Comment by scrapcode | Hacker News Reader

Comment by scrapcode | Hacker News Reader

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I'm nearing my 40s. In my mid-twenties I was diagnosed and over the next couple of years tried all of the usual ADHD meds and none of them were short of terrible in regard to side effects. I guess I've just learned to live with it in a way that outweighs the side effects I get from the drugs.

I was diagnosed with Shiftwork Disorder at one point in time and was prescribed Modafinil and it was incredible for the most part and had zero side-effects, but my doctor wont prescribe it for ADHD. One down-side to Modafinil is that I could get stuck on an unproductive task and would realize in hindsight that I had just been hyper-attentative to this unimportant task for hours.

Studies show Modafinil isn't effective in ADHD adults. It may have benefit in children with ADHD.

I think many prescribers give ADHD adults a high dose too soon causing side-effects. In my experience, it's best to start with a low dose and slowly increase as necessary. The myth is ADHD responds quickly, but observing hundreds of patients it takes months, not days, for benefit of treatment to develop. There's wisdom in the phrase, "start low and go slow".

Yep. What you find often is that the drug is effective right away, at a 20-30-40% effectiveness level. But over time you learn to take advantage of the benefits more effectively, and get more used to the side effects, so it tends to increase significantly in effectiveness at the same dose over 6-8 weeks much like SSRIs, not because the effects last that long, but because you use the tools to improve the tools.

Have you gone down the rabbit hole of non stimulants?

I have had bad reactions to every stimulant I tried since I developed bipolar 1 in my late teens (had taken them as a child for ADHD).

I had a good response to strattera, but there's a variety of them out there.

I had terrible brain zaps on Strattera and didn't notice anything at all in regard to benefits. Probably because I just could not get through taking it long enough.

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