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Different reaction to same medicine

Hi

I was diagnosed with combined ADHD-ADHD-PI a couple of years back. I’ve tried several medications and IR dextroamphetamine/d-amp/dex (Dexedrine) has worked the best for me. Problem is, how I reacted to it e.g. a year ago was quite different from how I react now.
First off, I’ve always had some problems with the dosing and scheduling; tried all doses between 2.5mg to 30mg at a time and how I respond to them varies greatly. At times a 10mg might be enough, at other times 30mg might not be enough, and vice versa. 10mg might put me into overdrive. And this happens regardless of sleep, exercise, diet, life etc. I also do not like the comedown effect.

Now my main point that I started with; For example, a year or so ago, I could be at the end of my dose cycle, get into an argument with my then girlfriend and pretty much lose all hope and lash out verbally on her. All in all every problem seemed worse when the meds were wearing off. And then, on re-dosing, I’d get a completely different outlook on life and have great patience and motivation.

Present day, I still sometimes get the brain activation from d-amp and get to doing things, but all in all my frustration levels don’t get better. I also get less flexible in my thinking now. Switching states has become more difficult.
Does anyone have thoughts on this?

Not really sure what info to write here without turning this into an essay!

Other meds I’ve tried (Brand/generic):
- Adderall - this one the first one I tried. Close to Dex in efficacy but requested Dex because I felt I was a little too robotic on it. But it did give me a ‘Oh so this is how it feels to be normal’ for the first time in my life. Now I don’t think I can get it in this country (moved since first diagnosis) as the rules are very strict and getting Dex prescribed was a real struggle already.

- Wellbutrin - wired, spacy, too serious

- Methylphenidate IR, ER, XR - IR was best but too still too much anxiety, sleep issues

- Vyvanse/Lisdexamphetamine - quite alright at times, but starts working as quickly as IR Dex and the comedown lasts a lot longer and is quite uncomfortable even at 2-3 x a day dosing. Even tried combining with IR but not really that good.

- Strattera - horrible. Did reduce my Dex intake but felt uninterested in everything and the sexual problems were bad too.

- Modafinil - no real effect, even on energy levels

- (for comorbid anxiety and depression) SSRIs - Zoloft, Venlafaxine - no good and venlafaxine was the worst experience I’ve ever had.

- Buspar - nothing really.

- A whole host of supplements with little to no positive effects.

I eat well, rarely any junk food, moderate to little caffeine and coffee, don’t really drink alcohol much or often, don’t smoke, lift weights and exercise 6-7 times a week, I do meditate regularly, have a social life, have a decent job.

Aaaand this turned out to be very long anyway!
Basically, I guess what I’m asking is, has anybody found a way to modulate their response to dexedrine and achieve consistency in its effects?

Thanks

Replies

Hi hchief,  I feel wholly unqualified to answer most of your questions.  Here are a couple of opinions.  You may have more than ADHD going on, and it sounds like you may need a doctor to tease out why the symptioms happen when they do.  One small piece of the puzzle is that the meds could be made by different manufacturers.  I react differently to the same med made by different manufacturers.

Posted by whizinc on Jul 28, 2014 at 3:58am

Hi whizinc,

Thanks for the reply. I’m looking to get into other treatments as well i.e. therapy but it just takes a long time where I live.
Also you might have a point with the manufacturers. I used to use generic dextroamphetamine from Barr (I believe) until the end of last year. Now I’m using a brand name by a local company. Too bad it’s the only one out here and there’s no generic version available.

BTW I was just reading Dr. Brown’s “Smart but Stuck” book and he talks about a guy who “needed to be on a maximum dose of immediate-release amphetamine to start the day, followed by a maximum dose of extended-release amphetamine, which was followed by another maximum dose of immediate-release amphetamine in late afternoon to provide coverage for homework and any evening activities.”
I might explore that option. Though I forgot to mention earlier I’ve tried the Dexedrine ER Spansules and they’ generally didn’t have much of a positive effect, but considering now doing this with lisdexamphetamine.

Posted by hchief on Jul 28, 2014 at 6:54pm
Posted by Pinnochio99 on Aug 01, 2014 at 7:25pm

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