299 replies to this topic

[Metagene]

Pitolisant might make a synergistic combo as well. Modafinil could be superior for treating ADHD though.

[lazarian]

I've just gone through most of the thread and I am going to follow it from now on, very interesting indeed!

[GetOutOfBox]

No need to worry GetOutOfBox. It would not be presumptuous to say everyone here appreciates the effort you put into your post. I suffer from ADHD mostly likely as a result of premature birth (33-34 Wks + development delay) so the genetic aspects may not be applicable to me but it's all good.

If you suffer effects of ADHD as a result of premature birth, I would heavily focus upon BDNF and NGF as a possible treatment mechanism. Premature birth tends to produce general grey/white matter deficits in the brain, though severe deficits are more common in 22-25 weeks. You were born just two weeks early, which means most of the neurological development should have completed successfully, leaving perhaps just a minor frontal lobe deficit. tDCS may be particularly relevant in this case, as frontal atrophy might be the problem in your case. Noopept might be worth a try in case of a deficit in the hippocampus.

So we've established ADHD is very likely a case of Prefrontal Cortical Dysfunction in regards to the attentional aspects (with dopamine receptors in the mesolimbic pathway more likely being involved in the motivational aspects).

This is a very painful problem for me, as I'm an artist, and my inability to motivate myself to create, has more or less taken me to a certain glass-ceiling in my carreer. Probably even worse for me personally, than inattentive-ness.

How would you go about upregulating the dopamine receptors? There seems to be dopamine reuptake inhibitor qualities to both Methylphenidate and Amphetamine -compounds, as well as the flooding of dopamine-release, of course.

BUT...! I discovered something very interesting here:

Amineptine - one helluva' Dopamine reuptake inhibitor!
http://en.wikipedia....wiki/Amineptine

It's not the best of drugs tho'... seems the side-effects of a pure Dopamine-reuptake inhibitor like Amineptine, may not be worth it. An interesting side-effect is the increased levels of testosterone tho', I seem to have low levels, since I have always had fairly acne-free skin, but also a curse of an immensely weak physique - I am quite physically underdeveloped, and I always struggle to find the right kind of excercise-regime and diet when trying to gain muscle. ( it may of course be caused by DCD as well, since that is common among us ADD-ers as well)

But do you think the side-effects could be limited with the use of some kind of Amineptine-salt? If one heightens bio-availability of Amineptine, perhaps dose could then be lowered, and therefore the side-effects as well.

It's an interesting drug and I have heard of it, however re-uptake inhibitors, release enhancers, and agonists generally do not upregulate the receptors they target (except for some weird exceptions, like nicotine upregulate nicotinic acetylcholine receptors it agonizes for some reason).

Aside from that, pure dopamine action might be desirable if norepinephrine has been established to not be a strong contributor to the attentional disorder (perhaps by experimenting with Strattera). Causing norepinephrine levels to rise beyond normal sometimes is beneficial to memory, but as far as I'm concerned the cost renders the gain worthless. Higher concentrations in certain parts of the brain tends to cause over-arousal, anxiety, and some other nasty side effects such as depression (a lot of people who try Strattera, and I mean A LOT, report feelings of depression/overstimulation as a side-effect).

The thing about Amineptine is that it does in fact affect norepinephrine, though perhaps to a lesser extent than methylphenidate does.

I just got a neat idea here... maybe the best option right now, side-effects -wise and so on, is a regimen of Intuniv and Modafinil? The Intuniv helps the PFC to get back in the game, and the Modafinil helps to increase PFC -activity, increasing the effectiveness of ones psychiatric treatment! =D

This actually looks more and more like a wonder-combo to me...

Modafinil definitely has a lot of potential, I'm very interested to see how it mixes with Intuniv.

[Metagene]

^Actually 6-7 weeks

http://www.health.ny...o_important.htm

[Metagene]

Thought this might be relevant to this thread. Pages 70-72.

http://books.google.... adults&f=false

Edited by Metagene, 17 November 2013 - 05:43 PM.

[GetOutOfBox]

So, today I took Intuniv for the first time, in the morning, 1 mg. I waited an hour before eating so that it could be absorbed without interference (interestingly, the prescription directions on the Intuniv website mention it should NOT be taken with fatty meals, as the fat enhances guanfacines uptake. My pharmacy did not pass this information along to me. This may also explain why some patients report higher side-effects than others, perhaps some are taking it with a fatty breakfast).

I did not notice a huge difference in just ordinary thinking (I didn't "feel" anything, but since it has no dopaminergic, norepinephrine or serotonin effects, it's unlikely it would cause a perceptible mood change, though the better PFC function might produce improved mood regulation). I tested myself with the digit span test about 2 hours after taking it and did not improve my score, though I did feel more confident about my current score (rather than hesitatingly remembering the numbers, they seemed be instantly recallable).

Today is not the best representation of it's effectiveness though, as it was incredibly stressful at work, so I'm fairly cognitively fatigued. I also have immediately cut back on caffeine intake, as caffeine is a PDE inhibitor (PDE metabolizes cAMP, so this would raise cAMP levels in the PFC) and would interfere with Intuniv's efficacy. I'm looking to quickly cut it from my diet entirely so I get an accurate picture of Intuniv's efficacy.

I did not notice the crippling drowsiness some patients report, I currently feel rather tired, but it feels like a normal sort of exhaustion from today's work, and I'm still able to keep my eyes open. No other obvious side-effects either.

I was not expecting an immediate improvement, as most patients took at least 2 weeks to have measurable improvements in placebo controlled trials, and I'm going to try this for 8 weeks just to be sure. Also, a few patient experiences I've found on the net seem to indicate the drowsiness side-effect may pop up after a few days, and then resolve in a week. We'll see I guess.

I will continue with daily updates.

Thought this might be relevant to this thread. Pages 70-72.

http://books.google.... adults&f=false

Very intriguing source, thanks for posting this!

[GetOutOfBox]

Some more ideas regarding Intuniv and ADHD:

I've noticed some interesting patient reports where patients took Intuniv before bed in an attempt to mitigate daytime sleepiness and take advantage of the sleep inducing effect in some. Interestingly, they still noticed large benefits even in the following evenings. One thing I noticed in some research on the PFC is that it's implicated in inducing Slow-Wave Sleep. It's possible that the cAMP dysfunction and subsequent PFC impairment prevents patients from entering Slow-Wave Sleep (or fragments it), and that Intuniv also serves to restore sleep quality.

Another interesting trait the PFC seems to be involved in is regulating the reward centers of the brain. It seems PFC impairment can impair sensitivity to negative stimuli in addicted rats (that is, they will still pursue the substance even if they receive electric shocks when they obtain it). What this translates to is, the PFC dysfunction in ADHD could also be the source of motivation issues many ADHD patients have (or anyone with PFC dysfunction), as it seems the PFC may regulate the reward centers of the brain (perhaps it serves to modulate responses from the mesolimbic pathway, to allow it to be more flexible and adaptive). Since Intuniv in theory reconnects the PFC, motivation issues might resolve. I suspect that results will not manifest for at least a month of Intuniv therapy.

[GetOutOfBox]

Ok, so Day 2 update on Intuniv:

Ok, definitely feeling it. Today was amazing, I noticed that my mood stopped swinging as much as it normally does, mostly because I found it easy to shrug off obsessive thought patterns. I found it much easier to focus my attention selectively as well. At work, I made two times my sales projections, my sales abilities were definitely taken up a notch. I'd say the number one reason why I performed better was that I was able to think on the fly much easier, to tune my sales pitches to individual customers and gauge their mood more effectively. Definitely more perceptive than usual.

The biggest difference I've noticed is in my moods. It's not that I feel "better" (in the sense of euphoria), it's that I'm so much more stable. I feel serene, which is rare for me. I can still worry about concerns, but I feel much more in control.

I didn't get the best sleep last night, so it's going to be really interesting to see how I perform when I'm well rested.

Now, it could of course be the placebo effect, though the feeling of stability was very prominent, and I definitely performed way better than usual at work. I'll have to see if the positive effects continue.

So far no perceptible side-effects, assuming my slight fatigue is caused by poor sleep (I'll have to get a couple of good night's sleeps before I can rule it out as a side-effect).

[MangekyōPeter]

Wow, thanks for the report GetoOutOfBox,

can't wait when one will be able to buy this in Europe feasibly.

[chris106]

Great to hear that Intuniv is working for you, GetOutOfBox! I'm looking forward to your future reports!

Combining it with Modafinil might indeed be promising - I am taking Modafinil (or rather Adrafinil, to be percise) with Agmatine (some mechanisms similar to Intuniv/Guanfacine) right now, and it's working wonders for me.

I would love to get into more detail later though, as I'm in the midst of a really stressfull and time-consuming rehearsal process for a play right now. Then again this also makes for the perfect testing ground for a nootropic trial

All I can say right now is that this combination has worked really well for me for the past week, way better than Modafinil alone. So much so that various colleagues (and the director) told me that I seem like a more positive , social and laid back person. To not seem suspicious I made up a story about some personal problems that recently got resolved - so no one seems to suspect that I am in fact "on something"

I myself notice that I am physically and emotionally more capable and flexible - I can take in much more information and have better control over my fine-motoric movement and my emotions. No signs of "fake" euphoria, either.

To sum it up - my ADD and slight anxiety seem completely gone for now!

As I said, a full fledged report on that later, as the rehearsal phase is now nearing it's end. I might then also ditch Modafinil and try if Agmatine alone can actually do the job of keeping my ADD brain in check...

Edited by chris106, 19 November 2013 - 11:28 PM.

[Mind_Paralysis]

How long have you been on the modafinil tho'? It might be a good idea to use Modafinil now and then, even if you've been on it for a couple months, to make sure your PFC is getting properly "exercised" for lack of a proper term.

Could you tell us a bit more about Agmatine as well? It seems to be a terribly obscure substance, with little documentation to be found readily. Is this actually sold over the counter? The only thing I seem to find about it, is that it increases blood-flow, and therefore is used by body-builders to "get pumped", when they go in for real power-lifting rounds of exercise.

Edited by Stinkorninjor, 20 November 2013 - 01:23 AM.

[GetOutOfBox]

Day 3 (for yesterday):

My mood is much more balanced. Before taking it, I seemed to have an overactive stress response, for example, when exercising I found that as I got fatigued, I would have bursts of anger. Little things would bother me immensely. So far, I noticed a very interesting detatchment, I would acknowledge something bothered me and feel a "twinge" of anger, but I could easily just think "it doesn't really matter that much" and move on. I'm still experiencing the full range of emotions, but my emotional state seems much more stable, which is refreshing.

I've also noticed that one symptom of inattention is reduced; I often have a weird visual manifestation of it, where my eyes easily go out of focus and I just stare glassily (not a complex partial seizure, I'm still aware of what's going on and can pull my eyes back into focus, but it requires conscious effort). Now I find it easier to keep my eyes in focus, or more specifically, I don't slip into that sluggish, staring glassily state.

Another interesting effect is I seem less sensitive to low blood sugar levels. Prior to taking Intuniv, if I missed a meal I would have very prominent hypoglycemic symptoms, I would feel anxious, unable to focus, prone to depression, etc. Now I feel them to a lesser degree. I still feel fatigued, but I don't feel like I haven't eaten for an entire day. Note that it has not decreased my appetite, I still feel the need to eat regularly.

Still no major side-effects.

[GetOutOfBox]

Day 5:

I missed taking it yesterday, as I spent the night at a friends house without my pills. Didn't notice any acute discontinuation effects during that one day (the main discontinuation effect of concern would be elevated blood pressure as a rebound effect, but at 1 mg it's unlikely to be an issue, probably 3+ mg is more of an issue in adults).

So far the noticable effects have primarily been mood stabilization and abolishment of obsessive thought pattern tendencies. I've noticed that my mood doesn't shift along the spectrum as easily (frustrating things don't push me from neutral to angry nearly as fast as they did before), which has definitely been improving my quality of life. I've also noticed that certain patterns of thinking I used to needlessly obsess about (i.e what others thought about me, musing about an ex, worrying about things outside my control, etc) occur to a far lesser extent now, to the point that I no longer feel dominated by some of them. Another big quality of life improvement. I've also noticed that it's much easier for me to control impulsive thoughts as well. I'm not particularly impulsive (definitely not to the pathological point), but I do tend to be easily vulnerable to cravings for sweets. If I have any on hand, I find it very difficult to control my consumption of them. Lately however, I've found it much easier to resist the compulsion, even with things that produce mild addiction (like caffeinated pop, which I consume fairly regularly. I've found it easier to limit my consumption, despite the fact mild caffeine addiction compels me to consume it).

I've yet to see large inattention returns (I'm experiencing a minor improvement right now, which may grow after a few weeks, according to the studies), haven't noticed any effect on motivation (I doubt it will directly effect motivation, as the feeling is likely triggered in the mesolimbic region. However improved PFC function may modulate motivation, perhaps increasing sensitivity. It's unlikely to have the same motivating "ON button" effect amphetamines do, but perhaps this is a good thing).

Still not experiencing the commonly reported side-effects (drowsiness, lethargy). I will regularly check my blood pressure when I up the dose to 2 mg (which I will probably do in 3-5 days, to give my CNS and body time to adjust to 1 mg. Upping too rapidly can produce side-effects much more often and intensely than titrating).

On a side note, in regards to some of my other nootropic usages, here's some mini-updates. PRL-8-53 has so far not been producing any short-term cognitive benefits I am aware of. Every time I take largish doses I notice odd visual effects, reminiscent of coming up on a psychedelic drug (colours seem subtly subjectively "different", visual noise), but in a subtle way. It seems to work sublingually, since I notice these effects with both oral and sublingual dosing. Sublingual seems to produce them more readily, likely due to more rapid absorption into the CNS (resulting in higher concentrations at once). Some studies indicate it enhances long-term memory formation, which I'd like to investigate rigorously, but unfortunately I cannot due to both the fact I'm consuming several other nootropics and my hectic work/personal schedule (which leaves me few unfatigued days). To get good picture of how well it works, I'd have to have a quiet week that I could spend learning while under it's influence, and also do a washout of the other noots that could affect the results.

I've also been revisiting Sunifiram lately. So far I've found it to have a negative effect on cognition for me, every time I've taken it (at roughly 10-15 mg orally with the scoop I use) I've found that my inattentive tendencies are amplified, I find it difficult to sit doing any one thing for extended periods of time, so I'll end up just watching TV and browsing the web (I find it difficult to just sit and read something, or to follow one train of thought for a while). Combining it with CDP-Choline did not help. Since the dosing range is 5.4-11 mg for a 150 lb person, it's possible the low end of the range would be better for me, but without a precise scale it would be difficult for me to accurately test (eyeballing the difference between 5 and 8 mg of the stuff is near impossible). I'm looking to get a good scale later, so I'll revisit it then.

I've also been taking Noopept again, though what I've been doing is taking it when I'm going out, and not when I'm doing intellectual work. I find that the mildly inhibiting effect it has (slightly spacey) is pleasant for interacting with people, but works against me when I'm trying to focus on academic-like work. I also theorize that it will improve my social skills if I socialize while under it's influence (taking advantage of the elevated BDNF and NGF levels in the hippocampus, so I more rapidly adjust to socializing). I'm currently dosing 20 mg sublingually, usually once a day, sometimes twice (always spread out 6-7 hours).

Still taking the Afobazole (so far it's been about 1 month and 10 days of taking it, with a 4 day break in the middle of it to test for addiction). So far no negative effects observed, and it seems to have had a nice anxiolytic effect. Not as strong as a benzo, more like it takes the edge off things. I doubt it would solely be effective in treating a moderate to strong anxiety disorder, but for mild anxiety tendencies or augmenting treatment of an anxiety disorder, it seems very useful due to it's low-side effect profile. I just personally strongly recommend against taking it close to your regular sleeping period, as ones of it's MoAs is that it antagonizes the MT1 and MT2 (MT = melatonin) receptors, so theoretically it could disrupt the circadian rhythm and hence cause insomnia and/or reduce quality of sleep.

[GetOutOfBox]

Day 7:

Mood stability is still very profound. I can hardly believe how calm, and happy (in a serene way) I feel. I wouldn't say happy as in I'm always feeling good, but overall I'm happier with my life because I just feel less frenetic, less of a slave to my emotions.

Still no large improvement to attention, nor am I experiencing side-effects. Yesterday was my birthday, so I spent the night drinking with friends. I'll note that there did not appear to be an adverse interaction with alcohol, though I was drinking later in the day. I doubt it would be unsafe unless you were on a very high dose of Intuniv (the vasodilatory effect of alcohol might not go well with the BP lowering effect of intuniv).

I also got my blood pressure checked at a pharmacy yesterday. Systolic was 124, Diastolic was 73, pulse was 66. The Systolic was in the prehypertensive range (though this is not a new development, I had my blood pressure checked a year ago and noticed it then too), Diastolic was normal, pulse rate optimal. The numbers indicate not adverse interaction between Intuniv and my BP. I find it odd that my systolic is prehypertensive, as I'm fairly active (I'd say that on average I do actual exercise for 50 minutes a day 4 days a week) and have a healthy diet. My low resting pulse indicates very good cardiological health, which contrasts with my systolic BP measurement. It might just be a genetic phenotype. Either way, it's not in the range that suggests a need for treatment, so no concern.

[Nootmeup]

I just wanted to add that I read the entire thread GetOutOfthebox It took me a couple hours but I found it extremely informative interesting and I could relate with you on so many levels. Thank you for putting in the time and leg work and sharing your thoughts and experiences with us. You are extremely knowledgable. I started a post much like yours before I read this thread today. Hopefully I will get closer and closer to a better me

[Mind_Paralysis]

Ey, getoutofbox, could you make another run-down of your nootropic stack, that you're currently consuming, in tandem with the Intuniv?

And perhaps a final review, of which substances you found to be the most helpful, for ADD-symptoms?

[GetOutOfBox]

Day 12 of Intuniv therapy:

I increased the dose to 2 mg yesterday and have stuck with it. Note that you can take two 1 mg pills as a 2 mg dose, I specifically checked with the pharmacist whether that would interfere with absorption. So far the positive effects are the same (I would say the emotional regulation is slightly improved, but not as dramatic as the jump from no Intuniv to the 1 mg daily intuniv). I am still not experiencing any negative side-effects. Attention span seems to be improving, though working memory remains normal. Motivation is improved, but I feel that it's a conscious reaction to being able to focus easier.

I got my blood pressure checked today, since I raised the dosage. My results were: Systolic 115, Diastolic 74, Pulse 71. My systolic dropped into the optimal range, while diastolic remained roughly the same. This is good I guess, since I went from pre-hypertensive to normal blood pressure. I will check it again in a week at the 2 mg dose.

I would also note that I am starting to believe Intuniv is enhancing (or perhaps returning to normal) my creativity. I'm into game development as a hobby (and career eventually), and one flaw I've always had is that I seem to lack any originality. I'm smart, but all my ideas always seemed to be cobbled together from my memories of the various books I've read, movies I've seen, or games I've played. All my ideas seemed to just draw purely upon past experiences, with little room for my own innovation. Well, I was brainstorming yesterday before work, and within 5 minutes of sitting down to come up with an idea for a game, I came up with a novel concept that was mostly my own work. We all draw upon past experiences for creativity, but for the first time it was MY idea, that was perhaps merely inspired by other works. Just something interesting, it could be a coincidence, we'll have to see if this creative burst holds up with time. The PFC is highly involved in interconnecting the various memory systems with the rest of the brain, and moderating them. It's conceivable that the PFC is involved in the creative process through re-interpreting memories, combining them, etc, to produce new ideas. It's definitely involved in complex cognitive behavior, so it makes sense that could extend to creativity.

I just wanted to add that I read the entire thread GetOutOfthebox It took me a couple hours but I found it extremely informative interesting and I could relate with you on so many levels. Thank you for putting in the time and leg work and sharing your thoughts and experiences with us. You are extremely knowledgable. I started a post much like yours before I read this thread today. Hopefully I will get closer and closer to a better me

No problem, I was frustrated that so many threads trailed off before a lot of research was done, so I decided to start my own, since I exhaustively research ADHD/ADD as a condition.

Ey, getoutofbox, could you make another run-down of your nootropic stack, that you're currently consuming, in tandem with the Intuniv?

And perhaps a final review, of which substances you found to be the most helpful, for ADD-symptoms?

I'm currently taking this stack daily:

2 mg intuniv (titrated from 1 mg)
800 mg Oxiracetam
500 mg ALCAR
20 mg Noopept - Sublingually
1 B-Multivitamin
2000 IU Vitamin D
250 mg magnesium
10 mg Afobazole

It should be noted that there are items I used to take that I do not now, but I would still recommend as I feel they helped "stabilize" various issues I had. The Bacopa I took for 1.5 months, and have felt lasting benefit from it, I would partially credit it with alleviating some chronic anxiety issues I've had. It's a very good herb, with quite a few clinically established benefits.

In terms of what I feel is the most important, I would say Intuniv has taken the cake as the substance with the most prominent psychological effects. I feel so much better, so much less stressed all the time. Many of the other supplements are very much more of a "behind the scenes" effect and hence tend to be much subtler. I would definitely advise all AD(H)D patients to take around 250 mg magnesium (a good bioavailable form, like citrate or threonate), the B-Vitamin, and the Vitamin D (especially if you're like me and you're not outside a lot and/or you have darker winter seasons). Between 2000 and 4000 IU are enough for the average person, with the exception of the severely deficient (I wouldn't go over 4000 IU unless you have a blood test saying you're clinically deficient). Deficiencies of those 3 are often implicated in exacerbating ADHD issues, and/or causing their own (i.e chronic anxiety, depression, etc). I would also highly recommend a fish oil supplement (between 1-3 grams daily), as it's the best source of Omega 3 fatty acids for the cost (plant sources like Flax Oil require extremely inefficient first-pass metabolism to be usable by the body). ALCAR and phosphatidylserine have been implicated with improving symptoms of ADHD after 30 days of usage, it wouldn't hurt to try them.

The Noopept I take on the notion that it increases "brain flexibility" (through increasing the release of BDNF and NGF), and hence probably improves my overall adaptiveness. I believe based on the evidence, that it strongly sensitizes the brain to positive and negative reinforcement, so for example, would be effective in treating an anxiety disorder when combined with exposure therapy. It likely helps with depression over time as well, as depression's root etiology is theorized to be in reduced levels of BDNF and NGF in the hippocampus (hence depression is really a syndrome of stress-induced neural plasticity impairment), based on observations of rats and human subjects I believe. It should be noted that SSRIs tend to increase BDNF expression in the hippocampus indirectly, which lends further credence to the BDNF-deficient theory.

So Noopept I feel doesn't exactly help with ADHD, but for me, it indirectly did as it helped to relieve my comorbid social anxiety and depression.

[Mind_Paralysis]

Cheers for the rundown Getoutofbox. =)

Btw, maybe you can give some advice on this - I have recently started suspecting that like 50% of everybody with ADHD/ADD I suffer from Developmental Coordination Disorder - do you suppose there's any nootropics that could help with coordination and dexterity? I've always been a bit clumsy, and although I like physical activity, I find that I'm constantly the worst in the group - at karate or dancing or what-have-you.

I think you mentioned that something in your regime actually improved coordination, I think? Do you happen to know if ADHD-medication has traditionally had any coordination-improving effects as well?

[GetOutOfBox]

Cheers for the rundown Getoutofbox. =)

Btw, maybe you can give some advice on this - I have recently started suspecting that like 50% of everybody with ADHD/ADD I suffer from Developmental Coordination Disorder - do you suppose there's any nootropics that could help with coordination and dexterity? I've always been a bit clumsy, and although I like physical activity, I find that I'm constantly the worst in the group - at karate or dancing or what-have-you.

I think you mentioned that something in your regime actually improved coordination, I think? Do you happen to know if ADHD-medication has traditionally had any coordination-improving effects as well?

Dopamine is the neurotransmitter strongly associated with motor behavior (cholinergic systems being more involved in actual muscular activation outside of the CNS, inside they relate more to memory). I suspect that for proper motor function, a balance of dopamine activity is needed, simply increasing or decreasing levels from baseline will likely not fix the problem.

Unfortunately Developmental Coordination Disorder is not as well researched as ADHD, so I don't have a lot to work with, but I'll assume dysfunctional Substantia Nigra circuitry, perhaps with secondary acetylcholine involvement in the peripheral nervous system. For treating the former, I think the best course of action would be to take Uridine (UMP form) daily, which has dopamine modulatory activity, and also improves overall neuron health. Combining it with Fish Oil (a good source of Omega 3 fatty acid, way better than flaxseed oil) is a good way to go for overall brain health. I would also supplement Tyrosine (unless you have a regular source of quality meats in your diet. Plant sources do not count as much as they tend to lack various essential amino acids unless you get a complex balance of different sources) and a Vitamin B multivitamin (get a quality one from Swanson). Tyrosine is a precursor to several neurotransmitters including dopamine. The B vitamins are heavily involved in producing various neurotransmitters, as well as a bunch of other stuff. Always good to make sure you have that covered. Finally for the cholinergic side of things, I would get a choline source, CDP-Choline would be my recommendation due to the fact that it upregulates dopamine receptors as well as being a source of choline. But cheap choline forms would also suffice since you're not really worried about getting choline into the brain, it's the muscles we're targeting. Also add a magnesium supplement (preferably citrate form), taking 250 mg twice daily. A large percentage of Americans have a magnesium deficiency, despite having the wealth to afford a proper diet. Magnesium deficiency could interfere with proper motor function (causing hyperkinetic activity, not in the victims benefit). Finally, toss in ALCAR (start with 1g daily, lower to 500 mg if you experience side effects), which is a source of acetic acid to form the acetyl part of acetylcholine. It also has some beneficial muscle endurance properties.

So: Uridine UMP, Fish Oil, Tyrosine, B multivitamin, CDP-Choline or a cheaper choline source (i.e bitartate), magnesium, and ALCAR

That's a good way to smooth the things out in the supplement department. But that alone will likely not fix the problem. Assuming a central dysfunction is involved, you're going to have to condition those neurons to work properly. This essentially involves physical training. Physiotherapy would be the best combo, but simply regularly practicing various cardio activities and reflexes should help strengthen the neural-connections in the areas you need, and prune the dysfunctional pathways. The supplement recommendations I made should prep your brain so that's its equipped to function adequately, but they won't magically strengthen the specific neural pathways that need targeting. Just keep practicing karate and dancing, keep mixing things up. And keep in mind that for noticeable neurological changes to happen, a lot of time is needed. You will not see any benefit prior to 4 weeks I suspect, assuming that the problem is neurological and not simply a shortage of a substance (in which case correcting the deficiency could correct the problem rather rapidly, but it's unlikely you're deficient unless you have a poor diet). It may take up to 2 months of regular supplementation AND regular activity practicing for you to see any benefits. Stick with it for at least 2 months, too many people give up too early and possibly miss out on a chance to see the true benefits.

[Hansen213]

Thank you very much for this journey! I have ADD myself and the information provided by you was very very helpful!

You mentioned that your current daily stack is this

2 mg intuniv (titrated from 1 mg)
800 mg Oxiracetam
500 mg ALCAR
20 mg Noopept - Sublingually
1 B-Multivitamin
2000 IU Vitamin D
250 mg magnesium
10 mg Afobazole

1.) Do you still take some other supps / Nootropics on a non-daily basis (you mentioned Phenylpiracetam or PRL-8-3 for example which had good results for you)?

2.) Did you have experience with Modafinil? Would you recommend trying it out for a short-term period, for example when you have a big projects or have several exams and need to study very much? The experiences for AD(H)D seem to be very positive, and in this forum there is a very positive journey about Modafinial and Noopept.

3.) If I decide to take Modafinil, which supplements or Nootropics should I avoid because of interactions?

[GetOutOfBox]

Thank you very much for this journey! I have ADD myself and the information provided by you was very very helpful!

You mentioned that your current daily stack is this

2 mg intuniv (titrated from 1 mg)
800 mg Oxiracetam
500 mg ALCAR
20 mg Noopept - Sublingually
1 B-Multivitamin
2000 IU Vitamin D
250 mg magnesium
10 mg Afobazole

1.) Do you still take some other supps / Nootropics on a non-daily basis (you mentioned Phenylpiracetam or PRL-8-3 for example which had good results for you)?

Not on a daily basis. To be honest, I've found a lot of the Racetams don't do a lot for me, I think that a lot of the hype behind them is based off of the placebo effect, as far to many people in longecity and reddit do not do actual cognitive tests before commenting on their perceptions of the nootropic in question, most end up posting stuff like "I felt really focussed today, and found myself remember things better". Subjective reports can provide good insight into drugs, but actual cognitive tests are needed to establish their actual efficacy and rule out the placebo effect (Cambridge Brain Sciences is really good for this). Even I myself have neglected to do rigorous cognitive testing, I intend to go back and re-try all of the nootropics I've taken and test myself to see whether there's actually an improvement.

I suspect a majority of nootropics don't really improve the brain a lot above baseline, but rather have dramatic improvements in those with neurochemical dysfunction, brain damage, or cognitive decline (age often reduces concentrations of various neurotransmitters, hence why the elderly tend to have dramatic responses to nootropics, while youth respond much more modestly).

2.) Did you have experience with Modafinil? Would you recommend trying it out for a short-term period, for example when you have a big projects or have several exams and need to study very much? The experiences for AD(H)D seem to be very positive, and in this forum there is a very positive journey about Modafinial and Noopept.

I don't, but I really want to try it. The limiting factor right now is money, it'll end up costing about $70 to get a months supply from a reliable vendor (a lot of places charge around $50-60 + shipping), which is a little much for me to spend so close to Christmas. I will get around to it though. I'm probably going to skip trying classic Modafinil and instead jump right to armodafinil, the pure active isomer. It's been found to produce much more stable serum levels than regular modafinil, hence reducing the highs and lows some people experience with it.

I suspect a lot of the extremely positive responses to modafinil are from people who may have undiagnosed sleep apnea, which can cause extremely erratic neurotransmitter levels. Pharmacologically, healthy individuals probably won't benefit a whole lot more than if they consume caffeine (which is, a moderate working memory improvement and improved mood), as increasing histamine activity in those who already have healthy levels won't really produce any positive effects on it's own, though it may indirectly increase dopamine levels, similar to how caffeine's adenosine antagonism indirectly increases dopamine levels slightly (reducing inhibition).

3.) If I decide to take Modafinil, which supplements or Nootropics should I avoid because of interactions?

I would not combine it with MAO-inhibitors (though the combination isn't as clearly dangerous as they would be with say amphetamine, but still it's not a safe combo). I'm not aware of any other dangerous interactions, though some nootropics may interact in an uncomfortable way (possibly causing temporary brain fog, headaches, jitteryness, etc), but nothing that won't go away after the dose wears off. It should be fine with racetams, I'm not aware of it having any substantial cholinergic actions.

[Hansen213]

Not on a daily basis. To be honest, I've found a lot of the Racetams don't do a lot for me, I think that a lot of the hype behind them is based off of the placebo effect, as far to many people in longecity and reddit do not do actual cognitive tests before commenting on their perceptions of the nootropic in question, most end up posting stuff like "I felt really focussed today, and found myself remember things better". Subjective reports can provide good insight into drugs, but actual cognitive tests are needed to establish their actual efficacy and rule out the placebo effect (Cambridge Brain Sciences is really good for this). Even I myself have neglected to do rigorous cognitive testing, I intend to go back and re-try all of the nootropics I've taken and test myself to see whether there's actually an improvement.

1.) Do I understand you right, that you are taking only the Nootropics / supps from the list you qouted on a non dailly basis? So no other stuff anymore, even not Choline?

Interesting. I think you might be very right, because I only read here about subjective experiences and never about someone really doing a cognitive test. The only example may be the med school student who was below average before taking any supplements, then improved to average after taking Gingko, and then went to the top 1% after taking Piracetam, Choline and some other supps (I can´t find the thread anymore though).

I suspect a lot of the extremely positive responses to modafinil are from people who may have undiagnosed sleep apnea, which can cause extremely erratic neurotransmitter levels. Pharmacologically, healthy individuals probably won't benefit a whole lot more than if they consume caffeine (which is, a moderate working memory improvement and improved mood), as increasing histamine activity in those who already have healthy levels won't really produce any positive effects on it's own, though it may indirectly increase dopamine levels, similar to how caffeine's adenosine antagonism indirectly increases dopamine levels slightly (reducing inhibition).

From what I´ve read on this forum, I think you are right again, because there are many people who say that it only had a little effect on them. After reading all of its side effects, I decided not to try it out and rather stick to substances, which have no to little side effects. First, for me it´s not worth to serious risk to health and my psyche if it´s not really needed and can be improved with harmless substances. Secondly, I have sensitive skin, so I am afraid of getting paranoid soon as I get a rash or flu like symptoms, because these are also the symptoms of SJS.

I've been using a huge variety of nootropics, which is admittedly not the best way for the wallet (it's been very expensive). I do agree with the advice to try one or two things at a time to find out what works for long-term stacks, however if you feel you have issues you'd like to fix vs simply improving yourself (i.e ADHD, social anxiety, depression, dementia, etc), a broad-spectrum approach is much more effective. There are multitudes of avenues of enhancement beyond ACh (Acetylcholine), such as targeting the glutaminergic system (i.e Sunifiram, Sarcosine), the dopaminergic system (Phenylpiracetam, Uridine, CDP-Choline, Ritalin), the seratonergic system (Bacopa, Afobazole, Tianeptine), hormonal (Selank, Semax), or even really niche areas like the immune system (Tenoten, a novel anxiolytic targeting antibodies

2.) So for people with ADD etc. you would recommend testing one thing at a time, but in each avenue of enhancement? For example to start with a stack like: ALCAR - CDP Choline - Sunifriram - Bacopa, test it for a few days, then starting to trying different substances in these areas, for example to switch CDP Choline for Uridine.

Edited by Hansen213, 11 December 2013 - 11:52 AM.

[Hansen213]

double post

Edited by Hansen213, 11 December 2013 - 11:37 AM.

[GetOutOfBox]

Not on a daily basis. To be honest, I've found a lot of the Racetams don't do a lot for me, I think that a lot of the hype behind them is based off of the placebo effect, as far to many people in longecity and reddit do not do actual cognitive tests before commenting on their perceptions of the nootropic in question, most end up posting stuff like "I felt really focussed today, and found myself remember things better". Subjective reports can provide good insight into drugs, but actual cognitive tests are needed to establish their actual efficacy and rule out the placebo effect (Cambridge Brain Sciences is really good for this). Even I myself have neglected to do rigorous cognitive testing, I intend to go back and re-try all of the nootropics I've taken and test myself to see whether there's actually an improvement.

1.) Do I understand you right, that you are taking only the Nootropics / supps from the list you qouted on a non dailly basis? So no other stuff anymore, even not Choline?

The list I gave is my current daily stack. Other supps/noots I'll take when needed, but so far I haven't noticed many doing anything obvious. They might be subtly enhancing my memory, but they haven't invoked a miracle-like improvement.

I suspect a lot of the extremely positive responses to modafinil are from people who may have undiagnosed sleep apnea, which can cause extremely erratic neurotransmitter levels. Pharmacologically, healthy individuals probably won't benefit a whole lot more than if they consume caffeine (which is, a moderate working memory improvement and improved mood), as increasing histamine activity in those who already have healthy levels won't really produce any positive effects on it's own, though it may indirectly increase dopamine levels, similar to how caffeine's adenosine antagonism indirectly increases dopamine levels slightly (reducing inhibition).

From what I´ve read on this forum, I think you are right again, because there are many people who say that it only had a little effect on them. After reading all of its side effects, I decided not to try it out and rather stick to substances, which have no to little side effects. First, for me it´s not worth to serious risk to health and my psyche if it´s not really needed and can be improved with harmless substances. Secondly, I have sensitive skin, so I am afraid of getting paranoid soon as I get a rash or flu like symptoms, because these are also the symptoms of SJS.

I wouldn't worry about SJS, it occurs extremely rarely with modafinil, and generally is preceded with warning signs, like a smaller rash. I have never heard of anyone here or on reddit who took modafinil recreationally and experienced SJS.

I've been using a huge variety of nootropics, which is admittedly not the best way for the wallet (it's been very expensive). I do agree with the advice to try one or two things at a time to find out what works for long-term stacks, however if you feel you have issues you'd like to fix vs simply improving yourself (i.e ADHD, social anxiety, depression, dementia, etc), a broad-spectrum approach is much more effective. There are multitudes of avenues of enhancement beyond ACh (Acetylcholine), such as targeting the glutaminergic system (i.e Sunifiram, Sarcosine), the dopaminergic system (Phenylpiracetam, Uridine, CDP-Choline, Ritalin), the seratonergic system (Bacopa, Afobazole, Tianeptine), hormonal (Selank, Semax), or even really niche areas like the immune system (Tenoten, a novel anxiolytic targeting antibodies

2.) So for people with ADD etc. you would recommend testing one thing at a time, but in each avenue of enhancement? For example to start with a stack like: ALCAR - CDP Choline - Sunifriram - Bacopa, test it for a few days, then starting to trying different substances in these areas, for example to switch CDP Choline for Uridine.

I generally tested multiple avenues at first, as I was fairly dysfunctional attention and anxiety wise. However you should eventually try individuals so you don't end up wasting large amounts of money.

[Hansen213]

I wouldn't worry about SJS, it occurs extremely rarely with modafinil, and generally is preceded with warning signs, like a smaller rash. I have never heard of anyone here or on reddit who took modafinil recreationally and experienced SJS.

That is my problem: Modafinil causes in very rare cases SJS, but it causes frequently rashes. Since rashes, or flu like symptoms, are the first symptoms of SJS, I would freak out soon as I have one of those symptoms.

Also I don´t like the fact at all, that it messes with your sleep cycles and can cause / increase severe psychological problems.

I generally tested multiple avenues at first, as I was fairly dysfunctional attention and anxiety wise. However you should eventually try individuals so you don't end up wasting large amounts of money.

Im starting right now with a high Potence Multivitamin (two per day by Life extension), D3 (5000), K2, magnesium, ALCAR, CPD Choline, Piracetam and Bacopa. I will test this for about 2 weeks. I want to add your supps (Uridine, Tyrosine, CILTEP stack) each by each, testing about 1 week before adding the next one. Also, I want to experiment with Racetams (Oxi, Prira, Phenyl, Sufriram, Noopept) and stick with the ones that had the best results. Would you rather add the supps or experimenting with the racetams first?

My main goal right now is to increase memory and concentration, since this is my biggest problem right now and I have exams starting in 6 weeks (last year university). Therefore, especially Priracetam and Noopept seem to be very interesting, since thy seem to be effective for studying. I read though, that one should have experience with the other racetams before moving to them, since these are the strongest racetams.

What do you think?

Edited by Hansen213, 11 December 2013 - 07:46 PM.

[Lemon.]

Hi, hope everything is going good for you, keep up the good things.

Just, a tiny bit of advice to take with a pinch of salt; when you're ordering the supplements online, just make sure that you're getting "good quality" / "valid" products.... From my experience, there are some "low quality/misleading" supplements out there, and that may seem to be a lot cheaper but it comes with a downside as the quality is bad, and or invalid proper product, now that was just my experience, what I am trying to say is ' just to keep an extra note by the side when your buying the items -> just make sure the product you are buying/using is valid and "on the good side".... in a way... so double check the reviews, company , ingredients,etc.

Edited by Lemon., 11 December 2013 - 07:16 PM.

[GetOutOfBox]

UPDATE and replies:

So I'm still on the 2 mg of Intuniv. No drowsiness so far. One thing I've noticed with specifically the 2 mg dosing is that it might possibly be causing mild irritibility, though at this point I'm not certain. There a few life factors which could be making me irritible, so I'm not pointing fingers at the larger intuniv dose yet. If I notice it persists for more than a month, I'll try cutting back to 1 mg. Aside from that, the emotional stability is still amazing. I'm certainly less easily depressed, I find it easier to stop myself from dwelling on things. Impulsiveness is reduced too, I find it easier to resist buying or addictive impulses (I've cut caffeine out of my diet entirely, been free of it for 1 week+ now).

Attention seems to be better in some ways, specifically that I find it easier to jump between things. My habit of rapidly doing multiple things is not the best one, but I find I get derailed a lot less easily. Like I can be distracted, and then quickly process the distraction and return to the original task.

Motivation is not improved. I'm not surprised, without any mesolimbic activity, it's unlikely to directly improve motivation. I'm starting to think of Intuniv as being the fix for the "functional" issues of ADHD, that is, the attention/impulse-regulation/sensory processing/mood regulation, as they all seem to reside in the PFC. Motivation on the other hand, resides mainly in the domain of the mesolimbic pathway.

Now I want to pose an interesting question for those who found motivation unimproved with Ritalin (which implies you're not one of the individuals with global dopamine issues, that is, dopamine transporter overactivity, and rather might be one of the people with a specific polymorphism, like DRD4). Perhaps the motivation symptom is actually an indirect result of the PFC issues. Perhaps individuals with PFC dysregulation develop amotivation issues as a result of finding complex work too difficult. Without the PFC's functional support, complex tasks become much more difficult as other systems are forced to adapt to process them. So these individuals as they are developing as children become geared towards activities which provide rapid rewards, as they are unable to complete the ones that give long-term rewards. Their reward system develops in such a way to encourage them towards these tasks, but they lack the motivation to perform more abstract tasks.

To explore this possibility, I'm going to now investigate self-applied therapy, in the form of:

A) Adopting a task organizational system. I've noticed that I tend to organize tasks very poorly. This occurs in all areas of my life, an example would be in programming (my personal interest). I tend to have lots of ideas, but I have trouble breaking them down into chunks that can be accomplished in small timeframes. Instead, I decide to just start working for 4 hours on the idea, which sounds good, but results in me working fairly inefficiently, and more importantly feeling less rewarded (setting such a high workload per session discourages me from working in the first place). So I'm going to start planning things in advance. This includes ideas, as well as things I have to do during the day. I want to record my progress, to give myself a more tangible feel of reward when completing tasks. I might investigate ways to make recording progress fun, reddit has a few suggestions (like making your progress record a mini-game of sorts). It sounds childish, but it appeals to the way our brains work.

B) Rewarding myself with tangible rewards during completion of abstract tasks. I've chosen candy as the tangible reward. For example, every time I complete one portion of a game I'm programming, I'll have 2 candies. These portions of work will be small, so that the rewards are small, but frequent. My theory is that this will resensitize my reward system to more complex tasks, and result in me initiating them more. I will correspondingly stop reinforcing lazy habits I've developed, so for example, I'll no longer eat candy while watching a movie or TV show (this doesn't have to be done religiously, but the point is to not reinforce these tasks often). I want to gear my brain towards deriving satisfaction from work. I suspect that as I develop my working skills, I will slowly cease to need the candy reinforcement, as I will more readily see the rewards of my work (producing actual games, etc). The candy is for the beginning phase where I have little motivation to get started.

I will post with regular updates.

I wouldn't worry about SJS, it occurs extremely rarely with modafinil, and generally is preceded with warning signs, like a smaller rash. I have never heard of anyone here or on reddit who took modafinil recreationally and experienced SJS.

That is my problem: Modafinil causes in very rare cases SJS, but it causes frequently rashes. Since rashes, or flu like symptoms, are the first symptoms of SJS, I would freak out soon as I have one of those symptoms.

Also I don´t like the fact at all, that it messes with your sleep cycles and can cause / increase severe psychological problems.

I'm not aware of it "frequently" causing rashes. Perhaps "more frequently" it causes rashes than SJS, but it's still not a regular occurrence. Even at high doses they don't regularly occur.

As for "psychological problems", as far as I'm aware, it's definitely not associated with causing any neuro-psychological disorders. I've seen no studies indicating it can cause any known psychological syndrome, which is in line with it's pharmocological properties. Aside from it's effects on orexins and the histaminergic system, modafinil is more of a modulator of other neurotransmitters. It's highly unlikely based on that MoA that it could cause chronic psychological disorders. In those who already have said disorders (as in, they have a genetic mutation that causes dysregulation of certain brain circuitry), sure, it's possible it could cause a temporary flair-up, but it's still far less likely than other more commonly used substances (i.e marijuana or ritalin/amphetamines, SSRIs, etc).

I do agree that it would mess with your sleep cycles if taken near your regular sleeping time, but why would you consume it so close to when you intend to sleep? It's meant to be taken prior to a long stretch of remaining awake, or during your regular waking hours. I would certainly not advise taking it anytime sooner than 6 hours before your intended sleep period. So if it's dosed properly, then no, it should not interfere with sleep.

I generally tested multiple avenues at first, as I was fairly dysfunctional attention and anxiety wise. However you should eventually try individuals so you don't end up wasting large amounts of money.

Im starting right now with a high Potence Multivitamin (two per day by Life extension), D3 (5000), K2, magnesium, ALCAR, CPD Choline, Piracetam and Bacopa. I will test this for about 2 weeks. I want to add your supps (Uridine, Tyrosine, CILTEP stack) each by each, testing about 1 week before adding the next one. Also, I want to experiment with Racetams (Oxi, Prira, Phenyl, Sufriram, Noopept) and stick with the ones that had the best results. Would you rather add the supps or experimenting with the racetams first?

My main goal right now is to increase memory and concentration, since this is my biggest problem right now and I have exams starting in 6 weeks (last year university). Therefore, especially Priracetam and Noopept seem to be very interesting, since thy seem to be effective for studying. I read though, that one should have experience with the other racetams before moving to them, since these are the strongest racetams.

What do you think?

If you have trouble with attention, I would skip CILTEP, at least for now during this important period of examines. I went over it in detail earlier, but essentially CILTEP works by increasing cAMP levels. People with certain inattentive types of ADHD tend to already have pathologically high cAMP levels as a result of a DRD4 polymorphism. Anything increasing them further (Caffeine, a mild PDE inhibitor, CILTEP), will exacerbate the problem of prefrontal-cortical dysfunction. Now, that's assuming you do have this mutation causing your inattentiveness. You may not. But I wouldn't experiment with that when you need to be performing at your best.

Also, skip Sunifiram unless you're willing to get a proper scale and measure each tiny little dose. Reccomended doses range between 5 and 20 mg (5 is definitely still psychoactive, 10 seems to be the median). There is no reliable way to measure such tiny doses just by "eyeballing". And due to the mechanism in which Sunifiram works, it's pretty important to get the dose right. The usual consequence of too high a dose is temporary brain fog, but more serious consequences could occur, especially in those mixing in a bunch of substances. Sunifiram is strongly glutaminergic (it works in two ways, increasing glutamate release and positively modulating receptors, a potentially risky combo), which opens up the risk of excitotoxicity. I would be very careful with that compound, as well as IDRA-21 (especially IDRA-21, due to it's multiple day half life, verrrry risky) and Unifiram.

Oxi and phenyl racetams are fairly reliable, I'd advocate their use. Oxi is a much less potent glutaminergic substance, so it's safer and you can be more relaxed with dosing. Phenylpiracetam has the potential to upregulate a bunch of receptors (though it has been observed to downregulate NMDA and nAch receptors, so cycling might be needed if you notice memory issues).

Hi, hope everything is going good for you, keep up the good things.

Just, a tiny bit of advice to take with a pinch of salt; when you're ordering the supplements online, just make sure that you're getting "good quality" / "valid" products.... From my experience, there are some "low quality/misleading" supplements out there, and that may seem to be a lot cheaper but it comes with a downside as the quality is bad, and or invalid proper product, now that was just my experience, what I am trying to say is ' just to keep an extra note by the side when your buying the items -> just make sure the product you are buying/using is valid and "on the good side".... in a way... so double check the reviews, company , ingredients,etc.

I've always been very vigilant. Newstarnootropics is my first vendor choice mainly because of the great customer support (unique for a nootropic depot), and because the publish CoAs for virtually all of their products. They have a good track record and good comunication with the community. They label all batches of compounds (each jar has a "batch number"), so if a problem does come up, it can be linked to a specific batch that might be causing problems due to inferior quality. For other things I either go with smart powders (I have much less faith in them, but they have a fairly good rep quality wise, so I still buy), or I browse around for individual brands if necessary. Some supplement brands I've come to trust include NOW and AOR.

[Mind_Paralysis]

Regarding the irritability, it's not at all implausible, since it seems to be a common temporary side-effect among children that take Intuniv for ADHD -symptoms. I've heard it mentioned tho', that something like a bit of DMAE -supplementing helps a lot of people get past the irritability, so that might definitely be worth a try, GetOutofBox. =)

By the way, I've been thinking a bit about the genetic testing you mentioned, is that something that you have tried yet? It'd be interesting to read your results, and then perhaps consider a bit of testing on my self, to see which potential polymorphisms I might have.

[GetOutOfBox]

Regarding the irritability, it's not at all implausible, since it seems to be a common temporary side-effect among children that take Intuniv for ADHD -symptoms. I've heard it mentioned tho', that something like a bit of DMAE -supplementing helps a lot of people get past the irritability, so that might definitely be worth a try, GetOutofBox. =)

By the way, I've been thinking a bit about the genetic testing you mentioned, is that something that you have tried yet? It'd be interesting to read your results, and then perhaps consider a bit of testing on my self, to see which potential polymorphisms I might have.

Yeah, it's quite odd, since I do feel much happier in that my mood is much more stable, but I've noticed I'm prone to snapping just a little bit more. It's not enough to affect my social life, but I notice that I snap more at my family (the threshold is lower for family, as you're closer, whereas with friends/dating the consequences of snapping are higher and hence you're less likely to do it). It's nothing serious like fits of rage, just slightly wound up a bit more. It's also over pretty quickly, I quickly realize I was just being grumpy and apologize. I would still emphasize it could just be my life making me irritable, there are a lot of confounding factors that could also be the cause(s). We'll have to see if it persists.

As for the genetic testing, I meant to post about that. 23andme have officially ceased providing their medical package, at the behest of the FDA. You can still get the raw data and use other site's tools to interpret it, but medical interpretations are now officially unsupported. The reason behind this is that it turns out the FDA has been trying to work with 23andme in validating their methods of interpreting gene data for a long time now. As it turns out, 23andme have been less than cooperative, and have been ignoring many of the FDAs attempts to work with them.

The FDA's issue with the medical side of 23andme's gene testing is that it turns out there is a fairly high rate of error in the hardware they use to analyse DNA samples. It's not that much higher than most SNP hardware, but it's high enough that it occurs fairly frequently. This is confounded by multiple testing, that is, if you're testing for 200 polymorphisms and the error rate is say 1 in 1000 the chance that you will falsely be found to have a polymorphism of some sort is much greater than testing just one (it's not that the individual chance for each is higher, it's that the overall chance of one of them being a polymorphism is higher). Essentially their problem is that there is a high chance (I believe one article quoted 1 in 3) that you'll get at least one false report out of the 200. Medical centers get around this issue by testing multiple times (and using hardware with a lower error rate but longer turnaround), reducing the chance of a false report. 23andme however provide an extremely low-cost service, so they cut corners in that department.

It's not completely useless, but the effectiveness and value as a diagnostic tool (in fact, it should not be used as a diagnostic tool, which is the FDAs point) is greatly reduced. I would use it more as an indicator to explore further, say it tells you you have a polymorphism increasing your risk of hypothyroidism, you should perhaps show that result to your doctor to back up a request for a thyroid panel.

[Hansen213]

If you have trouble with attention, I would skip CILTEP, at least for now during this important period of examines. I went over it in detail earlier, but essentially CILTEP works by increasing cAMP levels. People with certain inattentive types of ADHD tend to already have pathologically high cAMP levels as a result of a DRD4 polymorphism. Anything increasing them further (Caffeine, a mild PDE inhibitor, CILTEP), will exacerbate the problem of prefrontal-cortical dysfunction. Now, that's assuming you do have this mutation causing your inattentiveness. You may not. But I wouldn't experiment with that when you need to be performing at your best.

I have ADD, but not ADHD, I think that you are very right about the high cAMP levels though, because often when I drink coffein it is counter productive to my focus, since it becomes harder for me to collect my thought and to focus on just 1 task.

Also, skip Sunifiram unless you're willing to get a proper scale and measure each tiny little dose. Reccomended doses range between 5 and 20 mg (5 is definitely still psychoactive, 10 seems to be the median). There is no reliable way to measure such tiny doses just by "eyeballing". And due to the mechanism in which Sunifiram works, it's pretty important to get the dose right. The usual consequence of too high a dose is temporary brain fog, but more serious consequences could occur, especially in those mixing in a bunch of substances. Sunifiram is strongly glutaminergic (it works in two ways, increasing glutamate release and positively modulating receptors, a potentially risky combo), which opens up the risk of excitotoxicity. I would be very careful with that compound, as well as IDRA-21 (especially IDRA-21, due to it's multiple day half life, verrrry risky) and Unifiram.

Oxi and phenyl racetams are fairly reliable, I'd advocate their use. Oxi is a much less potent glutaminergic substance, so it's safer and you can be more relaxed with dosing. Phenylpiracetam has the potential to upregulate a bunch of receptors (though it has been observed to downregulate NMDA and nAch receptors, so cycling might be needed if you notice memory issues).

Since I got to know that Sufri has not been clinicly tested on humans and read about its side effects in a thread here, I dont want to try it, especially not in the beginning. As I understand your answer, the Oxi should be enough to improve the glutaminergic section in the beginning.

2 questions: 1.) What do you think of PRL-8-53? I read that it should be very good for writing exams

2.) Since Piracetam is usually the #1 option to start and has been most tested from all racetams, how come you never mentioned it (or at least I cant remember reading it in your thread)? Didnt it work for you or do you find that Oxi just works better?