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Comment by treeman79 | Hacker News Reader

Took adderal for year.

Completely life changing. My focus and energy level were on par with a normal persons.

Unfortunately it was far too hard on the body. Started stroking out on it. Plus it interacted with almost every Medicane I’ve been prescribed.

Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from that. Gave it up after a few weeks.

Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.

Kids have it strong. Wife wants them on meds, but weird reactions run in family so I’m highly reluctant.

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I'm not a parent, so I don't really have any grounds to argue how someone should raise their children. The only anecdote I'll add is that I would be reluctant to hold someone back from an opportunity to have the normalcy that I couldn't have in school. When I got to high school it was like my ADHD kicked into full gear, I started performing significantly worse and outright failing classes. My classmates, friends, and even teachers treated me like a lazy burnout.

Out of 120 students, I was the only one who didn't graduate that year. Sometimes I feel like I have the world's worst case of impostor syndrome because of how high school went for me. I was constantly testing top of the class but most everyone looked at me like an abject failure. I went into college with practically zero note-taking or studying skills and the first couple of years were a nightmare, even with medication.

All this is to say that medication can help when you need to feel normal, but it can't replace the skills you should have been developing. Some people can develop those skills and get shit done without medication and I applaud them, but I tried that route and ended up _years_ behind my peers.

> All this is to say that medication can help when you need to feel normal, but it can't replace the skills you should have been developing.

Exactly. These articles about ADHD and dopamine are often misinterpreted by people who assume that ADHD is a purely chemical imbalance with only chemical solutions.

It's similar to the situation with depression, where decades of misleading ads and pop-neuroscience articles led people to believe that depression == serotonin. Most people are coming around to the idea that the "chemical imbalance" narrative has done more harm than good in the realm of depression treatment, but the idea that ADHD == dopamine and that ADHD is a pure chemical imbalance is still common online.

These studies should be interpreted as a snapshot of the brain's function in the disordered state, but they shouldn't be interpreted as an inherent property of the person's brain. For example, patients suffering from depression will show certain patterns of serotonin activity during depressive episodes that will change following remission, even if the patient doesn't take medication. The brain isn't a unchanging machine that only operates in a single, fixed way.

You said it best: Medication can't replace the skills that one should be developing. Many people take medication as a gateway to develop those skills and go on to do quite well in life. Unfortunately, some people assume the medication lets them off the hook for learning those important skills. They tend to struggle years down the road when they've built a tolerance to the motivating and stimulating effects of the medications (the attention-enhancing effects tend to be more robust against tolerance, but the euphoric/motivating/stimulating effects will dwindle over time).

>Many people take medication as a gateway to develop those skills and go on to do quite well in life.

This is important. When I went on anti-depressants (for pure-o OCD), my intent was to get some breathing room and learn to manage my symptoms better.

I've definitely been able to do that, but it's lead to a few cases of thinking 'hey, I should be able to stop taking these now', which have all gone poorly for me. I think I'm better able to cope now if I don't have access to medication, but I won't be stopping again any time soon, it's too risky for me.

There are supplements, backed by research, that practically remove all of the negative side effects of adderall. To start with, the sadness you felt on vyvanse sounds like dopamine depletion. You want to be taking l-tyrosine to make sure there’s plenty of fuel for the amphetamine to work with. ALCAR + ALA counteract the psychomotor agitation and tolerance formation. Magnesium + zinc help with muscle cramping. Selenium is neuroprotective. And of course you want to make sure you’re getting enough electrolytes (sodium + potassium) and balancing your intake, as a general rule for life, but especially if you take stimulants.

With the aforementioned supplement stack I’ve been able to go off doses as high as 60 mg of adderall per day without any significant withdrawal symptoms. It’s been a complete game changer in terms of making this medication a sustainable option for me. I will say as a caveat that things which reduce drug tolerance formation also typically attenuate some of the effects. In my case, ALCAR + ALA basically erase the potential for euphoria but don’t seem to diminish the mental benefits.

Can you recommend any sources for the mentioned supplements and their interaction with amphetamines?

I’d try to retrace my path through the research for you but I’m on mobile for the rest of the day. I got the anecdotal recommendations from Reddit and then was able to confirm everything on google scholar. So just search for “amphetamine + supplement” on scholar and it should be easy to find the relevant papers. I will say that a lot of them were animal studies but I seem to recall at least a few human trials in the mix.

Dextromethorphan is the most potent anti-tolerance medication you can get your hands on, and it doesn't dampen any effects like ALCAR can.

I used to experiment heavily with all kinds of supplement routines and other nootropics when I had my Adderall Rx.

ALCAR works but like you mentioned, it does blunt things a bit.

https://clinicaltrials.gov/ct2/show/NCT03729128

https://link.springer.com/article/10.1007/s11373-006-9096-4

Dextromethorphan works for tolerance on things other than Amphetamine as well, but that's outside the scope of the conversation.

FWIW, the best I ever felt was on Adderall + 200mg l-Theanine + 10mg Noopept + 15mg Dextromethorphan.

On magnesium. It’s been a huge help for migraines and muscle aches. Aside from zinc the others haven’t been on my radar.

Ordering the rest now.

My chief issue is nerve damage. Anything that helps them is a big win.

It sounds like you've had too many bad reactions to want to keep trying, but did you try Concerta/Ritalin? That's what I was on when I was younger, and it seemed effective. I'm on Vyvanse now.

The only major side effect that's a problem for me is the utter loss of appetite. Frustratingly, it's not that I'm not hungry, I just don't want food. So my stomach will start hurting and I force myself to eat, but it's a challenge. Plus earlier this year I had to give up sugar to account for prediabetes, every day is a struggle to make myself get enough calories. Still, the ability to stay focused on a task for 15 minutes, or even just process my students' sentences, is worth it.

So, heres a lifer's perspective, if it helps.

If they aspire to aviator,stay away. If you really, really worry about locking them into somewhere with access to a Schedule II, then consider not doing it, but I can't overstate how effective and life changing the right treatment regimen is. For me it was like life going from black and white to full color. It can be a bit depressing 20-39 years down the line, and I'm considering getting something started with a Congress person to dial back some of the draconian controls if at all possible, because, not going to lie, it is disruptive as all hell to the lengths things have been allowed to achieve

I've seen other parents with kids who clearly have it do nothing, and the Kids are the ones who really suffer because they don't have a clue what is "wrong".

I kick the wall I'm physiologically disincluded from aviating, but I wouldn't trade all the life experiences I've been able to navigate because of the medication for that, and there's nothing that says the world has to remain so unfriendly to Adderall/ADHD med takers as well.

The Hypertension can be a problem, but a small maintenance dose of a blood pressure meds (or Hawthorne!) Tends to do the trick for me, but work with your doctor.

They're your kids so it's your decision but might I suggest trying a low dose of Adderall or other medication and ramp up over time?

ADD was REALLY hard on me when I was a kid. I had a difficulty making friends. I got really bad grades in school. Got in fights. Made me depressed and I thought something was broken with me.

You can start with 5mg and then ramp up from there. I'm on 15mg. I can't really feel 5m and 20mg is far too much.

At lower doses they won't really have any side effects and then you can keep them on for 90-120 days to see how they tolerate it.

Proper dosage for me can be 10-100 times less then a normal person. Varies greatly.

One kid gets really bad headaches from less then 2mg pill. It’s a hard decision. Constantly monitoring them to see if they can manage without it. I think one is going to be okay with out.

Other one is probably going to have to go on. Still very young though

Do they make them at such low doses or do you need to split it yourself?

Split myself. Quarter of a 10mg pill (2-3mg) will either give me energy $ focus all day, put me to sleep, or give me the worst imaginable headache/partial blindness that takes days to recover from.

Was prescribed amatriptine for nerve damage. I had to get the lowest possible dosage, break pills into quarters. Even then it was still way too strong. ~1mg by my guess.

Doctors & pills straight up hate me.

Having gone through this with my fam, given that you seem to have reactions to every med, have you considered it may be autism or aspurgers? ADHD and autism are often seen together, and reactions to other meds also seems to be fairly common. I just wanted to throw that out there because this realization that it's not just ADHD, not just anxiety, etc has changed our life dramatically... and there are meds that can help with this (on top of some dietary changes).

Anyway, good luck!

Bipolar, schizophrenia, and depression can also cause attention deficient. It is extremely common for children with Bipolar to be misdiagnosed as ADHD.

Depression is usually easier to diagnose accurately. Schizophrenia can be hit or miss, depending on severity. In my case (I'm bipolar), psychosis was so much a part of my normal life that I was completely blind to it and my external symptoms weren't severe enough to be recognizable.

For just ADHD, There are also other classes of medication that can help. Atomoxetine, bupropion, guanfacine, and clonidine are alternative medications that work differently than first line stimulants.

I'm curious if you're willing to share, how psychosis can be a part of a normal life, how you can have it for any length of time without it being recognizable? Did I understand correctly? Is it like, having a very unusual perception of reality, but not so unusual as to interfere with normal functioning?

In people I know who have experienced it, it was very debilitating, so I hadn't even considered the possibility of having it for a long time and still being able to function.

I'll send you an email, as this is getting off topic. :)

Edit... this ended up being an entire blog post, my blog and email are in my profile.

This is possible. When I was diagnosed, it was autism masking ADHD (apparently the other way around is more common though) because I have all the ADHD issues with everything except my special interest. I was told that ADHD more commonly masks autism though, so it's certainly worth exploring the possibility.

The “able to function normally for special interest” is a symptom of ADHD itself, there is no need to bring in autism as an additional explanatory variable. (Not saying your autism didn’t mask symptoms but what you described happens in ADHD without autism very frequently)

For example I have ADHD without autism and grew up thinking I was “smart but lazy” because I was > 99% as far as raw intelligence but had little motivation for the drudgery associated with school (or indeed life itself), yet I could play video games for hours straight without seeming to be at a disadvantage compared to neurotypical peers.

This is because ADHD, among other things, is a disorder of attention regulation as opposed to being completely unable to pay attention to anything.

Hyper focus is a cool super power of adhd.

So cool that you routinely don't do the dishes, laundry, rubbish, childcare or gardening because you're way too in the zone.

It's cool af if you're young and single and you can just go and go and go on what it is that you're totally wrapped up in. It's shite when you grow up a little and other people have expectations of you and you constantly fail to meet them.

Speaking about other possible conditions, anecdotally there are two people in my family who saw a psychiatrist for ADHD like symptoms, who years later were eventually diagnosed with sleep apnea (both with a normal BMI).

It seems like this is not uncommon, quoting Matthew Walker’s “Why We Sleep”:

> Based on recent surveys and clinical evaluations, we estimate that more than 50 percent of all children with an ADHD diagnosis actually have a sleep disorder, yet a small fraction know of their sleep condition and its ramifications.

Good guesses. I do have apnea. I have a cpap and it’s well controlled.

I have an auto immune condition(Sjogrens) as well As a clotting disorder. Plus way to much sugar in 20s.

Took many many years to figure the above out. Proper treatment diet has been helping, but a lot of damage has accumulated.

I have sleep apnea, and ADHD. Before getting on CPAP life was pretty tough. It definitely exacerbated my ADHD at least 2x. So, I can understand that if you're neurotypical and have sleep apnea it is going to be affecting your executive function such that you aren't at 100%. The flip side is ADHDers are significantly more likely to be morbidly obese and have other health complications like sleep apnea as a result. At that point it's a real downward spiral. Very glad I finally sought treatment for my apnea after kicking the can down the road for 4 whole years, which is very typical ADHD behavior in itself.

For real though CPAP is life changing if you need it and you get on it.

> Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from that. Gave it up after a few weeks.

Omg, I actually experience this very thing for myself. I thought I was unique in experiencing the "deepest most profound sadness imaginable" from Vyvanse. It's good to know it wasn't just me.

I did eventually connect the dots with Vyvanse, after taking it a bunch of times. I did several "test runs" where I took it some days, and not other days, and the deep sadness always and consistently occurred about 3-4 hours after taking Vyvanse.

Thankfully, Adderall doesn't have this horrible side effect.

> Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.

I've read that exercise can go a long way in mitigating ADHD. I'm trying to now motivate myself to exercise -- which if I'm able to do would essentially solve the problem ADHD (at least partially), and create a positive feedback loop that could improve my life for the better in the long run.

Exercise is a huge help.

I’m at my best when hiking hills 3-6 miles a day.

> Started stroking out on it

I've never heard this particular phrase before and I can only guess it's meaning vaguely from the context.

What does it mean?

Elevated BP & hypertension causing Serious Negative cardiovascular issues to the point of immobilization and even arrhythmia.

Adderall is so commonly prescribed but honestly for some people the better choice may be dextroamphetamine. I know it was for me.

The levo-amphetamine in adderall causes what is known as peripheral side effects. Higher heart rate. And so on. It doesn’t actually help the brain. Apparently it helps the dextro part last longer.

But its also potentially dangerous.

It sounds like the OP was talking about stroke. The way it was written ("started") it's a little unclear whether the OP was in fear of experiencing a stroke because of other side effects (elevated BP or something), or actually experienced a stroke, which is an extremely rare side effect.

I get minor strokes a lot. TIAs. So far haven’t a full blown stroke.

My blood is sticky(factor 5 Leiden), and cranial pressure runs high.

I tried going off blood thinners 2 months ago, for about a week. Dumb move.

My right side has regained most of its strength and sensation.

Neurologist chewed me out royal. I have to be very careful with meds.

Ah, good luck to you! I can see why you wouldn't want to add any risk factors at all. Sorry to be nosy but do you need to avoid caffeine?

Yes! I don’t avoid it nearly enough because, well high demand job. But I try.

Fewer stimulants I take the better. Vascular constrictors are dangerous for me.

Green Tea seems to not bother me. So I try and drink that or water.

You can get a genetic test to see which adhd medication works best with your DNA and is least likely to give undesirable side effects.

I did not know this.

Biab

From my understanding the verdict is still out on these. What test are you referencing and is it an FDA approved test?

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