especially if you had to try different medications to find one that worked

  • KrasMazovThought [comrade/them]
    ·
    4 years ago

    My ADHD diagnosis was recent, coming up on just about a year from when I went back on a heavy dose of antidepressants triggered by panic attacks and depression. I was diagnosed with social anxiety disorder, generalized anxiety and major depression early in my adult life, and while those are accurate as symptoms I also had marked ADHD that went untreated forever because I was too smart and too quiet to have it (the SAD, GAD and MDD are probably BPD but not necessarily relevant here).

    I've had a decent ringer of experiences for antidepressants, anxiolytics, stims and other types of pharmacopeia licit and illicit. Medications I've been on and can speak to personally: escitalopram, sertraline, bupropion, ketamine, venlafaxine (antidepressant class), lorazepram, diazepram, phenibut (anxiolytics), methylphenidate, dextroamphetamine, cocaine, lisdexamfetamine (stimulants), phenylpiracetam, fasoracetam, oxiracetam and aniracetam (racetams), guanfacine (adrenergic agonist), and brexpiprazole (atypical antipsychostics). Besides all that I used to be an alcoholic and until recently smoked about 3 grams of weed a day (nothing but stimulating sativas). The fact that the only weed I smoked was stimulating despite it causing anxiety was a definite clue as to what was up. When I started getting panic attacks early last year and went back on medication, the only thing that had an impact was buproprion, which was another major clue -- it doesn't work like typical antidepressants that target serotonin reuptake, but works instead on dopamine and norepinpehrine. So it turned out I was looking for things that would give me energy and motivation constantly, and I worked backwards from what made me feel that way, and then why I didn't feel properly to begin with back to ADHD.

    Right now I'm on 50 mg of Vyvanse (lisdexamfetamine), 2 mg of Intuniv (guanfacine) and have just started today 1 mg of Rexulti (brexpiprazole). I can't speak to the brexpiprazole since it's so new, but that's primarily for the borderline personality symptoms (wildly unstable mood, impulsiveness, intense fear of abandonment, lack of motivation) anyway. I can give as brief or in depth an overview of any of the medications you'd like, and I've also become fixated on contemporary trends in psychiatry so I can speak reasonably as well to the different effect profiles of different drugs, how they hit you, side effects and what they target.

    • 420sixtynine [any,comrade/them]
      hexagon
      ·
      edit-2
      4 years ago

      Please do let me know what you've tried and know about any info is good

      So far this is the list of ones I know about, I'm probably gonna go with a stimulant bc they help with my sleep issues

      • Lisdexamfetamine (Vyvanse)

      • Methylphenidate (Ritalin)

      • Dexmethylphenidate (Focalin)

      • Novo-methylphenidate (Concerta)

      • Dextro-amphetamine (Dexedrine)

      • Methamphetamine HCL (Desoxyn) Ik it's probably best not to ask for this one unless every other option has been tried lol

      • KrasMazovThought [comrade/them]
        ·
        edit-2
        4 years ago

        For sure! So of those, I've had D-Amp (Dexedrine brand) Adderall (D-Amp and Levioamphetamine), and Lisdex (Vyvanse), and methylphenidate (as extended release Biphentin). The amphetamines (Adderall, Dexedrine, Vyvanse) all work similarly with slight variations on delivery mechanism or effect, and the same with methylphenidate (Ritalin, Focalin, Concerta) which work similarly, and meth. I found methylphenidate to give me a headache and not really provide much of a boost while amphetamine has definitely improved my concentration, energy and mood. Adderall has more of a pronounced effect but lasts less which can be beneficial if you just want the focus and energy during school or work, say. Vyvanse is a smooth and delayed release delivery system for amphetamines which is probably your best bet for sleep and less jarring effects.

        Special shoutout here to guanfacine which is a non-stimulant medication for ADHD that smooths norepinephrine functioning -- personally I'm a fairly anxious person and one of the reasons is a dysregulated fight-or-flight system and emotional turbulence, resulting in inappropriate bursts of adrenaline, trouble sleeping, interpersonal wariness. Because stimulants can increase anxiety, it goes together really well for me.

      • SpookyVanguard64 [he/him]M
        ·
        edit-2
        4 years ago

        I've only ever been on Dexmethylphenidate/focalin, started at 5mg, now at 10mg. It's a bit inconsistent for me, and some of the inconsistency seems to be based on taking different versions from different manufacturers. Depending on whatever variant my pharmacy is using, sometimes it feels like 10mg works fine, but for other variant I have to take a 15mg dosage to get the same effect.

        There are also a number of side effects I've noticed. Consuming sugar or caffeine while on focalin is a complete no go for me, 'cause it causes me to become anxious/restless. Blood circulation is another problem I've noticed. I already don't have the best circulation to my hands and feet, and focalin can make them feel extra chilly sometimes, especially during the winter. The other circulation problem I've noticed is that it's very hard to get an erection while under the effects of focalin, so if that's applicable to you then it's something to keep in mind. Another problem is that sometimes it can cause brief instances of minor dizziness, but that's a pretty rare side effect for me personally and it's never been severe enough to cause me to worry. The last problem I've encountered is the focalin can cause a brief (~30 minutes) depressed/exhausted state for me while it's wearing off. This usually only happens if I'm under stress though (for example, driving home through rush hour traffic while focalin is wearing off), so I can avoid it if I'm careful.