OTC supplements for adult ADHD?

July 17, 2020 7:54 PM

Dopamine? Blood tests? Family member is struggling with ADHD and extremely resistant to therapy, so zero hope there. He's trying to adopt a 10-20 min (baby steps) daily meditation practice, which he says help...when he can make it happen. He's otherwise generally healthy. But he needs a hand. I see him struggle and am trying to come up with ways. Also interested in short but inspiring TED talks on the subject of (embracing?) overcoming adult ADHD (gifts?) challenges.

He does take a low dose of Adderall (prescribed by his PCP), which he says helps some. He's 50s, super smart, eats well, fairly fit though covid changed his lifestyle significantly and he used to get a lot more cardio. I think he hydrates and works on his sleep, though yes, screen time is an issue for him--he's a news junkie. He's been a stay-at-home dad off and on for many years and now newly certified in a data tool and looking for work. He worries about being able to focus in a new job. I see him every morning for zoom coffee (we're hours apart), and he is clearly having a rough time. I think his ADHD is crippling him. Lack of focus, poor sleep, worry about job performance. And sadly his spouse has little patience or empathy around this. Could be depression as well (I know they're connected). He's really trying on the meditation, and expressed some interest when I said I'd read about a connection to dopamine levels and possibly him trying supplements.

Curious if you've found success with supplements and what they are.
Also, is it necessary/helpful to get a blood test to determine levels for supplementation?
Is there any harm to be caused?

And... anything else you have to offer that frankly might be low-hanging fruit for someone really struggling to get anything done each day. Thanks.

posted by AnOrigamiLife to Health & Fitness (16 answers total)

As an adult ADD-er, some thoughts.

1. Perhaps his dose isn't high enough? Medication isn't a cure-all by any means but I definitely struggle a lot less when I am at the right dosage.

2. Related to this, does he take medication holidays? I try not to take my meds on the weekends unless I really need to, because after too long without a break I find that the same dosage is less effective. Kind of sucks because I'm more tired on the weekends, but it's a helpful tradeoff.

3. Other than medication, the only thing that I've found that consistently helps my focus is really energetic exercise. Walking or jogging don't work. Things like rugby or boxing where you're exhausted at the end. He might be struggling a lot more during covid because of this. I haven't found good substitutes for this kind of exercise other than this kind of exercise; so if this is the cause, he really needs to figure out how he can add good cardio back into his routine I think. It'll probably help with other aspects of his mental health too. I say this knowing how hard it is to make it work during covid. If he can't go to a gym, I've found that even lifting heavy weights or doing sprints is much better than nothing.

Sorry I don't have supplements, but honestly I haven't found any supplements that have ever made a damn bit of difference to me.
posted by forza at 8:01 PM on July 17, 2020 [2 favorites]

Fish oil supplements help me with general focus. (Wherever possible, get the flavored kind because you can surprise yourself with horrifying fish reflux from the unflavored, even if they have a coating that is supposed to prevent that.)

Other things that help: routines, exercise, checklists, limiting screen time, and frequent low-glycemic-index meals to cut back on energy crashes.
posted by corey flood at 8:41 PM on July 17, 2020 [1 favorite]

Vigorous exercise is the best way I’ve heard of to manage ADHD with or without medication. Also, about that unsympathetic spouse: it can be really hard to be married to someone with ADHD, especially when there’s a kid. Working on a system (alarms? reminders?) to keep up with household and family responsibilities may help improve that important relationship and help him with any self-esteem issues.
posted by bluedaisy at 8:47 PM on July 17, 2020 [3 favorites]

Caffeine used to help me calm down and focus.
posted by NotLost at 9:55 PM on July 17, 2020 [1 favorite]

If you haven’t already, talk to your family member about what kind of assistance they think they would benefit from that you can help with. You never say in your post that your family member consents to your help, and thats a really important thing when ADHD is involved. There can be so much that feels out of control! Some people like help with reigning the chaos in, and some people will feel like outside intervention is just one more thing they can’t control and it can be very upsetting.

For me, following ADHD advocates on Twitter has helped normalize things for me:
Particularly Renè Brooks, Dani Donovan, and Jessica McCabe.

Looking at the symptoms that affect me and addressing those particular symptoms has also been helpful. How ADHD causes problems for people can really vary. People with ADHD can experience depression, anxiety, intrusive thoughts, etc as symptoms of ADHD. Determining the ways in which the ADHD is causing interruption to his enjoyment of life is really important for progress.

ADHD is crippling him

Please find another word besides “cripple” for this description.
posted by HMSSM at 10:02 PM on July 17, 2020 [6 favorites]

Add a couple grams/day of omega 3 with a high EPA:DHA ratio
posted by Jacqueline at 10:10 PM on July 17, 2020 [1 favorite]

I don't know exactly what your friend does, but I have an office job that involves working with data and honestly it's a terrible fit for me. I'm on Twitter too much, I sit in front of my computer feeling bad about not working, etc. Finding something different is easier said than done, though, so I've done my best and am getting by.

I don't have normal online ADHD opinions so I don't want to speak for anybody else, but I've had bad luck or results-indistinguishable-from-chance with almost every intervention that wasn't making sure my medication dose was correct. Activists/fellow-ADHD-havers talking about ADHD were helpful at the very beginning but eventually made me feel extremely claustrophobic, like there was one axis on which I turned and one way in which I should interpret my life, so I stopped following them all; supplements, aside from some shady nootropics (think Russian pharmaceuticals) that are "supplements" in the broadest possible sense, were mostly a bust.

Some behavioral interventions (like where I put my keys, etc.) have helped quite a bit, but it would be hard for me to explain how it suddenly became possible for me to put my keys in the same place every time; it was impossible for years and then we moved to this new house and it just wasn't. I'll have weeks where sticking to a written day-planner makes me supremely productive, and then I can't bring myself to look at it for a week and I'm back at square one (though on balance it's been a useful addition.) Exercise makes me feel better but keeping up with it, especially at first, is very difficult for obvious reasons.

At this point in my comment I went up and reread your original question, so I should add: sleep is extremely important on stimulants, at least for me. Being on Adderall with sleep feels like I have become your most charming possible acquaintance who would never sit on the couch thinking about walking over to get his planner for an hour; being on Adderall without sleep feels like I've taken a pill whose mechanism of action is to keep me awake by vibrating me like one of those electric-football-table guys. Sleep is going to be way more important than anything else I suggest here, maybe even including making sure his medication dose is correct. I'm a parent too so I know it can be tough.

Going back to your specific supplement question, I've felt a tiny amount of relief from taking 200mg of L-Theanine with my first Adderall of the day—it's indicated for anxiety, but people in nootropics forums talk about using it specifically in conjunction with caffeine to make the caffeine less jittery and themselves more productive (and also less jittery, for that matter). I can't be sure it's working but it's worth a shot. Magnesium having some salutary effect on regular stimulant users is ancient ADHD forum wisdom, so I take that too.

For me and me alone, the most useful perspective is just to accept my brain as ill-equipped for a lot of aspects of modern life, which after all are not nearly as old as my brain is. That's really neither my fault nor modern life's, but I have to live where I was put and with the tools I have. Right now it's this job I'm a poor fit for; in the medium or long term, though, I have my eye out for something that's a better fit for my significant limitations, since my strengths will be useful anywhere.
posted by Polycarp at 11:06 PM on July 17, 2020 [10 favorites]

I know you're asking about OTC supplements that help with ADHD, so here are the ones that helped me with mood and focus: CoQ10, fish oil (the flavored liquid version is more effective than capsules), Vitamin D, and probiotics.
posted by nightrecordings at 5:29 AM on July 18, 2020

IME the trouble sleeping is bc the adderall is wearing off too early in the day, and thoughts return to racing by bedtime. he could try an extended release version of his adderall dose with a second small regular release dose about 6-8h after the first one. it's literally the only way i can sleep at night. i have severe delayed sleep phase whatever it is and the two doses definitely makes a difference, although it's still a huge nightmare living on a 24h planet when my brain wants a 30h one.

lack of sleep makes stimulant adhd meds close to worthless. the medication spends all its energy animating your flesh prison and leaves your mind to twitch around like a furious chihuahua. trying to make up for lost sleep with caffeine will make things worse.
posted by poffin boffin at 6:18 AM on July 18, 2020 [5 favorites]

I mean, does he want your help? As someone with ADHD if I were struggling and someone tried to cure me by giving me fish oil I’d be insulted.

The best thing you can do is just gently talk to him. Tell him you couldn’t help but notice he seems to be struggling and ask if he’s okay. If he starts to open up, I would gently but firmly suggest that he talk to his doctor and maybe get therapy. That’s all you can do. If he doesn’t want your help, drop it.

And please don’t try to cure him with supplements.
posted by Amy93 at 6:35 AM on July 18, 2020 [7 favorites]

If I were in his situation, I would get a Vitamin D test & supplement Vitamin D as necessary. I’m not officially ADHD, but once treated for low Vitamin D levels my sleep, energy, focus, and mood all improved. Vitamin D has multiple roles. I believe it increases dopamine through some mechanisms, but you’ll have to explore the science behind it if curious. For me, it increases the sense of sleepiness at night & overall daytime energy.
posted by dog-eared paperback at 6:40 AM on July 18, 2020

Protein within the first half hour of waking up was the 'one weird trick' that has helped me, my dad, and my spouse, all of us ADHD-ers.
posted by wellifyouinsist at 7:05 AM on July 18, 2020 [5 favorites]

Agree with pretty much all of the above. FWIW my ADHD-specialist psychiatrist insists I take omega 3 supplements but I find they do absolutely nothing for me.

Personally, I find it incredibly obnoxious to be sent "inspirational" videos about ADHD being a gift, especially when I'm struggling. Great, let's just rub in some more that I'm a failure and that I should be perversely happy to have this thing that makes simple tasks so difficult and does not actually seem to make me more creative or whatever the "gift" is supposed to be.

Similarly, unsolicited advice on supplements and exercise or anything else at all really is also pretty obnoxious. If he's directly asked you for advice on that stuff, it's fine, but otherwise I've already heard enough "just exercise and take fish oil and you'll be cured" for several lifetimes and I'm sure he has too.

Getting the right medication and dose is critical but the troubleshooting process can be long and frustrating, especially if his current meds work ok and new ones might not work at all, so this may or may not be the time to experiment. If he isn't currently being treated by a psychiatrist or an MD with a very good knowledge of ADHD, switching to someone like that instead of a general doc can help.

If you're in a position to do so, you could consider gifting something that would be helpful but not too... direct? I was gifted an Alexa Echo for Christmas and it's been incredibly helpful for managing ADHD stuff since I can set verbal reminders, timers, notes etc immediately as I think of them, without having to track down my phone or anything else and risk getting distracted.
posted by randomnity at 9:18 AM on July 18, 2020 [1 favorite]

And sadly his spouse has little patience or empathy around this.

It is to hard to be a spouse/partner of someone with ADD! So some of what might help is trying to massage that relationship back into a good place, find ways for him to be a better partner so he can get that boat righted a little better. The things that help my ADD partner a lot are

- cardio (aggressive, every other day more or less, can just be fast walking but for a long time)
- meds, adjusted appropriately (helps with "sticky" behavior like doomscrolling types of things)
- decently healthy diet with attention to caffeine and sugar
- ROUTINE (regular wake-up and more-or-less bedtime) so that he things he wants to fit in during a given day are predictable and come with alarms and back-up alarms on his phone
- screen time limits (not externally prescribed but just basic "Try to turn the laptop off by 2 am" for this night owl guy)

Some of this kind of feeds other things. Walking for an hour+ per day means an hour offline which is good (and could be kid time in your friend's case). If you are meeting with them regularly, some kind of a clipboard-holding coaching thing could be useful and might save their partner from having to do that (so exhausting!) "OK what are you doing today? Do you have alarms set? Did you do that thing from yesterday? Where is that going to fit in?"

There are a LOT of pretty effective ADD strategies that help people a lot, once meds are adjusted right and people have accepted their diagnoses. Some of this in a partnership is trying to determine what behaviors they have that are ADD-linked are a problem and need to change (if possible) and which ones are maybe not perfect but an ADD thing that is NOT going to change and so people can learn to develop new ways of framing those things. Depending on where their partner is at with this kind of thing, that can be part of making this work. Like, my guy's ADD is part of him and he's amazing. However that doesn't mean he can always be late because he has a lot of time-compression stuff, but it does mean that if he takes the normal steps to not be late and occasionally they don't work, that's got to be something I can roll with.

And, lastly, if you haven't read ADHD alien, it kind of is a good way to look at and think of some of these things, for your firend and/or maybe for their partner. I specifically found the part about rejection-sensitivity unlocked a part of the puzzle me and my partner had a hard time dealing with otherwise.
posted by jessamyn at 10:35 AM on July 18, 2020

Coffee makes me anxious so I can't drink it all day, but I have found that a quadruple espresso first thing in the morning quiets things down so that I can handle the noise. But that's after a lifetime of acquiring coping strategies as well, and coping strategies are my go-to supplement. Strategies include meditation, a real basic meta-strategy ("I have enough, one thing at a time, put things away, plan, pack") a whole lot of self-forgiveness, and at least one long walk a day.
posted by Peach at 11:27 AM on July 18, 2020

Getting enough quality sleep is SUPER important. Taking melatonin supplements within an hour of when I want to go to bed has helped make it easier for me to fall asleep, but it definitely works best within the confines of a bedtime wind-down routine.

The How To ADHD channel on YouTube has a lot of great content and the person behind the channel also gave a TED talk about her experience with ADHD.
posted by helloimjennsco at 10:51 AM on July 20, 2020