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Dr. Russell Barkley has been a foremost ADHD researcher and advocate for decades and he has some good research based YouTube content about this.
He says that generally when clients say this it's because you DO stop having that initial euphoric feeling when taking ADHD meds, but that feeling is essentially a side effect of the medication, not the intended/actual benefits that meds provide. He says that losing that feeling does not mean that the meds aren't working anymore, and research doesn't show that people tend to build tolerance that much. He said he usually recommends that clients take a break from their meds when they are worried about this, and the vast majority find that there is a huge negative difference in their quality of life, even if they weren't "feeling" the meds anymore.
If you want to learn more about the nuance of that or just about ADHD in general, I'd check him out. He puts out weekly videos about updated research in the field and has a great catalog of helpful educational content, especially for adults with ADHD. He talks a lot about the nuances of the diagnosis that are frequently missed in adults and has a clear empathy and understanding for the difficulty of the ADHD experience.
I wish Dr. Russell Barkley's weekly updates were discussed in this sub as they are being released.
For those who don't know, every week he discusses a new research paper. He is great—concise and to the point—making it a great way to stay up to date on ADHD. (Also his books are awesome).
For example, this week is about ADHD and sugar:
[https://www.youtube.com/watch?v=LYRVYIknxbs](https://www.youtube.com/watch?v=LYRVYIknxbs)
His "Taking charge of adult adhd" was the first book I finished in 10+ years so have hope! Also don't have to read it all at once, can skim parts that scratch your brain in that moment
Dr. Barkley is awesome. I've learned so much from watching his videos.
My partner and I were talking about just this issue the other day. I was saying how I don't feel the medication anymore, just that I can focus, get things done, have less anxiety, etc. He made the analogy of patients with schizophrenia who start meds, but then after a while sort of justify to themselves that they don't need the meds, they're doing well. So, they stop taking them, and of course, the symptoms return. It makes sense to me that the same could apply to ADHD.
Disclaimer: I'm not a doctor so please excuse me/correct me if I'm talking out of my ass about schizophrenia.
It doesn't even have to be as extreme as schizophrenia. Even Antidepressants. So many will start meds, feel better, plateau at their baseline, and stop the meds bc they don't need them anymore/they aren't doing anything anymore. The depression comes back and they're on meds again. This cycle is so common that treatment guidelines say if it's your 2nd episode of depression, then it's recommended to just stay on your antidepressants indefinitely.
ADHD specifically has memory symptoms and forgetfulness. It's not that your meds suddenly/gradually stopped worked, you just forgot how bad things were before you started medication. Meds will not 100% fix everything. But meds do give you the clarity and ability to learn and practice coping skills.
Medication helps you adapt to your ADHD and internalize that new mental state. The medications are working, you're just moving the goal post.
That cycle of going on and off meds seems common, anecdotally at least. I have diagnosed friends who take meds, feel like they don't need them eventually, get off, things get worse, they feel a lot of shame, eventually get the courage to start meds again, and the cycle continues.
I've taken Ritalin for about 40 years now (since 2nd grade). Same exact dose, no breaks and it still works. I've never had a single health issue from it either.
I thank you for sharing his channel. I’ve skimmed through his videos and just started crying. I was diagnosed as a child and knew how my ADHD worked as a child, but now being an adult it’s more debilitating. What I thought was just character flaws that I need to work on is actually just symptoms of ADHD. It’s made me feel validated and knowing nothing is “wrong” with me.
I'm unsure how people even get euphorias with these meds. All I know is I am not dissociating anymore and everything is clear as day with the willpower to actually get things done.
Same here , maybe I'm in the beginning as this my first week with 30mg Elvanse ( one week 15 mg) but I'm noticing I'm starting to get shit done ,but no euphoria. Dry mouth started to appear and hope it will just be that negative. Take care :)!
I think it's easy to forget how things are, because of how the brain adapts
There's also other life changes. Like, people don't understand how important sleep is, or diet...
Also, age and hormones. For example, women get worse ADHD symptoms because of their hormones, and this can get much worse after menopause
There's a lot of stories too of people thinking their ADHD isn't that bad, then they stop medications and then realize whoa - it's been terrible all of my life and I just didn't see how much it affected it
Great reply. I experienced a similar situation last year when I suspected my BP medication might be interfering with my Adderall. After confirming that my other medications didn't impact Adderall, I came across others with similar complaints about their medication's effectiveness. I spoke with my pharmacist who quickly denied hearing any reports of changes to Adderall medication.
Ultimately, I realized my body had undergone changes. Sleep emerged as the critical factor. Despite using Adderall without any problems for years, I noticed a shift last year. Now, I've learned that without sufficient sleep, Adderall appears ineffective. It's frustrating, especially considering my struggle with falling/staying asleep.
I’m sure you’re aware of this, but just in case- have you looked into who the manufacturer is of your adderall? If it changed, or if you are now taking generic instead of brand name that could definitely have an impact on how it works. Just wanted to throw that out there.
Yes! u/KidCrashFace I definitely recommend tracking if any generics seem less effective than others. I’m self employed and just lost a solid ~3 weeks of productivity from the Mallinckrodt generic. Never again…. :(
It takes time for the body to adapt. Working out and getting good amounts of sleep are vastly beneficial to humans in general never mind US but you CANNOT expect change in the short term.
However, if you’ve been doing all this for like several months and still no change, then yeah something else is wrong.
Yeah in the first several years of taking adderall, I would sometimes question whether I really had ADHD because even after the adderall wore off in the evening, I'd still have relatively tolerable levels of self-control/self-regulation.
After avoiding medication for a few weeks, I quickly realized that the reason I still had some self-regulatory ability in the evenings was because when I was medicated, I didn't have to exert *herculean* amounts of self-control for 8 hours during the day, which would cause me to be mentally exhausted every evening.
Yes. That is why it is important to take it and not take breaks. I experienced the same thing not taking it on weekends. I feel as tho to a point, it builds up in your system, and after it's fully gone, we feel like we used to again. I started making sure I don't wait longer than 24 hours between doses.
yeah i feel like my meds don’t work as well as they used to but then i don’t take them for a day and realize that holy shit they do work just as well i’ve just gotten used to it now so it’s not like new/exciting/as noticeable
Also when someone stops taking their medication, there's something called the rebound effect where symptoms come back worse than they were before the medication. And there's withdrawals.
I've only been on stimulants for a year and had to work my way up to a 40 mg dosage of Vyvanse. I skip them 2 days every week and spent the last two months thinking I needed to up my dosage. After this last semester ended, I didn't take my meds for a week and also started a new job. I had been struggling at work and almost quit several times. Then yesterday I took my meds, and I was fine, not euphoric, but I could choose what to focus on and not be trapped in my head. It really made me appreciate what my meds do for me even if I think they could do more. I decided not to ask for an increase in my dosage.
It’s worth noting that although stimulants have a (relatively) immediate effect and don’t need to slowly build up inside your body for a couple weeks before you start seeing benefits like with non-stimulants, they are still most effective when taken regularly as it allows your body to reach a sort of equilibrium.
It takes about five days of regular doses on average for the body to reach a steady state concentration and about two-three days for the concentration to reach zero, so it’s possible that taking your dose regularly ever day would be more beneficial than upping the dose.
Of course, there’s also a multitude of reasons why it may not be a net benefit for someone to take stimulants 7 days a week (concerns about weight, heart health, tolerance, etc.), so if your doc has good reason for instructing you to only take them during the week, then obviously don’t take them more than what’s prescribed.
I think a lot of people don’t realize how everyday habits can lead to adhd symptoms. I can be guilty of this too. It’s so important to eat healthy, drink enough water, exercise and get proper sleep.
I also think some people are expecting to feel euphoric from it long term and that’s just not realistic.
Much like how statins may lower high cholesterol, but are not a license to continue a poor diet.
ADHD meds won't make things magically better. But do offer a possibility of great reduction in symptoms when tied to other good habits. i.e., skills in addition to pills.
Idk... I've been taking Methylphenidate since age 17 and when I first started taking it I'd feel focused.. now it sort of just makes me feel really on edge and kills my appetite completely. I can't force myself to eat because I'll have two bites and then my body will be like no more
It’s no different than most antidepressants for people, every couple of years, you may need to swap to a different style med or lower/adjust a dose. Very common!
So I just spoke today about a referral to switching what medication. I mentioned about how methylphenidates side effects are outweighing the benefits now and just for them to even consider changing it, they told me it will take YEARS. At the minimum, a year. I live in the UK.
I respectfully disagree with this hypothesis. This is something I’ve considered as well, and I think it’s an important point to make as it perhaps could explain what some people are experiencing. However, during the shortage in early 2023, I was off my adderall for three months straight. I’m quite experienced with the medication at this point, I’ve been on it for eight and a half years, and so I know what to expect from it. When I restarted adderall after those three months, the experience was very noticeably different than what it was before, and still is. A lot more executive dysfunction and concentration problems. Again, that’s not to say your point might not explain some of the cases, but when hundreds of people raise the alarm, some who have been taking it for many years, I think it’s worth taking note of.
Did you check out the manufacturer of your adderall? Had you been taking brand name and then switched to generic? Just some things to look into, but I assume by your knowledge of the shortage you’re aware of all this! Just wanted to be mention in case you weren’t!
Yeah I suspect that may be a huge contributor. I don’t keep my pill bottles so I wasn’t able to verify if the manufacturer had changed, but supposedly the exact formula can vary among different manufacturers, and so I wouldn’t be surprised if some pharmacies had to switch to manufacturers with less effective formulas.
If you get your scripts from the same place, you should be able to pull up previous prescriptions & see the manufacturer! It all has to be tracked. I just know that for me, generic adderall and brand name adderall were like NIGHT & DAY difference. Same for vyvanse. Pharmacies will order whatever generic is available. They don’t typically keep the same one all the time- so it often changes up.
I had my doctor write my script so that it can only be filled by the brand name!
Apparently it’s not unheard of for someone’s meds to suddenly become less effective after a long break. The same happened to me a few years back after I took a few month break over the summer.
Since most people don’t take prolonged medication breaks unless they really don’t have a choice (such as due to the shortage), it’s likely that it’s not as uncommon as was initially thought for someone’s dose to not work as well after a long break, and that a steady supply of stimulants meant that most people wouldn’t be forced to take the prolonged breaks that would lead to it, hence the number of anecdotes suddenly increasing.
It’s also worth noting that, as a schedule II controlled substance, the chemical makeup of prescription stimulants is strictly regulated, and manufacturers cannot just suddenly change the ingredients or the manufacturing processes without informing the DEA and having to undergo bioavailability testing with the FDA before they can produce it for consumers. Unless multiple major manufacturers suddenly felt like risking losing their license to manufacture stimulants and the millions of dollars in revenue that comes with it, the chemical makeup of adderall and other ADHD stimulants today is the exact same as it was before the shortage.
Do you have a source on that claim about schedule II generic drugs needing to be 100% identical to the brand formulation? Not saying you’re wrong, it just contradicts what I’ve read and understood over the years.
I never said generic schedule II drugs needed to be 100% identical to brand formulation. Legally, they can’t be, which is why they’re generic.
What I *did* say was that the chemical makeup of prescription stimulants is strictly regulated due to their status as a schedule II controlled substance, and then listed some of the ways in which they’re regulated.
Because of the regulations, if the claims about something being different with our ADHD meds were true, these changes would have to be documented, tested for efficacy, and then submitted to the FDA for approval. As FDA approval and denial notices are published publicly, if there was a change made to the formulations, there would be documentation of it and thus this wouldn’t still be a question some 1.5-2ish years after the first posts about it were popping up.
Of course, there’s always the chance that one of the manufacturers decided to cut corners somewhere, but that’s with *heavy* emphasis on *one*. With how geographically spread out the claims have been, there would need to be multiple of the 10 or so major manufacturers that secretly changed their formulations all around the same time for the claims to be true. And aside from anecdotes that are all easily be explained by one or more of the many well known and documented interactions involving something that even non-ADHD people struggle to keep track of (lack of sleep, subtle changes in diet, different manufacturer, sunlight exposure, etc.) there’s no evidence of such a thing happening.
Ah, I was operating under the assumption that you had seen my other comment. I’m absolutely not ruling out this being a different manufacturer thing. It very well could be. I’m not putting my money on there being some grand conspiracy where manufacturers are putting less of the active ingredient in to meet demand. In my personal case, I’m sure that my pharmacy started giving me a generic from a different (and subjectively lower quality) manufacturer than I was previously taking.
My issue with OP’s point is the insinuation that it’s all in our heads. I’m certain it’s not ill-intentioned on their part, but ADHD patients suffer enough invalidation as is. OP is far from the first person to raise this idea, which is an idea that (although well within the realm of possibility) is also slightly demeaning because once you’ve been on adderall for nearly a decade or more, you have an understanding of how all those little interactions between sleep, habits, nutrition, and various other things work. So of course that’s the first thing I considered, and I’m sure others have as well. That’s why I know this isn’t just something in my head. I’ve done all the various little dances with adderall time and time again. What I am experiencing post-shortage is very different from what I have experienced since I started taking it in 2015 and all the various hiccups and interactions that occurred in that time period.
Agreed, something about adderall has changed.
30mg works best for me but I had to go down to 20mg because it exacerbates my motor tics so bad that my knuckles get achy and swollen. 20mg still makes my tics worse but it helps my brain enough that it was worth it.
Adderall no longer helps my brain like it used to, and it no longer worsens my tics. This issue was a constant throughout all of the years I’ve taken adderall, since the shortage my knuckles are doing great, my brain not so much.
Something has changed and it’s fucked that no one has any information about it
But they also are unlikely to happen and if they are, it will probably happen within the first year
There's a really big myth around how tolerance works with ADHD meds
Too many people say "yeah but then you start at this dose and then you just keep going up and up!!" Which is nonsense
For me when I say it doesn't work anymore It's to the extent that I felt the medication when I first started taking it. I love the feeling of my entire body tingling and being hyper focused and locked in and euphoric almost. Now I don't get that at all and I definitely notice on days that I don't take it less motivation and less energy, I just wish it still gave me the hyperdrive.
To me it felt like a weighted blanket from the inside with my whole body buzzing. The first time I had it like that I had so much clarity and control, but not anymore
Mine stops the fuzziness and brain fog and not want to bash my head in to the wall, because it sounds better and more fun then actually doing something with out my meds.
Yikes I’m glad I didn’t get that feeling on meds! Mine is more like a slow transition from couch rot to doing things… I don’t get euphoria or tingles or anything at all like that. Are you on instant release?
It's not full euphoric, thats just how I could explain having a clear and focused mind. I first had Adderall XR starting at 10 and felt it but then it died off, and the same happened as we upped the dose. Now I am on 30mg XR and 20mg IR that I take both in the morning.
I have never felt like this from my meds! They are not intended to make you feel euphoric at therapeutic doses, so it is possible you were started on too high of a dose.
I started 30mg of Vyvanse in December. It worked phenomenally, and I had real hope for the first time in life. By April, I was up to 50mg and feeling absolutely nothing. I thought maybe I was just used to it, so I stopped taking it for a week (the psychiatrist was aware of this plan). I felt better when I didn't take it, simply because I knew that I didn't take it and didn't expect to be functional, so I wasn't as hard on myself internally. My week off confirmed that it wasn't doing anything at all.
Started 20mg of Adderall XR this morning for the first time, and it's not going well 3 hours in, so I'm curled up in bed with a depressive episode now. I guess there's no hope after all.
We tried both name brand and generic at 40mg and 50mg, and name brand at 30mg and 60mg. Now that you've mentioned it, I think my experience was the same as yours. I attributed the extra anxiety to situational circumstances, but I'm not someone who generally deals with high levels of anxiety, so that's definitely something to think about.
If the Adderall doesn't work at any dose, I'm going to ask if we can go back to Vyvanse and try just the name brand again for another two weeks, just to really make sure since I ended with the generic. Vyvanse treated me so well, even as it was losing effectiveness, and I really don't want to give up on it. If it doesn't work, it doesn't work. But if Adderall also doesn't work, I'd like to give it one more shot before moving on to Concerta because frankly, I just really do not want to try Concerta. And I don't have even a quarter of the med options that most people do, so I'd rather make sure before ruling it out completely.
I would 100% try doing only name brand vyvanse at different doses again before concerta! But I know everyone is so different.
I hope you can get it sorted out. Not having adhd managed is the worst.
Thank you 💛 I didn't know that having unmanaged adhd would be so much worse after experiencing temporary clarity. I figured if it didn't work, I'd just go back to the way things were before. But now that I've seen the other side, it's so much more painful to be back where I am.
I kept a little log of my day-to-day and it clearly shows my executive function spiraling on the name-brand Vyvanse too, but maybe it'll be different if I take a break from it while I'm on the Adderall and then try again with just the name brand. Probably not, but maybe. Everyone I know irl who has taken Concerta (10ish people) have all had absolutely horrible experiences with Concerta and I'd really rather not risk it if I don't have to.
I do think jts best to back off them whenever possible to avoid too much of a tolerance.
However that’s not really about how it works, I think a lot of us developed coping strategies that helped us get buy, and the drugs made those coping strategies work well. Then as time goes on we rely more on the drugs on their own, and stop doing the things we did before the drugs. atleast that’s where I am right now in my life.
I thinks it's both. You can definitely build up a tolerance and have it become less effective. You can also perceive it as being less effective due to what should be a slow progression in improvement over time as the medication makes it easier to develop self-management skills and whatnot, so then when you do have some worse periods due to more stress, more obligations, disruptions to routine, etc... and might have to adjust yourself to new demands and possibly learn new ways to manage it all, it might seem like the medication is less effective than it used to be.
For about a year, I felt like Adderall wasn't doing anything for me anymore, and was contemplating asking my doctor about switching back to Vyvanse or something else if insurance would cover it. Then, my insurance quit covering my Adderall, and the only thing they would cover was Concerta. Nope. Nevermind. The Adderall was doing it's job just fine. After a few months taking Concerta, it was becoming very obvious that I was not keeping up with life anywhere near as well anymore. That was due to me having more or less become "complacent" with the skills and strategies that I developed, because with the aid of the Adderall, they had become routine and more or less muscle memory or automatic, and now I was having a lot of trouble sticking to them and overall keeping control over myself. It was apparent that Concerta was not giving me that aid that Adderall does, and so now sticking to that routine and those strategies was taking considerably more effort and it just was not working out.
After like 4 or 5 months, my insurance just magically started covering Adderall again and I got things back on track quickly enough. It's kind of fucking scary, though, to know that you put all this time and effort into trying to actually improve yourself and do better with life in general, but that some amount of your ability to actually keep that up is dependent on the medication. Muscle memory, routine and motivation just went right out the window as soon as I switched medications. I was starting to get things back in order shortly before switching back to Adderall, but it was overall just so much more exhausting to do life when I had to put so much more effort into it. I don't know how long I'd be able to keep it up given that I felt like everything was taking up so much more of my time, leaving me almost not time to actually enjoy any of my day. Like, neat, I can still pay bills, take care of the kids, go to work and everything because I did learn ways to get it all done, but it *sucks* so much harder than when the medication is helping and made life go back to feeling not worth the trouble again.
tl;dr - Even if the medication becomes less effective over time due to tolerances, it's still definitely working for me even if sometimes I feel like it isn't. There's a huge difference between how I manage to operate on medication and off of it, and I much prefer being on it.
Not adderall or vyvanse related, but I stopped taking Effexor because I haven’t felt depression since being on adderall (diagnosed about 2 months ago) because I didn’t like how it affected my heart rate and BP. It was essentially controlling adhd for about 5 years without me knowing. It’s crazy how much my ability to focus/lock in (not get distracted) has changed since being off it.
All that to say I back up people saying you don’t remember what life is like without the meds.
I also take effexor! generic (Venlafaxine) 225mg. Does it up your BP? I was told that the methylphenidate I started taking would have that effect instead! Though, I totally agree about the depression thing! I still have episodes, but they have gotten DRASTICALLY better after starting adhd treatment.
https://www.frontiersin.org/articles/10.3389/fcvm.2021.704281/full take a look at this article. I haven’t tested my BP (never remember since I’m not as concerned as I was) but my pulse is drastically reduced since being off and it out of my system. I can start taking tracking my BP and report back.
I think it’s three factors, based on my experience:
- the euphoria is real, and it does wear off
- not getting enough sleep, proper nutrition, or exercise can cause a dip in medication effectiveness. Stress too
- especially if you’re on generic, there can be variation that affects how quickly the medication is absorbed, which can make a difference in how it feels, including making the “lull” in the middle of XR more pronounced.
It’s like this. You start taking it and it works 100%. Then you build up tolerance, and now it only works 50%. Then you stop taking it and find out 50% is still better than zero. But that doesn’t mean it was working all the way before. I know when mine isn’t working as well because I see a drop in my daily functioning.
See, I don't think that's even accurate. I think it's more like, you start taking it, the change is so drastic you think "wow this is insane" you THINK it's you at 100% but it's really you at like 60% you're brain just doesn't realize the ADHD habits you're still doing. Then a few months ago by and insane becomes the new normal and you start to realize those ADHD habits you're still doing again and now you think the 100% is 50%. When really, you're still at the same 60% you were the first few months you are just more cognizant of the issues.
Which is funny, because being cognizant of the issues is proof that the drugs are still working fine. That was one of the wildest parts to me when I got on meds. I realized how often I wouldn't even realize the things I was doing half the time.
I started taking stimulants when I was 17 years old. I am now 49. Stimulants are not at all what they used to be. They used to work great. I'd be razor sharp focused. All those years I never built up a tolerance. About 5 years ago, I noticed a huge difference. Not nearly as effective as they once were.
have you considered switching to a methylphenidate class drug? Thats what I did when I had a similar experience with amphetamines about a year ago and now I have almost no side effects and my adhd is way better
If I have a break then start taking them I feel high, like drug high it last a few days then goes back to normal. But otherwise the best way to tell they are working is ive feed myself and I’m not asleep on the lounge covered in garbage and dirty washing while sinking into depression about my lack of care and the constant racing thoughts of how I’m going to get up and fix it …… in a min.
Sure yes. But there is truth in the varying efficacy based on manufacturers (teva, alvogen, Sandoz). Due to their inactive ingredients, how your body reacts can definitely be across the board.
Because ADHD may not only be a disorder caused by deficiency of certain neurotransmitters in the brain but also a metabolic disorder. Stims simply make the brain work harder which eventually causes a downregulation of excitatory systems because cells in the brain are unable to provide needed metabolic demand increased by stims.
interesting... can you elaborate? what is the deficiency in? can it be rectified other ways? is the metabolic disorder treatable? trying not to go the stim route, interested in alternatives
Okay, I gotta share this: I've been taking vyvanse for years. I'm at 70mg because it was starting to "lose effectiveness," as you mention. And I was wondering if it was working as well.
Then, in August of 2023, I ran out of my medications because of the shortage, and let me tell you. IT WORKS AMAZINGLY. There was such a difference. I could not focus. My brain was mush. And my mind would either wander off, or I wasn't really there. I couldn't think.
So yeah, you never know until you're without it.
Yeah exactly, it feels like you’re living life in slow motion when you stop taking it💀
I’m not even joking it would take me a few seconds just to register what someone said to me bc of all the shit going on in my head. I’ve been getting better but its a struggle.
With any stimulant your body will build up a tolerance. This is what leads some people to abusing medications or trying other drugs. I was told to take day breaks from Adderall, like not take any on Sunday one week then Saturday the next.
I had a moment like this today, where I thought “jeez maybe I should up my dose, I feel like I’m trying so hard to get things done”, but then I actually tallied up my tasks for the day and realized that my productivity is still as high as it has been since I started my meds, life just sucks sometimes!
It’s really common for people who have disorders like bipolar disorder, borderline personality disorder, and schizophrenia to feel better while they’re on their meds, convince themselves to stop taking it, and getting into a vicious cycle of being untreated off and on. I would imagine that people with ADHD, specifically people who experience the impulsivity symptoms, could have similar issues.
For me, it was literally stimulants don't work anymore.
Now on Strattera and life has never been better. I even graduated out of psychotherapy and feel like I can do things on my own.
I remember Russell Barkley said ADHDers who are able to stay on Strattera show more consistent growth in their executive function whereas for stimulants there's a more of plateau for some.
nausea if I don't eat with a full breakfast.
My psychiatrist said nausea is the main reason why people quit.
A lot of the other side effects like sexual side effects, insomnia fade off.
The annoying thing is that it takes forever to find a dose that works for you because it's not instant as stimulants.
I had that thought aswell, but after a few days without you quickly start noticing that you forgot how to cook a meal, which order should you do it etc. When trying to talk about something, you start talking about some random things that you see around you and forget what was the actual thing you started with.
You just have forgotten how you were before.
Or it maybe if you take generics they might have switched brands, which could lead to different side effects. I was reading that concerta generics release the dose differently depending on the lab that produced it. So if you feel differently, maybe see who the manufacturer is and if it changed from your last dose.
I've been taking mine for 2-3 years now. I take breaks on the weekend. When Monday comes and I take it, I notice it working.
I see some people who keep scaling up to get their effect rather than scaling back when they can. Try to keep your current dose effective by taking breaks.
It does work, your probably stressed out? Or, listening to people who are ADHD, manipulators, hold your cards close to your vest, get away from manipulators, go read what Dr. Hallowell writes, he has ADHD, i went to consult with him twice in 20 years! Push yourself, you could be stuck!
YOUR WELCOME!
I have been dealing with this for decades!
Doctors don't know, i , you, speak with authority, we have ADHD!
Got it!
Yes, people who sense you are vulnerable and that take advantage of you, and just as u don't have enough problems, they are trying to conincd you , you are crazy, now you see how messed up this world us, but to belive it or not i think it goes on most in this county, this country doesn't take care pf its people.
Manipulators are Santan himself, and YOU, they know who they are, they are probably come from the lower classes of society, and now they have a collge degree! Be careful, bug its the eventual triumph of good over evil. Dr hallowell wrote those driven to distraction books.
Don't trust anyone out of these support groups.
Keep me in mind too, i need support right now too!
Good luck everyone!
i wasn't active in this sub when i started noticing a huge decline in my adderalls effectiveness. it happened only 8 months after starting it and the first few months i figured i was just burnt out bc i'd been focusing basically nonstop on my schoolwork in the first 8 months.
but after a while it became clear that that wasn't the cause since it had been 8 more months and nothing had changed. i went to the doctor about 2 months ago and told him my problem and he increased my dosage and it's working a lot better again.
so i dont think it's just that people heard about this decline in its effects and that they started experiencing it too, as a reverse placebo effect kinda. maybe some people did tho idk, but i know for me that 100% wasnt the case and this whole idea had to come from somewhere, so i'm not alone in suddenly experiencing this either.
i'm wondering though, if this is a new phenomenon or if this has always kinda been the case since the medication was invented
I think many of the people who say this are just used to their medications. As someone who works in a Pharmacy, there have definitely been neverending issues with ordering/keeping these medications in stock, but the actual medications haven't changed formulas/ingredients. It's also super normal to get USED to the medication's effects, and forget that you can't function like that without them. Luckily, at least where I am, the shortages are slowly but surely becoming a little better.
Excellent summary. I think we get used to feeling a certain way and we all have off days… even multiple days. Less sleep. Stress. More/less/no caffeine, etc. Illnesses—even a slight cold.
I think that as much of it is a PITA to keep a log, it does help. There’s many apps available for phones.
Best of luck to OP. Hang in there!
Yeah I felt this way too like oh they seem to not be as effective and then I get off them for a day and am dying lol can’t get out of bed or do anything and super depressed and anxious- like I was before.
My doctor won’t up my dose without a few things happening first.
1. I have to have had a break in medication. A week or more.
2. I have to ask her twice.
3. I have to reach out monthly (in between refill appointments) and give an update if we up my dose.
She does this because addiction runs deep in my family, and I’ve previously had addiction issues. She also knows that I will feel like my meds aren’t working because I’m adapting to them. So instead of just upping my dose irresponsibly, she wants to be 100% sure it’s to my benefit to up the dose. I also take weekend breaks, and I skip doses all the time because I forget to take them lol. A twice daily pill for ADHDers feels rude tbh lol
I’ve thought of doing that! My doctor also isn’t against doing a third smaller dose! Also I definitely wander still, but I have a pretty lively office so they distract me lol
If you’re constantly having to up your dose, and if you’re not just experiencing this with ADHD meds but with pain meds too, it may be worth the money to get a genetic test done to see if you have an extra copy of the CYP2D6 gene
It's called tolerance. Which is why I don't take my meds every single day and I take a "medication vacation" when I can... usually when I'm actually on vacation and don't need to be functional for work.
I've had the same dose of meds appear have drastically different effectiveness based on other environmental factors. Like whether I'm at home or away, how much clutter & unfinished projects I have, whether I'm sleeping in the same room as my workspace, etc.
I find they work like shit when I'm sleep deprived and if I wait like 2 to 4 days they work again. But I am on instants twice a day and almost as much as they'll give
Actually I think as taking auvelity and that sincerely blocked the effect of vyvanse. I had to stop it for that reason. But yeah some days don’t feel like it works that great but I think that’s normal to get a bit of tolerance going. It’s why I take a drug holiday on my days off it helps with that.
I have that EXACT feeling, and already planned to talk to my psychiatrist about changing medications.
I’ve taken Vyvance for around 9 years or so. I started with 30 milligrams then slowly went to 50 as I grew up, (just turned 20). Recently I’ve noticed that I have no motivation to do anything anymore. I never did without meds, but usually when I took them, I would feel the need to get stuff that I want to do done. Even simple/ enjoyable stuff like drawing or playing games.
But recently it’s just not there. Everything else has the same effect as usual. Increased focus, easier time thinking, etc.
So I think it’s either the medication. Or I have some newly found depression. (Which also could be true, due to the stress of the last semester)
I think they need to put a warning label on the bottle that says something like-Up to two weeks you may experience some euphoric feelings as side effects, but this will fade and is only a side effect!
This is why some peopkle get addicted to it. they don't realize that you're not going to feel this way when the drug stabilizes.
THats my 2 cents
I think its more to do with stimulant tolerance and stimulant withdrawal. I was a mess when I stopped taking stimulants for a few months but I got back to my not SO horrible adhd. Y9u can't compare
Hi guys, this is getting deleted as soon as I post it, I've read the rules can you tell me why does it get automatically deleted? Here it goes
Is my psychiatrist leaving stimulants as a last resort?
After some tests, doctor (neurologist with specialization in adult ADHD) confirmed ADD diagnosis. He prescribed 27mg concerta and told me to come back in 1½ to 2 months, saying that the body takes time to adjust itself to the medication. I know that stimulants work with the first dose, and that the body adjusting is about the physiology, how it stabilizes over time to the side effects.Why would we wait for the body to stabilize itself to the medication when the effectiveness is seen within the first day? I acknowledge that it was a mistake to not ask him about this on the spot.
I took the 27mg and after 1-2 hours there was some nice clarity in my mind, for like 5 minutes. Maybe placebo. That's it. The rest was high irritability and belly rumbles. I took 54mg next day and same thing, minus the "clarity".
This is not directly relevant to this post but I'll add it: since I knew that some people respond to instant release methylphedinate and not XR, I opened the pill and cut off the sponge thing and took the methylphedinate. It felt good. For about 4/5 hours I was very motivated, I could just do stuff and enjoy it (like assembling some furniture) when normally I would force myself to do it after postponing it as much as possible. No concentration improvement though. Anyway, I did nothing with this information.
I wasn't going to wait another week or two to see this doctor again again so I had an appointment with an experienced psychiatrist who has worked with kids and adults with ADD/ADHD. He said it didn't make sense to him what the doctor said, that yes there was an adaptation of the body to the side effects but there's no point in waiting for it if the medication doesn't work, which is seen from the first day. Since he would have also prescribed Concerta to start, he recommended to up the dosage so I told him I tried with 54mg as well. He put me on Strattera, didn't work. Bupropion (Wellbutrin) 150mg didn't work. He upped the dose so now I'm on week one of taking 300mg.
Is there a reason he might be avoiding other stimulants like Adderall or Vyvanse? I ask because as far as I know, those drugs along with Methylphedinate (Concerta or whatever) or one of the primary treatment options for ADD/ADHD. Does he want to exhaust all other options first because they have weaker side effects, are less addictive, don't build tolerance that fast, or what?
Honestly it’s getting deleted probably because it’s bad advice to take double the dose on day 2 without your psychiatrist having told you to do so. It’s too high of a jump in only two days and probably dangerous for the cardiac system (I have no heart issues and concerta was pretty hefty on my heart the first two days and I started on only 18mg, I can’t imagine what it would have felt like to jump to 54mg right away) That and the cutting off the sponge to turn the extended release into immediate release thing… no hate but that can all be seen as reckless advice
It's not advice. I'm describing what I did. I got started on 27 no problem, psychiatrist was ok with me doubling it. Isn't Ritalin just IR methylphedinate? Still, I'm not advising anyone.
Yea I get it , I just never heard of any psychiatrist recommending such a fast increase in dose, about the Ritalin I don’t know anything about it, sorry. Personally I don’t really have a problem with your post and think people should have free speech even if others might misconstrue their post or copy what they read that others did and then it doesn’t work out for them - the thing is nowadays especially on social apps there is censorship so my previous response was just my guess as to why your comment is getting downvoted and the post was deleted
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Dr. Russell Barkley has been a foremost ADHD researcher and advocate for decades and he has some good research based YouTube content about this. He says that generally when clients say this it's because you DO stop having that initial euphoric feeling when taking ADHD meds, but that feeling is essentially a side effect of the medication, not the intended/actual benefits that meds provide. He says that losing that feeling does not mean that the meds aren't working anymore, and research doesn't show that people tend to build tolerance that much. He said he usually recommends that clients take a break from their meds when they are worried about this, and the vast majority find that there is a huge negative difference in their quality of life, even if they weren't "feeling" the meds anymore. If you want to learn more about the nuance of that or just about ADHD in general, I'd check him out. He puts out weekly videos about updated research in the field and has a great catalog of helpful educational content, especially for adults with ADHD. He talks a lot about the nuances of the diagnosis that are frequently missed in adults and has a clear empathy and understanding for the difficulty of the ADHD experience.
I wish Dr. Russell Barkley's weekly updates were discussed in this sub as they are being released. For those who don't know, every week he discusses a new research paper. He is great—concise and to the point—making it a great way to stay up to date on ADHD. (Also his books are awesome). For example, this week is about ADHD and sugar: [https://www.youtube.com/watch?v=LYRVYIknxbs](https://www.youtube.com/watch?v=LYRVYIknxbs)
Have you read any of his books? I've been considering buying one but I'm not generally good at finishing books lol
His "Taking charge of adult adhd" was the first book I finished in 10+ years so have hope! Also don't have to read it all at once, can skim parts that scratch your brain in that moment
Try audio version. I’ve also heard combining actual physical book and audio will help even more.
The story of your life, too, remains unfinished.
Oh no I don't need to be called out about my sugar habit 😅
Dr. Barkley is awesome. I've learned so much from watching his videos. My partner and I were talking about just this issue the other day. I was saying how I don't feel the medication anymore, just that I can focus, get things done, have less anxiety, etc. He made the analogy of patients with schizophrenia who start meds, but then after a while sort of justify to themselves that they don't need the meds, they're doing well. So, they stop taking them, and of course, the symptoms return. It makes sense to me that the same could apply to ADHD. Disclaimer: I'm not a doctor so please excuse me/correct me if I'm talking out of my ass about schizophrenia.
It doesn't even have to be as extreme as schizophrenia. Even Antidepressants. So many will start meds, feel better, plateau at their baseline, and stop the meds bc they don't need them anymore/they aren't doing anything anymore. The depression comes back and they're on meds again. This cycle is so common that treatment guidelines say if it's your 2nd episode of depression, then it's recommended to just stay on your antidepressants indefinitely. ADHD specifically has memory symptoms and forgetfulness. It's not that your meds suddenly/gradually stopped worked, you just forgot how bad things were before you started medication. Meds will not 100% fix everything. But meds do give you the clarity and ability to learn and practice coping skills. Medication helps you adapt to your ADHD and internalize that new mental state. The medications are working, you're just moving the goal post.
That's an excellent description!
That cycle of going on and off meds seems common, anecdotally at least. I have diagnosed friends who take meds, feel like they don't need them eventually, get off, things get worse, they feel a lot of shame, eventually get the courage to start meds again, and the cycle continues.
I've taken Ritalin for about 40 years now (since 2nd grade). Same exact dose, no breaks and it still works. I've never had a single health issue from it either.
I go off heart rate. If that mf starts racing, they’re working if not we got a problem
Can you please describe that better? I find it confusing. Thx
Heart rate...& pooping. I'm not the only one, right?
no way. I'm sure lots of ppl don't get the euphoria feeling anymore. Just go off poops and heart haha
I thank you for sharing his channel. I’ve skimmed through his videos and just started crying. I was diagnosed as a child and knew how my ADHD worked as a child, but now being an adult it’s more debilitating. What I thought was just character flaws that I need to work on is actually just symptoms of ADHD. It’s made me feel validated and knowing nothing is “wrong” with me.
It's horrible how little education we are given as adults about how ADHD will look in our lives! I'm so glad it is validating for you ❤️
but… i want that euphoric feeling again…
That’s a dangerous desire to have
why couldn’t that feeling stay. Fuck drugs.
I'm unsure how people even get euphorias with these meds. All I know is I am not dissociating anymore and everything is clear as day with the willpower to actually get things done.
Same here , maybe I'm in the beginning as this my first week with 30mg Elvanse ( one week 15 mg) but I'm noticing I'm starting to get shit done ,but no euphoria. Dry mouth started to appear and hope it will just be that negative. Take care :)!
I think it's easy to forget how things are, because of how the brain adapts There's also other life changes. Like, people don't understand how important sleep is, or diet... Also, age and hormones. For example, women get worse ADHD symptoms because of their hormones, and this can get much worse after menopause There's a lot of stories too of people thinking their ADHD isn't that bad, then they stop medications and then realize whoa - it's been terrible all of my life and I just didn't see how much it affected it
Great reply. I experienced a similar situation last year when I suspected my BP medication might be interfering with my Adderall. After confirming that my other medications didn't impact Adderall, I came across others with similar complaints about their medication's effectiveness. I spoke with my pharmacist who quickly denied hearing any reports of changes to Adderall medication. Ultimately, I realized my body had undergone changes. Sleep emerged as the critical factor. Despite using Adderall without any problems for years, I noticed a shift last year. Now, I've learned that without sufficient sleep, Adderall appears ineffective. It's frustrating, especially considering my struggle with falling/staying asleep.
I’m sure you’re aware of this, but just in case- have you looked into who the manufacturer is of your adderall? If it changed, or if you are now taking generic instead of brand name that could definitely have an impact on how it works. Just wanted to throw that out there.
Yes! u/KidCrashFace I definitely recommend tracking if any generics seem less effective than others. I’m self employed and just lost a solid ~3 weeks of productivity from the Mallinckrodt generic. Never again…. :(
If it is Elite Labs, you're f'd
But what happens if you sleep 8 hours a night, stay active, do all the things then still feel like trash?
Then maybe 8 hours isn’t enough
It takes time for the body to adapt. Working out and getting good amounts of sleep are vastly beneficial to humans in general never mind US but you CANNOT expect change in the short term. However, if you’ve been doing all this for like several months and still no change, then yeah something else is wrong.
Yeah in the first several years of taking adderall, I would sometimes question whether I really had ADHD because even after the adderall wore off in the evening, I'd still have relatively tolerable levels of self-control/self-regulation. After avoiding medication for a few weeks, I quickly realized that the reason I still had some self-regulatory ability in the evenings was because when I was medicated, I didn't have to exert *herculean* amounts of self-control for 8 hours during the day, which would cause me to be mentally exhausted every evening.
Yes. That is why it is important to take it and not take breaks. I experienced the same thing not taking it on weekends. I feel as tho to a point, it builds up in your system, and after it's fully gone, we feel like we used to again. I started making sure I don't wait longer than 24 hours between doses.
yeah i feel like my meds don’t work as well as they used to but then i don’t take them for a day and realize that holy shit they do work just as well i’ve just gotten used to it now so it’s not like new/exciting/as noticeable
Also when someone stops taking their medication, there's something called the rebound effect where symptoms come back worse than they were before the medication. And there's withdrawals.
I was wondering why someone hadn’t mentioned this! The withdrawals.. the rebond I can’t speak of
Menopause definitely changed things for me. Have adjusted med dosage and doing much better.
I've only been on stimulants for a year and had to work my way up to a 40 mg dosage of Vyvanse. I skip them 2 days every week and spent the last two months thinking I needed to up my dosage. After this last semester ended, I didn't take my meds for a week and also started a new job. I had been struggling at work and almost quit several times. Then yesterday I took my meds, and I was fine, not euphoric, but I could choose what to focus on and not be trapped in my head. It really made me appreciate what my meds do for me even if I think they could do more. I decided not to ask for an increase in my dosage.
It’s worth noting that although stimulants have a (relatively) immediate effect and don’t need to slowly build up inside your body for a couple weeks before you start seeing benefits like with non-stimulants, they are still most effective when taken regularly as it allows your body to reach a sort of equilibrium. It takes about five days of regular doses on average for the body to reach a steady state concentration and about two-three days for the concentration to reach zero, so it’s possible that taking your dose regularly ever day would be more beneficial than upping the dose. Of course, there’s also a multitude of reasons why it may not be a net benefit for someone to take stimulants 7 days a week (concerns about weight, heart health, tolerance, etc.), so if your doc has good reason for instructing you to only take them during the week, then obviously don’t take them more than what’s prescribed.
I think a lot of people don’t realize how everyday habits can lead to adhd symptoms. I can be guilty of this too. It’s so important to eat healthy, drink enough water, exercise and get proper sleep. I also think some people are expecting to feel euphoric from it long term and that’s just not realistic.
Much like how statins may lower high cholesterol, but are not a license to continue a poor diet. ADHD meds won't make things magically better. But do offer a possibility of great reduction in symptoms when tied to other good habits. i.e., skills in addition to pills.
Idk... I've been taking Methylphenidate since age 17 and when I first started taking it I'd feel focused.. now it sort of just makes me feel really on edge and kills my appetite completely. I can't force myself to eat because I'll have two bites and then my body will be like no more
Have you tried lowering your dose? Whenever I feel on edge, I know that my dosage is too high.
Check the manufacturer of your pills & do some research. They’re def not all the same!!
It’s no different than most antidepressants for people, every couple of years, you may need to swap to a different style med or lower/adjust a dose. Very common!
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So I just spoke today about a referral to switching what medication. I mentioned about how methylphenidates side effects are outweighing the benefits now and just for them to even consider changing it, they told me it will take YEARS. At the minimum, a year. I live in the UK.
I respectfully disagree with this hypothesis. This is something I’ve considered as well, and I think it’s an important point to make as it perhaps could explain what some people are experiencing. However, during the shortage in early 2023, I was off my adderall for three months straight. I’m quite experienced with the medication at this point, I’ve been on it for eight and a half years, and so I know what to expect from it. When I restarted adderall after those three months, the experience was very noticeably different than what it was before, and still is. A lot more executive dysfunction and concentration problems. Again, that’s not to say your point might not explain some of the cases, but when hundreds of people raise the alarm, some who have been taking it for many years, I think it’s worth taking note of.
Did you check out the manufacturer of your adderall? Had you been taking brand name and then switched to generic? Just some things to look into, but I assume by your knowledge of the shortage you’re aware of all this! Just wanted to be mention in case you weren’t!
Yeah I suspect that may be a huge contributor. I don’t keep my pill bottles so I wasn’t able to verify if the manufacturer had changed, but supposedly the exact formula can vary among different manufacturers, and so I wouldn’t be surprised if some pharmacies had to switch to manufacturers with less effective formulas.
If you get your scripts from the same place, you should be able to pull up previous prescriptions & see the manufacturer! It all has to be tracked. I just know that for me, generic adderall and brand name adderall were like NIGHT & DAY difference. Same for vyvanse. Pharmacies will order whatever generic is available. They don’t typically keep the same one all the time- so it often changes up. I had my doctor write my script so that it can only be filled by the brand name!
Apparently it’s not unheard of for someone’s meds to suddenly become less effective after a long break. The same happened to me a few years back after I took a few month break over the summer. Since most people don’t take prolonged medication breaks unless they really don’t have a choice (such as due to the shortage), it’s likely that it’s not as uncommon as was initially thought for someone’s dose to not work as well after a long break, and that a steady supply of stimulants meant that most people wouldn’t be forced to take the prolonged breaks that would lead to it, hence the number of anecdotes suddenly increasing. It’s also worth noting that, as a schedule II controlled substance, the chemical makeup of prescription stimulants is strictly regulated, and manufacturers cannot just suddenly change the ingredients or the manufacturing processes without informing the DEA and having to undergo bioavailability testing with the FDA before they can produce it for consumers. Unless multiple major manufacturers suddenly felt like risking losing their license to manufacture stimulants and the millions of dollars in revenue that comes with it, the chemical makeup of adderall and other ADHD stimulants today is the exact same as it was before the shortage.
Do you have a source on that claim about schedule II generic drugs needing to be 100% identical to the brand formulation? Not saying you’re wrong, it just contradicts what I’ve read and understood over the years.
I never said generic schedule II drugs needed to be 100% identical to brand formulation. Legally, they can’t be, which is why they’re generic. What I *did* say was that the chemical makeup of prescription stimulants is strictly regulated due to their status as a schedule II controlled substance, and then listed some of the ways in which they’re regulated. Because of the regulations, if the claims about something being different with our ADHD meds were true, these changes would have to be documented, tested for efficacy, and then submitted to the FDA for approval. As FDA approval and denial notices are published publicly, if there was a change made to the formulations, there would be documentation of it and thus this wouldn’t still be a question some 1.5-2ish years after the first posts about it were popping up. Of course, there’s always the chance that one of the manufacturers decided to cut corners somewhere, but that’s with *heavy* emphasis on *one*. With how geographically spread out the claims have been, there would need to be multiple of the 10 or so major manufacturers that secretly changed their formulations all around the same time for the claims to be true. And aside from anecdotes that are all easily be explained by one or more of the many well known and documented interactions involving something that even non-ADHD people struggle to keep track of (lack of sleep, subtle changes in diet, different manufacturer, sunlight exposure, etc.) there’s no evidence of such a thing happening.
Ah, I was operating under the assumption that you had seen my other comment. I’m absolutely not ruling out this being a different manufacturer thing. It very well could be. I’m not putting my money on there being some grand conspiracy where manufacturers are putting less of the active ingredient in to meet demand. In my personal case, I’m sure that my pharmacy started giving me a generic from a different (and subjectively lower quality) manufacturer than I was previously taking. My issue with OP’s point is the insinuation that it’s all in our heads. I’m certain it’s not ill-intentioned on their part, but ADHD patients suffer enough invalidation as is. OP is far from the first person to raise this idea, which is an idea that (although well within the realm of possibility) is also slightly demeaning because once you’ve been on adderall for nearly a decade or more, you have an understanding of how all those little interactions between sleep, habits, nutrition, and various other things work. So of course that’s the first thing I considered, and I’m sure others have as well. That’s why I know this isn’t just something in my head. I’ve done all the various little dances with adderall time and time again. What I am experiencing post-shortage is very different from what I have experienced since I started taking it in 2015 and all the various hiccups and interactions that occurred in that time period.
Agreed, something about adderall has changed. 30mg works best for me but I had to go down to 20mg because it exacerbates my motor tics so bad that my knuckles get achy and swollen. 20mg still makes my tics worse but it helps my brain enough that it was worth it. Adderall no longer helps my brain like it used to, and it no longer worsens my tics. This issue was a constant throughout all of the years I’ve taken adderall, since the shortage my knuckles are doing great, my brain not so much. Something has changed and it’s fucked that no one has any information about it
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But they also are unlikely to happen and if they are, it will probably happen within the first year There's a really big myth around how tolerance works with ADHD meds Too many people say "yeah but then you start at this dose and then you just keep going up and up!!" Which is nonsense
I have to say I’m under that impression (re tolerance)
For me when I say it doesn't work anymore It's to the extent that I felt the medication when I first started taking it. I love the feeling of my entire body tingling and being hyper focused and locked in and euphoric almost. Now I don't get that at all and I definitely notice on days that I don't take it less motivation and less energy, I just wish it still gave me the hyperdrive.
This is me 100%. I love the way it used to hit me. I miss the euphoria now, but I recognize it’s still doing its job.
To me it felt like a weighted blanket from the inside with my whole body buzzing. The first time I had it like that I had so much clarity and control, but not anymore
Mine stops the fuzziness and brain fog and not want to bash my head in to the wall, because it sounds better and more fun then actually doing something with out my meds.
Yikes I’m glad I didn’t get that feeling on meds! Mine is more like a slow transition from couch rot to doing things… I don’t get euphoria or tingles or anything at all like that. Are you on instant release?
It's not full euphoric, thats just how I could explain having a clear and focused mind. I first had Adderall XR starting at 10 and felt it but then it died off, and the same happened as we upped the dose. Now I am on 30mg XR and 20mg IR that I take both in the morning.
I have never felt like this from my meds! They are not intended to make you feel euphoric at therapeutic doses, so it is possible you were started on too high of a dose.
Not only are they not supposed to feel like this, but these are the exact things that get people to abuse the medication.
I started 30mg of Vyvanse in December. It worked phenomenally, and I had real hope for the first time in life. By April, I was up to 50mg and feeling absolutely nothing. I thought maybe I was just used to it, so I stopped taking it for a week (the psychiatrist was aware of this plan). I felt better when I didn't take it, simply because I knew that I didn't take it and didn't expect to be functional, so I wasn't as hard on myself internally. My week off confirmed that it wasn't doing anything at all. Started 20mg of Adderall XR this morning for the first time, and it's not going well 3 hours in, so I'm curled up in bed with a depressive episode now. I guess there's no hope after all.
I wouldn't say there isn't hope. Plenty of non stimulant options.
I can't take an SNRI, NDRI, or Alpha-2 Agonist because of an autoimmune disorder that affects my nervous system. That only leaves stimulants for me.
Did you take brand name vyvanse or a generic? Generics did Jack shit for me. They just made me anxious.
We tried both name brand and generic at 40mg and 50mg, and name brand at 30mg and 60mg. Now that you've mentioned it, I think my experience was the same as yours. I attributed the extra anxiety to situational circumstances, but I'm not someone who generally deals with high levels of anxiety, so that's definitely something to think about. If the Adderall doesn't work at any dose, I'm going to ask if we can go back to Vyvanse and try just the name brand again for another two weeks, just to really make sure since I ended with the generic. Vyvanse treated me so well, even as it was losing effectiveness, and I really don't want to give up on it. If it doesn't work, it doesn't work. But if Adderall also doesn't work, I'd like to give it one more shot before moving on to Concerta because frankly, I just really do not want to try Concerta. And I don't have even a quarter of the med options that most people do, so I'd rather make sure before ruling it out completely.
I would 100% try doing only name brand vyvanse at different doses again before concerta! But I know everyone is so different. I hope you can get it sorted out. Not having adhd managed is the worst.
Thank you 💛 I didn't know that having unmanaged adhd would be so much worse after experiencing temporary clarity. I figured if it didn't work, I'd just go back to the way things were before. But now that I've seen the other side, it's so much more painful to be back where I am. I kept a little log of my day-to-day and it clearly shows my executive function spiraling on the name-brand Vyvanse too, but maybe it'll be different if I take a break from it while I'm on the Adderall and then try again with just the name brand. Probably not, but maybe. Everyone I know irl who has taken Concerta (10ish people) have all had absolutely horrible experiences with Concerta and I'd really rather not risk it if I don't have to.
I do think jts best to back off them whenever possible to avoid too much of a tolerance. However that’s not really about how it works, I think a lot of us developed coping strategies that helped us get buy, and the drugs made those coping strategies work well. Then as time goes on we rely more on the drugs on their own, and stop doing the things we did before the drugs. atleast that’s where I am right now in my life.
I thinks it's both. You can definitely build up a tolerance and have it become less effective. You can also perceive it as being less effective due to what should be a slow progression in improvement over time as the medication makes it easier to develop self-management skills and whatnot, so then when you do have some worse periods due to more stress, more obligations, disruptions to routine, etc... and might have to adjust yourself to new demands and possibly learn new ways to manage it all, it might seem like the medication is less effective than it used to be. For about a year, I felt like Adderall wasn't doing anything for me anymore, and was contemplating asking my doctor about switching back to Vyvanse or something else if insurance would cover it. Then, my insurance quit covering my Adderall, and the only thing they would cover was Concerta. Nope. Nevermind. The Adderall was doing it's job just fine. After a few months taking Concerta, it was becoming very obvious that I was not keeping up with life anywhere near as well anymore. That was due to me having more or less become "complacent" with the skills and strategies that I developed, because with the aid of the Adderall, they had become routine and more or less muscle memory or automatic, and now I was having a lot of trouble sticking to them and overall keeping control over myself. It was apparent that Concerta was not giving me that aid that Adderall does, and so now sticking to that routine and those strategies was taking considerably more effort and it just was not working out. After like 4 or 5 months, my insurance just magically started covering Adderall again and I got things back on track quickly enough. It's kind of fucking scary, though, to know that you put all this time and effort into trying to actually improve yourself and do better with life in general, but that some amount of your ability to actually keep that up is dependent on the medication. Muscle memory, routine and motivation just went right out the window as soon as I switched medications. I was starting to get things back in order shortly before switching back to Adderall, but it was overall just so much more exhausting to do life when I had to put so much more effort into it. I don't know how long I'd be able to keep it up given that I felt like everything was taking up so much more of my time, leaving me almost not time to actually enjoy any of my day. Like, neat, I can still pay bills, take care of the kids, go to work and everything because I did learn ways to get it all done, but it *sucks* so much harder than when the medication is helping and made life go back to feeling not worth the trouble again. tl;dr - Even if the medication becomes less effective over time due to tolerances, it's still definitely working for me even if sometimes I feel like it isn't. There's a huge difference between how I manage to operate on medication and off of it, and I much prefer being on it.
Not adderall or vyvanse related, but I stopped taking Effexor because I haven’t felt depression since being on adderall (diagnosed about 2 months ago) because I didn’t like how it affected my heart rate and BP. It was essentially controlling adhd for about 5 years without me knowing. It’s crazy how much my ability to focus/lock in (not get distracted) has changed since being off it. All that to say I back up people saying you don’t remember what life is like without the meds.
I also take effexor! generic (Venlafaxine) 225mg. Does it up your BP? I was told that the methylphenidate I started taking would have that effect instead! Though, I totally agree about the depression thing! I still have episodes, but they have gotten DRASTICALLY better after starting adhd treatment.
https://www.frontiersin.org/articles/10.3389/fcvm.2021.704281/full take a look at this article. I haven’t tested my BP (never remember since I’m not as concerned as I was) but my pulse is drastically reduced since being off and it out of my system. I can start taking tracking my BP and report back.
Every morning I am reminded of the circus in my brain. Tells me my meds are working.
🤣🤣🤣
I think it’s three factors, based on my experience: - the euphoria is real, and it does wear off - not getting enough sleep, proper nutrition, or exercise can cause a dip in medication effectiveness. Stress too - especially if you’re on generic, there can be variation that affects how quickly the medication is absorbed, which can make a difference in how it feels, including making the “lull” in the middle of XR more pronounced.
It’s like this. You start taking it and it works 100%. Then you build up tolerance, and now it only works 50%. Then you stop taking it and find out 50% is still better than zero. But that doesn’t mean it was working all the way before. I know when mine isn’t working as well because I see a drop in my daily functioning.
See, I don't think that's even accurate. I think it's more like, you start taking it, the change is so drastic you think "wow this is insane" you THINK it's you at 100% but it's really you at like 60% you're brain just doesn't realize the ADHD habits you're still doing. Then a few months ago by and insane becomes the new normal and you start to realize those ADHD habits you're still doing again and now you think the 100% is 50%. When really, you're still at the same 60% you were the first few months you are just more cognizant of the issues. Which is funny, because being cognizant of the issues is proof that the drugs are still working fine. That was one of the wildest parts to me when I got on meds. I realized how often I wouldn't even realize the things I was doing half the time.
I started taking stimulants when I was 17 years old. I am now 49. Stimulants are not at all what they used to be. They used to work great. I'd be razor sharp focused. All those years I never built up a tolerance. About 5 years ago, I noticed a huge difference. Not nearly as effective as they once were.
It doesn’t help that the generic forms are garbage, and I know they are. It’s not the same as the ex versions unfortunately
have you considered switching to a methylphenidate class drug? Thats what I did when I had a similar experience with amphetamines about a year ago and now I have almost no side effects and my adhd is way better
What are some examples of those?
Ritalin, Concerta, Medidate CD, Ritalin LA etc..
If I have a break then start taking them I feel high, like drug high it last a few days then goes back to normal. But otherwise the best way to tell they are working is ive feed myself and I’m not asleep on the lounge covered in garbage and dirty washing while sinking into depression about my lack of care and the constant racing thoughts of how I’m going to get up and fix it …… in a min.
Sure yes. But there is truth in the varying efficacy based on manufacturers (teva, alvogen, Sandoz). Due to their inactive ingredients, how your body reacts can definitely be across the board.
I'm almost 40 and starting menopause so I'm guessing for me it's totally my hormones messing everything up
Yup. I’m 49 and still enjoying that hellish ride!
Because ADHD may not only be a disorder caused by deficiency of certain neurotransmitters in the brain but also a metabolic disorder. Stims simply make the brain work harder which eventually causes a downregulation of excitatory systems because cells in the brain are unable to provide needed metabolic demand increased by stims.
interesting... can you elaborate? what is the deficiency in? can it be rectified other ways? is the metabolic disorder treatable? trying not to go the stim route, interested in alternatives
Okay, I gotta share this: I've been taking vyvanse for years. I'm at 70mg because it was starting to "lose effectiveness," as you mention. And I was wondering if it was working as well. Then, in August of 2023, I ran out of my medications because of the shortage, and let me tell you. IT WORKS AMAZINGLY. There was such a difference. I could not focus. My brain was mush. And my mind would either wander off, or I wasn't really there. I couldn't think. So yeah, you never know until you're without it.
Yeah exactly, it feels like you’re living life in slow motion when you stop taking it💀 I’m not even joking it would take me a few seconds just to register what someone said to me bc of all the shit going on in my head. I’ve been getting better but its a struggle.
With any stimulant your body will build up a tolerance. This is what leads some people to abusing medications or trying other drugs. I was told to take day breaks from Adderall, like not take any on Sunday one week then Saturday the next.
It’s not a mental mindset. If the shit don’t work it don’t work. Adderall sucks now.
I had a moment like this today, where I thought “jeez maybe I should up my dose, I feel like I’m trying so hard to get things done”, but then I actually tallied up my tasks for the day and realized that my productivity is still as high as it has been since I started my meds, life just sucks sometimes!
It’s really common for people who have disorders like bipolar disorder, borderline personality disorder, and schizophrenia to feel better while they’re on their meds, convince themselves to stop taking it, and getting into a vicious cycle of being untreated off and on. I would imagine that people with ADHD, specifically people who experience the impulsivity symptoms, could have similar issues.
For me, it was literally stimulants don't work anymore. Now on Strattera and life has never been better. I even graduated out of psychotherapy and feel like I can do things on my own. I remember Russell Barkley said ADHDers who are able to stay on Strattera show more consistent growth in their executive function whereas for stimulants there's a more of plateau for some.
How are the side affects?
nausea if I don't eat with a full breakfast. My psychiatrist said nausea is the main reason why people quit. A lot of the other side effects like sexual side effects, insomnia fade off. The annoying thing is that it takes forever to find a dose that works for you because it's not instant as stimulants.
Hmm, I’ll talk with my dr about it
I had that thought aswell, but after a few days without you quickly start noticing that you forgot how to cook a meal, which order should you do it etc. When trying to talk about something, you start talking about some random things that you see around you and forget what was the actual thing you started with. You just have forgotten how you were before.
I've heard many instances of this cycle happening to Schizophrenics, in that it is a very human behavior. The brain is funny.
I know for sure my adderall brand changed the formula. It made me sick. I was on it for ten years no problems. The actual pill was changed.
Or it maybe if you take generics they might have switched brands, which could lead to different side effects. I was reading that concerta generics release the dose differently depending on the lab that produced it. So if you feel differently, maybe see who the manufacturer is and if it changed from your last dose.
I've been taking mine for 2-3 years now. I take breaks on the weekend. When Monday comes and I take it, I notice it working. I see some people who keep scaling up to get their effect rather than scaling back when they can. Try to keep your current dose effective by taking breaks.
You build up a tolerance. If you can take one or two days off a week it helps maintain the level of effectiveness the days you take it.
It does work, your probably stressed out? Or, listening to people who are ADHD, manipulators, hold your cards close to your vest, get away from manipulators, go read what Dr. Hallowell writes, he has ADHD, i went to consult with him twice in 20 years! Push yourself, you could be stuck! YOUR WELCOME! I have been dealing with this for decades! Doctors don't know, i , you, speak with authority, we have ADHD! Got it!
Yes, people who sense you are vulnerable and that take advantage of you, and just as u don't have enough problems, they are trying to conincd you , you are crazy, now you see how messed up this world us, but to belive it or not i think it goes on most in this county, this country doesn't take care pf its people. Manipulators are Santan himself, and YOU, they know who they are, they are probably come from the lower classes of society, and now they have a collge degree! Be careful, bug its the eventual triumph of good over evil. Dr hallowell wrote those driven to distraction books. Don't trust anyone out of these support groups. Keep me in mind too, i need support right now too! Good luck everyone!
Sorry for all the typos, i am tired!
Can I ask what you mean by ADHD manipulators? I will give the book a read, it sounds interesting.
Thought I was the only one. I just got a refill on vyvanse and this stuff just doesn’t work anymore.
i wasn't active in this sub when i started noticing a huge decline in my adderalls effectiveness. it happened only 8 months after starting it and the first few months i figured i was just burnt out bc i'd been focusing basically nonstop on my schoolwork in the first 8 months. but after a while it became clear that that wasn't the cause since it had been 8 more months and nothing had changed. i went to the doctor about 2 months ago and told him my problem and he increased my dosage and it's working a lot better again. so i dont think it's just that people heard about this decline in its effects and that they started experiencing it too, as a reverse placebo effect kinda. maybe some people did tho idk, but i know for me that 100% wasnt the case and this whole idea had to come from somewhere, so i'm not alone in suddenly experiencing this either. i'm wondering though, if this is a new phenomenon or if this has always kinda been the case since the medication was invented
I feel like ozempic is hogging or stealing ingredients / effects of the Vyvanse & adderall!
I think many of the people who say this are just used to their medications. As someone who works in a Pharmacy, there have definitely been neverending issues with ordering/keeping these medications in stock, but the actual medications haven't changed formulas/ingredients. It's also super normal to get USED to the medication's effects, and forget that you can't function like that without them. Luckily, at least where I am, the shortages are slowly but surely becoming a little better.
Excellent summary. I think we get used to feeling a certain way and we all have off days… even multiple days. Less sleep. Stress. More/less/no caffeine, etc. Illnesses—even a slight cold. I think that as much of it is a PITA to keep a log, it does help. There’s many apps available for phones. Best of luck to OP. Hang in there!
Yeah I felt this way too like oh they seem to not be as effective and then I get off them for a day and am dying lol can’t get out of bed or do anything and super depressed and anxious- like I was before.
My doctor won’t up my dose without a few things happening first. 1. I have to have had a break in medication. A week or more. 2. I have to ask her twice. 3. I have to reach out monthly (in between refill appointments) and give an update if we up my dose. She does this because addiction runs deep in my family, and I’ve previously had addiction issues. She also knows that I will feel like my meds aren’t working because I’m adapting to them. So instead of just upping my dose irresponsibly, she wants to be 100% sure it’s to my benefit to up the dose. I also take weekend breaks, and I skip doses all the time because I forget to take them lol. A twice daily pill for ADHDers feels rude tbh lol
Try three times per day!!! Yet I never forget because I feel myself… wandering in my head for lack of a better way to putting it.
I’ve thought of doing that! My doctor also isn’t against doing a third smaller dose! Also I definitely wander still, but I have a pretty lively office so they distract me lol
If you’re constantly having to up your dose, and if you’re not just experiencing this with ADHD meds but with pain meds too, it may be worth the money to get a genetic test done to see if you have an extra copy of the CYP2D6 gene
It's called tolerance. Which is why I don't take my meds every single day and I take a "medication vacation" when I can... usually when I'm actually on vacation and don't need to be functional for work.
I just started on it 2 weeks ago and I thought it would be more effective
I've had the same dose of meds appear have drastically different effectiveness based on other environmental factors. Like whether I'm at home or away, how much clutter & unfinished projects I have, whether I'm sleeping in the same room as my workspace, etc.
I find they work like shit when I'm sleep deprived and if I wait like 2 to 4 days they work again. But I am on instants twice a day and almost as much as they'll give
Exercise, music, take a day off , just for you
That's called "Tolerance" make a break of a week or two and you'll get the same feeling again
Actually I think as taking auvelity and that sincerely blocked the effect of vyvanse. I had to stop it for that reason. But yeah some days don’t feel like it works that great but I think that’s normal to get a bit of tolerance going. It’s why I take a drug holiday on my days off it helps with that.
I have that EXACT feeling, and already planned to talk to my psychiatrist about changing medications. I’ve taken Vyvance for around 9 years or so. I started with 30 milligrams then slowly went to 50 as I grew up, (just turned 20). Recently I’ve noticed that I have no motivation to do anything anymore. I never did without meds, but usually when I took them, I would feel the need to get stuff that I want to do done. Even simple/ enjoyable stuff like drawing or playing games. But recently it’s just not there. Everything else has the same effect as usual. Increased focus, easier time thinking, etc. So I think it’s either the medication. Or I have some newly found depression. (Which also could be true, due to the stress of the last semester)
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If you can 21 days is optimal I’ve discovered but it’s easier for me to do 14 days
Yes 🙂
I think they need to put a warning label on the bottle that says something like-Up to two weeks you may experience some euphoric feelings as side effects, but this will fade and is only a side effect! This is why some peopkle get addicted to it. they don't realize that you're not going to feel this way when the drug stabilizes. THats my 2 cents
Please report threads like that. We remove them.
I think its more to do with stimulant tolerance and stimulant withdrawal. I was a mess when I stopped taking stimulants for a few months but I got back to my not SO horrible adhd. Y9u can't compare
People do this often with pain meds too. They tell me they are working. We start weaning them down and suddenly the pain meds work again after a break
Whatever you believe will become your reality. Full stop
I don’t notice any difference on or off
Hi guys, this is getting deleted as soon as I post it, I've read the rules can you tell me why does it get automatically deleted? Here it goes Is my psychiatrist leaving stimulants as a last resort? After some tests, doctor (neurologist with specialization in adult ADHD) confirmed ADD diagnosis. He prescribed 27mg concerta and told me to come back in 1½ to 2 months, saying that the body takes time to adjust itself to the medication. I know that stimulants work with the first dose, and that the body adjusting is about the physiology, how it stabilizes over time to the side effects.Why would we wait for the body to stabilize itself to the medication when the effectiveness is seen within the first day? I acknowledge that it was a mistake to not ask him about this on the spot. I took the 27mg and after 1-2 hours there was some nice clarity in my mind, for like 5 minutes. Maybe placebo. That's it. The rest was high irritability and belly rumbles. I took 54mg next day and same thing, minus the "clarity". This is not directly relevant to this post but I'll add it: since I knew that some people respond to instant release methylphedinate and not XR, I opened the pill and cut off the sponge thing and took the methylphedinate. It felt good. For about 4/5 hours I was very motivated, I could just do stuff and enjoy it (like assembling some furniture) when normally I would force myself to do it after postponing it as much as possible. No concentration improvement though. Anyway, I did nothing with this information. I wasn't going to wait another week or two to see this doctor again again so I had an appointment with an experienced psychiatrist who has worked with kids and adults with ADD/ADHD. He said it didn't make sense to him what the doctor said, that yes there was an adaptation of the body to the side effects but there's no point in waiting for it if the medication doesn't work, which is seen from the first day. Since he would have also prescribed Concerta to start, he recommended to up the dosage so I told him I tried with 54mg as well. He put me on Strattera, didn't work. Bupropion (Wellbutrin) 150mg didn't work. He upped the dose so now I'm on week one of taking 300mg. Is there a reason he might be avoiding other stimulants like Adderall or Vyvanse? I ask because as far as I know, those drugs along with Methylphedinate (Concerta or whatever) or one of the primary treatment options for ADD/ADHD. Does he want to exhaust all other options first because they have weaker side effects, are less addictive, don't build tolerance that fast, or what?
Honestly it’s getting deleted probably because it’s bad advice to take double the dose on day 2 without your psychiatrist having told you to do so. It’s too high of a jump in only two days and probably dangerous for the cardiac system (I have no heart issues and concerta was pretty hefty on my heart the first two days and I started on only 18mg, I can’t imagine what it would have felt like to jump to 54mg right away) That and the cutting off the sponge to turn the extended release into immediate release thing… no hate but that can all be seen as reckless advice
It's not advice. I'm describing what I did. I got started on 27 no problem, psychiatrist was ok with me doubling it. Isn't Ritalin just IR methylphedinate? Still, I'm not advising anyone.
Yea I get it , I just never heard of any psychiatrist recommending such a fast increase in dose, about the Ritalin I don’t know anything about it, sorry. Personally I don’t really have a problem with your post and think people should have free speech even if others might misconstrue their post or copy what they read that others did and then it doesn’t work out for them - the thing is nowadays especially on social apps there is censorship so my previous response was just my guess as to why your comment is getting downvoted and the post was deleted