[dlytle]

I'm currently taking adult ADD meds (Adderall); it's a double edged sword, and I'd personally really prefer to find another method.

The primary problem is, during any sort of transition I would be pretty useless, and I can't afford to take that long being useless with my current job.

I went cold turkey from 25mg of Adderall XR daily, and for about a week and a half I was absolutely dead. I'd have a splitting headache due to dehydration, but I couldn't summon the energy to get off the couch and walk 12 feet to where I had bottles of water. I'm glad I went cold turkey rather than just tapering the dose, though, because tapering the dose would have taken months of feeling miserable, rather than 1.5 weeks of feeling like a dead man.

If you hear anything interesting from people about biofeedback/etc, long-term non-medicinal adult ADD treatments, could you toss me a mail at [e-mail]? I'd really like to see other peoples' opinions on those routes, and I don't lurk enough on HN to be likely to see a submission about it.

(Just to clarify; yes, I'm back on the Adderall XR again, although at 5mg rather than 25 this time.)

[tripzilch]

I tried a few sessions of bio-feedback but quit because I got frustrated by it and not being worth the time and money.

During the intake the therapist described Ritalin as "poison". I should have probably gotten up and left right there. If you have the opinion that Ritalin is overprescribed, or that it should not be given to small children, that's all fine with me. But "poison" has a pretty clear definition, you'll find that whenever someone refers to a drug as "poison", you're dealing with pseudo-scientific quackery.

What made me quit was mostly that I couldn't find any correlation between the signals received from the electrodes and my own state of consciousness, be it more relaxed or more concentrated or alpha/beta waved, whatever.

When I watched the graphs on the monitor, I noticed a few things. There is a LOT of noise. If I'd clench my jaw, move a muscle in my neck, my ears, whatever, it'd cause an avalanche of noise, completely drowning out any possible brain signal. Ok so you sit still, you're meant to focus or relax anyhow. Except that muscles just seem to generate a whole lot more electrical signal than your brain, and every time I even blinked my eye there was a burst of noise (probably also because the eye muscle is relatively close to the electrodes). The software did nothing to filter out these noise-bursts, even though it'd have been trivial to make at least a basic attempt that would throw away the data during a burst so the other filters wouldn't trigger.

Ah, the other filters. Well, it quickly became clear I knew a lot more about DSP than this guy. He had no idea how his device operated, at least not how the signals were transformed into whatever was displayed on the screen. There's not really an excuse for this. Sure enough a surgeon might not know about the algorithms used to convert an MRI scan into a picture, but the radiologist does (at least, on some level), which is why we have radiologists.

So you know about these alpha/beta/theta/gamma brain waves right? They're at 12/10/7/3 Hz frequencies or something like that. Now I always had the idea that by this they meant some fundamental Eigen-frequency of signals in the brain, so you'd think to apply some auto-correlation to determine the base frequency and its harmonics. But instead he had a bunch of bandpass filters running concurrently being graphed through some ancient MS-DOS program with obvious leakage from one band to another and we were looking at the raw filtered signal, not even its energy and as I said there was no noise suppression.

I'd have loved to take that device home, write some code for it and see what it could detect though. Hell, even detecting muscle movements is already way cool :)

Anyway, no correspondence between my state of focus or relaxation.

Staring at a computer screen (with a game, usually one frequency band was used to control a game of some sort) for 1-2 hours per week, actively trying to relax or focus would definitely have a result of course.

Which is why I'm doing a universal yoga meditation class. Dunno if it helps with the ADD, but it can't hurt and it definitely has some other advantages (notably: posture and stress/tension). One thing I do notice, yoga works best if I haven't taken meds that day. You'd think it improves focus, but this yoga class is mainly being able to really feel your whole body and muscles should not be tense for that, but on meds I find I get way more fidgety and subconsciously re-tense every muscle I relax as my focus shifts to the next part of my body. Fortunately, noticing and being aware of such subtle effects in your body is exactly what the class it about :-)

[rms]

The evidence is much more strongly in favor of amphetamine being actually poisonous (neurotoxic) than ritalin. Even then, it only happens at higher higher than a certain, not really well known dosage.

You might like playing around with Neuro-Programmer 3. You can get substantially similar or even stronger effects to EEG neurofeedback with simple audio brainwave entrainment. I actually question the value of EEG neurofeedback not combined with audio brainwave entrainment, which serves the purpose of teaching people what different brainwave states feel like. http://www.transparentcorp.com/products/np/index.php You can hook up an EEG to it to. Or build your own for a few hundred, http://openeeg.sourceforge.net/, but the signal processing is actually the hard part. Among the cheap commercial EEG products I've tried, only the NeuroSky Mindwave filters out facial movements well, but it's one sensor is not really useful for doing much of anything.

The kind of meditation that helps with ADD is concentration meditation, where starting Vipassana, when you focus intently on watching your breath, is a concentration meditation.

[webnrrd2k]

I was diagnosed with ADD. I'm not sure that was the problem, exactly, because there were some other things going on, but I was talking Adderall for almost two years, along with Wellbutrin. I quit cold-turkey and went through a long period of being almost totally exhausted both physically and mentally.

As I slowly recovered, I was more strict about my diet, got a lot more exercise, and started meditating. I found that vipassana-style meditation was a tremendous help.

This is speculation on my part, but I think that meditation really strengthens some of the areas that I'm weak in due to ADD. I think sitting still forces me to develop "inhibition" skills that are typically rather weak in people with ADD. Also, mindfulness develops memory skills that I've been having a lot of trouble with lately. Also, paying close attention to direct sensations and thoughts makes it a lot easier to relax, so I tend not to build up anywhere near as much stress through the day. The bottom line is that I have more energy and focus, and just seem to function a lot better when I meditate regularly.

I'd bet that you will get a lot of the same benefits from yoga, alone. But I'd like to suggest that you look into vipassana and see if it works well for you, too. I don't think you will have any trouble finding resources on the internet, but please let me know if you'd like some recommendations.

[rdl]

A $99 Zeo comes with an API and will let you do exceedingly simple biofeedback; the manufacturer is quite helpful, too. (I was going to work on a waking study using the hardware, but ended up not having time).

There's also the EPOC Emotiv.

[qrybam]

Scary thought: Going cold turkey with coffee has had very similar effects on me (after 2 weeks of 1-2 cups a day; 2-4 shots/day).

I've also had a similar feeling of deadness when I stopped eating meat, dairy and anything with additives for 6 weeks. The first week or so I was completely useless - this could have also been due to me trying to feel my way through to a balanced diet.

So much of what we consume ends up having all sorts of unknown effects on us and the minute we stop consuming them we really feel it - it's easier to never stop.

One bonus of cutting certain stimulants out of my life has been that I've ended up feeling much better.

[protomyth]

The last time I got rid of coffee (back on it now), I switched to a high caffein tea and then steadily walked my way to low / no caffein teas. It is really, really hard to get going with cold drinks in a ND / MN winter.

[pearkes]

Hot water with lemon and honey is easy and warms you up. If you feel more adventurous, non-alcoholic hot cider.

[salemh]

I'd add, cinnamon naturally "perks" one up for the most part. I used to add cinnamon to my coffee (to avoid sugar), but works as well for tea, or your hot water, lemon and honey for a non-caffeinated morning (or afternoon slog) beverage.

http://en.wikipedia.org/wiki/Cinnamon#Medicinal_value

It has insulin "mimicking" effects, which could be part of the "boost" I feel.

[X-Istence]

I went cold turkey from all caffeine. One day, almost 10 months ago I said enough is enough and quit. While on caffeine I was always highly irritated, and was snappy with people. I just couldn't get enough caffeine to feel good, and was always tired.

When I went off I was dead to the world for about 2 - 3 weeks. I had a splitting headache which no medicine seemed to fix, and felt laggy. But after those 3 weeks I started to feel better. I had more energy, I was a lot less irritated and was happier in general. I was able to contain angry outbursts and in general have changed entirely. I have more energy now than when I was binging caffeine. I can stay awake longer, fall asleep faster, and I feel refreshed when I do get at least 6 hours of sleep.

Not drinking any soda has also helped in other ways. I no longer have a real need for sugar throughout the day and don't have nearly the same headaches I used to get from not getting my sugar fix. Since I have also lost a major source of calorie intake I have started to lose weight.

I don't drink anything with HFCS in it, soda's with natural sugars every so often (maybe once or twice a month), but mostly I drink water. I drink a glass or two of milk a day as well. One thing I have noticed is that living in America is that soda is pushed with every single meal. It doesn't matter where you go, what soda would you like with that.

---

Since you mentioned no longer eating meat ... I have recently started eating a lot less meat, and even in the past week have stopped eating meat altogether, and I have yet to feel a real difference. It does make it a lot harder to think of meals to make though as I have been eating meat my entire life and it is an integral part of any meal my family used to make. Will see what happens in a couple of weeks from now :-)

[jerf]

"When I went off I was dead to the world for about 2 - 3 weeks.... Not drinking any soda has also helped in other ways. I no longer have a real need for sugar..."

You may be misattributing. Caffeine withdrawal is a matter of days [1]. 5 tops and I'm usually done in 2 or 3. (I've dropped cold turkey three times now, and each time I've personally experienced a marked decrease in my ability to function, but I've got various other possibly mitigating circumstances. I'm planning on trying again with my latest set of circumstances to see if it helps any as soon as my infant is no longer an infant.) Dropping that much sugar out of your diet can definitely take substantial time to acclimate to. (But it's a great thing to acclimate to.) You sound a lot more like someone who has gone through adjustment to a much lower carb lifestyle than someone who has gone off caffeine.

[1]: http://en.wikipedia.org/wiki/Caffeine#Tolerance_and_withdraw...

[X-Istence]

I went from drinking four liters of mountain dew, 6 cups of coffee and taking 500 mg No-Doze caffeine pills to nothing.

It is possible that lower carb may have had something to do with it. One thing I did notice though is that in compensation I was eating a LOT more candy at first. I'd eat gummi worms and haribo gummi bears by the kilo. The local gas station started giving me discounts on swedish fish! Luckily I eased off that after about a month, and now I eat very little to almost no candy.

One thing I would note is that it has changed how I taste sugar. A lot of sugary drinks such as juice (even natural sugars) will quickly taste too sweet. I also find it harder to eat candy because it just has this disgustingly sweet taste to it. The other thing is that with drinking water with my meals instead of soda I am finding that a lot of foods are over salted, and could do with half the salt and still taste just as great. My personal believe is that people want taste even after making their taste buds taste something really sweet like soda.

[furyofantares]

I'd love to find another method as well. I am 31 and I've been on and off it for the last 6 years or so. More off than on, because I really don't like the effects it has on me, so I really only go on it when my life is in shambles.

One pattern I've noticed is that when I'm off it, I self-medicate with caffeine and energy drinks. It starts with an occasional Starbucks or Coke and before I know it I'm getting a venti latte with an extra shot every morning, then drinking 3-6 rockstars/redbulls/cokes throughout the day.

[Osiris]

I was also taking Adderall XR 25mg for about 2 years until I had to change doctors and the new doctor was concerned about my high resting heart rate so he gave 1 month of 10mg. After that was gone, I was pretty unproductive for about 2 months. I simply had a hard time concentrating, like I was in a haze.

I just restarted on Adderall (generic, 5mg x2 a day) and the side-effects are definitely difficult to deal with. I am able to hyper-focus but I also get irritable, daily headaches and exhaustion when it starts wearing off. I tend to take it one in the morning as I start work and perhaps once in the afternoon if I find that I need it, but I don't take it on weekends at all.

There's definitely something to be said for behavioral adjustment rather than medication. That's how my mom deals with it, but even so she's pretty scatter-brained.

[ulisesrmzroche]

I stopped on 56mg for two months and did not have any withdrawal symptoms. You may want to talk to your doctor about this, withdrawal like the one you experienced is not very common, I think.

[wahnfrieden]

When I used to be on an Adderall IR prescription, I didn't have any withdrawals but the effects declined very noticeably after a few days use, and the side effects worsened. I started taking it only a few days a week at most instead and was much happier. If I didn't have work that needed the extra focus on a particular day, there was no need for taking it that day. I've never understood the people who use it daily, including weekends, unless it's for something else like narcolepsy of course.

[ulisesrmzroche]

I don't get the "happier" part, it's very subjective. I take it daily, as the doctor prescribed, and it has made my life noticeably better.

If you use the medication only once in a while, do you have ADHD or do you only think that you do?

[wahnfrieden]

My doctor prescribed it for daily use too, but I asked him about it and was told it's fine to take it whenever I feel the side effects are worth the relief from ADHD. Where did you get the idea that it's necessary to take it every day or not at all? Adderall is not a drug that requires that. You should ask your doctor more about it.

[ulisesrmzroche]

That's how it's commonly prescribed, but I'm sure it varies depending on the person.

I have stopped taking the medication in the past and I did not have any withdrawal symptoms or felt happier or anything of the sort. I've always used caffeine though.

I guess what I'm saying is that someone who thinks they may have ADHD shouldn't discount methylphedinates because some people have withdrawal symptoms, which mostly happen only when someone is abusing the medication, or is nervous about it in the first place.

[rue]

I'd be interested to hear why the GP thought tapering would be worse. It's almost universally the better option.

[dlytle]

The reason I went cold turkey was that I was already seriously tolerant to my prior dose, and the doctor had recommended several months of tapering to reduce my tolerance. (I had been on that dose for about 5 years.) I couldn't afford to spend that amount of time eliminating my tolerance, because I'd be operating at such a reduced capacity (from withdrawal) that I'd risk my job.

So, instead, I took a week off coinciding with a long weekend, and just went off it completely. It sucked really bad, but I had some stuff in place to make sure I wouldn't be in as much danger as I could be. (I removed all potential weapons/poisons from the house, stocked up on "comfort food" so I wouldn't be tempted to get in a car, etc.)

I wouldn't recommend it for everyone, especially due to the suicide risk, but in my case (for various reasons) that risk was pretty much 0. (I'm aware that self-diagnosing suicide risk is really unreliable, but I have a few personal situations that make suicide impossible to seriously contemplate, so I'm pretty safe in that regard.)

[ulisesrmzroche]

I think it's probably a lack of familiarity with this sort of thing. Sort of like how folks are thinking 56mgs is insane, and 25mgs are almost cocaine and speed.

High dosages are up in the 150+, more like people who binge on 3 pills, or crush and snort them. That would create withdrawal symptoms and be neurotoxic. Therapeutic dosages (like the ones the doctor will prescribe you) are supposed to be just that.

[rms]

That's a high dosage, to the level where I expect it is neurotoxic. I think you might be more of the exception than the rule... some withdrawal is to be expected, though not necessarily as strong as OP.

[rsheridan6]

56mg means Concerta, which is an all-day extended release formulation - not the same as injecting 56 mg into your mainline, or taking an immediate release tablet.

Concerta wouldn't come in a 56mg tablet if it was expected to be neurotoxic.

[rms]

Good point. As he was responding to someone discussing amphetamine, I thought he meant amphetamine. I have known someone prescribed 3x20mg short acting amphetamine daily who after stopping is now quite aware of the long term negative effects.

[ulisesrmzroche]

I really don't think my psychiatrist would prescribe me anything that is neurotoxic.

[rms]

High dose stimulants in rats are neurotoxic. http://www.dr-bob.org/babble/neuro/20091104/msgs/931964.html Your mileage may vary, but I think prescribing patients >50mg amphetamine is often irresponsible. Ask your psychiatrist at what dosage he thinks amphetamine is neurotoxic. 90mg maybe? Doctors agree that a certain dose is neurotoxic but disagree on what that dosage is. 60mg is the official maximum safe dose, but it's not like you should put all of your trust in the FDA. Given clear stimulant burn-out I have noticed in multiple taking >50mg of amphetamine daily, I have no doubt that dosages like that cause negative neurological effects and that caution is merited in amphetamine dosing.

[trotsky]

Stimulants aren't neurotoxic, specific substances at specific levels are. Methylphenidate's majority of benefit comes from its reuptake inhibition of both dopamine and norepinephrine. While it is also a dopamine releasing agent, it does so at dramatically lower levels than the amphetamine family. The difference turns out to be significant - while they both promote more dopamine activity in the brain, it turns out that preventing the disposal of brain chemicals is generally much safer than promoting their release. As far as I know there aren't real concerns about MPH neurotoxicity.

[rms]

Sorry, yes, I'm suggesting that amphetamine is much more dagnerous than methylphendidate.

[ulisesrmzroche]

Methylphenidate and amphetamine is not the same thing, and I have not experienced anything like what you've said.

I really don't think burn-out is as common as people say, high-doses are more like in the 100+mgs, and that's not in anything that is considered therapeutic and extended release.

[drumdance]

I tried Adderall last year and had a similar reaction. I used it during the week but went off it on weekends. I only did it for two weeks and that was enough for me to know I didn't want it.

[rms]

Modafanil works to cut Adderall withdrawal symptoms for most people. And Modafanil withdrawal is nothing more than being unusually tired, but not miserable.

[tocomment]

What do you mean by transition?