BIG QUESTIONS for Adderall newbie! Please help!

[Lucy-Honeychurch]

I’m new to taking meds for my ADHD and have a lot of questions! I felt absolutely nothing with 5mg adderall 2x day last week so my dr said to double it and take 10mg at once. I tried that for two days and still didn’t notice much, maybe a slight decrease in appetite and staying awake later but I’m still unfocused and have scattered thoughts. I haven’t taken it the past two days or today because she said to try taking weekends off and this is a long 3-day weekend (holiday). I plan to resume tomorrow with 10mg in the morning and 5mg or 10mg later. Here are my questions:

Is it normal for 10mg in one dose to be ineffective for some people who have never taken it before? I don’t want to take more than I should, especially since I just started. I’ve read so much about people saying they definitely felt it when they first started taking it but then needed to increase so I’m concerned that I felt nothing from day 1. Should I consider going to 15mg? (Obviously consulting my doctor first.)

Is it helpful to go off the meds on the weekends? How is it helpful? Does it help prevent tolerance? Any other benefits? Do most people take weekends off or do most people take it daily?

What should I expect with tolerance? Am I going to build tolerance in a matter of weeks, months or possibly not at all? If you take a break for a few weeks, is it more effective when you resume?

Does coffee or caffeine taken with adderall affect the absorption enough to negate its effects so much that I wouldn’t feel anything? I did have it with coffee but cut back to 1/2 cup… I can try decaf/herbal tea next time. If I take it with no coffee in the morning, can I have coffee later in the day without diminishing the adderall effects or should I just cut it out completely?

What are ideal breakfast options with adderall? I’ve read that protein is helpful and to avoid caffeine and vitamin c… can I take vitamin supplements later in the day with no concerns?

Has anyone taken phentermine? I’m not taking it now but I took it for many months for weight loss and it worked really well and also helped a bit with my adhd, but I developed tolerance so I stopped taking it and started adderall a few days later. I’m wondering if maybe my recent past phentermine use is making the adderall less effective for me.

Thank you all for the feedback! I’ve had ADHD for decades and it was suggested to me that I take meds multiple times, but now is my first time actually doing it. I will consult my doctor about all of the above questions but would love feedback from others with related experience. I hope the multiple questions help others too!

[Tigger4me]

Hello Lucy, To be as accurate as possible when asked about my experience with Adderall, I should probably tell people that it a matter of how much change I've had in my major ADHD behaviors, and for me not all my major ADHD behaviors change the same. In general, I experience a quietening of my overactive, jumping around thoughts, but I wouldn't say my mind is quiet, however, it is quieter. My hectic thoughts slow down enough for me to feel more in control. I notice that my brain is trying to distract me, but it is so much easier for me to ignore the distraction; being able to ignore internally generated distractions usually happens so quickly that my mind feels "quiet".

Same for my ADHD derived impulsivity; I now have a long enough "pause" in wanting to interrupt someone, that I don't interrupt but just say to myself "later" and I can wait for a naturally occurring gap in the conversation before speaking.

Without meds, it is very typical for me to miss the first several words anyone says to me because my inner thoughts are running so strongly. With meds I'd say it would be 50/50 for missing words, especially if I was not looking directly at the other person. If I am looking at the other person when they start speaking, with meds I might miss the first two words it is much easier to then catch up with what is being said.

Similar change with starting something new. But for me, it really is a matter of the degree to which my ADHD (without meds) compels me to do things, to having more of a choice with meds. This freedom of choice makes me feel much more "normal" so one of the biggest pluses for me with taking ADHD meds, is psychological, less anxiety, less depression, less self loathing.

[Lucy-Honeychurch in reply to Tigger4me]

Hi Tigger4me, this is all very helpful! I appreciate hearing how the meds help you. I have the same challenges so I’ll try to pay more attention to the specifics you described to see if and how the meds affect me.

Do you take your meds daily or do you skip weekends? Have you built up tolerance over time?

Thanks!

[Tigger4me in reply to Lucy-Honeychurch]

Hi Lucy, Of course I forgot to answer those questions from your post; story of our lives unfolding on an ADHD chat site.

When I was working, I took my meds weekdays and weekends alike. I am now retired and I still take my meds 7 days a week. I take the Adderall even when I'm on vacation.

As for building up a tolerance, I started out taking 2 10mg tabs of Adderall a day (or the equivalent amount of Ritalin) around the mid 1990's. Around 2010 I began taking 10mg Adderall 3 times a day, 7 days a week. I might have built up a tolerance, but I also might have been under medicated at the beginning. I was under a lot of stress at work around that time (2008 financial crash, etc.) and that undoubtedly played a role in my increasing my daily dose.

The most important consideration for you at this time, however, might be getting your current dose adjusted for best results. Life changes and/or building up tolerances might cause you to readjust your meds at a later date.

Best of luck for you.

[Lucy-Honeychurch in reply to Tigger4me]

This is such a helpful reply- thank you! My biggest concern is building up a tolerance and then feeling helpless as a result of that. With the phentermine (a stimulant that I took for weight loss), it was just a matter of months before it was barely effective anymore. I had to take some time off for it to be effective again, and that’s a frustrating cycle, so I really hope I don’t have to go through anything like that with adderall. I really want to take the adderall daily because I need it daily! It’s so encouraging to hear that you were at the same dose for so long (years!) and that you felt it was effective for so many years before you felt the need to increase it.

I took 10mg this morning and another 10mg in the early afternoon. It’s after 1am as I write this now, so I probably should have taken the second dose a bit earlier since I’m noticing it does keep me awake too long, but other than that, it was a much better dosage for me. I don’t feel the effect of it that much but I do feel less stressed out and less overwhelmed. I’m going to take the same amount tomorrow and see how it goes. I also exercised this morning so that helped my mood.

Why did you switch from Ritalin to Adderall? Do you think you are taking the right meds/dosage now?

I’m seeing my doctor again in 3 days to follow up on my starting the medication for the first time and to discuss the dosage. I’m feeling increasingly comfortable with the idea of being on adderall, and increasingly hopeful that it will help me, and that it will be a long term solution. Thanks again for your feedback!

[Tigger4me in reply to Lucy-Honeychurch]

Hi Lucy, Glad you are going to see your doctor to check on meds and health. Are you going to see your PCP or specialist? While my old, but now retired PCP was great with effective ADHD treatment, I have found that the younger docs in the practice are somewhat mixed in their understanding of ADHD and their ideas of proper treatment. One example was when one doc said that I should cut back on taking my Adderall once I retired because obviously I would need to focus as much in retirement as when working. I found the exact opposite to be true; without the structure of my job and without all the ADHD adaptations I'd developed over the years, my ADHD was mangling my life much more than before retirement. I quickly started going to a different PCP doc who after hearing my difficulties in retirement quickly increased the anti-depressant/anti-anxiety meds I was taking .

If you are not currently taking medication for depression/anxiety you might want to discuss this with your doc in your up coming appointment. I know that for me (and I've heard similar comments in these posts) if I start getting stressed from non-ADHD related events, this increase in stress will cause my ADHD traits to get worse.

I've been reading Hallowell and Ratey's book ADHD 2.0, and I have found it wonderfully insightful and helpful; both are psychiatrists with ADHD. I'm going to get a extra copy and give it to my PCP next time I see her, if she hasn't already read it or have a copy. I was thinking that you might want to mention this book with your doc as well. If your doc isn't aware of this book, you might want to just mention that Hallowell, MD (psychiatrist), was on the Harvard Medical School faculty for over 20 years. Ratey, MD (psychiatrist), is currently teaching at Harvard Medical School. Sometimes such name dropping is helpful with people in medicine.

Best of luck.

[Queen_of_Tara in reply to Lucy-Honeychurch]

Going off what's already beeen written, I would say to track your symptoms or behavior/thoughts carefully and share that with your doctor. And go back and review yourself. Also, my doctor prescribed a short acting version of Adderall that I often take early afternoons so it doesn't affect sleep since it's out ofm my system faster than the regular version. Obviously I'm not a doctor just puttting it out there as something to ask about if you need that boost to get thru the afternoon. I take 20 mg regular and 10 mg short acting in the morning and, often, the 10 mg short acting in the afternoon. You're asking the right questions! And getting good advice from Tigger4me! Best of luck to you.

[Squirmy32]

LucyI just saw your post. It is late here and I am going to bed but I am not an expert, but do have some experience. Let me get back to you tomorrow.

[Tigger4me]

Hi Lucy, I forgot to mention that I notice when my meds are running down in the late afternoon because I start to hum/whistle some tune as needed extra stimulation since the meds are no longer providing enough stimulant. Sometimes I drum with my fingers as well. Drives my wife crazy. Cheers.

[adhdpeachykeen]

hi there new ish to adderall! for a background I’m a 23y female with combo type as my psychiatrist explained as agressive adhd lol. I’m a smaller person about 5’3-104lbs and she started me on 20 mg extended release in the morning and a 20 mg tablet booster at noon, of the generic for adderall. I noticed it work right away and she was the first doc who got the dose right first try which was badas*!

I don’t necessarily go off on weekends and they don’t always recommend you should because some patients have depression/anxiety symptoms that piggyback onto the adhd so if you don’t take them for a couple days you will notice those symptoms come back. That’s not always the case it does depend on the person and how you feel. I try to take mine every day but pretty much when I remember because of my adhd peabrain. Been on that dose for about 8 months and haven’t noticed a tolerance increase, still works like a charm 🤓

Caffeine can give you palpitations and increase your heart rate they say it’s not great for your cardiovascular health. I was an avid caffeine drinker and I just switched to decaf, meds work so I don’t really need the caffeine anymore.

Any decent breakfast will do, avoid orange juice or anything acidic that can mess with the meds. Even though I drink decaf I try to take my meds an hour before or an hour after I’ve had my coffee because the acidity will mess with the meds like juice. Also seen people recommend taking 2 tums the magnesium can aid in metabolizing the medicine.

After taking it for 3 days I walked into my room and paused and thought to myself “is this what my peers without adhd feel like?” And it brought me to tears because it was like I had been living life on hard mode for the last 23 years. I’m grateful to have access to this medicine. This was just my experience, remember everyone is different! Goodluck on your mental health journey!