To those taking Adderall/similar ADD medications

[upsguy27]

I first started taking Adderall around a month ago, starting off with simply 20mg a day. It worked fantastic the first day, and pretty well the following week. However, as the days went on the effects of it lessened and lessened until it had almost no effect at all and I began to feel depressed after the adderall wore off. I researched online and found that was a common side effect. So I talked to my doctor and got my dosage changed to the adderall XR, so I would get 20mg in the morning and 20mg later on, and I was to take 20mg of the regular short-release adderall in the afternoon. Again, that first day it was great, worked well and I felt focused and happy.

However, this time when I took it the next day, the effects were severely weekend and again I felt that depressing feeling beginning. That carried on for a while, slowly getting worse and worse, until I decided to stop taking it for four days to see what would happen. It made me... depressed, tired, and unmotivated to do anything, and yet whenever I would take it again I would feel the depression still.

Two days ago, I decided to take 40mg of the regular adderall. This was amazing. In a three-hour period, I accomplished a ton of work I was behind on and felt very happy and productive. After it wore off, I felt a small sense of depression but not much. Yesterday, the depression came back as I went back to my original dose, which now does absolutely nothing for me. Today was the same, and the effects are worsening. Severe loss of appetite, tiredness, severe depression, lack of desire to be social, etc. It's really bad, and I can't see my doctor or therapist or anyone as all are either out of town or booked for weeks.

Point is, what do I do? The depression is much worse now, I can't enjoy anything on or off the medication and if I try taking the 40mg again, my body has built up a tolerance to it. I don't want to keep taking more and more to keep getting that good effect, but I can't stop taking it as it ruins my body and mind and this coming week is loaded with tons of work. I need to figure out something very very soon... Ironically the adderall has made me accomplish less, I'm very far behind on everything and need a solution, please, anyone?

PS this is long as hell, sorry about that

 

[Christian81]

The first thing you should do is get back in to see your doctor, this is a medication with side effects and abuse potential (in regards to needing more to feel a similar effect like you are describing). My advice would be to take it as prescribed and see your doc

 

[upsguy27]

The first thing you should do is get back in to see your doctor, this is a medication with side effects and abuse potential (in regards to needing more to feel a similar effect like you are describing). My advice would be to take it as prescribed and see your doc

Right, but I need at least a temporary fix until I can see them again, this weekend and the coming week are literally filled with things that need to get done and I can tell you right now if I'm like this the whole time, nothing will. Taking the normal dose does nothing for me anymore.

 

[Svend]

I found I would build a tolerance quickly. I was on 20mg/day, then 40mg/day, then 60mg/day. I found that I could stop taking it without any issue. So, I would just take 20 or so when I needed it. If I took it as prescribed, it eventually didn't do anything. Can you just take what you need this weekend and then go see your dr to work on a different doseage? There may be something better for you than Adderall. I don't take it anymore. I found it too harsh on my body. Now I just deal with the ADD. Sucks.

 

[kellen]

There are multiple drugs you can be on for ADD/ADHD so consult your primary care provider with your worries/problems.

Putting someone on 20mg right out of the bat seems like a higher dose than I have seen for someone starting Adderal, but I am no expert in the area.

Talk to your MD/DO/PA/CRNP.

 

[Rodimus Prime]

I wonder say talk to your doctor about alternatives and other medication. There are multiple ADD drugs out there and some people to not work well on some.
For example I can not take stratria (ADD med) because it does not work very well for me but more importantly is I get really bad insomnia for from it.

As for depression that is a lovely thing that tends to go with ADHD and what you are feeling in terms of depression is when the Adderall starts leaving your system the chemical in the your brain it is messing with drops so your depression kicks in. As for tollerance you body does not like having an imbalance from it so it reduces it and depends more on the drug. Either way talk to your doctor about alternatives.

For me in the past concerta work really well. I took that until I went on meds for depression and that is what I am treated with now even though I more than likely could use some ADHD meds.

 

[appleguy123]

Is building up a tolerance normal? I've been on 20mg XR for about a year and it still does the same for me as always.
I wouldn't say that I ever needed the drug, but it does help me focus way more and improve my grade substantially.
@OP, When i take mine in the morning, I don't eat breakfast use drink an energy drink instead. Maybe you could try that for a few days and see if it works for you?

 

[yojitani]

Do as others here have suggested, talk to your MD. You might ask about EMSAM. I've heard positive things about it from people who have ADD and depression.

 

[ErikCLDR]

Tolerance can be acquired very, very quickly in adderall and similar drugs. Stimulants are known for this, literally becoming tolerant from one dose to the next. The extended release versions try to help decrease this but the fact still remains. Withdrawal symptoms (depression) are common and occur quickly.

Talk to your doctor and pharmacist about options. You may find that other drugs work better for you (such as Ritalin/Concerta, Focalin, etc).

The best way to keep tolerance down is to take the drug as little often as you can manage and use the minimum amount necessary. It's probably very difficult to pick and choose when you're going to use the drug but it will make the drug more effective when you need it the most.

Additionally, if you're withdrawal depression is this bad, you should definitely should talk to your doctor as you are at risk for dependency. Keep in mind, however, loss of appetite and poor sleep quality are side effects of the drug.

Good luck.

 

[upsguy27]

To all, thanks, I'm definitely going to follow through with this advice. Anything I can do in the short short term, as in the next couple of days/tonight, dealing with the intense depression? Taking the regular dose/not taking it at all does the same thing.

 

[ErikCLDR]

As this is not an imperative medicine, I would suggest taking a break from it and notifying your MD, or taking at as prescribed and see if he can taper you to get things under control. Not taking it or taking your prescribed dose won't make you feel better. Increasing the dose a. goes against your prescription and b. ultimately will make you feel worse after it wears off and increase your tolerance (and you'll run out of medicine faster which you and your doc will not be happy about).

As for the depression, just try work though it. It shouldn't last very long. Try and be social or doing things you enjoy. Exercise is an excellent way to get your mind off things. Believe it or not, using your fine motor skills has also been shown to decrease feelings of depression. Things like drawing, painting, sewing, etc.

 

[Rodimus Prime]

To all, thanks, I'm definitely going to follow through with this advice. Anything I can do in the short short term, as in the next couple of days/tonight, dealing with the intense depression? Taking the regular dose/not taking it at all does the same thing.

make sure you keep taking your regular does and get an appointment ASAP. Cold turkey on meds like that can have some really nasty side effects.

 

[NickZac]

Adderall is a very strong stimulant and it will repress appetite and can cause insomnia. It is an amphetamine and works in a somewhat similar manner to cocaine and meth amps. It can also cause a 'crash' period which can be characterized by depression and anxiety. The restlessness from it can be really bad. Also, Adderall is very addictive, causes a dependency quickly, can quickly cause a tolerance, greatly increases the chances for sudden death, and carries many side effects and risks. It has been linked to sudden death, even in healthy children. It has numerous effects on brain chemistry and it has the potential to contribute to major depression and/or a GAD. Its overall safety profile is disputed. It's a Schedule II drug for a reason. Other drugs in that class are Oxy Contin, Morphine Sulfate, Hydromorphone, Oxy Morphone, and others.

Are you on any other meds/supplements? (especially benzos or opioids)?

You need to get off that particular medication as building a tolerance like this is either a drug interaction, improper use, or your body simply does not tolerate the medication well. Prolonged use of any amphetamines, including Adderall, carry risks for numerous unpleasant conditions, some which are permanent. Do NOT increase the dosage on your own. When you took 40mg of Adderall, you took a substantially higher dosage than the maximum size single pill and 40mg is a very large dose. You can OD on Adderall just like other amphetamines. If you bump the dose up high, you are begging for a heart attack. You need to simply stop the medication and find a better alternative that won't harm you. Numerous supplements and much safer medications have been found to be very effective for ADHD/ADD. You will want to see a specialist if you haven't already.

 

[Abstract]

I don't take Adderall, but I take Ritalin. Sometimes it works, and sometimes it doesn't. It's hit or miss. Actually, it works well if I have slept well and I don't drink coffee in the morning. Unfortunately, I don't get enough sleep, and I make myself a nice cup of coffee every morning at work, so the pills don't work as well as they could (and neither do I). In fact, I don't even know how I'm still employed.

 

[mscriv]

Please, please, please, do not adjust your meds on your own accord. As others have said this can be very dangerous. Are you just diagnosed with ADD/ADHD or has your doctor also diagnosed a depressive disorder? Either way, as many have stated, you need to see your doctor as quickly as possible. Most physicians are good about doing an emergency appointment if you will call their office and explain what is going on. You might have to wait in the office for a couple of hours until the doc can work you in, but that's a small price to pay for getting the help you need.

Clearly explain your symptoms and side effects. All pharmacology is "trial and error" to a certain degree as there is no way to predict how the medication will specifically interact with your individual system. That is why it is so important for you to give your doctor all the information they need to make informed decisions about how to adjust your medication regimen. If you are not already seeing a psychiatrist then I would suggest you make an appointment. General MD's can often treat simple behavioral concerns like ADHD, depression or anxiety, but from what you are describing your condition could benefit from a specialist.

There are a variety of ADHD medications out there some of which are not stimulant based. (Strattera, Clonidine, Guanfacine/Intuniv) There are also antidepressants that are used to treat ADHD like Bupropion and Imipramine. These are sometimes used in cases where depressive symptoms are more heavily experienced comorbidly with inattention and hyperactivity.

If you cannot get in to see your prescriber then I would just maintain the dosage you are supposed to take and focus on other things that in the past have helped you stay positive and focused. These could include, exercise, certain foods/beverages, social contact to debrief and work through symptoms, a friend/family member to routinely check in with you for encouragement and task orientation, routine breaks in work for stress relief and refocus of energy, etc. etc.

I hope people's responses in this thread prove helpful and hang in there.

 

[almostnuts40]

I have too totally agree with you this is why we seek advice from Doctors you ask him/her and they make decisions whether need it or not. I am prescribed Adderall 20 mg 3 times a day and sometimes I only take 40mg keep it working well and also sometimes don't need it.

 

[TheBizarb]

I know this is VERY late, but I have ADD, and have a script for 10mg IR, which I break in half, so I'm essentially on 5mg. I find it working well the first 2 days, but then day 3 I start having anxiety pretty bad. Today is day 4 and I haven't taken it. I've been on it for a year or two, but go for large chunks of time off of it, because it makes my heart race and the anxiety (which, my Dr wanted to put me on ANOTHER medication to combat the anxiety, which didn't help, so I quit taking both). Does anyone else have this? I try not to take it during the weekend so I'm not dependent on it. I just hate this feeling (anxiety)!!

Thanks in advance.

 

[A.Goldberg]

I know this is VERY late, but I have ADD, and have a script for 10mg IR, which I break in half, so I'm essentially on 5mg. I find it working well the first 2 days, but then day 3 I start having anxiety pretty bad. Today is day 4 and I haven't taken it. I've been on it for a year or two, but go for large chunks of time off of it, because it makes my heart race and the anxiety (which, my Dr wanted to put me on ANOTHER medication to combat the anxiety, which didn't help, so I quit taking both). Does anyone else have this? I try not to take it during the weekend so I'm not dependent on it. I just hate this feeling (anxiety)!!

Thanks in advance.

Your experience is not uncommon. Adderall increases primarily dopamine and norepinephrine in the central nervous system. Norepinephrine stimulates the “fight or flight” response... which includes raising your heart rate (tachycardia). Both increased NE and tachycardia can induce anxiety. 5mg is a very low dose, the lowest in fact, so you can’t really reduce the dose any more (there are 5mg tabs that can be split to 2.5mg- might be worth a shot but it may be insufficient to treat the adhd/add).

As a clinical psychiatric pharmacist, in patients experiencing this situation I probably would not add a medication. The first thing I’d probably try is switching the XR (extended release) version, providing a longer, more stable release of the drug into your system often reduces side effects. The XR version is available in doses as low as 5mg. Another option would be to switch to Vyvanse, which simply put is prodrug form of Adderall, meaning if first must be metabolized in your liver before it becomes active. This provides an even more balanced release of the drug. It however is more expensive and not all insurances cover it. There are also a number of narcotic and non-narcotic options when it comes to ADHD. Non-narcotic options will have lesser or no cardiac side effects.

I’m not sure what anti-anxiety drug your doctor wanted to try. Many doctors first idea is to go with benzodiazapines like Xanax, Ativan, Klonopin, etc which IMPO is a very poor choice. There are better options that are more conducive to long term use (such as alpha-2 adrenergic agonists), but my general opinion says less is more when it comes to medication therapy. Additional drugs should not be added unless absolutely necessary, especially when the offending agent, in this case Adderall, has many alternatives.

[note- this is hypothetical advice, talk to your doctor. I’d definitelt recommend a psychiatrist or neurologist over a GP/family doc/pediatrician. I see a lot of patients who were previously prescribed by the latter bunch and they often really don’t know what they’re doing. You should probably find out what your heart rate and blood pressure are while taking your current dose.]

 

[sherryson]

Hi, I am new to this forum. I want to share my situation.

I am diagnosed with ADHD when I was 18 years old. I discover it when I was a hard time focusing on something, I also have memory issues. I read resources to assess my self but I was not contented, then I seek help from the professionals. Yes, I have ADHD, I have a hard time coping in it and it affects my studies. I really want to overcome it but I don't want to take medicine.

What should I do? Any comments will be much appreciated.

Thank you.

 

[A.Goldberg]

Hi, I am new to this forum. I want to share my situation.

I am diagnosed with ADHD when I was 18 years old. I discover it when I was a hard time focusing on something, I also have memory issues. I read resources to assess my self but I was not contented, then I seek help from the professionals. Yes, I have ADHD, I have a hard time coping in it and it affects my studies. I really want to overcome it but I don't want to take medicine.

What should I do? Any comments will be much appreciated.

Thank you.

Welcome. I’m not sure why you’re first post on a Mac forum is in reference to ADHD, perhaps you should seek out an ADHD-related site?

There are a number of non-pharmacological options out there. I would first reccomend finding a quality psychiatrist or therapist who is experienced with ADHD. He/she should be able to help guide you on lifestyle modifications that can help you cope with the symptoms of your condition.

There are various types of therapy to cope with ADHD including behavioral therapy and mindfulness training (to help reduce distractions, improve focus, and be more productive). Regular exercise has also been shown to improve attention. There are also some neurofeeeback programs. Diet can also be important, especially avoiding sugar and carbs and caffeine that can amp you up and then make you crash.

———

As an aside I thought I’d inform people of a relatively new ADHD drug called Mydaysis. It’s basically a new formulation of Adderall/Amphetamine salts however it has a new extended release delivery system that allegedly allows for a 16 hour duration. A lot of people find even the extended release version of Adderall (Adderall XR) or the prodrug version (Vyvanse) to be too short acting and/or have a profound crash when they wear off. This new drug has a 3-stage release mechanism which hopefully translates to a longer duration and less crash.

It is pretty expensive though- $350/month. That said it’s brand name so there’s probably a manufacturer coupon. Not sure how friendly insurance is with this, they probably want step therapy and prior authorization. I have yet to have any patients on this yet, but I’m sure its only a matter of time.

 

[Gutwrench]

I took adderall for three years and it was quite beneficial for lots of things.
I wouldn’t mind using it again, but nope.

 

[sherryson]

Welcome. I’m not sure why you’re first post on a Mac forum is in reference to ADHD, perhaps you should seek out an ADHD-related site?

There are a number of non-pharmacological options out there. I would first reccomend finding a quality psychiatrist or therapist who is experienced with ADHD. He/she should be able to help guide you on lifestyle modifications that can help you cope with the symptoms of your condition.

There are various types of therapy to cope with ADHD including behavioral therapy and mindfulness training (to help reduce distractions, improve focus, and be more productive). Regular exercise has also been shown to improve attention. There are also some neurofeeeback programs. Diet can also be important, especially avoiding sugar and carbs and caffeine that can amp you up and then make you crash.

———

As an aside I thought I’d inform people of a relatively new ADHD drug called Mydaysis. It’s basically a new formulation of Adderall/Amphetamine salts however it has a new extended release delivery system that allegedly allows for a 16 hour duration. A lot of people find even the extended release version of Adderall (Adderall XR) or the prodrug version (Vyvanse) to be too short acting and/or have a profound crash when they wear off. This new drug has a 3-stage release mechanism which hopefully translates to a longer duration and less crash.

It is pretty expensive though- $350/month. That said it’s brand name so there’s probably a manufacturer coupon. Not sure how friendly insurance is with this, they probably want step therapy and prior authorization. I have yet to have any patients on this yet, but I’m sure its only a matter of time.

Thank you. I already went to a clinic and I'm done with the assessment and I am currently taking medication. And, I'm planning to have a behavioural treatment for an adult with ADHD. I hope it gets well.

 

[A.Goldberg]

Thank you. I already went to a clinic and I'm done with the assessment and I am currently taking medication. And, I'm planning to have a behavioural treatment for an adult with ADHD. I hope it gets well.

Sounds like you’re on the right track then. As with many mental health conditions, with ADHD medication can only take you far. The more profound, longterm changes are often a consequence of changing how one thinks, which is done through therapy. For most people it’s a process that takes time and effort. That said, medication can help but often times is often just an aid to help. But it seems you’ve figured that out. I’m a Clinical Pharmacist a psych hospital and far too many people want to find the answers to their problem in a pill.

 

[sherryson]

Thanks for listening @A.Goldberg, I know that taking a pill will just help me to overcome and a behaviour of a person is the key to overcome this kind of illness, that's why I'm planning to have a therapy.

 

[A.Goldberg]

Thanks for listening @A.Goldberg, I know that taking a pill will just help me to overcome and a behaviour of a person is the key to overcome this kind of illness, that's why I'm planning to have a therapy.

You’re welcome. I wasn’t suggesting as much, I was impressed you are seeking behavioral and lifestyle modifications. Most people don’t want to do that.