Please share with me your experiences with Adderall XR for ADD!
July 8, 2013 7:19 AM   Subscribe

I am in my late 20's and have had Inattentive ADD/comorbid anxiety for as long as I can remember. I am considering an ADD medication (Adderall XR) for the first time. I am scared of the long-term effects of the drug, as well as afraid of getting addicted and becoming unable to function without the med. I would like to hear from people who have been taking Adderall long-term: How has it helped/change your life? Both positive and negative stories welcome.

I am currently taking Wellbutrin, which (along with exercise) is definitely helping my mood and to a lesser extent my ADD/productivity, but unfortunately significantly increases my anxiety (causing parasthesia in my hands) so am going to have to wean off.

Unmedicated, I am a scatterbrained mess - my nickname was actually "ADD" in college! Fortunately I am relatively smart so I was able to get through school, but upon entering the adult world consisting of holding down a job/paying bills, my life is suddenly crashing. I can't keep up with the daily tasks that I am expected to do everyday, and constantly get sidetracked. If I don't write down the most minute detail, I will forget. I feel like an idiot because I am unable to multitask and do the things normal people seem to be able to do with ease day-to-day.

I know that I shouldn't be searching for a magic bullet, and constantly make grandiose plans on a daily basis to change my behavior and suddenly become a productive workaholic - it doesn't work, which makes the anxiety worse. I started exercising, which I am able to do almost everyday but not at the same time as I have a hard time sticking to a schedule.

So, I would Adderall, but as I wrote previously I have some reservations. I know it is a powerful stimulant, and is not to be taken lightly. I'm worried about the long-term effects, both on my body and mind, of ingesting this drug. So, I'd love to hear more from people who are taking it long-term.

Thanks in advance!
posted by anonymous to Health & Fitness (15 answers total) 5 users marked this as a favorite
I've been taking Adderall for ADHD for longer than I can say (well over a decade at this point), and I can say that it is as close to a magic bullet as you're ever going to see. It's not perfect and it won't fix bad habits in terms of productivity, but it will allow you to focus on things in a way that will be very different from what you've known in the past. The difference (for me anyway) is like night and day. It also helps with a lot of the emotional aspects of ADHD that I have to deal with - impulse control becomes a lot easier.

I haven't really noticed many bad side effects, although it can be a little rough on the digestive system at times (start getting more fiber in your diet now, because you're going to need it). I routinely have my blood pressure taken by the doctor who prescribes me Adderall and there's been no real change in terms of that.

You may find yourself building up a tolerance over time. Drug holidays are a good idea. Avoid taking it on weekends and on days when you don't have to work, if you can help it.

Like I say, it will not suddenly fix everything and you will not become a workaholic overnight, but it will definitely help a lot.
posted by FAMOUS MONSTER at 7:30 AM on July 8, 2013 [1 favorite]

I'm not a long-term Adderall user but I have been taking prescription stimulants for a sleep disorder for a little over a year. I worried about the risk of addiction so I take weekends off occasionally. I don't know if that's an option with Adderall but I felt more comfortable taking stimulants during the week knowing that I could take time off without feeling miserable. When I don't take them, I feel more tired but I'm functional.

I also take a low-dose - I split my pills in half. I am always tempted to take another half during the day and I keep thinking, I'll try that this week, and haven't. I should be tired at the end of the day. Just not during the middle, ideally.

Regarding productivity, if I don't want to do a task at work, taking stimulants doesn't magically make the task get done. But I can say with confidence that taking them has improved my quality of life.
posted by kat518 at 7:45 AM on July 8, 2013

Have you looked at your concerns about taking the drug in light that they might be caused or exacerbated by your anxiety alone? At the very least, you could pilot Adderall for a month, and once you have stabilized, return to this question to see whether you are still feeling undue anxiety about it.
posted by Miko at 7:47 AM on July 8, 2013

I took generic Adderall (amphetamine salts) for almost five years before quitting it cold turkey when it became too much of a hassle to find a new doctor to continue writing me scripts after I moved. The extent of my withdrawal symptoms were sleeping a lot for a couple of weeks and gaining weight. And a torn shoulder tendon (and subsequent inability to do anything physical for months) coincidentally around the same time is probably more responsible for the weight gain than quitting the amphetamines.

They don't stay in your system very long after you stop taking them so addiction isn't much of an issue if you've been taking them as prescribed (and haven't manipulated your doctor into prescribing more than you need). From what I've seen, almost all of the addiction risk is for people who abuse it by taking enough to get high instead of just the minimum therapeutic dose for their metabolism and brain chemistry.

The biggest problem I had was affording it. You should definitely call around to several pharmacies for price quotes before filling your prescription because the prices vary a LOT. IIRC, I could get my prescription filled for $30-something at Costco whereas it could cost upwards of $200 other pharmacies.

Also, last I checked, the extended release (XR) was still only available under the Adderall brand name and not as generic amphetamine salts and thus much more expensive. In my experience, you can achieve the XR effect by taking half doses of the generic more frequently and with food. So you might want to try that before shelling out for the brand name version.
posted by Jacqueline at 8:13 AM on July 8, 2013

Adderall has been a magic bullet for me. Unlike drugs like Wellbutrin, you aren't building it up in your system. In fact, you can feel it wear off as the day goes on. I take the XR version and I get about 12 hours out of it.

I try to take frequent drug holidays (not using it on the weekends or holidays), and I do not feel ill effects for not taking it (such as withdrawal symptoms). I'm just less productive overall. I go back to my natural, fuzzy-brained, distraction-prone, cranky-about-doing-anything-difficult self. That self is a real pain in the ass, so I look forward to taking the drug and being the productive, useful person that I want to be. The drug-taking me was recently promoted at work, pays her bills on time, sends birthday cards to older relatives, and is planning a wedding & honeymoon for this fall. I prefer this me.
But the drug holidays are really crucial. While I never feel withdrawal symptoms, I do feel weirdly tired and stretched if I take it for too many days without a rest. The days off help the drug work better overall.

There are certainly a lot of people who have not felt that the drug worked for them. That is perfectly reasonable. However, it has been a miracle for me.
posted by aabbbiee at 8:21 AM on July 8, 2013 [1 favorite]

The extended release (XR) was still only available under the Adderall brand name and not as generic amphetamine salts.

This is not true anymore. I am getting the XR in generic form (in mid-Missouri, USA) at my regular pharmacy.
posted by aabbbiee at 8:23 AM on July 8, 2013 [3 favorites]

The XR capsules are indeed available as generics, and I have felt a noticeable difference between the regular and the generic.
posted by elizardbits at 8:26 AM on July 8, 2013 [1 favorite]

I take Synthyroid every day and have for 15 years. Same with Adderall XR. Am I addicted? No, I need these medications to function because my body's failed to supply the materials I need. You might find that you don't need Adderall every day or that you can skip weekends. It doesn't build up in your body. Over the 15 years, I've had my thyroid meds changed a number of times, the Adderall dosage once.
posted by Ideefixe at 8:33 AM on July 8, 2013 [1 favorite]

I've been on generic immediate release amphetamine salts (10mg, twice a day) for about 6 months now, and I have to say that the magnitude of positive change this medication has helped facilitate in my life is immeasurable. I finally feel like a fully functional adult, rather than a wishy washy, wallow about, do-nothing child, and my co-morbid depression has pretty much resolved as a result.

I am on a low dose, and I want to stay this way so I take med holidays. I'm med-free most weekends, and take a 5-10 day break every 8 weeks or so, and that has (thus far) nipped any increased tolerance issues in the bud. As soon as I start to feel the effects of the medicine waning, or the thought creeps in to double my dosage to feel the same effectiveness, I take a little break and I'm right back on track.

I've found that even on my medication holidays, I'm able to maintain a semblance of "normal" life due to what I can only guess is the carryover effect of not wanting to screw up the progress that I've made while medicated. So, I'll still do my dishes every night because I already had been doing so for the past 2 months and the sink is not filled to the brim and the task will take 5 minutes and I'm not feeling super ashamed about my sink full of dirty dishes. I know my limits though, and unmedicated, it takes a truckload of willpower and focus to tackle more complicated projects, so I schedule these holidays during a period I know will be slow at work. Or, even better, over an actual vacation.

I say give it a shot. I know my experience is a little shorter term than you're asking for, but the risks are really pretty minimal, and the payoff is pretty damn sweet.
posted by Gonestarfishing at 9:12 AM on July 8, 2013 [1 favorite]

On the topic of med holidays, I took med holidays on weekends for the first few years because I was (mistakenly) under the impression that was necessary to avoid addiction. In reality, the emotional and energy-level rollercoaster that resulted from taking my meds inconsistently was bad enough that my psych doc suggested that I just take the same doses at the same time every day because the increased risk of developing a tolerance was the lesser evil in my situation. I stopped taking med holidays for the last year or two and didn't notice any tolerance issues and as I mentioned above I didn't have a problem quitting cold turkey even after taking it daily.

So while med holidays are a popular strategy for mitigating your tolerance/addiction risk over time, if med holidays end up being bad for you it's not necessarily worse to medicate every day. It's about tradeoffs and finding what works best for your metabolism and brain chemistry. There are no black-and-white rules about what will or won't result in an addiction that work for everyone.
posted by Jacqueline at 9:35 AM on July 8, 2013 [1 favorite]

I got screened for ADHD back in December and started taking Adderall XR a few weeks later (after asking this question), but because of my terrible insurance I now take generic mixed amphetamines, non-extended release.

It wasn't a magic bullet for my bad habits, but it made a WORLD of difference in my ability to tackle and improve them. I had slightly high blood pressure and heart rate prior to starting on it, which was something my primary care doc suggested I might start doing more cardio for anyway, but the meds have not substantially exacerbated the issue.

I also had some initial anxiety about taking stimulants. I have never remotely had any drug dependency problems, but I too was afraid of becoming addicted, requiring ever-increasing doses, etc etc. It's obviously only been a half a year, but this is no longer anything I fear. My Rx is 15mg taken ever 4 hrs, three times a day. Some days I only take two doses. Some days I take all three. Some weekends I'll skip it. Even when I don't take a regular dose, I can honestly say I have more unpleasant withdrawal symptoms from not getting my morning coffee -- the brain fog, inattentiveness, and general fatigue comes back, but I've NEVER had any kind of gotta get my fix feeling.

I'm aware that there are risks and occasionally negative side effects, but as yet I have not had problems and I guess I don't really anticipate ever having them, apart from some initial issues with a bit of insomnia and loss of appetite (these stabilized after about a month). It's been my experience (and also the experience of a friend with narcolepsy who takes Adderall to combat daytime fatigue) that healthcare professionals seem to overemphasise these risks. I'm not a healthcare professional, so maybe they've read studies or seen things that I haven't read or seen and so their concern is totally valid. But I think many people's lives have been improved by medications with vastly more problematic or harmful side effects, and I do suspect that much of the handwaving about mixed amphetamine ADHD stimulants comes from being related to meth. Along with the fact that many people, even the most open-minded of us as well as educated and trained doctors, probably still harbor some degree of cultural baggage and weirdness around the idea of taking brain drugs (I know I kind of did, sadly).

I recommend that you give it a try. I told myself if I was still uncomfortable and anxious about taking them by the time I was ready for a refill, I never had to take it again. Same for you! And feel free to Memail if I can answer any other questions.
posted by hegemone at 11:09 AM on July 8, 2013

Hegemone's experience is very similar to mine, except that I've been on some variation of these meds for about six years now and have finally settled into a good dosage and routine; I have 10mg dextromethamphetamine tablets that I break in half and take every three hours or so; one at 9am, one at noon, one at 3, and one at 6 (all times are ish). It's not for everyone, but spreading it out like that works the best for me; when I miss pills the spaciness definitely returns. But like Hegemone said; it's not a magic bullet, but I can't deny the positive effect it's had.

And you know what? I secondguess that positive effect ALL the time. The main reason it took so long to get on medication in the first place is because I wanted to believe I could buckle down and get better at doing things all by myself (Those grandiose plans! Don't I know it!). I've done a ton of cool stuff since starting medication, but it was all stuff I wanted to do anyway, so it's not like the medication took hold and steered me in a new direction; it's more like the meds helped me figure out better ways to do the stuff I wanted to do.

I've gone off my medication a few times due to insurance issues, and although I turned into a total ditz during those weeks or months, I was still me. I just reverted back to the version of me who is much more likely to forget a crucial thing at home, or who didn't respond to emails for a month, and then felt so bad that I ended up never responding at all.

Oh, and here are the worst side effects I've had from the current regimen:
Sometimes, if I skip some doses, I'll grind my teeth while I'm sleeping. I used to do that before medication, as well.
Another side effect from skipping doses: If I sit and watch a movie I'll notice that my arms or legs feel a little tingly, restless, and uncomfortable, and I'll shift around a lot. If my partner is around, I'll have a very difficult time feeling comfortable with their arm resting on me, and the same thing will happen while we're in bed, along with some resulting mild insomnia. This side effect has actually gone away in the last six months or so, thank goodness, but I had developed a pretty good coping routine in the meantime: Hot tingly shower and a bowl of milk+ cereal usually cured it.
posted by redsparkler at 12:31 PM on July 8, 2013

My experience: I've been on ADHD meds for about 3 years and they have been as close to a silver bullet as one can get, I think. Side effects have been super-minimal and mostly went away after a few months (they were things like dry mouth and decreased appetite).

However, it did take me a few months to find the right med to use. I started with the lowest dose of regular ritalin, which I liked, but found it annoying to have to take two pills a day. So then I switched to Adderall XR for a few months, but I found it made me feel a bit "speedy" which I didn't like. So I switched back to ritalin, this time in the extended-release format (concerta).

I've been on the minumum dosage of concerta for over two and a half years with no problems and lots of good results. But I have friends who felt speedy on ritalin but love adderall. So definitely be aware that the drugs work differently for different people, and if you have a problem with adderall, you may want to try ritalin.

Good effects: I've been promoted twice in that time, gotten my finances under control, can now clean my house (though it's still messy more often than not, at least cleaning without massive frustration is a possibility).

Anyway, I typically take the meds on weekends as well as weekdays because weekends are when I run errands/clean the house/cook for the week/see my friends and it's nice to be patient and able to focus for all of those things. I do tend to start to feel cranky after about 48-72 hours off the meds but I think that may just be that life with ADHD can be frustrating, especially once you get used to things being easier! And if it is withdrawl, well, it's certainly no worse than the withdrawl I experience from caffeine (actually, that withdrawl is a lot worse) so it's a decent trade-off for me. YMMV.

Definitely talk to your prescribing doctor about any concerns, and make sure you schedule follow-up appointments to make sure things are working for you.
posted by lunasol at 1:27 PM on July 8, 2013

Nthing what everyone else said - it's not magic, but it's a giant huge difference in learning how to get shit done. I still by default will scatter from task to task (at work and at home) but the meds allow me to realize that and reorient myself back to the task I need to be working on.

I was laid off from my last job and I swear that my ADD ineffectiveness and frequent inability to complete a task/project was the main reason I was chosen to be canned. It was a major wake up call for me to get my ADD under control, and I'm so glad I did it.

Interestingly, once I got on the right med my anxiety went down instead of being exacerbated by the speed. (Concerta made it worse, Adderall was fine.) Since I was actually getting things done I did not need to think about the giant anvil of oh-shit-I-forgot-to-do-that-what-else-did-I-forget-who-else-is-waiting-on-something-from-me that was always hanging over my head, and BAM there was a lot less to be anxious about all of the sudden.

I don't usually take drug holidays, but I do take a half or 3/4 dose on the weekends or vacation days. Once I got up to the right dose for my system, that kind of dosing seems to be the winner for me.

Good luck!
posted by 8dot3 at 10:17 AM on July 9, 2013

Oh: I've been on it for about 5 or 6 years. Minor weight loss at the start, a little more teeth grinding (which was already a habit) so I eventually got a bite guard for night.
posted by 8dot3 at 10:20 AM on July 9, 2013

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