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Comment by volemo | Hacker News Reader

The country I live in prohibits stimulants and moving is not an option for the time being. What are my options besides atomoxetine?

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Fringe product, not geared for ADHD specifically. But look at Gorilla Mind Rush/Smooth depending on your stimulant tolerance. In your position you don't have many efficacious options, but this works for me as diagnosed ADHD probably 60% as good as the low dose stimulant medication I take.

Bupropion would be one. Helps with quitting smoking, which around 50% of ADDers do, too.

I posted elsewhere in the thread about my late diagnosis. When I was much younger than when I was diagnosed, I was on Bupropion for smoking cessation and it had a pretty significant positive effect for me with respect to my ADHD symptoms (which I didn’t recognize as ADHD at the time). Definitely worth exploring; it doesn’t work for everyone but it can be quite effective if it does work for you.

I would second your suggestion to investigate bupropion. More than a decade ago I was suffering from severe depression. Psychiatrists with meds were an easy-to-access front line treatment, but I was very concerned about SSRI side effects, particularly erectile side effects. It didn't take much persuading to have the psychiatrist prescribe bupropion instead of an SSRI. I too felt it helped with my then undiagnosed ADHD a lot.

As a note, bupropion did make me feel a little funny. It wasn't bad, weird, or intolerable, but yes I did have a faint perceptual awareness that I was in a medicated state.

For the first couple of weeks the first time I took it, Bupropion:

- made me feel pretty energetic. Not buzzed, but maybe counteracted low-grade depression. I was on it because I wanted to quit smoking, because I was hoping quitting smoking would make me feel better/happier

- slightly affected my vision/perception. Colours seemed more vibrant. Everything just felt perceptually… brighter.

- made me really horny, but not in a compulsive way. It wasn’t distracting and didn’t cause any problems, but I definitely had more drive. When it was go time, it was Go Time :)

What's up with the bullet points? This almost reads like a ChatGPT/AI comment, which is especially weird for a personal recollection. Are people writing like frickin robots now?

Lol that’s how I’ve written for 25 years. I’m flattered that LLMs are copying me.

Don’t be an ass. People used lists before LLMs.

They’re just lucky I didn’t have a big run-on sentence, like I used to before taking a serious look at how ADHD affected my writing and thought processes, including significant use of parentheticals (because every thought comes with a couple of extra thoughts, for free!)

If I had more time, I would have written a shorter letter.

The more time I have, the more of those extra thoughts I can decide aren't really important.

> every thought comes with a couple of extra thoughts, for free!

Bonus points if you branch deep enough to lose the original thought.

I have to say, buproprion had severe, life-threatening side effects for me. I'm not in a typically high-risk group for psychotic symptoms, but it caused me to become quite agitated and delusional.

It feels strange to type that now, and I know these side effects are quite rare, but I can't help but warn people when I see it mentioned. It was genuinely the most terrifying experience of my life.

It happened about 6 weeks into treatment, quite acutely. I wasn't even aware it was happening.

a) try to find a way to fill declaration of prescribed medications for customs and for police. (let the google/llm and local adhd communities help you) Find verified cases of how that have worked for others in your particular country. Sometimes workarounds exists, but it would take some paperwork

b) plan a trip to the Turkey, find a specialist there, get the prescription, do all the paperwork/preparations before going back

c) fill all the papers and get the approval at customs even if they didn't know about that before - prepare all the necessary links to official documents, as maybe you would have to explain them how to do their job

p.s. I know that feeling. Atomoxetine is full of side effects without direct effects.

Bupropion, Guanfacine, Clonidine, Modafinil. Check out John Kruse on YouTube for explanation of these and others.

Thanks, but Bupropion and Modafinil are also banned over here. I’ll look into the other two.

Caffeine perhaps? Yerba mate? Also CBT therapy on its own is pretty good.

Yes, caffeine works but I’m very cautious not to build up tolerance, i.e. I’m afraid that if I start drinking tea/coffee regularly, it’ll loose the jolt it gives me now and I’ll just become addicted.

Guanfacine is underrated.

Nicotine. But not the smokeable kind. And low dosage. But not if you’re likely to get addicted. The absurdity is that your country definitely makes it legal for historical reasons rather than useful less addicting stimulants.

nicotine is ridiculously addictive. everyone is likely to get addicted to it

I agree that it’s ridiculously addictive. There’s a big correlation to delivery type and how your brain can associate it to drive that compulsion. It’s very fast acting, esp when smoked.

https://www.pbs.org/newshour/amp/science/column-recent-resea...

Nicotine is amazing... for a week. Then you will be chasing the dragon forever. Tolerance builds up crazy fast and doesn't meaningfully lower even when you cease smoking for years.

Plus pretty bad for your health and crazy addictive. Absolutely not a good recommendation.

> Tolerance builds up crazy fast and doesn't meaningfully lower even when you cease smoking for years.

I specified not smoking it though?

> Plus pretty bad for your health and crazy addictive. Absolutely not a good recommendation

You’re saying that it’s “bad for health” as something separate from its addiction potential?

How is it bad for your health exactly?

Also, ‘Crazy addictive’ is related to delivery method.

Also, there may be critical differences to people who have never smoked before.

It wasn't till I quit nicotine that I began to struggle with undiagnosed adhd. I wish there was a way to make nicotine safe and non-addictive. I think it was far more effective to spike my nicotine level and tackle a task than adderall twice a day has been. Vaping was huge for controlled nicotine consumption.

You are being down-voted by people making big claims ("pretty bad for your health and crazy addictive", "nicotine is ridiculously addictive") without any proofs. In fact, I challenge anyone making such claims to reference a scientific study proving either of major addictive potential or significant health concerns of _nicotine patches_ since OP specifically mentioned "not the smokeable kind" of nicotine.

I mean, tobacco smoke is terrible for anyone's health but even nicotine on its own is not exactly good for you. It's definitely a stimulant and can give you the kinds of side effects you might expect from any stimulant, including a raised BP and heart rate.

> It's definitely a stimulant and can give you the kinds of side effects you might expect from any stimulant, including a raised BP and heart rate.

Sure, but people wouldn't downvote a comment suggesting having couple of cups of coffee per day to improve ADHD symptoms as hard, for example. And for me caffeine withdrawals symptoms have always been more difficult to overcome compared to nicotine.

For average tech worker HN user living a sedentary life-style, having stressful job in polluted city periodic usage of nicotine patches won't make it to their top list of health concerns IMO.

So much of the research and the general understanding is just conflated with cigarettes as the delivery type. They present a bunch of problems: the smoke and other chemicals makes it damaging in a lot of ways. People sometimes swap the terms “nicotine” and “cigarettes”. Cigarettes (and presumably vaping) have one of the highest and fastest nicotine deliveries — this is critical in creating the physical/chemical (dopamine) response that your brain and body use in addiction formation.

We can have two companies release the same code, but the ui/UX of the users interaction with it can make all the difference.

Wait, you’re just repeating general empty statements. Why isn’t nicotine on its own good for you? A raised heart rate and BP for a period isn’t a bad thing. It’s an expected response from any stimulant.

I mean, sex and exercise also cause the same responses.

Khat?

Khat will wreck your teeth if you chew the leaves. And it's about on par with caffeine as far as stimulants go, so personally I'd stick with coffee or tea instead of khat.

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