Hello,
I'm on dexedrine. I'm experiencing tolerance. My doctor an I are trying to work out a regimen that will reduce the tolerance as much as possible, including possibly trying different drugs. My current approach is to alternate between different drugs on different days of the week. I've found that if I take the dexedrine two days in a row, then give myself a 5 day rest, I seem to avoid the tolerance. However, 2 days a week is hardly enough to deal with my ADD symptoms, particularly at work where I need it the most. So as an example of alternating between drugs, I'll take caffeine pills on the remaining days of the week. Caffeine can help with ADD symptoms but it's not recommended by doctors (and I find it has mixed results). It also makes me feel like crap on the second and third day--jitters, feelings of uneasiness, feeling worn out--and the withdrawal on the weekend is just awful (tired and depressed). So I'm continuing to search for other substitutes.
Ephedrine seems to be a viable candidate. I just tried 8mg this morning. Didn't have an effect. Then I tried 16mg after lunch today. After an hour, I felt the onset--bit more alert, more focused--but didn't last long--started to come down after another hour. According to erowid, I should be able to bump it up to 24mg, maybe even 32mg, for the "common" dosage. Maybe I'll try that tomorrow.
In order to overcome tolerance to dexedrine, I would need a medication that acts as a stimulant in terms of concentration, sharp/quick thinking, alertness, and also mood enhancement (more on this below), and its mechanism of action would have to be something other than dopamine receptors (and most likely norepinephrine receptors as well). Dexedrine works by flooding the synaptic gap with dopamine (and to a lesser extent norepinephrine). Tolerance builds up from the dopamine receptors on the recipient neuron reducing in number in order to adjust for the excess amount of dopamine. Therefore, I would need a drug that works on different receptor types, thereby giving the dopamine receptors a break so that they can recuperate their numbers.
An example of a drug combination that DOESN'T work is alternating between dexedrine and methylphenidate (another ADD med). They both increase the amount of dopamine (and norepinephine to a lesser extent) in the synaptic gap but by different means, so it does no good to switch from one to the other in order to get around dopamine tolerance (I've tried it).
I'm going to talk to my doctor about atomoxetine. Atomoxetine works on norepinephrine receptors instead of dopamine receptors (but then again, dexedrine and methylphenidate also work on norepinephrine receptors but to a much lesser extent). However, atomoxetine takes time to have its effect (two to three weeks) so it may not be the kind of drug one can simply "swap out" when one becomes tolerant to another drug. And if one becomes tolerant to atomoxetine, one can take a break from it for 5 days to a week, but then would one have to start over again? Then again, maybe the fact that it requires so long to come into effect means that one would be much less likely to develop a tolerance.
I also want to note that what I'm looking for is not so much an ADD med, but a medication that targets at least these three symptoms: cognitive deficiencies (slowness, mistakes, non-responsiveness), fatigue, and depression. <-- These are the three struggles I deal with in my life. These are a common set of symptoms when it comes to ADD, but because ADD is so variegated, I don't want to put what I'm trying to accomplish in terms of ADD. Putting it in terms of cognitive deficiencies, fatigue, and depression narrows down the focus and makes it much less likely that people will misunderstand what exactly it is I'm trying to target. This also makes it clear that if there are drugs that work to ameliorate certain symptoms but not others (say atomoxetine helps with the cognitive deficiencies but not the fatigue or depression--I don't know, haven't tried it), then people can make suggestions on meds that target ONLY depression or fatigue (to be supplemented with the meds that work on cognitive deficiencies). Asking strictly for ADD meds might miss these. Dexedrine and methylphenidate have been the only drugs so far that have helped with all three of these symptoms. Caffeine helps put me in a better mood, but only the dexedrine and methylphenidate have actually made me feel confident, and given me a constructive attitude (as in I'm far more prone to react to problems constructively, believing that I can overcome them with the right effort and approach, rather than worrying and complaining about how my problems will be the end of me). The confidence also helps a lot with the social anxiety (which I kinda lump together with the depression because depression and anxiety tend to go together) whereas caffeine tends to heighten anxiety. I understand this to be a direct effect of an increase in dopamine (the "feel good" chemical). I'm told that atomoxetine heightens focus and attention by a different means--by stimulating the "danger" system in the brain, which can raise alertness and focus--which sounds to me like it might be an unpleasant experience (though if it acts on norepinephrine receptors, which act similar to dopamine receptors, this may not be true). But suppose atomoxetine worked for me--at least in terms of the cognitive deficiencies--then I might be able to supplement it with something like kratom, a mild opiate, in order to deal with my mood. That's sort of an example of what I mean by supplementary drugs that you might want to recommend.
Any suggestions and/or advice are welcome.
I'm on dexedrine. I'm experiencing tolerance. My doctor an I are trying to work out a regimen that will reduce the tolerance as much as possible, including possibly trying different drugs. My current approach is to alternate between different drugs on different days of the week. I've found that if I take the dexedrine two days in a row, then give myself a 5 day rest, I seem to avoid the tolerance. However, 2 days a week is hardly enough to deal with my ADD symptoms, particularly at work where I need it the most. So as an example of alternating between drugs, I'll take caffeine pills on the remaining days of the week. Caffeine can help with ADD symptoms but it's not recommended by doctors (and I find it has mixed results). It also makes me feel like crap on the second and third day--jitters, feelings of uneasiness, feeling worn out--and the withdrawal on the weekend is just awful (tired and depressed). So I'm continuing to search for other substitutes.
Ephedrine seems to be a viable candidate. I just tried 8mg this morning. Didn't have an effect. Then I tried 16mg after lunch today. After an hour, I felt the onset--bit more alert, more focused--but didn't last long--started to come down after another hour. According to erowid, I should be able to bump it up to 24mg, maybe even 32mg, for the "common" dosage. Maybe I'll try that tomorrow.
In order to overcome tolerance to dexedrine, I would need a medication that acts as a stimulant in terms of concentration, sharp/quick thinking, alertness, and also mood enhancement (more on this below), and its mechanism of action would have to be something other than dopamine receptors (and most likely norepinephrine receptors as well). Dexedrine works by flooding the synaptic gap with dopamine (and to a lesser extent norepinephrine). Tolerance builds up from the dopamine receptors on the recipient neuron reducing in number in order to adjust for the excess amount of dopamine. Therefore, I would need a drug that works on different receptor types, thereby giving the dopamine receptors a break so that they can recuperate their numbers.
An example of a drug combination that DOESN'T work is alternating between dexedrine and methylphenidate (another ADD med). They both increase the amount of dopamine (and norepinephine to a lesser extent) in the synaptic gap but by different means, so it does no good to switch from one to the other in order to get around dopamine tolerance (I've tried it).
I'm going to talk to my doctor about atomoxetine. Atomoxetine works on norepinephrine receptors instead of dopamine receptors (but then again, dexedrine and methylphenidate also work on norepinephrine receptors but to a much lesser extent). However, atomoxetine takes time to have its effect (two to three weeks) so it may not be the kind of drug one can simply "swap out" when one becomes tolerant to another drug. And if one becomes tolerant to atomoxetine, one can take a break from it for 5 days to a week, but then would one have to start over again? Then again, maybe the fact that it requires so long to come into effect means that one would be much less likely to develop a tolerance.
I also want to note that what I'm looking for is not so much an ADD med, but a medication that targets at least these three symptoms: cognitive deficiencies (slowness, mistakes, non-responsiveness), fatigue, and depression. <-- These are the three struggles I deal with in my life. These are a common set of symptoms when it comes to ADD, but because ADD is so variegated, I don't want to put what I'm trying to accomplish in terms of ADD. Putting it in terms of cognitive deficiencies, fatigue, and depression narrows down the focus and makes it much less likely that people will misunderstand what exactly it is I'm trying to target. This also makes it clear that if there are drugs that work to ameliorate certain symptoms but not others (say atomoxetine helps with the cognitive deficiencies but not the fatigue or depression--I don't know, haven't tried it), then people can make suggestions on meds that target ONLY depression or fatigue (to be supplemented with the meds that work on cognitive deficiencies). Asking strictly for ADD meds might miss these. Dexedrine and methylphenidate have been the only drugs so far that have helped with all three of these symptoms. Caffeine helps put me in a better mood, but only the dexedrine and methylphenidate have actually made me feel confident, and given me a constructive attitude (as in I'm far more prone to react to problems constructively, believing that I can overcome them with the right effort and approach, rather than worrying and complaining about how my problems will be the end of me). The confidence also helps a lot with the social anxiety (which I kinda lump together with the depression because depression and anxiety tend to go together) whereas caffeine tends to heighten anxiety. I understand this to be a direct effect of an increase in dopamine (the "feel good" chemical). I'm told that atomoxetine heightens focus and attention by a different means--by stimulating the "danger" system in the brain, which can raise alertness and focus--which sounds to me like it might be an unpleasant experience (though if it acts on norepinephrine receptors, which act similar to dopamine receptors, this may not be true). But suppose atomoxetine worked for me--at least in terms of the cognitive deficiencies--then I might be able to supplement it with something like kratom, a mild opiate, in order to deal with my mood. That's sort of an example of what I mean by supplementary drugs that you might want to recommend.
Any suggestions and/or advice are welcome.