28 replies to this topic

[gizmobrain]

I have decided to return to Adderall. At this time in my life, too many opportunities are slipping by, the bills are piling up, and I'm going to be married in less than a year. My end desire is to drop the Adderall, but I cannot do this until I can find a safer alternative that reliably works as well.

After a year of trialing various supplements, I now have the knowledge to combat most of the side effects that previously made Adderall intolerable.

• Mood: by using herbs that help to reduce irritability, such as Ashwagandha.
• Jaw and Muscle Clenching: Magnesium L-Threonate eliminates these within 10-30 minutes of ingesting. Also, I plan to investigate Epsom Salt baths as a cheaper alternative.
• Heart Rate/Blood Pressure/Headaches: by using herbs that reduce blood pressure, heart rate, and vasoconstriction, such as Jiaogulan

For me, that leaves the neurotoxicity as the only intolerable side effect...

I spoke with the doctor about Memantine to block the neurotoxicity and prevent tolerance from forming to Adderall. This should allow me to maintain a much small dosage, as well, which should reduce the intensity of most of the periphery side effects.

I'm currently taking 10mg/day of Selegiline. With the addition of Adderall, there is less of a need for the metabolites of Selegiline. However, the MAOI-B effects may still be desirable, since it might allow me to take a smaller dose of Adderall.

Would there be any recommendation against combining a low dose of Adderall + Memantine + Selegiline? I'm thinking maybe that dropping the Selegiline back to 10mg/week would still allow for the MAOI-B effects without over-doing it, but this is just a guess. I'm willing to cut out the Selegiline completely, if it is going to do more harm than good.

I'm proposing the following stack:

Adderall: 5-10mg, 2x/day
Memantine: 10mg, 1x/day
Selegiline: 5mg, 2x/week

Advice, thoughts?

Edited by zrbarnes, 01 April 2012 - 10:39 PM.

[jadamgo]

You could try continuing the selegiline, but I'd suggest every other day dosing or Mon-Wed-Fri dosing of 2.5mg instead of 2x weekly dosing of 5mg. I know cutting tablets in half is a pain in the ass, but it would really be worth it to avoid playing around with your MAO levels too much.

If you're getting any euphoria with the adderall, or if you feel urges to take more of it than you find helpful for symptom control, stop the selegiline and don't get back on it until you've found an alternative to amphetamines.

Overall, don't worry too much. Very low doses of selegiline usually get along fine with low doses of amphetamines. It may even reduce the amphetamine's neurotoxicity.

Now, if you were using selegiline sublingually or on the EMSAM patch, that would be another matter -- amphetamines do NOT get along well with MAO-A inhibition.

[gizmobrain]

You could try continuing the selegiline, but I'd suggest every other day dosing or Mon-Wed-Fri dosing of 2.5mg instead of 2x weekly dosing of 5mg. I know cutting tablets in half is a pain in the ass, but it would really be worth it to avoid playing around with your MAO levels too much.

If you're getting any euphoria with the adderall, or if you feel urges to take more of it than you find helpful for symptom control, stop the selegiline and don't get back on it until you've found an alternative to amphetamines.

Overall, don't worry too much. Very low doses of selegiline usually get along fine with low doses of amphetamines. It may even reduce the amphetamine's neurotoxicity.

Now, if you were using selegiline sublingually or on the EMSAM patch, that would be another matter -- amphetamines do NOT get along well with MAO-A inhibition.

Unfortunately, the 90 doses I have of Selegiline are 5 mg capsules, not tablets. I could try cutting them if necessary, but it would probably be pretty messy business.

Honestly, the only reason I have ever upped my dosage of Adderall in the past was due to tolerance. Its amazing how quickly it builds. I'm really hoping Memantine will allow me to stay at the 5-10mg range, because when I stopped taking Adderall last time, I was up to 60mg/day within a year. The side effects were atrocious.

I'm still waiting to hear back from the doctor about Memantine. He's pretty open minded though, so I'm guessing he will write the prescription. In the meantime, I've starting taking 5mg Adderall + 5mg Selegiline daily. The first day I took this combo, I completed everything I needed to get done (I was shocked at it's effectiveness). Started grinding my teeth about 4 hours in. Took 2 capsules of Mag L-Threonate, and it went away after 15 minutes or so. The Jiaogulan has kept my heart rate/bp from spiking, and I've not had the headaches when the amphetamine is clearing my system, so that seems to be working.

I have noticed increased talkativeness and emotional response, but I haven't tried combining Ashwagandha or any other herbs yet.

On the third day, I've noticed a drop in the motivation department, and I'm considering adding the 2nd 5mg of Adderall in order to get my work done.

Edited by zrbarnes, 03 April 2012 - 08:51 PM.

[jadamgo]

Sorry, double-post. Tends to happen when you have satellite internet. Can a mod please delete this?

Edited by jadamgo, 03 April 2012 - 10:15 PM.

[jadamgo]

Uh oh, increasing the dose to get more motivated is a trap. I can't count how many times I've fallen into that one before I finally got the lesson. The simple fact is, you get tolerant to the motivation enhancement. It's one of the first effects to dissipate -- it's linked to the euphoria and confidence that come with a classic "stimulant high." It's not caused by the improvement of attention span or self-control. People generally won't get tolerant to the improvement of self-control and attention span, but the high simply cannot be sustained, even if you're only a very tiny bit high, and even if you take memantine and selegiline.

If this is why you pushed the dose up to 60mg the last time you took it, I'm not surprised that the side effects were terrible. The dopamine and norepinephrine receptors do not all re-regulate at the same speed. Some of the effects never go away, whereas a person is already becoming tolerant to other effects before the dose even wears off. If your limbic system was tolerant to the motivation enhancement, your heart would not necessarily be tolerant to the cardiac stimulation, and your kidneys would not be tolerant to the diuretic effects. And so on and so forth. I bet your reward system must have gotten pretty dependent on the adderall, which could cause you to feel tired, depressed, or anxious when the adderall wears off. And it could get to where you needed the adderall every morning just to get going, and you still didn't even feel that motivated.

There's just no way to prevent those side effects if you escalate the dose too high. And there's no way to keep getting a little bit high off it, day in and day out. From personal experience with ADHD and ADHD meds, the only long-term way to get motivated is to use behavior modification on yourself. And if there's any depression or anxiety or sleep problems, those have to be taken care of. What are your thoughts on all this?

[Reformed-Redan]

Side question. Does Selegiline loose effectiveness after a while?

If so, how can I increase receptor density or whatnot?

Edited by redan, 03 April 2012 - 10:09 PM.

[jadamgo]

What effects are you losing? Some of them stay, some of them go and they can't be brought back.

[gizmobrain]

Uh oh, increasing the dose to get more motivated is a trap. I can't count how many times I've fallen into that one before I finally got the lesson. The simple fact is, you get tolerant to the motivation enhancement. It's one of the first effects to dissipate -- it's linked to the euphoria and confidence that come with a classic "stimulant high." It's not caused by the improvement of attention span or self-control. People generally won't get tolerant to the improvement of self-control and attention span, but the high simply cannot be sustained, even if you're only a very tiny bit high, and even if you take memantine and selegiline.

If this is why you pushed the dose up to 60mg the last time you took it, I'm not surprised that the side effects were terrible. The dopamine and norepinephrine receptors do not all re-regulate at the same speed. Some of the effects never go away, whereas a person is already becoming tolerant to other effects before the dose even wears off. If your limbic system was tolerant to the motivation enhancement, your heart would not necessarily be tolerant to the cardiac stimulation, and your kidneys would not be tolerant to the diuretic effects. And so on and so forth. I bet your reward system must have gotten pretty dependent on the adderall, which could cause you to feel tired, depressed, or anxious when the adderall wears off. And it could get to where you needed the adderall every morning just to get going, and you still didn't even feel that motivated.

There's just no way to prevent those side effects if you escalate the dose too high. And there's no way to keep getting a little bit high off it, day in and day out. From personal experience with ADHD and ADHD meds, the only long-term way to get motivated is to use behavior modification on yourself. And if there's any depression or anxiety or sleep problems, those have to be taken care of. What are your thoughts on all this?

You bring up very valid points. My hope is that the selegiline + memantine + adderall combo will prevent the need to increase the dosage, which definitely causes the effects you described. I also am very honest with myself about the addiction capacity of Adderall, and make sure to weed out and eliminate any self deception that might cause me to fall into that trap.

I think maybe I should mention a few things though that might explain some details I left out. The first time I started Adderall, a couple years ago, my previous doctor had me on 20mg. I was on that dose for 3-4 months before the motivating effects seemed to diminish. When I let him know this, he increased the dosage. It repeated this twice, and I stopped taking it after a year.

This time around, as I mentioned in my last post, I was surprised by the effectiveness of the 5mg combo. However, I still had it in my mind that I was inevitably going to need to up the dose to a more "practical" level to see sustained results. Shortly after my previous post, I re-evaluated and decided against upping the dosage today. I realized that I was letting my presumption interfere with my actual state of mind. I always try to make sure I evaluate these things before making decisions. I do not generally have problems with addiction, so it is easy for me to evaluate what is true vs. what my brain/body wants. If I find myself getting urges that are caused by the addictive effects of certain substances, I stop myself from acting on these urges. Today, after I realized that 5mg might actually be enough, I found that I was able to accomplish the things I needed to get done. I am, once again, pleasantly surprised.

As far as the "stimulant high", I understand this to be the euphoria effect that happens when first starting Adderall. Generally, I find the euphoria to be pleasant, yes, but not helpful. It is distracting, because I will do tasks that feel good to my stimulated brain instead of the tasks that I need to do. I have always been happy that the euphoria phase goes away quickly (usually after the first day or two). I do not try to seek out this feeling.

As far as depression, anxiety and sleep problems: my lack of motivation has been around since birth. I've always had a slightly sedated, day dreamy feeling that results in a lack of sensitivity towards prioritizing and goal acheiving. The first experience I had with stimulants (besides caffeine which seems to do nothing for me mentally, only physically) was when I started taking time released psuedoephedrine during highschool for allergies. My continuous, life long brain fog rolled back and I started thinking clearly. I didn't trip over my words any longer, and became known for my quick wit. At the time, I just thought it was part of growing up. Looking back now, I can see that I was effectively treating my undiagnosed ADD with a mild stimulant.

When I went to college, I stopped taking the allergy medicine. The sedated feeling came back. Even if I mentally knew something was important, I didn't have the drive to accomplish it. I was remarkably resilient to depression and anxiety through many years of failure and setbacks. By the time I quit school, I did face some minor depression and anxiety because of the struggle (I think most anyone would, probably more than what I felt). This rendered the Adderall slightly ineffective for my studies because of the anxiety that I felt related to the failure. However, I found that I was able to do all of my non-school related tasks like never before. Getting out of bed became automatic instead of the painful process that it had been for 23 years. If I needed to go to the store for milk, it no longer took a monumental amount of effort: I just did it. Before Adderall, each task was like a giant boulder that I had to struggle and strain against to get rolling. With Adderall, I could walk up to it and barely push, and it would roll along.

Over the last year of not taking any stimulants, I've tried as many different brain building supplements and herbal anti-depressants as possible. I've changed my diet, exercised, developed proper sleeping cycles, dealt with all remaining emotional baggage causing negativity, etc. When all is said and done, I feel healthier and wiser. But healthier and wiser has gained me very little ground towards the ability to get up in the morning and do what I need to do. By comparison, 3 days ago, I took one 5mg dose of Adderall, and suddenly my eyes opened to all that needed to be done, and how I needed to do it. I got up and did more work in two hours then I had done in the previous week.

Ultimately, I have hated Adderall because of it's side effects, but nothing else has given me the ability to take control of what's going on inside of me like it has. I feel like it does many things inside of my body that I don't want or need, but it is doing one thing that I've been unable to do by 25 years of willpower.

I wish I could find the root of the problem, and I will continually be searching for it, but until then, I can no longer justify not taking Adderall. It just works too well at doing what nothing else has seemed to have been able to do.

Edited by zrbarnes, 04 April 2012 - 09:46 AM.

[gizmobrain]

What really made me pursue the Memantine/Adderall combo was the following passage from the Mind and Muscle Memantine Wiki:

It is well established that psychostimulants, including amphetamine, have been shown to increase extracellular glutamate in the nucleus accumbens (NA) to levels of hyperexcitation ([1],[2],[3],[4]). As a result of this glutamate hyperexcitation, NA core (NAc) dopamine (DA) sensitivity is downregulated. It has been found in [5], in rats chronically treated with amphetamine, NA DA neurons were significantly less sensitive to glutamate excitation.

NAc DA sensitivity has large implications for motivation, though. [6] provides a thorough review of just this idea. It mentions studies that have proven 'NA DA depletions... impair activational aspects of motivation.' Certainly, it is plausible that these feelings of motivation can have a positive, therapeutic effect on ADD treatment.

Additionally, [5] also found that chronic amphetamine exposure has been shown to increase and decrease, respectively, the responsiveness of NAc neurons to glutamate. This closely matches anecdotal reports of subjective increases in mood and motivation during the beginning of stimulant therapy which then taper off as effects of stimulant treatment normalize.

One possible solution to controlling this glutamate hyperexcitation to restore sensitization of NAc DA neurons and the therapeutic motivational effects of amphetamine is coadministration with memantine. Memantine is an uncompetitive antagonist at glutamatergic NMDA receptors. Most importantly to our purposes, because memantine has a low-to-moderate affinity for NMDA receptors, it does not seem to block normal glutamate transmission; rather, it reduces abnormal neurotransmitter-mediated activation of the receptors [7], thereby potentially reducing excitotoxic neuronal damage. Normal glutamate function, then, is not impinged upon.

Memantine is very well tolerated ([8][9][10]) and does not have drug-drug interactions with amphetamine [8]. Also, memantine has been studied in healthy, non-dementia patients with no signs of problems and, in fact, showed evidence of cognitive enhancements and other beneficial effects in these patients ([11][12][13]). It also provides beneficial, healthful side effects, including an increase in BDNF [[14].

Theoretically, co-administration of memantine and amphetamine is a safe, novel, and promising solution to restore NAc DA sensitivity that is lost by amphetamine-induced glutamate hyperexcitation and, as a result, restore the plausibly therapeutic motivational effects of amphetamine lost in the early stages of treatment.

However, the same passage got me wondering if my normal state is hypo-excitation on the glutamate receptors. Since memantine will (dose-dependently) correct hyper-excitation AND hypo-excitation, I wonder what effects Memantine alone will have. I plan to initially do a trial run of Selegiline + Memantine without the Adderall, in order to find out.

Edited by zrbarnes, 04 April 2012 - 10:02 AM.

[gamesguru]

Mind & Muscle is claiming to know what no one else knows. There is very little research concerning the long-term combination of NMDAR antagonists and dopaminergics (this study, which finds that memantine causes more tolerance to certain effects of amphetamines, will reveal the extent of the controversy/confusion: http://www.sciencedi...006899393909138). If it was NMDAR antagonists and opiates, then I could say, yes, mematine will reduce opiate tolerance (see this well-cited study: http://www.sciencedi...304395996031855).

[gizmobrain]

Mind & Muscle is claiming to know what no one else knows.

Yes, you have to take their wiki with a grain of salt for sure, but that passage and some of the cited studies is was what got me interested in researching further.

Thanks for the links!

[gamesguru]

See these also:

finds that NMDAR antagonists prevent behavioral-sensitization to amphetamines: http://www.sciencedi...00689939191202C
speculates that NMDARs are unrelated to the rewarding sensations and to the locomotive-activating/place-condition effects of amphetamines: http://www.sciencedi...09130579490295X
suggests that NMDARs, Ca++, glutamate, and cAMP are involved in dopaminergic gene expression: http://www.jneurosci...6/13/4231.short


As you can see, most of the studies have to do with acute sensitization (basically a few doses, then a few days of abstinence, then the tests with NMDAR antagonists), and there are basically NO studies dealing with chronic co-administration of amphetamines and NMDAR antagonists. Nevertheless, the studies we have on the topic are fascinating.

[singularvision]

interesting topic. How did this work for you?

Anyone have experience combining memantine and good doses of l-tyrosine? How did that work out?

[gizmobrain]

Apparently my doctor still hasn't received the articles that he ordered through the hospital library, so I haven't yet trialed Memantine.

My current regimen is still working surprisingly well, even after 2 weeks.

Upon waking:

• 5mg of Adderall
• 2 capsules of Nature's Herbs Artichoke Extract
• 1 capsule of Nature's Plus Coleus Forskohlii

For breakfast about an hour later:

• 2 eggs cooked in olive oil
• 5mg of Selegiline
• 2 capsules of Doctor's Best High Absorption CoQ10

In the afternoon:

• 400mg of Berberine Sulfate

Before bed:

• 1 tablet of Schiff's Sweet Slumber

As needed:

• Solaray Jiaogulan Extract
• Life Extension Magnesium L-Threonate

Edited by zrbarnes, 14 April 2012 - 12:54 AM.

[peakplasma]

I'm just wondering if you're getting the same effects from Adderall combined selegiline?

I noticed that low dose l-deprenyl (~1mg daily) completely blunted the punch of amphetamine.

[gizmobrain]

The effects I feel from the above regimen is similar to the effects I felt from 40mg of Adderall (2x20mg daily) that I took about a year ago (by itself). The difference is that this regimen has drastically reduced side effects. Also, the positive effects last for 8-10 hours, whereas Adderall by itself would only last for 4-6 hours.

I was already on the above regimen minus the Adderall for a couple weeks prior to adding in the Adderall. On the few days that I have deviated from the regimen, I notice an "off" feeling. I have tried to leave out the herbs, and just take Adderall + Selegiline, but it doesn't seem to work as well. The herbs, by themselves, don't seem to help much with motivation. I tend to think of it as the Adderall gets me going, but the herbs + Selegiline keep me going.

I feel like I have stumbled onto a great little stack that works for me. I would recommend anyone who is healthy but suffers from space cadet troubles (aka SCT, ADD, CFS), to give it a shot. I think it might be too stimulating for energetic, manic, bipolar, schizophrenic, or even hyperactive ADHD'ers. Maybe switch out the Artichoke to Rosemary extract (too sedating for me), for starters. I definitely increases my talkativeness, passion, and libido, as well, but in a more balanced, controllable way than high doses of Adderall.

I am interested in finding out how Memantine will play into all of this.

Edited by zrbarnes, 14 April 2012 - 04:15 AM.

[riloal]

Hi, zrbarnes, could you finally tried the combo adderall with memantine and selegiline? Thanks

[gizmobrain]

Unfortunately, no. My doctor dragged his heels too long, then I lost my insurance. I may revisit this at some point in the future when I have insurance.

[royalland]

where do you buy Adderall ?

[tritium]

where do you buy Adderall ?

You need a prescription. But, I have about 2 grams of active ingredient in tablets just sitting here not being used.

[royalland]

where do you buy Adderall ?

You need a prescription. But, I have about 2 grams of active ingredient in tablets just sitting here not being used.

Hum for us ? for french is very hard no found ;(

[khemix]

If you want memantine for tolerance prevention to amphetamines, you are going to need a hell of a lot more than 10mg. Such a dose is child's play, you need to be somewhere around 30+mg for tolerance purposes. This is based on user reports on various forums and not on any scientific study.

And why the selegine?? Do you need elevated DA/NE levels even when you sleep? That will only accelerate tolerance. Adderall is sufficient, as it not only prevents reuptake but also acts as a releasing agent.

[Reformed-Redan]

If you want memantine for tolerance prevention to amphetamines, you are going to need a hell of a lot more than 10mg. Such a dose is child's play, you need to be somewhere around 30+mg for tolerance purposes. This is based on user reports on various forums and not on any scientific study.

And why the selegine?? Do you need elevated DA/NE levels even when you sleep? That will only accelerate tolerance. Adderall is sufficient, as it not only prevents reuptake but also acts as a releasing agent.

From what I've heard it blunts the comedown and smooths out the whole up and down of the drug. Seems like a win win for people with ADD. Only thing that comes to mind for desensitization of DA neurons is long term running. Say you study 4 hours, (I think the marginal benefit after 4h is low), right after that you grab something to eat (high in carbs) go the gym and start running on the treadmill (maybe ALCAR), do this for a good 30min and you're good to go tomorrow. What's left is supplementation of DLPA at night or in the morning along with a good meal. Repeat and do the behavioral modification therapy in the morning before starting anything else, maybe meditation also. Actually, you can combine behavioral BM with meditation. I do this alongside tDCS on left DLPFC. I try and implement this plan every other day so as to leave room for recovery. Don't forget a multivitamin+DHA+ALA. If you can schedule this all with the 1.25 mg Selegiline, 5mg Adderall, and latter on Memantine every other day, nothing is impossible. Obviously a source of income is another matter. Someone give me a +1.

[Reformed-Redan]

So, I took 5mg+5mg of adderall after 2 days on 1.25mg selegiline. The effects were much more different from adderall without selegiline. It was like my DA threshold had already shifted by +1 and the usual +2 shift of mt DA threshold was lessened by 1. So, it was like selegiline gave me already +1 and then adderall just got +1 instead of +2 without selegiline. No apparent euphoria or anything like that. I'm going to see how this works out tomorrow or the day after tomorrow to see how if this is the case. I might just stick to adderall without the selegiline if selegiline blunts the effects of adderall, don't know why.

Also, there is an apparent forehead 'pressure' feeling, as if you'd taken too much Tyrosine or DLPA. Not a nice effect. Adderall+memantine is better for tolerance reduction. Selegiline has little benefit as it doesnt affect NE, and that might effect adderall's efficiency.

[3AlarmLampscooter]

So, I took 5mg+5mg of adderall after 2 days on 1.25mg selegiline. The effects were much more different from adderall without selegiline. It was like my DA threshold had already shifted by +1 and the usual +2 shift of mt DA threshold was lessened by 1. So, it was like selegiline gave me already +1 and then adderall just got +1 instead of +2 without selegiline. No apparent euphoria or anything like that. I'm going to see how this works out tomorrow or the day after tomorrow to see how if this is the case. I might just stick to adderall without the selegiline if selegiline blunts the effects of adderall, don't know why.

Selegiline definitely reduces the "rush" of amphetamines, but overall potentiates the stimulant/cognitive effects. Same with modafinil. I personally far prefer it, you should give at least a few more tries.

[Reformed-Redan]

So, I took 5mg+5mg of adderall after 2 days on 1.25mg selegiline. The effects were much more different from adderall without selegiline. It was like my DA threshold had already shifted by +1 and the usual +2 shift of mt DA threshold was lessened by 1. So, it was like selegiline gave me already +1 and then adderall just got +1 instead of +2 without selegiline. No apparent euphoria or anything like that. I'm going to see how this works out tomorrow or the day after tomorrow to see how if this is the case. I might just stick to adderall without the selegiline if selegiline blunts the effects of adderall, don't know why.

Selegiline definitely reduces the "rush" of amphetamines, but overall potentiates the stimulant/cognitive effects. Same with modafinil. I personally far prefer it, you should give at least a few more tries.

I don't know. I've associated the rush feeling from amphetamines with the positive aspects in terms of focus and motivation. I'm not sure. What do you think about it?

I think, basically I prefer the amphetamine rush than the constant stimulation from selegiline+adderall.

[riloal]

yadayada, are you taking memantine also with selegine and adderall? Thanks

[Reformed-Redan]

yadayada, are you taking memantine also with selegine and adderall? Thanks

No, just selegiline. I rad somewhere that selegiline actually dampens the effects of adderall. I think I'll just stick with adderall and cycle it along with whatever else in terms of physical activities I can do to re-sensitize my DA receptors.

[3AlarmLampscooter]

I don't know. I've associated the rush feeling from amphetamines with the positive aspects in terms of focus and motivation. I'm not sure. What do you think about it?

I think, basically I prefer the amphetamine rush than the constant stimulation from selegiline+adderall.

The rush definitely has a positive effect on motivation, but I'd say less on focus. You'll especially notice this if you try 2-FMA, it is far less euphoric than d-amphetamine but provides even better focus. The rush can even tend to get a bit distracting at higher doses, and start to decrease the performance enhancing effects. Tianeptine on the other hand seems to provide a lot of motivation from being about equally as euphoric, but is far less distracting IMO. Hence why I prefer Selegiline+Modafinil+Tianeptine with my amphetamines. Overall a much more "clear headed" experience.