TLDR: What is ADHD medication supposed to feel like? Is it supposed to feel like anything at all? Will someone with ADHD feel really gacked out/high? does it change based on food intake or other factors?
So I received an unofficial diagnosis from my AuDHD psychologist a while ago, and then my psychiatrist did a very short written assessment on me and determined a positive diagnosis. I really want to get a full assessment one day, but for now I was prescribed Focalin (dexmethylphenidate). I originally wanted it as a prn.
The first time I took it, I definitely felt "peppy", needing to stand while gaming, needing to move around more frequently, generally more awake. I didn't eat breakfast, and had coffee. My blood pressure was also very high. Within a couple of days I took it again, but being good and eating in the morning with no coffee. I couldn't even tell if it was working. I may have taken it another time soon after and did not notice a difference, so I stopped taking it. I've been extremely fatigued and my executive dysfunction has been off the charts so I tried taking it again. Yesterday I didn't eat right away, and I felt gacked. Tight jaw, jittery, like definitely felt like I was on stimulants. I felt like that today as well; I tried to eat a little something this morning but it didn't seem to make much of a difference. It kicked in during a client appointment, too. Jaw tight, jittery, making a ton of typing mistakes, my body feeling fuzzy.
So, is it something where you should be able to notice a difference when you take ADHD meds? I'm assuming that I felt it so intensely because I didn't eat, but when I do it it literally doesn't feel like anything has changed. I may also not even have ADHD at all and was misdiagnosed (I was informally dx'ed with ADHD, Autism and bipolar disorder).
Took a few basic pharmacokinetics classes in uni but far from an expert. Food intake and drug uptake into the body can be very closely related, does the medication say anything about taking with food? Low amounts of food in the stomach can lead to quick absorption into the body, maybe that's why you are having the jittery effects? Note that food and certain types of food can also increase absorption into the body, but that doesn't seem to apply here. Some food/drug interactions only change the rate at which the drug is absorbed, others change the total amount.
I'd also recommend taking a dose as consistently as possible and not on/off because even when you're not feeling effects directly there is still drugs in your system and might still be providing pharmaceutical benefits. You're trying to keep that drug serum level within the range between "not having any actual effect" (too long between doses) and "jittery stimulant feeling." (taking too high of a dose on an empty stomach perhaps?)
Drugs are usually designed/prescribed so that taking it at the prescribed schedule will keep you in that range, some are better than others at this, even in the same class of drugs. If you keep getting that jittery feeling even with consistent dosing I'd talk to your doctor about trying something else.
It doesn't say to take with food but I assume that with most stimulants you should. It's just extremely hard for me to eat in the mornings, or often at all anymore. I did eat more today but I was still super distracted and avoiding all of my work lol.
I think I'm going to try to keep on it for another week or so and see if it evens out. What was puzzling to me is that I'm on day 4, and it's been very consistently intense, when before when I'd take it on and off, sometimes I wouldn't feel it at all, and others I would; it seemed unpredictable. I've also been at the office every day, whereas before I think most of the time I was working from home so maybe the environment is making a difference? Hmmmm