Brain changes observed in longterm Chronic Stimulant treatment in ADHD.

[KurtAurelius]

Apologies for being lazy, this is the only study that was coming up to this “phenomenon” I’d come across before.

The Pharmacology of Amphetamine and Methylphenidate: Relevance to the Neurobiology of Attention-Deficit/Hyperactivity Disorder and Other Psychiatric Comorbidities - PMC

Psychostimulants, including amphetamines and methylphenidate, are first-line pharmacotherapies for individuals with attention-deficit/hyperactivity disorder (ADHD). This review aims to educate physicians regarding differences in pharmacology and ...

pmc.ncbi.nlm.nih.gov

But this “information” has presented itself through various sources I’ve personally come across, Wikipedia, YouTube and Instagram.

(Impulsive defecit regions of brain more the size etc of a “typical” brain)

Before using Stimulant medication daily,
I was convinced these possible brain changes were a form of a lobotomy, the world doing so that my “disruptive mind” could be calmed to keep racking in taxes.

I’m happy to report that I’m still my paranoid and cynical self in regards to govermant and capitalism after a few months using daily, but with many remarkable and lasting changes.

(Appetite, sleep, restlessness, concentration and emotional impulsivity)

Alas, I signed myself to rolling the dice on chronic dosing of Stimulants, but so far I’ve seen benefit in a few months now without it dropping of due to tolerance per say.

I find consistency in effects, leading to my speculation the dopamine release etc isn’t the entire story here (rather a maintenance and then new homeostasis kind of effect)

Yes the treatment is crazy at first but not realistic, how I felt on 54mg Methylphenidate for the first time is not indicative of a more usual experience, and I’d now think of it as a induction period.

I’m at 77mg now total, but either will stay, go down to 72mg or even 59mg as I’m not sure the benefit past that sort of range versus Side Effects, blood pressure things etc.

I’m not sure pushing more is worth it when there’s may be a maintenance effect for myself and trying to foolishly push for that inappropriate total silence and muteness when dosed with Stimulants without adequate tolerance.

This is perfect, and I still have to use a bit of challenge and have a dashing of that chaotic ADHD that makes me well me.. but not so much I can’t bear living.

I would not have hopes of this FOREVER, but 6 months is good going I’d like to think and any longer is still a gain.

love to hear any thoughts to my silly rambles..

 

[Allylbenzene]

Alas, I signed myself to rolling the dice on chronic dosing of Stimulants, but so far I’ve seen benefit in a few months now without it dropping of due to tolerance per say.

It might be worth exploring agmatine. It's endogenously produced and is commonly used as a supplement for various purposes. The most relevant one here is mitigation of tolerance build-up which effectively makes chronic drug use more sustainable. It's also been reported to reduce the necessary dosage for drugs, especially for amphetamine-type stimulants. This includes methylphenidate.

Doses range from 200mg to 2.6g.

Whilst drugs like amphetamine and methylphenidate work to increase dopamine and noradrenaline, a complementary approach is to reduce things which are actively lowering the natural production of dopamine. Agmatine is one of many such things.

 

[KurtAurelius]

It might be worth exploring agmatine. It's endogenously produced and is commonly used as a supplement for various purposes. The most relevant one here is mitigation of tolerance build-up which effectively makes chronic drug use more sustainable. It's also been reported to reduce the necessary dosage for drugs, especially for amphetamine-type stimulants. This includes methylphenidate.

Doses range from 200mg to 2.6g.

Whilst drugs like amphetamine and methylphenidate work to increase dopamine and noradrenaline, a complementary approach is to reduce things which are actively lowering the natural production of dopamine. Agmatine is one of many such things.

Your one of the people who got me onto it (not literally of course, read some posts and conducted my own research) ahaha,

I’ve been taking it for a few weeks, absolutely mental utility, I’m so shocked as I thought it was a “too good” to be true kinda deal but it’s the real deal.

I take 3gs most nights, if I have a night off I don’t stress due to the high dose, and its effects definitely last anyhow.

I’ll chuck in 400mg theanine and 3200mgs taurine 3/4 times a week too as well as 1/2x a week Gylnac, experimenting with dose, 600-1800mg but finding 900mg atm more appropriate

 

[Allylbenzene]

I’ve been taking it for a few weeks, absolutely mental utility, I’m so shocked as I thought it was a “too good” to be true kinda deal but it’s the real deal.

I take 3gs most nights, if I have a night off I don’t stress due to the high dose, and its effects definitely last anyhow.

Nice, I'm glad its helping! It's been compared to fast-acting antidepressants like ketamine but this might give unrealistic expectations.
Still it's got great theraputic potential. It does share several identical properties with ketamine...

What's interesting is there's an ADHD drug called Guanfacine which shares the same property as Agmatine. Both drugs activate the alpha-2A receptor.
The end result of this involves a reduction in the effects of stress which partly explains why it's beneficial for ADHD.

I’ll chuck in 400mg theanine and 3200mgs taurine 3/4 times a week too as well as 1/2x a week Gylnac, experimenting with dose, 600-1800mg but finding 900mg atm more appropriate

Good choices.
Theanine stops the stress response which is a key cause of low dopamine and ADHD symptoms. Taurine boosts thyroid and the wider metabolic system.
Issues with the metabolic system are another key cause for ADHD symptoms.
Theoretically you could take theanine daily which would contribute towards improving ADHD symptoms.

Yes the treatment is crazy at first but not realistic, how I felt on 54mg Methylphenidate for the first time is not indicative of a more usual experience, and I’d now think of it as a induction period.

I’m at 77mg now total, but either will stay, go down to 72mg or even 59mg as I’m not sure the benefit past that sort of range versus Side Effects, blood pressure things etc.

Restoring full metabolic function would help a lot since that would increase your baseline levels of dopamine & noradrenaline. A sustainable long-term approach.
This is a viable alternative to relying solely on drugs which artificially boost those two neurotransmitters.

It seems appropriate to mention Rhodiola rosea. It's an adaptogen that encompasses the key qualities of methylphenidate, theanine and taurine. With a genuine Rhodiola extract you'd theoretically only need ~10-30mg of methylphenidate.

Rhodiola Rosea is a flat-out performance enhancer known for its ability to enhance both physical and mental endurance, reduce fatigue, and fight stress.
Rhodiola is also prized by athletes and anyone who wants to perform better under challenging conditions.
It helps the body adapt to stress -- enhancing resilience, energy, and both mental and physical endurance under pressure.

Modern research continues to support Rhodiola's role as an adaptogen, particularly in combating fatigue and stress. It has been shown to enhance cognitive function, reduce symptoms of anxiety and depression, and increase stamina during physical exertion.

Rhodiola appears to work by modulating the body’s stress response, balancing neurotransmitter levels like serotonin and dopamine, and increasing cellular energy production, which boosts overall vitality.

 

[TheLightBringer]

Apologies for being lazy, this is the only study that was coming up to this “phenomenon” I’d come across before.

The Pharmacology of Amphetamine and Methylphenidate: Relevance to the Neurobiology of Attention-Deficit/Hyperactivity Disorder and Other Psychiatric Comorbidities - PMC

Psychostimulants, including amphetamines and methylphenidate, are first-line pharmacotherapies for individuals with attention-deficit/hyperactivity disorder (ADHD). This review aims to educate physicians regarding differences in pharmacology and ...

pmc.ncbi.nlm.nih.gov

But this “information” has presented itself through various sources I’ve personally come across, Wikipedia, YouTube and Instagram.

(Impulsive defecit regions of brain more the size etc of a “typical” brain)

Before using Stimulant medication daily,
I was convinced these possible brain changes were a form of a lobotomy, the world doing so that my “disruptive mind” could be calmed to keep racking in taxes.

I’m happy to report that I’m still my paranoid and cynical self in regards to govermant and capitalism after a few months using daily, but with many remarkable and lasting changes.

(Appetite, sleep, restlessness, concentration and emotional impulsivity)

Alas, I signed myself to rolling the dice on chronic dosing of Stimulants, but so far I’ve seen benefit in a few months now without it dropping of due to tolerance per say.

I find consistency in effects, leading to my speculation the dopamine release etc isn’t the entire story here (rather a maintenance and then new homeostasis kind of effect)

Yes the treatment is crazy at first but not realistic, how I felt on 54mg Methylphenidate for the first time is not indicative of a more usual experience, and I’d now think of it as a induction period.

I’m at 77mg now total, but either will stay, go down to 72mg or even 59mg as I’m not sure the benefit past that sort of range versus Side Effects, blood pressure things etc.

I’m not sure pushing more is worth it when there’s may be a maintenance effect for myself and trying to foolishly push for that inappropriate total silence and muteness when dosed with Stimulants without adequate tolerance.

This is perfect, and I still have to use a bit of challenge and have a dashing of that chaotic ADHD that makes me well me.. but not so much I can’t bear living.

I would not have hopes of this FOREVER, but 6 months is good going I’d like to think and any longer is still a gain.

love to hear any thoughts to my silly rambles..

Do you feel like taking therapeutic dosages of stimulants have improved your baseline procastrination and focus even without the medications?

I remember seeing a Leo and Longevity video a while ago where he claimed that low therapeutic dosages will make your brain adapt overtime and behave more like a neurotypical brain (Im twisting his words a little bit to make the sentence easier to type out), however Im having a hard time believing it fully since any dosage of a stimulant should result in some degree of downregulation.

But could it be that the building of a ”habit” with the aid of a medication makes the individual behave differently long enough that they fundamentally change part of their character?? (Repeated behavior strengthening certain synaptic pathways and making the behaviors more ingrained)

Maybe I ought to make a different thread just for this…

 

[KurtAurelius]

Do you feel like taking therapeutic dosages of stimulants have improved your baseline procastrination and focus even without the medications?

I remember seeing a Leo and Longevity video a while ago where he claimed that low therapeutic dosages will make your brain adapt overtime and behave more like a neurotypical brain (Im twisting his words a little bit to make the sentence easier to type out), however Im having a hard time believing it fully since any dosage of a stimulant should result in some degree of downregulation.

But could it be that the building of a ”habit” with the aid of a medication makes the individual behave differently long enough that they fundamentally change part of their character?? (Repeated behavior strengthening certain synaptic pathways and making the behaviors more ingrained)

Maybe I ought to make a different thread just for this…

These are interesting points,

I notice on lower dose days I’ve retained some effect with a more natural feel, but not totally absistent for quite a bit, compared to taking off days at first.

I do believe it’s a artificial modulation at the end of the day, and with enough time, the brain would readjust to a “new” constant, due to the change without the constant input chemically, this still is its disadvantage and you have to weigh up the need to continually dosage for life.

It’s why I think best for me to rain check, and continually find other means to keep dose low, and rely on habit, input and endogenous methods for the monamines. I know it’s not cut and dry but I observe drastic mental and then physical changes. Life bad without nice brain chemicals, all other content attached to that is feigned intellucal attachment imo.

Therefore it’s not perhaps a crazy thing, rather an effect that comes from the intial cascade of monamines, then the brains receptor response still netting a postive overtime. Take away artifcal input and the brain will have to adjust. How far back to before or a new variant is a question I’d ask.

These are all speculations from somebody who reads merely to retain “facts” and not someone with a grasp on science rigidly under circumstances that can guarantee that grasp.

I do belive in what your saying overall- forming the habits is forming circuitry (postive) that could remain.

So it’s not hopeless without. I have to be careful but I’m using it to make it easier, but to consider the cost of not using any of my own skills or ptoential for the change. The drug should only be a means and this concept is the only way for the medication to work really due to tolerance.

 

[Allylbenzene]

This quote partly explains why pro-dopamine drugs (methylphenidate, amphetamine) and anti-adrenaline drugs (clonidine, guanfacine) are used to help with ADHD symptoms:

Systems That Counteract Adrenaline's Toxic Effects

"There are several systems that oppose the toxic effects of adrenalin. GABA, dopamine, and adenosine have multiple anti-adrenergic effects. In many situations, the parasympathetic system is protective against adrenalin. The protective steroids also act at many levels. Magnesium, retained in the cell largely under the influence of ATP and thyroid, is our basic calcium blocker, or calcium antagonist. GABA and dopamine inhibit the ACTH-glucocorticoid system, and shift the steroid balance toward the protective anti-glucocorticoids (anti-cortisol), progesterone, testosterone, pregnenolone, and DHEA."

Things like agmatine, taurine, theanine, niacinamide, CBD, CBG, pyroglutamic acid, Rhodiola and low-dose caffeine have similar effects.

 

[Vastness]

I'm personally very skeptical of the idea that chronic stimulant administration (at least, specifically those typically prescribed for ADHD - methylphenidate and amphetamine formulations) actually leads to any long term beneficial neurological changes of any kind. I've heard this before and it's a very tempting idea which of course everyone would love to be true, but I've just never seen any particularly compelling evidence. I couldn't find any suggestion that beneficial long term changes were in any way implied, suspected, or even investigated in the paper you linked - I'm not saying the evidence doesn't exist, there might well be some studies that hint at some kind of effect like this but just personally I only ever hear this idea alluded to very vaguely from third-hand sources...

It doesn't seem to make much sense intuitively - although of course, that's not a scientific perspective - given that there is plenty of fairly undisputed evidence for the negative neurological changes which can occur with chronic stimulant administration, and given their mechanism of action it seems like it would be particularly odd for these substances to have a more nootropic-esque U-shaped effect curve for the long term neurological element but not the actual acute effect profile which is comparatively linear.

Not that they might not have beneficial long term impacts in certain users, I accept the therapeutic usefulness of these substances of course, but to me it seems far more likely that any long term beneficial impact is far more complex and specific to the individual, relating to better habits, the ability to create a better general life environment while under the influence of the acute effect, etc, which persist after the actual acute effects have worn off. Otherwise these things would surely be far less important when compared to some kind of inevitable chemical determinism. I'd think we'd also see far less negative outcomes from stimulant addictions and dependency.

Admittedly I am biased by my own experience being prescribed a range of stimulants over 2 years or so up to about 4 months ago to treat a supposed ADHD diagnosis. They most definitely are very very effective substances, within the window of the acute effects. But what I have to conclude personally after a few years of - IMO - denial about a doctor-endorsed stimulant addiction, is that they just do not do anything good beyond this, and probably do some harm. I did not abuse them, took as prescribed, took breaks, etc, etc, I dunno though, maybe I was somehow doing something wrong and hoping for the substance to do something that it would never be able to do, but even 4 months of abstinence later I still feel somewhat lobotomized. This is just my personal experience of course and not scientific, but, it's relevant to the topic nonetheless.

I recognize of course that many others will have dramatically different experiences, BUT currently I still don't see any reason to think this is due to these substances themselves causing any kind of positive neurological changes, rather than some people simply experiencing dramatic enough improvements from how they are able to use the acute effects that have lasting positive impacts in spite of the (IMO, most likely) negative long term neurological changes that chronic stimulant administration induces.


Edit: I did a little more reading and I'll say I think the above probably applied primarily to amphetamine type formulations, methylphenidate seems to be a little different and it seems not in dispute that methylphenidate has some neuroprotective properties that amphetamines just don't have, so if there's anything to the "beneficial long term neurological changes from chronic stimulant use" idea, it's far more likely to apply to methylphenidate but, IMO, not any amphetamine. It's no doubt also relevant that my own personal negative experience primarily involved dexamphetamine.

 

[KurtAurelius]

I'm personally very skeptical of the idea that chronic stimulant administration (at least, specifically those typically prescribed for ADHD - methylphenidate and amphetamine formulations) actually leads to any long term beneficial neurological changes of any kind. I've heard this before and it's a very tempting idea which of course everyone would love to be true, but I've just never seen any particularly compelling evidence. I couldn't find any suggestion that beneficial long term changes were in any way implied, suspected, or even investigated in the paper you linked - I'm not saying the evidence doesn't exist, there might well be some studies that hint at some kind of effect like this but just personally I only ever hear this idea alluded to very vaguely from third-hand sources...

It doesn't seem to make much sense intuitively - although of course, that's not a scientific perspective - given that there is plenty of fairly undisputed evidence for the negative neurological changes which can occur with chronic stimulant administration, and given their mechanism of action it seems like it would be particularly odd for these substances to have a more nootropic-esque U-shaped effect curve for the long term neurological element but not the actual acute effect profile which is comparatively linear.

Not that they might not have beneficial long term impacts in certain users, I accept the therapeutic usefulness of these substances of course, but to me it seems far more likely that any long term beneficial impact is far more complex and specific to the individual, relating to better habits, the ability to create a better general life environment while under the influence of the acute effect, etc, which persist after the actual acute effects have worn off. Otherwise these things would surely be far less important when compared to some kind of inevitable chemical determinism. I'd think we'd also see far less negative outcomes from stimulant addictions and dependency.

Admittedly I am biased by my own experience being prescribed a range of stimulants over 2 years or so up to about 4 months ago to treat a supposed ADHD diagnosis. They most definitely are very very effective substances, within the window of the acute effects. But what I have to conclude personally after a few years of - IMO - denial about a doctor-endorsed stimulant addiction, is that they just do not do anything good beyond this, and probably do some harm. I did not abuse them, took as prescribed, took breaks, etc, etc, I dunno though, maybe I was somehow doing something wrong and hoping for the substance to do something that it would never be able to do, but even 4 months of abstinence later I still feel somewhat lobotomized. This is just my personal experience of course and not scientific, but, it's relevant to the topic nonetheless.

I recognize of course that many others will have dramatically different experiences, BUT currently I still don't see any reason to think this is due to these substances themselves causing any kind of positive neurological changes, rather than some people simply experiencing dramatic enough improvements from how they are able to use the acute effects that have lasting positive impacts in spite of the (IMO, most likely) negative long term neurological changes that chronic stimulant administration induces.


Edit: I did a little more reading and I'll say I think the above probably applied primarily to amphetamine type formulations, methylphenidate seems to be a little different and it seems not in dispute that methylphenidate has some neuroprotective properties that amphetamines just don't have, so if there's anything to the "beneficial long term neurological changes from chronic stimulant use" idea, it's far more likely to apply to methylphenidate but, IMO, not any amphetamine. It's no doubt also relevant that my own personal negative experience primarily involved dexamphetamine.

Thank you so much for sharing your experience, really appreciated, suffice to say similar to yourself I’ve only heard these third hand accounts.

Ive landed on Methylphenidate as it seemed to be “safer” but I’ve got to weigh up my choices long term whether this is sustainable or to pull back sooner rather than later.

 

[Allylbenzene]

I'm personally very skeptical of the idea that chronic stimulant administration (at least, specifically those typically prescribed for ADHD - methylphenidate and amphetamine formulations) actually leads to any long term beneficial neurological changes of any kind.
...
Edit: I did a little more reading and I'll say I think the above probably applied primarily to amphetamine type formulations, methylphenidate seems to be a little different and it seems not in dispute that methylphenidate has some neuroprotective properties that amphetamines just don't have, so if there's anything to the "beneficial long term neurological changes from chronic stimulant use" idea, it's far more likely to apply to methylphenidate but, IMO, not any amphetamine. It's no doubt also relevant that my own personal negative experience primarily involved dexamphetamine.

Both of these stimulants increase noradrenaline and dopamine but amphetamine does it in several ways - and has other effects involving histamine release, opioid release, glutamate release, stress hormone release which contribute to it's inappropriateness for long-term use (IMO). Amphetamine has a "messy" profile when compared to methylphenidate.

Admittedly I am biased by my own experience being prescribed a range of stimulants over 2 years or so up to about 4 months ago to treat a supposed ADHD diagnosis. They most definitely are very very effective substances, within the window of the acute effects. But what I have to conclude personally after a few years of - IMO - denial about a doctor-endorsed stimulant addiction, is that they just do not do anything good beyond this, and probably do some harm. I did not abuse them, took as prescribed, took breaks, etc, etc, I dunno though, maybe I was somehow doing something wrong and hoping for the substance to do something that it would never be able to do, but even 4 months of abstinence later I still feel somewhat lobotomized. This is just my personal experience of course and not scientific, but, it's relevant to the topic nonetheless.

Were you ever prescribed non-stimulant drugs? It's quite interesting to compare ADHD drugs as some work in entirely opposite ways.

increased noradrenaline

methylphenidate / amphetamine (+ ↑ dopamine)​

atomoxetine / viloxazine​

decreased noradrenaline & adrenaline

guanfacine / clonidine​

​

The stimulants boost noradrenaline/dopamine which has immediate - albeit temporary - effects. They mask symptoms without really addressing the root issue. The non-stimulant drugs reduce noradrenaline/adrenaline (and increase GABA) which has the effect of reducing anxiety and the effects of stress. They also mask symptoms but (unlike stimulants) actually address some root issues that are responsible for ADHD in the first place. Theoretically a combination of the best of both classes - boosting dopamine & reducing anxiety/stress - would work very well for ADHD and avoid side-effects from artificially increasing noradrenaline which itself is involved in the stress response (fight-or-flight).

I recognize of course that many others will have dramatically different experiences, BUT currently I still don't see any reason to think this is due to these substances themselves causing any kind of positive neurological changes, rather than some people simply experiencing dramatic enough improvements from how they are able to use the acute effects that have lasting positive impacts in spite of the (IMO, most likely) negative long term neurological changes that chronic stimulant administration induces.

An alternative to stimulants might involve addressing the root issues which are responsible for low noradrenaline/dopamine. This removes any reliance on prescription drugs and more importantly avoids any long-term issues caused by chronic stimulant use.

​

 

[Vastness]

Were you ever prescribed non-stimulant drugs? It's quite interesting to compare ADHD drugs as some work in entirely opposite ways.

increased noradrenaline
methylphenidate / amphetamine (+ ↑ dopamine)
atomoxetine / viloxazine
decreased noradrenaline & adrenaline
guanfacine / clonidine

No, never, was never even given the option and I admit I didn't ask as didn't even really know about or consider this. I had already been self-medicating on and off with a range of things just prior to actually being prescribed something, I guess I was somewhat functional for quite a long time doing this before making the jump into "hard" stimulants which is where the wheels really fell off, so I was a bit delusional about the sustainability of just keeping on doing what I was doing forever, even while being aware of the predatory capitalist element behind pushing stimulants and believing myself to be informed enough to not get delusional about a profoundly addictive class of substances... so I really went into it kinda knowing I wanted to be prescribed an instant-release stimulant, and thinking that since it was all above board legally and medically and such surely, what could go wrong?

But yeah so my progression was XR methylphenidate -> IR methylphenidate -> lisdexamphetamine -> dexamphetamine (40mg), which I mean, fuck it just seems batshit thinking about it now quite honestly, that dose is just way too high, it's plainly obviously not gonna be sustainable in the vast majority of cases... I have another review appointment in a few weeks though so I'll ask about nonstimulant options then, otherwise honestly been planning to just tell 'em fuck their bad advice and the (IMO, possibly) misguided, easily gameable ADHD diagnosis which really doesn't seem to have done me much good at all.

 

[KurtAurelius]

An alternative to stimulants might involve addressing the root issues which are responsible for low noradrenaline/dopamine. This removes any reliance on prescription drugs and more importantly avoids any long-term issues caused by chronic stimulant use.

​

I hope I’m not that “guy” but is it just

extensive exercise coverage, sleep, social, purpose, diet, sunlight, breath work, grounding etc

Plus all of your avoidance stuff, too much screens, plastics, forever chemicals, etc

Then honour mention of more psychological like extensive meditation, visualisation, affirmations, gratitude, reflection, extensive journalling

I’m not saying I did cultivate a perfect system, but although I was very impressed with my output, my ADHD was extremely debilitating even with the above met to an amazing standard.

All it made me good for is becoming a work horse which isn’t very fulfilling, forcing yourself to keep going like that doesn’t seem endearing, so I changed approaches with adding a stimulant and priotising personal pursuits and smaller community work.

I completely agree that the stimulants are a partial treatment and in some respects a band aid however, but if I let myself be “myself” (Unmedicated) it comes into incredible conflict with day to day life, with people in my life and work.

I decided to drug myself yes, but it makes me able to work and provide better.

It’s been a interesting experiment for me but I’ve leaned heavily in reexamining my approach and seeing ways to reduce my stimulant use, and go back to taking days of and deploying other chemicals as a last resort.

 

[Allylbenzene]

...and thinking that since it was all above board legally and medically and such surely, what could go wrong?

Drugs from the medical industry always tend to come with built-in side-effects.

I have another review appointment in a few weeks though so I'll ask about nonstimulant options then, otherwise honestly been planning to just tell 'em fuck their bad advice and the (IMO, possibly) misguided, easily gameable ADHD diagnosis which really doesn't seem to have done me much good at all.

Fwiw, you should be able to buy agmatine which works similarly to those non-stimulant ADHD drugs. It's sold otc as a supplement. It has other benefits like being neuroprotective (increases BDNF).

I can't advise combining it with amphetamine, but agmatine has been used by recreational stimulant users to reduce the negative effects. Agmatine has also been reported to reduce drug tolerances for opioids and stimulants. If you look you'll find reports on using agmatine for all sorts of theraputic purposes.

As for the doctors, do you expect them to genuinely help? (rarely some will, usually from older generations). I'm paraphrasing here but IMO they are essentially official dealers for the pharmaceutical industry. The industry creates names for new conditions and new drugs to "treat" them. This is taught to doctors who push the drugs. I bet that many doctors know the drugs just mask symptoms but it's not their job to tell patients.

 

[Allylbenzene]

An alternative to stimulants might involve addressing the root issues which are responsible for low noradrenaline/dopamine. This removes any reliance on prescription drugs and more importantly avoids any long-term issues caused by chronic stimulant use.

I hope I’m not that “guy” but is it just

extensive exercise coverage, sleep, social, purpose, diet, sunlight, breath work, grounding etc

Plus all of your avoidance stuff, too much screens, plastics, forever chemicals, etc

Then honour mention of more psychological like extensive meditation, visualisation, affirmations, gratitude, reflection, extensive journalling

Everything you mentioned is very important.

Addressing the root biological issues for ADHD is achieved differently, usually by reducing an overactive stress response. This is what non-stimulant ADHD drugs (guanfacine, clonidine) are good at doing, albeit temporarily.

A more long-term strategy is to restore proper metabolic function so the body doesn't rely on the stress response so much. When the "primary" metabolic system can't keep up the body uses the "back-up" stress response to supply energy (adrenaline).
This is paraphrased but that is the crux of it.

Some popular anti-stress substances that people use (some are more sustainable than others):

• ADHD drugs (guanfacine, clonidine)
• agmatine
• CBD/CBG cannabis (+terpenes)
• THC cannabis (+terpenes)
• theanine
  
• alcohol
• benzodiazapenes
• opiates
• taurine
• nicotinamide

AFAIK the only thing that positively supports metabolic function directly is coffee since caffeine is a metabolic stimulator. This has nothing to do with regular stimulants like amphetamine or methylphenidate which behave very differently.

If someone wants to use coffee it makes sense to learn how to use it properly. Symptoms to expect when you do coffee right are calmness, focus, motivation, warmth, and stable energy. No crash, no shakes.

...my ADHD was extremely debilitating... All it made me good for is becoming a work horse which isn’t very fulfilling

This resembles the psychoactive effects of chronic high adrenaline.

I completely agree that the stimulants are a partial treatment and in some respects a band aid however, but if I let myself be “myself” (Unmedicated) it comes into incredible conflict with day to day life, with people in my life and work.

I decided to drug myself yes, but it makes me able to work and provide better.

There's nothing wrong with using drugs medicinally to support your day-to-day activities. Some drugs are more sustainable than others. Modern medicine has many drugs which temporarily mask symptoms but no genuine solutions which are bad for business.