember my brief brush with amphetamines gave me clarity that I had never experienced. I became a powerhouse. Whilst I don’t wish to use meds recreationally at all, or abuse them (my body is now a temple 😇), I do long for even a fraction of what that experience brought me.
I seem to have a lot of the same traits as you. Working memory is an issue, I guess it’s like our unmediated brains are short circuited - and with the meds there’s no crossover and we can complete tasks - moving seamlessly from one to the other… well I hope that’s the ‘after’ for me too.
ADHD meds, pretty much ruining my life. Dependent on Adderall to regulate my neurotransmitters since my brain isn't doing it anymore. Ruined my emotions, I take very little joy in any of the things I used to do. Hard to switch meds when you have to also deal with crashing neurotransmitters if I stop Adderall. Messed up my endocrine system. And that happened within the suggested dosages. Now I am taking more than prescribed due to a series of events outside my control. During an Adderall shortage in the U.S. in which I may lose my job if I run out before they fix the shortage. Since I would crash out and not be at all functional. Difficult to get motivated or have energy any more. Wife is fed up. I"m fed up. Spend so much time researching things it's like a second job. Insurance company's prescription management is fraudulent at best so fighting with them. If my doctor who helped me transition from Ritalin to Adderall in the first place new as much as I do right now about dosages and the drug duration profiles, I may have been able to get by on a relatively low dose and not be where I am today.
Very negative, but don't let me scare you too much. Most people get by just fine without my drama. But, there are a lot of us who don't. Let this be a warning that not everything goes as hoped. Make sure to get enough sleep so you don't get into the escalation of more meds to make up for lack of sleep, which keeps you up because they are stimulants, which means less sleep and more meds...I do have to take my fair share of credit though. There are a number of factors that got me to where I am. Some of it is discipline. Which Adderall gradually stripped from me before I realized what was going on.
Be aware that there are many medication options. I am not familiar with what they are in the UK. But even if you do go the stimulant route or not, if you find that your dosage is no longer optimal, you don't have to increase your dosage necessarily. You can add a second medication. Strattera was my prefered medication, but not strong enough as my dosage escalated. Ritalin was even better for concentration, but also escalated to the max dose. Adderall, stronger than Ritalin. Most of the time I have been on a stable dose. Have taken Strattera with it and that had helped. Other people have found that some meds for other conditions help since they overlap with the ADHD neurotransmitters. Things like Guanfacine can be a treatment on its own, or can be taken with stimulants in which it enhances the therapeutic effects, and for some helps curb side effects. Some take Clonidine for ADHD, others take it before bedtime because for them, in addition to ADHD benefits, it can make them sleepy and able to fall asleep( For stimulant insomnia). Modafinil and Armodafinil help with daytime sleepiness, wakefulness and arousal. Some take by themselves. others with other meds. But some have found that with stimulants they had to dial back the stimulants a bit since it was too much with their existing stimulant dosage. Depakote, don't fully understand that med yet but I have seen 1 or 2 people who take it in combination with stimulants and that was their optimum therapy. Luvox is supposed to help with mind wandering. Qelbree is supposed to be similar to Strattera, but doesn't have the long ramp up time. Focalin, is just stronger Ritalin. Ritalin without the weaker levo racemate. But some still find Ritalin to work better. Dexedrine, Zenzedi, just stronger Adderall. All dex, no levo racemate. Adderall is 75% dextroamphetamine and 25% levoamphetamine. Dex is was helps with your ADHD symptoms in your brain. Levo has a stringer influence on your peripheral nervous system ie, heartrate and breathing. But in general is weaker than dex. I like Adderall for the smoother come down, less like a switch being turned off. But not quite as strong as Dexedrine and Zenzedi (100% dex). Evekeo is 50% levo and 50% dex. Tried it. Too weak. Vyvanse, think Adderall prodrug. I.e. you body converts Vyvanse into the active ingredient of Adderall. But, much harder to get addicted or to be abused. Good one to start on if going the stimulant route. Much less of it is actually converted to the active drug that effects your body than what is in other amphetamine based meds. Desoxyn is methamphetamine. Aside from the stigma of the name, many people find it much smoother and less side effects than other amphetamine based drugs. I assume some people try the nootropic approach and take the amino acids that your body uses to make the neurotransmitters that these drugs work on. It takes a lot to get enough into the brain. And even then, don't know how effective it is. Studies have shown 0 to a little effect. But nothing spectacular. So, there are still a few more potential medications that can be used themselves or in combination. Thing is, look into some stuff yourself. Don't just rely on a therapist. They don't always know about all the options. But do talk to them about what you find. They may have insights about it that you don't find. Or may look into it and prescribe it or give you a better option. BTW, adding wellbutrin to my Adderall just made me feel yucky. Works for others though. SSRIs do help some people, especially people with comorbid issues. But have to be careful with them.
There are a number of websites with forums for people with ADHD or people with kids with ADHD specifically. And many of those people can give good advice for whatever situations you may need advice for. Or share their experiences. I'd list some others but don't know if HealthUnlocked might get jealous or not. Healthunlocked is quite good as well.
wow. This is a lot of great info. I’m sorry to hear of your experience but grateful for your honesty (there’s no point in going in blind). I’ll take your advice and start to do a bit of research. I do know there’s been a shortage here too and that’s concerning. I suppose with the explosion in diagnoses here, the demand may continue to outstrip supply for quite to some time. Perhaps that explains the delay in my even getting a prescription.
I hope things improve for you.
We tend to have an amphetamine shortage here every few years in the U.S. Different causes each time but our Drug Enforcement Agency that controls the quotas of amphetamine ingredients to manufacturers always exacerbates it unnecessarily. Which spills over into other medications when people are scrambling. If similar things happen over there, that can be a factor in what med to take and to hoard some of it or not.
I'd also say, keep track of the brand of generic you take. Generics are supposed to be equivalent, but can actually vary drastically. I got switched without knowing it and was going nuts trying to figure out what was making my ADHD meds not work right. Thought it was some drug interaction. Nope, just a poor quality generic. Same size shape and scoring. Slightly different color but looked same in bedroom with lights off in the morning. Literally doubling the dose of the crap generic was still less effective than a decent one. I have come across 3 useless generic Adderall brands. Aurobindo, Sun, and not sure what the 3rd was. Aurobindo and Sun are Indian brands. Nothing against India, but there pharma culture is make it cheap, sell it cheap. And the results speak for themselves.
Thsts good to know. Yes - I’ve experienced cheap generics before on my contraceptive meds. I felt like a fraud saying they gave me different side effects but eventually got moved back into the right one.
Have you ever thought no meds was better than the uncertainty? 🤔
It is pretty common now for people to know that they don't all react the same to generics. That is why doctors can put on the script things like only the name brand or specific generic. Not all pharmacies can oblige since they can't all get drugs from every maker. But it can come in handy. Instruct your pharmacist as to what is acceptable. There is some certainty if you are proactive. You can also search online to find out what brands are generally good or bad.
You can post on or search this website to get info on drugs, including what generics people have found to have bad side effects. I'd try posting there with your drug and make a list of good and bad manufacturers if enough people respond. medschat.com/
You can identify a pill on this website if you don't know who makes it. It doesn't always match exactly what is on the package the med comes in due to some manufacture for other companies and may have the manufacture listed instead of the labeler. drugs.com/imprints.php
I never get my Adderall filled without knowing which brand I am getting any more. I alway ask first. If they have a brand I don't respond well too, I ask for my script back and go somewhere else. If it is one I haven't tried or don't know about, I tell them to hold on and do some searches on my phone to see if any good or not first. I've been looking into my other medication manufacturers too.
If someone ever tells you that generics are the same as name brand and bioequivalent, just tell them the excipients can make a huge difference and the FDA's tests for bioequivalence only assume therapeutic equivalence, do not actually test for it, nor consider the excipients own drug profiles. If you can't remember that, just give them the finger LOL.
haha. So eloquently put.
Thanks for this. That’ll help me avoid some pitfalls.
My psychologist said in October I should expect a psychiatrist appointment in January for meds. I’ve been chasing things up with her secretary and yesterday found out that the referral hasn’t even gone through 🤦🏻♀️
Excellent article HCStymie I dont type that fast or I would Credit you more on the article you wrote lol! I am having problems with the adderall shortage I am on Pristiq and Adderall been on for 10 years and the interruption of my daily adderall uage has been very difficult . No motivation drive or energy to do anything also very depressed
It’s so sad that people can’t get the meds which help normal functionality. 😞 hope things improve for you.
Have you tried getting switched to something more available than Adderall?I don't know the current shortages for other meds but methylphenidate based meds like Ritalin, Concerta, Focalin among others usually work quite well. Or a different amphetamine med besides Adderall like Dexedrine, Zenzedi, Mydayis, etc? Or if on Adderall IR, Adderall XR was easier to find than IR.
Also, you can't take what I wrote earlier as absolute. It is the general case for much of it since individuals can have different reactions based on genetics and other factors. Like 15% of people respond better to Evekeo than Adderall or Dexedrine. And some respond better to Ritalin even though Focalin should be stronger. There is still a lot more info to be found.
My advice would be patience. It may take a year or so to get your meds right. Also know that ADHD, anxiety and depression all go hand in hand - so you may find the best combo of drugs for you personally treats more than just the typical ADHD symptoms. My first diagnosis was with a general practitioner who prescribed me Adderall. It wasn't until years later that I felt I got the best combo of meds for me when I ended up working with a psychiatrist instead. Also working with a psychologist weekly on CBT has helped in combo w/ the meds. I have had to learn basic "adulting" in CBT and had no idea that was what I needed. Also my advice is to remember that the meds are definitely not a cure all. They will help tremendously, but you really will have to work on behavior therapy as well to learn tricks to help you not forget things, etc. Good luck!
I'd also like to stress that everything you said is true and VERY important.
To anyone else reading this, about 80% of people with ADHD are diagnosed with at least 1 other disorder in their life. And the non medicinal therapy is paramount. CBT and other therapies. For both understanding how to manage ADHD, how it effects other aspects of your life, to address other disorders that may be entirely separate, crossover, or caused by ADHD, etc.. I usually post about medication because that is my primary personal concern. Between my therapists and a ton of psychology courses I took in college, I think I have a good understanding and coping mechanisms of and for myself.
Some topics that have helped me personally outside of therapy. Not self help books, but psychology based books based on real psychology. No quacks looking to make a buck. Self help books can be great, but need to filter out the crap from the legit ones.
Motivation and Performance, learn how to motivate yourself and what things drive you. And under what circumstances to optimize performance and what to avoid. How not to get overwhelmed.
Social Psychology, understand a little about social psychology helped me understand that I don't need to be so self conscious or need to take some things personally. Also about group dynamics.
Industrial and organizational psychology - psychology of the workplace. Especially good if anyone is or wants to be a manager.
The book Men are From Mars, Women are From Venus. Long winded book but it is actually based on gender differences in psychology. Men and women have different ways of communicating, different expectations. If you are a woman and ever got mad at a man for being clueless or couldn't take a hing, or a man who couldn't figure out why a woman was mad at you or nagging, this is for you. Also very good for LGBQ and all the other letters. Still applies.
I can’t speak yet from personal experience (I just started short acting low dose stimulant this week) for myself. Our son, however, has combined type ADHD & mild autism and started medication for ADHD at 5. He started very young only because he literally couldn’t stay at school unless his behavior improved and we were desperate. For him, a stimulant was like a miracle. He was much calmer, goal-directed, could follow a 1 or 2 step command, and could function at school. He has always been on methylphenidate (first short acting, given 2 times daily) then eventually switched to long acting once in morning. He is very thin and as he began outgrowing his dose, he was too thin to increase it. He therefore went on a second medication called long acting guanfacine, which is not a stimulant. It took about a week-10 days to see an effect and about 2 months to get him to an ideal dose.
We have been incredibly grateful to get his diagnosis and went outside of insurance to see an excellent child psychiatrist for medication expertise. I know many people don’t have that privilege, and we were incredibly lucky and did without some other things to afford it. But it has helped his behavior and his sense of accomplishment tremendously and improved our home life a lot!
Medication definitely doesn’t teach skills! We have worked hard with our son on time management, planning, organizing, etc.
Thank you for sharing your experience with your son’s medication. It’s so good to hear the impact and the challenges that might come up and the difference meds have made in your and your sons life. 🙏🏼
I’m still waiting. My (private) psychologist also had ADHD, so the referral from October was only done a week or so ago I believe. Here’s hoping it won’t be too long.
ADHD meds are used for eating disorders aswell, so you'll lose weight. You'll feel euphoria, a good sense of well being, a nice accomplished sense of 'can do... will do', clear and precise understanding, and all within a relaxed brain and body. The medication is good.
Then there's the negatives, can't sleep, won't sleep, overuse risks, a more exaggerated symptom system lies within the meds, when they wear off it's back to busy brain, the meds only mask the issue, can't eat certain foods with them i.e vitamin C, coffee and any other acidity rich foods, and it takes about 2 years to actually realise what's happening and if they work for the better or not. Some days will be good, some days will be bad, some days will be worse than you've ever experienced, some days will be better. Dosages can change throughout, so you're always adapting to new levels.
The positives well outweigh the negatives though in my opinion
All the best
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