200 replies to this topic

[floweryriddle]

I am suffering from ADHD and currently take stimulant medication for it. 

It makes things better, but it still feels like my brain is fighting me for everything that doesn't trigger an immediate reward response. Everything new that requires initial effort is very hard to get started with, and because of that a lot of my hobbies seem to die down because I can't get to start them. 

 

I think this is because of the dopamine imbalance that's associated with ADHD. That things that are hard to start because they are not rewarding feel a million times more unrewarding because of this imbalance (though I could be wrong with this). 

 

I was wondering what's out there to tackle this.

 

- Stimulant medication? Yes, I am currently on Methylphenidate and it helps. But it just inhibits dopamine re-uptake, doesn't it? So unrewarding things vs rewarding things still feel very very different

- Non stimulant ADHD medication? I am taking Strattera (Atomexetine). Not sure it's changing anything on here. It's primarily a norepinephrine reuptake inhibitor but might also act on Serotonin

 

How about others? 

- Guanfacine is another non-stimulant medication for ADHD. Seems to be still kind of new and not many reports out there 

- Antidepressents? SSRIs? SSNIs? 

[MichaelFocus22]

 I feel you man, I wish I had an answer for you, I've been self-developing for months and Nothing seems to really work. Even after going off medication, I still have the same impulsive tendency's and crass towards addiction AFTER  a year and half. Ultimately the conundrum comes down to this impossible paradox that appears to be unsolvable. From my perspective, I don't feel successful and my success and progress appears to be going to way side off medication and my life feels pointless. On medication I make progress yet I'm equally as miserable. Nothing really gives me reprieve from this empty feeling I feel inside myself..Ultimately I feel like a loser like yourself. I've no real job prospects, I no longer wish to work for a shitty a employer that treats me bad, I still have no girlfriend, I've no real friends, Life is very empty and distracting myself from this is my only way to hide from my world. What you need to realize, is that on medication you won't be able to dictate social situations and off it you will expend all off your willpower by the TIME you manage everything.  What is the answer? The only answer is to find a cure somehow, I've literally tested every single thing possible and nothing works. Let me illustrate to you, how much I ended up loosing I lost my Job,my gpa, my spartan mambo dance team which I LOVED to death and I spent every moment working on myself. Everyday was pain and everyday I did all I could but nothing I did was ever enough. I wish I could tell you there is an answer, I don't know what the answer is...precisely because their is no answer. We've been dealt a rather bad hand. All I can say is be very careful what you do or you will lose everything.It's not a fun experience I lost everything I loved from one bad decision and I can never take it back ever. I watched everything implode. How many normal people have seen that happen? None that's what. Thus, I wish you well in this confusing game. Stimulants are only a band-aid and a shitty one at that. I wouldn't mind not being alive right now. My life feels empty and pointless even if I appear moderately successful. Do you think a normal person will ever know, the pain it is to exist? That's what I tell them, I simply EXIST.I feel moments of pleasure and then I'm empty again. I wish you well. Goodluck your going to need it.

[floweryriddle]

I feel you man, I wish I had an answer for you, I've been self-developing for months and Nothing seems to really work. Even after going off medication, I still have the same impulsive tendency's and crass towards addiction AFTER a year and half. Ultimately the conundrum comes down to this impossible paradox that appears to be unsolvable. From my perspective, I don't feel successful and my success and progress appears to be going to way side off medication and my life feels pointless. On medication I make progress yet I'm equally as miserable. Nothing really gives me reprieve from this empty feeling I feel inside myself..Ultimately I feel like a loser like yourself. I've no real job prospects, I no longer wish to work for a shitty a employer that treats me bad, I still have no girlfriend, I've no real friends, Life is very empty and distracting myself from this is my only way to hide from my world. What you need to realize, is that on medication you won't be able to dictate social situations and off it you will expend all off your willpower by the TIME you manage everything. What is the answer? The only answer is to find a cure somehow, I've literally tested every single thing possible and nothing works. Let me illustrate to you, how much I ended up loosing I lost my Job,my gpa, my spartan mambo dance team which I LOVED to death and I spent every moment working on myself. Everyday was pain and everyday I did all I could but nothing I did was ever enough. I wish I could tell you there is an answer, I don't know what the answer is...precisely because their is no answer. We've been dealt a rather bad hand. All I can say is be very careful what you do or you will lose everything.It's not a fun experience I lost everything I loved from one bad decision and I can never take it back ever. I watched everything implode. How many normal people have seen that happen? None that's what. Thus, I wish you well in this confusing game. Stimulants are only a band-aid and a shitty one at that. I wouldn't mind not being alive right now. My life feels empty and pointless even if I appear moderately successful. Do you think a normal person will ever know, the pain it is to exist? That's what I tell them, I simply EXIST.I feel moments of pleasure and then I'm empty again. I wish you well. Goodluck your going to need it.

I'm not a doctor, but this sounds like a pretty clear depression to me. Might make sense to talk to your psychologist about this and see if you can try some treatments for it.

For me personally, I am really more talking about the motivation issue. Sure, it probably is depression related somehow, but still in a mild stage (I think).
I talked with my doctor about this a little and he confirmed that it probably is some sort of underlaying depression. For a test, I got a very low amount of Amoxapine prescribed (tricyclic antidepressant) to take alongside my Concerta to see if it results in changes in my motivation. (He said he mostly wants to try increasing my norepinephrine). Not so happy about taking something that acts on serotonin as well, but let's see how this testrun goes.

I am very curious about Guanfacine and asked about it and while my doctor said he thinks it’s a good idea to try, it currently is only approved for children and not adults so he’s unable to prescribe it to me. I’d have to wait a few years until trials in adults finish.

Edited by floweryriddle, 30 August 2018 - 05:26 AM.

[MichaelFocus22]

Also what you need to recognize is that the moment you take medications your "vibe" will be imbalanced if you will and you won't receive any social attention which is the direct cost of medication but frankly who cares when you can accomplish your goals. I've also noticed i get WAY less likes and responses on both linkedin and my youtube channel as well. It's pretty interesting to observe actually. Just remember your friends nor your familes can accomplish your goals and they will never understand what you and I go through precisely because their neurotypicals who enjoy the privelged position of having all the dopamine they need in order to get the job done. Most people with ADHD-PI  suffer from chronic periods of AHEDHONIA and depression when you run out of shit to do. You will be subjected to chronic impulses which you will battle and basically you will find yourself self-destructing. I heavily reccomend you reference back to my  ADHD thread, you should get alotn of good insights. No neurotypical can ever understand what it's like to be you, they will say shit like work harder and blablabla you will always fail..So I reccomend you accept that and make peace. Goodluck bud 

[cat-nips]

Consider lowering or even eliminating Strattera. I have noticed that anything that works on Norepinephrine too much, helps in planning abilities BUT at the cost of lowered actual completion rates and lowered ability to devise new ideas.  Meaning I run in circles and spend massive amounts of time planning, but not actually doing.  Like spending hours planning a class or workout schedule or even a daily schedule, but not having the motivation to actually go through with it.  It also makes it very difficult for me to think creatively or consider new ideas. It definitely helps some aspects of functioning, but is in no way, a complete picture. The balance is what is difficult to get right. 

 

Methylphenidate works on both dopamine and norepinephrine. In combination with the Strattera it could be throwing off the ratios. I don't have personal experience with Strattera, but when I trialed Concerta and/or Ritalin I pretty much turned into a complete taskmaster and a emotionless bitch to everyone around, although my focus was much improved and I did get things done. But that's no way to experience life.    

 

Guanfacine is a high blood pressure med and will help your focus a lot and even perhaps working memory.  It makes you really tired at first and takes maybe about a week to start having positive effects. The first few days you're pretty sleepy all the time but it passes and stops being sedating after a few days-weeks.  It helps, if you don't get massive hypotension or depression from it as a side effect.  It could be worth a trial along with your other meds and could potentially help.  Small doses at night to start and then add another smaller dose in morning along with your other meds. However, If you exercise on a regular basis, it will also make your workouts worse and harder to get through from muscle heaviness.  That was the clincher for me, but I did trial for about 2 months and found it helpful for ADHD symptoms alongside stim meds.  When I stopped for awhile, anxiety went through the roof, which worsened focus so much that I tried to go back on, but couldn't get back there.  Your mileage may vary.

 

Another option would be to add a good source of Omegas. Higher EPA to DHA content, and again this takes a little while to notice and effects are subtle but it does help. There is also a non stimulant pharmaceutical called Vayarin for ADHD. It's a standardized, prescription formulation of both EPA and phosphatidylserine, another nutrient found to be helpful with ADHD.  These could be either adjunctive or if possible, a replacement. But there shouldn't be any interactions with your current meds.  You could also try a dopamine precursor with your meds, like L-Tyrosine. Again, small dose just to raise effectiveness of your current meds but be careful to monitor any possible blood pressure spikes, which could be dangerous.    

 

SSRI's and the sort have usually just made things worse for me, at least in the focus department goes.  It does somewhat tame the crazy mood swings being on stim meds could bring, but at a cost of sometimes negating the stim or giving a whole new set of side effects. Balance needs to be found and I would suggest not exploring this option as a first option, unless you're having crazy swings. 

 

Of supreme importance is to go slowly. I know being impatient comes with territory, but with the pharmaceuticals, give each change at least a week or two to gauge what is doing what.  Best of luck. 

 

 

 

 

 

 

 

 

 

 

Edited by cat-nips, 31 August 2018 - 04:02 PM.

[floweryriddle]

Hi cat-nips, thanks a lot for the feedback! Definitely very very helpful. 

 

That's interesting that you react on Norepinephrine like that. For me, Strattera was a wonder medicine that gave me a sense of complete control in my life. The higher I went, the more I felt like I was in charge. The highest I went was 120mg which is a ton of Strattera, but eventually had to stop because it started getting pretty heavy on my heart and gave me some problems. After stopping and taking a break, I am currently on 25mg and can't go higher without my heartbeat skyrocketing. 

I don't know if I actually did more things when I was on that much Strattera sadly. It's already a while back. 

 

One thing I noticed for sure though is that Strattera is killing my impulsiveness which I kinda consider as a good thing. So previously I might have done more things, but mostly out of impulsiveness rather than planning to do it. Does that maybe fit to your situation too? 

 

I might try to stop it and see how things go. Amoxapine, the tricyclic antidepressant that I got is also acting on norepinephrine though. 

I would absolutely love to replace strattera with guanfacine, but yeah it's not an option for me where I live. Ordering generics from the internet is still setting me back $60 a month

 

 

 

 

I don't have personal experience with Strattera, but when I trialed Concerta and/or Ritalin I pretty much turned into a complete taskmaster and a emotionless bitch to everyone around, although my focus was much improved and I did get things done. But that's no way to experience life.    

 

Did you try different dosages? I am on 36mg and feel no different besides more a little more productive. I don't think it changes my emotions. 

When I titrated different dosages though, I sometimes had moments where it felt like my brain was tranquillized. Kind of like a numb feeling, but... in your brain if that makes sense... 

 

 

 

There is also a non stimulant pharmaceutical called Vayarin for ADHD. It's a standardized, prescription formulation of both EPA and phosphatidylserine, another nutrient found to be helpful with ADHD.  These could be either adjunctive or if possible, a replacement. But there shouldn't be any interactions with your current meds. 

 

Interesting, never heard of that one. Looking at it, yeah, it's just EPA/DHA + Phosphatidylserine for a very marked up price. I'll just stock up on some fish oil + ps instead and see if it does anything.  

 

 

Amoxapine, I am not sure if it's doing anything. I'm taking the smallest available option (10mg) which is far under what is usually prescribed for adults. 

I want to say that I feel a little bit more like I want to try new things, but it might also just be placebo. It's a strange feeling, almost a little like impulsiveness. Like I feel I am getting more excited when I think about hobbies or things that I want to do. Maybe. I'll report back. 

Edited by floweryriddle, 01 September 2018 - 05:49 AM.

[floweryriddle]

I'm not sure what exactly is causing it, but something in the MPH + Atomoxetine + Amoxapine combination is giving me a very strange feeling. Almost like my brain is numb or dulled down. I had this feeling previously without Amoxapine but just once. With Amoxapine added, it seems to be more frequent though, hmmm... 

 

As a test I stopped taking Atomoxetine + Amoxapine and the dullness didn't come back so far, but as expected, without medication acting on epinephrine my impulsiveness is through the roof. Maybe my motivation is better? But I'd blame that on me just being a lot more impulsive and jumping around between things. 

 

For Vayarin, I ordered some high quality fish oil and phosphatidylserine and start supplementing 200mg phosphatidylserine / 1.5g omega-3 (1g EPA, 500mg DHA) from today. 

[floweryriddle]

Just a checkin - I'm on Omega3 + phosphatidylserine for a couple weeks now but don't notice anything different. Maybe a tiny bit elevated mood but there is no way I can pin that on the supplements. 

 

I'm back on Atomoxetine (Strattera) but I'm not so comfortable with stuff that acts on Serotonin so decided to stop Amoxapine for good for now. The dullness didn't come back since. Impulsiveness went down, but motivation is still an issue. 

[MichaelFocus22]

    Straterra is historically a stronger, noneprhrine inhibitor, so it increases the amount you have within your brain and it builds up over time,so you have more and more focus and more calmness as well. Historically, speaking though, most stacks are merely placebo's, I've tested basically everything from acentlycestein all the way, to bacopa, to acetylcaritine, iodine, selenium, methyfolate ect. So keep your expectations incredibly low. The only useful supplement, that I was ever able to identify was L-tyrosine, which is just basically a crapp methylphenidate. Another good one is to use energy drinks, I used to use those to give me energy when I would run out of willpower, they work moderately well. Unfortunately, I no long have access to those resources like I used to anymore. I've never actually taken straterra myself, but it will only work in cases, where there is a  norepinephrine dsyfunction. Most people with ADHD-PI have a dsyfunction of both, hence forth why it probably doesn't allow to complete tasks efficiently speaking. As for the heart issue, I wouldn't really be too concerned,that's how you know that the drug is actually working, just make sure that you work out well, and drink  some water with a good meal plan and you'll be fine. So I reccomend, you just go on concerta or methyiphenidate, it's basically the best of both worlds in my view, although you will have to get used to being a zombie, it's not all that bad. I wouldn't bother with adderall or any other classical stimulant that acts mostly on purely dopamine reuptake inhibitors. Hence, forth what you could do, is get a methyiphenidate 36 Mg, Calculate the best dose beyond your weight. Then get an extra "booster" to help you finish the rest of the day, this could be a ritalin. Then you could do as follows, Monday: MEDS Tuesday: Meds Wednesday:  Meds Thursday: Meds+ Booster Friday Meds:Booster Saturday: Breakday Sunday: Breakday: Then rest. This is the ideal schedule to maximize concerta without building tolerance, unfortunately I've built tolerance for someone unknown reason. I attribute this to the fact of taking dexerdrine, which didn't work me at ALL. It also raised my tolerance significantly. Finally be very careful with experimentation in supplements without knowing how they interact with your pre-existing medication, supplements in some cases even reduced the effectiveness of my meds.   I recommend you check out my reference thread.

[floweryriddle]

    Straterra is historically a stronger, noneprhrine inhibitor, so it increases the amount you have within your brain and it builds up over time,so you have more and more focus and more calmness as well. Historically, speaking though, most stacks are merely placebo's, I've tested basically everything from acentlycestein all the way, to bacopa, to acetylcaritine, iodine, selenium, methyfolate ect. So keep your expectations incredibly low. The only useful supplement, that I was ever able to identify was L-tyrosine, which is just basically a crapp methylphenidate. Another good one is to use energy drinks, I used to use those to give me energy when I would run out of willpower, they work moderately well. Unfortunately, I no long have access to those resources like I used to anymore. I've never actually taken straterra myself, but it will only work in cases, where there is a  norepinephrine dsyfunction. Most people with ADHD-PI have a dsyfunction of both, hence forth why it probably doesn't allow to complete tasks efficiently speaking. As for the heart issue, I wouldn't really be too concerned,that's how you know that the drug is actually working, just make sure that you work out well, and drink  some water with a good meal plan and you'll be fine. So I reccomend, you just go on concerta or methyiphenidate, it's basically the best of both worlds in my view, although you will have to get used to being a zombie, it's not all that bad. I wouldn't bother with adderall or any other classical stimulant that acts mostly on purely dopamine reuptake inhibitors. Hence, forth what you could do, is get a methyiphenidate 36 Mg, Calculate the best dose beyond your weight. Then get an extra "booster" to help you finish the rest of the day, this could be a ritalin. Then you could do as follows, Monday: MEDS Tuesday: Meds Wednesday:  Meds Thursday: Meds+ Booster Friday Meds:Booster Saturday: Breakday Sunday: Breakday: Then rest. This is the ideal schedule to maximize concerta without building tolerance, unfortunately I've built tolerance for someone unknown reason. I attribute this to the fact of taking dexerdrine, which didn't work me at ALL. It also raised my tolerance significantly. Finally be very careful with experimentation in supplements without knowing how they interact with your pre-existing medication, supplements in some cases even reduced the effectiveness of my meds.   I recommend you check out my reference thread.

 

Thanks for chiming in again. I agree with you that most stacks are useless, that's why I am not on one, besides Fish Oil + phosphatidylserine, and the reason for that is because Vayarin is selling this combination specifically for ADHD. 

That being said, I just now remembered that the Mr. Happy / Uridine stack gave me a good boost before I went on Methylphenidate, so maybe it's worth to give that a try again. 

 

I'm still on Methylphenidate (Concerta) and yeah, it definitely helps with doing things, but not so much with motivation in my opinion. Boosters aren't available where I live (Japan), so the only extend to which I have an instant release Ritalin is if I cut out the time release mechanism of some of my 18mg Concerta caps, which I did a few times. It works, just annoying. 

 

I noticed that Caffeine + Methylphenidate feels more motivating than Methylphenidate or Caffeine alone. Maybe. 

 

 

I started reading a lot about MAOIs and RIMAs and how many people use them to efficiently treat ADHD to a similar degree than Methylphenidate, on top of depression and RSD. I created a thread for it (https://www.longecit...epression-adhd/), but since I'm worried about interactions, and currently can't stop MPH, I didn't give it a try yet. Moclobemide or Seligiline are on my list of possible 'fixes', but yeah, at the current time I won't mess around with them unless I can stop other medication, find enough evidence that a combination is safe, or find a safe way to take them together (while monitoring). 

 

 

In summary

 

What worked best so far:

Methylphenidate + Atomexetine - both alone have great effects, together even better. Focus and impulsiveness is in check, motivation is still lacking

 

Maybe

Omega3+phosphatidylserine - need to take it longer from what I gathered

Amoxapine / stuff that acts on Serotonin - also need to try it longer but not feeling so comfortable to continue it yet

Methylphenidate + Atomexetine + Coffee - still trialing

 

Next

MAOI / RIMA like Selegiline or Moclobemide - looks extremely promising, but staying away because of interactions for now

Guanfacine - same, looks very promising but hard to get and not prescribable where I live. Dosages are usually 1mg-2mg in ER so messing around with powder seems like a horrible idea unless you have a really precise scale that's regularly adjusted

Uridine / Mr. Happy - I remember getting a good caffeine-like boost and elevated mood from this combination a while ago. I have some laying around so maybe good to re-evaluate it again

Modafinil - just throwing it in here. Some people use it to treat ADHD symptoms and like it, so might be interesting to see how I react to it. Tried talking to my doc about it but he said he's unable to prescribe, even just for trying. 

Atypical antidepressants like Tianeptine - Might be safer than SSRI/SSNIs? 

 

 

Past

Clonidine - seems to be a inferior to Guanfacine in every way. Time release generic is hard to get and stopping it abruptly can result in some serious problems. Tried IR a few times but very sedating and initial side effects are pretty strong

NSI-189 - absolutely not sure about this one. I definitely felt it, but more in an agitated way when I tried it while on Atomexetine

Amoxapine - gave me a dull feeling in my head. Maybe did something, but for the time being want to try to stay away from things acting on Serotonin unless I have no other options left

Edited by floweryriddle, 26 September 2018 - 06:51 AM.

[MichaelFocus22]

 Here is my reference thread, You will see the evolution of on medication and off medication. Both require invariable tradeoffs, depending upon the type of ADHD that you have. Use this thread as guidance, to avoid the mistakes I've committed, and you will spare yourself much pain. If you can integrate or execute even 35% of my recommendations, you will be significantly well off. I've all but stop wasting my money on useless stacks, especially when you spend 600$ dollars. I have no real recommendations, all I know is concerta seems to be the only winner in my case. The caveat is obviously, you will be susicidal, a zombie, be unable to balance the vibe, and ofcourse you derive little enjoyment from life. Hence, forth your life still becomes meaningless. I've essentially exhausted every practical option.  Hence, I'm currently working on a cure For ADHD, as we speak. Medication is only a band-aid and nothing more. When you find yourself in paradox, your life is pointless. Thus, the only answer is a cure, irrespective of how impossible the task is. I wish you luck.

 

                     The thread is here: https://www.longecit...ons-on-adhd-pi/

[CWF1986]

If we're purely talking medications and/or supps then don't forget about wellbutrin.  It very well might be the most activating of the common AD's.  I find it helps with motivation more than adderall, but doesn't give me nearly the same amount of focus, ability to think many steps ahead, and does nothing for restlessness.  I ended up having to pick one or the other because taking both together at the same time gave me really bad anxiety so I went with the adderall.  

[cat-nips]

Guanfacine will help concentration and working memory but not necessarily motivation. It also changes your blood pressure and can make it too low but maybe not in conjunction with MPH.

The Vayarin combo is marketed to do the same thing for focus but not necessarily motivation.

Not sure if anything directly increasing serotonin would help motivation. Usually hear the opposite.

What about trying to swap the MPH with an MAOI. Believe I saw a few studies out there I think that show similar efficacy with MAOIs. Maybe you should ask your doc if that’s an option instead of trying to take them together. I don’t think many docs would be comfortable with coadministration and would probably rather have you on one or the other. There are a couple of anecdotals out there from those that combine the two but it’s experimental and they stick to really low dosages and you’d be playing with fire here.

Nothing is perfect. What you’re calling as “motivation” I’m translating as desire to want to do things that you like, don’t like, and don’t know about yet in a consistent manner. MPH will probably help get through tasks you already know but it won’t necessarily make you happier or more creative or willing to try new things.

There is no perfect pill or stack. With things like this we have to take the least amount needed and build up the rest environmentally. If you’re using Adhd meds to try to get to a point over baseline, you’re setting yourself for a long ordeal of trying to manage your life with constant volatility and possible damage to your health.

I don’t know if MAOIs and Strattera are ok together but it might be an better option to take out the MPH at this point and try MAOI with Strattera or even by itself, rather than continuing to look for validation for a risky combo. Problem with MAOI is that they cause levels of neurotransmitters to rise over time so things could be fine for 2 weeks and then you suddenly start having interactions which is partially what makes them unpredictable and unsafe. RIMA is safer but I’d still pause at combination with MPH.

Modafinil is somewhat similar to MPH but weaker. It may be worth a try at some point independently, or maybe with just Strattera. Please check the interactions. The risk of it adversely affecting your heart if you take it with any type of mao is something you should probably stay away from. Best of luck.

Edited by cat-nips, 27 September 2018 - 12:31 AM.

[floweryriddle]

Thanks guys for the replies guys

 

 

Nothing is perfect. What you’re calling as “motivation” I’m translating as desire to want to do things that you like, don’t like, and don’t know about yet in a consistent manner. MPH will probably help get through tasks you already know but it won’t necessarily make you happier or more creative or willing to try new things.

 

What I mean with 'motivation' is mostly towards things I actually like, like hobbies. 

Chores like 'clean the dishes', 'do this task', 'buy groceries' are no problem. Maybe starting is sometimes difficult when not medicated, but no big issue. 

 

But hobbies, like 'go out and take pictures with your new camera', despite me really wanting to do them, I can't. I can do everything until actually doing it, like researching techniques, buying lenses and equipment, but when it's time to use all of that, it feels like a mental block. 

Another example is dancing. I love dancing and am doing choreographies with friends. It's always a ton of fun and practicing with them is no problem, but when I want to practice alone to get better, I just can't. I can think about every step I am going do, pick out the location where I will go to, what to pack, but then when it's time to actually go out and do it, the block is back. 

 

This happens to most things that require initial motivation out of my own will to start that are without external influence, just me. And these are things that I genuinely enjoy and have fun doing and look forward to. It's very hard to describe, almost like a mental wall?

I checked a bit up and some people with ADHD have similar issues. Stims help really well with sticking to things and focus, but I hoped there was more I can do because living like this is very frustrating. That's why I created this thread. 

 

 

 

If we're purely talking medications and/or supps then don't forget about wellbutrin.  It very well might be the most activating of the common AD's.  I find it helps with motivation more than adderall, but doesn't give me nearly the same amount of focus, ability to think many steps ahead, and does nothing for restlessness.  I ended up having to pick one or the other because taking both together at the same time gave me really bad anxiety so I went with the adderall.  

 

Wellbutrin didn't cross my mind. Though it seems to be very similar to my current Atomexetine + MPH combo in that it inhibits dopamine and norepinephrine. I'll try to read a bit up on it!

 

 

 

Guanfacine will help concentration and working memory but not necessarily motivation. It also changes your blood pressure and can make it too low but maybe not in conjunction with MPH.

 

 

The reason why I also added Guanfacine to the list is because it's helping a lot with rejection sensitive dysphoria. It's a far stretch, but one thought was that maybe this somehow attributes to depression, or to fear of trying things and failing. Again, far stretch.

 

 

 

The Vayarin combo is marketed to do the same thing for focus but not necessarily motivation.

 

Omega3 is probably good in either way. There is also talk about it improving depressive symptoms in high dosages. I'm a strict non-fish / seafood eater and thought that I might be lacking in it. Again suspecting maybe some sort of depression. Adding phosphatidylserine on top was because of Vayarin.

 

 

 

What about trying to swap the MPH with an MAOI. Believe I saw a few studies out there I think that show similar efficacy with MAOIs. Maybe you should ask your doc if that’s an option instead of trying to take them together. I don’t think many docs would be comfortable with coadministration and would probably rather have you on one or the other. There are a couple of anecdotals out there from those that combine the two but it’s experimental and they stick to really low dosages and you’d be playing with fire here.

 

Nothing is perfect. What you’re calling as “motivation” I’m translating as desire to want to do things that you like, don’t like, and don’t know about yet in a consistent manner. MPH will probably help get through tasks you already know but it won’t necessarily make you happier or more creative or willing to try new things. 

 

There is no perfect pill or stack. With things like this we have to take the least amount needed and build up the rest environmentally. If you’re using Adhd meds to try to get to a point over baseline, you’re setting yourself for a long ordeal of trying to manage your life with constant volatility and possible damage to your health.

 

I don’t know if MAOIs and Strattera are ok together but it might be an better option to take out the MPH at this point and try MAOI with Strattera or even by itself, rather than continuing to look for validation for a risky combo. Problem with MAOI is that they cause levels of neurotransmitters to rise over time so things could be fine for 2 weeks and then you suddenly start having interactions which is partially what makes them unpredictable and unsafe. RIMA is safer but I’d still pause at combination with MPH. 

 

Modafinil is somewhat similar to MPH but weaker. It may be worth a try at some point independently, or maybe with just Strattera. Please check the interactions. The risk of it adversely affecting your heart if you take it with any type of mao is something you should probably stay away from. Best of luck.

 

 

Yes I agree with you. I gave up on the idea idea of combining a MAOI and MPH, unless I find a way to try it in a very safe matter (that is, for MAO-A).

The reason why I even started with this was because MAOIs seem from what I gathered very good for ADHD (+ symptoms like RSD) and depression in general. I hate munching pills, and being on stimulants most of the time worries me about long term effects, so replacing all of that with a MAOI which seems to be much safer, is something that absolutely caught my attention. 

 

Swapping MPH for a MAOI is something I want to do, but currently my work makes it difficult to stop MPH completely without falling back a good chunk. It's going to be another few months or so before I have enough time, sadly. 

 

---

 

On the topic of MAOIs, I posted in my other MAOI thread as well that I ran into Selegeline which is in very low dosages (5mg~10mg) selective to MAO-B. 

There is also this study here (https://www.research...andomized_Trial) comparing Selegiline to MPH, but it looks like with the dosaging up to 15mg, that it might have lost selectivity for that study.

 

Nevertheless Inhibiting MAO-B exclusively would still act on dopamine and maybe allow to reduce MPH, if not stop it completely which is still a win but it probably won't do much to motivation or any of the other symptoms I mentioned though. So, meh. 

 

 

 

 

Sorry for being a little all over the place. I am also still learning about all of this day by day and any input is helping me a lot. 

[floweryriddle]

Little update:

Turns out this motivation problem the way I described it is textbook adhd and not depression. I just wasn’t fully aware to what degree this condition messes with things yet.

Dr Russel Barkley phrased it well with

> Adhd kids cannot motivate themselves. It means you will always be dependent on the environment around you and it’s immediate consequences for how hard and how long you can work. And if there are no consequences in that context, you cannot work.


This is a good step forward in understanding what’s going on, but also a step back because it makes this feel like there isn’t much I can do to fix it.

Nevertheless, I gave modafinil a go but it didn’t do much besides making me really awake.

Tianeptine sodium didn’t do much for me in the short time I tried it. I want to do a more longer test but Japan recently added it to the no-import list so it might become a pain to get if it happens to work.
Nevertheless I’ll try the rest my stash and see if it does something.

Selegiline arrived today. Planning to fade out MPH and try selegiline by itself, then re-introduce low dosage of MPH.

Edited by floweryriddle, 14 October 2018 - 02:13 AM.

[MichaelFocus22]

 Flowerriddle, it's very easy to tell if you have ADHD or not. You will find yourself mindlessily searching for the optimal stimulus to keep you awake and have to constantly battle yourself in order to stop doing something. You will hyperfocus and get bored with everything and you won't know why. Like today for myself I'm VERY BORED, not on medication and simply speaking there isn't ANYTHING to really do. I'm doing OK but i'm still impulsive and wasted 3 hours on internet, so the only thing that works is to permanently ban it nothing else really works. What  your describing is called the ADHD wall, I've been going to the gym for months and haven't been able to improve. Obviously their are many factors, dictating this but I know this wall ALL TO WELL. What happens, is once you reach a certain competence level, you will struggle to get any better because the reward for stimulus will slowly decrease over-time until your interest either wanes or you get so angry at not improving you stop doing it. Be very careful not to let this habit occur or you will lose everything that you have invested into the habit and be a loser once more. ADHD is  the inability to sustain focus and self-regulate impulse for short-term gratification. You know you have ADHD when your not able to delay gratification. My delay of gratification is AWFUL, even with all the copying mechanisms I have it's just horrenduous.  I reccomend using a pomodoro timer, it makes my days SOMEWHAT bareable without medication and it allows me to at least quantify my productivity so, i can keep myself on task. It's the second best thing besides a planner or to dolist obviously. Just be careful and not to take too many breaks or you won't get very much done. If the Methylphenidate doesn't make you susicidal like it does for me, you should STAY on it. You will AVOID alot of grief. The problems with meds though, is that I'm not able to dictate vibes, which also sets me back. Yet in the later case, I get things don't but am still not able to dictate vibes. So we are pretty screwed in this respect. Finally, stop working towards mastery, just get as close as you can get to a higher competence level. That is WAY  more doable than the later case. Trust me you will spare yourself alot of rage. You will why am I not able to get any better when everyone else can? Oh, it's just a stupid chemical, but that chemical is VERY important. Neurotypicals ironically look down upon us for taking stimulants when they get to be stimulated ALL the time with infinite dopamine. Yet, when we take it we are drug addicts. Dr. Barkley is VERY status quo, so don't expect any new cures or new innovations coming from the ADHD field anytime soon. It's up to us young people to innovate to hopefully live closer to a normal life, if only I knew what a cure looked like. Finally, I reccomend stop tinkering with your medication and get someone who is actually trained. I tinkered and went on dexerdrine and built up a tolerance to my OLD methyphenidate that worked for over a year and it hasn't been the same sense. I studied the effects of the drug for months before doing ANYTHING and it backfired. I was unable to accomplish half of what I did before hand because the medication stopped working and my psychiatrist wouldn't raise the dosage. So your playing with fire here in this respect. Goodluck.

[CWF1986]

Little update:

Turns out this motivation problem the way I described it is textbook adhd and not depression. I just wasn’t fully aware to what degree this condition messes with things yet.

Dr Russel Barkley phrased it well with

> Adhd kids cannot motivate themselves. It means you will always be dependent on the environment around you and it’s immediate consequences for how hard and how long you can work. And if there are no consequences in that context, you cannot work.


This is a good step forward in understanding what’s going on, but also a step back because it makes this feel like there isn’t much I can do to fix it.

Nevertheless, I gave modafinil a go but it didn’t do much besides making me really awake.

Tianeptine sodium didn’t do much for me in the short time I tried it. I want to do a more longer test but Japan recently added it to the no-import list so it might become a pain to get if it happens to work.
Nevertheless I’ll try the rest my stash and see if it does something.

Selegiline arrived today. Planning to fade out MPH and try selegiline by itself, then re-introduce low dosage of MPH.

 

 

Well whaddya know!  I'm doing the same thing with selegiline but I'm subbing in for adderall instead.  If it's not enough on it's own I'll try carefully titrating phenylalanine.

[John250]

Well whaddya know! I'm doing the same thing with selegiline but I'm subbing in for adderall instead. If it's not enough on it's own I'll try carefully titrating phenylalanine.

Update us on how this goes for you? I’m always looking for something to substitute Adderall.

[Major Legend]

Selegiline is not a good idea.

[floweryriddle]

Selegiline is not a good idea.

Reason being? 

[floweryriddle]

Update

 

it's been roughly 10 days. I stopped MPH + Strattera and started with Selegiline 5mg orally. Then after around a week, slowly re-introduced Methylphenidate in very low dosages while monitoring my heart rate constantly. 

My impression from what I gathered was that it would make MPH stronger due to MAO-B inhibition, but the opposite happened and it feels weaker or less pronounced than before. I read that Selegiline can blunt the effects of stimulants and it looks a little like that might be happening here. It's still a little odd though. Maybe it's also just taking off the high edge so it doesn't feel as jittery anymore? In general, it feels less wired, which is good!

 

I noticed a bit more impulsiveness though, but that might also just be rebound from stopping Strattera.

 

Tianeptine I am currently on 12.5mg x 3 / day and for the first time, I think it's actually doing something. I feel subjectively more motivated, happy and the wall in my head feels weaker. 

I still didn't get to the actual doing part and block, but it feels easier to start things (esp with MPH on top). Tasks, which are already easier thanks to MPH, feel like they have even less conflict. On top of that I have a lot less sad thoughts and am less harsh on myself.

I don't notice anything acute from it though and I can't 'feel' Tianeptine, so if I don't write down that I took it I probably wouldn't even know. It started after a few days constantly taking it. 

(This little experience made me also question if it might not just be better to try a proper antidepressant) 

 

All in all, I am happy with a little bit of success. 

 

 

I also talked with my doc again. He still wants to try to further up my norepinephrine but I said I'm a little worried about SSRIs and don't want to take Amoxapine for now. He gave me more Concerta to try if increasing dopamine more is resulting in stronger motivation (doubt it though)

Edited by floweryriddle, 25 October 2018 - 10:34 PM.

[MichaelFocus22]

  What were you results with Straterra and Concerta from a cognitive level? Did you have any objective improvement in your cognitive functions in being able to attend to boring tasks consistently? It's important to realize, that you probably won't find a real answer with testing a bunch of different drugs, in hopes of finding the right balance to function like a neurotypical. I've yet to find a solution to this, if there was I would have found it by now. Despite, my alarming comment, keep experimenting until you find what works for you. I just hope you realize, that true ADHD-PI, is a very hard disorder to treat, especially for myself in particular.  Perhaps, you should investigate a good diet. I've been noticing my focus and impulsiveness skyrocket when I eat low quality foods. Maybe, there is  a connection. Nonetheless, you should transparent about your ADHD, so people get more educated about it and this will benefit all ADHD sufferers. Finally, it's important to note, that all big pharmaceutical drug's have yet to address the issue of tolerance. Almost all drugs, appear to develop some level of tolerance and appear to make you a zombie, who hates the world. Meaning you won't be able to dictate vibes and live a fairly pointless life regardless. It's my cynical view, that they probably won't be providing any real solutions any time soon. Thus, we must develop a cure within our lifetime, otherwise your life and my life will have been a waste. Hence, why I'm working towards the development of a non-profit for this exact mission. Nonetheless, I wish you luck.

[floweryriddle]

  What were you results with Straterra and Concerta from a cognitive level? Did you have any objective improvement in your cognitive functions in being able to attend to boring tasks consistently? 

 

 

Boring tasks are no problem with medication for me. I use a todo list app in combination with a timer for my stuff. For example: In the morning or day before, I move tasks I want to get done into my list for the next day and schedule where appropriate. eg: I have 1h to do task x planned in the morning. I prepare, start my timer and for 1h I work on it. If it's done earlier - great, time to do the next one. if I start hyper-focusing and my timer runs out, I strictly stop so other planned tasks don't suffer. This helps me a lot with actually getting things done. 

Without medication I have problems starting tasks or easily drift off to something completely unrelated. 

Strattera I use mostly for impulsiveness and 'evening myself out'. Without it I sometimes buy things I don't need or say things I shouldn't have said. It also gets random obsessions in check. I feel more organized with it.

 

I agree that testing a bunch of different drugs isn't the most optimal thing to do, but it gives me hope that maybe finally things will get better. I hate that I am wasting so much time telling myself to do things but never actually doing it, and it's taking a pretty big toll on me mentally over time. 

I also don't test random things, but usually do my own research to evaluate if it even makes sense to try, so everything I use has it's reason why it's there.

 

From talking to a few doctors here, the only thing they do is 

a) give you more strattera

b) give you more concerta (most won't touch stimulants)

c) give you an antidepressant like lexapro

 

Japan is still a pretty conservative country when it comes to mental health, so trying more unconventional things just won't happen. 

 

Diet and exercise - I think I am a pretty active dude. I usually look after my intake, don't eat junkfood, stick mainly to water and exercise almost daily. 

 

It's like you said, a very hard disorder to treat and the more I learn about it, the more I hate it. 

Edited by floweryriddle, 26 October 2018 - 02:42 AM.

[MichaelFocus22]

 The issue is, your searching for a cure or appear to be solution oriented like myself. you appear to be dissatisfied with your existence, so your using a vast quantity of different drugs, which I applaud. The issue, is if your going to be a solution-oriented person, you might as well work towards inventing a cure for the disorder, if your intellect  provides you adequate resources. I reccomend start writing a book or develop a business model perhaps on ADHD. It's unclear what the cure is but, the first step is to mobilize it. Think of it this way, if more than one person, especially a non-neurotypical is working towards a cure, then we have a higher probability of finding it within our lifetime. I agree as usual, yes saying you want to do actions but not doing them is infuriating now isn't it? Mines, is I have to many misprioritizations overtime, which cause me to waste vast quantities of time and impulsive information consumption. Obviously, you can dismiss my effort to coerce you to a cure and it seems lunacy but I have this simple question for you: What is more lunancy, wasting your one life "managing" a disorder or working towards an initiative to find a disorder in your lifetime? If it seems crazy, then I suppose continue experimentation, however, I've yet to identify true causal answers, no neurotypicals seems to care if we rot. Anyways, if you do have insights, I'm open ears.

[CWF1986]

Boring tasks are no problem with medication for me. I use a todo list app in combination with a timer for my stuff. For example: In the morning or day before, I move tasks I want to get done into my list for the next day and schedule where appropriate. eg: I have 1h to do task x planned in the morning. I prepare, start my timer and for 1h I work on it. If it's done earlier - great, time to do the next one. if I start hyper-focusing and my timer runs out, I strictly stop so other planned tasks don't suffer. This helps me a lot with actually getting things done. 

Without medication I have problems starting tasks or easily drift off to something completely unrelated. 

Strattera I use mostly for impulsiveness and 'evening myself out'. Without it I sometimes buy things I don't need or say things I shouldn't have said. It also gets random obsessions in check. I feel more organized with it.

 

I agree that testing a bunch of different drugs isn't the most optimal thing to do, but it gives me hope that maybe finally things will get better. I hate that I am wasting so much time telling myself to do things but never actually doing it, and it's taking a pretty big toll on me mentally over time. 

I also don't test random things, but usually do my own research to evaluate if it even makes sense to try, so everything I use has it's reason why it's there.

 

From talking to a few doctors here, the only thing they do is 

a) give you more strattera

b) give you more concerta (most won't touch stimulants)

c) give you an antidepressant like lexapro

 

Japan is still a pretty conservative country when it comes to mental health, so trying more unconventional things just won't happen. 

 

Diet and exercise - I think I am a pretty active dude. I usually look after my intake, don't eat junkfood, stick mainly to water and exercise almost daily. 

 

It's like you said, a very hard disorder to treat and the more I learn about it, the more I hate it. 

 

Oh wow.  I've been experiencing very similar results.  There isn't any additive or multiplicative effects of combining the selegiline and adderall.  However, there definitely is with coffee and fat burners.  I have to do smaller cups of coffee if I don't want to bounce back and forth between being high and agitated for a couple of hours.  I tried PEA and depending on the dose it does nothing to making me sky high like nothing else can so it's therapeutically useless for me.  Next, I'll be trying 250mg DLPA with the selegiline to see if I can get adderall focus and motivation without the adderall.

 

With just the selegiline, I feel calmer and it feels easier to get up and do things.  As if the wall is lowered.  As opposed to the adderall where it doesn't so much feel easier to do things, I just get more drive and focus to overcome inertia.  As if I've been given more energy and pop to get over the wall.  

 

Also, doing things like talking to people I like about interesting things, exercise, reading about interesting subjects or even just being able to put a check next to an item in a to do list is more rewarding and gives me a stronger good feeling.  The adderall didn't so much make these things rewarding or feel good.  It just kind of put a fire underneath my rear and pushed me to do them.  

 

The real test will be to see how the selegiline is working a few months from now, but based on what I see so far it's definitely a keeper.  I have a couple of off work days coming up so I'll see how I can do sans adderall.  

[cat-nips]

Hi flowery,

 

Good to hear you're having some success.  I am about to start selegiline monotherapy soon to see how it helps with motivation and focus symptoms as I've become disenchanted by Modafinil, but still determined to try all the safer routes of treatment before resuming Amphetamine or Methylphenidate treatment.  The crashes, withdrawals and side effects are hard to deal with, especially over time. 

 

I am curious about the selegiline and tianeptine combo, myself.  Keep going with the EPA/DHA.  It's pretty subtle and I was taking 1-2 grams of Lovaza a day and didn't notice how much it helped until I stopped.  But it worked only for concentration, a bit perhaps.  

 

MAO's build over time so be mindful of any potential reaction with the Tia or the MPH.  Best to use a high blood pressure monitor to check blood pressure because pulse rate, in itself isn't completely indicative.  What is your dosage for Selegiline?  Just 5mg oral, once per day?  I've read that sublingual dosages are absorbed way better and you can avoid some metabolites by using way less sublingual dosing.  So 5mg oral, you would only need about 1.25 or 2.5 sublingual.  Not sure if you'd be interested in trying that, but could be a more effective way to dose with MPH if you were interested in that.

 

Best of luck going forward.  

 

 

[floweryriddle]

Hi flowery,

 

Good to hear you're having some success.  I am about to start selegiline monotherapy soon to see how it helps with motivation and focus symptoms as I've become disenchanted by Modafinil, but still determined to try all the safer routes of treatment before resuming Amphetamine or Methylphenidate treatment.  The crashes, withdrawals and side effects are hard to deal with, especially over time. 

 

I am curious about the selegiline and tianeptine combo, myself.  Keep going with the EPA/DHA.  It's pretty subtle and I was taking 1-2 grams of Lovaza a day and didn't notice how much it helped until I stopped.  But it worked only for concentration, a bit perhaps.  

 

MAO's build over time so be mindful of any potential reaction with the Tia or the MPH.  Best to use a high blood pressure monitor to check blood pressure because pulse rate, in itself isn't completely indicative.  What is your dosage for Selegiline?  Just 5mg oral, once per day?  I've read that sublingual dosages are absorbed way better and you can avoid some metabolites by using way less sublingual dosing.  So 5mg oral, you would only need about 1.25 or 2.5 sublingual.  Not sure if you'd be interested in trying that, but could be a more effective way to dose with MPH if you were interested in that.

 

Best of luck going forward.  

 

From my personal experience, Methylphenidate is still one of your best bets and if you have access to it, it's probably the way to go. It's been around so long that we at this point understand it and it's risks fairly well.

 

I am at 5mg orally. Selegiline is another thing that's technically not allowed get imported into Japan, same with Tianeptine. I was able to get generics from an online pharmacy, but they only had the 5mg tabs. I am very interested in the patches though, just can't get my hands on them here. 

1.25mg sublingual is an extremely small dosage. Even with a good mg scale you have margin of error and could by accident easily take 3mg instead of 2 and so on. Should still be not a problem, but at some point it will attack MAO-A as well, and when that happens can vary a lot. From what I gathered 5mg orally is pretty safe with keeping it on MAO-B, that's why I am sticking with that (esp since I am taking other things at the same time and really don't want MAO-A inhibition) 

 

I also noticed that it very gradually gets stronger. When I'm not on MPH, I now sometimes feel more... stimulated? Like a very very small dosage of MPH, but not the subjective feeling but less of a feeling of wanting to waste hours on my phone. I'll make sure to keep monitoring!

 

But if you're thinking of completely swapping for a MAO, why not give a proper MAOI that acts on MAO-A a try? Stuff like Moclobemide is still on my future 'want to try list' since it seems to tackle so many things at once (depression, ADHD, rejection sensitive dysphoria, etc etc)

 

 

 

And thanks a lot for joining in guys! It's really great to hear that other people dealing with similar issues and are on the same path

Edited by floweryriddle, 27 October 2018 - 01:37 AM.

[gamesguru]

stimulants, glutamate uptake inhibitors, cortisol releasers (don't overdo it), TH/DBH inhibitors, and nictonic modulators.

 

yes most of these exist naturally, in a sufficiently active form

[jacobjerondin]

stimulants, glutamate uptake inhibitors, cortisol releasers (don't overdo it), TH/DBH inhibitors, and nictonic modulators.

 

yes most of these exist naturally, in a sufficiently active form

 

What glutamate uptake inhibitors, TH/DHB inhibitors (wouldn't inhibiting TH reduce levels of dopamine tho? For DBH, beta alanine comes to mind), and nicotonic modulators do you recommend gamesguru? I don't care at all if they're natural or not tbh (in fact I tend to prefer synthetic substances since they tend to be far stronger than natural ones).

 

I've been following this thread with quite a bit of interest, not as someone that necessarily has ADHD or any particular condition, but simply as a student and entrepreneur that often struggles to find the motivation and drive to start difficult tasks and stay on track.

 

Any and all suggestions for off the beaten substances (anything popular I've prob come across and considered already).

'

Love your posts by the way man, I've learned a lot from them

[gamesguru]

What glutamate uptake inhibitors, TH/DHB inhibitors (wouldn't inhibiting TH reduce levels of dopamine tho? For DBH, beta alanine comes to mind), and nicotonic modulators do you recommend gamesguru?

 

for glutamate i recommend turmeric and theanine.  others would add taurine to the mix, but i am leery of GABAergic deficits

 

DBH may be significantly inhibited by ginseng, st. johns, the poppy, common wheat, and by following a low copper (and high iron, zinc, magnesium) diet [i like the first and last suggestions myself]

 

TH can be modulated with horny goat weed, and inhibited with Xerula australis (containing oudenone).. however probably not the most effective or potent choices on this list

as for why this would be a good thing, lower dopamine.  Drug addicts have low dopamine but for the wrong causes (or rather, too often).  You want low dopamine for the right reasons in the right durations, then it will prime your receptors.

 

for the nicotinic side of things, rhamnetin and quercetin, again turmeric, eggs, and i'm told ketamine

 

i really don't keep as up to date on the synthetic stuff as much as i should.  As I will never touch them, they don't concern me and I have no anecdotes to offer