The Tragic Truth Of Prescription Adderall, or “Madderall”

Prescription Adderall

Prescription Adderall and its commonly poor prescribing is the topic here—not how to illegally obtain and abuse illegally obtained prescription Adderall.

Let’s get this out of the way:

  • Prescription Adderall works very well for some people with ADHD.
  • For others, however, Adderall effects can create more problems than it solves—exacerbating anxiety, irritability, anger, grandiosity, and even rage.

That’s why 20 years ago I started calling it Madderall

Here’s what you likely won’t hear from your prescriber:

  • Poorly prescribed Adderall can ruin lives and ruin relationships. 
  • The same is sometimes true for Dexedrine, too. Those of you in Australia, where the NHS considers it the stimulant of choice, be aware.
  •  The individuals experiencing poor results often don’t realize it.  They assume it’s the price of focus. Their loved ones might, too.
  • Next stop: These adults with ADHD might develop a cannabis habit to “come down”.
  • Or: They love the intense focus too much to let go—a focus that often simultaneously reduces self-awareness. (In other words, they assume that everyone else is being annoying, not them.)

The truly tragic part? There are so many less risky options to try first. Why do doctors too often insist on prescribing Adderall to newly diagnosed patients—and with little guidance?  It seems they are misreading a meta-analysis, which I will write about in a future post.

Bottom Line:

  • Treating ADHD is not simple.
  • There are genetic differences among individuals that affect drug response.
  • Prescribing requires expertise and method. Start low, titrate slow. Rating scales. Third-party feedback. And much more.
  • To further complicate matters: Adderall is also a popular drug of abuse. Yet, even the story of “Adderall Abuse” is complicated.

You Won’t Find Adderall-Abuse Tips Here

Thanks to “Google keywords,” many people find this article while seeking to illegally procure or “hack” stronger effects from Adderall. You will not learn about that here.

Moreover, when you leave after 5 seconds—your goal not accomplished—that increases my blog’s “bounce” rate. Not a good thing.

I leave this post here anyway. Why? You won’t find what you’re looking for, but you might find something better. 

I’ll be blunt: Chances are good that you actually have ADHD  and are attempting to “self-medicate” it. Please know: That never ends well.

Mostly, readers find this post legitimately, using terms such as these (to name only a few):

  • Adderall makes my spouse angry
  • Can Adderall make you irritable?
  • Why is Adderall making my ADHD worse?
  • Depression and anxiety from Adderall?
  • Anger outbursts and Adderall 
  • Does Adderall change your personality?
  • Adderall is spiking my blood pressure
  • Irritable after Adderall
  • Can Adderall cause bipolar?
  • My husband started Adderall and is an angry jerk now
  • Can Adderall cause aggression and sexual behaviors in the elderly?

This Post Covers Five Points:

  • Warning that The New York Times (the initial catalyst for my writing this post) has a long history of anti-psychiatry reporting. 
  • Explaining the very good reasons to consider prescription Adderall not as a first try but rather a last-stop in stimulant medications.
  • Alerting readers to the fact that many (far too many, in my long experience) prescribers are incompetently treating ADHD. This is having devastating consequences.
  • Emphasizing the importance of ADHD self-education and self-advocacy—for yourself or on behalf of your loved ones.
  • Offering an excerpt from my first book’s chapters on medication—self-education is critical!

I wrote those three chapters on ADHD medications so patients can be smarter mental health care consumers. So they can avoid negative and even tragic outcomes.

The book also contains also a sidebar on the important distinctions between and within the two classes of stimulants: 1) methylphenidate (MPH) and 2) amphetamine (AMP).

It’s hard to imagine, but I was the first person to write about that in a consumer book on ADHD, published in 2008. Still relevant.

Eight years later, Arthur L. Robin, PhD, and I created a license-appropriate protocol for couple therapists to help guide medication treatment. We included it in our professional guide:  Adult ADHD-Focused  Couple Therapy: Clinical Interventions.

It takes a critical mass of mental-health care consumers to seriously turn this tide. That means consumers must be educated and must demand better. Educating on this topic is a huge focus of my training in development:  ADHD Success Training.

Now, back to the story.

Adderall abuseMore ClickBait From The New York Times?

A back-channel tip came to me yesterday. I steeled myself for the next anti-ADHD screed from The New York Times.  What did I expect? The next in a long and vicious pattern: a stigma-producing attack on the diagnosis itself, not to mention the medications so often successful in treating it.

Many reporters seem to think this is an original angle. We who know better see it as transparently traffic-boosting clickbait, not honest journalism.

As a young journalist many years ago, I was taught to respect The New York Times as an exemplar of journalism.  That has changed.

Make no mistake: The paper still has respectable editor, reporters, and sections. Yet, wthe editor is in charge of mental-health coverage seems to have festering personal problems with neuroscience. That or the publisher issues orders based on the website’s analytics. Any piece stigmatizing ADHD tends to draw lots of readers—and therefore ad dollars. SEO bonanza!

It was only when I became an expert on ADHD that I realized that The New York Times is incredibly anti-science and pro-stigma when it comes to psychiatric conditions. Over the years, I’ve written several posts:

  1. Talking Back to The New York Times’ ADHD Myth-Mongering.
  2. The New York Times’ Unnatural Opinions on ADHD
  3. The Truth Behind “10,000 Toddlers Medicated for ADHD” – Parts 1 and 2.

This Time: More Grief—But Also Tiny Relief

Yet, when I read the story by reporter Alan Schwarz (“Drowned in a Sea of Prescriptions”), my reaction was both grief and relief.

Grief —that yet another person fell victim to the stimulant Adderall. Again, this is a legitimate medication that, even though helpful for many people, can create severe reactions in many others.

Relief—that finally The New York Times’ grandstanding front page finally got something right about ADHD. At least in tiny part.

The tiny part is this: The manner in which many prescribers treat ADHD  largely resembles a giant game of “Pin the Rx on the ADDer.” Or even worse — a “test the spaghetti” equivalent of throwing chemicals at someone’s brain and seeing what sticks.

All else in the story, unfortunately, is sensation and twisted assumptions. And it wasn’t the last story in Alan Schwarz’s campaign to win a Pulitzer. He didn’t, by the way, and he’s no longer at the paper. Nor is he still a reporter. But during the time he was, he inflicted immense, perhaps lasting damage.

Moreover, after writing a horribly sensational book on ADHD, Schwarz featured in the “documentary” from Maria Shriver and her daughter, Christina Schwarzenegger: Take Your Pills. (See Netflix’s Take Your Pills: Anti-Science—and Mean)

adderall anger

Core Problem: Poor Monitoring of Prescription Adderall

In the early days of my advocacy, the early 2000s, I heard story after story repeated in my Adult ADHD monthly discussion group in Palo Alto—as well as my online group for the partners of adults with ADHD (ADHD partner):  Very reckless prescribing patterns, particularly around Adderall. 

It’s hard to explain why, even today, so many prescribing physicians consider Adderall the “most effective” medication for ADHD. Where did they get that? There is no published evidence to support this practice. 

To understand the essential problem, we have to start with poor prescribing protocols for ADHD overall.

—Prescribing physicians should have a method for tracking progress.

They should be using a checklist of symptoms that helps them monitor how well the medication is working—and what side effects it might be creating.

—Physicians should gather reports from family or close friends.

That’s because sometimes folks with ADHD lack accurate self-observation. Typically, this improves with medication, but the wrong medication can further cloud self-observation.

—Too many physicians most don’t bother with either method.

Instead, they rely on a casual, “So, how is that working for you?”

Has Poor Prescribing Created ADHD Backlash?

To summarize the points above: The prescribing of any stimulant is often done badly. Moreover, too often, little attention is paid to rebound or co-existing conditions such as anxiety or depression. But the problems with Adderall often appear an order of magnitude more serious.

In fact, I credit these poor prescribing patterns for much of recent years’ blowback against ADHD. The fact that I publicly predicted and warned about this years ago brings me no pleasure in being right. Every day,  I help to educate and steer in a better direction. But I am just one person—without an “authoritative” MD after my name. I am, however, a Crusader Rabbit journalist with dyed-in-the-wool respect for accuracy.

When it comes to ADHD medications, lives truly do hang in the balance. Prescribers need to pay attention.

Caveat: Prescription Adderall Works Great Sometimes

Make no mistake: For some people, prescription Adderall works well and with few side effects. It is the best choice for them.

Yet, prescription Adderall has a higher side-effect profile.  So, individuals with ADHD just beginning treatment might consider a conservative route. That is, try Adderall only after trying the methylphenidate class stimulants (Ritalin, Focalin, Concerta, Daytrana, etc.) and some newer delivery systems in the amphetamine class (such as Vyvanse).

Ideally, a trial should be given of both the amphetamine and methylphenidate classes, as I explain in my book. (Based on interviews with preeminent ADHD experts.) That way, you can judge which works best.  There is no way to predict beforehand how a person will respond to either class of stimulant. It all depends on genetics and their unique neurochemistry.

Despite all that, many physicians routinely start new patients with Adderall, and at too high a dose. It makes so little sense.

Adderall

Contributing Problems: A Larger View

Still, the ignorance around prescription Adderall remains only one piece of a very problematic and often tragic puzzle:

1. Physicians who see ADHD as a “simple condition.”

“You just throw a stimulant at it!” one psychiatrist told me at a meeting of the American Psychiatrist Association. It was his way of summarizing why he failed to find ADHD treatment interesting and therefore not worth his study.

In fact, ADHD is a highly complex condition, especially when it is diagnosed later in life. For example, other conditions—such as sleep deprivation and substance use—complicate medication response.

A thorough history must be taken, including teasing out signs of the co-existing conditions suffered by an estimated 75 percent of late-diagnosis adults with ADHD. Moreover, 50 percent of these adults will have two co-existing conditions.

2. Physicians who believe in a “starting” or “average” dose

“There is no starting or average dose!” I’ve emphasized that in my lectures for years, based on advice from the top experts I respect most. Yet still, that seems the status quo.

—Some people are slow metabolizers: an “average” dose might be too high for them.

That means it might present intolerable side effects, causing them to give up a medication that might, if prescribed at a lower dose, work very well for them.

—Some people are rapid metabolizers: an “average” dose might be far too little for them. 

They “burn through it” too fast. They need a higher dose in order to get an average effect.

My scientist-husband and I wrote a 7-part series explaining metabolizing issues and more:  Genetic Testing for ADHD Medications.

3. Insurance companies who reimburse poorly for psychiatric treatment

Yes, insurance companies share the blame. They do not reimburse psychiatric treatment at a rate commensurate with the kind of expertise and time required. But physicians are responsible for understanding on a basic level the medications they prescribe. And, too many are failing at that responsibility.

(If you think that single-payer is the solution, think again. The very worst countries when it comes to ADHD  medication options are the single-payer NHS countries, including the United Kingdom and Australia.)

4. People with ADHD who are impatient for results—would rather “feel” it than observe it objectively

The hard truth is, you can’t depend on a “visceral feeling” to tell you when the medication is working. In fact, sometimes you won’t realize that the medication is working—but the people around you will!

Moreover, relying on that visceral feeling (especially if it feels like booster rockets attached to your behind) almost guarantees a bad end. Maybe not today. Maybe not tomorrow. But soon. And you might be so strung out you don’t even know it.

Often, patients (or their parents or partners) will consider my cautions only after the fact—after the typical crash that happens. For many people, in my observation, that’s about two months into Adderall usage.

That’s when they are completely depleted:

  1. Typically from exhaustion (why go to sleep when for the first time in your life you have “superhuman” focus?).
  2. But also perhaps due to Adderall’s mechanism of action, their very supply of neurotransmitters might be depleted.

5. Parents’ and Loved Ones’ “Denial” of ADHD

Now we turn back to the NYT story. Did Richard Fee, the poor young man featured in the piece, truly not have ADHD, as his parents claim? I’ve seen no evidence of that. This was the weakest point of the story.

Reporter Alan Schwarz has made it clear that he has no understanding of ADHD’s complexity. He gives lip service to ADHD as a legitimate condition—and then proceeds to rip it apart.

As a former newspaper editor, I have seen the pattern: “Hot Dog” reporters who will do anything to land on the front page, above the fold. They might have had success on one topic (in his case, starting as a sports reporter, concussions from sports) and fancy themselves a rockstar on all topics. 

Schwarz failed to comprehend that ADHD sometimes had a way of “sneaking up” on people later in life. That’s when their innate intelligence and ability to get by in school without good study habits are no longer enough to let them keep up with their goals. It might seem that these people are “abusing” stimulants when really they are seeking help. It might also be that they are suffering from poorly titrated and monitored prescription Adderall.

Could it be that Fee’s parents’ own denial systems about their son’s long-running ADHD-plus-related problems augmented their son’s distress? At least these doctors believed him, Richard Fee might have felt. 

Richard Fee Adderall
Richard Fee, the subject of The New York Times article

6. Prescribers Who Fail to Ask for Third-Party Feedback

 Please understand: Richard Fee’s parents have my deepest sympathies. It seems they truly tried to warn the physicians of what was happening to their son. 

I’ve seen the same for years.  The partners of adults with ADHD try desperately to get through to the Adderall-prescribing physicians, to explain that their partners are turning into rageaholics. (Their partners will never report increased anger and ability to their prescribers. They don’t want to lose access to their life’s long-missing focus.)

Yes, there are privacy laws. But that does not mean the prescriber must not request such feedback.

Did Fee have a condition such as bipolar disorder (either instead of ADHD or co-existing to it)? That is, a condition that made him more vulnerable to abuse or become addicted to Adderall? Did he have ADHD and was using Adderall to minimize sleep so he could study more, thus becoming sleep deprived and further deteriorating his mental function?

We’ll never know. But I suspect that there were red flags throughout his childhood and young adulthood. 

Rest in peace, Richard.

Excerpt: My Book’s Chapter on Medication

Now I’ll share with you now the introduction to my first book’s chapter on medication. Please share it with anyone who is thinking of seeking treatment for ADHD. 

Let me be clear: I do not want to scare people away from seeking treatment that can vastly elevate their lives. But I do want to emphasize: We consumers must be educated, we must self-advocate.

To lack vigilance is to risk a lot. Please don’t let you or your loved one be another casualty. The method of identifying ADHD symptoms and medically addressing them is, for the most part, not rocket science. It’s not even brain science. It’s step-by-step logic and observation.

Chapter 21: RX Treatment Results That Last

Adderall

It took Alex two grueling years to convince his wife to seek an evaluation and then treatment for her diagnosis of ADHD.

“Now, who knows how long it will take me to convince her to ditch this psychiatrist, who refuses for no logical reason to prescribe stimulants and find one who actually understands ADHD,” he complains. “My wife is skeptical that I or this support group could know something her psychiatrist doesn’t. But trust me, it’s alarming how little this guy knows.”

Looking back, Alex wishes they’d been far more careful in selecting a physician.

In Jeanette’s case, the irony is that she never found her husband’s ADHD a problem—until after he started medical treatment for it.

“I used to go to bed at night thinking I’m the luckiest wife in the world,” she recalls. “Yes, Mike is lousy at paperwork and he doesn’t remember to take out the garbage (or what day it’s collected!), but he is fun, very goodhearted, and rarely gets angry, and loves being with me and the children.” 

All that changed soon after Mike learned that he might have ADHD and decided to do something about it. He had recognized in himself the traits he didn’t like in his father, including poor follow-through on promises, and wanted to do a better job with his own family. “His attitude was, ‘If treatment can help me to be a better person, why not?” Jeanette recalls.

Unfortunately, under the first physician’s care, Mike’s personality changed completely after starting medication. 

“I went from this perfect marriage to hating my life and being ready to leave him. The worst part was that he didn’t realize that things were getting worse, especially the anger, until we were in major trouble. As far as he was concerned, his focus was better so that was great. But in reality, his focus was unrelenting.”

Jeanette found the support group’s feedback critical to realizing what was happening. He was probably either on the wrong type of stimulant medication or at too high a dosage. She also learned how to find a more qualified physician and, more importantly, convince Frank that he was turning into a father far worse than his own.

Such stories are way too common for the support group’s comfort. 

Sure, we want to place our faith in our physician’s ability to navigate the increasingly complex world of medicine for us. Yet, one troubling fact remains: Many physicians, including psychiatrists, are poorly trained to treat Adult ADHD. Some know that and respect their limitations, but some don’t.

As long as you understand this going in, and as long as you take steps to be a smart healthcare consumer, the chances are good that you will avoid common pitfalls and come out a success story.

“My message to those embarking on this journey,” Jeanette says, “is don’t be afraid of medication; it can bring great changes. Just be aware.”

Indeed, lest you be scared off entirely from pursuing medication treatment, know that, for many, it is a straightforward issue. In fact, ADHD Partner Survey respondents report that when their partner started taking medication, symptoms improved significantly within:

  • Hours (15 percent)
  • Days (39 percent)
  • Weeks (19 percent)

As Jeanette learned, however, the initial “promise” of medications to smooth out the ADHD roller coaster can soon peter out. Support-group members have agonized over this phenomenon for years.

This chapter will support you and your ADHD partner in creating your own success story by helping you to:

  • Avoid common pitfalls that lead to low treatment adherence.
  • Understand that treatment education and goal setting form the foundation of successful medication treatment.
  • Know that each person has a unique biochemistry, which eliminates the possibility of any single medication or standard dose being the
    best choice for everyone.
  • Recognize that it requires a careful, methodical process to find the best fit in a medication regimen.
  • Know that ADHD commonly coexists with other conditions, which must be considered in any treatment plan.

The good news is that physicians are increasingly becoming more educated, and these guidelines should help you shop for and recognize competent care when you encounter it.

For more posts related to ADHD medications, click here: archives

For more information on my book, click here: Is It You, Me, or Adult A.D.D.? 

COPYRIGHT 1201 ALARM PRESS, 2008

—I welcome your comments.
Gina Pera

 

147 thoughts on “The Tragic Truth Of Prescription Adderall, or “Madderall””

  1. This whole article really spoke to me. I’m 19 now, and I was first put on Adderall when I was 9 years old. I can’t even remember life without Adderall in it. I have wasted so much time going to different physiatrists, doctors, specialists; you name it I’ve seen them. I’ve always known that Adderall has been causing problems because it never really worked in the first place. I became so dependent on that drug that when I did not take it I would feel moody and anxious. For the first time in my life, I have a choice, and after reading this I am going to talk to my physiatrists about stopping it.

    1. Dear Blaire,

      Good for you. Being pro-active is the only way to go.

      So many kids with ADHD have been turned against treatment because the prescriber was not careful, did not educate the child on how they should (or should not) feel, did not ask for feedback from the child or parent. It’s just criminal, really, especially because it still happens.

      It might be that you still benefit from stimulant medication, but that Adderall is not the best choice. So, you should know your options. Trust me on this.

      I encourage you to read my book’s chapters on medication before talking about this with your psychiatrists. Chances are good that, after you do, you will know much more than they do. You can even provide them with a photocopy.

      https://amzn.to/3jdB1FS

      Good luck!

      Gina

  2. as drug addiction. Elvis, who in his last decade lived on alternating currents of uppers and downers, took pain medication and other approved substances. But like most prescription-drug casualties, he was convinced that he occupied a different sphere from all the scurrilous and sordid addicts hooked on cocaine or heroin. (He wasn t a junkie; he was taking his medicine.) Today, if you talk about the opioid crisis, or what it means to be a methamphetamine addict, you ll conjure up a desperate, grunged-out myth of heartland depravity that s light-years removed from the safe medicalized images of a dutiful shrink writing out a prescription for Adderall. Yet in the urgent and eye-opening documentary Take Your Pills , which premieres today on Netflix, the director Alison Klayman deconstructs those prejudices to show you how potentially misleading and dangerous they are. Her movie focuses on the class of psychotropic stimulants (Adderall, Ritalin, etc.) that are now prescribed, at epidemic levels, to treat ADHD and other attention disabilities.

    1. You’re welcome, Brian! I’m glad you found it useful.

      Treating ADHD with medication is not typically that complicated — for prescribers who know what they are doing.

      Too many, however, see treating ADHD as simple. As one psychiatrist said to me (and I’ll never forget it):

      “Treating ADHD is easy. You just throw a stimulant at it.”

      take care,
      g

    2. I was misdiagnosed with ADHD at 38. And adderall ruined my life and relationships. I am still trying to repair the damage. It ruined my relationship with my family, my children, my friends, my coworkers. I destroyed my health. Adderall is a terrible drug especially for someone who doesn’t have ADHD. I’ve beem off of it for over a year. I took it for almost a year. My life has improved immensely. I am so grateful to be off of it and rebuilding my life.

    3. Dear Dan,

      I’m glad you have been on the road to recovery.

      It’s so difficult, to have heard these stories for years, and still to—after finally helping someone to get diagnosis—learn that the doc has prescribed Adderall.

      It’s insane, really. And I’d like to take away their prescribing pads.

      Thanks for validating the phenomenon,
      g

  3. Gina,
    I came across your article while researching adderall as I have just started taking it. I wasn’t diagnosed until now, at 22. I really resonated with the section in your article about ADHD sneaking up on people. I felt seen, heard. I was the smart kid in high school who didn’t have to pay attention to do well, so I didn’t, and no one noticed because my grades were good.

    But then I got to college. I struggled through college, I couldn’t sit through a lecture without messing around on my laptop, or my phone, or just doodling. I didn’t even get help until I actually graduated and realized I can’t even watch tv anymore because I couldn’t focus for a 30 minute episode.

    Anyway, I just appreciated knowing I’m not alone in this situation. Especially now, coping with my new diagnosis and thinking about what could have been if I’d gotten help before.

    1. Dear Madeline,

      Thank you for validating a storyline I’ve heard a few times—but that of course raises eyebrows among people who don’t understand ADHD. Including the grandstanding reporter at The New York Times.

      It’s a storyline that many mental-health professionals won’t understand, either.

      It might be that your distractibility, etc in college is “professionally” interpreted as something else entirely….after all, you did great in high school! It must be that you have Fear of Success or …something.

      It can be the same thing with marriage, with buying a house, with having a child, with getting a promotion. Even “good” things can be the straw that broke that camel’s back — that is, push the brain’s executive functions beyond their capacity the brain’s executive functions.

      Though it may be difficult, I support your reflecting on what might have even — not to be maudlin or stuck in the past (and not that you can really ever know how the past might have been different…it might have been not so good!). But rather to understand on a profound level how when ADHD goes recognized, it can rob people of their free will and the future they might have had.

      I hear from people of all ages, many decades older than you, only now discovering that ADHD explains so many mystifying (and sometimes crippling) challenges.

      Thanks for writing and good luck to you.

      G

  4. Hello I have been in a relationship with a man who has a severe adderall addiction. I won’t get into the horrendous details in this comment.
    But, your article came up, about adderall and you spoke of how your husband? Is this correct? How the medicine changed him? And then I clicked on your book link and felt like this may be a book I really might need to read. But I wanted to get reviews on it, Amazon didn’t offer a description of what the book was actually about…
    So I googled it…
    And I found a link that actually allows you to read the first 40 pages like a “sample read”
    And I have just read the introduction, I guess you could say, it sort of confused me and wasn’t really what I expected…
    I read the introduction and you state how you are “pro-medication? Is this correct?
    Because they introduction to me didnt seem congruent with what I read in your article online?
    I just want you to know that I am genuinely trying to understand is all. And please correct me if I am wrong.

    The introduction seemed more focused toward identifying adult ADHD, and how to deal with it, and manage it, which is great for people seeking out this very much needed information, which I absolutely commend you and others for sharing your stories, and for putting this information tool out there for people who I am sure have and will benefit very much from…
    Because what I think I was able to perceive about you? Is that you are very well knowledgeable and educated about the subject of ADHD.
    I did also get the feel that you want to help.

    AND me myself I apologize for any struggles and my heart sincerely goes out to you and any other person who is affected by anything having to do with mental issues, strife, conflict, addiction, grief, or any sorta struggles in life making life more of a struggle than others already is.

    I have a deep empathy because I myself am a single mother of 5 children ages 19- down to 6… who have been diagnosed with different mental illness ranging from high functioning aspergers/with a combination of prevalent comorbiding bi-polar, to Borderline personality disorder, in the middle I have a child also on the spectrum but has been dianoised with ADHD also raised two boys that my ex-husband had from his first marriage and they are ages 25 and 26 now, were 5 and 6 when I met him. The 25 year old was also dianoised with aspergers so I understand fully the struggles and my ex-husband and I myself are very educated about a wide variety of mental issues, unfortunately it seems we are more knowledgeable than “the experts” to the point of having to educate them…if that makes any sense?

    and I hate to say this, and I don’t want to come across as arrogant but it is true, and it has been a very difficult road I have to say for him? Over 20 years, for me? 20 years and it continues to be a struggle… But we constantly educate ourselves effectively co-parent best we can, during the times we don’t have horrible communication breakdowns….

    But like I was saying, I was expecting the introduction to be more anti-medication I guess??

    Giving information about the drug adderall and the cons of taking it and the effects it has on a person’s brain, personality ect that people may be unaware of.
    And how “adderall” was what changed your husband, causing martial break-down and the affects that did to you? And your marriage. Like, what I have perceived from this article.

    But, like I said that’s not what I gathered when i read the introduction and a sample page.

    Your book introduction actually contradicts this article? I believe because you say you are pro medication, and it more focus on how ADHD was the problem in yours and others situations? Not the medication

    Like the stories of the husband that had a spending problem, or the one who would get distracted when the children were left in his care?
    So, please. If you could help me understand my perception of incongruency? And correct me if what I have perceived is incorrect…I would appreciate it very much.
    Thank you

    1. Dear Faith,

      I appreciate your question. And I understand your confusion. I’ll take each question separately.

      1. My “pro-medication” stance

      When my first book came out, in 2008, Adult ADHD was little known. Much less well known: Adults taking stimulants for Adult ADHD. There was also a certain organization that calls itself a “church” (for tax purposes) that was waging quite a nasty campaign against ADHD and the medications used to treat it.

      As a book based on the science, my book confirmed the science of ADHD medication treatment: It works. That’s why I wanted to take a very clear statement on medication.

      My book also, though, detailed an approach to medication that few prescribers follow. Instead, many have been “throwing Adderall” at patients, with little regard for monitoring.

      That is what I warned about in this article (and warned about for years previously):

      https://adhdrollercoaster.org/adhd-news-and-research/the-tragic-truth-of-prescription-adderal-or-madderall/

      Adderall is unique among the stimulant class of medications. It has additional effects. That means it works the best for a minority of people. But it creates a higher side effect profile for many others.

      That’s why prescribers need to pay attention.

      But no, Adderall did not cause a marital breakdown for me and my husband. He tried Adderall early on, and that’s when I noticed that the “treatment was worse than the condition.” But the condition was still difficult enough.

      That motivated me to help others avoid the dangers of mindless prescribers.

      Done properly, medication for ADHD can make an enormously positive difference. This is an essay from a woman diagnosed later in life with ADHD, followed by her husband’s diagnosis. She writes about the before and after of medication treatment for them both.

      https://adhdrollercoaster.org/book-club/medication-help-adhd-relationships/

      2. You are more knowledgeable than “the experts.”

      You ask if that makes sense. Unfortunately, yes.

      Especially when it comes to the “specialists” who see only one piece of the puzzle and ignore the rest.

      For example, if you see a mental-health professional who knows about (or thinks he or she knows about) autistic-spectrum disorders (ASD), you might get that diagnosis for yourself or your child when the correct diagnosis is actually ADHD. Or at least ASD and ADHD.

      That’s because the professional doesn’t understand that ADHD is not always about “hyperactivity.” It can be about difficulty with social skills, making eye contacts, etc….all the things they think are ASD.

      Also: At least half of those diagnosed with ASD are thought to also have ADHD. So treating the ADHD might help them, too.

      And the same with “bipolar specialists” — they want to see ADHD symptoms as a type of bipolar.

      All this misdiagnosing and mistreating is a public-health crisis, in my opinion. That’s why I do this work.

      I hope that answers your questions. And best of luck to you in helping your children. You have a lot on your plate.

      g

  5. Hi Gina,
    I have a few questions. I have been prescribed vyvanse for my ADD and taking it for over 9 years now. My tolerance had built gradually and for the past 3 years I’ve been on 70mg. My doctor also prescribed myself 20 mg adderall to take on afternoons if I had excessive work that evening. I’ve had my “as needed” prescription of adderall for the past 4 years now. I am a 21 year old student in college. For the past few months I have noticed my extreme lack of motivation and excessive sluggishness—even with my vyvanse. And I can do absolutely NOTHING without it—even the smallest tasks I used to be able to do. I can confirm that I am reliant on it to even get out of bed. THE SMALLEST TASKS FEEL IMPOSSIBLE. I even struggle to take my pill in the morning because I don’t even have enough motivation to go get a glass of water to take it. I have also been experiencing chest pains from time to time and it has been really hard for my eyes to focus lately (specifically when I take my adderall). This realization has been extremely concerning to myself so I reached out to my mother. Here is the thing, I told my mother that I think I am dependent but she dismisses me. Considering I’ve been on meds since 6th grade, my mother knows how much they have helped me focus with my add. I think she doesn’t want to believe that this dependency is a problem because she has seen firsthand the good they have done. She thinks I’m exaggerating and since she can’t feel what I’m feeling she doesn’t understand. She only sees 9 years of positive results.

    Here’s the other thing.
    I decided to research theses changes and the more I researched the more problematic things became. I think I was misdiagnosed with ADD and that in 6th grade I SHOULD have been diagnosed with Sensory Integration Disorders (which are commonly mistake for ADHD). I have never had the hyperactivity—my main symptoms were that I could not focus on homework and if there was even the smallest sound I would throw a tantrum. I also had trouble with reading comprehension (which the doctor attributed to my inability to focus).
    I am 99 percent certain I have SID after reading about it. I Don’t know what to do now. It’s been over 9 years of my life on these meds and I’m not even sure if they were the correct diagnosis to begin with—what if that is the reason I kept upping the doses—not tolerance but because they weren’t fixing all of my symptoms (specifically my reading comprehension skills—my meds only caused me to hyperfocus and dissect words and reread paragraphs 50 billion times until they made sense). Then I started reading about long term effects of taking these drugs if you don’t have ADHD as well as long term abuse. Chest pain, blurred vision, etc. I have literally experienced multiple of the effects over these years and I never even knew it. I’m terrified that I have done 9 years worth of irreversible damage on my body. I don’t want my mom to dismiss me again and I know she will and I’m worried that my doctor will stop my meds because they are already so cautious with prescribing them (for good reason). And I’m worried if I tell her these things and it turns out I’ve done irreversible damage on my body, how will I ever get out of bed again?? I cannot fathom how I will handle that especially with the numbness and lack of motivation I have recently been feeling.

    Sorry this is so long! I just needed to get this out.

    1. Hi JoAnn,

      I’m sorry you are struggling with these side effects—because from what you’ve written, it seems likely that’s what they are.

      But I completely understand why you are questioning your diagnosis of ADHD, in favor of one for SID. I’ll explain about that below.

      Overall, I encourage you to relax a bit about the side effects you are reporting, insofar as doing “permanent damage.” There is a lot of nonsense online about ADHD and stimulants.

      That doesn’t mean you should just live with it. No, you should definitely try to improve this situation — and recruit your mother’s help. None of what you report should be the price of “focus.”

      https://amzn.to/3a9WDQH

      Here are my thoughts:

      1. Battle for Territory

      SID is one of those conditions that tend to be secondary to ADHD — that is, ADHD neurobiology can result in those symptoms. That means ADHD treatment typically helps treat the “SID” as well.

      Keep in mind: SID is a term used in the field of occupational therapy, not psychiatry. It is not a psychiatric diagnosis. It is not even a medical diagnosis.

      And that’s part of the problem. It’s a “territory battle” between two specialties: medical psychiatry and occupational therapy.

      The trouble is, occupational therapists (as much as I respect them) are not neuropsychiatrists. That means too often the occupational therapists (OTs) see SID where a competent neuropsychiatric sees SID as resulting from ADHD neurobiology.

      In other words, OTs are essentially seeing one “side effect” of having ADHD — and viewing it as a standalone condition.

      Speech therapists often do the same thing with “auditory processing disorder” (APD). But there is no evidence that APD exists except as secondary to ADHD.

      It’s important to make these distinctions because in both cases stimulant medication has been shown to be the most effective.

      In the end, it might be that you have only SID (even though it’s not a recognized medical diagnosis). But I see enough other issues that point to having inferior treatment for ADHD, and that might be causing the side effects you report.

      I encourage you to start there and put SID on the back burner for a while.

      2. Stimulant addiction

      I understand your mother’s perspective — she is probably worried that you are close to rejecting the ADHD and stopping the only treatment that has been effective.

      But I also understand your perspective. You express alarm at feeling that you would be completely non-functional if it weren’t for the drug that is also potentially creating chest pains. You report also experiencing blurred vision.

      It might be that you have developed a tolerance. But it might also be that your dose is too high or other factors are at work.

      Some questions I would ask about factors that can increase stimulant side effects:

      Are you getting sufficient sleep>?
      Are you consuming caffeine?
      Are you eating a well-balanced diet, including sufficient proteins (not “HIGH PROTEIN DIET”, but enough protein ….because protein’s amino acids are the building blocks of neurotransmitters such as dopamine)
      Are you taking a supplement or other medication that might be interfering?
      Have you been evaluated for co-existing depression or anxiety (that is, standalone conditions that aren’t the result of being “depressed” or “anxious” from facing ADHD fallout)?

      3. The “booster” dose

      Personally, I am not a fan of the “booster” dose. That’s because I’ve seen it too often used when the entire process of “dialing in” a medication for an individual has been done in a haphazard manner.

      70 mg is a relatively high dosage of Vyvanse (if you aren’t a known fast metabolizer). Sometimes doctors increase the dosage when they should be adding another dose hours later. In other words, instead of increasing the dosage in order to make it last longer, they should be considering adding a second dosage later. Increasing the dosage above what works well for a patient means more side effects.

      In other words, maybe you would do best on one lower dosage of Vyvanse in the morning and another dose as that first is wearing off. The fact is, these long-acting medications don’t always last as long as promised. It depends on the individual’s metabolism — slow, normal, or fast.

      For another thing, Adderall is NOT the same as the medication in Vyvanse. Both are amphetamines but their mechanism of action is very different. By taking Adderall when Vyvanse wears off, you are essentially starting an entirely different process in your brain, one that might require adjustments each and every time.

      Moreover, it might be that you would do better on a methylphenidate option (e.g. Ritalin, Concerta, etc.) than on an amphetamine (e.g. Vyvanse, Adderall, etc.). If you’ve never tried a methylphenidate option, that might be worth looking into.

      I encourage you to print my comment for future reference and for sharing with your mother. And do read my book’s chapters on medication — and ask your mother to read, too:

      https://amzn.to/3fBADzl

      I hope this helps!

      g

  6. Hi Gina,

    Great write up! Definitely know your stuff. I see some comments about people stating their opposition – most of them with a strong emotional response rather than using logic and rational thought.

    I had been on vyvanse 60mg for over a year (30s, Male/active/health-conscious) and saw many of the undesired sx that you mentioned: increased irritability, random bouts of anger (often internalized into “unused adrenaline-dump” feeling), and lack of emotion – all during the second half of the day. I wouldnt say it was ruining any relationships but I realized something was not right.

    I assume it has something to do with dose and come-down type effects – but many of these symptoms became worse as time goes on even with routine breaks in medicating. I soon found though that I could not take more than a day w/o meds before I was sad, unmotivated, and stuck in bed all day.

    I am interested to hear your thoughts on how hormones might play in here. Obviously you have extensive knowledge so I am sure this has crossed your mind. But I recently had a blood test for total/free testosterone (and some other markers) and although I was considered “normal” – ~400 total T – I knew from speaking with other professionals that normal falls under a large window for males, ~250 – 1000. I saw an online MD and he prescribed me TRT with a follow up blood panel.

    Generally I dont advocate HRT or TRT for individuals still in their prime but after about two months I am around ~750 total T and my other markers look normal. I cant believe how amazing I feel: no anxiety, fear, anger, etc. during those two months starting TRT I weaned off vyvanse from 50mg to 40mg, to cold turkey. I slept extraordinarily well the first three nights off, then felt normal with no depressive sx and havent looked back. I feel focused, calm, and driven.

    Sorry for the long response. Just wanted to share and hear your thoughts. Thank you!

    1. Hi Cam,

      Thanks for the kind words.

      Over 20 years, I’ve sort of gotten used to the attacks. Mostly, I see how desperate the people making them feel. Even though it can still sting, I get it.

      You ask a question I’ve been asking for a long time. About testosterone.

      Shortly after I started this work, a urologist came out with a book on testosterone, mood, libido, etc.. He made a very convincing case.

      I’d heard from more than a few men with ADHD about having “low T.”

      The more I researched, the more I wondered if ADHD itself was creating the low T.

      For example, hormone functions are controlled by the brain. When the “signals” are erratic so too can testosterone (and other hormone) production.

      Also, I read about some evidence that testosterone can be affected by one’s perceived “status”. That is, roughly, a man whose ADHD means he has trouble at work, in relationships, etc. feels “low in the pecking order” — and that, on some primitive level, can affect testosterone.

      Plus, for men with ADHD who lack the motivation and initiation to exercise regularly or eat well, that can affect testosterone, too.

      So, I could see that pursuing ADHD treatment (including medication, improving diet/exercise/sleep, etc.) might raise T levels.

      My main concern with testosterone supplementation, from what I’ve read, is that there are risks. For a man in his 30s, the risks might be particularly worth heeding.

      Generally speaking, 400 is not low. Most of the men I know with ADHD who complain of low T hover in the 300 and below level.

      The thing is, maybe Vyvanse was not the right Rx for you. Or, maybe it was exacerbating brain-based vulnerabilities around serotonin (anxiety, irritability, depression, etc.).

      Most adults with ADHD will have at least 1 co-existing condition — and 50% will have two.

      It’s important that the prescriber address the full range of symptoms. Ask me how often this seems to happen. I’d guess about 20% of the time, if that.

      If you feel great, it’s hard to argue with success. But I might encourage you to get a second opinion. An “online MD” might have quite the mill going, with insufficient concern for patients.

      Thanks for writing.
      g

    2. Hi I struggle with amphetamine script addiction I so desperately want off this medication but can’t stop now I’m wondering if this could be because of my hormones could you tell me what TRT and HRT mean.Thank you so much.
      Gina you will never know how your helping people may God bless you..

    3. Hi KC,

      Thanks for letting me know. It helps to re-charge my batteries. 🙂

      I’ll give Cam a chance to respond. But HRT= “hormone replacement therapy” and TRT = “testosterone replacement therapy.”

      Which amphetamine are you taking? Adderal? Dex?

      If you’ve never tried the other class of stimulants (methylphenidate), you might talk to your doctor about that. The choices include Concerta, Ritalin, and many more.

      Or, if you do better with the amphetamine class, maybe try a smoother delivery such as Vyvanse.

      Sometimes the biggest problems are caused by the delivery system. Immediate release or even some extended-release options can be very “hill and valley” or “roller coaster”.

      The more sophisticated delivery systems, such as with Vyvanse and Concerta, offer a long, smoother, steadier release.

      take care,
      g

  7. Hello Gina. I’m reaching out because I’m in the midst of trying to help my son who lives with me.

    He’s a senior in college now and has been on adderall for ADD for 4 years now and before that on Focalin and vyvance. We are trying to find a mental heath doctor who is good and who takes my insurance even though I’m on a high deductible plan.

    He is being treated by his general P.C. and just now she changed his medication. He also suffers from anxiety, panic attacks and depression.

    He definitely began to become addicted to the adderall because his regular dose of 60mg a day just didn’t seem to cut it anymore. So here and there he would take more in a day that inevitably lead to his running out before he could get more.

    He then began to have episodes of rage that caused many things to get broken in my house. I am away here to support him but it became progressively worse in the last month or so and the pandemic hasn’t helped.

    We had to go to urgent care one weekend because he punched something so hard we thought he broke his knuckle. He had a telemed appointment with his doctor last week and he told her he keeps getting very angry.

    She took him completely off his generic adderall ER and has put him on the generic Strattera. He’s beside himself depressed that he has lost his stimulant and he hasn’t gotten out of bed all day.

    He just started taking Strattera yesterday so only has two doses in him — 3 pills of 18mg every morning. Do you know if this may be a good option for him.

    His doctor felt he needed to come off any stimulant because he asked her if he could try vyvanse.

    I can go on about all the details but that would require a phone call I think. He’s also taking clonazepam to great his panic attacks and the doctor has started him again slowly on generic lexapro, which he’s taken now only the past couple of days. Can you offer an insight about Strattera? He’s so upset and thinks this will not do him any good. How can I get a phone appointment with you if you’re even doing that anymore… ? Thank you for your helpful input.

    1. Hi Ann,

      I sympathize with you and your son. It should not be this hard.

      The cavalier fashion in which far (far!) too many MDs prescribe for ADHD qualifies for malpractice, imho.

      While I am not qualified to give medical advice, I can tell you about the basic recommended protocol for ADHD. (You can also read about it in my first book, which I highly recommend as a “consumer’s guide” for anyone dealing with Adult ADHD.)

      There are so many questions I’d have for you. Unfortunately, I am not taking consulting calls now. Work developing online training is taking everything I have.

      You say he “also suffers from anxiety, panic attacks, and depression.”

      Who says? How did whoever said that make a differential diagnosis? That is, was ADHD causing the “anxiety” and “depression” and “panic attacks”? Or did that come on when he started a stimulant?

      Here is the most common and grossly negligent practice I see: “Throwing a stimulant at” ADHD, failing to treat the range of symptoms, and even failing to understand how ADHD can “look like” anxiety, depression, etc.

      How did he take Adderall for four years without these problems? Obviously, he’s working/studying at a higher level now. And, as you say, the COVID restrictions can be very stressful.

      re: panic attacks

      Clonazepam is a benzodiazepine. This is probably the most over-prescribed drug today, especially for older people. It was never intended to be an ongoing treatment, only episodic, for anxiety. So-called “Benzos” can also have a nasty rebound — wherein when they wear off, symptoms return stronger than before.

      What’s happening now.

      You said: His doctor felt he needed to come off any stimulant because he asked her if he could try Vyvanse.

      It seems the doctor has pegged your son as an amphetamine addict. Maybe he is. I don’t know. But it sounds like he’s been doing his best to cope — and whatever doctors came before weren’t taking a careful approach to his treatment.

      In fact, your son might have been on the right track, to try Vyvanse instead of Adderall. It has a smoother delivery system with fewer of the spikes and troughs common to Adderall.

      But if he’s come to over-rely on Adderall—and has not optimized his sleep and diet and organizational/time-management strategies, even Vyvanse might pose a problem. (Those are questions to ask yourself.)

      It is not generally considered good psychopharmaceutical practice to start two new medications at the same time: Strattera and Lexapro. Especially while still taking the clonazepam. The reason is simple logic: How will you know which one is working and which one is causing side effects?

      re: Strattera. 54 MG is not an exorbitantly high dose. But it is higher than the recommended starting dose of 40 mg.

      While technically Strattera is considered a first-line treatment for ADHD (that is, the type of medication most likely to be effective), most high-level clinicians and experts I’ve asked say that it works well for a minority but generally does little as monotherapy (that is, by itself, not in combination with a stimulant).

      It takes a few weeks to build up in the system — where you’ll see its full effect — but it can also make its presence known much earlier. Keep an eye on your son. Is he “depressed” because he can no longer have Adderall or because the Strattera is creating that effect?

      If he seems to be getting more depressed, call the doctor—or find another doctor.

      It’s impossible to establish blanket rules. People with ADHD are individuals, each with a unique brain — like all humans.

      But going slowly and methodically — and tracking progress or regression — is the only way to go, imho.

      I encourage you to self-educate so you can better self-advocate for your son. The sorry truth is, we simply cannot rely on the average (or even above-average, sometimes) physician to know what the heck he or she is doing when it comes to ADHD.

      I hope this helps.
      Good luck to you and him! Please tell him I said to hang in there. This is a problem that can be fixed. And it’s not his fault.
      g

  8. Hi Gina, excited to see some recent activity on this article – I am really frustrated at how hard it is to find information on Adderall exacerbating the ‘hyperfocus’ problem of ADHD besides ‘yeah it does that’…it seems I see a lot of acknowledgement everywhere that yes, the user will be stuck on whatever they’re working on when the med kicks in and that isn’t an unusual response, so better make sure you’re on the right task before meds kick in…and that just seems like a strange/unacceptable solution to me?!

    I was just diagnosed earlier this year at 27 and have been on generic adderall IR for 4.5 months or so and while it helps some areas, it doesn’t in others (for example, getting unreasonably angry…). One of my biggest struggles has always been task switching – so getting ‘stuck’ on things with adderall has been very frustrating, even if it’s something that I would have resisted getting into before. I’ll even be aware that I’m ‘stuck’ but can’t seem to disengage and switch tasks. We tried lowering the dose and my life slowly fell apart in those 2 weeks until we bumped it back up again and it didn’t help with the hyperfocusing problem, so I don’t think that’s the solution…

    Your 4th point about being impatient was really interesting – I thought I was being pretty careful about not expecting too much and tempering expectations, but I definitely ‘burned out’ recently, which lined up with your 2 month estimation a little too much to be a coincidence, I think. (Is there a link to more info about the 2nd point about depletion somewhere that I missed?) I had some pretty good established routines like exercising and getting into the daily work flow that went out the window when I started meds and got off track during those first few days adjusting, and it’s now been months of me trying to get back into it and just not seeing a lot of success, which I thought meds were supposed to help with, hence thinking maybe adderall isn’t the one for me…

    I have discussed a little with my Dr when I first expressed concern that I wasn’t getting the supposed 5-6 hours (only 4) and they suggested trying Focalin rather than a different extended release amp based med because of more potential side effects, I haven’t pulled the trigger yet because of the whole devil-you-know-vs-devil-you-don’t fear, it’s more expensive than generic IR, the thought that maybe it’s just me not using meds ‘correctly’ so switching won’t fix it, or it’s the specific generic I’m on, or idk! It’s very hard to evaluate, and while I’m sure it’s a variety of factors that contribute to why some days are better than others, I would have hoped to have noticed some more obvious patterns or indicators by now, rather than only being able to say it’s very inconsistent…

    Do you have any easy to digest resources on amphetamine salts vs dexmethylphendiate in adults that doesn’t require a pharmacy degree to understand but is written for intelligent adults interested in the topic?!

    1. Hi Kate,

      This has long been my most popular blog post. Every day, for years, I’ve seen the search terms that bring readers here: “Adderall is making my husband a jerk” and “why is Adderall making me angry?”

      Of course, some find the post because they are seeking to abuse or illegally procure Adderall—then I hope they at least read a bit and think twice.

      The sad truth is—and it is a major reason I launched my advocacy and wrote my book—is that too many prescribers have no idea what they are doing. The company that introduced Adderall is one known to make a big marketing push, so I suspect that is a chief reason.

      To your points:

      1. Generic adds a whole set of variables.

      2. Yes, “tunnel vision” translates as “difficulty task switching”—which is already a common challenge with ADHD (“hyperfocus)

      3. My 2-month estimation comes from many years of observation (and a ridiculously good memory). I wish more MDs understood this.

      4. When I wrote my first book, I had the almost impossible task of getting at least one MD to comment, on the record, about the different mechanism of action with Adderall. All turned me down (and these are people I respect and who respect me). Only Chuck Parker, DO—bless his heart—was willing to even comment on it. So you can read about the differences there.

      5. So, when it comes to understanding the “depletion” angle, this is mostly my informed deduction. This is a very difficult issue to research. Genetic differences, for one, affect dopamine transmission and activity at the synaptic gap.

      Here is a paper that presents at least some of the complexity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753078/

      And this is the study it refers to (a mouse study, which has big limitations when it comes to humans): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3711765/

      6. It’s really not important for you to develop a strong understanding of the psychopharmacological differences between mixed amphetamine salts and the other amphetamine options. I’ve seen many people with ADHD (who don’t have a molecular biology background) get bogged down in that topic, thinking that if they just understand what an isomer it, they will have the Holy Grail. 🙂 It’s mostly just wheel-spinning.

      The only thing that matters is making judicial trials of several options in each class of stimulants before settling on one. The delivery system makes all the difference. For example, Ritalin and Concerta both contain the same raw ingredient: methylphenidate. But the delivery system can create entirely different effects in the individuals who take them.

      From what I glean here, you have never been given a trial of methylphenidate stimulants. Focalin is one, but it’s not often the first choice. Perhaps your prescriber has specific reasons for trying it, though.

      7. There are individual differences in metabolism, too. Even though the generic Adderall you’re taking is “supposed to” last 6 hours, that is a ballpark estimate. Especially with a generic, which can vary wildly manufacturer to manufacturer. Want to do a deep dive into the science? Check out this 7-part blog post from my husband and me: https://adhdrollercoaster.org/adhd-gene-testing/adhd-dna-and-predicting-medication-response-introduction/

      8. There is a basic method for selecting and titrating stimulant medications (and addressing co-existing conditions that also might be exacerbated by the stimulants). And I detail it in my first book. I encourage you to read it. Read it, and you will know more than many (most?) prescribers. Seriously. Read it. Write a log. Take notes. It’s the only way, imho.

      Good luck!
      g

  9. Gina is correct. I am a former RN, an adult with ADHD and my two sons have ADHD. We all take different combinations of medications because we are all different. I have medical and psychological CEU’s from attending many CHADD international conferences where the top experts in the country lecture to other medical professionals on the subject. Gina has also been invited to be a presenter at CHADD and I have heard her present a couple of times. She is very well respected.

    1. Finding the right medication and dosage takes some trial and error, but Gina is correct that dosing is supposed to be done low and slow (low dose and gradually titrating upwards until the most benefit without side effects occurs).

    2. A full physical exam should be done first to rule out any medical conditions that may look like ADHD. This usually does NOT include expensive brain scans and medical tests unless a brain issue in structure is probable. An ADHD workup does not typically include an MRI, CT, EEG, EKG or genetic testing. I have done the research and I’m well aware of what the valid science says.

    3. The FDA has not approved genetic testing for a diagnosis of ADHD, since no gene has been
    identified for each of the three presentations.

    4. Research validated rating scales for ADHD, Executive Functioning and other mental health issues are part of best practices and supported by most professional medical organizations. Many doctors still aren’t using them and this is huge problem in tracking symptoms and determining what symptoms are connected to what conditions.

    5. The primary medication treatment and the most effective drug class for ADHD is still stimulant
    medication. There are options to treat co-morbid conditions and often a combination is used in
    these situations where someone has both ADHD and anxiety or depression, for example. Anti-
    depressants alone are NOT a primary treatment for ADHD, they are a treatment for depression
    which has similar, but not the same basis, for symptoms and the symptoms are not the same and
    usually do not present the same.

    6. Provigil is a CNS medication, but is not typically prescribed for ADHD. It’s primary use is for
    patients with narcolepsy (for people who fall asleep during the day). ADHD is not an issue with
    sleep. However, those with ADHD can have sleep issues more so than the average population.

    7. Scientific research shows that people with ADHD who are treated with the appropriate dose of
    stimulant medications and given the type or combination of medications that work for their
    particular neurobiology are LESS likely to abuse substances than those who are under treated or
    not treated at all. This has been presented by multiple experts at the CHADD medical breakout
    sections.

    8. A family history of addiction does NOT mean a person who has an ADHD evaluation or workup or is seeking one is seeking drugs or is an addict themselves and any physician that thinks that or treats patients as if they are….are not following the hypocritical oath and could be committing medical malpractice and contributing to the horrendous stigma that still exists regarding ADHD.

    In each of our situations, we had work ups that were done correctly, including rating scales (not just self reports), ruled out medical conditions by highly qualified MDs, tried non-stimulants-which were not without side effects, had FDA approved testing when available and every provider for the past 10+ years has agreed with our diagnoses. None of us have misused ADHD medication and all function better on stimulants than without them.

    Our biggest challenges right now, is the miseducation and stigma created by others, school staff who refuse to follow the federal laws to protect those with documented ADHD, attorneys who won’t file due process when clear violations of the law have occurred and been documented and issues with crappy ADHD generic medications that don’t work and aren’t as effective and have created side effects in a large population of people who take them (methylphenidate or generic concerta-which is not Adderall and in a different class of stimulants).

    I would highly suggest than anyone that doesn’t like what Gina is blogging about, remove themselves from this blog since you don’t believe in what she is saying (which is supported by the experts). In any instance, it is rude and unhelpful to personally attack someone in a blog that has helped many people. As I have said, she is well respected by the top experts in the county. Your opinions do not trump our experiences or expertise which is based on hard science and fact.

    1. Wow, Gwen. Thanks for the backup! I appreciate your support.

      We Fans of Rating Scales must stick together! 😉

      thanks again,

  10. Peter Hjemdahl

    Adderall (Attentin) success story!

    HI, I just wanted to share my experience with dexaphetamine (In sweden there are two drugs available with dexamphetamin, Vyvanse and Attentin.) Attentin is not RX. And it differs from Adderall in that it is 100% dexamphetamine compared to the 3/1 formula of Adderall 75% dexamaphetamine and 25% levoamphetamine.

    Anyways, for me it really working magic _in combination_with my 36 mg Concerta. A game changer really. I think it’s the extra boost I get in my norepinephrine? Ihave tried skipping my concerta and doubling the Attentin, works well but I would rather have the extended release effects of the concerta.

    The side effects are also different from my Concerta, less anxiety and less irritability. Will probably check with my Dr if I can try Vyvanse (maybe called Elvanse in the US?).

    All the best / Peter

  11. TO MEDICATE ADHD – IN 7 YEAR OLD WITH PRENATAL DRUG EXPOSURE?
    Gina, I have been reading your advice on your webpage – and obviously – you know alot about ADHD. We adopted our 7 year old son as a baby from foster care (received him at 4 months). He is sweet and kind- not hyper – just extremely inattentive. He suffers from EXTREME focus issues – in addition with executive functioning problems, occasional anxiety (dentists, doctors etc), some sensory stuff, fine and gross motor delays. Yet, Eli is very well behaved and well liked by teachers and peers.
    We have been seeing a psychologist – who is referring us to a psychiatrist in her practice – because she thinks we should begin medicating to help him in the classroom. Here’s the BIG ISSUE: my son was born with prenatal drug exposure. His teen mom was in foster care and a runaway – and although just THC showed up in the meconium – my gut tells me he was exposed early on to a cocktail of different substances – that has affected his brain. His birth family are all addicts – with a history of “mental illness” – which I wonder – is it really mental illness -or just drug addiction?
    I am fretting over beginning a medication. In your experience with ADHD – would you medicate a 7 year old with prenatal drug exposure – or would you be more hesitant?

    1. Dear Tiffany,

      I truly appreciate your dilemma and concerns.

      I understand your suspicions that your son was exposed prenatally to more than THC (though we won’t discount that as benign) but you cannot know for sure.

      What you do know is that his birth mother’s family suffers from addiction and a vague history of “mental illness”.

      You wonder, is it really mental illness “or just drug addiction?”

      In fact, drug addiction is considered a mental illness. More to the point, many people living with undiagnosed/untreated mental illness (including ADHD, bipolar disorder, anxiety, etc.) are vulnerable to developing an addiction to the substances that, at first, are attempts at “self-medication.” That is, to feel better, to slow the noise in their brain, etc.

      If you trust this psychologist and she will work as a team with a psychiatrist in her practice, I’d say that you owe it to your son to try. That can be an ideal situation, much better than when the prescriber and therapist never compare notes.

      You will never know the exact effect of the birth mother’s substance-use habits on your son’s developing nervous system. In fact, all fetuses are vulnerable to all kinds of adverse in utero effects such as a mother developing an infection while pregnant, having nutritional deficiencies, and so forth.

      This is all an unknown.

      The only thing that you know for sure is that your son is exhibiting what well might be ADHD symptoms. ADHD symptoms that his birth mother and her family might have attempted to “self-medicate” with all manner of substances.

      And, that is good news. Because ADHD typically responds to treatment. You say your boy is well liked and has no behavior problems; that is also good news. How much better his life might be if his potential ADHD symptoms could be treated.

      There are no lasting effects from a trial of medication. As I always say, “It’s not like cutting off a leg.”

      In 20 years, after hearing thousands of stories, I have gone from “How can you medicate that child!” to “How can you NOT medicate that child!” 🙂

      You want to make sure that the prescriber “starts low and increases slow.” That is, start with a low dose of medication and increase slowly over time, keeping a watchful eye on improvement as well as side effects.

      It might take a few different trials of stimulant medication. There are many options. That means ADHD patients have a better chance of finding a choice that works best for them.

      There is also a chance that the stimulant might exacerbate an underlying condition, such as anxiety. A good prescriber should view that not as a reason to stop the stimulant but as useful data that informs treatment going forward. It might be that a different stimulant or dosage will provide better results, or it might be that a second medication is necessary. This is completely normal.

      I write about a simple protocol in my first book. Though targeted to adults, the principles are the same for children.

      I encourage you to read and be familiar with the basic principles. That way, you can better advocate for your child.

      https://amzn.to/2U2XE7O

      I hope this helps. Good luck!
      G

  12. When i first started needing to take meds i was 9. Thats when i started getting random problems that landed me in the ER starting at age 13, before that, i showed symptoms of serious illnesses and constantly had to get tested and be in hospitals, my rare deep depression disorder that was diagnosed when i was 9, surprised my doctor and he didnt really know how to explain it due to the fact i have not experienced any severe and emotionally scarring trauma that would be the best explanation to why someone my age would have this disorder. When i got older i was seen by specialists at Stanford who thoroughly evaluated me and went deep into my head and the therapist who graduated at Stanford and taught there, she somehow was just so good she got me to open up about my entire life, things i didnt even know i could say just came out and i told her everything ive been through since like ever and i made her cry, she and the other doctors who were a team on me decided that in order to treat my physical health problems and everything else i would need to be in a depression ICU to effectively treat the depression because they feared that with my depression being so deep rooted that i wouldnt be able to progress into treatment for other things until my depression is helped. My depression didnt show on the outside though, only when you got me talking about my life in depth you saw it. That was how bad it was, that it was to the point of extreme that it was all in my head and i never let it out, because why act depressed? i get it if you are depressed if you have depression, you tend to act depressed but for most people that ends up fading or going away, for me it was so constant that if i showed it, there wasnt a point. To let it control me. I acted happy, half my friends in school didnt know i spent so much time in the ER and shit that when they got the news i was in the ER the previous night they were all worried, little did they know that was a typical week for me. I don’t have ADHD i have ADD my twin brother had ADHD. When i was being evaluated to figure out what kind of meds i needed to be on for my problems that i couldnt control and they were interfering with my life, like my ADD the psychiatrist was in no rush to give me a ADHD diagnosis. He thought it was possible because its popular in children but a lot of them grow out of it. He wanted to put me through a series of tests for ADHD and similar things. I did a lot of testing and then he found out i had ADD not ADHD. In your world of what the majority of psychiatrists do, what should of happened (if you are correct) then he would of seen that i had symptoms of ADHD and he would of put me on adderall right then and there at the age of like 10. Nope. Everyone who gave me meds was always very careful and watched me by seeing me regularly. I was on other meds for ADD before adderall. But when i was 13, i started smoking weed because my twin brother did, which got us smoking ciggarettes to 1 enhance the high, 2 cover the smell of weed so we can get into our rooms without our parents getting a big whiff of skunk when we walked to the hallway. One day he came to me and had 40mg of adderall for the both of us. We both took it and i got really high, i was so happy, very euphoric and emotional, i was on World of warcraft during the start of catacylsm xpack, if you know wow you know what i mean, and the land that got destroyed, i did a quest chain where i helped rebuild and save people and whatnot and then the quest giver gave me a tree companion pet that grew in water and i started bawling in tears because i was so honored that i could be so helpful and shit. I found out that when my brother was in the car with my dad going somewhere during this time he ended up breaking down from something my dad said and got all emotional and confessed to taking adderall…. So we both couldnt hide that high. But i am very observant. I noticed that while on adderall even though i was abusing it, everything felt clear, all the ways my disabilities made things foggy and hard to concentrate on things and just my world felt kinda foggy in my head and i couldnt really focus easily. I remembered the energetic feeling i felt, because it was something i felt before i started getting sick, what normal felt like. Before i had problems. So i went to my psychiatrist told him about my experience, he tells me it is helpful for someone like me but warned me i have to take it exactly how he tells me to and not increase the dose without him increasing it. He told me that he will see how i do on it because it effects people differently, it can make you agitated and speedy and shaky if you aren’t really meant for that type of drug and could look at prozac or something that has less of the agitation if you are sensitive to that. He saw my improvement and even the fact that i was one of the 4 to 5% of people who experienced the anti-depressant factor of adderall, its rare that it effects people so its not listed as a anti depressant even though the effect of the anti depressant in adderall is very good and is there mainly to make you feel good and combat the chances of jittery issues or racing issues to just give you the overall effect of feeling good. But i was experiencing the anti depressant part of it as if it were a separate drug. Because its so hard to find anti depressants that work for me (i still havent found one that is good enough, im on a super strong one but its not enough) he wanted me to get the most from that effect with adderall, he saw that i didnt abuse the drug, i showed major improvements and no red flags were up when on the drug so he felt it safe to keep increasing the adderall until it made me uncomfortable with jitters or shaking or racing and speed talking and acting like i took a little too much cocaine after smoking meth with some random guy on a longboard (i did do this before…) but i wasn’t active enough to be on much of a higher dose, if i got out and lived my life like a normal person id be on more right now, ive settled at 90mg now im at 150mg. When i turned 18 and then aged into a 21 year old my psychiatrist was pediatric and i could no longer hold onto him anymore so when i changed my psychiatrist. He said he wouldnt perscribe me adderall over 60mg and that was even a stretch and id have to be on 30mg (one pill) and move up. Fucking moron. I can’t find a kaiser psych that will perscribe me adderall at my dosage, i need to actually use connections i have with really great doctors to find someone in Kaiser who will prescribe me my actual dose. So i kind of wish that these psychiatrists would be how you think they are and give me the dose i am used to and function on. When i was a kid, no psych was eager to put me on a drug like adderall as a kid, now when i take it and i take a high dose, the psychiatrists wont perscribe me that much…. Whatever psychs you are reffering too that give adderall to potential and possible ADHD kids like candy must be the type of psychiatrist you get when you don’t have insurance. Those places hire people that can’t get a job somewhere like kaiser because they are too stupid and uneducated in their field that only a lower quality place where no psychiatrist has ever made anything good of themselves. I went to a place and saw someone for therapy at a place that didnt require insurance and wasnt a part of kaiser and the lady was so goddamn stupid if she prescribed drugs she would probably give me 140mg of adderall at age 12 if it made a positive difference on my focus ability and my energy levels, the fact that id basically be a pre-teen on speed and speeding around wouldnt matter cause technically she solved the problem. I couldnt focus before, now i can. So what if i act like im on crack? thats the level of idiotic these people are. So when you go write books, act like a specialist, why dont you talk to people who have actually experienced getting ADD treatment from places like Kaiser where you need insurance and shit, instead of the places that would hand out heroine to people who have depression if the law let them. When you are someone like me, who was born with both my parents working for kaiser, meaning i automatically got full insurance coverage, and it helped that my dad is a drug specialist and can make sure no one puts me on something that id have a bad time on. Medical funding goes to places with insurance mostly also the requirements to hire someone after they obtain the proper things needed to get the job, are not very high. If you pass the interview seem qualified enough, even if you aren’t and they just need to hire someone and you are passable. No big red flags. But places you need insurance at, for like meds, usually have a lot smarter doctors. I can say from experience, i have seen fewer good doctors and whatnot than the bad ones, very stupid people can get hired at kaiser, you just gotta learn to detect the idiots and move on.. i no longer see a psychiatrist at kaiser. I see one that works in a building that has nothing but offices for people to see psychiatrists. Hes a really good and smart guy and i used to see him as a kid when i kept getting crappy psychiatrists because of my age, and even kaiser failed me with one person so we just went to a guy who we already know is smart and good. But costs 100$ per visit, No insurance would mean id have to spend $1,000 on a months worth of adderall…. I know the type of places bad child psychiatrists tend to work at who would give adderall to a child without a care or second thought, but its not easy for me to get my adderall, so why is it easy for everyone else according to you? You are claiming that professionals are handing out adderall like candy on halloween to anyone who has ADHD symptoms. I don’t see this in real life. You don’t have all the facts. When i read your article i can’t even think at the same time “a professional wrote this” without being like “lol no” i cant in a serious way think a professional of anything would be so uneducated and i bet you just figured out that if you make all these claims, hunt down stories of when a psychiatrist gave someone adderall and they had a bad time on it, to make yourself seem credible, random stories that look like it was some random news article you stumbled on, then you write books of bullshit that the less inteligent population of middle aged people who didnt pay attention to drugs in their youth and are old enough to believe what they read on the internet from someone claiming to be a professional. So you just profit off all this stuff but you know its all crap right? But acting like your doing all this for a good cause and awareness even if thats partly true yet all your info is opinion based not fact, so the whole doing it for a good cause, yeah thats out the window if you can’t provide the true side of things while making people believe what you are selling. Its simple, if you are a good parent who loves your child, odds are is you notice how they behave in the day, you notice if they act different and such, you pay attention to your child. Thats the least we can expect from parents who are having their kids take medication. If the doctor gives your child adderall and you agree to try it, you should notice by doing the basic parent thing to do by watching your kid, how your kid acts and noticing differences. If you see your child acting a way that you aren’t entirely comfortable with, its your job to take them off the drug, its your job to notice if that drug isnt right for your kid because your kid may not be able to tell you if its good or bad because it makes you feel good and people like to feel good. If you can’t be a legit enough parent to make sure your kid is not drugged up and on medication thats making things very complicated. The psychiatrist may be the one who says its okay to be on the drug, but he or she isnt the one giving it to your kid and watching them and how it effects them to see if it works. If you end up with a kid having adderall problems because a psych gave it to them, the blame may fall on the psychiatrist for starting it, but ultimately its your fault as a mom or dad that they are addicted or whatever to adderall by allowing them to take it when you should of seen it was jacking em up, the way a child gets addicted to it is if they increase it without parents knowing, then as a parent you should notice if they took extra because they would be even more amped up. If you don’t pay enough attention to your child especially when taking certain types of medication to the point that they end up with problems, ITS THE PARENTS FAULT. THE PSYCH JUST ALLOWED IT TO HAPPEN, IF YOU CANT EDUCATE YOURSELF ON THE DRUGS GIVEN TO YOUR CHILDREN AND LEARN HOW TO MAKE SURE THEY DONT GET FUCKED LATER ON THEN YOU SUCK AS A PARENT AND ITS SAD WHAT FATE YOUR CHILD GOT BUT ITS YOUR FAULT FOR BEING A BAD PARENT. Any parent that pays enough attention to their kid on adderall, would not be getting them in a pickle for later in life. So, your stupid book, pointless, it doesnt matter what these doctors give us, its up to us to take the damn drug so if you dont learn what it does, if you notice weird changes you do something. Like you are pathetic. All these people who go to you about how their kid is addicted because a psychiatrist gave them adderall automatically and fucked them up.Well if you are that mom i want to say to you, and to you miss author, parents, its your fault, my mom started motherhood at age 46 and had twins for her first time having kids and i was introduced to medication at a young age and my parents were smart and not dumb and payed enough attention to me to make sure i didnt suffer later on, so if my parents could do that on their first attempt at parenthood, why did you fail? You hurt your own kid, dont blame the doctor for giving it to the kid, blame yourself for not paying attention or being educated. First thing that comes with being a parent to a child who needs to be on medication: Always research the drug they might be put on, look at all side effects, everything about that drug, easy to do in 20-30mins on google. Then you would know what to look for if the drug is wrong for them. So haha you suck its your fault, should of been prepared when you had kids. As for you author, you are pathetic and all this content you offer, no one who is educated on any pill other than advil or whatever would buy into your shit. You try to get money where you can by putting fake info out there and making gullible people believe it and buy your crap. Its until they quote you or recommend your book to someone who knows their shit and knows that you are a moron and tells them that they got it all wrong and explains that the person just stops frequenting your site and the location of your book would be unknown cause they probably left it at the gas station outside their car next to the pump like the trash it is.

    1. Hello again Georgia,

      I’m sorry but I find that huge block of text unreadable.

      From reading the beginning, it seems that you have been through the mill of misdiagnosis or incomplete diagnosis, poor approaches to treatment, and all the rest. I am sorry for that.

      What puzzles me is that, in your previous post, you are still ready to accord respect to any random doctor and you excoriate me, a person who is trying to educate so as to be pro-active when pursuing psychiatric help for oneself or a loved one.

      As for me trying to get money, I’m afraid I will disappoint you there, too. This advocacy, for 20 years, has mostly been a labor of love. I have made immense sacrifices financially, psychologically, and physically. Mostly, I hear positive reports; lives are improved, and that’s my goal.

      So, please know that your anger is probably a symptom, one that might be helped with proper medication.

      Good luck
      g

    2. As someone who has taken adderall for 20 years, I can see you are over prescribed in just your writing. Be careful.

  13. Anna Lynn Portwood

    I was on Adderall for about 15 yrs. Over that time it changed my personality drastically. I had very little compassion or empathy. I left my husband, had an affair and was self mutilating by cutting myself. I was severally depressed and very angry. I also lost a lot of my memories and I couldn’t remember things I learned in school. It was like it was there but I couldn’t get to it. Luckily my husband never gave up on me and after getting back together I became pregnant. Once I became pregnant I came off the Adderall and it was like I woke up. I dont know how else to explain it other than I woke up. I believe the Lord blessed me with my son and my son saved my life because if I hadn’t gotten pregnant I’d probably still be on Adderall today not knowing that the Adderall was making me “crazy”. I was a completely different person on it. I am still ADHD and I struggle especially with staying on task at work. But I will NEVER go back on any medicine for it. I do the best I can and I’m good with that. Adderall took a lot away from me. I think the long term side effects are terrible. People should know what they are getting into. I had so much nervous energy my mother said it was almost impossible to carry on a conversation with me. She said I’d make everyone nervous with my constant pacing, picking and non stop talking. She said it was like I was on Drugs. I hope this helps someone.

    1. Hi Anna Lynn,

      I’m sorry that your story, like many others, underscores my warning.

      I would urge you to at some point be open to other medications if you need help managing your ADHD. Especially with a young son.

      I recommend that people with ADHD pursuing treatment have a partner to help (a spouse, romantic partner, friend, family member, etc.).

      Too many physicians simply don’t get it, and they absolutely fail to monitor progress and setbacks.

      I do wonder why your husband never questioned your treatment. Perhaps you weren’t open to it, or he didn’t feel confident.

      But everyone absolutely must be self-educated and self-advocate when it comes to ADHD treatment.

      best,
      Gina

    2. Dear Anna Lynne,
      Could it be possible that the dosage of medicine you took in the form of Adderall was not tweaked, adjusted over so many years? You grew up. Chemistry changes. Plus, there have been so many new medicines and better understandings of this Disorder …. Keeping a record of how you feel would give the physician a better guide and so much more information. Just sayin’ ……

      Exercise, Mindfulness Meditation and Medicine plus a bit of Therapy go a long way to better health.

      Stay open to learning allllllll you can. I am reading SMART but STUCK * Emotions of Teens and Adults w/ADHD by Thomas E. Brown, PhD. at this time.

      The more you know, the more you can manage. ** Accually, it seems to help when I place a name on certain behaviors of mine. Calling myself out, in a positive way, makes a difference for me. (No negative thinking allowed. :^)
      Good luck.
      Nancy

      Take care and be good to yourself.

    3. Well, you can’t even give us the right name of the drug you were on. Adderall boosts attention span, enhances and gives better ability to focus, gives you more energy, does not make you depressed at all, not one thing in adderall causes depression, personality changes, lack of empathy, or anything you described. There is nothing in the drug that causes these things, it helps memory, it helps you focus on things you learned like things in school, there is no way that adderall could of possibly done that to you. Its pretty much impossible. Actually, here is how adderall can bring that upon someone but its not the adderalls fault. If you took a high dose to start with and self medicated and abused the drug to the point your system was used to high doses so lower doses didnt cut it, created a dependency for it by abusing it, and then took so much of it that you were so doped up you couldnt be happy and your personality changed…. but what i honestly think, is that you are against adderall usage, you think its a bad drug, so you maybe had some bad abuse experience with it that doesn’t stand out as much or maybe you were never on it, and you made up some story to feel important or like you are supporting the anti adderall cause. Because everything you listed as a problem because of adderall, the drug itself does not contain anything to cause that to happen to you unless you abused the shit out of it. Ive never seen anyone have an experience like that on adderall, even when you look up every side effect and even then with every negative side effect it wont have that effect on someone. My dads a specialist in drugs (illegal and medicine) i asked him if its possible adderall can do that to someone and he laughed and said no. It is a stimulant, a upper, it doesn’t bring you down unless you took too much and its wearing off then you are like drugged and groggy and dont wanna move. So either you never took it, you got your drugs mixed up, but you seem pretty confident its adderall…. or you abused the shit out of it and want to pretend to be a victim by acting like its not your fault. It seems like you were on a anti depressant that is a generic kind sometimes prescribed to test out antidepressants on you and if you experience a certain change then you are likely sensitve to the part of the drug that gave you that effect. Like basic anti depressants that are used for simple shit, can remove a lot of your feelings, emotions, you may not care about much you pretty much have that experience. But the thing is, that means that you could be sensitve to antidepressants that have a side effect that can make you feel numb and like you have no emotions. But thats when you go and see your doctor and get something else, you do that BEFORE you have an affair and leave your husband. Honestly if some of your story rings true about what you lost and shit, honestly i cant feel sorry for you because it honestly is very black and white when it comes to taking meds. If you feel worse or start having problems like that you go and get off the drug, if you weren’t smart enough to figure out there are more than one type of medicine and you are on one that isnt helping and you didnt change it or do something about it before you fucked your life up? thats your fault. Its very black and white. I was just on a anti psychotic that fucked with a lot of my brain, hormones and whatnot, i dont like it when im on something that can change so much in my body and affect me so weirdly so i didnt even tell my doctor i just stopped taking it and use weed to sleep instead of that pill. No way im going to suffer any more than i have to because of a pill i clearly don’t need and is not good, coming off it is crazy too, but i just turned 23 and i know better than to let a drug do that. You should of known better and educated yourself and prepaired yourself properly before deciding to take medication. The doctor isn’t always going to be the best source either, you need to take it in your own hands, its your life and you let yours get fucked up and you blame it on a drug that can’t even do that to you without you hardcore abusing it. So if you abused the shit out of it, you are an idiot, its your fault, if you weren’t smart enough to get on something that works before you ruin your life, its your fault. Dont blame the drugs or the doctor lol some people are too stupid to be taking medicine in the first place, hey author lady, i bet you could make a lot more money and do some actual good by writing books and articles about how to make sure you are ready to take on the responsibility of taking medication. Because clearly people are too stupid to be on it. like this lady or man. Educate these people instead of give them BS about a drug you aren’t educated in. Instead of make money with lies and crap, do good. Its the same thing as don’t drive a car until you are prepared to deal with the consequenses and are capable of handling situations that can be deadly or dangerous on the road by knowing signs, and shit, you dont go driving like everyone else when you realize you need a car. You dont go controlling a deadly big vehicle without knowing what to do or how to handle things. Same with taking meds. If you cant be a grown up and you are young enough, have your parents help. Its your fault. Stop trying to play the victim over a fake story or a story hiding the fact you abused adderall. Clearly adderall didnt do this to you and whatever did if it even did you weren’t smart enough or ready enough to handle the responsibility so you suffered, you got what you got because thats what you did to yourself, go find the drug responsible, and find a website about it and share your story that you still arent the victim in because no one is a victim of being prescribed something and choosing to stay on it to the point it fucks your life up.

    4. Again, Georgia. You are operating on some very limited information.

      And, until you actually read my book, you are seriously out of line to condemn it.

      If you can’t read a blog post with comprehension, though, I’m not sure what you’d get out of a 400-page book.

      Thanks for all your thoughts.

      Now, please go self-medicate elsewhere. Political forums are always a good option. 🙂

      g

    5. I stopped taking Adderall one month ago after being on it the past four years (20 mg per day). It was prescribed to help with fatigue resulting from what turned out to be inadequate treatment of obstructive sleep apnea. During this time, I suffered from brain numbing anxiety that made me fearful, antisocial, and highly agitated. Fortunately, in the last six months, I finally received proper care and treatment for the sleep apnea. However this sleep disorder can cause long lasting activation of the sympathetic nervous system (fight or flight response) that requires a fairly long treatment time for it to dissipate. Knowing this, I started to realize that Adderall was the primary cause of the anxiety since it is a strong nervous system stimulant, so I stopped taking it. And just like Anna Lynn, I woke up and felt like my old self; grateful and happy to live life to its fullest, all happening within two weeks after the last day of taking Adderall. There’s a lot more to the story, but essentially I suffered greatly for the past twelve years because my initial symptoms and complications of insomnia were considered a sign of mental illness by my doctors, one of which convinced me that I did not have sleep apnea because I was not overweight or obese.

    6. Dear Girardo,

      I’m aghast at your story. Truly, that is a horrible thing to have endured. I’m sorry that happened to you.

      I wish it were the first time I’ve heard such a story.

      That’s great that you are feeling yourself again.

      I have devoted a HUGE amount of study and work to the sleep module of my online training (coming soon). Most of what the “sleep specialists” say it wrong, such as obstructive sleep apnea even being obstructve.

      The research is fascinating.

      People with ADHD are more likely to also have sleep apnea. Treating their apnea is helpful, but it won’t also treat their ADHD.

      But there are people without ADHD who also can have sleep apnea, based on neurobiological factors.

      Such complexity….must be respected.

      take care,
      g

  14. Hi Gina, I am in my forties and knew I was probably ADHD for a while but never sought a diag until 2 of my sons were diagnosed with ADHD. Their symptoms were mine growing up. After going through the process with my psych, which took a long time, my family doc and I decided to try Adderall. Started on 20 and upped it to 30 after a month. I go for second checkup in a few days. So, the reason I am writing. I want your book, and may get the digital copy in order to read before I see him. I believe he is good and I trust him. He did mention Vyvanse is s good option if adderral did not work.

    You mention several times that things can go bad a few months in on adderall. Can you go into detail some on that? I also have been dissapointed that the ‘rocket booster on my butt’ feeling has gone. It has caused me to spend hours and hours in research trying to figure out what this drug does and what can I do to get the most out of the motivation and focus I get. Also really scared now after reading what can go wrong. I don’t want to increase the dose because I have a feeling the next time I see the doc, I will need a higher dose again. I don’t want to go down that path. I am thinking about asking my doc to switch me to Vyvanse. I just have so many questions and it is all a bit confusing. Will Vyvanse also wear off in time as Adderrol seems to? What a crazy situation to be in. Makes me kinda wish I had never started these meds. But I now know they really do help, and my job, which I love, demands that I spend hours of focused time putting forth my best.

    Any recommendations?

    1. Hey Tim,

      I definitely don’t want to discourage you! I want to EMPOWER you and help you achieve long-lasting positive effects from medication.

      I see so many men in my Palo Alto group, working high-pressure jobs in high tech or law firms, who keep upping the Adderall dose to “keep up” with work. Yet, they are highly inefficient at work.

      The main trouble with Adderall is this: It trains you to “know the medication is working” by feel alone. Not by objective evidence. It also lets you think you can get by without the supportive strategies and habits. Huge mistake.

      You should have a trial on a methylphenidate medication, just to see if you might do better on that class of stimulant.

      If that doesn’t work, many (but not all) people who respond well to Adderall do better on Vyvanse. It’s a longer lasting, smoother-delivery.

      While still in the amphetamine class, Vyvanse is chemically different than Adderall. Adderall is four mixed-amphetamine sales. Vyvanse is dexedrine, in a novel, extended-release delivery system.

      Just remember…the point of ADHD treatment is to help you better manage and balance your life — not to take a “performance” drug.

      I do offer telephone consultations. Just this week, I added some time slots — http://wp.me/P5Ilzb-1O5

      Good luck! Keep going. This is part of the process, some trial and error.

      g

  15. Gina,
    Thank you for this post and all your helpful insight on the subject. I am a wife who is desperately looking for some answers about whats going on with my husband. He has been on Adderall about 4 years now… slowing increasing the dose because he would “run out each month” from taking extra. I’d say for 3 years there really hasn’t been much issue to it. But we are soon going to have a second baby and he has had a lot of stress in trying to find a career that fits him. He has CHANGED the past few months. And it even escalated to me getting him to go to the hospital with me a few weekends ago because he was in a manic state (has never beem diagnosed bi polar, just ADD by his sorry excuse of a doctor) he was making no sense what so ever, seemed to think he was greater than anyone in the world, was convinced he’d come into a lot of money (delusional, hallucinating) they sent him off to a psychiatric hospital for three days where they for the most part said he seemed fine. It was a poor facility and the only psychiatrist he saw was over a computer monitor. They disgnosed him bi polar 1 and highly recommend he stop adderall. He wasn’t having that. Since then hes been in a rollercoaster of being totally normal to seeming “manic” and talking pretty crazy. He is INSANELY intelligent on top of all of this so he talks way above everyones head and seems to make barely any sense most of the time.
    My question is….. I’m lost at what to do. He’s since seen a therapist (because I couldn’t get him into a psychiatrist for over a month) and she only heard his side of the story (he wouldn’t let me go) and she told him he should stay on adderall of its helping him. I’m so frustrated at the mixture of opinions of whats going on with him, different diagnoses and waking up unsure of what form of my husband Ill get that day. Any suggestions? I’m so desperate here.

    1. Hi Lyndsey,

      This is serious. Especially with a baby on the way.

      It’s time for you to seriously educate yourself on ADHD treatment (which is probably why you visited my blog) and take the bull by the horns. The future of your family and the welfare of your children, not to mention yourself and your husband, depends on it.

      Have you read my book? If not, you need to read it right now. If not sooner.

      http://amzn.to/2qL2wwy

      It sounds like he is seriously abusing the Adderall, probably getting little sleep, and maybe abusing caffeine, too.

      In some people, Adderall can trigger this mania-like behavior, especially if they are taking high doses. Further complications set in when they take generics.

      In my book, you’ll learn that some therapists can make a bad situation worse. It sounds like that therapist is one of them.

      You can no longer depend on your husband’s efforts to deal with prescribing physicians and quack therapists. You must own your power and learn about ADHD treatment.

      I offer telephone consultations and will soon open some time on my calendar. If you are interested, please be sure to subscribe to my blog to be notified when that happens.

      best,
      Gina

  16. I’m 17, and Adderall used to cause Anger, Irritation, Rage, Depression, and all the other negative symptoms for me until I experimented with it. Upon experimenting with it, I discovered the problem for me. I wasn’t getting enough sleep, and I wasn’t eating an actual nutritious breakfast before taking it and also, Hydration is 100% important when taking it. I fixed the three of those and now I no longer have those negative symptoms, just the positive side to Adderall. I’m not saying it will work for everyone, but it will definitely improve some of the user’s experience with it.

    1. HI Sway,

      Excellent points! Thanks for writing.

      I make those same points myself, in presentations. You’re very smart to figure that out!

      It seems that Adderall can be a setup for those problems — not getting enough sleep, not eating breakfast, insufficient hydration — because it can create a kind of monofocus that thwarts balance.

      Some people will do best on Adderall, but when it’s the first medication a person has tried, after a lifetime of struggling with ADHD…the extra “boost” it gives can be almost intoxicating. They want to “keep going” — not eat, not sleep, etc.

      Medication should help provide life balance, not simply attach a hyper-focusing booster rock on one’s behind. 🙂

      thanks,
      g

    2. Thankfully I have never really had the Anger side effect or it change my personality, I did notice that I would get anxiety a lot but that eased a lot when I ate proper and slept properly as well.

    3. Hi Collin,

      Yes, sleep deficits and poor diet tend to exacerbate adverse reactions.

      As I mentioned, for some people Adderall might be the best choice.

      The problem is that too many MDs try Adderall first.

      cheers,
      g

  17. Adderall ruined my life!

    It started out great. I could have an argument without feeling emotional.I was commended at work and everything was organized at home. I was on time to appointments and work. Then slowly everything went downhill.

    I was a narcissist, then went into a depressive state, then uprooted my entire life to “live in the moment” and looked to sexual encounters to make myself have the confidence I never had.

    Every heartfelt moral and feeling I had was gone! Except for my anxiety.

    I went to a heart doctor from the heart palpatations, shortness of breath, and that dying feeling after eating. I had every medical condition known to man but I couldn’t have been happier! I just had to eliminate all stresses of life…work husband kids tying me down…you know all the important stuff…

    I was always the responsible one and I couldn’t care less about anything other then what I wanted at that moment! Id struggle with depression when I would feel the meds wear off sometimes and be bitter for my past relationships making me this way…I left my husband of 8 years to live like I was 20.

    I would speed down streets just for the thrill and music came alive again. Life mattered so much more because i was free and didn’t care about anyone! Even the people I used to feel better.

    I got stage 3 precancer and then my daughter got lice and the psychosis set in…I then I thought I had diseases from the 3 men I’d slept with 2 with no condom just so I could “live in the moment.” I went from sexually transmitted diseases to worms and scabies…

    It didn’t matter how much doctors told me I didn’t have these I was going to prove them wrong! I’d tape my skin to catch things crawling and look through my feces to prove everyone wrong I was not crazy…Ive always been normal!!!

    I didn’t want anyone around me I didn’t have time for people only time to research and prove people wrong! They almost took my kid away before I could admit to myself that it was my medication. Its taken me a long time to even somewhat improve my life…to prove to the people that didn’t know me my whole life that I was not crazy!!!

    My husband and he put me through a lot considering what i did to him I took everything he threw at me. I deserved it. There were a couple of times i just couldnt take the mental beatings…to listen to what i had done one more time…I almost killed myself. I had plans when it wasnt in the moment to insure they would be left with money and i could help people realize how strong this medication is through my death. Please get help if you are addicted! Every moral boundary ive ever had has been broken and the way back is lonely if youve gone too far!

    1. I also had suicide attempts on adderall after about a year of being on it…over 15 dollars taken off my check due to being late because the psychosis kept me up at night…i failed to mention its been 2 years and im severely depressed at times due to all of the things that i would have NEVER done. And the man that is with me knows that deep down but will never understand. I loved him before the medication and after but loved nobody during. And now I still struggle with my add even worse and cant say that ive never or would never because I did. Adderall was the perfect drug until it ruined me. Please watch closely to anyone that is on this medication…my counselor couldnt even figure out that it was my medication! She just told me to buy plants for my house lol

    2. Hi Katie,

      Wow! Buy plants for your house! Sure, that will fix an Adderall=-induced semi-psychosis. Yikes.

      I’m sorry this happened to you, but I am grateful that you’ve told your story here. I hope others will learn from it.

      g

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    1. Why would you even recommend that with confidence? You don’t know much about adderall at all you are not a professional, you are not a medical professional you arent a drug specialist so shut up and stop acting like you know things so you have purpose in your life. You make women look bad, men see us with our books we make about drugs that we describe to people in the most over dramatic way (just like dumb females do) and hold onto it with pride and probably say things that are very wrong but said as if its true and with confidence. Like a true moron. The fact you call it madderall? LMAO you are such a sorry excuse for a blogger, i wish there was a restriction on what type of people can have certain types of blogs online, seperating people like you from the medical stuff….

    2. Hello Georgia,

      I am sorry that you are unable to understand the nuance that I have tried to present here.

      I won’t entirely accept the blame for being unclear. This is not a black and white topic and one must be able to navigate complexity.

      Could it possibly be that you are addicted to Adderall? Or that it’s not working well for you but you like the buzz? Because I suspect that a better medication approach would help you to read with this post with comprehension—and less self-medicating with anger and attacks.

      Cheers,
      g

    3. Gina,

      You are doing great and many people appreciate you and the research and the dedication to your husband that you have done. To me, reading Georgia’s posts, it appears that she is off-balance on her Adderall, or has taken too much. I would not give it too much thought. My family doctor has to know and treat so many things, and ADHD is something that he knows, but has not researched in depth. I speak with him often about it, and much of my knowledge and research has started with you. There is not a perfect formula that fits all people, as you are well aware. My doc just told me the other day that he finished another research book on ADHD and is planning to read yours next. He thinks the more info he has, the better.

      So thank again for everything that you do, and I agree with you that simply blocking Georgia’s further comments is the wisest thing to do.

      Tim

    4. Gina,
      First and foremost, I want to thank you from the bottom of my heart and I’m sure somewhere in my brain.

      I started taking Adderall about a year ago after being diagnosed with ADD or ADHD by an NP. She also said it would help me stay awake during the day so that i could finally feel tired at bedtime, and help with my depression. Wow. Sounds great right? So, she got to the diagnosis in a super fast way. She asked me like 5 questions that I answered yes to each of. For practical reasons, know I have Bipolar 2, generalized anxiety disorder, panic disorder, and clinical depression.

      Not all of those diagnosis came at one time which makes me look back over almost 15 years of seeing random psychiatrists, psychologists, MD’s, and eventually CNPs and company due to insurance restrictions. I now think “omg, what do I ACTUALLY have, and who am I?” I seriously don’t even know the real me bc of all the meds and what I feel was disinformation.

      This site and if course you- have again brought ne to a cross roads. I’ve read things like this about adderall previously during endless (what I call) research. It’s really just a waste of time in the end bc I realize I’m just trying to justify my prescription. That’s adderall for ya. It’s manipulative, addictive, and toxic i think. In the beginning, it made me feel like superwoman. I was finally in a good mood, had energy, a libido, was being social, and just getting shit done. None of that was ever without negative side effects that I at the time decided to deal with bc well, that’s what I’ve always done. I noticed myself feeling a need to be in it, a longing as if it were a love affair. Over the course of time I developed high blood pressure, rapid heart rate, worsening anxiety and eventually (yup) anger, worsening depression, suicidal ideation, self mutilation, severe mood swings, shit self esteem, zero appetite leading to malnutrition and physical sickness, etc… I’m worse off now than ever. I feel as though i have dementia now which sucks, I’m so foggy that I stare off for periods of time that don’t make sense. When asked what I’m doing i reply with “idk”. That’s concerning to the only person i trust to help me, my partner. That’s where I am now. Still on it and lost as to what to do now. The adderall says ‘love me! Stay with me! I’ll give you more energy and weight loss, including a good mood SOMETIMES’. Here I am….surrounded by incompetent prescribers who basically let me decide what I take and how often. I’m asked “so, how are things?” If I answer “good, I’m good”, my scripts get sent in and there I am for 2 or 3 months. I can’t find a single solitary doctor that 1-has time for me, 2- takes my insurance and 3- knows anything about medicine. Even if I want to pay cash, I can’t because my insurance says “no you’re not allowed”. What a mess our system is. I want to come off of it but that means my prescriber to agree to Vysvance, come off adderall slowly, and somehow maintain my mood. At the same time, do I even want anything for ADD/ADHD? Idk!

      Awaiting another appeal hearing for SSI since i haven’t worked since 2009 due to my anxiety and depression, I’m over here feeling worse. I want more for myself than this. Adderall has fucked me up. Thank you for warning people, and let my unorganized story serve as a cautionary tale. Pills don’t solve everything. Be careful, and stay informed because in the end, it’s only you sitting with you. It could potentially be very bad. Adderall helps people sure, but idk if it should even be an option for treatment. Please, try other meds first. This is a love affair that no one can afford in every aspect of your life. I’ve lost a lot. It’s not worth it. Thanks Gina.
      -G

    5. Dear Gacia,

      I really appreciate your writing to let me (and readers) know that this is a valid caution I am making.

      I hope you figure out how to manage the transition. The good news is that stimulants leave the system fairly quickly…and enter quickly, too. So, if you do decide to try Vyvanse, maybe it won’t be an extremely abrupt change.

      With my local Adult ADHD group, we joke that the best doc is the one who will listen to us. Truly, if you can find that…if you can find a doc who will listen to you (and maybe read the medication chapter in my book), you will be better off than most people seeking medical help for ADHD. Sorry to say.

      Yes, our “system” is a mess. But guess what, the U.S. still has the best ADHD treatment in the world. Many countries, even those (especially those) with national single-payer systems, don’t even treat Adult ADHD.

      I hope you can read my first book’s chapter on medication. It will really help to ground you in how it should go. And be sure to solicit your partner’s help. Teamwork is best!

      best of luck to you!

      And again, thanks so much!

      g

    6. Hello Georgia,
      It sounds like you have been through a lot, and you found some relief with medication. There is so much more to your story though. It’s not just about the medication for you. You talked about depression and a deep desire to feel connected to others and appreciated.
      I can see that you are in a chaotic place right now; I’ve been there too many times. If you need to talk, there are support groups. If not, I’m around as well. Good luck!
      Fight that good fight.
      Angelo

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  20. Hi Gina, you seem very active here. I was looking to find out if losing the emotional ups and downs were common when taking amphetamines. I recently started taking phentermine for weight loss due to my high cholesterol and noticed better functioning in my daily life. I take it from 7am and it wears off by 5pm. I was being prescribed strattera and would fall asleep at work by 3pm. Strattera did not help with my emotional excitability (happy, anxious, sad, angry) but did help with inattention. I can say that the low dose phentermine is much better than the adderall from my childhood. With the phentermine, I no longer struggle with insomnia. Weekends and weeknights with my parents left them with only negative memories of me. Maybe it should be considered that the anger mentioned in this page is a result of high doses and heavy withdrawls.

    1. Hi Beatris,

      Yes, Strattera isn’t widely known for treating the full range of ADHD symptoms. I’m surprised neither that you had that effect nor that you’re experiencing positive effects from the phentermine.

      I don’t know much about that medication. But I do know that untreated ADHD is associated with greater risk of obesity, and stimulants can often help not just with general ADHD symptoms but also with the weight issues. Here’s a blog post about some research in that area:

      https://adhdrollercoaster.org/tools-and-strategies/can-adhd-make-you-fat/

      You wrote: “Maybe it should be considered that the anger mentioned in this page is a result of high doses and heavy withdrawls.”

      No doubt that is true in some cases. But, in many others, it is the Adderall itself that can create or exacerbate mood issues and irritability/anger. That’s why I wrote about it. It’s a highly problematic choice, one I would relegate to trying after other, smoother delivery systems have been tried.

      For other readers who might be curious about Phentermine, here is some info from Wikipedia: https://en.wikipedia.org/wiki/Phentermine

      Phentermine has some similarity in its pharmacodynamics with its parent compound, amphetamine, as they both are TAAR1 agonists,[8] where the activation of TAAR1 in monoamine neurons facilitates the efflux or, release into the synapse, of these neurochemicals; at clinically relevant doses, phentermine primarily acts as a releasing agent of norepinephrine in neurons, although, to a lesser extent, it releases dopamine and serotonin into synapses as well.[9]

      Phentermine may also trigger the release of monoamines from VMAT2, which is a common pharmacodynamic effect among substituted amphetamines. The primary mechanism of phentermine’s action in treating obesity is the reduction of hunger perception, which is a cognitive process mediated primarily through several nuclei within the hypothalamus (in particular, the lateral hypothalamic nucleus, arcuate nucleus, and ventromedial nucleus). Outside the brain, phentermine releases norepinephrine and epinephrine – also known as noradrenaline and adrenaline respectively – causing fat cells to break down stored fat as well.

      best,
      g

    2. I’m curious to know now if maybe my aggression at home in high school was because of the Adderall. I manage my ADHD very well but still had issues with controlling my emotional responses and multiple psychiatric evaluations told me I had bipolar “Rapid Cycling”. Taking the medications they prescribed made me so much worse. Suicide, violence, drugs, and just general worsening of my adhd symptoms. With that in mind, I have been refused stimulant medication because they want to treat the “emotional instability first.” Would you recommend any ADHD medications that I can recommend to them?

    3. Hi Beatris,

      Yes, it’s entirely possible that Adderall was worsening ADHD-related emotional dysregulation. Hence my post. 😉

      I’ve known people with ADHD who showed no signs of bipolar before taking Adderall. But once they started Adderall, they became more aggressive and “manic” (milder than bipolar). And THEN the psychiatrist claimed that the Adderall “unmasked” bipolar. Next stop: Another medication to treat bipolar!

      Nonsense.

      Of course it is possible that the clinicians you saw were right: You might also have “bipolar rapid cycling.” But it is equally possible that those clinicians mistook ADHD-related emotional dysregulation for bipolar. It used to happen a LOT. It still happens more than is acceptable.

      Your clinicians need more than a stimulant medication recommended to them (for you). They need some education on the emotional dysregulation aspect of ADHD.

      ADHD is a common “traveling companion” for depression, bipolar, and other conditions, any of which could be compounding what is called DESR (deficient emotional self-regulation). To treat it comprehensively requires an understanding of all these conditions.

      Here’s one paper that might prove helpful:

      http://www.ncbi.nlm.nih.gov/pubmed/23413201

      I hope this helps.
      g

  21. Wow I am getting this book. I need to find out whatever my doctors not telling me. At times in college I usually can’t sit still or focus and then a lot of social anxiety to top it off. I live with bipolar 1 and I get adderall just to have enough energy to do my job. I do have reason to believe I have adult ADHD and my providers aren’t telling you. But in all honesty this medicine makes me
    A. Not hungry
    B. Lack of sleep
    C. Hypomanic and
    D. The general sense that I am straight up going crazy
    E. Fast heart rate
    F. Elevated body temperature

    I am an elementary school teacher with 6 medical certificates in medicine and I analyzed this pill to the point I thought I was losing sanity. I need more clarity and other drug treatments because sometimes I just feel like I’m on auto pilot

    1. Hi Mark,

      Oh yes, if you’re taking Adderall and it’s not triggering mania, are you sure that you have bipolar disorder? Or, is that stabilized with another Rx?

      There are definitely other, less problematic options for you.

      Please do read my book, and see if the various broad strokes and small nuances I describe make sense for you. You wouldn’t be the first person I met whose ADHD was misdiagnosed as bipolar. Or who has both.

      I can’t remember the number, but people with bipolar have a fairly high risk for also having ADHD. Not so in the other direction (people with ADHd also having bipolar).

      You deserve better medical options. Truly!

      Good luck!
      g

    2. If Mark has Bipolar 1 and is struggling with energy, why adderall? Why not introductory doses of neurontin?? Low dose neurontin is very effective for anxiety and fatigue for my bipolar friends Zach & Elisabeth. Ask your psychiatrist about a 1 week inpatient stay to start a new medication.

  22. What about Focalin???? will this drug work for me? Adderall did not. I was getting angry in the evening. Finally figured it out and talk to my doctor about it.

    1. Hi Deb,

      Medically treating ADHD is not simple. There’s nothing “slam dunk” about it.

      When you say Adderall “did not work for you,” that really means little. The prescribing physician should use whatever problems you report as “data” to drive the next decision.

      For example, it sounds like you might have been rebounding. You said you were getting angry in the evening, but you don’t mention how it was the rest of the time. Adderall leaves the system quickly, instead of tapering off like Concerta or Vyvanse.

      But much also depends on the class of stimulant.

      My book’s chapters doesn’t explain everything about ADHD medications, but it explains a lot. I encourage you to read them.

      Good luck,
      g

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  24. We lost our home five years ago and went through two bankruptcies, mostly as the result of my husband’s ADD, multiple medical bills, and the downturn in the economy. However, we were finally recovering, he was doing well with job contacts, therapy, etc. when he was prescribed Mirapex for RLS and later Aderrall. He was fired twice and now his cognitive abilities are all but destroyed. So we’ve lost everything again, I had to actually leave him to qualify for a small state old age pension and Medicaid, and was homeless for most of this year (and I have multiple health problems). I was once a teacher and editor but now barely recognize myself.

    My husband started showing signs of amnesia and dementia after being on the Mirapex, which I now know to be a horrible drug, especially for someone with ADD. The Adderall has turned him into a zombie, and the neurologist yanked him off the Mirapex cold turkey. He was a senior level IT professional before. Now he can’t remember to do anything, much less do any work in his profession of thirty years. He’s living in a
    homeless shelter but can only stay there for through December. Last week, he scared me to death by leaving the ER (after his PC failed for the third time to refill his Adderall on time) and walking for three miles back to the shelter in just
    shorts and a t-shirt, late at night, in Colorado. His Medicaid taxi never showed up and he said all he could think of was finding his bed.

    Our marriage was shaky before because of all the chaos caused by the ADD, but we were trying. Now our lives are destroyed. It’s beyond me that I can’t find a single law firm to take on his case while our disability lawyer tries frantically to get him SSDI. If it’s not approved soon, he’ll be on the streets. I’m in a bed bug-infested room which doesn’t allow but one person.

    We once had a solid, middle-class home, friends and family – a life. These drugs aren’t candy. At over sixty, we feel pretty hopeless. Even our church has shunned us – they don’t “believe in ADHD.”

    Please keep warning people about these medications.

    1. Dear Jean,

      I’m horrified at your story, and extend my condolences.’

      It is very tricky to be an advocate who promotes the judicious use of medication for ADHD while still warning people that too many physicians do not know what they’re doing.

      I wish you all the best in finding support during this difficult time.

      best,
      g

  25. My son takes this and his becomes angry but we have tried the others with more depressive issues happening. I wish they made a combo type med. The Dr he sees. Just writes scripts he needs a new Dr. Just hard to find in my area who takes our insurance.

    1. Hi Kim,

      Most people with ADHD have a co-existing condition. That condition needs to be treated as well, especially if it something like anxiety/depression (“serotonin issues”), because otherwise those are exacerbated by the stimulants.

      This is RULE 1 of ADHD treatment, but ask me how many prescribing physicians understand this. So frustrating.

      Please read up and become pro-active. Don’t accept this slipshod treatment for your child.

      best,
      g

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  27. This site has been very helpful. I’ve been searching the internet since my husband was diagnosed with ADHD, and put on Adderall XR. He has not been himself! I have searched for behavior changes due to Adderall, but the side effects listed, are generic. It doesn’t seem that studies have been done on adults, or they are not available. He feels the medication is helping him with his focus, and keeping him on track with his tasks. But he doesn’t see what we (his family) sees. Before he takes his pill in the am, he is usually agitated, angry, especially if something isn’t going his way. Once he takes his pill, within an hour, he’s a totally different person! At night, when the med is wearing off, he stays up until 2 or 3 in the morning, sometimes only getting 4 or 5 hours of sleep. I’m not really sure what to do! He’s had his medication adjusted several times, and he feels it is working for him. I have told him I want to go to the dr. with him, but he makes them his apts when I am working.

    1. Hi Kathy,

      Unfortunately, the standard of care for adult ADHD is pretty bad. In fact, that was a major motivator for me in writing my book.

      I encourage you to read my book, particularly it’s chapters on medication. I wrote them to educate consumers, so they can educate their physicians. 🙂

      Here is the link to purchase the book on Amazon, where it’s available in paperback and audio. It’s also available at Barnes & Noble and other bookstores.

      http://www.amazon.com/dp/0981548709/tag=wwwginaperaco-20

      Good luck!
      g

  28. Excellent article, Gina. I wholeheartedly agreed that patient’s willingness to think their physician knows and, and physicians throwing the same medication at everyone to see what works is a plague within our medical system. It’s also one reason the third leading cause of death in the U.S. is medical treatment, a great deal of which is due to side effects of prescription drugs. I commend you on your mission!

    1. Thanks so much, Molly.

      I know that many MDs are hamstrung by insurance reimbursements. Many are doing the best they can in a difficult situation.

      But when I see high-priced private-pay docs pulling some of these stunts, it’s really unforgivable. Patients are not abstractions; real lives are at stake.

      tx
      g

  29. I’ve never suffered from ADD/ADHD, but I’ve experienced similar frustration with doctors taking the same approach to treating fibromyalgia. It’s wonderful that you’ve taken the time to present this information in such depth. I’m passing this link on to a friend who needs this info so she can start having a better conversation with her doctor.

    1. Thank you, Lynn. Yes, there is a similar world of confusion around treating fibromyalgia. I’m fully, and personally, aware of that!

      best,
      g

  30. Thank you Gina for your followup. Crossing my fingers it all works out….thinking positive thoughts! I like the Mp3 audio book idea.

  31. I don’t know where to start, thank god that I found your page! Gina and Betsy you are 2 wonderful ladies. I have been going online for weeks, gathering data and learning. Learning lots and lots. What a difficult subject to wrap your arms around, considering everyone is different and responds different. My dear BFF needs help and won’t help herself at the moment, so I want to understand what I am dealing with. I do not want to miss inform her, but encourage her to seek help from a professional. I see many of the signs on this page and in the comments posted. Maybe I will buy your book and give it to her? Wonder if she will read though. She is on Adderall and I think it is high time to switch.

    1. Hi Linda — There are so many other options now, it makes no sense not to try something else. At least just to see.

      Good luck to your friend!
      g

    2. Hi Linda,

      As I write in this piece, Adderall might be the best, or maybe a good, choice for a minority of people with ADHD. For the vast others, in my 16 years of observation and talking with 1,000s of people with ADHD and their partners, it can be very problematic.

      My book does talk about the difference between stimulant classes, and how the delivery system (the way the medication is delivered into the body) can make a difference. If you think she won’t read it, it’s available on audiobook — CDs or Mp3 download:

      http://www.amazon.com/dp/0199790558/tag=wwwginaperaco-20

      Or, you could purchase the book and photocopy the pages on medication, highlight portions, and give to her, with a copy for her MD.

      It’s very difficult trying to help someone when the physicians are failing them. But it’s possible.

      She’s lucky to have you as a friend.

      Good luck,
      g

    3. Hi Gina, I’m going to order your book.

      But a quick question: you seem to advocate that people who have good effect from Adderall might do better with Vyvanse, (fewer side effects). I’m on Concerta (36mg) and Adderall (10mg), and have better effects with the combo compared to just one or the other.

      Would Vyvanse give me less than what I get now? I mean, would I lose the benefits of the Concerta?. I understand it’s a difficult and individual question, but perhaps you have a general answer?

    4. Hi Peter,

      Yes, I do suggest that people who seem to get a good effect from Adderall might want to try Vyvanse.

      It is not the same medication. Adderall is mixed amphetamine salts. Vyvanse is Dexedrine in a non-abusable “pro-drug” delivery system.

      But they are both amphetamine class stimulants. Vyvanse brings the benefit of a longer, smoother sustained-release — rather than the roller coaster of immediate-release Adderall (even Adderall XR is still roller coasterish).

      And yes, to your other question. In Ye Olden Days, when medication choices were very few (i.e. about 4-5), some enterprising prescribers would try a combination of each class stimulant to try for the best response.

      I still suggest it if one has a physician who understands why this might be helpful and has an accommodating insurance pharmacy benefit. Because neurogenetics being what they are, some people have a positive response to both classes but with neither being enough to take them to the finish line.

      I’ve always found it problematic, though, to take Vyvanse for daytime and follow it with a “booster” of Adderall. It’s commonly done but I haven’t heard that many great results from it. They are two different medications with different mechanisms of action.

      If I were you, I’d start simply in giving Vyvanse a trial. Without the Concerta.

      Not everyone has the time for this kind of experimentation. They need to be “on” every day. If you have some time, though, it might be worth it. And it might take a few days to gauge the full effect.

      I hope this helps,
      Gina

    5. YES! BUY her the book and even one for yourself. Start a book club. Read a chapter. Discuss it. See if it resonates to her. Rather than proclaiming this ADHD is her issue. Write down what you have observed. Does it match up with anything in the book?
      Good luck! I have both of Books written by Gina. I also sent one to the office of my son’s therapist.
      Nancy

  32. I’ve been in college for about 8 and a half years, and for most of that time, especially in recent years, I’ve dodged/avoided reading the classroom material for a variety of reasons, I had severe and chronic procrastination problems in which my mind wouldn’t think clearly until by the time I was nearing a deadline, I had severe and chronic problems with time management, I’d have mood swings, I’d be aggressive at times, etc. About 2 months ago, I went online and checked the symptoms and it matched up with ADHD almost perfectly. I wrote a list of every symptom that I’d experienced and it had AT LEAST 20 ADHD symptoms on there.

    I went to a psychiatrist and she diagnosed me with 1) paranoia (because I felt like government snipers were outside of my window-to my credit, it wasn’t a far-fetched notion given that the US government has assassinated and murdered people before, including recently) and 2) “mild” ADHD. She said that I had mild ADHD and that my case was a rare case because usually symptoms of ADHD would be more apparent and noticeable at earlier ages, like in elementary school, middle school etc., which in general I didn’t notice or observe. My primary reason for going to a psychiatrist was because I wanted Adderall, to deal with my inability to focus/concentrate on my school work (that I was finishing up for college) and internship work (that I was also doing for college) and also, to considerably diminish my procrastinating ways, and a variety of other reasons.

    Ultimately, she prescribed me Guanfacine, which is a generic Tenex. It’s meant for ADHD, but also to treat high blood pressure. She prescribed it for my anxiety, my quick temper (ADHD), and overall, to regulate my emotions and behavior, to calm me down. It’s been about 6 days and I haven’t noticed anything yet, but some dizziness (a side effect). Still, I’m a little discouraged and frustrated at the fact that I went in there for Adderall to address my lack of focus/concentration, procrastination, poor listening skills, easily distracted, utterly disorganized, unable to think clearly and thoughtfully-especially on the spot, etc. All of these and more, are the reasons why I went to see a psychiatrist, instead, I feel like I was given medicine for something that wouldn’t effectively take care and address my main issues/ailments.

    1. I understand your frustration, but I can also understand the physician’s actions. Too often, patients who go in asking for Adderall are what is called “drug seekers.” That’s because Adderall is the most highly abused (and abuseable) of the stimulant medications.

      Instead of asking specifically for Adderall, it might have gone better if you’d asked for an evaluation, detailed your history, specifically asked about ADHD, and see what the doc recommended. If you’d done a little more research first on the medications used to treat ADHD, you could have had a conversation on the choice she offered.

      For some people with ADHD-related anger/irritability, Tenex does help. But I’ve never heard of it helping with the full range of symptoms.

      When you go back, you can report that none of your target symptoms have been addressed. But I recommend that you educate yourself first. My book offers guidelines for patients and physicians alike on selecting and titrating medications for ADHD:

      http://www.amazon.com/dp/0981548709/?tag=wwwginaperaco-20

      Good luck,
      Gina

  33. As an almost 40 year old mother of two that was just recently, finally diagnosed with add after decades of struggles, adderal has been a godsend. Although my dr had initially prescribed alternatives to this medication I just couldn’t afford them. Adderal isn’t covered either but the 20 dollar price tag was acceptable. It has changed my life. I’m happier now than I’ve ever been because I feel like my brain is working for me not against me. I take the minimum dosage and I have no intention of abusing the medication that I feel saved my sanity. I’ve never been happier or felt more stable.

    1. I’m happy to hear that, Emily. Adderall does work well for many people. It’s just all the problematic angles to it that has created such a backlash against the very idea of ADHD itself.

      Humans have always abused stimulants, as far as I can tell. In 1991, one study found that 19 percent of medical students surveyed used cocaine or amphetamines.

      The general public always has a hard time treading gray area. Understanding that a medication that can lead to addiction for some people but higher functioning for others….difficult.

      You said you’ve just started taking it recently. Some people find that Adderall becomes more problematic over time. Typically about 2-3 months. So if you notice something is “off,” that might be it. As for costs, most of the pharma companies have patient assistance programs to those who financially qualify. So, that shouldn’t be an obstacle for you.

      take care,
      g

  34. i think the key is to find what works for you. Adderall might get a bad name, but i am doing well on a very low dose. My dr. started me on Vyvanse 30 and i i progressed to a 40 and was a crying, dark, mess. always felt like i had hangover in the morning when taking vyvanse…people at work commented that i was not myself. then i tried ritalin and foclin… i was depressed and i just couldnt focus…. then i tried Adderall…i have the same sleepless night as with the other drugs. i had insomnia before meds so not sure its any worse, but at least i feel like me… im not constantly raging and sad….i get my work done…and feel fine in the mornings

    i am a teacher of children with special needs and just like i tell their parents to keep a journal about their child and talk to the dr…..we the add population need to take care to find what works for us…and not knock what works for some and not others…

    1. Thanks for comment, Joy. I’m glad you found something that you think works for you. But if you are having “the same sleepless night,” then perhaps you should continue working to improve your medical treatment. ADHD itself is associated with sleep disorders, and they require targeted treatment.

      Obviously, the key is finding what works for the individual. That is the entire point of my book’s chapters on medication. And some people will never find that if they start with Adderall, find its side effects intolerable, and assume that is the nature of medical treatment for ADHD (that is, the treatment is worse then the condition).

      This is a nuanced subject, with plenty of gray area. But I’ve seen too much damage from Adderall not to repeat the caution I’ve repeated for years: For some people, it might work better than other options. But for many, it can be a huge problem.

      tx
      g

  35. Screen name here

    Well, Concerta 54 mg was WAY too much.

    2 days were wasted on the experiment, after the first I messaged my MD that I wouldn’t drive or use power tools at that level and he sent me a message suggesting I BREAK A CONCERTA IN TWO?!

    Fortunately I had read the drug information sheet and knew better. After another medical message my MD did too, and I got a Concerta Rx at 27mg instead. 6 days into that now.

    It’s certainly not a magic pill that makes me into a normal person, whatever that is. At least I don’t have tachycardia and it feels safe to drive or use a tool now. More later, after I see how much work gets done and what quality level my output has.

    1. Unbelievable, the stupidity of that physician. No wonder we’ve seen such a backlash against ADHD. Multiply his recklessness times thousands…..shocking.

      But yes, there’s not going to be the “easy fix” that the ADHD-denyers proclaim. But you should feel significant improvement in your self-regulation (of focus, effort, motivation, emotion, etc.), and it should get better over time.

      Avoid coffee and cigarettes. Get some sleep. Good luck!
      g

  36. Screen name here

    Thanks for the comment-

    I had another visit with my MD, and have started Concerta 54mg as of this morning. Seems to be a little calmer- I’m about to try working under the influence, we shall see. Rather surprised I wasn’t started at a lower dose and then worked up. I weigh about 200 to 210 lb., usually.

    Asked my MD what his next plan was if this change in meds doesn’t produce a state of mind suitable for work and also allow allow “normal” behavior around other people… He didn’t have much to suggest, so I requested he immediately START looking for a psychiatrist with specialty or at least a lot of experience with adult ADD/inattentive. He agreed to look into finding who was available and could be used under my insurance.

    Down side, he said it would likely be 3 to 4 months before I ever got to talk to a psych. That’s not going to be a good thing if I really need one! He did suggest talking to a neurologist, not sure how useful that’s going to be?!

    There’s this tactic I’ve heard of for cutting down wait time in getting to see an MD at the ER: You grab your left arm, and start talking about sudden chest pains, you can’t get your breath and “Oh, my left arm has just gone “funny”!”

    I suspect the psych equivalent of such a tactic is not a good choice for keeping one’s various “safety sensitive position” related licenses and professional standing.

    Oh well, the news just informed people in (major US city I lived in) that it will be 3 to 15 minutes before our local 911 calls are answered. That’s ANSWERED. As in, the operator picks up the phone. Hope we all don’t have any actual emergencies- Because the fire/police/EMS will be another 5 to 30 minutes responding.

    Ah, brave new world! Take a number and a seat…

    1. Yes, it’s a problem. A shortage of psychiatrists, made worse (or perhaps caused) by low reimbursement rates.

      Most of the good psychiatrists I know are scrambling to get out of the business.

      The sad fact is that, to get the best results, people with ADHD often have to be very pro-active.

      I encourage you to start by reading my book. The medication chapter alone is worth the price of admission.

      http://www.amazon.com/dp/0981548709/?tag=wwwginaperaco-20

      That doc should NOT have started you on 54 mg. Pardon my French, but that is imbecilic. The dosage has absolutely nothing to do with weight or size.

      Yes, I don’t think that strategy will work at the psychiatric ER. 🙂

      Good luck!
      g

  37. Screen name here

    I’m an over 50 male diagnosed with adult ADD/inattentive and prescribed Adderall for a bit over a year now.

    Diagnosis was spurred by a younger relative who was diagnosed, and a belated recognition by a sibling that we kids had ALL had various undiagnosed forms of ADD (1960’s-70’s, not a “fashionable” diagnosis back then…). We were all bright enough kids to get by anyhow, and it didn’t start to pile up to impossible levels until later in life, as noted by others here.

    Both our parents had PHD’s, but I’d say my dad had ADD inattentive and compensated by a very narrow hyper focus on work, mom had at least a mild case of ADD inattentive as well. Supporting family and different social norms got them through school, but raising children pretty much pushed them past being able to cope too, looking at our home life in retrospect (and from far enough away in time to see it a bit more clearly than when it was happening!).

    This article is pretty accurate as to my experience- Adderall is the all purpose noodle, and “throw the spaghetti at the wall and see if it sticks”. If it isn’t sticking, throw MORE spaghetti at the wall! STILL not sticking? THROW MORE AND THROW IT HARDER!!!

    I went from experiencing some help with inatentive symptoms for the first 3 or so months on Adderall to progressively less and less help, telling my physician what was occurring and having the dose bumped up- and up, and up again.

    The focus on important tasks became random flashes of hyper focus, the unwanted euphoric effects obscured the correct emotional re-enforcement for properly done work or from previously enjoyable leisure activities, physical effects such as muscle tension headaches, changes in the way my teeth met from constant grinding. Something that seems to be VERY like Tourette’s syndrome set in along with a constant ANGER that makes me want to avoid people I like because of the way I felt and might treat them.

    I tell my primary physician (he’s an internist, and I really like and respect him medically otherwise, and as person) what is going on. He minimizes it, suggests other scenarios and ups my dose. He’s a good man with broken bones, infections, hernia and other straight forward physical issues, but totally out to sea on this.

    So here I am, with a medically approved amphetamine addiction that doesn’t address my original issue effectively- And is causing dramatically BAD, unpleasant things to happen in my personal and work life. I won’t even pick up the phone to talk to my “significant other” many evenings, the downside of the day’s meds make my behavior far too poor for human company.

    I’m on this page while researching the odds of unilaterally quitting Adderall cold turkey and NOT replacing it with other drugs. My research on non amphetamine medications had led me to ask for a trial of Provigil- Which my insurer denied. I have NO desire to substitute a different stimulant formulation for Adderall, speed is speed, even if it does come from big pharma rather than Walter White.

    Don’t know what else you could suggest, but hey, at least I got this off my chest.

    1. Hi B.,

      Excuse me while I pound some sand. What you describe is inexcusable. It’s abhorrent. It should be actionable.

      In what other disease category would this kind of reckless monitoring of care be considered okay?

      Can you get to a board-certified psychiatrist? Not that this is a guarantee they will know what’s what with ADHD meds, but it might be better than your internist.

      If that’s a problem, ask your internist to consider prescribing a less-problematic stimulant, such as Concerta, Daytrana, or Vyvanse. If you’ve never been given a trial of the MPH medication (Adderall is AMP), that is worth a try.

      I’ve not met one person with ADHD for whom Provigil has been helpful. Not saying it’s impossible, but you’d think in 15 years and talking with thousands of folks, I’d have heard it. Provigil is a narcolepsy medication that is sometimes used for ADHD, but not sure who and why.

      If you feel that Adderall helped you to some degree (minus the nasty side effects), it might be that Vyvanse will work well for you.

      Then again, it could be that Adderall has exacerbated an anxiety condition, and that will need joint treatment with the ADHD.

      Still, I’d start with the Vyvanse. Please ask your MD to give you trial or refer you to a physician who cares to be a more responsible prescriber. It’s something of a joke in our local group, that when people complain of bad side effects, their MD says to “double the dosage.” But it’s not that funny. In fact, it’s tragic. Sometimes there will be side effects in the beginning that go away. But that’s not what you are describing.

      I recommend that you read my book’s chapter on medication — and maybe give a copy to your doc, if you’re stuck with him. It can make a huge difference in your understanding of how ADHD should be treated medically. It’s clearly written, and bulleted. Not a lot of ponderous prose. 🙂

      http://www.amazon.com/dp/0981548709/?tag=wwwginaperaco-20

      Good luck! Demand better!
      Gina

  38. I am transgender, and have been misdiagnosed as having BPD despite the clear guidance in the DSM to not count the traits if they are better accounted for by an existing Axis I diagnosis such as Gender Dysphoria, and ADHD. It has ruined my relationships with the doctors I need to treat me.

    1. Argh, I am so sorry to hear that, Emily.

      I know this “brain stuff” is complicated, and there are no easy answers.

      But it’s the lack of intellectual curiosity that gets to me.

      In my experience, the clearer people with ADHD are about their challenges and the more validation they receive for their perception, the better their chance of finding a doc who can help them. So, seek all the validation you need. One site I like is http://www.ADDforums.com

      best,
      g

  39. I’m currently a junior in highschool and I was diagnosed with ADD in eighth grade. I began taking concerta, but due to it making me sweat a lot, my doctor (not very helpful) switched me to adderall in 9th grade and I have been on it ever since. I have never really noticed many side effects of my adhd medicine besides dry mouth and sweatstains, that is until this year. I did some research and pieced it together. Whenever I take breaks in school and go off the medicine and come back on it, i get so depressed the first week and i’m generally a super always happy type person. It wasn’t till over Christmas break when I went off it that I noticed how miserable the medicine made me. I get stomach aches when i’m on it, i’m not as friendly, i’m quieter, i’m sadder, i sweat a ton, i’m way more irritable, and almost in a sense it makes me so much more focused on myself. I have been crying the past few days over how much I hate taking the miserable drug, but half way through my junior year in highschool is no time to start experimenting i feel like because I need to get good grades so I can get a scholarship but at the same time I can’t stay on this drug that changes who I am…. I’m nervous about letting it go what if the remedies don’t work? Please help me out/contact me/ give me any more advice I’m desperate to be care free again!!

    1. Hi Leah,

      You shouldn’t have to tolerate such extreme side effects in order to get benefits from the medication.

      I encourage you to look into other options with your physician. Adderall is an older formulation, and it has a higher side effect profile than the newer formulations, such as Vyvanse.

      Remember, too, that your body and brain are still developing. That means that a medication that worked for you last year might not work now. Some girls and women also need a little higher dosage during the menstrual periods.

      When you say that, off medication, you are a “super happy” person, that could possibly indicate that untreated ADHD allows you to approach life more superficially, to gloss over challenges, and to not see future consequences. You might feel “happier” at such times, but you might not like the eventual consequences.

      At the same time, too high a dose of Adderall could create this feeling of “depression,” too.

      It is hard, at your age, to know “who you are.” Are you your “true self” when your symptoms are not medicated — or is the real you being obscured by your ADHD symptoms?

      When the “real me” goes around my house without wearing my glasses, I can fool myself into believing that the house is neat and tidy. Then I put on my glasses, and see something else. 🙂

      I hope you can find a counselor or physician you can discuss these issues with. It’s important.

      No one can be “care free” forever. At some point, consequences will come up to bite you in the butt. Don’t let that happen! The trick is balancing responsibility and pleasure.

      Good luck,
      g

    2. First of all it sounllds like she is on the wrong med. What is she taking for the anxiety and depression and I wouldn’t jump into adderall at this point. Adderall is not a fix all and is too slow starting. Along with slow release capsules you can’t tell where your body is what it’s doing you can’t tell when it starts to work and when it starts to wear off or is it working at all. These are things you must know. The problem is not just knowing what drug to use but how much per dose and how often. The first place I turned when I was investigating these questions was Harvard University School of Medicine. I don’t just talk to anybody I talk to the professor that is teaching the doctors and download any information that comes from that Professor I had question for him and I got the answers I needed. I had concerns about medication and the safe amounts, so i called Costco corporate and spoke to the corporate pharmacist who is ahead of all Costco pharmacy across the country if anybody is going to know he will and he will talk to you. The thing I kept in mind all the time is the safety of my body. I wish I could have helped this girl. I could have. It sounded as though she got off to a bad start.

    3. Good for you being such a great observer and self advocate at such a young age. I understand that the focus is on Adderall, but I’m really surprised that nobody is mentioning puberty in this situation. Research shows that girls with ADHD experience a worsening of symptoms (ADHD and hormonal symptoms) during puberty. Sometimes, medications need to be adjusted. Additionally, many teens with ADHD (both boys and girls) have issues with executive functioning due to increasing demands and expectations for independence. All of these changes combined can cause many strong feelings and emotions. Hang in there. Keep up your research and self advocacy. It will serve you well in the future. Gina is a great resource! I’ve met her and heard her speak many times.

  40. It never occurred to me that I might have ADHD. I have been diagnosed with: Bipolar II disorder, Borderline Personality Disorder, Depression, Anxiety and PTSD (not all at the same time and not all by the same psychiatrist). ADHD was never a consideration. I have a traumatic past, and have attempted suicide on numerous occasions as well as going through a period of self-harming. All of the diagnoses seemed to fit except ADHD. However, the most relief I have ever experienced has been as the result of a stimulant medication. Unfortunately, Adderall, while extremely helpful to me in many ways, caused side effects that made it impossible for me to use.

  41. I am now on Rydalin due to problems with Adderall, but this drug is not as effective for me. I am wondering if anyone has used a drug similar to Adderall without the adverse effects?

    Thanks.

    1. Hi Constance,

      Congratulations on discovering the diagnosis. It is extremely hard to work on solutions until the correct diagnosis is in place.

      Yes, due to genetics, it might be that one or the other class of stimulants (methylphenidate or amphetamines) work better for you. If Ritalin did not prove effective (and you tried the brand, at a sufficient dose, not the generic), it might be that the amphetamines are a better bet for you. In addition to Adderall, the amphetamine choices include Dexedrine (an older Rx that still works best for a minority of people) and a newer Rx called Vyvanse, which is delivered slowly and steadily into the blood stream over a longer period of time than Adderall or Adderall XR. It’s well worth asking your MD about it.

      Good luck,
      Gina

    2. I have sought psychiatric care in response to deep genetic research of my own personal genome.

      I was never diagnosed with ADD – but genetically I express ADD. In other words, my treatment regimen is strictly guided by my genes. Not what my husband says about me. Not what my co-workers say about me. Not even what I think or feel about me.

      My genetics are my medical road map. And the deficiencies caused by my genes are treated – and overcome – by medicines specifically targeting those defective genes. It is the only way to remove the guess work for everyone involved. And is the reason I can’t take any of Gina’s recommendations seriously.

      Genetically, I cannot tolerate methyl donors. Ritalin is a methyl donor. I have been prescribed generic Adderall which has brought great relief. But I also take an MAOI due to my MAO A gene being triple active. These medications are contraindicated but have made a difference in my life in a matter of months after suffering for over a decade. Thank God I found a practitioner who had one ounce of open mindedness and a whole lot of genetic training.

      I have been having strange ankle swelling while on generic Adderall. I’m currently researching substitutions – but there are not a lot of options. Especially, when I have orthostatic hypotension as a result of the MAOI. The stimulant helps counteract hypotension – (Yes read that again- NOT hypertension – but HYPOtension – they are different.) and also treats my ADD genetic profile. I cannot tolerate extended release stimulants because my blood pressure has to be monitored closely. In the event I eat something deadly while on my MAOI – and suffer HYPERtension – compounded by a stimulant – it is best I remain on immediate release formulas.

      I could go on and on about all the BS touted in this post – and probably in Gina’s book if I had the inclination to read it – but your attention span wouldn’t last. Everybody here should do themselves a favor and have their genome profiled and learn exactly what your prescribed and why that chemically does or does not work for you or your loved one.

      As for Gina – it’s a shame you deter patients from mental health and wellbeing based on collected stories. I’m sure individuals have reacted and suffered side effects from Adderall or any other stimulant. But the answer lies in their genetics. Genetics tell the story of every chemical reaction in your body. Every chemical action has a psychological reaction.

      Instead of telling patients or their loved ones to continue on the prescription merry-go-’round you should be telling them how to get the exact answer to their problem. If individuals know their genetic makeup they can do the math (and the chemistry) and find the exact answer to their chemical problems that manifest physically and psychologically.

      My visit here today was mainly to read about Constance Wilds’ reaction to Adderall with swollen ankles. Since I’m not alone in this symptom – I know for sure an ingredient in the formula is causing the reaction. I also can say in the absence of Adderall – the swelling goes away. It won’t take me long to see the math and the chemical causes – because I understand fundamentally what Adderall is doing to the dopamine supply, transport, uptake, and reuptake in my brain. I understand it because my genes tell me what, when, and why Adderall “fixes” their mutations.

      My hope is that everyone here will find their medical map and stop torturing themselves and everyone around them. Get your DNA tested. Then spend immense time studying your genes as if your life depends on it. It does. Genetic research is hard. I spent 2 years studying mine – before treatment. All the while suffering. But once I saw the problem – I could seek the solution. And no doctor, lecturer, pharmacy, “expert”, husband, friend, or colleague could tell me I was wrong. You are born with your genes. They will never change. The answer you derive about your chemical and thus mental health will be definitive.

      Debbie

    3. Hi Debbie,

      It’s too bad you couldn’t share your interesting perspective without denigrating the accurate information that I share here.

      I stand by my statements. Adderall is a problem for many people, and the failure of physicians/parents/consumers to understand the nuances has thrown too many lives off the rails and contributed to the backlash of ADHD itself.

      As for the rest, I don’t know where you’re getting your information, that somehow Ritalin is a methyl donor while Adderall is not, but I’m afraid you’re relying on less than credible sources.

      A genetic test will only tell you certain details, which must be understood in immense complexity. If then. My husband and I wrote this 7-part series on using gene-testing to inform ADHD medication therapy. You must have missed it.

      https://adhdrollercoaster.org/tools-and-strategies/adhd-dna-and-predicting-medication-response-introduction/

      The fact that you have mis-read/mis-interpreted this blog post on Adderall, and further feel the need to denigrate me, might provide a tiny indication that your genetic sleuthing isn’t working as well as you think it is.

      Gina

    4. @Constance Wilds
      Don’t listen to her. Honestly im shocked she would even go far enough to act like she is educated enough to give you advice on drugs, but at the same time, if you had problems on adderall, she suggests that you should try more stimulants and even amphetamines. Clearly if you had a problem with one type of drug you shouldn’t keep trying the stimulants and amphetamines, you should go down a different path. Im not a professional, but i am pretty educated and i can tell you this with legit experience. If i were you i would try taking Provigil, even over vyvance . Provigil is like a clone of adderall but without the amphetimines and approaches how it goes about helping you in a more safe, less invasive and if you dont do well on adderall you might do perfect on that, but there are side effects, its worth trying. Its way better than what you are on. A lot of people don’t know that Provigil is possibly the best alternative to adderall, even psychiatrists. But i know this with my long medical history and my dad. My dad was a druggie and criminal when he was 18 and in his 20s, it got to the point he was skinny and so unhealthy that his skin was pale as fuck, he didnt really move much or eat, he just did hard drugs and was on the road to death until one of his old crimes caught up with him and he spent a year in prison where he turned everything around, became a body builder and got very far in life being very successful, but because he was such a hardcore drug addict, he cant take certain meds, and he certainly cant take any amphetimines which includes whats in adderall, and he has had times where he has needed medication for ADHD problems and so when he needs it, which is rare he gets Provigil, it has pretty much the same effects and does the same thing without the problems with taking drugs similar to speed. He tries to get me to switch onto it over adderall but im like nahhh. So i hope this does get to you in case you are at a point in your life where you may still need some help finding something that works. I think this gina lady has to approve every comment that goes through and since ive been ranting about how she is spreading so much false info she may already be rejecting every comment i make, but itd be pretty low of her to reject this one because i actually have some credible info and advice that could potentially help you or another reader with your question and for her to not let my comment show would just be pretty low considering the horrible advice she gave you. Shes just as bad as a psychiatrist that doesn’t know enough about what they prescribe to people. She has no clue what she is talking about, giving you info and advice that would potentially keep you looking for the right meds or just give up. I know what its like to not have meds for something that i need meds for, and i hate it. i got lucky with my parents being very educated and guiding me into meds safely. But not many other people are lucky enough to be born with parents who work at kaiser and are in the medical field while i have medical problems…

    5. That’s right, Constance. Listen to a random anonymous person for your misinformation, not someone who is recognized as an expert in Adult ADHD by a virtual “Who’s Who” of top experts.

      That will work out great. 🙂

      That’s the last message I am approving, Georgia. I don’t care what you say about me; I recognize the blame-shifting and self-medicating with provocation.

      The problem is that you risk hurting people with very bad information.

      Particularly your comments on Provigil are way off the beam. In study after study, it seldom does better than placebo—and with adverse side effects.

      Gina

  42. Constance Wilds

    My psychiatrist prescribed Adderall for my PTSD & depression, which caused me to have problems with concentration. He indicated that Adderall had worked well for many of his PTSD patients. I developed swelling in my ankles after about a month of use (20 mg 2x/day). Further, the tops of my feet itched terribly. There were no problems found with my kidneys or heart. My family physician said that this seemed like an allergy. My psychiatrist only indicated that he had never hear of someone having this reaction to Adderall. Also, I found myself becoming extremely angry to the point of violence. I have never been an angry or violent person. When I told my psychiatrist about the anger problems and how concerned I was about them, he blamed it on my traumatic past. Finally, I stopped taking the Adderall because of the ankle swelling and was put on Ridalin instead. Since then, I have had no ankle swelling and no further anger/violence problems.

    I am certain all of these issues were caused by the Adderall. Physicians need to educate themselves about all of the potential side effects of a medication and be open to the fact that everyone is different and some people can suffer side effects that many others do not. I never knew about the connection between Adderall and anger problems until I read about it on the internet. My doctor never once connected the two.

    1. Hi Constance,

      I’m sorry to hear of your experience. Your MD might be onto something; oftentimes ADHD is misdiagnosed as PTSD, so it would make sense that sometimes a stimulant medication would help.

      It’s too bad that he didn’t see the physical reaction to the meds, though, and instead blamed it on your traumatic past. In what world does this make sense? Especially given that there are so many alternatives when it comes to stimulant. Not only that, but the dopamine system affects all kinds of physiological processes — not just “focus.”

      Yes, you are right. Physicians need to educate themselves about the potential side effects of all medications, most especially including Adderall. But you would not believe how much grief I get when I try to do this. Almost all docs have tried to talk me out of this, as if I’ve imagined it. Instead, I’ve been closely listening to first-person stories for almost 15 years.

      So, I gave up educating the physicians and started educating the patients. That’s why I detailed medication treatments for ADHD in my book (three chapters worth) — to educate the patients who would then, I hope, educate their physicians.

      Good for you for listening to your body!

      g

  43. Thanks for weighing in, Stuart, and for being an “early adopter.” 😉

    I’m going to stick to my point, that I would not recommend Adderall as a first try for anyone — only as the last option. Because I’ve seen too many people go off the rails, and never return. Especially never return to trying a different medication. Adderall can close doors, and sometimes end relationships, jobs, and no doubt some lives.

    Trouble is, most of the times MDs don’t hear about this. People just don’t go back and are deemed “non-compliant” and “non-adherent.”

    Thanks for serving this population.

    Gina

  44. Gina, I just have to stop and thank you so much for your dedication to this topic. You have answered me personally on your other blog so when I googled “Adderall rages” and came to this page I was incredibly comforted that I was able to KNOW who was writing this. Medicine forums are usually so full of bad news, it’s hard to believe it because the people who don’t have a problem aren’t spending time on these forums. I know when you say “first hand experience collecting these stories for 15 years” it’s not just a knee jerk reaction to the things you heard second hand.

    I have read your book, I will reread the medicine chapter and probably be back with questions. Thank you so much for the work you do, it makes a real difference in our little family.

  45. Thanks Gina! I did read that chapter but I am going to reread it because when I read it, my husband wasn’t on the medication yet and I was still so astounded by everything else in the book and how it compared to our marriage so well! I am also hoping to find him a physician or a psychiatrist to monitor the medication he is on. His primary care physician prescribed it for him. He hasn’t been back in almost a year and it was only monitored a couple of times (and that’s only because he has a health issue to go back for). My husband wouldn’t let me go the the appointment either. I like his doctor. I just think my husband needs a psychiatrist or someone that specializes more in these types of medications and will monitor it better. Thanks again for your ideas! 🙂

    1. I just read your review and thoughtful text. My best friend goes with her husband, my Mom went with her Mom… then I went with My Mom…. An extra set of ears is so helpful. As Gina explained, the one with ADD or ADHD will think everything is rosy. It’s not unusual for the partner to express a different view…. Make it fun! Promise lunch after the appointment.
      Good luck.

      I hope your are doing well.

  46. Hi,

    Is it possible that Adderall just doesn’t work for some people? My husband is on it and he isn’t more angry but he still can’t control arguing with me or lettinng things go. He still gets distracted by other things. I have noticed a little bit of a difference (as far as being able to focus better) but not as much as I had hoped. His doctor just put him on it the first time and he hasn’t really monitored it at all and when he asks my husband if it is helping, he tells him yes that he feels great! However, he is still saying hurtful things to me. Thanks

    1. Yes, it is definitely true that Adderall “just doesn’t work for some people”. Neither will Ritalin or other medications. The choice of stimulant should be made methodically, with the knowledge that individual neurogenetics mean some Rx will work better than others. I detail this in my book’s chapters on medication. You would do well to read them and ask your husband’s physician to read them, too. 😉
      http://www.amazon.com/dp/0981548709/?tag=wwwginaperaco-20

  47. I have no problem getting medication for my children or myself but getting my HMO or the schools to give us support in other ways has been my biggest frustration. They definitely believe in the “throw medication at the disorder” mentality. I was lucky in that my primary care physician is thorough and referred me out a specialist for the medicine or I’d probably give up. However, I am in a battle between the school and HMO with both of them pointing the finger at each other saying the other is responsible for behavioral training.

    With regards to Jeff and his story, my parents still refuse to believe I am ADHD. I was a great student and always held a job. I am yet another example of somebody that got missed due to my academic performance.

    1. I know what you mean about the HMOs, Andrea. Locally, at our Adult ADHD group, whenever new members join the group and mention their HMO provider, there is a collective groan. Because we know that that HMO can just wear you down until you stop trying. That’s one of the group’s benefits: we act as a cheering section to keep persevering.

      Some HMO’s mentality is very short-term. They expect a high turnover among enrollees (due to job changes, relocations, etc.) and so they don’t focus on long-term benefits. If they did — if they wanted to avoid many of the problems associated with a lifetime of untreated ADHD (hypertension, diabetes, traffic accidents, sleep disorders, etc.) — they would take ADHD treatment seriously.

      Still, the people who have HMOs are usually paying very little for their medical care. So, if they can afford it, I encourage them to go out of system. It’s worth it. Trying to stay “within the system” can be a foolish strategy if one has the cash.

    2. Andrew,

      Depending on what state you are in, there are laws the schools have to follow to support your child. Many schools actually ignore them (to their later peril). If your school is not supporting your child, talk to them about doing an IEP or a 509 for your child. One is formal, the other is not. Then you can force the school to give your child the help they need. We know this since we work with schools. The HMO is responsible for the medical and mental health of the child. The school is responsible for the education of the child. But they do inter-connect. And that is where those forms and requirements apply. They join the two sides to get the children the best possible chance in education.

      Teachers today handle ADD and ADHD differently than they did 20 or 30 years ago. Many are not trained or capable of dealing with such students unless the student ‘gets medicated help.’ Truth is, plenty of students like myself succeeded in school without meds after very rough learning periods. Went from F’s in elementary school to valedictorian in HS without such help. But I later sought help for ADHD as an adult to deal with work and family responsibilities since they are much more weighty issues than school. It helps considerably.

  48. My husband is taking Adderall XR and it is NOT working!! I took both of my children off Adderall because it made them angry. Concerta has been much better for them but it doesn’t seem to work for my husband. The Adderall “works” for being able to sit at his desk at work but the side effects are really bad. He can’t sleep, gets easily agitated, becomes verbally aggressive, can’t handle crowds & noise, grinds his teeth, and to offset the affects of Adderall he drinks. His moods are all over the place. If he takes his Adderall he does better at work but home life suffers so he gets down. No Adderall his work life suffers but home is better so he gets down. It’s a vicious cycle and all I can do is take baby steps hoping some day it will get better. Gina has suggested that if he didn’t do well on the Concerta to try the Vyvanse, but that isn’t affordable for us right now. Wish us luck! JS

    1. Betsy Davenport, PhD

      I do wish you luck. Vyvanse has been the best medicine for my daughter. She took Adderall from age 8 to whenever Vyvanse came out. She preferred the latter.

      Perhaps your husband could be tried on it to see if it is better, and you keep some logs to inform the doctor. Some drug companies will provide medications for reduced cost, and some insurance companies will cough up the money for the more expensive medication if the doctor will make a case for it. Anything less than the best you can obtain is too little.

      It’s exhausting to be the support arm of the situation, especially with kids and spouse with ADHD. I feel for you.

    2. Doc Bets – I surely appreciate you always lending a hand by sharing your expertise on blogs, news articles, and lists. You have generously performed a great service for the ADHD community ever since I met you (what? 10 years ago?). In particular, I will never forget your early support of my efforts. You have helped me to help so many.

      Gina

    3. I have ADHD, have since I was a child. Was not a diagnosis back then, they thought it was sugar-related. Graduated top of my classes, though never got treatment until I was an adult.

      I tried Strattera as an adult – it worked but gave bad headaches. Later went to Adderall – and had all the symptoms you mentioned, plus made my heartbeat race uncontrollably during exercise (I am in great physical shape, so it was definitely the new medicine). I stopped taking it and asked my doc for alternatives. Doctor switched me to Vyvanse and it’s amazing…none of the previous side effects and to this day still solves all the symptoms. Yes, expensive, but insurance covers it. It’s only been out a few years, so time will tell what other side effects this may have later. But for now, it’s working great. Vyvanse also has a patient assistance program to help offset the cost – your doctor might have information and script cards for that like mine did.

    4. Hi Lana, Yes, that’s a helpful website!

      Also Costco doesn’t require membership to purchase Rx.

      Thanks for sharing.
      g

  49. This triggers my “PTSD” around my ex-husband getting treatment for his ADHD 10 years ago. The MD refused to listen to me when I tried to tell her that the Adderall was making my husband angry. Over the top angry. He was eating the pills like they were M&Ms and threatening me if I dared to tell the doctor what was happening. Of course he didn’t want his “supply” cut off. I moved back in with my mother because he was scaring me so badly. He ended up losing his job because he shot the bird at his boss. Mind you, he’d never been a “nice” person but that Adderall turned him into a raging scary person. “Madderal” is right. It wasn’t right what happened to him. He was trying to get help, and instead the “help” made everything worse. Frances

  50. Thank you Gina! David Fee’s Story could have been my son’s. Fortunately, we were able to intervene, with no thanks to the shrinks. This is a story that had to be told. I just hope it doesn’t further damage the legitimacy of ADHD treatment in the public’s eyes. The medications can work so well, when properly administered.

  51. Shlomo Dovid Freedman

    Thank you again, Gina. I too noticed the story and assumed it was part of the New York Times’ unrelenting attack on ADHD medications the reality of ADHD. I skipped the article completely, though — thank you for bringing it to our attention and for providing your expert commentary.

  52. You nailed it again, Gina. I feel sorry for that young man’s family. Thank you for taking the time to write this. Jamie.

  53. Thank you, Gina, for your tireless efforts. I don’t know what my husband and I would have done without your guidance. My husband was headed toward a bad end, and the doctor didn’t have a clue. Amazing. We have learned the hard way what you have been lecturing about for many years. I hope others listen to you.

  54. “Did the poor young man in the NYT story truly not have ADHD, as his parents claim? (…the reporter did not dig deeply enough, perhaps because he does not know that ADHD sometimes had a way of “sneaking up” on people later in life, when their innate intelligence and ability to get by in school without good study habits are no longer enough to let them keep up with their goals.) ” – Absolutely spot on! This story could be reported as an ongoing series of stories…with one examining his childhood as seen by teachers and others…examination of others in his family (if he had ADHD…it would be evident in other family members), of the doctors that guided and misguided him, of the way he “played” the doctors, and so on. Of course…I know I’m preaching to the choir on this one. This is a much deeper, multifaceted story that, unfortunately, will never be fully told.

    1. Yes, you’re right, Jeff. There are many facets to this story.

      We cannot depend on the parents or his friends to truly know if this boy had ADHD, or maybe ADHD+ bi-polar.

      And I’ve heard many stories of adults with ADHD not telling the physician the full truth of Adderall’s effect — even to the point of forbidding their partners from contacting the physician, for fear of stopping the “focus.”

      They truly feel it is their only solution, because they never tried another, less problematic stimulant before the Adderall. All they know is that they want the focus that has eluded them throughout their lives. And, sometimes, in the process, they become addicted.

    2. Betsy Davenport, PhD

      I’ve always said, high intelligence masks ADHD, and ADHD can mask high intelligence.

      When life’s demands increase, as with career and family, and in the case of women, career and FAMILY, the “extra” brain power isn’t available anymore and it is inevitable that decreased functioning and/or a crash of sorts comes to pass.

    3. Betsy, I appreciate your comment. When I started learning about ADHD, I thought it probably applied to me too, but because of the “high-intelligence” I was blessed with, it never showed. Now that I have so many pressures in life, as a very very busy adult, I find that it’s harder to keep my focus, and I am recognizing many of my behaviors to be ADHD like. Yet no professional I’d ever asked agreed. Your statement about high-intelligence masking ADHD and vice versa helps!

    4. Yes Jeff, you may be right about the ADHD creeping up at a later age, but sometimes it’s hard to tell, especially if the young man is out of High School, facing his manhood experiences & challenges, one of those “just becoming a man”, and going through the changes of young adulthood. To this day, I don’t think there’s a definite cure, just like in cancer, there’s ways of making the person feel a little better, worthy or part of this society, but not in a total comfort zone.
      But to prescribe Adderall to someone who may not need it, and cause that person to do something radical, is not to blame the parents, or the patient for not knowing the real reason. That is why they go to a doctor for his/her expertise, and end up in the morgue, the psychiatric ward, or just a plain Joe with an altered brain. Trust me I have and still am living this by watching someone so dear to me.

  55. Betsy Davenport, PhD

    In my experience, most of the APA conferences are peopled with shrinks clinging to the psychoanalytic model. Nothing wrong with it used properly, but it takes little notice of brain research, for example.

    1. Yes, that seemed to be the case. They were packing it in at the lectures on Borderline Personality Disorder. I think the docs liked the drama; plus it made them feel like psychiatric sleuths. I just sat there wondering how many people with ADHD were being misdiagnosed as having Bordeline Perosnality Disorder because no one was drawing distinctions.

  56. Betsy Davenport, PhD

    Well done, Gina. It is so HARD to obtain really expert diagnosis and treatment for ADHD, even after all this time. It used to be that we couldn’t get doctors to believe it exists; now we can’t get them to believe it co-exists, and that treatment is, as you say, anything but simple.

    1. Thank you, Betsy.

      That doc who called ADHD a “simple” condition — just throw a stimulant at it?

      That was at the American Psychiatric Association confab a few years ago in SF. Where NOT ONE lecture was devoted to ADHD.

      Only pre-conference “industry supported” lectures on ADHD (excellent, by top experts). But of course many of the docs attending the conference through a pharma-sponsored lecture beneath them.

      What a big, sticky, complicated mess.

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