Have you or someone you know been on ADD medication* or amphetamine? If so, what was it like?
Anything particular to know for someone who takes that medication or is in charge of someone who takes that medication?
How does one make the most of the advantages and minimize the disadvantages?
*Including people who took analogous drugs as part of their job like, say, the military.
Michael, I was on methylphenidate (generic for Ritalin) for ADD for several years. Since I’m an adult, without addiction issues, I was trusted to take the medication as prescribed. I was not tempted to take additional doses, but then, I’m very conscious of potential addiction (my father was a drug addict).
Within the last year, my psychiatrist switched me to Strattera. Strattera, unlike methylphenidate, does not raise your blood pressure (at least, not as much). Since my blood pressure was beginning to become a concern, she thought the change was a good idea. I’ve been very pleased with it so far.
Another positive for Strattera is that it’s not a controlled substance, unlike methylphenidate. So you won’t have to get a physical script (scrip?) and take it to the pharmacy every time you need a refill.
I don’t know if this answers your question, but I hope the information is helpful nonetheless. 
My daughter was on Concerta (same as Ritalin) for a few months, but she didn’t like the way it made her feel. Now she takes dexamphetamine. She is on a pretty low dose. It messes up her appetite, but as long as she eats before she takes it, and after it wears off, she is OK. It messed up her sleep for a little while, until she got used to it. She takes a slow release tablet before school that lasts till the afternoon. I don’t usually give her any after that to make sure she eats and sleeps. She doesn’t normally take it on weekends, either.
She says the dex helps her concentrate, but doesn’t change her mood like Ritalin did. It doesn’t have any big side effects for her and makes things a little easier at school.
I don’t have ADHD, but I do have excessive daytime sleepiness for which I take a non-amphetamine wakefulness medication (Nuvigil).
For days when I skip it but must drive later in the day, or days where it’s worn off and I still have to drive, I have a small supply of Ritalin.
For me, it makes me more alert but does not otherwise affect how I feel. I’ve been able to do 12-hour driving days solo, several times, and at the end I’m just tired, not drowsy.
No feelings of being wired at all - though my dose is fairly low (10 mg, I think); I don’t know how I’d feel if on a larger dose. It’s short-enough acting that on a longer driving day I can take it at 8 PM and have no trouble going to bed at 12:30. Clearly I’m more alert when it’s on-board; I presume I’d do better in tests or something.
A funny story with the Nuvigil: I first tried that 4 or so years ago. I happened to develop a nasty case of bronchitis right after I’d started it, and had to go on steroids, so I skipped the Nuvigil for a couple of weeks. During that time, we drove to Florida to visit family, and I got 9 or more hours of sleep every night.
So on the return drive, I restarted the Nuvigil. And it scared the crap out of me.
See, I felt GOOD. Not HIGH, but, just well-rested and alert. This was something I had not felt in literally decades and it terrified me :D. I was behind the wheel, and I kept asking my husband “Am I doing anything scary? I’m not driving erratically or anything?” because I was genuinely afraid the medication was doing something to me.
Nope, just - for once in my life - adequately rested and alert.
Even when I knew it wasn’t making me “high”, I got a bit worried: there’s a small, but NOT nonexistent, risk of dependence in that class of drugs.
I’ve since found that I don’t seem to be among that small group, fortunately.
Good point on the Strattera - my daughter has a supply of that. It’s got some anti-anxiety properties which was why it was an especially good choice for her. She had tried Adderall when she was in 5th grade, and while it improved her focus, it also caused her behavior to be more volatile.
We’d been warned of that possiblity, but decided it was worth the experiment. I think she used it for maybe 2 months before we decided the problems outweighed the benefits.
She’s actually tried Vyvanse in the past year; that’s a prodrug which metabolizes into one of the amphetamines in the body. Less of a sudden influx of the effect. She’s found that to be much better tolerated than the Adderall.
I take Vyvanse (Lisdexamfetamine) every day for ADHD, and I can testify that it’s a lot more tolerable (to me at least) than Adderall. Adderall made me feel like I was having a manic episode.
Okay, ignore for a moment that I’m posting this at work instead of working… 
There are physical and mental effects to taking amphetamine, that last until the drug wears off.
Vyvanse gives me a dry mouth, especially when I talk, so I have to keep a cup of water on hand at all time. (Adderall was much worse for this.) It reduces my appetite to the point where if I’m not careful, I will only think to eat when I start notice I’m shaking/nauseated. The Vyvanse I take is not an extended release formula, so it wanes by the afternoon, and I have to make sure to do any work requiring concentration and persistence in the morning. At the same time, I have to take the pill before 10 am in the morning or it will keep me awake at night. For the first 1-2 weeks of taking it, I felt jittery and light-headed when doing any kind of physical activity (even walking down a flight of stairs).
Mentally, Vyvanse gives me motivation to do difficult/boring tasks and the ability to stick with them. At work this summer I am responsible for planning and implementing a months-long, multi-step project, by myself – it’s involved coming up with solutions, breaking them into steps, prioritizing the steps, planning the steps chronologically, having to accommodate new data and re-do past planning, etc. I can tell you, I would not be able to do this without medication. I would have immediately become overwhelmed by the enormity of the task and gotten frustrated with some roadblock early in the process and quit. Or I would have been on step 5 when I realized I hadn’t taken into account these 3 things I should have done first, or had forgotten them, or had gotten stymied on a step and never progressed. Vyvanse gives me the energy/motivation to work on the project and a mental clarity and persistance to continue working on it.
There are disadvantages. Right now I’m illustrating one of them – if my attention gets sufficiently distracted away from my main task onto something equally engaging or stimulating, I will focus intently on that instead. I’ve come to think of my attention as a hunting dog on a leash – I have to be careful what direction I point my direction in, because once it takes off running, it will run and run and run.
(This is also a symptom of ADHD itself, called hyperfocus. The difference – at least for me – is that when I’m unmedicated, there are only a few tasks which will cause me to hyperfocus. For example, I can play video games and feel like only a few minutes have gone by, when it’s actually been 6 hours. When I’m on meds, I will hyperfocus on whatever task you put in front of me.)
If you’re asking about addiction potential, I can’t speak to that. I take this medication under the guidance of a psychiatrist, we have periodic check-ins to see how I’m doing on it, and I don’t have any other substance abuse issues.
If you have any other questions, feel free to ask.
For the record there are only three often prescribed medications for ADHD (all others are related):
FWIW - I’ve been on stimulants for more than a decade.
Straterra - some people respond favorably to this, but personally I thought it was an awful drug. I have taken literally dozens of psychiatric medications and it was the only one that I thought changed my personality (and I don’t mean like the little things like more or less motivation, sex drive, whatever). To me - it started to change who I was as a person - and not in a good way.
Ritalin/Methylphenidate - I thought this was the best, but unfortunately developed a tolerance in around two days. Other drugs are related to it - like focalin (which is just one of the isomers of the racemic mixture - it’s the same thing really - just a patent play)
Adderall/Amphetamine Salts - Adderall is four amphetamine salts - again a patent play - two of these salts have been used for other current ADHD - vyvanse (which BTW - IS EXTENDED RELEASE - it just isn’t extended like most - the salt in. Vyvanse is combined in such a way that it needs to be broken down by the digestive system to release the good stuff. You can’t crush it like you can with Adderall XR/ER/Whatever to get it to an immediate release form. there are also meds like Zenzedi - which is just a special amount (not type) of one of the four salts in Adderall.
Also
Normal doctors & even psychiatrists are scared to write for schedule II drugs Straterra is the only one that isn’t schedule II. On the other hand if you go to a psychiatrist that specializes in ADHD - they usually have no problem with it. Most people seem to regard Straterra as the least (by far) effective ADHD medication.
Different people have different experiences - for me Ritalin would make me normal if it worked for more than two days - I can think correctly and plan ahead - which I can’t do on Adderall or anything else.
Adderall for me makes me more energetic and able to concentrate on tasks. Unfortunately the tasks I end up concentrating on aren’t always the ones I want to be concentrating on.
My suggestion is if you take or are given Straterra to read all the warnings and watch for all the signs. I really think it’s a bad drug, but granted I’m biased as it had a really bad effect on me. If you read the ADHD forums - I think you’ll find most people think it’s useless. Not saying you shouldn’t try it, but:
If you take a stimulant - as the escalate the doses - at some point you’ll find (most likely) that it works. You & your doctor will be tempted to try a higher dose as you either develop a tolerance or want it to work better.
Basically any Stimulant you take over the minimum amount you need is harming you. In many cases extra doses don’t make it work better - just longer. The reason it’s harming you is not cause it’s doing damage to your body, but it’s affecting your dopamine receptors in such a way that you will need more and more as time goes by - and the good things you experience will start to disappear one by one.
By taking as little as possible you are maximizing the amount of time this drug will be effective.
Unless you are sure - for example - that 40mg works better than 30 – I’d suggest dropping back to 30.
As far as addiction goes - I think the fears are overblown. Virtually everyone I know that has taken opiates for a long time becomes at least dependent on them. I know dozens of people addicted/defendant on opiates. I only know of two people (and not directly) that I would consider addicted to Adderall. I’ve taken the highest dose 60mg a day for over ten years and have no problem (other than having not much energy and feeling like I did before Adderall).
I’m very familiar with the black market in my area - there is virtually none for Adderall except for a few college kids around exams and stuff looking for it). Granted my experience is somewhat limited in who I know and stuff, but I know that there are people that end up getting some and have a hard time selling it.
Also - I see an expert psychiatrist in ADHD for treatment - and saw a different one before him. Most regular psychiatrists don’t understand ADHD fully, but these two did. Both seem relatively unconcerned about the addiction potential and think it’s overblown.
I’m not saying you can’t get addicted to it, but in believe you are much more likely to get addicted to a benzo - which I think some are only schedule IV (don’t quote me on that) - than you are a stimulant. I couldn’t even take much more than 60 if I wanted to as my jaw would start clenching and I’d sweat like a pig. I mean I could, but I would get less than zero enjoyment out of it.
The potential exists, but I know lots of people on it - and I really don’t think any feel dependent on it. I do know of two people that are friends of friends that obviously have a problem with it (and they both have other problems as well).
Sorry to keep posting. My number one tip if you have trouble getting up in the morning:
Have something to drink by your bed. Along with your stimulant. When you wake up - either by accident on purpose close to the time you want/need to get up - take the stimulant and go back to sleep. You’ll have a much easier time getting up in the morning.
This seemed a little “unconventional” to me, but my current doctor actually recommended this to me recently (I discovered it on my own within a couple months) - so at least one doctor seems to think it’s ok - and I’ve found it to be awesome.
Also - if you get the extended release capsules - you can take a little out if you don’t feel like you need the whole thing and sprinkle it in applesauce (it doesn’t have to be apple sauce - but applesauce is what is in the monograph). Theoretically you are supposed to use the whole thing, but that is only cause they are concerned other people will accidentally find what is left over. Of course discuss this with your doctor.
The non extended release Adderall - I feel I should mention kinda looks attractive and - almost - at least as far as pills go - candyish. It also kinda tastes good. Ok not great - and good might be pushing it, but my point is you should be especially careful around children. Obviously you should do this anyway - but just feel like I should mention it.
So, I was prescribed 5mg 3 times orally a day. I think that dose had an impact but I’m not sure, might have been placebo.
Taking 10mg at once under the tongue most definitely did have an impact.
There seems to be an overall preference for Vyvanse. Is there a non-extended release form of it?
How do Ritalin and Adderall compare?
You were prescribed which drug?
Obviously not one which makes me pay due attention to all details : )
Ritalin.
Took another 10mg sublingual and half an hour later I was able to go to bed and sleep 4-5 hours on it. Only woke up because I needed to use the restroom.
No - well not really - the purpose/marketing of vyvanse is to make money. In order to get a patent - they need something different. They basically have marketed this drug as being abuse resistant - as it is converted to dexamphetamine inside the body.
It sort of acts like extended release Adderall - although some stuff I’ve read suggest a higher/quicker peak. To me it feels like extended release Adderall:
There are only really four drugs (I listed above in a different post) that are approved in the US for treatment for ADHD - the other ones pretty much fall into these categories.
I’ve tried virtually all except methamphetamine. The differences between Ritalin, Concerta, Focalin IMHO are very minor. As is the differences between Adderall, Dexamphetamine, and Vyvanse. It is more likely to be a difference among the amphetamines - as you are dealing with four different salts - while with Ritalin you are only dealing with two different chemicals (one of which is supposed to have very minor effects - and is simply removed).
If someone responds well to Adderall - they will almost certainly respond well to vyvanse or dexamphetamine, but they may experience less side effects (or more in theory as you’d likely need a higher dose of the specific salt to achieve the same effect).
Same with methylphenidate - there seems to be more of an issue with tolerance (intra day) with methylphenidate(Ritalin). Part of the reason Concerta was invented was to address these concerns. But it is basically the same drug. I don’t think (for example) it is possible to drug test someone and tell if they are on Ritalin or Concerta. Focalin Is simply one of the parts of the racemic mixture of Ritalin.
So the main difference is between classes Methylphenidate vs Amphetamine.
For me the biggest difference is that Adderall gives more more energy and makes it easier to concentrate - while with someone with executive function disorder - methylphenidate lets me think more normally.
For example. If I make a peanut butter and jelly sandwhich - without drugs 99 times out of 100 I will make the sandwhich and not even think about cleaning up afterwards. When I’m on methylphenidate - and before I develop a tolerance - I think several steps ahead. Something tells me - “oh you are done with the knife - put it in the dishwasher” and “put the cap back on and put it in the fridge”. Everyday tasks - that to a normal person seem effortless - become effortless for me. I have to want to make the sandwhich.
On Adderall - I would feel more energetic and likely to make the sandwhich - and could concentrate on it, but my kitchen would still end up a mess (it may have been better in the early years). I can concentrate better and longer, but I can’t think better. Also I have little control on what I concentrate on. I may play a video game for hours and hours or map out my office to the centimeter, or who knows.
Adderall to me is helpful, but mainly because I so rapidly build up a tolerance to methylphenidate.
Also the build up to tolerance is gradual (in some cases) - and not all to the same effect. Adderall used to work better for me, but it’s hard for me to remember exactly how. But eventually the good stuff you experience starts to fade away.
I used to be able to direct my concentration more - I can’t remember exactly all the great things I experienced, but I remember several points thinking “well there goes another thing”. The main thing left is it helps me get going in the morning. It doesn’t work as well during my second dose.
::sheepishly raises hand:: I started reading this thread, and wondered what had been tried on my ADD. So I plowed through the “archive” medicine cabinet, and there it was: Desoxyn (and what’s this, in the tiniest 4 pt type at the bottom of the label?: Methamphetamine HCL) :eek:
That was one of many drugs a specialist tried on me. I’ll stop back soon and tell you what finally worked best…
(Sorry for the interruption, was ‘Checking The Dope’ in the middle of painting a bathroom, and realized I had to get back* before a half-finished wall dried…)
So, is anyone else here doing caffeine?
After decades of distractions (and before I lost a job and a wife), I ended up at a specialist who does nothing but try different drugs on adults with ADD/ADHD. After months of experiments (and some weird side effects), we finally hit on one that didn’t mess with my brain and allowed me to focus, but I could still get to sleep at night. (sorry, don’t remember the name)
After a month of that, he said “What you’re on now is very close, chemically, to caffeine. You can continue to take it, or just have a second cup of coffee at noon.”
“Waaaaait… you’re telling me I can just drink a legal beverage, and actually function in the world? Sign me up!”
Now, I have to drink the hard stuff (luckily, my work has a coffee joint with sludgy stuff that’s full of wakey-wakey). And I still have a ton of coping mechanisms that I have to do religiously (think Memento: if I don’t tattoo an event on my arm or calendar within 5 minutes, it’s gone).
Only downside? I had a copay on the drugs, not on the java.
*BUT, I remembered I was painting, AND remembered to come back! It’s working!
I haven’t tried the latter, but one of the reasons I quit taking Adderall was it seemed like I was developing a tolerance frighteningly fast.
IIRC, I began taking 10 mg XR on a Monday, it had a noticeable effect on me until Thursday, when I began feeling actually impaired by it (like my IQ had dropped by 30 points, I couldn’t think straight, it was hard to talk, etc.) I got freaked out and called the neuropsych I was seeing, and he advised me to double the dose. For a couple of weeks, that made me able to concentrate 1000% better, but it also made me get all these grandiose thoughts and ideas, akin to a manic episode. (Especially noticeable at work – I got tons of ideas on how to improve things around here, and they all seemed like fabulous ideas, and I saw nothing wrong with writing a few long wall-of-text emails to all 40 of my coworkers listing all the ideas all out in painful detail. :smack:)
Even the 1000% concentration increase was frightening, because I would work on a task and I wouldn’t want to stop, even when it was over. If another more urgent task fell into my lap, it was remarkably difficult to switch gears and work on that instead.
That all lasted for about 2 weeks, and then I started feeling normal again for about a week, and then I started feeling impaired.
That, coupled with the physical side effects I got when it was working – constant dry mouth, clenching my jaw, feeling tense and jittery, and having pressured speech – made me quit. I know people abuse it and, well, they must have a different experience than I did because that whole experience was really unpleasant and not something I want to go through again.
What I like about the Vyvanse (and I’ve gone through two dosage increases since May, from 20 to 40 to 50 mg) is that I only had noticeable physical side effects for about the first week I started taking it, and they were much milder than the Adderall. Now, as I sit here having taken 50 mg this morning at breakfast, I feel normal (albeit with a dry mouth).
When my psych increased my dosage, it was mainly because the drug wasn’t helping me with the other problem it’s prescribed to treat – binge eating. I never felt like I had hit a tolerance level or worse.
E:
I’m not deliberately, but I frequently drink a cup of caffeinated tea in the morning. I don’t notice a difference between the days when I have my tea and the days I don’t, though. I do know of other people who do supplement their ADHD meds with coffee when they feel their meds are wearing off. (I also have anxiety and my therapist has told me to avoid caffeine so it combined with the Vyvanse don’t make my anxiety worse. YMMV.)
So, update.
I’m taking 20mg of Vyvanse which will be increased to 30mg on the 10th September and perhaps 40mg two weeks later. I usually take it a few minutes before breakfast so that I’m hungry enough to eat the first meal. I’m still losing maybe 2lbs a week though. That’s fine since I have a BMI of 24 and I’ve been trying to lose weight anyway. If I ever get below 20BMI, woe is me I’ll have to eat more cake and ice cream.
I also take 300mg of Effexor XR per day for the first half of the month and then every other day for the second half. And 1000-2000mg of St John’s Wort. And about 4-8 ounces of espressos mixed in lattes.
So, in terms of chemicals, I’m not suffering from a lack. I am curious about cognitive, affective or behavioral ways of improving ADD. Anyone can help with that?
Interesting data I found on Wiki:
Long-term amphetamine exposure in some animal species is known to produce abnormal dopamine system development or nerve damage,[45][46] but, in humans with ADHD, pharmaceutical amphetamines appear to improve brain development and nerve growth.[47][48][49] Reviews of magnetic resonance imaging (MRI) studies suggest that long-term treatment with amphetamine decreases abnormalities in brain structure and function found in subjects with ADHD, and improves function in several parts of the brain, such as the right caudate nucleus of the basal ganglia.[47][48][49]
Godspeed!
I’m not sure what you’re trying to do with the variable Effexor dosing, but you may want to reconsider taking St. John’s wort, as it’s alleged to increase the risk of serotonin syndrome when taken with SSRI/SNRI antidepressants or amphetamines— and you’re taking it with both.
I had severe problems with depression that caused my doctor to try all sorts of different things that might have been wrong with me. I didn’t have any particular issue with things that are typical for those with ADD; I just didn’t want to get out of bed unless I had a good reason. Trying to get anything done that didn’t absolutely need to get done was practically impossible because I much rather would have been in bed. And then of course the view of what exactly “needs to be done” slowly changed such that I basically didn’t think anything was worth doing other than sleeping and eating. My psychiatrist tried all sorts of things, and I sorta responded to Ritalin, so eventually he put me on Adderall.
The difference is almost night and day. Every once in a while I end up not taking my morning dose because I’m very scared of overdosing and sometimes have a poor memory for if I’ve taken it first thing in the morning upon waking. I have a weekly pill case to remind me for most days, but if I forget to refill it Saturday, odds are I won’t take it on Sunday. And that day I basically spend in bed until my afternoon dose. When I forget to take my afternoon dose, I can generally feel it wear off as I start getting strong urges to yawn and not deal with whatever bullshit it is that I have to do. I sat for a section of the CPA and scheduled it to start right after my afternoon dose, which I’d have to take when I arrived. Well, I forgot. I did fine for the first three hours, and finished an hour early, but once I had answered the last question and had double-checked everything in the most recent section, my desire to go back and check everything again in the extra time dropped to nothing. Despite having another hour left to take the exam and check for any mistakes in the last section, I just submitted it early and left. (I scored extremely well regardless)
Unfortunately, it makes it very difficult for me to get to sleep, and I take something else to help me sleep. It feels very strange to me to take medication to be able to get out of bed, and then other medication so that I can sleep, and wonder just what the hell is wrong with me that I can’t do it naturally. But, it’s been several years now and I’m a fully productive person that just happens to need drugs in order to be so. I’m also on a couple other drugs that I don’t know if they do anything important, but my doctor doesn’t see the point in trying to take me off of them if I’m continuing to do well while on them.
I’m definitely concerned about the long-term impact of taking stimulants every day just to function, but it’s not like I have much of a choice. My life without controlled prescription stimulants would be absolutely miserable and probably would not have lasted this long. I still feel there’s something else going on, potentially related to mono I got in college right before things really started to go downhill, but if it is related to that, I don’t think there’s anything anyone can do about it, and the best way forward is to just treat the symptoms most effectively, which is what we’re doing.