My doctor has been prescribing different meds to see which work for me. He's reluctant to prescribe Adderall because of the (artificial FDA-created) shortage. Here's what we've tried so far:

Wellbutrin: Awful, made me feel depressed and generally shitty, quit after a few days.

Strattera: Better reading comprehension, less scattered thoughts. But I was sometimes tired, confused, and unfocused after meals. Also I had a weird tingly sensation on my tongue like I was drinking soda.

Strattera plus Methylphenidate: My doctor had me take a lower dose of Strattera with 10 mg time-release Methylphenidate for a week as a transition between the two. The combo was effective in that it got me to focus, but it effectively killed my inner monologue and made it nearly impossible to have any creative thoughts. Made me feel like the aliens in Blindsight: intelligent but not sentient.

Methylphenidate: What I'm on right now. 10 mg time-release first thing in the morning, plus another 5 mg quick release in the afternoon if I'm feeling tired or unfocused (not sure if I should make that an everyday thing). Generally, it seems very similar to caffeine, but more mellow and consistent over time, and I've been able to cut my caffeine use in half. It seems to help with focus and energy, but not as much with procrastination (I should really be doing chores right now).

I've seen people on here and elsewhere say that Vyvanse helped them, should I ask my doctor if I should try that next? Or does it have the same problems with shortages that Adderall does? Would Strattera plus Vyvanse have the same effects as it did with Methylphenidate?

  • fanbois [he/him]
    ·
    edit-2
    1 hour ago

    DISCLAIMER - I AM NOT A DOCTOR JUST AN ADHD NERD (but your doctor really should have told you this):

    Methylphenidate (MPH, Concerta, Ritalin) and Dexamphetamine (Adderall, DEX, as Vyvanse/Elvanse: Lisdexamphetamine/LDX) are stimulants and the most well researched ADHD medications with highest efficacy rates. They are considered the first-in-line medication when treating ADHD. DEX has slightly better response rates in trials, but it's really a coin toss what works for you.

    Strattera (Atomotexetin) is usually the third choice when the other two fail. Lower response rate than MPH and DEX, but works for some people. The combination with a short release MPH or DEX is fairly common to get started / help in criticial situations.

    Wellbutrin/Bupropion shows strictly worse response rates and is not registered as ADHD medication in many places. Sometimes it gets prescribed as anti-depressant or if all other medication attempts have failed, but it should not be first in line for ADHD at all. I am honestly a little worried that your doctor would prescribe it for ADHD.

    I am not familiar with the medication availability in the US, but unless there are very specific contra-indiciations, a first treatment attempt should be done with MPH or DEX, a second with the other one. I personally take LDX (Vyvanse) and it absolutely changed my life for the better.

    plus another 5 mg quick release in the afternoon if I'm feeling tired or unfocused (not sure if I should make that an everyday thing)

    Your medication level falls over the day, even with an extended release and a "rebounding" effect in the afternoon is extremely common. Do not feel bad about treating your ADHD if you need it. On the other hand: Being tired in the afternoon if you have been active/working during the day is just... normal. I use an advanced recovery technique i call "napping", but of course it's upon you to decide what you need. You could also consider increasing your XR dosage and see if that helps you through the afternoon.

    • Bobson_Dugnutt [he/him]
      hexagon
      ·
      1 hour ago

      Thanks for all the info!

      Wellbutrin/Bupropion shows strictly worse response rates and is not registered as ADHD medication in many places. Sometimes it gets prescribed as anti-depressant or if all other medication attempts have failed, but it should not be first in line for ADHD at all. I am honestly a little worried that your doctor would prescribe it for ADHD.

      I'll definitely ask at my next appointment. I think this was prescribed before I had a diagnosis of ADHD and he thought it was depression or something else. Or possibly because I was wary of stimulants.

      I use an advanced recovery technique i call "napping"

      Napping has never worked well for me, I usually wake up feeling groggy and tired, if I can fall asleep in the first place.

      • fanbois [he/him]
        ·
        edit-2
        3 minutes ago

        Thanks for all the info!

        Hope it helps a little. Keep trying and feel free to give an update.

        Napping has never worked well for me, I usually wake up feeling groggy and tired, if I can fall asleep in the first place.

        Never did for work for me either. Until i got medicated. The fact that i can fall asleep, nap comfortably for 30-40 minutes and get up with a clearer head and some energy recovered, while on 70mg LDX still makes me wonder what the fuck is wrong with my brain.

  • tactical_trans_karen [she/her, comrade/them]
    ·
    1 hour ago

    Methylphenidate time release for me, 54mg seems to be a good balance. I'm also on a heavy dose of dutasteride, which has funny enough positively balanced my mood. Prosac too. But I still procrastinate and it seems to be getting less effective, but I have SAD and less daylight seems to be negatively effecting me along with Burgerland culture, I've had some really bad dysphoria and depression lately.

    • Bobson_Dugnutt [he/him]
      hexagon
      ·
      59 minutes ago

      I have SAD and less daylight seems to be negatively effecting me along with Burgerland culture

      same

  • propter_hog [any, any]
    ·
    2 hours ago

    Strattera made me quick tempered. Not a good thing since I have comorbid anxiety that already gives me the peacefulness of a wasp.

    Vyvanse was the best I've tried so far, and I want to get back on it.