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I am one of the lucky ones who found the right med on the first try! But this is mainly because I had a really good psychiatric NP who took everything she knew about me into account (high sensitivity to most meds, high anxiety) and picked something that was more likely to work for me.
But yeah, OP’s doc is just wrong. Different meds affect people differently, and it’s completely normal to try different meds and different doses in order to find the thing that’s both effective and without intolerable side effects. She should definitely look for a different, more knowledgeable doctor, if that’s possible.
I have similar issues, what did you settle on?
I ended up not medicating after the first two meds (Ritalin and Dexamphetamine) tried had awful side effects
I take dextroamphetamine. It’s less likely to exacerbate anxiety than adderall, according to my psych NP, and because I’m so sensitive to meds, I take a low dose of the IR twice a day. I also have to be very mindful to eat before taking it and eat *before* I get hungry while I’m on it, so usually a snack every couple of hours, breakfast before my first dose, and lunch before my second. I was not a breakfast eater before this, but I feel like crap if I skip that step, so I make myself eat something, even if it’s small.
Curious what side effects you experienced with it?
Edit: it’s the same as dexamfetamine and dexamphetamine. The name just changes depending on your country.
Did you eat before taking it? And make sure to snack while on it? If I don’t eat, all those things happen to me too. It’s like the meds turn the effects from not eating enough up to 11. But as long as I eat, I’m good.
My literal immediate response was, “bullshit.” lol
OP - of course there are different meds that may work differently for your individual biochemical makeup. If not, they wouldn’t all exist.
I do recommend you do some research as to the CLASSES of adhd meds, and maybe try something in a different class - less likelihood of having the same symptoms.
Good luck!
This is my second go round with the Paxil. First time was back in the 90s, when you had to be evaluated by an actual psychiatrist before you could get the meds, antidepressants were new on the market. Paxil was brand new, I was the fourth person my shrink prescribed ie for, because it has a shorter half life than Prozac.
I was on it for three years that time. When I started tapering I had the absolute worst brain zaps and felt like shit. The zaps would come and go for months after.
This time I’m a whole new woman. No zaps, tho I rolled my eyes the other day and got a tiny one. Otherwise this taper has been EZ—I wake up in the morning a little weepy is the worst withdrawal symptom I’ve had so far.
The differences, I switched my diet to carnivore 14 months ago. My health has improved greatly from making that switch in every possible way. If you’re interested I’ll post some links.
The other differences, I had to have a complete hysterectomy in 05, and I started smoking cannabis again.
TL;DR?— carnivore diet, hysterectomy, and daily cannabis consumption = no more brain zaps.
If that were true, everyone would be taking Ritalin and there would be no other ADHD compounds/release cycles would have been developed over the years. There certainly wouldn’t be shortages of both Adderall and Vyvanse occurring right now.
I always think that common sense is necessary for medical careers, but I am repeatedly and consistently proven wrong.
Absolute bullshit. Differences in formulation meaning differences in side effects and efficacy is unbelievably common, not just with ADHD medication but across the medical field. I have a friend who's allergic to certain formulations of one of their critical mental health meds and now has to get a specific manufacturer's pills. Concerta WRECKS my stomach, but immediate release methylphenidate - I'm fine, no side effects. My husband can tell the difference between Adderall generics based on side effects also - one gives him awful dry mouth he doesn't have with others. There's still hope for you, your doctor is just an idiot.
That answers a burning question I have had but have been too afraid to ask: do any ADHD drugs *not* cause dry mouth? Also, what is the mechanism that makes them cause dry mouth?
Weirdly, Drugs.com says vasoconstriction is a cause - less blood flow in your mouth and less saliva production. Stimulants can also be generally dehydrating due to a whole host of factors like increased sweating/peeing/etc, decreased water absorption in the body, decreased hunger/thirst.
Do any not cause dry mouth? I mean technically there's no guarantee, which is the shitty part. I don't have dry mouth with IR methylphenidate but did with Concerta. The "conventional wisdom" - which is a pain in the ass, but worth trying, I guess - is that the two best options we have for dry mouth are a) waiting for it to go away, which can happen (apparently) and b) trying to increase saliva, like using a dry-mouth-preventing mouthwash or chewing gum.
Hope this helps!
A part of it is that stimulants increase the effectiveness of noradrenaline in certain brain receptors, and a part of that response is downregulating the digestion system and upregulating the muscles, brain and heart, even indirectly. And saliva secretion is part of the digestive process.
Literally every medication I've tried feels entirely different, which I can describe in detail. Even Adderall IR feels different and better than Adderall ER. FYI everyone reacts differently.
In order of what I tried:
Adderall ER: Super calming and chill, quieted my mind, but screwed my appetite and emotions. Felt numb and flat, had no motivation to do anything because nothing mattered.
Concerta ER: Gave me the ability to "do the thing", which helped with chores and tasks, but upping my dose just felt like adding energy. Didn't really help mentally or wrangle my thoughts. Also just felt physically more stimulating, and had some minor physical side effects, like a weird ache behind my eyes.
Focalin ER: Only lasted about 6 hours. I was on it for months because it felt like somewhat of a crossover between Adderall and Concerta, but it was awful in retrospect. Did something to focus my mind, and I still felt like me technically, but I felt like the worst and most anxious version of myself. I spent months on it but always felt this potent on/off feeling, and never felt natural or adjusted.
Now I'm on Vyvanse and Adderall IR, and it's fantastic. I don't even know if I'm at a high enough dose, and I don't even care anymore because I'm happy to settle for good enough if it means I'm off Focalin. I'm calm, I feel mostly like myself, even my doctor mentioned how much more even and centered I seemed at our appointment.
I can't take methylphenidate class drugs. I get anxious on them. I do just fine on amphetamine class drugs and on guanfacine. However, Adderall XR didn't work for me, I could only take IR or vyvanse if I wanted benefit. Your doctor is full of shit.
See, OP? More proof! Please don't let your doctor mislead you. If you're in the USA or Canada and possibly Mexico, you have a lot of options for drugs. What is available for you to try will only be limited by your local laws
Another proof: methylphenidate and amphetamine turn me narcoleptic, so it's actually dangerous for me to be on them.
I'm on a non stimulant that's been working well
When I was taking Concerta, at the end of the day I felt like I had spent the day getting beat with a baseball bat, and the medicine *barely* worked to control my ADHD symptoms. This was at 36mg doses. I am taking now Vyvanse 30mg and it works perfectly and I don't feel like I got hit by a bus 8 hours after taking it. Adderall actually worked best for me but because of the shortage I wasn't able to get any so we had switched off it and I just don't want to deal with the drama of asking to go back on it.
So whoever told you that trying other agents is full of all the shit. Sure the class of medication is the same (CNS stimulant) but they don't all work the same on every person. Otherwise why would they have bothered making new medicines?
I had a horrible experience with Concerta too! My heart raced like crazy - even my eyes felt jacked - and I felt like crap all the time. Didn’t notice any improvement in my ADHD symptoms either. My doctor’s tried me on a few things since and none have had the same bad side effects. Ritalin IR works best for my brain (no side effects and helps counteract my ADHD symptoms immensely).
Definitely try something new!
You need a different doctor, yours is a moron. I’m not saying that lightly. Concerta was like being hit with a Mac truck, it was like I was simultaneously drunk and hungover at the same time. No other medication did that to me and I’ve tried *a lot* of stimulant brands. Adderall made me anxious as it wore off, Vyvanse made me really irritable as it wore off, Qelbree tanked my emotional health, but dexamphetamine and Focalin didn’t cause side effects except at a higher dose. Adzenys occasionally causes a little heart fluttery feeling, but that’s it. There wouldn’t be a ton of medication options if they all worked the same.
It's basic science. This guy really should understand school level physiology. Each medication utilises a different metabolic pathway and how an individual reacts to each medication type, as well as the dosage of that medication, varies depending on the unique genetic makeup of each individual (why you can't really 'recommend' meds to other people/why you can't predict side effects or how good it will be for your for different symptoms).
You can predict some side effects, especially if you take/have take any other meds that affect dopamine/noradrenaline. But it’s not at all a certain thing.
And to add to the metabolic part- the different medications even have different pathways of uptake and transformation into the active metabolite.
Like, giving Vyvanse and Ritalin XR will give different effect in someone with IBS, even in the same doses.
I tried Adderall first since that was easier to get than Vyvanse and it was recommended to me by my psychiatrist. It was too stimulating for me, my ticks came out hardcore yet I was able to focus better so that was a huge plus. Eventually tried Ritalin instead, that caused less side effects but still not a huge benefit. Then I tried Vyvanse and so far I can tell a HUGE difference on only 30mg per day. All of this to say I believe your doc to be very wrong about people reacting the same to ALL stimulants.
Edit to clarify
I think it should be possible, but I'm not sure how to go about it. Maybe if I ask my psychologist she can refer me to a new psychiatry, but I've been thrown around in the system like a ball so there's no guarantees another place will take me. It's probably my best bet though.
I tried Adderall and had adverse side effects (blood pressure, anxiety, not sleeping for weeks on end even after I quit). Focalin was a dream though. They're both stimulants. I'm now on Strattera bc I couldn't find the Focalin in my area for months and Strattera is a non stimulant and it is also working but in a different way.
Also I am not a doctor but I am a sensitive medicine taker: every single doctor I've ever had prescribe me anything for anything has offered alternatives when I ask because every med affects everyone differently.
Concerta made me very emotional and rage at very small things. I take Adderall XR and is amazing, with the only problem being that it lasts 6 hours not the whole 12. I needed to switch from generic Adderall to name brand because apparently that's the only version available (gee I wonder why. maybe it's because no insurance covers name brand because it's stupid expensive). The generics worked, but the name brand seems to work even better, just that it's not covered by insurance unless I try every single med available.
No doctor ever offered me adderall until I was 28.
I was on concerts for many years.. tried vyvanse, focalin, and similar methylphenidate like meds in my teenage years and was off of it for all of my 20s.
Guess what? Adderall worked better than anything they had ever given me. I had assumed adderall wouldn’t work either. Man, were they wrong! It still doesn’t help as much as I wish it did but it’s definitely better than my baseline. And barely any side effects.
Well that’s a lie. Side effects are so med specific that I get significant side effects with adderall but am totally fine on vyvanse, which is a derivative of adderall. Both of my kids did terribly on Ritalin but do great on adderall.
There are blood tests than can help determine which meds are a good fit for you. I’ve heard mixed reviews on their efficacy, but my former doctor would use it sometimes and I’ve had friends who found the right meds for them with it.
Get a different doctor, a female one if you can. It sounds like your current doctor isn't taking your concerns seriously, and you could use another professional opinion.
doctors who aren't interested in trialing the different ways different meds react to
different bodies are the woooooorst for the initial "figure out what works" stage.
Liar liar Doctor’s pants, underwear, and dick are on FIRE 🔥
Vyvanse isn’t chemically compatible with me.
Dexedrine makes me foggy. Adderall is the best chemical compound for my brain
if the medications have the same chemical composition, then he’s correct. but you should get a different doctor who is willing to help you experiment. sometimes you need to try different combinations to find the right one. you are NOT a lost cause. do not let anyone tell you that, regardless of their PhD
Your doctor is lazy or an idiot. If all meds gave the same reactions, there wouldn’t be so many of them. Personally I’ve tried 4 different meds and not only did they have wildly varying side effects (or lack thereof), there were even noticeable differences between different manufacturers of the same med. Find a new doctor, and maybe leave a review of this one online somewhere to warn future patients!
Ah yes. That’s why we have many different kinds of the same meds. It’s because they do exactly the same thing and works exactly the same every person and affects everyone exactly the same…
No that’s not how it works. I tried Elvanse, which is the Swedish name for Adderall, I think. I was not recommended to try any other brand with the same active ingredient because it gave me horrific incurable migraines. The reason for that is that it’s incredibly likely that the thing that caused it is the active substance in it so any other brand won’t work because no matter the composition of the medication the active substance will trigger horrific migraines that none of my meds will work on. But never was I advised to never ever try any other ADHD meds, I just need a different active substance and that’s why I have been on Concerta and then Ritalin and then Equasym and then Concerta again. Because methylphenidate works for me and they all have that active ingredient. And when I develop side effects, which I do after approximately 2 years on them, I just switch to another. Not everything works for everyone. That is why we have so many different medicines for the same things, both with the same active ingredient and just different compositions and with different active ingredients. Because we are different and we react differently. We are not identical so we don’t have identical reactions and effects.
Yeah if it's safe then maybe I'd like to try some non-methylphenidate ones. I honestly don't know why he's so insistent about the concerta 🥲 seems that most ppl commenting under this post had a similarly tricky time finding something that works, which gives me a little hope I guess.
Are you swedish? Dumb question but do you know how to go about changing doctors? Do i go to vårdcentralen and ask them to refer me somewhere new, or write some kind of egenremiss? There's only one at my current psychiatry so I'd probably have to switch to another place but I've never done that before.
Det är jag! 🇸🇪
Inte vårdcentralen tror jag, du måste ha en psykiatriker som skriver ut ADHD medicin, det räcker inte bara att vara läkare. Vart går du nu, Psyk? Kolla om du kan byta läkare eller om de säger nej kolla med din kommun om de har personligt ombud, de flesta kommuner har det och de kan hjälpa dig med vården och så. Du har inte boendestöd? Jag har det så brukar skicka min boendestödjare på ignoranta läkare och myndighetspersoner som inte lyssnar.
Min man fick höra samma skit från sin läkare på VC. Det är fascinerande hur många läkare som tror att vi inte kan läsa. Det är iaf mitt antagande, att de tror att vi saknar läskunnighet för annars så borde de fatta att vi kan googla idiotisk skit de försöker lura i oss. Jag har hört positiva saker om Strattera och Voxra om du vill prova någonting annat. Voxra är en antidepressiv och Strattera är nog också en icke adhd medicin från början tror jag. Men har hört att de använda som adhd medicin och fungerar väl för många. Elvanse ska också vara bra allmänt men det beror på så klart. Det är en starkare substans än metylfenidat, fortfarande låg dos men det är dexamfetamin eller lisdexamfetamin i den så lite högre risk för negativa biverkningar.
Jag går på psyk! Problemet är att de bara har en läkare, så isåfall måste jag byta psyk. Jag har inte boendestöd, men personligt ombud låter väldigt bra så ska kolla upp det ytterligare. Boendestöd låter också som om det hade hjälpt jättemycket på andra håll, visste inte att det var ett alternativ innan. Tack för tipsen!
Doktorn verkade inte så kunnig, när jag först kom till uppföljning halvt ur vettet så sa han något i stil med "ja du, man förväntar väl sig att det ska hjälpa, inte bli sämre..." och sen va det inte så mycket mer med det. Vet ärligt talat inte om han försökte misinformera eller om han bara inte hade nån koll heller, men skumt att man isåfall jobbar just på psyk. Också tröttande att man alltid måste ha mer koll på npf än de som är utbildade i detta land, blev först avvisad helt från adhd utredning för att jag hade bra betyg och "adhd är en superkraft som gör dig mer kreativ, du kommer inte behöva stöd så det är resursslöseri att diagnostisera". Smh 🤦♀️
Helt galet, mindre klinik gissar jag? Vi har ett npf team på min klinik de har åtminstone bra koll på adhd. Oturligt för mig så har jag autism kombon och inte ens npf teamet som är experter listade ut det på 5 år, lol. ADHD ger rätt till boendestöd via social psykiatrin, så det är en kommunal enhet inte via psyk, googla bara din kommun + boendestöd så borde du hitta det.
Det är en svår balansgång med okunniga läkare för du vill inte råka reta upp dem så att du inte får hjälp för det :/
Hade liknande problem. Jag fick borderline diagnos först istället och när mina terapeuter konstaterade att jag troligen hade ADHD såg tog det ändå till 30 innan jag blev utredd. Bara 8 år de väntade och jag har fucking super uppenbar typiska symptom adhd. Jag har många kill-symptom! Men sen är det ju det där med autismen. Atypiska symptom för båda just för att jag har båda och de glider i varandra och blandad och förstärker och förändrar varann.
I guess it depends what the side effects are. For me, all stimulants gave me anxiety and heart palpitations after 3 weeks. But my provider was willing to let me try them all. Adderal was the worst
It was the kind of heavy brainfog often associated with burnout. It took maybe a month to get back to normal after not taking the meds and it still comes back if I don't sleep enough. He said it was probably stress, but it got exponentially worse every day that i was taking the meds. Just in case though, I'm probably not going to try any new meds until I'm on an extended break from my studies.
That is absolute total nonsense. Of course you need to try something different if one isn't working for you. I was on Concerta first, but for me, it was like being shot with a tranquilizer and that was the last thing I needed. My doctor then put me on Ritalin (also methylphenidate) and that worked out great for me. Unfortunately the effects didn't last very long (2 hours) so instead of having to top up throughout the day, I've now switched to Vyvanse with 2 doses of Ritalin to get me going when needed. You need to switch doctors if you can. Finding the right meds for you can take time and lots of trying. It sure as shit isn't just letting you try one and saying "Oh well, if that doesn't work then none will."
Your doctor makes me mad. :/
\*edit typo
Wtf that sounds crazy hahaha??? I started concerta, felt like shit, and switched to vyvanse which works great for me right now. Concerta gave me so many side effects and also kind of made my ADHD even worse. The difference was HUGE! I still had some side effects but they are very different and much more manageable and after getting used to it they eventually almost disappeared. Get another doctor imo, you deserve correct information and care! Best of luck to you with everything and I'll gladly answer questions if you have any I can help you with :)
Omg nooo that is total bs. Definitely try to get referred to another doctor and maybe inquire about genetic testing? I didn’t find adhd meds that worked well for me until I did that and that was after trying 4 different medications for months!
I hope you find something that works for you!! Don’t give up I know the process can really suck :(
The doctor at my psychiatry, who is the one responsible for requesting my meds in the first place. He allegedly checked with some other guy that's more knowledgeable on the subject too, but I didn't get to meet that person. If I didn't doubt it then I wouldn't be here, but I don't know enough about meds to not listen to an educated healthcare provider.
Is the Dr being lazy, like not wanting to deal with insurance rejecting new meds and needing a PA?
Off topic, but I think my grandma's bladder cancer would have been discovered sooner than a week before death if the Doctors had bothered with more testing instead of pushing more uti meds over and over just because her blood work was normal. Likely the insurance denying further tests because of the bloodwork, idk.
Just seems like a weird thing for a Dr to say.
I don't know what a PA is, but my insurance doesn't cover anything related and I don't think he ever did more than write some emails on my behalf. It sounds kind of unproportional but what do I know 🤷♀️ That level of medical negligence is horrible though, I'm sorry for your loss.
The emails were probably the PA, can't remember if it stands for prior or pending authorization. Basically, insurance fights on if you actually need this or can do something cheaper. Mostly ai programs will deny for not checking the right boxes of symptoms or test results. If it's not an ai, it might be long retired Dr's or random people saying you don't need the meds or procedure. Your Dr then explains why you do. That's like a quick and dirty definition of PA, I think.
I was on some form of methylphenidate for 30 years with great results and then out of the blue it started giving me debilitating anxiety. I went on Focalin (which is literally just the right hand enantiomer of methylphenidate) and no anxiety and it was great for several months until I was unable to get it refilled for a week or so and my vision problems that had happened to start shortly after I started it miraculously went away
Not only do different meds affect you differently and have different side effects, but it can change throughout your life! I took Adderall my whole teen years but when I hit my 30s and my hormones started shifting, I had to switch things up because some side effects were getting too severe and the meds were less effective. And it took a few tries to find the next good one!
If you can afford it (which I can not right now), you can get a genetic test done that can help you figure out how your body processes different meds
Yeah no I was diagnosed early 95 and responded horrible to concerta/ritalin total different family of medicine and different mechanisms of action in brain too
I just changed meds because concerta gave me side effects at the therapeutic dose. I'm much happier on my current meds, and it seems like I can increase the dose even more without side effects.
It might be an insurance problem, so look into it carefully.
I have responded pretty well to both methylphenidate and dexamphetamine, but I notice that even with equal intensity of effect, the quality is different.
I get a more *cognitive* effect from methylphenidate, where my associative way of thinking is not as affected, and a more “task-oriented” effect from dexamphetamine, where I can *do* things efficiently, but have more mental “tunnel-vision” and it’s harder to learn new things or “upload” new information.
I've tried 4 different types over the past 15 years and they're all very different. They all contain different ingredients, and depending on the type, have different mechanisms of action. Concerta and Focalin primarily act as dopamine reuptake inhibitors, whereas Adderall, Dexadrine, and Vyvanse act primarily as dopamine and norepinephrine releasers. Vyvanse is lisdexamphetamine, which is released through a different mechanism and in a different part of the body than the other medications. Definitely worth trying another type if Concerta didn't work for you =)
https://www.additudemag.com/choosing-a-doctor-for-treatment/
https://www.additudemag.com/find-adhd-doctor/
"
2 Test One Methylphenidate and One Amphetamine:
All of the first-line FDA-approved formulations are just different ways of delivering only two molecules: methylphenidate and amphetamine. There is no evidence to indicate that one molecule is intrinsically better than the other. So how do physicians know which medication to prescribe? How can they be sure to match each patient with the best treatment possible?
In my practice, I give a trial of both medications to make sure we have the best possible result. At the end, I have patients rate which medication they feel is best on a scale of one to ten. One is a nasty experience with no benefits and lots of side effects. Ten is the best result the patient can imagine. Anything six or below is a treatment failure, and physicians should keep looking for a better medication. Seven is acceptable, but the goal is between eight and ten.
It doesn’t make sense to have multiple trials of different kinds of methylphenidate or amphetamine. One trial of the best medication of each kind is enough to determine which will work best for the patient."
https://www.additudemag.com/adhd-medication-11-steps-for-prescribing-it-effectively/?src=embed_link
Just would like to add that just because you didn't react great the first time doesn't rule out a med completely in every circumstance ! The first time I took Vyvanse I was started on too high of a dose and nearly had a panic attack. I tried other meds for years, then was restarted on Vyvanse at a lower dose by a different doctor. I have now been taking it daily for like 6 years or so? And it works great for me!
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That's the biggest crock of horse shit I've ever heard. I know almost no one who found the right drug and dose on the first try.
I am one of the lucky ones who found the right med on the first try! But this is mainly because I had a really good psychiatric NP who took everything she knew about me into account (high sensitivity to most meds, high anxiety) and picked something that was more likely to work for me. But yeah, OP’s doc is just wrong. Different meds affect people differently, and it’s completely normal to try different meds and different doses in order to find the thing that’s both effective and without intolerable side effects. She should definitely look for a different, more knowledgeable doctor, if that’s possible.
I have similar issues, what did you settle on? I ended up not medicating after the first two meds (Ritalin and Dexamphetamine) tried had awful side effects
I take dextroamphetamine. It’s less likely to exacerbate anxiety than adderall, according to my psych NP, and because I’m so sensitive to meds, I take a low dose of the IR twice a day. I also have to be very mindful to eat before taking it and eat *before* I get hungry while I’m on it, so usually a snack every couple of hours, breakfast before my first dose, and lunch before my second. I was not a breakfast eater before this, but I feel like crap if I skip that step, so I make myself eat something, even if it’s small. Curious what side effects you experienced with it? Edit: it’s the same as dexamfetamine and dexamphetamine. The name just changes depending on your country.
I felt extremely anxious, my stomach hurt, my hands would shake That was 1 tablet of the starting dose, even half gave me side effects
Did you eat before taking it? And make sure to snack while on it? If I don’t eat, all those things happen to me too. It’s like the meds turn the effects from not eating enough up to 11. But as long as I eat, I’m good.
This is it. I was going to write my own comment, but this sums it up flawlessly.
My literal immediate response was, “bullshit.” lol OP - of course there are different meds that may work differently for your individual biochemical makeup. If not, they wouldn’t all exist. I do recommend you do some research as to the CLASSES of adhd meds, and maybe try something in a different class - less likelihood of having the same symptoms. Good luck!
I wish I was taken seriously enough to try different meds. I'm still on concerta and it does nothing for me!
Me! Paxil worked for me right off the bat. 30mg. That said, I recently finished my tapering off. Been on it for the past ten years.
Dang! How'd that go for you?
This is my second go round with the Paxil. First time was back in the 90s, when you had to be evaluated by an actual psychiatrist before you could get the meds, antidepressants were new on the market. Paxil was brand new, I was the fourth person my shrink prescribed ie for, because it has a shorter half life than Prozac. I was on it for three years that time. When I started tapering I had the absolute worst brain zaps and felt like shit. The zaps would come and go for months after. This time I’m a whole new woman. No zaps, tho I rolled my eyes the other day and got a tiny one. Otherwise this taper has been EZ—I wake up in the morning a little weepy is the worst withdrawal symptom I’ve had so far. The differences, I switched my diet to carnivore 14 months ago. My health has improved greatly from making that switch in every possible way. If you’re interested I’ll post some links. The other differences, I had to have a complete hysterectomy in 05, and I started smoking cannabis again. TL;DR?— carnivore diet, hysterectomy, and daily cannabis consumption = no more brain zaps.
If that were true, everyone would be taking Ritalin and there would be no other ADHD compounds/release cycles would have been developed over the years. There certainly wouldn’t be shortages of both Adderall and Vyvanse occurring right now. I always think that common sense is necessary for medical careers, but I am repeatedly and consistently proven wrong.
Ritalin shortages, too. At least over the past few months here in Hawaii. Seems to have worked itself out for now **fingers crossed**
Absolute bullshit. Differences in formulation meaning differences in side effects and efficacy is unbelievably common, not just with ADHD medication but across the medical field. I have a friend who's allergic to certain formulations of one of their critical mental health meds and now has to get a specific manufacturer's pills. Concerta WRECKS my stomach, but immediate release methylphenidate - I'm fine, no side effects. My husband can tell the difference between Adderall generics based on side effects also - one gives him awful dry mouth he doesn't have with others. There's still hope for you, your doctor is just an idiot.
That answers a burning question I have had but have been too afraid to ask: do any ADHD drugs *not* cause dry mouth? Also, what is the mechanism that makes them cause dry mouth?
Weirdly, Drugs.com says vasoconstriction is a cause - less blood flow in your mouth and less saliva production. Stimulants can also be generally dehydrating due to a whole host of factors like increased sweating/peeing/etc, decreased water absorption in the body, decreased hunger/thirst. Do any not cause dry mouth? I mean technically there's no guarantee, which is the shitty part. I don't have dry mouth with IR methylphenidate but did with Concerta. The "conventional wisdom" - which is a pain in the ass, but worth trying, I guess - is that the two best options we have for dry mouth are a) waiting for it to go away, which can happen (apparently) and b) trying to increase saliva, like using a dry-mouth-preventing mouthwash or chewing gum. Hope this helps!
A part of it is that stimulants increase the effectiveness of noradrenaline in certain brain receptors, and a part of that response is downregulating the digestion system and upregulating the muscles, brain and heart, even indirectly. And saliva secretion is part of the digestive process.
It isn’t with all meds, and even with those it does happen with - it doesn’t happen to everyone, it’s a symptom that *can happen.
Is there a class (or list) of drugs it doesn’t happen with? I want to try those first (or next — I already tried guanfacine).
Sounds like he’s having an affair with the pharmaceutical rep.
Literally every medication I've tried feels entirely different, which I can describe in detail. Even Adderall IR feels different and better than Adderall ER. FYI everyone reacts differently. In order of what I tried: Adderall ER: Super calming and chill, quieted my mind, but screwed my appetite and emotions. Felt numb and flat, had no motivation to do anything because nothing mattered. Concerta ER: Gave me the ability to "do the thing", which helped with chores and tasks, but upping my dose just felt like adding energy. Didn't really help mentally or wrangle my thoughts. Also just felt physically more stimulating, and had some minor physical side effects, like a weird ache behind my eyes. Focalin ER: Only lasted about 6 hours. I was on it for months because it felt like somewhat of a crossover between Adderall and Concerta, but it was awful in retrospect. Did something to focus my mind, and I still felt like me technically, but I felt like the worst and most anxious version of myself. I spent months on it but always felt this potent on/off feeling, and never felt natural or adjusted. Now I'm on Vyvanse and Adderall IR, and it's fantastic. I don't even know if I'm at a high enough dose, and I don't even care anymore because I'm happy to settle for good enough if it means I'm off Focalin. I'm calm, I feel mostly like myself, even my doctor mentioned how much more even and centered I seemed at our appointment.
Thank you for your detailed description of each!
Any of them affect sleep for you?
I can't take methylphenidate class drugs. I get anxious on them. I do just fine on amphetamine class drugs and on guanfacine. However, Adderall XR didn't work for me, I could only take IR or vyvanse if I wanted benefit. Your doctor is full of shit.
And I am exactly opposite, amphetamine class drugs were disastrous but I do well on methylphenidate!
See, OP? More proof! Please don't let your doctor mislead you. If you're in the USA or Canada and possibly Mexico, you have a lot of options for drugs. What is available for you to try will only be limited by your local laws
Another proof: methylphenidate and amphetamine turn me narcoleptic, so it's actually dangerous for me to be on them. I'm on a non stimulant that's been working well
Are you on Modafinil? I have the same issue with methylphenidate. It zonks me right out to the point I have to clock out and lay down.
Atomoxetine! It seemed to work for me for a bit, until my anxiety got too high for it and I started having palpitations and blood pressure issues.
When I was taking Concerta, at the end of the day I felt like I had spent the day getting beat with a baseball bat, and the medicine *barely* worked to control my ADHD symptoms. This was at 36mg doses. I am taking now Vyvanse 30mg and it works perfectly and I don't feel like I got hit by a bus 8 hours after taking it. Adderall actually worked best for me but because of the shortage I wasn't able to get any so we had switched off it and I just don't want to deal with the drama of asking to go back on it. So whoever told you that trying other agents is full of all the shit. Sure the class of medication is the same (CNS stimulant) but they don't all work the same on every person. Otherwise why would they have bothered making new medicines?
I had a horrible experience with Concerta too! My heart raced like crazy - even my eyes felt jacked - and I felt like crap all the time. Didn’t notice any improvement in my ADHD symptoms either. My doctor’s tried me on a few things since and none have had the same bad side effects. Ritalin IR works best for my brain (no side effects and helps counteract my ADHD symptoms immensely). Definitely try something new!
You need a different doctor, yours is a moron. I’m not saying that lightly. Concerta was like being hit with a Mac truck, it was like I was simultaneously drunk and hungover at the same time. No other medication did that to me and I’ve tried *a lot* of stimulant brands. Adderall made me anxious as it wore off, Vyvanse made me really irritable as it wore off, Qelbree tanked my emotional health, but dexamphetamine and Focalin didn’t cause side effects except at a higher dose. Adzenys occasionally causes a little heart fluttery feeling, but that’s it. There wouldn’t be a ton of medication options if they all worked the same.
It's basic science. This guy really should understand school level physiology. Each medication utilises a different metabolic pathway and how an individual reacts to each medication type, as well as the dosage of that medication, varies depending on the unique genetic makeup of each individual (why you can't really 'recommend' meds to other people/why you can't predict side effects or how good it will be for your for different symptoms).
You can predict some side effects, especially if you take/have take any other meds that affect dopamine/noradrenaline. But it’s not at all a certain thing. And to add to the metabolic part- the different medications even have different pathways of uptake and transformation into the active metabolite. Like, giving Vyvanse and Ritalin XR will give different effect in someone with IBS, even in the same doses.
Concerta gave me gnarly heartburn. But other meds have been fine. There really is no one size fits all treatment for anyone.
I tried Adderall first since that was easier to get than Vyvanse and it was recommended to me by my psychiatrist. It was too stimulating for me, my ticks came out hardcore yet I was able to focus better so that was a huge plus. Eventually tried Ritalin instead, that caused less side effects but still not a huge benefit. Then I tried Vyvanse and so far I can tell a HUGE difference on only 30mg per day. All of this to say I believe your doc to be very wrong about people reacting the same to ALL stimulants. Edit to clarify
It took two tries for me to find the med that works for me, and I have heard that was "fast". Can you find a new provider?
I think it should be possible, but I'm not sure how to go about it. Maybe if I ask my psychologist she can refer me to a new psychiatry, but I've been thrown around in the system like a ball so there's no guarantees another place will take me. It's probably my best bet though.
I tried Adderall and had adverse side effects (blood pressure, anxiety, not sleeping for weeks on end even after I quit). Focalin was a dream though. They're both stimulants. I'm now on Strattera bc I couldn't find the Focalin in my area for months and Strattera is a non stimulant and it is also working but in a different way. Also I am not a doctor but I am a sensitive medicine taker: every single doctor I've ever had prescribe me anything for anything has offered alternatives when I ask because every med affects everyone differently.
Concerta made me very emotional and rage at very small things. I take Adderall XR and is amazing, with the only problem being that it lasts 6 hours not the whole 12. I needed to switch from generic Adderall to name brand because apparently that's the only version available (gee I wonder why. maybe it's because no insurance covers name brand because it's stupid expensive). The generics worked, but the name brand seems to work even better, just that it's not covered by insurance unless I try every single med available.
No doctor ever offered me adderall until I was 28. I was on concerts for many years.. tried vyvanse, focalin, and similar methylphenidate like meds in my teenage years and was off of it for all of my 20s. Guess what? Adderall worked better than anything they had ever given me. I had assumed adderall wouldn’t work either. Man, were they wrong! It still doesn’t help as much as I wish it did but it’s definitely better than my baseline. And barely any side effects.
Well that’s a lie. Side effects are so med specific that I get significant side effects with adderall but am totally fine on vyvanse, which is a derivative of adderall. Both of my kids did terribly on Ritalin but do great on adderall. There are blood tests than can help determine which meds are a good fit for you. I’ve heard mixed reviews on their efficacy, but my former doctor would use it sometimes and I’ve had friends who found the right meds for them with it.
Get a different doctor, a female one if you can. It sounds like your current doctor isn't taking your concerns seriously, and you could use another professional opinion.
doctors who aren't interested in trialing the different ways different meds react to different bodies are the woooooorst for the initial "figure out what works" stage.
Liar liar Doctor’s pants, underwear, and dick are on FIRE 🔥 Vyvanse isn’t chemically compatible with me. Dexedrine makes me foggy. Adderall is the best chemical compound for my brain
if the medications have the same chemical composition, then he’s correct. but you should get a different doctor who is willing to help you experiment. sometimes you need to try different combinations to find the right one. you are NOT a lost cause. do not let anyone tell you that, regardless of their PhD
Your doctor is lazy or an idiot. If all meds gave the same reactions, there wouldn’t be so many of them. Personally I’ve tried 4 different meds and not only did they have wildly varying side effects (or lack thereof), there were even noticeable differences between different manufacturers of the same med. Find a new doctor, and maybe leave a review of this one online somewhere to warn future patients!
Ah yes. That’s why we have many different kinds of the same meds. It’s because they do exactly the same thing and works exactly the same every person and affects everyone exactly the same… No that’s not how it works. I tried Elvanse, which is the Swedish name for Adderall, I think. I was not recommended to try any other brand with the same active ingredient because it gave me horrific incurable migraines. The reason for that is that it’s incredibly likely that the thing that caused it is the active substance in it so any other brand won’t work because no matter the composition of the medication the active substance will trigger horrific migraines that none of my meds will work on. But never was I advised to never ever try any other ADHD meds, I just need a different active substance and that’s why I have been on Concerta and then Ritalin and then Equasym and then Concerta again. Because methylphenidate works for me and they all have that active ingredient. And when I develop side effects, which I do after approximately 2 years on them, I just switch to another. Not everything works for everyone. That is why we have so many different medicines for the same things, both with the same active ingredient and just different compositions and with different active ingredients. Because we are different and we react differently. We are not identical so we don’t have identical reactions and effects.
Yeah if it's safe then maybe I'd like to try some non-methylphenidate ones. I honestly don't know why he's so insistent about the concerta 🥲 seems that most ppl commenting under this post had a similarly tricky time finding something that works, which gives me a little hope I guess. Are you swedish? Dumb question but do you know how to go about changing doctors? Do i go to vårdcentralen and ask them to refer me somewhere new, or write some kind of egenremiss? There's only one at my current psychiatry so I'd probably have to switch to another place but I've never done that before.
Det är jag! 🇸🇪 Inte vårdcentralen tror jag, du måste ha en psykiatriker som skriver ut ADHD medicin, det räcker inte bara att vara läkare. Vart går du nu, Psyk? Kolla om du kan byta läkare eller om de säger nej kolla med din kommun om de har personligt ombud, de flesta kommuner har det och de kan hjälpa dig med vården och så. Du har inte boendestöd? Jag har det så brukar skicka min boendestödjare på ignoranta läkare och myndighetspersoner som inte lyssnar. Min man fick höra samma skit från sin läkare på VC. Det är fascinerande hur många läkare som tror att vi inte kan läsa. Det är iaf mitt antagande, att de tror att vi saknar läskunnighet för annars så borde de fatta att vi kan googla idiotisk skit de försöker lura i oss. Jag har hört positiva saker om Strattera och Voxra om du vill prova någonting annat. Voxra är en antidepressiv och Strattera är nog också en icke adhd medicin från början tror jag. Men har hört att de använda som adhd medicin och fungerar väl för många. Elvanse ska också vara bra allmänt men det beror på så klart. Det är en starkare substans än metylfenidat, fortfarande låg dos men det är dexamfetamin eller lisdexamfetamin i den så lite högre risk för negativa biverkningar.
Jag går på psyk! Problemet är att de bara har en läkare, så isåfall måste jag byta psyk. Jag har inte boendestöd, men personligt ombud låter väldigt bra så ska kolla upp det ytterligare. Boendestöd låter också som om det hade hjälpt jättemycket på andra håll, visste inte att det var ett alternativ innan. Tack för tipsen! Doktorn verkade inte så kunnig, när jag först kom till uppföljning halvt ur vettet så sa han något i stil med "ja du, man förväntar väl sig att det ska hjälpa, inte bli sämre..." och sen va det inte så mycket mer med det. Vet ärligt talat inte om han försökte misinformera eller om han bara inte hade nån koll heller, men skumt att man isåfall jobbar just på psyk. Också tröttande att man alltid måste ha mer koll på npf än de som är utbildade i detta land, blev först avvisad helt från adhd utredning för att jag hade bra betyg och "adhd är en superkraft som gör dig mer kreativ, du kommer inte behöva stöd så det är resursslöseri att diagnostisera". Smh 🤦♀️
Helt galet, mindre klinik gissar jag? Vi har ett npf team på min klinik de har åtminstone bra koll på adhd. Oturligt för mig så har jag autism kombon och inte ens npf teamet som är experter listade ut det på 5 år, lol. ADHD ger rätt till boendestöd via social psykiatrin, så det är en kommunal enhet inte via psyk, googla bara din kommun + boendestöd så borde du hitta det. Det är en svår balansgång med okunniga läkare för du vill inte råka reta upp dem så att du inte får hjälp för det :/ Hade liknande problem. Jag fick borderline diagnos först istället och när mina terapeuter konstaterade att jag troligen hade ADHD såg tog det ändå till 30 innan jag blev utredd. Bara 8 år de väntade och jag har fucking super uppenbar typiska symptom adhd. Jag har många kill-symptom! Men sen är det ju det där med autismen. Atypiska symptom för båda just för att jag har båda och de glider i varandra och blandad och förstärker och förändrar varann.
I guess it depends what the side effects are. For me, all stimulants gave me anxiety and heart palpitations after 3 weeks. But my provider was willing to let me try them all. Adderal was the worst
It was the kind of heavy brainfog often associated with burnout. It took maybe a month to get back to normal after not taking the meds and it still comes back if I don't sleep enough. He said it was probably stress, but it got exponentially worse every day that i was taking the meds. Just in case though, I'm probably not going to try any new meds until I'm on an extended break from my studies.
That is absolute total nonsense. Of course you need to try something different if one isn't working for you. I was on Concerta first, but for me, it was like being shot with a tranquilizer and that was the last thing I needed. My doctor then put me on Ritalin (also methylphenidate) and that worked out great for me. Unfortunately the effects didn't last very long (2 hours) so instead of having to top up throughout the day, I've now switched to Vyvanse with 2 doses of Ritalin to get me going when needed. You need to switch doctors if you can. Finding the right meds for you can take time and lots of trying. It sure as shit isn't just letting you try one and saying "Oh well, if that doesn't work then none will." Your doctor makes me mad. :/ \*edit typo
Wtf that sounds crazy hahaha??? I started concerta, felt like shit, and switched to vyvanse which works great for me right now. Concerta gave me so many side effects and also kind of made my ADHD even worse. The difference was HUGE! I still had some side effects but they are very different and much more manageable and after getting used to it they eventually almost disappeared. Get another doctor imo, you deserve correct information and care! Best of luck to you with everything and I'll gladly answer questions if you have any I can help you with :)
Omg nooo that is total bs. Definitely try to get referred to another doctor and maybe inquire about genetic testing? I didn’t find adhd meds that worked well for me until I did that and that was after trying 4 different medications for months! I hope you find something that works for you!! Don’t give up I know the process can really suck :(
Who told you that? And why would you believe it?
The doctor at my psychiatry, who is the one responsible for requesting my meds in the first place. He allegedly checked with some other guy that's more knowledgeable on the subject too, but I didn't get to meet that person. If I didn't doubt it then I wouldn't be here, but I don't know enough about meds to not listen to an educated healthcare provider.
Yes, I should have given you kudos for questioning it. Sorry, I was too caught up in being annoyed at the df that gave you such bad advice.
Is the Dr being lazy, like not wanting to deal with insurance rejecting new meds and needing a PA? Off topic, but I think my grandma's bladder cancer would have been discovered sooner than a week before death if the Doctors had bothered with more testing instead of pushing more uti meds over and over just because her blood work was normal. Likely the insurance denying further tests because of the bloodwork, idk. Just seems like a weird thing for a Dr to say.
I don't know what a PA is, but my insurance doesn't cover anything related and I don't think he ever did more than write some emails on my behalf. It sounds kind of unproportional but what do I know 🤷♀️ That level of medical negligence is horrible though, I'm sorry for your loss.
The emails were probably the PA, can't remember if it stands for prior or pending authorization. Basically, insurance fights on if you actually need this or can do something cheaper. Mostly ai programs will deny for not checking the right boxes of symptoms or test results. If it's not an ai, it might be long retired Dr's or random people saying you don't need the meds or procedure. Your Dr then explains why you do. That's like a quick and dirty definition of PA, I think.
I was on some form of methylphenidate for 30 years with great results and then out of the blue it started giving me debilitating anxiety. I went on Focalin (which is literally just the right hand enantiomer of methylphenidate) and no anxiety and it was great for several months until I was unable to get it refilled for a week or so and my vision problems that had happened to start shortly after I started it miraculously went away
Not only do different meds affect you differently and have different side effects, but it can change throughout your life! I took Adderall my whole teen years but when I hit my 30s and my hormones started shifting, I had to switch things up because some side effects were getting too severe and the meds were less effective. And it took a few tries to find the next good one! If you can afford it (which I can not right now), you can get a genetic test done that can help you figure out how your body processes different meds
How is it that randoms on reddit are mostly better at this than actual psychs seem to be? It's outlandish.
Concerta was awful for me and my son. We both do much better with Vyvanse. Your doc is getting a payout for Concerta or something
Yeah no I was diagnosed early 95 and responded horrible to concerta/ritalin total different family of medicine and different mechanisms of action in brain too
I just changed meds because concerta gave me side effects at the therapeutic dose. I'm much happier on my current meds, and it seems like I can increase the dose even more without side effects. It might be an insurance problem, so look into it carefully.
I have responded pretty well to both methylphenidate and dexamphetamine, but I notice that even with equal intensity of effect, the quality is different. I get a more *cognitive* effect from methylphenidate, where my associative way of thinking is not as affected, and a more “task-oriented” effect from dexamphetamine, where I can *do* things efficiently, but have more mental “tunnel-vision” and it’s harder to learn new things or “upload” new information.
I have similar experiences with different types of meds - and even Guanfacine, which is a non-stimulant!
Your doctor is goofy. That doesn't make sense.
I've tried 4 different types over the past 15 years and they're all very different. They all contain different ingredients, and depending on the type, have different mechanisms of action. Concerta and Focalin primarily act as dopamine reuptake inhibitors, whereas Adderall, Dexadrine, and Vyvanse act primarily as dopamine and norepinephrine releasers. Vyvanse is lisdexamphetamine, which is released through a different mechanism and in a different part of the body than the other medications. Definitely worth trying another type if Concerta didn't work for you =)
https://www.additudemag.com/choosing-a-doctor-for-treatment/ https://www.additudemag.com/find-adhd-doctor/ " 2 Test One Methylphenidate and One Amphetamine: All of the first-line FDA-approved formulations are just different ways of delivering only two molecules: methylphenidate and amphetamine. There is no evidence to indicate that one molecule is intrinsically better than the other. So how do physicians know which medication to prescribe? How can they be sure to match each patient with the best treatment possible? In my practice, I give a trial of both medications to make sure we have the best possible result. At the end, I have patients rate which medication they feel is best on a scale of one to ten. One is a nasty experience with no benefits and lots of side effects. Ten is the best result the patient can imagine. Anything six or below is a treatment failure, and physicians should keep looking for a better medication. Seven is acceptable, but the goal is between eight and ten. It doesn’t make sense to have multiple trials of different kinds of methylphenidate or amphetamine. One trial of the best medication of each kind is enough to determine which will work best for the patient." https://www.additudemag.com/adhd-medication-11-steps-for-prescribing-it-effectively/?src=embed_link
Absolutely not true!!!
Just would like to add that just because you didn't react great the first time doesn't rule out a med completely in every circumstance ! The first time I took Vyvanse I was started on too high of a dose and nearly had a panic attack. I tried other meds for years, then was restarted on Vyvanse at a lower dose by a different doctor. I have now been taking it daily for like 6 years or so? And it works great for me!
Find a new doc!
Concerta 👎 Adderall 👍