[bumblehean]

I really wish my body could tolerate stimulants.

I tried the major ones (Adderall, Ritalin, Vyvanse, Concerta, etc.). They all made dealing with ADHD significantly easier, but even at the lowest doses they turned me into an extremely anxious and irritable person. I had never experienced anything close to a panic attack or nervous breakdown in my 30+ years of being alive until I started taking stimulant medication.

I decided that living with untreated ADHD was the better alternative, so now I'm back to copious amounts of coffee to deal.

[kamranjon]

Just a heads up, Ive taken stimulants on and off as a treatment for ADHD for many years but my body/emotional health always felt compromised as a result. I've recently started on a non-stimulant ADHD medication called Atomoxetine and so far it has not had the emotional blunting, irritable effect of stimulants at all, and I haven't noticed any negative effects so far. It seems to help me get over the hump of being able to start things and stay with them which has always been my biggest downfall. We will see if I stick with it, but just wanted to mention that there are alternatives. There is also another medication called Guanfacine that I may try if this current medication does not work out - I don't think I can go back to stimulants.

[bumblehean]

Interesting! I'll be sure to ask my doctor about those options

[user_of_the_wek]

I hope what I write will not scare you away from trying these, I just want to add to make sure to know about all potential side effects. My daughter tried Atomoxetine and reacted very badly to it. I recognized it as a potential side effect from the documentation that came with the meds. The doctors did not even know it could happen. Everyone is different though! She uses Elvanse now (I don’t know how that’s called outside Europe) and it works for her.

Again, chances are it will work for you without side effects so work with your doctor. Just be well informed.

[antinomicus]

Elvanse, which is lisdexamphetamine, is sold under the Vyvanse brand in the US. It is a prodrug for one of the isomers found in adderall. This just means that you take elvanse, which is initially sort of ‘inactive’ and your body eventually converts it into what can essentially be thought of as adderall, or more accurately, d-amphetamine. Adderall specifically also contains l-amphetamine which is absent from this drug, the l-amphetamine isomer is responsible for more of the unwanted nervous system / cardiac effects.

[tempacct2cmmnt]

Hey, just popping in as a psychiatrist:

Speak to your psychiatrist about atomoxetine, viloxazine, guanfacine, clonidine, bupropion, desipramine, or protriptyline. Probably in that order.

[DrewADesign]

My wife had some serious problems with the stimulant meds, and atomoxetine did the trick for her.

[alecco]

Things that work for people with too many side effects:

Try a much, much lower dosage (e.g. 7mg/day instead of 30mg) and spread it out over hours (even if it's already a slow release medication!). Do exhausting exercise in the morning. Eat very small amounts of slow releasing carbs over the day to keep your glucose levels right as these medications lower blood glucose and that gets you grumpy, and also they reduce appetite. If you absolutely need caffeine, drink green tea with 3x water, and take L-Theanine to curb the anxiety.

Zero alcohol, cannabis, and nicotine because they will mess up your dopamine system.

And find a better doctor.

(And read this other comment on schedule https://news.ycombinator.com/item?id=45091187)

[InMice]

Same here, the lowest dose concerta keeps me wide awake for 24 hours. The non stimulants give me side effects not touching those with a 10 foot pole. Did you try 2.5mg ritalin? i think thats the lowest dose.

[DrewADesign]

I can take pretty high doses of Ritalin and sleep as long as it’s not the extended release. The lowest dose extended release medications didn’t touch my symptoms and reduced my average sleep to about 4 hours per night.

My wife gets good results with atomoxetine, which isn’t a stimulant.

[klipklop]

If you can’t sleep, for sure avoid extended release meds like Concerta. Stick with immediate release with no afternoon doses. Take it the second you get out of bed. You want to time things so it wears off after your work day and you begin to get tired.

[jawon]

You might be how surprised how low a dose you need for an effect. 5-10ug of Ritalin noticeably reduces the "noise floor" for me.

How do you take 5-10ug? Dissolve 10mg in a litre of something. Get a 1ml dosing syringe. It has 0.1ml markings.

You could start there and increase it until you find what works. Also, if you take very little you can have a break on weekends and not suffer too much while remaining sensitive to lower dosages.

[k__]

On Vyvanse, I felt like a machine for like two weeks. Couldn't sleep and had to be productive.

After that it normalized.

I started taking it 1h before I get out of bed every morning, so I could sleep well at night.

[idiotsecant]

How does that work? You just sleep 1 hour less?

[k__]

If I'm already well rested, yes.

If not, I'm taking the pill and go to sleep again quickly.

The pill will take ~1h to "wake me up".