The Tragic Truth Of Prescription Adderall, or “Madderall”

The topic here is prescription Adderall. Specifically: Adderall is too often prescribed badly.  It has repercussions on individuals— and it accounts for intensifying backlash against the diagnosis itself.

Do most prescribers treating ADHD know this?  No,  in fact, many believe just the opposite — that Adderall is “best” for adults. That is patently false.

Whatever the complex reasons for that (I’ll touch on a few below), the important thing now is to self-educate and be prepared to self-advocate. No one cares more about your or your loved one’s life than you.  Being passive is extremely risky.

Poorly prescribed Adderall can create negative personality changes in people who seek only to treat their ADHD. Anxiety. Anger. Irritability. Even what looks like mania. Trouble is, they might not see this objectively. Unfortunately, their prescribers often don’t ask—or connect the dots. You might say, “So what? Just try another medication.”   For reasons I’ll explain, though, that is often not an option.

The topic is not how to illegally obtain and abuse Adderall.  Still, if that is your goal, please read this first. It might save your life.

This is a long post. By necessity. I hope the subheads aid scanning. At the end, I’ll offer a preview of what competent prescribing for ADHD looks like.

You will find other articles on this topic ….now. Mine was first, in 2013, and the only until very recently.  

Let’s get this out of the way:

  • Prescription Adderall works very well for some people.
  • For others, Adderall  create more problems than it solves.

You likely won’t learn from your prescriber:

  • Poorly prescribed Adderall can ruin lives and relationships.
  • The is sometimes true for Dexedrine, too. Those of you in Australia, where the the national healthcare system (Medicare) has long considered it the stimulant of choice, be aware.
  • Individuals experiencing poor results from Adderall often don’t realize it.  They believe it’s the price of long-illusive focus. Their loved ones might, too—while they walk on eggshells, frightened. (Read the comments.)
  • Next stop: These adults with ADHD might develop a cannabis, alcohol, or benzodiazepine habit to “come down”.
  • Or: They love the intense focus too much to let go— no matter if that focus dangerously reduces self-awareness. (In other words, they assume that everyone else has the problem, not them.)
  • Poorly prescribed Adderall can  create or exacerbate anxiety, irritability, grandiosity, tunnel vision, and even rage.
  • That’s why 20 years ago I started calling it Madderall.

    (Note: I’m seeing the term Madderall now appropriated to describe combining marijuana and Adderall. That’s not my definition.)

Reckless Adderall Prescribing Fuels ADHD Backlash

The truly tragic part? There are so many less risky options to try first. Prescribers should be making things better, not worse. From my perspective, this is is a long-running  public health crisis.  It has contributed to a backlash against the diagnosis itself.

Recent case in point:  Alarming stories about  “tele-health” clinics over-prescribing Adderall. became inseparable from “ADHD is over-diagnosed.” For example:

Wall Street Journal Startups Make It Easier to Get ADHD Drugs: That Made Some Workers Anxious

Axios: Telehealth startup to Stop Prescribing Adderall for New ADHD Patients.   

No doubt these venture-capital startups were cutting corners. Yet, also COVID pushed ADHD to the fore for untold numbers of people who had been only marginally coping before. They needed care, and now news outlets and grandstanding pharmacies (CVS) were conspiring to make it harder to get the diagnosis and treatment.

Why Has This Malpractice Been Allowed?

Why do doctors too often insist on prescribing Adderall to newly diagnosed patients?  Especially with so little guidance and failure to use rating scales or seek third-party reports?

Here’s one shocking reason: Many prescribers misread a meta-analysis based on old, scant (and one might say one-pharma-skewed) data. A meta-analysis is not established standard of care.

Three other reasons:  

  1. Adderall’s manufacturer was notoriously aggressive in its marketing and fraudulent in its claims—with lasting effects

This company was fined $56.5M in 2014 for its false claims about Adderall and a few other drugs.  Read more at the U.S. Department of Justice website:  Shire Pharmaceuticals LLC to Pay $56.5 Million to Resolve False Claims Act Allegations Relating to Drug Marketing and Promotion Practices

2. This manufacturer has long wielded, in my observation, undue influence over most ADHD websites and personalities you see online. Unfortunately, this includes  psychiatrists, psychologists, coaches, and  non-profits, including board members and conference speakers and organizers.  Most people would be shocked at how this one pharma covertly pushes its agenda through so many tentacles. And what a weird agenda it is.

(Please know, I’ve been openly “pro-medication” for 22 years.  Medication properly chosen and prescribed, that is.)

3, Too many prescribers remain clueless, cavalier, and disconnected from consequences.  I don’t say this to discourage seeking treatment!  Instead, I want you to be a savvy healthcare consumer.

Yes, prescribers often have little time with a patient. That does not excuse this scandalous mess that is happening with Adderall and prescribing in general for ADHD.

Why haven’t other ADHD experts calling this out?  You’d have to ask them.

Conflict of Interest

I was an award-winning journalist before falling into ADHD world, in 1999. As such, I naturally avoid conflict of interest. Good journalists know that even accepting a free lunch is a slippery slope.  My “pro-medication” stance was exceedingly rare at that time. The “ADHD Gift” campaign was going full throttle.  Taking Pharma support clearly would muddy this position.  

I’ve rejected all Pharma support—direct and indirect.  This fact puts me squarely at odds with certain organizations, personalities, and outlets. 

To be clear: Researchers receiving pharmaceutical funding is a distinctly different matter. Research validity rests on the researchers’ reputations and methods — and replication. Researchers must disclose  such funding. By contrast, most of those proclaiming ADHD expertise online are not researchers nor do they have proper credentials.

Moreover, most “ADHD influencers” don’t even disclose this  pharma support. That includes licensed psychologists and physicians. This indirect support includes public relations efforts on their behalf and being placed (forever) in prominent positions at ADHD non-profits, at “tele-conferences,” and more.

Other Complications:

  • Treating ADHD is not simple. It is a complex syndrome that affects individuals, not clones.
  • Genetic differences among individuals 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.

No Adderall-Abuse Tips in This Post 

Maybe you found this article while seeking to illegally procure or “hack” Adderall. Sorry to disappoint!

Moreover, when you leave in disappointment after 5 seconds, my blog’s “bounce” rate increases. That’s a big Google-search penalty. That means my post will be less likely to turn up in search results. Especially when  a slew of paid and promoted articles top the search list.

I leave this post here anyway. Why? You won’t find what you’re looking for, but you might find something better.  Please consider this: Chances are good that you actually have ADHD  and are attempting to “self-medicate” it. That never ends well.

Which Search Term Brought You Here?

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?
  • Why is Adderall dilating my pupils and making me look crazed?
  • 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?
  • Why is Adderall making me tired now, after working for 2 months?

This Post Covers Five Points:

  1. The New York Times has a long history of anti-psychiatry reporting. This was my initial catalyst in writing this post, in 2013.
  2. Many prescribers are incompetently treating ADHD. This is having devastating consequences.  
  3. Why, to avoid these adverse outcomes, we might best consider prescription Adderall not as a first try but rather a last-stop in stimulant medications
  4. The importance of consumer self-education and self-advocacy
  5. An excerpt from my first book’s chapters on medication

Adderall abuse1.  More ClickBait From The New York Times?

A back-channel tip came in yesterday. I steeled myself for the next anti-ADHD screed from the paper.  

Many reporters seem to view ADHD as rife for an expose. We who know better see transparently traffic-boosting clickbait. As a young journalist many years ago, I was taught to respect The New York Times as an exemplar of journalism. Sadly, that is no longer true.

Make no mistake: The paper still has respectable editor, reporters, and sections. Yet, the front-page editor for several years demonstrated festering personal antipathy toward neuroscience. That and/or  the publisher issued orders based on the website’s analytics. Any piece stigmatizing ADHD tends to draw lots of readers—and therefore ad dollars. For years, the ADHD community protested in comments. Then they just mostly gave up.

It’s All About the Web Traffic

Bottom line: It’s an SEO (Search-Engine-Optimization) bonanza! After leaving the paper, former Executive Editor Jill Abramson called it “publishing by the analytics.”  Google analytics, that is, that show traffic, how long a reader has read a page, where the reader went after, reader demographics, and lots more.   It is now pervasive online, with virtually every news outlet, amplified in social media. That goes double for ADHD topics.

Over the years, I’ve called out the paper’s negative targeting of ADHD:

  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—And Tiny Relief

Yet, when I read the 2013 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 prescription Adderall—and died by suicide. Again, this is a legitimate medication that, even though helpful for many people, can create severe reaction (including addiction and manic-like behavior) in many others.

Relief, that finally The New York Times’ grandstanding front page finally got something right about ADHD. Well, 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.” 

All else in the story, unfortunately, is distortion. It wouldn’t be former sports reporter Alan Schwarz’s last apparent bid to land a Pulitzer Prize. He didn’t, however, and no longer works at the paper. Nor is he still a reporter. But during his reign, he and his editors inflicted immense, perhaps lasting, damage. 

Moreover, he went on to write a horribly sensational book on ADHD. Then, Schwarz featured in a Netflix “documentary” from Maria Shriver and her daughter, Christina Schwarzenegger.  It’s called Take Your Pills. It’s a one-two punch castigating Adderall and ADHD, as if they are inseparable. Because, in too many prescribers’ minds, they are.  That is exactly my point.  (See Netflix’s Take Your Pills: Anti-Science—and Mean)

adderall anger

2. 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. 

I heard similar in my online group for the partners of adults with ADHD (ADHD partner). That is, they reported reckless prescribing patterns, particularly around Adderall. What was happening here?

What’s Not Happening, Specifically?

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

—Prescribers should track response

That is, they should be using a checklist of symptoms that helps them establish a baseline and then monitor medication response—and note any side effects.

—Prescribers should gather reports from family or close friends

ADHD is commonly associated with poor self-observation. Typically, this improves with medication. The wrong medication, however,  risks further clouding self-observation — and worse.

—Too many physicians don’t bother with either

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

Poor Prescribing Created ADHD Backlash?

To summarize: The prescribing of any stimulant is often done badly. But the problems around Adderall appear an order of magnitude more serious.

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 — verbally collaring this pharma’s reps at conferences, asking “why aren’t you warning prescribers?” — brings me no pleasure in being proved right. 

But I am just one person—without an “authoritative” MD after my name. (Google now actually penalizes this page because it’s not “reviewed” by an MD. Meanwhile, the plethora of “health” sites scrapes the bottom of the barrel for unknown MDs who will slap their “reviewed by” on the article.)

3. Prescription Adderall Works Well Sometimes

Again: 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.  What does that mean, in practical terms? It means that if you’re just starting treatment, let’s consider it common sense to begin with a less risky choice.  In other words, trying Adderall only after other stimulants (Ritalin, Focalin, Concerta, Vyvanse, etc.) have not proven effective.

Ideally, a trial should be given of both the amphetamine and methylphenidate classes, as I explain in my book (Is It You, Me, or Adult A.D.D.?). There is no way to predict beforehand how you will respond to either class of stimulant. It comes down to genetics

Despite all that, many physicians routinely start new patients with Adderall—and at too high a dose. 

Adderall

 

Contributing Problems: A Larger View

The issues around prescription Adderall remain only one piece of a problematic puzzle:

A. 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 Psychiatric Association.  Obviously, he failed to find ADHD treatment interesting and therefore not worth his study. 

(I saw him later at a presentation on Borderline Personality Disorder. Hundreds of psychiatrists, sitting on the edge of their seats, listening to dramatic stories.  But not one presentation on adult ADHD, which has historically been misperceived as BPD.)

In fact, ADHD is a highly complex condition, especially when it is diagnosed later in life. Other conditions can complicate medication response. These include sleep and substance-use disorders. It also includes psychiatric conditions that are more highly associated with untreated ADHD in adults. (That is, living for years with untreated ADHD can increase incidence of depression, anxiety, and bipolar disorder.)

B. 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. That’s based on advice from the preeminent experts I respect most. Yet still, that seems the status quo.  The trouble with this?  

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

In response to the side effects, they might give up on that medication entirely. Yet, if might be that a lower dose would work just fine. 

—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.

C. Insurance reimburses 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, too, for understanding basic protocols.

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 healthcare countries.

That includes the United Kingdom and Australia.

UK residents wait years even for an ADHD evaluation—well before COVID.

In Australia, at least until very recently, adults cannot diagnosed if they were not already diagnosed in childhood.  Very handy, as pediatric ADHD was largely ignored except in the most extreme cases. Only recently was Vyvanse approved for us within the healthcare system, with the mainstay being dexedrine. Last I heard, Concerta was available for $100-150/month. )

D. ADHD impatience —want to “feel” it than objectively measure it

Let’s be frank: Some people with ADHD love Adderall because it feels like a booster rocket attached to their back.

The hard truth is, however,  is this: 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—or causing problems. But the people around you will!

Moreover, relying on that visceral feeling almost guarantees a bad end. Maybe not today. Maybe not tomorrow. But soon. What if you’re so strung out you don’t even realize it?

Over-relying on a “booster rocket” to propel you through your day means you’re using Adderall as a performance drug, not ADHD treatment. Medication should help create more balance and self-regulation but higher-functioning also requires learning new skills and habits.

Often, patients (or their parents or partners) believe my cautions only after the fact. After all, I’m not a doctor. In other words, they write to me after the typical crash. That comes about two months into Adderall usage, in my observation.

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 unique mechanism of action, their very supply of neurotransmitters might be depleted.

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

Now we turn back to the NYT story for a moment. The story that finally prompted me to write this post, after years of warning about it in my groups and public talks.

Did Richard Fee, the young man featured in the piece, truly not have ADHD, as his parents claim? Was he simply abusing Adderall as a “performance drug.” Perhaps, but the report shows no evidence of that. It seemed the weakest point of the story.

Reporter Alan Schwarz repeatedly made it clear that he lacks understanding of ADHD’s complexity. He gives lip service to ADHD as a legitimate condition—and then proceeds to rip it apart.  Schwarz started as a sports reporter and, using his love of statistics, reported on concussions from sports. His editors apparently found that qualified as being knowledgeable in neuroscience — and sic’d him on ADHD. 

As a former newspaper editor, I have seen the pattern: “Hot Dog” reporters who will do anything to land on the front page.  (Now, online, it’s the featured story, highlighted on the website and promoted through social media.)  

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  no longer are enough.

In other words, 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 came into play here?  Perhaps Richard felt that at least these doctors believed him. 

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

F. Prescribers Failing to Seek 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. 

This story is not new to me.  The partners of adults with ADHD try desperately to get through to the Adderall-prescribing physicians. They try explain that their partners are turning into rageaholics. (The ADHD adults themselves seldom 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 cannot request such feedback—nor cannot accept it.

Did Fee have a condition such as bipolar disorder (either instead of ADHD or co-existing to it)? That is, did he have a particular vulnerability to Adderall abuse or addiction? Or, was that particular vulnerability ADHD? Perhaps he was mis-using Adderall to minimize sleep so he could study more and achieve. Thus, he compounded AHDD with sleep deprivation and amphetamine addiction?

We’ll never know. But I suspect that there were red flags throughout his childhood and young adulthood. And the same will be true of many others.

Rest in peace, Richard.

gina pera adult adhd course

5. 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 know:  The last thing I want to do is scare you away from seeking treatment that can vastly elevate your life. Just the opposite! You deserve that.

Rather, I am emphasizing: 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. Don’t be passive, thinking that any licensed professional knows what’s what. No one cares more about your or your loved one’s life than you do.

Identifying ADHD symptoms and medically addressing them is not, for the most part, rocket science. It’s not even brain science. It’s step-by-step logic and observation.  I teach this in Course 2 of my online training, on medication and sleep: Solving Your Adult ADHD Puzzle: Physical Strategies

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.” 

Then It All Changed

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. That included poor follow-through on promises. He 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, 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.

How Do We Navigate This?

Sure, we want to place our faith in our physicians. Yet, one troubling fact remains. Many physicians, including psychiatrists, are poorly trained to treat Adult ADHD. Some know that and respect their limitations. Some don’t.

It’s important that yo know this going in.   Smart ADHD healthcare consumers can  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.”

Please know that, prescribing for ADHD 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.

How These Chapters Can Help

The book’s three chapters on medication will support you and/or your partner in creating your own success story by helping you to:

  • Avoid common pitfalls that lead to low treatment adherence.
  • Understand that goal setting forms the foundation of successful medication treatment.
  • Remember that each person has a unique biochemistry — no cookie cutters!
  • Recognize that finding the best medication regiment requires a methodical process.
  • Know that ADHD commonly coexists with other conditions, which must be considered in any treatment plan.

If you are familiar with this guidelines, you can better recognize competent care when you encounter it. And when you don’t encounter it?  You can either keep moving or, if your choices are few, diplomatically help it along.

For more posts related to ADHD medications:

Visit ADHD Roller Coasters Medications category of posts

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

 

For more information  My NEW Course on ADHD Medications and Sleep:  Solving Your Adult ADHD Puzzle — Physical Strategies

 

 

—I welcome your comments.
Gina Pera

The first version of this post appeared in 2013.

 

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

  1. Dear Author,
    I am struggling in my marriage and believe Adderall is to blame for many issues, but not all.

    When my husband does not take his Adderall, he is and can be a sweetheart. Once he takes his “speed” as he nicknames it, he often gets irritable, loud, aggressive, suspicious, and even manic.

    We have only been married less than a year, and due to synergism, when we have tried to go out on a day that he may have take Adderall, he often ends up drinking copious amounts and then making very bad a destructive decisions that result in infidelity.

    This morning, he has been up almost all night. We had an argument last night because he thought I was being distant and was being quite short and snappy with me. I become defensive trying to convince him otherwise and being met by what I perceive as coldness. If he lashes out, I then get upset that I am being treated poorly and ask if he has taken his Adderall which he often claims he has not, when he actually has.

    Sadly, for me, I feel I am often the target/ focus of his intense negative energy, while others often get treated very well and lovingly. In his intense focus, he will frequently decide to monitor me and make claims that I am cheating or not at work, when I am at work. Trying to convince him is futile.

    He will see an erroneous GPS plot on our phone or device and fixate. There is also fixation on my timelines; if I am perceived to have missed a “deadline” to come home or change plans like going to get my car washed, I get very negative responses and incessant phone calls, if I set a boundary when I am being baselessly accused of being “distant,” “suspicious,” “acting abnormal,” and “questionable.”

    I feel like this drug puts me under an unwanted and unfair microscope and I am constantly squirming like an ant being burned by the magnified sunlight.

    I try to not get defensive, but this drug seems to have exacerbated his negative traits, and put our marriage and relationship into a tumultuous state. He isn’t honest with his psychiatrist about his behavior and often pegs me as being the aggressor/ disruptive one in the relationship.

    I am definitely not perfect, but I know I am pretty even just this rollercoaster ride has thrown me for a massive loop and brought out the worst in me. I crave the good days and ones where he is relatively sober and not on Adderall and then using alcohol or drugs to come down.

    1. Hi Madame,

      Unfortunately, I’ve seen this pattern too many times.

      In addition to the anger and irritability, Adderall for some people with ADHD can create “tunnel vision.” That’s what your describing him having you “under a microscope” sounds like.

      What are you doing to do? You’re only one year into a marriage. Things typically don’t get better from this type of situation.

      You can let the psychiatrist know what’s happening (privacy laws do not preclude that, just the MD not responding). But any MD reckless enough to prescribe Adderall without using rating scales or getting third-party reports (such as from spouse) will probably refuse to consider your perspective. It’s risky.

      g

  2. Sleepy sleeperson

    My doctor had me on a very high dose of Adderall for 6 plus years. 180mg daily. I had a genetic test done she said I was ultra rapid metabolizer.

    My tolerance became so high that I needed 4 30mg adderall just to began my day. I believe my dose never should have been above 90 mg. I felt it was sufficient at that time and when it got raised ya at first I felt like I was super mom. Now I’m 40. I had difficulty filling the script every month. Pharmacists questioned the dose. I decided after my mom died suddenly that I didn’t want to do this forever. My doctor was old. I knew my dose was unlikely to be prescribed by anyone else and I needed to ween off. My doctor didn’t agree so I changed doctors.

    Anyways it’s been 6 months without adderall and I feel no motivation still. I gained 20 pounds within 3 weeks of quitting adderall which put me at a 28 bmi. I feel no joy. Taking a shower is dreadful. I stair at the wall and typing this is the most productive thing I’ll do this week. I don’t know If I’ve made the right choice.

    No article gives me hope. I’ve depleted my dopamine my receptors etc.. everything says if u took it as prescribed u should recover within a few months. I took it as prescribed and honestly the last year I usually never took the full dose. I can’t find anything regarding research on anyone who has overcome longterm high dose use. I can’t fins anyone who has been prescribed 180 mg daily. Also I forgot to add that I asked to be switched to vyvanse.

    Instead of switching me to vyvanse she just added vyvanse. So I was prescribed 180 mg of Adderall and 60mg of vyvanse daily. I wish I could have a brain scan to see if anything is happening if there is any point to keep staring at this wall or if I should just start taking a lower dose again just to feel something and contribute to my family.

    1. Dear Sleepy,

      Outrageous. I’m so sorry this happened to you.

      Thanks for writing this comment. Because ADHD specialists routinely think I am exaggerating. “All medications have side effects,” some say, patronizingly. Yes, they often “gaslight” me.

      I don’t care for my sake. I know what I know. But I do care for the public’s sake.

      1.
      You say you were taking 180mg daily — and, toward the end, took a “topper” of Vyvanse.

      I’m really glad you didn’t have a stroke or some permanently crippling side effect.

      2.
      You have gone from taking that much Adderall over six years to taking nothing for the past six months.

      Of course you will feel no motivation, joy, etc.. You’ve gained weight, etc.

      There will be a period of active recovery — optimizing diet, sleep, overall health, etc.

      3.
      I assume that you legitimately needed the Rx in the first place. In other words, you had significant ADHD symptoms, and Adderall helped to some degree.

      There is no reason to think that, over those six years, your ADHD symptoms went away. They are probably still there.

      4.
      At this point, you cannot know what is a long-term effect of high-dose Amphetamine and what is untreated ADHD?

      I encourage you try again — this time learning more about proper prescribing for ADHD so you can better self-advocate.

      I cover ADHD-related sleep and medication issues in Course 2 of my online training:

      https://ginapera.adhdsuccesstraining.com/course-2-physical-strategies

      5.
      If you were never tried on a methylphenidate-class stimulant (e.g. Ritalin, Concerta, etc.), it might be worth a try.

      Genetically speaking, some people with ADHD respond better to one than the other.

      Perhaps Adderall simply was a poor choice for you — resulting in such high dosages. But anything’s possible.

      I hope this helps. Good luck!
      Gina

  3. Gina,

    I just wanted to thank you again. I posted a comment on 12/19/21 about my husband’s unwillingness to see how negatively adderall was affecting him. It completely transformed him into someone none of our family and friends recognized anymore. He was always a goofy, kind-hearted person and adderall made him into a walking ego. He was at best insufferable and at worst scary to be around for two agonizing years.

    Things finally changed when I told him I honestly just didn’t like the person he had become and didn’t want to share my life with him anymore. He just… completely unraveled.

    He said he’s noticed things for a while and he’s been lying to himself as much as me. He hasn’t taken adderall since and the craziest part is it was just like flipping a switch. He went right back to the same funny, lovable person he always was… I kept waiting for the shoe to drop. For him to crash or… idk, something. But it’s been weeks and he’s just… happy. He’s back to being a parent and husband and son again.

    He brings up a lot how sorry he is for what he put us all through and that he’s grateful I finally just told him I was done because it saved him from ruining his life and losing everyone he cares about.

    But I think it’s important to stress that I didn’t make anything about adderall when I told him I was done with our marriage.

    When I would bring it up in the past (“can we just see if things improve with our relationship by not taking it for a short period?” Etc) he would get irate. Once he grabbed his rx bottle in a rage and pointedly threw it in the trash but I got it out and put it back on his desk. Because I knew if he only stopped taking it, “for me,” then he might not come to the realization on his own that it was affecting him so terribly (and resent me for it, only making things worse).

    I just wanted to share that part because it could help someone in the same situation and because he brought it up, specifically. He said it was one of the moments that forced him to realize he was being irrational (even though he wasn’t ready to admit it, yet).

    I had quit taking adderall a couple months before he did (in an attempt to encourage him to try, also) so now neither of us are taking anything. It’s a little frustrating because I think it probably is the right adhd med for me, but I’m happier without it in the house of it means I have my best friend back.

    1. Dear Jane,

      Thank you SO MUCH for taking the time to share your story with ADHD Roller Coaster readers. It’s critically important to have these first-person stories.

      And, to see how skillfully you negotiated this. That is, by not “making it about the Adderall.” By making a clear and definitive statement about what YOU were going to do — leave the marriage. That seems to have given him the “mental space” to realize that your previous concerns were no joke. Nothing that would pass.

      It’s VERY easy to get distracted by fighting about these things. “It’s the Adderall” and “No, it’s not.” Thereby completing ignoring the core issue.

      I hope that once things settle, you will again find a medication that works for you (maybe Adderall, or maybe Vyvanse, if you haven’t tried it). And something that works well for your husband.

      Do you know about my new course? It’s on medication and sleep. This is THE course I wish I could have given to everyone who has written desperate e-mails to me over the years, every support-group member.

      I have HAD IT with MDs bungling ADHD medication — not even aware that they are wrecking lives.

      I’d love for MDs to take this course (there are others, by MDs, but honestly, I don’t find them detailed enough or “real world” enough). But meanwhile, consumers will know more than 80% of prescribers and sleep specialists by taking this course.

      It launched yesterday and the sale continues through midnight Labor Day (in U.S., September 5):

      https://ginapera.adhdsuccesstraining.com/course-2-physical-strategies?coupon=LABORDAY75

      Thanks again and good luck!

      Gina

    2. Dear Jane/Gina,

      Jane – I take comfort in your story. I am living a nightmare with my husband who was casually prescribed Adderrall for “concentration” several months ago. To say that he is a changed person is a total understatement. He was so caring, thoughtful, helpful, kind – a wonderful human all-around. We have been married for almost 12 years and have three young children and a beautiful life. Despite that, he is decimating our marriage and family with his apathy, hostility, contempt, and misery. He has distorted our past – making it this narrative of how I have never supported him, loved him or been happy. None of which is true. All the while, he is laser focused on work and fully immersed in other bad habits – including desires for other women. I am at a loss and simply devastated here. Despite visiting our doctor a couple of weeks ago to request no more prescriptions, he just got another one filled, and I am crushed because I know this saga will continue. (Meanwhile, my doctor had reassured me that he would not give him another one without recommending testing. He called me to say “sorry, his request feel through the cracks.”.)

      My had feels forced to end our marriage because the living situation is is untenable. The constant criticism and avoidance is too much to bear. I have asked him to stop taking the drug but he laughs that off and only points to my flaws and defects. It is truly sad that this drug can transform someone like this – and, sabotage the most sacred relationships around you.

      Sara

    3. Sara,

      Not another one….how awful for you.

      And yet, still, when I try to alert ADHD professionals in positions of influence, they pretty much “gaslight” me.

      Some of them, anyway. The smart ones know that I speak the truth.

      My public posts about this in LinkedIn recently drew a condescending comment from a pediatrician who specializes in ADHD — “just ask for another medication.”

      So clueless. Of course she didn’t know who I am or my work. Just thought she’d do some MD’splaining.

      They don’t get it. They don’t get how once a person gets hooked like this (not necessarily the addiction kind of hooked but hooked to that feeling of super focus).

      If you feel you have a marriage to save, you might want to try a little harder.

      We all swim uphill with this one.

      Absolutely failure among leading clinicians and those who formulate guidelines to warn about Adderall.

      Absolute failure of his prescriber failing to include you in the discussions and offer feedback.

      Absolute failure of the online hustlers and snake-oil charlatans that no doubt are feeding the distortions….”see, you could have felt this great all alone. Your ‘neurotypical’ wife was holding you back.”

      It’s just horrible.

      take care
      g

  4. Dear Gina,
    Thank you for this and other posts that have provided info on my ADHD that I can’t find anywhere else.

    For several years, I was on Vyvanse and Zoloft. Things were not perfect, but better than they are now. I had to stop taking the Zoloft because of stomach bleeding. After that the Vyvanse began making me very angry, even at a lower dose.

    I tried Adderall, same problem, though not quite as bad. Concerta was all but useless and the end of the day crash was terrible. My doctor just shrugged her shoulders and basically said I am out of options.

    Is that really all I can do as far as stimulants? I know there are more drugs under different names, but my impression is that there are only 3 main stimulant drugs. I haven’t tried non-stimulents yet, but I am wary because Strattera made my daughter deeply depressed. It’s been about 6 months and I’m not really functioning, especially as mom to my kids. Are there any other options for me?

    1. Dear Natalie,

      How frustrating, to say the least. I’m frustrated just reading of your ordeal. In fact, I would like to give that “doctor” a piece of my tiny mind! 🙂

      Seriously, you’re “out of options”. No. Just NO.

      If only more prescribers read my first book’s chapters on medication…..they would know so much more than they do!

      As it is, there is typically no method. Just throwing a stimulant at someone. Like a game of Pin the Tail on the Donkey.

      You deserve better and so do your children.

      re: Concerta. Are you sure it was brand? Here is my ongoing coverage of the Concerta generic debacle:

      https://adhdrollercoaster.org/adhd-medications/authorized-generic-concerta-update/

      Also, there are other factors that most prescribers don’t even know to ask about, such as how much sleep are you getting, what about any hormonal factors (peri-menopause or menopause…..or even estrogen dips each month…can affect ADHD symptoms.

      So can caffeine, nicotine, diet, etc..

      If your daughter didn’t do well on Strattera, maybe you won’t, either. But your genetics are not the same. So who knows. Strattera doesn’t work as well as the stimulants for most people. Maybe 25% of people with ADHD, by some estimates.

      Stay tuned on my blog. I’m about to release Course 2, on Physical Strategies. This is an in-depth but highly digestible course on medication and sleep. It’s been an exhausting task but somebody needed to do something. 🙂

      Hang in there. In all likelihood, there are workable options for you. It just will take some informed sleuthing.

      take care,
      Gina

  5. When I need to take a break from work and wonder what else I should know about my new ADD diagnosis at 43 as an American living in Germany I come to your page. I was lucky to convince my Psychiatrist to consider my ADD (ADHS in Germany) as a potential catalyst for my depression. Citalopram got me out of my funk and leveled enough to continue with the 43 years of learned masking and coping skills, but boy did it make my symptoms of ADD more profound! So, here we are today and I’m taking 10mg of Attentin work days with a weekend break. My psychiatrist had set me up with a collegue of his who specialized in ADHD but that guy spent 5 mins reviewing my file and then prescribed me mediknet saying the Attentin was only for “kinder”. The sad thing is the mediknet made me very very depressed and I stopped it immediately when I had suicidal thoughts.
    I’m back on the Attentin which is “ok”. I crash about 3 pm every day. Some caffine will get me alert enough to drive home after work but at 6pm I want to sleep!!!! The weekends are worse, I just want to sleep! Then Monday and Tuesday I’m in a fog, often very talkative at work, Wednesday through Friday I’m ok if I have a nap after work. As I said my Psychiatrist isn’t an expert on ADHD. He treats one other patient with it and he too was disappointed with the the collogue he sent me to. Would it be wise to ask for for another drug option?

    1. Hi Joe,

      I’ll make this quick as my COVID booster vaccine has hit me like a ton of bricks.

      Absolutely, you should be able to try whatever stimulant is available to you. Keep track. A log. There is no stimulant just for kinder.

      Do you have my first book? It details the basic procedure.

      You deserve to get what works best for you.

      Good luck,
      G

  6. Jennifer Kelly

    So happy to have found your site. Your insight is right on! My beloved baby brother just took his life. He had been on Adderall for quite some time. I would love to share his story soon so others can gain insight. Thank you for your work here. It helps more than I can say….

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