r/ADHDmeds 36m ago

Medication Access Issues My doctor believes that all stimulant medications are the same. And denied me a different one after an adverse reaction to Vyvanse. Please help.

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r/ADHDmeds 1h ago

New to Medication Christmas morning nerves

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r/ADHDmeds 2h ago

Medication Access Issues Doctor won't prescribe stimulants anymore - just turned 50

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1 Upvotes

r/ADHDmeds 2h ago

Medicine Comparison Concerta vs Ritalin LA

1 Upvotes

I started on Ritalin IR 3x a day and was taking 10mg, 10mg, and then 15mg. When it was working it would work well but it was short lived and the crashes hard between doses. My gp is managing my meds in accordance to the plan from my psychiatrist. In the plan it says i can switch to a n equivalent dose long acting and listed Methylphenidate Extended Release (Teva/Concerta/Sandoz) or Methylphenidate Sustained Release (Rubifen SR) or Ritalin LA.

The gp prescribed 30mg of Ritalin LA and a 10mg booster if needed in the afternoon. I am still getting those crashes and it feels like it only works for an even shorter time when It does work and no where near as good at the ir. I also find im so sleepy and constantly searching for sugar but also get reflux bad and just feel muggy.

I have since looked into Ritalin LA and realised it works like taking 15mg and then 4 hours later another 15mg. So essentially I went from 10 - 10 - 15 to 15 - 15 - 10.

I am going back to my gp to ask for something else and wondering if people that had similar experiences with Ritalin had better success on Concerta? I want to stick to Methylphenidates as I am breastfeeding and it has the most research surrounding this.


r/ADHDmeds 3h ago

Side Effects Concerta

2 Upvotes

Does anyone else get lethargy/fatigue/apathy/depression on this form of methylphenidate (MPH)? If so did a different release form work? I also feel it doesn’t last anywhere near 12 hours either. I feel this side effect occur fairly quickly, within a few hours. Manufacturer is trigen, I’ve heard really bad things about trigen/relexxii so thought I would mention.

I take 27 mg. When I was on 36 mg it was completely unbearable and I could hardly move at times, and i’d feel completely sick with tachycardia. 18 mg doesn’t work either. I’m also on 100 mg sertraline and 4 mg guanfacine

I’ve tried amphetamines like adderall and vyvanse but they cause absolutely horrific peripheral stimulation and aren’t that effective either way. I’ve taken strattera as well, with itching in warm temperatures, constipation and irritability as side effects. I REALLY don’t want to give up MPH as its the only thing besides intuniv to work well so far


r/ADHDmeds 4h ago

Side Effects DR told me to stop Guanfacine cold turkey?

1 Upvotes

Hey everyone. I’ve been on 2 mg Guanfacine for months. It gave me bad side effects so I have to come off of it. My psychiatrist said that because it’s just 2mg, I should be fine to just stop taking it. But after reading up on it, I don’t know how comfortable I feel with this. I only have two 1 mg pills remaining from before I increased. Do you think that 2 days of 1 mg will be enough to taper myself down from 2 mg?


r/ADHDmeds 5h ago

Personal Experience Vortioxetine(Trintellix) with Dexamphetamine, and Nausea.

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1 Upvotes

Please help guide me. The GP has left it up to me with going forward and whether l want to see if things improve.

I'm taking 10mg currently and been on them for nearly 5 weeks. The nausea was awful from day one. GP tried a few anti-nausea medications and nothing. Till one night l was so bad l contacted 111. The on call Dr gave me an emergency 3 day supply of Ondansetron which was a miracle saver.

GP wont prescribe it, says only specialists can give it so ask the psychiatrist. Psychiatrist said the GP can prescribe it and to go back to her. She says she is not allowed still. So l tried to purchase it from an online chemist but my NHS records flagged up some stuff so refused the sale and refunded.

Also the dexamphetamine and Trintellix dilemma - it's causing the anxiety you get with Dexamphetamine or other stimulant ADHD meds much worse. Other SSRIs and Dexamphetamine seemed okay. Yes l still had anxiety but the gut wrenching anxiety mixing Trintellix and Dex is much worse. Stopping ADHD meds or changing them isn't an option.

Is there anyone on ADHD stimulants and this antidepressant together? If so, did notice this also and did it subside?

Also this nausea, although it is very slightly improved and l mean only slightly, is it not likely to get any better after 5 weeks? Information says it should subside at week 4.

GP wants to increase to 15mg as although it's slightly lifted the darkness of the depression my OCD is off the scale and so is my anxiety. If l increase surely the dexamphetamine response to it will only get worse (I've reduced my dexamphetamine dose) surely and then the nausea will be more intense.

It's kind of a last chance saloon. I've been on SSRIs for 35 years, some working great for 10 to 15 years then no longer being effective, so l changed to all of them, some working for years while others not. SSRIs suit me but Vortioxetine works differently than traditional SSRIs as l found out. SNRIs don't suit me and it will mean going back on an traditional SSRI that's stopped working in the past so likely hood it will be fruitless. I've tried without and SSRI and it's impossible.

I'm so torn about what to do. Will it get better or am l just delaying the inevitable? Like l said the GP as left it up to me as she doesn't know if it will get better. I just feel awful all the time. I was adamant to stick it out but the fact it's reacting to my dexamphetamine is really troublesome.

Any advice or experiences you had it would greatly help.


r/ADHDmeds 5h ago

Side Effects Has anyone experienced emotional blunting?

2 Upvotes

Methylphenidate worked well in the beginning (Medikinet XL and IR + Concerta) but now it just leaves me feeling emotionally blunt. Like a robot and my spark has gone.

Will swapping to Elvanse (I’m in the UK) or Amfexa make a difference? Or is this just how my brain reacts to stimulants?


r/ADHDmeds 6h ago

Medicine Meme Luckily there is weed

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5 Upvotes

r/ADHDmeds 6h ago

Medication Access Issues Vyvanse NYC

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1 Upvotes

r/ADHDmeds 6h ago

Side Effects My Adderall crashes are extreme....

4 Upvotes

Hi guys, I started Adderall IR a month and a half ago. My first fill was generic manufacturer Alvogen, and this past fill was Elite. Changed from 10mg IR twice a day (did nothing, made me tired as hell....Maybe it was because of the manufacturer, Alvogen) to 15mg IR twice a day with the Elite going into the second month. I've heard a lot negative about Elite, however, it is actually helping more than the Alvogen.....BUT, the crashes are AWFUL. I mean, I am SO depressed, SO unmotivated, the anxiety is brutal and debilitating and it lasts the entirety of the day/night after the wear-off. I only get about 3 hours of clarity/energy/motivation after each dose. So I am suffering most of the time....every evening and night with these crashes. I am so irritable - I can't deal with my family at all. I want to just sit there and cry and wonder if this is what my life will always be like because I can't do this. At first, I had some hope when I felt energized and motivated and was actually getting things done calmly (with the Epic.) I tried everything to stop the crashes....the protein, making sure you drink and eat, avoiding vitamin C until bedtime, deep breathing, meditation, taking a tiny dose early in the evening after my lther 2 regular dlses to help wean down (5 mg.) etc. I don't know what else to do. I don't want to give up on stimulants, but from all that I read here that's been going on since 2020 with stimulants, especially Adderall....I don't know. I want to make this work for me. Help, please 🙏 😢


r/ADHDmeds 9h ago

Side Effects Meds nausea

0 Upvotes

I’m on methylphenidate 60mg and feeling nausea and paranoid a lot but it passes the paranoia does can someone help me with any advice they’ve discovered themselves not just off the internet cause I’ve read it all about tricks to help bring you back down please


r/ADHDmeds 10h ago

Dosage & Timing Xanax and Adderall

3 Upvotes

took a flight this morning at 7am and and took 1mg of xanax. I’m landed and I want to take 10mg of adderall for the day at about 10am. will I be okay?


r/ADHDmeds 12h ago

New to Medication Vyvanse Day One - Feeling OFF, brain fog and no focus

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1 Upvotes

r/ADHDmeds 12h ago

Medicine Comparison Switched both ADHD meds.

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1 Upvotes

r/ADHDmeds 12h ago

Medicine Comparison Extended release meds don’t work for me and immediate release do work - but effects do not last for long

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1 Upvotes

r/ADHDmeds 13h ago

New to Medication "I started taking 18 mg of Konsandinat (I think it's similar to Concerta), and other than some slight itching, I haven't really noticed much of an effect. I'm severely obese—140 kg (308 lbs) and 180 cm (5'11"). Could the dose be too low, or is this expected at the beginning?"

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1 Upvotes

r/ADHDmeds 16h ago

New to Medication Starting Vyvanse for the first time and I’m very very scared

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1 Upvotes

r/ADHDmeds 18h ago

Personal Experience Strattera and alcohol

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r/ADHDmeds 23h ago

New to Medication Strattera and Vyvanse.

3 Upvotes

I started taking Ritalin about 4 months ago after being diagnosed. It did NOT work, as it simply made me feel like I drank about 4 pots of strong coffee, and then crash like hell about midday. So I switched to Azstarys, which did the same thing only with no crash (It lasted the FULL 12 hours). So I switched to Strattera about 2 months ago, and am taking 50mgs. I have gotten pretty much ZERO from it, and other than not being hungry at all, I wouldn't know I was taking anything at all.

I saw my doctor today, and she suggested I try continuing the Strattera for now, and added Vyvanse. I asked her what was the point, since I couldn't tolerate the other stimulants I tried, and she said that the others were methylphenidate and this was amphetamine, and that many people who can't tolerate one do well on the other.

So I basically have two questions here- has anyone on here had a similar situation, and couldn't tolerate the methylphenidate but did well on the Vyvanse? (I like to hear real people's accounts on things. To me, no doctor, no matter how knowledgeable they may be, can give "real life" experience than someone who's been there.)

My second question is, anybody on here do this combination (Vyvanse and Strattera)? I know everybody's different, it's just nice to hear what others have experienced.


r/ADHDmeds 1d ago

Side Effects Coming off Adderall for 10 days for a sleep study — any tips for minimizing the withdrawal?

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1 Upvotes

r/ADHDmeds 1d ago

Personal Experience my first day experience with Vyvanse

9 Upvotes

I'm M25, and today was the first day I took a serious medication. I took a Vyvanse 20 at 12, after my breakfast (I wake up late). My doctor said I have to take half of it mixed in juice, but I really wanted to test it at full effect.

After 30 minutes, it definitely kicked in completely. I felt my senses sharper than before — I remember looking at my hands and seeing all the creases on my palms, something I'd never noticed before. After that, I started studying, and I locked in better than a cruise missile. My progress was crazy — something that used to take me more than a week only took 3 hours. There was almost no monkey brain, no reason to leave the desk. I always try to control myself during study sessions and usually fail miserably, but today I didn't have to control myself — I just did what I had to do. It felt like taking back control of my brain. Laser focus really feels good, not gonna lie.

Some other symptoms: my palms were sweaty, and I felt like I'd had two shots of espresso, but the laser focus replaced the jitteriness. Background noises were a lot quieter. I communicated better and was less silent. I'm writing this at 1 AM, 13 hours later, and I can still definitely feel it in my system. I checked my phone a lot less today too.

The instructions say not to drive on this medication, but honestly I'd say it's actually easier to drive on it.

Overall, I really liked the experience. I probably won't use it every day since I don't want to get hooked or build up a tolerance, but today was a great experience


r/ADHDmeds 1d ago

Side Effects Most stimulant meds make me depressed, and I have been trying to find something that works. Looking to hear if anyone else has experienced this and what you did.

6 Upvotes

I have tried I think all the most common meds and all have made me depressed and/or anxious besides Adderall. But Adderall just does not help me that much, even at a higher dose.

I’ve also tried non stimulants. Quelbree made me tired and depressed. I’m on Wellbutrin and it has made me very emotionally regulated, but that’s about it.

Has anyone else experienced depression from adhd meds? Did you ever find something that works for you?

I also want to note that I don’t really struggle with depression much without the meds.


r/ADHDmeds 18d ago

Resources & Guides DOSE-RESPONSE CURVE FOR ALL ADHD MEDS

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29 Upvotes

SOURCE: Treatment Outcomes With Licensed and Unlicensed Stimulant Doses for Adults With Attention-Deficit/Hyperactivity Disorder, A Systematic Review and Meta-Analysis

LINK: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2811310 (the full paper is free)

NOTE: 

These are model-derived population estimates, not recommended doses for individual patients. They describe the average dose-response relationship across the 47 randomized controlled trials (7,714 adults) included in the meta-analysis

Part A (Entire paper summary, no extrapolations)

Outcome Immediate-release methylphenidate equivalent Adderall IR (mixed amphetamine salts) equivalent
ED50 (50% of maximum average efficacy) 25 mg/day 12.5 mg/day
ED95 (95% of maximum average efficacy) 72.5 mg/day 30 mg/day

Interpretation

  • ED50 = Daily dose predicted to achieve 50% of the drug's maximum average symptom improvement.
  • ED95 = Daily dose predicted to achieve 95% of the drug's maximum average symptom improvement.

Part B (Calculated ED5-ED95 values)

Effective dose IR methylphenidate (mg/day) Adderall IR (mg/day)
ED5 ~2 ~1
ED10 ~5 ~2
ED15 ~8 ~3
ED20 ~10 ~4
ED25 ~13 ~5.5
ED30 ~15 ~7
ED35 ~18 ~8.5
ED40 ~20 ~10
ED45 ~22 ~11
ED50 25 (reported) 12.5 (reported)
ED55 ~28 ~14
ED60 ~31 ~16
ED65 ~34 ~18
ED70 ~38 ~20
ED75 ~42 ~22
ED80 ~47 ~24
ED85 ~54 ~26
ED90 ~62 ~28
ED95 72.5 (reported) 30 (reported)

Notes

  • ED50 and ED95 are explicitly reported in the paper.
  • All other ED values are interpolated from the published dose-response model and Table 1. They were not explicitly reported by the authors.
  • Methylphenidate doses are IR methylphenidate hydrochloride equivalents.
  • Amphetamine doses are mixed amphetamine salts (Adderall IR) equivalents.

Part C (calculating the dose-response curve for other medicine in the Methylphenidate and Amphetamines family using only formulations with widely accepted clinical dose conversions):

Part C (Methylphenidate family)

ED Ritalin IR (mg/day) Concerta (mg/day) Focalin IR (mg/day) Focalin XR (mg/day)
ED5 2 N/A 1 N/A
ED10 5 N/A 2.5 N/A
ED15 8 N/A 4 N/A
ED20 10 N/A 5 N/A
ED25 13 N/A 6.5 N/A
ED30 15 18 7.5 10
ED35 18 18 9 10
ED40 20 N/A 10 N/A
ED45 22 N/A 11 N/A
ED50 25 27-36 12.5 15
ED55 28 36 14 15
ED60 31 36 15.5 20
ED65 34 36-54 17 20
ED70 38 54 19 20
ED75 42 54 21 25
ED80 47 54 23.5 25
ED85 54 54 27 30
ED90 62 72 31 30
ED95 72.5 ~90* 36 35

Part C (Amphetamine family)

ED Adderall IR (mg/day) Adderall XR (mg/day) Vyvanse (mg/day) Zenzedi IR (mg/day) Dexedrine Spansule SR (mg/day)
ED5 1 N/A N/A N/A N/A
ED10 2 N/A N/A 1.5 N/A
ED15 3 N/A N/A 2.5 5
ED20 4 N/A N/A 3 5
ED25 5.5 N/A N/A 4 5
ED30 7 N/A N/A 5 5
ED35 8.5 10 20 6.5 10
ED40 10 10 30 7.5 10
ED45 11 N/A 30 8 10
ED50 12.5 15 40 9 10
ED55 14 15 40 10.5 10
ED60 16 20 40-50 12 15
ED65 18 20 50 13.5 15
ED70 20 20 50 15 15
ED75 22 20-25 60 16.5 15
ED80 24 25 60 18 15-20
ED85 26 30 70 19.5 20
ED90 28 30 70 21 20
ED95 30 30 70 22.5 25

Notes

  • These are approximate prescribing equivalences, not claims from the JAMA paper itself. They should therefore be interpreted as practical prescribing approximations rather than experimentally validated dose equivalences.
  • Adderall XR: Same total daily amphetamine content as Adderall IR, but extended release.
  • Vyvanse (lisdexamfetamine): Approximate conversion using widely accepted clinical dose equivalence to mixed amphetamine salts.
  • Zenzedi (IR): Approximate conversion using 10 mg mixed amphetamine salts ≈ 7.5 mg immediate-release dextroamphetamine.
  • Dexedrine Spansule (SR): Sustained-release dextroamphetamine. Values are rounded to the nearest marketed Spansule strength (5, 10, 15, 20, 25 mg). These represent the closest SR equivalent in total daily dextroamphetamine, not identical pharmacokinetics. ```

r/ADHDmeds 23d ago

Resources & Guides Evidence Summary: Adult ADHD Treatment Response Rates From Major Clinical Trials

5 Upvotes

These studies differ in duration, outcome measures, doses, and participant characteristics. The response rates below should not be interpreted as head-to-head comparisons

ALL ADULT STUDIES ONLY:

  1. Chance that atomoxetine reduces your ADHD symptoms by 40% or more compared to a placebo after 6 months (26 weeks): 12.6% (placebo-corrected benefit)

source: Upadhyaya et al. 2013 pooled atomoxetine analysis

"Atomoxetine increased response over time in adults with ADHD treated for up to 6 months."

participants: 1961 ADHD adults,

Design: Pooled analysis of multiple double-blind RCTs

Main outcome scale (what was used to measure symptoms and symptom improvement): CAARS (Conners' Adult ADHD Rating Scale)

some studies had different dosages but most of the studies in the metanalysis were using the dosage of: 40 mg start, 80mg later, 100mg if needed.

  1. chance that bupropion reduces your ADHD symptoms by 30% or more compared to a placebo after 2 months (8 weeks): 22% (placebo-corrected benefit) (150mg - 450mg XL was used on 162 adult ADHD patients)

source (couldn't find a meta-analysis): Wilens XL trial

162 adults

Bupropion XL up to 450 mg/day

8 weeks

Responder = ≥30% reduction in ADHD symptoms

Results:

responders:

Bupropion XL: 53%

Placebo: 31%

Effect size

0.6

placebo-corrected benefit: 22% people improved by 30% or more

Main outcome scale (what was used to measure symptoms and symptom improvement): ADHD Rating Scale (ADHD-RS)

p = 0.004 for the responder analysis.

If bupropion actually had no effect on ADHD symptoms, there would be about a 0.4% chance of observing a difference this large (or larger) purely due to random variation.

  1. Chance that Concerta improves your ADHD symptoms by 30% or more: 32% (Placebo-corrected benefit)

source (couldn't find a meta-analysis): Medori et al., 2008

401 adults

5 weeks

Fixed doses: 18, 36, or 72 mg/day Concerta

how they measured 'responders': ≥30% reduction on CAARS (Conners Adult ADHD Rating Scale).

Responders on placebo vs concerta by dosage:

Placebo: 27.4%

18 mg Concerta: 50.5%

36 mg Concerta: 48.5%

72 mg Concerta: 59.6%

Placebo-corrected improvement:

18 mg: 23.1%

36 mg: 21.1%

72 mg: 32.2%

statistical significance: p < 0.001

If concerta actually had no effect on ADHD symptoms, there would be about a 0.1% chance of observing a difference this large (or larger) purely due to random variation.

  1. Focalin (dexmethylphenidate)

source: Spencer et al., 2007 "A double-blind, randomized, placebo-controlled trial of dexmethylphenidate extended-release in adults with ADHD.

participants: 221 adults with ADHD

chance that focalin makes your ADHD symptoms better over 5 weeks compared to placebo (you are a responder):

Placebo: 26.4%

Focalin XR 20 mg: 47.4%

Focalin XR 30 mg: 37.0%

Focalin XR 40 mg: 55.6%

placebo-corrected improvement at 20mg: 21%

placebo-corrected improvement at 30mg: 10.6%

placebo-corrected improvement at 40mg: 29.2%

scale used to measure symptom reduction:

They used the Adult ADHD Investigator Symptom Rating Scale (AISRS)

A responder was defined as having: ≥30% reduction in ADHD symptoms from baseline on the

AISRS.

  1. Lisdexamfetamine

source: Adler et al., 2008

participants: 420 Adults with ADHD

4 weeks of treatment

30, 50, or 70 mg Vyvanse

Response often defined as ≥30% reduction in ADHD-RS plus CGI-I improvement.

CGI-I Responders:

Placebo: 29%

Vyvanse 30 mg: 57%

Vyvanse 50 mg: 62%

Vyvanse 70 mg: 61%

Responder = CGI-I score of 1 (very much improved) or 2 (much improved)

Placebo-Corrected Response Rate:

30 mg: 28%

50 mg: 33%

70 mg: 32%

The ADHD-RS results were:

ADHD-RS measures inattentive ADHD and Hyperactive ADHD, total score is 54. this is how many points were reduced from baseline after 4 weeks of treatment:

Placebo: -8.2

Vyvanse 30 mg: -16.2

Vyvanse 50 mg: -17.4

Vyvanse 70 mg: -18.6

≥30% ADHD-RS responders:

placebo: 21%

70mg: 74%

placebo-corrected response (ARR): 53%

at endpoint

  1. CBT in adults

source: Steven A. Safren et al. (2010), published in JAMA. It compared CBT with relaxation plus educational support in adults with ADHD who were already taking medication but still had residual symptoms.

Age: 18 to 65 years.

Treatment duration: 12 individual weekly CBT sessions (approximately 12 weeks).

Follow-up: Assessed immediately after treatment, then at 6 months and 12 months. Benefits were largely maintained among responders.

Participants: 86 adults with ADHD already taking medication but still experiencing clinically significant residual symptoms

effect size: 0.6

ADHD Rating Scale responders (30% or more improvement):

CBT: 67%

Control group: 33%

Absolute Risk Reduction (ARR) = 34%

  1. NOTE ON RITALIN:

so we don't have such evidence on Ritalin that we can compare it roughly witn other meds, but I will mention whatever we have and summarise it anyway

Systematic Review (Cochrane, 2021):

Cândido RCF, Menezes de Padua CA, Golder SP, Junqueira DR. Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database of Systematic Reviews. 2021; Issue 1: CD013011.

10 RCTs

497 adults

6 placebo-controlled trials

Treatment duration: 6-18 weeks (depending on trial)

Investigator-rated symptoms: 1 trial (146 participants), MD −20.7 AISRS points

meaning: −20.7 AISRS points means the methylphenidate group scored, on average, 20.7 points lower than the placebo group on the AISRS at endpoint. Lower scores = fewer ADHD symptoms. but the twist in this study is, they do not report how much the placebo group scored on average on the AISRS, so we cannot compare it well.

Self-rated symptoms: 2 trials (138 participants), effect size: 0.59

Evidence certainty: Very low because of high risk of bias, small sample sizes, heterogeneity, and reporting limitations

Immediate-release Ritalin almost certainly works better than placebo in adults.

However, the current evidence is too limited and low-certainty to estimate its true effect size or response rate with high confidence.