So I made a post here about a month ago asking for help because I was struggling through life and couldn't figure out why. I had like literally $0. Y'all helped me keep the lights on and covered the co-pay for a doctor's appointment. They said I probably definitely have ADHD, but since I'm on state insurance they've been giving me antidepressants and SNRIs and all that because they "can't" prescribe the first-line treatment.
Going on wellbutrin and strattera and qelbree fucked me up, and so did coming off them. The doctor is now trying to give me another non-stimulant and I'm about to break, honestly. Getting to work was much much harder with the horrible nausea and headaches and I just had to stop taking the drugs but now I'm feeling actually fucking depressed. It's like these drugs pumped me full of happy chemicals and then stopping ripped it all away. I've even been strongly craving alcohol which is scary because I'm 7 months sober.
Anyway, I have an appointment with a real psychiatrist in 27 days, and I'm really trying to white knuckle to get there, but I'm really struggling to keep up to date on my bills. Asking for money fucking sucks and I hate that I'm in this situation but I don't know what else to do. I appreciate any and all help and also any advice too.
Cashapp: $ghostsburner
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I'm sorry that you're going through this and also sorry that cashapp isn't available in my country.
Strattera is known for being pretty rough with side effects for most people, so you aren't alone in that. Surely the doctor put you on those meds you mentioned one by one, right?
If you feel comfortable in sharing the effects and side effects of each one I can give you my amateur assessment of your situation and what I would expect to work and what adjunct meds might ideal to manage side effects. Not a doctor or anything, just a person who has had it rough with ADHD meds and who also has the autism DLC which gives me a +1 bonus to research and pattern recognition.
Do you know what the next one you're going to get prescribed? Guanfacine? (Des)venlafaxine?
There aren't many left in the non-stimulant lineup for ADHD tbh. Venlafaxine might hit the right spot for you though. In adults guanfacine doesn't seem to have significant effect for a lot of what I'd consider "primary" ADHD symptoms, although I've heard one report that very high doses of guanfacine to be effective (around the 6-8mg mark). Guanfacine is reasonable for addressing impulsivity, and in some cases hyperactivity, focus, and brain fog depending on the causes, but I wouldn't have high hopes for it making significant improvements with things like anxiety and a lack of drive.
There are a few options available that are probably going to be overlooked by doctors here and there might be some antidepressants that might help you with happy chemicals too, but their effects probably aren't going to kick in for a while.
There's also a few options available on the grey market and possibly supplements although in the case of the latter I wouldn't put a great deal of hope in. Still, if you're stuck and you're low on options but you're desperate then there are things that might be helpful. Obviously cost becomes a factor which sucks though.
Anyway, if I get a picture of what symptoms you want to address based on priority, how you responded to different meds (positives and negatives), and anything that you're currently taking, I can do my best to give you advice on what will likely be more useful, what side effects to expect with different meds, and maybe some options for managing side effects and troubleshooting. No pressure though - if you don't feel comfortable listing out all of your medical woes to a stranger online then I respect that.
In the meantime, hang in there. You are really close to a turning point. I know you're going to look back on this period of your life with pride for how your determination and perseverance got you through to and you have arrived at a place in life where you are able to manage things so much better.
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Ah right, thanks for the description. This paints an interesting picture and it gives me a pretty decent angle I think.
Regarding Wellbutrin, that's not a wildly uncommon experience for people who don't take to it well.
Nausea on Strattera is also really common, especially in the early days or when your dose increases too rapidly. What's really interesting is the Qelbree side effects, and the urination side effects of both.
From what you've described it seems like you're a prime candidate to benefit from guanfacine in particular. You might not really notice it having much of an effect until you start on the next medication as it tends to work better as an adjunct med than being good by itself.
If you do get put on it and you can tolerate it or you don't notice any effect, I would strongly recommend staying on it when you move on to your next med.
If you can't tolerate it then I'd recommend trying out clonidine - same story as guanfacine and you will probably need a fairly low dose (100mcg or 200mcg) at least until you get onto your next med, at which point you may need to increase it to manage side effects.
Adderall especially is probably also going to cause you to have urination issues, unfortunately. Guanfacine or clonidine might be able to mitigate these side effects or you might find that you can tolerate a low dose of Adderall, just be aware that this is likely what you're going to have to deal with. I wouldn't be surprised if Ritalin did too.
Guanfacine typically has the effect of boosting the effect of stimulant meds while reducing some side effects and ADHD symptoms, so it might be particularly useful in combo with low-dose Adderall. This is why I think you're a prime candidate for it.
I would also recommend considering modafinil as an alternative to Adderall/Ritalin - this will provide you with a similar(ish) effect to Ritalin or Adderall but based on your reports it's unlikely to cause those urinary side effects. You might be able to ask your doctor about this as it's a medication that is technically a stimulant but due to how it works there's basically no potential for addiction. It definitely gets "abused" or used outside of a prescription context but countries tend to be much more lax about it because it's not an amphetamine.
Which leads me onto my next point: if you're really stuck and you need something to get you through the next period, there are people who import modafinil on the grey market. It's not wildly expensive afaik but it's not dirt cheap either. Make sure that you don't have allergies to any medication if you decide to source modafinil outside of a prescription I can elaborate on this but my comment is already too long as it is.
Regarding antidepressants, mirtazapine might be a good option - it's a bit unusual in how it works compared to most other antidepressants, so there's less chance of getting some of the side effects you've mentioned from other antidepressants. Might help with some of the happy chemicals and it tends to kick in a bit quicker than other antidepressants. I'm guessing that you're in the US which makes agomelatine pretty difficult to obtain so that probably rules out that option.
If you're open to supplements or considering them I'd specifically recommend magnesium and L-theanine. These are the most likely to help you manage your focus better.
Zinc wouldn't hurt to throw into the mix tbh. L-dopa may help with motivation and other symptoms, but evidence is limited. Iron would be a good thing to consider, especially if you menstruate, but I wouldn't expect to see an improvement from regular iron supplementation for a couple of weeks at minimum, which isn't going to be helpful for you in the short term.
Magnesium and iron especially are worthwhile supplementing even if you're on the right ADHD meds. Zinc too but to a lesser degree. (At this point you might be better off just go on a multivitamin.) L-theanine might be helpful after you're on the right ADHD meds or it may not be.
Anyway, I'll wrap up the reply here because it's already too long and there's a lot to chew on in this comment. I'll be around so if you want more info or there's also c/Neurodiverse too. Feel free to keep me posted or to reply if you want any more info.