ADHD meds no longer working
May 6, 2019 10:39 AM   Subscribe

You Are Not My Doctor. Your body is not my body. Tell me about your experiences with ADHD/ADD meds anyway.

Going to see my health care provider tomorrow. My old-school generic Ritalin doesn't seem to be working well for me anymore. On top of that, my chronic depression has reared up again. I will be talking to trained professionals about this stuff tomorrow but I am interested in the hive mind's personal experiences.

1. If you take something that helps you with focus and/or motivation, what is it? Have you personally experienced any side effects? How long you been on it?
2. If you take something that helps you with ADHD and also seemingly helps with depression, what is it? Have you personally experienced any side effects? How long you been on it?

I am exercising, I am doing all the things I can think of, I am in no danger, I just need a meds adjustment (or it seems to me). Also, I hate change. Hate it, hate it, hate it, so the idea of having to suffer through trying new meds really annoys me at the same time that I can tell I am not in a healthy place and I need to get there. The idea of taking new meds makes me anxious. So share your stories. They don't have to be happy ones but happy ones are okay, too. Thanks!
posted by Bella Donna to Health & Fitness (14 answers total) 10 users marked this as a favorite
I take generic Focalin (Ritalin before that, just switched because Focalin felt a little smoother) and have for years. It still works about as well as it always did, but if I'm getting less sleep or otherwise am not up to 100% of my normal level it can be less effective. One thing that's helped me, or at least hasn't hurt me, is not taking it on the weekends; have you tried that?
posted by Polycarp at 10:42 AM on May 6, 2019 [1 favorite]

I take Adderall (the quick-release version) and an SSRI for depression. A few years ago I dropped the SSRI and was just on the Adderall for a while, and after several months it became clear that I needed the separate antidepressant as well; YMMV.

For me, when it seemed as if the Adderall wasn't helping enough, we first switched from the extended release to the quick release (because it seemed like my body was processing the XR too slowly), and that helped. Then we increased my typical morning dose, and that higher dose seems to work well for me - I've been stable on it for a while. So you may not need to switch meds at all, an increase may work just fine for you.

It also seems to help me if I take a day or two off the ADHD meds sometimes, like on weekends or on workdays when I know I won't need them. If nothing else, it gives me a baseline to compare my medicated self to, which helps me notice what the meds are or aren't doing.

On the non-meds side, another thing that has been a big help for me was connecting both my ADHD and my depression to anxiety, a diagnosis which I hadn't thought applied to me before. But all three of those conditions are so interlinked that anxiety may be worth exploring for you as well. The whole "really hating change" thing can be a product of clinical anxiety.
posted by showbiz_liz at 10:50 AM on May 6, 2019 [1 favorite]

My thing is more anxiety than depression, but that being out of control is not something that my Adderall can override in terms of getting things done; I have to take meds for both. ADD meds can have an antidepressant effect but they don't always, and lots of people take multiple things at once. I have some depression symptoms when I'm off of it but they're fairly mild compared to the giant anxiety elephant trampling over everything. It does seem to help that far, but I wouldn't expect it to help with ongoing major depression without other meds.

I think Adderall IR works fine for me; I haven't tried Ritalin. It definitely came with some early sleep disruptions and I get some heart palpitations occasionally that I manage with a beta blocker, but less than I used to. I used to do the weekends off thing, but I don't anymore; my housework suffered a lot from the breaks, and I don't think it really helped much. I probably wouldn't personally push to change my ADD med before trying other medication as a supplement, when there's clearly-identified other brain weasel stuff going on, but I don't think the Adderall adjustment was that bad or something to be afraid of if your doc wants to go that direction.
posted by Sequence at 11:02 AM on May 6, 2019

HEYOOO sorry to ride my hobbyhorse into this thread but not all generics are created equal and some of them are fucking terrible and dangerous! I was forced by insurance reasons to switch to generic adderall this month and experienced acute amphetamine withdrawal! It was a fucking nightmare! I would regain "consciousness" sobbing in random locations! The difference between generic adderall XR by Impax Labs and the brand name from Shire is astonishing and I will now be paying $260 out of pocket every month to avoid the horrors of generic ever again.

DEFINITELY find out if your pharmacy has inexplicably switched generic brands on you. Some of them are great and indistinguishable from the real thing, and some of them are dangerous garbage, and sometimes when things are proven to legitimately be dangerous garbage, the FDA does nothing, issues no notices or recalls, and the patients suffer, as was the case with Ranbaxy Wellbutrin which caused suicides. Google for any problems with your specific generic brand.

WRT specifically your meds: I was on various ritalins for a while and they worked great until one day they suddenly Did Not, specifically with the Daytrana patch, which caused increasingly disturbing symptoms like fainting, asthma attacks, and panic attacks. Switching to adderall XR has been a game changer for me, it's been probably 10 or 11 years now and I will ideally never have to switch to anything else. People get very fearmongery about adderall because it is truly just amphetamines, but I've been on the same low dose for the entire time and I don't feel like I need to up it due to tolerance.

Change is terrifying and upsetting with medications that you rely on to feel "normal" but suffering with them because of that fear is so awful.
posted by poffin boffin at 11:05 AM on May 6, 2019 [13 favorites]

two other things that i have found can affect how my meds work are whether or not i've had enough sleep, and, bizarrely, seasonal allergies, which now instead of making me sneeze and have itchy eyes, make me pass out constantly from overwhelming physical and mental exhaustion. it sounds insane, i know, but if you're feeling super worn out and stupidbrained, try taking an otc allergy pill and see if there's any respite?
posted by poffin boffin at 11:08 AM on May 6, 2019 [4 favorites]

Vyvanse is the only amphetamine combo that helps me focus without triggering panic attacks OR causing me to cheerily pull out my hair. (Concerta: See My Dime-Sized Bald Spot.) I take it with horse doses of Effexor.

Also, seconding allergy pills! Which of course might also make you feel stupidbrained, because everything is terrible.
posted by chesty_a_arthur at 11:22 AM on May 6, 2019 [1 favorite]

Sleep study
Med holiday (I do weekends regularly but you may need a week or so)
posted by internet fraud detective squad, station number 9 at 11:29 AM on May 6, 2019 [1 favorite]

poffin boffin: HEYOOO sorry to ride my hobbyhorse into this thread but not all generics are created equal and some of them are fucking terrible and dangerous

Heartily nthed. My girlfriend has been prescribed adderall for ADHD and the difference in her mood, experience, and mental health varies DRASTICALLY depending on the manufacturer of the generic that her insurance approves. Teva, especially, has been awful for her, intensifying her depression and self-harm ideation, while some are just not effective and some are incredibly helpful.
posted by hanov3r at 11:46 AM on May 6, 2019 [1 favorite]

OH NO i was going to try teva next, thank you for the warning.
posted by poffin boffin at 11:53 AM on May 6, 2019

Some [generics] are great and indistinguishable from the real thing, and some of them are dangerous garbage, and sometimes when things are proven to legitimately be dangerous garbage, the FDA does nothing, issues no notices or recalls, and the patients suffer

Yeah; I guess it was validating to find out several years later than my Teva Wellbutrin generics were, in fact, definitely not bioequivalent to the name-brand stuff. But I really could have done without all the miserable headaches and increased anxiety that I suffered through at the time. Obviously this may not be what's going on for you! But if the provider of your generic meds has changed, it's worth seeing whether you can explicitly request the formulation from the previous manufacturer that you know worked.
posted by ubersturm at 11:54 AM on May 6, 2019 [1 favorite]

I have decades of experience with ADHD meds, primarily standard and extended release Ritalin and extended release Focalin. After about 20 years of trying, quitting, and trying again I gave up completely. Dosages were only "right" for a stretch of a few weeks at a time, after which I would either feel nervous and wired or physically exhausted and depressed while on the medication.

Instead of medication, I do 45 minutes of breathing meditation every morning and have been doing it for about two years. My symptoms are mostly gone, to the point that I was able to take a very extensive battery of neurocognitive testing and get negative results for ADHD. Added benefits were elimination of negative ruminative thoughts and significant reduction in alcohol consumption.
posted by TrialByMedia at 12:05 PM on May 6, 2019 [3 favorites]

I've been taking the generic version of Adderall XR since being formally diagnosed with ADHD about a year ago. It took about a month of gradual increase to hit a good dosage for me, and, well, it's good. I can focus. I'm better at prioritizing things (although I could still use work on that). My days go pretty smoothly and I rarely feel like I've wasted a day.

On weekends I usually skip it or take half a dose, even though I probably should just take it - it's not like I don't have stuff to accomplish when I'm not at work. As far as I can tell, it's less addictive than coffee (which I gave up when I started taking Adderall). I haven't tried other ADHD meds, so have nothing to compare it to.

Years ago, I took Wellbutrin - it was the only antidepressant I found that helped at all (SSRIs were terrible for me). In retrospect, my depression was at least partially ADHD, so possibly it was helping those symptoms somewhat, but not a lot.
posted by Kriesa at 12:53 PM on May 6, 2019

I am a female non-drinker & don't use recreational drugs but I started micro-dosing Psilocybin (magic mushrooms -- about 1/20th of a full trip dose), took my first dose yesterday. I was terrified but I am so glad I did.

Obviously it is waaaay to soon to tell but yesterday was unlike any day I can remember in the last decade. It was as close to a miracle I have ever experienced.

It decimated my ADHD (and the accompanying anxiety & depression) and I still feel the effects today. No side effects so far.

I plan to dose every four days.

Message me if you'd like my twitter handle. I tweeted throughout the day yesterday and will be tweeting for the next few months.

Good luck!!
posted by i_mean_come_on_now at 2:41 PM on May 6, 2019 [7 favorites]

Long story short, I took Ritalin IR (2x10mg) for a few years, and they worked okay, not great but combined with my anxiety we couldn't go higher. Then for a year or so I was on Ritalin XR (2x20mg + 1x10mg booster Ritalin IR in the morning). It was better in some ways but my anxiety issues got somewhat worse and it made me slowly depressed and miserable and I literally stopped laughing at things.

Another long story short I switched to Vyvanse (1x30mg) and it's like night and day. I can't go any higher (see: anxiety issues) but still, while it works, I'm in many ways a lot less miserable, and with or without Vyvanse my ability to feel joy and laugh at things have been restored. I cannot emphasize enough how great that is.

The downside is that as an actual ADHD medication it works a lot less; I'm much more forgetful and distracted and all that. But it's worth the tradeoff.

(ah yes, some stats: I'm a cishet white guy who's 30 and overweight, don't do drugs, only drink alcohol like once or twice a month. hope this helps somehow.)
posted by KTamas at 3:45 PM on May 7, 2019

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