Mental Health Best drug for ADD/ADHD?

[Zon]

My life's been a bit messed up lately, basically depressed because I'm not getting anything done, and I finally worked out that probably the biggest cause of all that is that I have ADHD and was never diagnosed (I am now 30 years old). I know that if I can get the motivation and concentration to get things done and start moving towards my goals everything will be great again. So tomorrow I will see my doctor and ask for some pills. Unfortunately this doc is a bit of an idiot, I sometimes wonder if he just found his medical certificate in a kinder surprise egg he knows so little about medication (he actually thought Effexor was an SSRI, which it's not) so I want to research and decide which med will work best for me and hope that my doctor will agree to give it to me.

The meds I've been looking at so far are Modafinil(Provigil), Desoxyn, Dexedrine or Adderall, roughly in that order so far.

Does anyone have any opinions on any of these or any suggestions? I don't specifically plan to use it recreationally, just to use it to get as much work done on my work days as possible (especially as my freelance work requires a lot of small mondaine tasks and a lot of self studying).

Ideally I would also like to take an SSRI or other anti-depressant along with it to help pull me out of this bad patch, and I'm also a casual weekend drinker, although I don't really plan to take a strong ADHD med on the weekends anyway.

Any advice?


PS I know people on here are not doctors or a replacement for such and of course will do all my own research on any suggestions made

 

[aihfl]

I was also diagnosed with ADD (I don't have the H) in my early 40s. It was such a relief to finally know in my 40s that there was a reason for all the "bad behavior" I was punished for by my mother and at school. I haven't taken it, but from my understanding, Adderall is the standard bearer. It might not be, I don't really know. My pdoctor prescribed me clonidine, which is actually a blood pressure med, but in the USA, off label uses are anxiety (which I have), and ADD. It is not off label for ADD in Australia. Plus, I also have high blood pressure so this med hits a trifecta for me.

Anyway, good luck and let us know what the doctor said.

 

[AlphaMethylPhenyl]

To his credit, Effexor is an SSRI for the most part below 150mg. Chances are you're doctor isn't an idiot.

As far as I know, modafinil is both more safe and less addictive than your other options.

No sane doctor would prescribe someone desoxyn without extensive trials of all the other treatments and a record clear of drug abuse. If you're going to be dependent on a drug (which I'm not contesting you may need), even if it's legally prescribed, you don't want it to be meth.

I would guess that adderall is prescribed more often than dexedrine, not sure why, but I'm guessing it partly has to do with adderall producing anxiety at abusive doses.

My main, most clear piece of advice would be to stop drinking. It seems harmless, I know.

Why don't you ask your doctor if you should try an antidepressant to see if the depression is making you unfocused rather than jumping to stimulants?

 

[Mmp85]

Is this doctor a general physician or a psychiatrist?
If you're serious about finding the right medication and the right diagnosis you need to see a psychiatrist. I made the mistake for years of getting my meds from regular doctors, I thought because I'd gotten the iniatial diagnosis from a psychiatrist that it was fine but I didn't realize how little some doctors actually know about psychiatric disorders and medications.

 

[SourCloudz]

Amphetamine Salts. Instant Release tablets. 20mg or 30mg twice a day.

 

[Zon]

Thanks for the replies, to reply back to some of the answers. Well Effexor is an SNRI, because it does not selectively work on seretonin, but that's not the problem... Effexor should not be given to a person with relatively mild depression without first trying other less damaging drugs. Once you are on Effexor it can take several painful months to get off of it. I know SSRIs and even stimulants also have withdrawal effects but not anywhere near as bad as Effexor. Try googling "worst anti depressant to quit" and guess which name you will see mentioned the most. I'm actually pretty furious that he gave me this AND didn't tell me a single thing about it! This was not his first mistake in my opinion either. His first choice of medication was also quite a strange choice, at a ridiculously low dose, and didn't give enough pills to last to my next appointment... I've been trying to get a new doctor for weeks but it's just impossible without waiting 1-2 months in my country... So I need to swallow my hate of this guy, put on a fake smile and hope he will be more helpful this time.

Also, sorry I forgot to mention, yes he is a Psychiatrist.

Anyway I will go to see him in a few hours today with my wife and ask him to give me some stimulants to get me doing stuff again, and maybe an SSRI as well to keep me balanced and happy. Will see if he listens this time :/ Wish me luck.

 

[jammin83]

Dex is the best for me. Adderall is decent but has more side effects. Vyvanse was like stimulant training wheels, overpriced and too weak, very few side effects though. If you are prone to um er sexual issues while on stims, don't use vyvanse. The stuff lasts so long that I couldn't ever get it up without viagra which is like 20 bucks a pill. Basically perma limp dick. At least with addies that would wear off after a few hours. No such luck with vyvanse. I didn't really care for provigil, felt dirty and stimmy to me. I found the various methylphenidate formulations pretty worthless with lots of side effects.

I think the pharmacutical meth thing is a bit over rated as far as effects go. I don't think you really are going to get that but I don't think its much worse than dex or addies at least. Its more for treatment resistant ADD but I really don't think it's much more prone to abuse than anything else. I find street meth pretty similar to adderall just a little cleaner in my limited experience with it.

After years of being on stims though, I eventually found them to be counter productive and do better without them anymore. Still a space case, but it doesn't bother me and I get things done.

 

[feedtheSoul]

I have tried a few medications for my ADHD over the years.

IME, concerta made me far too anxious, and i disliked that you had to slowsly increase your dose for the first month. Vyvanse was a great drug for me with little side effects but the comedown was miserable. not to mention my tolerance grew rapidly, and since it is structured to be *less abusable* while providing a gentle come-up, it is difficult to tell if it has even kicked in, once you grow more tolerant of course. I also was one who metabolized it quickly so rather than having the ~7 hours of focus, I got maybe one to two hours out of it.

Straterra was a waste of my time. In fact, my mom had taken Strattera for a few years and claimed she actually focused better once she stoped taking it!

Adderall is my personal preference. It is always noticeable when its effects start kicking in, and it provides me with the mental clarity I need to stay on task. I have also only needed one dosage increase since I fully switched to adderall about a year ago.

I always hear great things about modafinil and dexdrine though I have no experience using either of these and I may be wrong but I believe modafinil can be pretty expensive.

OP, good luck to you with finding the one that works best for you!

 

[Zon]

Ok just got back from the Psych and.... yeah... He basically accused me of making the whole thing up (which I am not at all btw). He said he wouldn't give me any more medications because I didn't take the ones he gave me before properly, to which I had to directly look him in the eye and remind him that he had not given me enough to take it the way he had prescribed! The only thing that we both agreed on is that I need to find a new doctor...

In the end, I managed to hold my anger inside and he finally gave me a prescription for 5mg Ritalin up to 3 times a day... I guess I should be glad of that, although I took one an hour and half ago and so far don't feel anything... Maybe the dose is too low? I read starting dose for this is usually 10mg :/ Anyway, will see over the next few days, and hopefully find a better doctor soon.

Thanks again for all the positive comments. It is always appreciated!

 

[feedtheSoul]

Sorry to hear that, Zon. I had the same issue with my previous psychiatrist. It wasn't until I was admitted into a hospital and referred to a new psychiatrist that I was prescribed something to manage my ADHD. the previous doc thought I was making it up also. Some people "Doctor shop" and "med seek" so he could have gotten that impression but the one person who knows how you feel better than anyone else, is you.

 

[I B Profane]

I'm prescribed 200mg of R-Modafinil per day for ADHD, and it works wonders.

Let me know if you'd like to know more. I've been prescribed various stimulants (Adderall, Dexedrine, etc) since I was 15 for severe ADHD. I find that R-Modafinil (the right handed isomer of Modafinil, which is too expensive for my insurance to cover) works just as well for concentration and focus as all the other stims, but it is nowhere near as heavy on the side effects. I like it.

 

[Zon]

Yeah I think I would like to give Modafinil a try if my insurance can cover it.


Btw is it normal that 5mg Ritalin has absolutely no affect on me at all? I've taken twice now and nothing... The box is not in my language so thought maybe it was not the instant action Ritalin I thoguht it was... Not like I can tell my doctor that it isn't strong enough either... :/

 

[jammin83]

Yeah, 5 mg is a pretty low dose. I used to take the 72 mg concerta which is extended release but that's still about 15 x that dose. Just find a different doctor. Just make sure when you call around that they treat ADD and prescribe stimulants. Don't go demanding anything though, they usually start you on a low dose which is fine. You adjust to whatever dose you are on anyway and you might need to updose after a year or so anyway.

 

[Zon]

Well I just took 2x5mg around 5pm and still nothing.... so I had the box translated as it wasnt in my language and worked out they are slow release caps......... That is why 5mg did nothing!

Is it me or is that ****ing weird that the doc prescribed me 5mg XR 3 times per day? I've been reading and reading and that seems to be the dose for IR, and XR is a once per day higher dose...

Anyway tomorrow I plan to crush 5mg and stick it under my tongue then pop 10mg XR to hopefully give me a nice productive day... Tired of wasting my time because of this doctor.... :/

 

[Mmp85]

Has the doctor diagnosed you as ADD or ADHD through any testing?
If your insurance covers it and or you can afford it, have the real testing done even if it's through a new doctor. Having that diagnosis on paper and the proof you went through the process of being evaluated shows future doctors you're not just trying to score pills and you'll have it in your medical records pretty much forever and it'll be basically impossible to refute.

 

[AlphaMethylPhenyl]

Thanks for the replies, to reply back to some of the answers. Well Effexor is an SNRI, because it does not selectively work on seretonin, but that's not the problem... Effexor should not be given to a person with relatively mild depression without first trying other less damaging drugs. Once you are on Effexor it can take several painful months to get off of it. I know SSRIs and even stimulants also have withdrawal effects but not anywhere near as bad as Effexor. Try googling "worst anti depressant to quit" and guess which name you will see mentioned the most. I'm actually pretty furious that he gave me this AND didn't tell me a single thing about it! This was not his first mistake in my opinion either. His first choice of medication was also quite a strange choice, at a ridiculously low dose, and didn't give enough pills to last to my next appointment... I've been trying to get a new doctor for weeks but it's just impossible without waiting 1-2 months in my country... So I need to swallow my hate of this guy, put on a fake smile and hope he will be more helpful this time.

Also, sorry I forgot to mention, yes he is a Psychiatrist.

Anyway I will go to see him in a few hours today with my wife and ask him to give me some stimulants to get me doing stuff again, and maybe an SSRI as well to keep me balanced and happy. Will see if he listens this time :/ Wish me luck.

Ok just got back from the Psych and.... yeah... He basically accused me of making the whole thing up (which I am not at all btw). He said he wouldn't give me any more medications because I didn't take the ones he gave me before properly, to which I had to directly look him in the eye and remind him that he had not given me enough to take it the way he had prescribed! The only thing that we both agreed on is that I need to find a new doctor...

In the end, I managed to hold my anger inside and he finally gave me a prescription for 5mg Ritalin up to 3 times a day... I guess I should be glad of that, although I took one an hour and half ago and so far don't feel anything... Maybe the dose is too low? I read starting dose for this is usually 10mg :/ Anyway, will see over the next few days, and hopefully find a better doctor soon.

Thanks again for all the positive comments. It is always appreciated!

I'm not going to ram this into the ground but Effexor is understood to have clinically insignificant action on norepinephrine at doses below 150mg per day.

When someone is engaging in treatment for depression, the most salient factor is reducing the depression with a medication that the patient understands is deemed best by them given their specific manifestation of the illness, not figuring out how to deal with some possible future problem.

It's a classic case of compromising one's quality of care by thinking that side effects people post on the internet will happen to them. What kind of experiences are of such magnitude that people take the effort to type and post them?

No one person responds the same to any medication, and responses vary widely. Effexor=unscheduled. Amphetamine/methylphenidate=schedule two. People don't pull these labels out of their ass.

Stimulants aren't meant to make people do "stuff", they're meant to increase concentration for those who naturally lack it.

Stimulants also aren't supposed to be felt. Why are you even going through this rigmarole if you just want to get tweaked?

 

[Zon]

Has the doctor diagnosed you as ADD or ADHD through any testing?
If your insurance covers it and or you can afford it, have the real testing done even if it's through a new doctor. Having that diagnosis on paper and the proof you went through the process of being evaluated shows future doctors you're not just trying to score pills and you'll have it in your medical records pretty much forever and it'll be basically impossible to refute.

Its a good idea although I dont know if I'd really want that on my official reccord? I mean, it means I would have to declair it to any future health insurance company or some things like this no? And as I will move to a new country next year I donno how that could affect me.... I am lucky that I have an insurance that covers most medications and tests though, I don't know what I would do if it didn't.

I'm not going to ram this into the ground but Effexor is understood to have clinically insignificant action on norepinephrine at doses below 150mg per day.

When someone is engaging in treatment for depression, the most salient factor is reducing the depression with a medication that the patient understands is deemed best by them given their specific manifestation of the illness, not figuring out how to deal with some possible future problem.

It's a classic case of compromising one's quality of care by thinking that side effects people post on the internet will happen to them. What kind of experiences are of such magnitude that people take the effort to type and post them?

No one person responds the same to any medication, and responses vary widely. Effexor=unscheduled. Amphetamine/methylphenidate=schedule two. People don't pull these labels out of their ass.

Stimulants aren't meant to make people do "stuff", they're meant to increase concentration for those who naturally lack it.

Stimulants also aren't supposed to be felt. Why are you even going through this rigmarole if you just want to get tweaked?

I understand your point, and yes it is true I'm sure a lot of people look up side effects and freak out about stupid stuff, but I am really not doing that. I am mostly using drugs.com user ratings, which is similar to IMDB for medications and reading what 100s of people have said, and A LOT of people said it takes months to quit this drug, even after just taking it for a short time. It also has a much lower rating out of 10 than other SSRIs, I guess because of the withdrawal effects, also the fact that out of the 100s out there it is the first result when googling "worst anti-depressant to quit" really does add credit to the reviews. The fact that this doctor prescribed it to me without telling me ANYTHING about it to me is absolutely disgusting...

About the stims, I really am not trying to get tweaked, although I don't say no to any positive feelings that is not my main objective... I am trying to get that feeling of clarity and motivation where I can get all my daily jobs done. As for motivation, it was actually someone on here which suggested adderall for motivation and which led to me taking an ADHD test (which I was in the top group for adult ADD), and I've read it quite a few times. I am still new to this though so I don't know how it will affect me, I've also read ritalin especially makes some people sluggish and lazy... So like you said, it affects everyone differently.