I was diagnosed with ADHD a few years ago at 18. I was initially prescribed Adderall XR. Adderall XR was helpful but when taking it for extended periods (during school year), it would become less effective throughout the day. I would be prescribed Immediate release Adderall as a booster when XR began wearing off earlier in the day, but immediate release has always made me incredibly sleepy, no matter the dose. I don't take Stimulants every day, only when I have work to do (I have a fulltime job and am a full-time student, so I take it more frequently during the school year) ... Still, Adderall was a hit or miss, it was only reliable after I took a long "tolerance break".
Recently I was switched to Vyvanse about 2 months ago and it felt like a game changer.
Adderall was helpful in that it allowed me to focus on work-related tasks and meet deadlines at work and school... but just like before I was diagnosed with ADHD, I remained ridden with anxiety and felt overwhelmed by life. I still struggled to focus on things I enjoy like reading, writing and drawing or self-care. I felt like I didn't have enough time to or just couldn't manage my time well enough to allocate any for myself or life outside of work.
The first few weeks on Vyvanse helped me complete work/school tasks but also helped me manage my thoughts and time better than ever, I felt like I could rationalize my feelings, pinpoint the cause of my anxiety and find resolutions before freaking out and feeling depressed. With this newfound clarity, I felt like "myself" again... I finally understood how people could enjoy their personal life while also meeting deadlines for work and school. I went from feeling overwhelmed constantly to reading more books in 2 months than I have in years, I had the words to write poetry I am proud of. I even created a design for my poetry Instagram page which is something I have NEVER had the patience and focus to do in my entire life. I felt rational, for the first time ever. Not overwhelmed by the simplest tasks, no anxiety to make me miserable.
And now (passed week or so), I can feel myself becoming tired again. I have brain fog, and my working memory is lacking... it is hard to articulate myself verbally. And I fear that Vyvanse will begin to make me feel the same way Adderall did. I was so happy that life felt manageable for the first time in my adult life. I can't describe just how big of a difference Vyvanse made on my outlook on life.
Does anyone have advice, insight or a similar experience that I could learn from?
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bbykeemlvr
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1. I have only used Ritilin. Not for a while. It knocked me round a bit. Then for a while I selectively took it. Needed to work for a day, take a pill for the day.
2. Is exercise and diet and sleep OK in your life? Just asking.
3. I know I sad two.
Do not give up. Check that your prescriber has considered all options. I talked to a guy today, at work. He took 8 months and 3 goes to get the right mix, dose and timing of meds.
sleep is fine for me. I don’t exercise much but within the passed few months I’ve been trying to be more active by going for walks (still not as frequently as I should).
I naturally don’t eat a lot, but eat even less while medicated. I’ll eat one big meal (usually seafood, rice, noodles and a bit of veggies…I love Vietnamese and Japanese food) and not feel hungry. When I’m not medicated I do have a bigger appetite and have a hard time controlling how much I eat if I find something tasty… but under normal circumstances I’m not a big eater. I skip breakfast, feel hungry around lunch-dinner time and will eat one big meal.
Did you experience the brain fog regularly before you started on ADHD medication, or did it really only become a regular problem after?
Stimulants can reduce appetite, as you've noticed.
• Some people can get by just fine on one big meal per day.
• Others, like me, cannot...I need 3 meals a day, or I might experience low energy, brain fog, maybe even stomach growling.
How do stimulants affect your sleep? Not getting enough restful sleep can cause a person to develop brain fog.
I'm not an expert, but I think that some people can also develop brain fog as a reaction to certain medications (including stimulants), or from developing a tolerance to a stimulant medication.
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My brain fog:
Before my ADHD diagnosis, I had persistent brain fog. It would only lift when I got an adrenaline rush...I would become temporarily clear headed and laser focused.
Not only did I have persistent brain fog, it was in two distinct parts of my brain, one across the front and the other across the back.
When I got diagnosed with ADHD, my doctor put me on Adderall XR first. It only partially helped my ADHD. It also only cleared the brain fog in the front of my brain.
I eventually convinced my doctor to try me on a non-stimulant ADHD medication, Strattera (atomoxetine). It treated my ADHD twice as well as Adderall did, and it cleared the brain fog on both the front and back parts of my brain.
Now, I only get brain fog when I'm short on sleep, stressed out for days on end (which makes for less restful sleep), or I have consumed enough alcohol to get a buzz.
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ADHD is caused by issues with either or both of two neurotransmitters: dopamine and norepinephrine (aka noradrenaline, which is closely related to adrenaline).
Stimulants treat dopamine deficiency.
Atomoxetine treats norepinephrine deficiency.
• In my case, it seems that I'm more deficient in norepinephrine than I am in dopamine.
Now, I'm on Wellbutrin (bupropion), a nontraditional antidepressant. It treats a deficiency of both dopamine and norepinephrine. (It helps both my ADHD and my anxiety.)
I did experience brain fog before being diagnosed. i especially had trouble expressing myself verbally (which is how I’ve noticed that my Vyvanse isnt working as efficiently). I could have the knowledge in my brain but I’ve always had a hard time finding the words to formulate and communicate my thoughts, or forget right as I’m on the verge of saying it. My mind just goes blank.
Presently, I make sure to get enough sleep. I had horrible sleeping habits for most of my life but in recent years I’ve learned how important sleep is and make sure to get enough of it.
I briefly tried Wellbutrin and other medications for anxiety but after a few years, I realized that I don’t like being on medications that I need to take every day. I like that stimulants work instantly and that I can stop taking them whenever I want without withdrawal symptoms.
After responding to a few comments, im under the impression that I might be burnt out or overly stressed because I am a lot busier than I’m used to. I’m hoping that after this semester I can relax and the brain fog will go away.
I figured it out by trial and error, but I also had come across some helpful information.
When I was going through my diagnosis and afterwards I had immersed myself into learning all that I could about ADHD. Early on, I got most of my information from reading books & articles, and YouTube videos featuring Jessica McCabe (How to ADHD), Dr. Edward Hallowell, or Dr. Russell Barkley.
From Dr. Barkley, I learned about different medications and how they work to treat ADHD. I'm pretty sure that something he said made me realize that some people with Predominantly Inattentive ADHD, like me, tend to respond better to non-stimulants than stimulants. (I can't recall exactly what he said that made me think that.)
Also, he talked about another attention disorder that's similar to ADHD and often a comorbidity with it (co-occurring condition): Cognitive Disengagement Syndrome, or CDS. It used to be called Sluggish Cognitive Tempo (SCT). It is not in the diagnostic manual yet, but has been researched since at least back to the 1980s.
• Studies have found that CDS responds well to non-stimulant atomoxetine (Strattera), but not to stimulant methylphenidate (Ritalin, Concerta).
I self-identity as having all the traits of CDS, in addition to the traits of Inattentive ADHD. And atomoxetine works better for me than Adderall.
Add to that my observation that my flight-or-flight response clears my head and helps me focus (which triggers the release of adrenaline and noradrenaline, aka epinephrine and norepinephrine).
So, it seems to make sense that I must be more deficient in norepinephrine than I am on dopamine.
...It took me several months to piece this together.
There are genetic tests that can be done, the most well known is called GeneSight. Based on your genes, it can suggest which types of medication you might respond to the best. It's not a guarantee. The test costs hundreds of dollars, and health insurance might not cover it.
~~~~~
Do I think that type of ADHD plays a part?
Well, I think it does, but not with certainty.
• I think that people with Hyperactive-Impulsive traits usually respond well to stimulate medications better than non-stimulants.
• I think that people with Inattentive traits would be more likely to respond to non-stimulants (but many of them will also respond to stimulants, to some degree).
• I think that people with Combined ADHD would likely respond well to both types of medication.
This is just my opinion, based on all the bits of information that I've taken in, and my own hypothesis that I've developed from that information.
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Some newer research suggests that most men with ADHD will respond better to stimulants, while most women with ADHD will respond better to non-stimulants.
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These are all generalizations.
The fact of the matter is this:
• Each person will have their own individual response to each ADHD medication. Also, a person's response to each of the medications can change over time, as you found with Adderall.
Drugs given for ADD/ADHD only work for a short while then as you said it stops working as well. I take it when I think I really need it for something and then don't take it when the rest of the time. It usually works for me. Bon Chance
I try not to take my medication often but as I mentioned I work full time and am full time college student. this semester I am especially busy because I’m taking more classes than I usually do, am doing an internship and other projects (trying to get into grad school). so I have a task to focus on like all the time . Even still, one bottle of 30 pills usually lasts me about 1.5-2 months. How often do you suggest taking it? Are you still able to focus on work without taking it?
Im hoping to take a tolerance break during this coming winter break. Now that I’m thinking about it, I very well may just be burnt out from having a busier schedule than I’m used to.
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