The silent struggles of workers with ADHD

As school kids we had the same thought about 'drug stores' - and I even found it amusing when a Pharmacy/beauty shop opened called 'Superdrug' - seemed such an odd turn of phrase to someone who had only heard of drugs as the illegal and dangerous things...

I guess if you’re arguing (I know you are not, I am just putting unsolicited info out) in terms of what amphetamines are the worst… methamphetamine, pharmaceutical grade & at the equivalent therapeutical dosage for ADHD symptoms - which is something like 5mg-15mg max, & potentially up to 45mg for the very worst cases of chronic fatigue syndrome - is actually less hard than others on your body from a neurotoxicity standpoint, as well as on your vascular system in general. You can also very easily take naps on it (at those dosages).

It just happens to be highly addictive because of the whole blood brain barrier crossing thing. & then once you get out of that therapeutic dosage into “recreational/abusive” dosages… that is when meth is very bad.

So if you don’t have an addictive personality & can control yourself, prescribed methamphetamine (Desoxyn, not sure if a generic exists) is otherwise the safest treatment for ADHD if expected to be consistently on it for decades/life.

I believe it then goes

DextroAmphetamine

50:50 Racemic Amphetamine (Evekeo may be brand for this in US?)

Adderall (which is 3:1)

From least harm on your body to most harm over time.

My doc & I for the time being found Vyvanse was nearly perfect for me, & essentially perfected it by adding a small (10mg) instant-release DextroAmphetamine (Zenzedi, specifically branded - seems to be the most perfected formulation in the US pharmacy system as of now.) along with it to kickstart things in the morning. There are also times when I’m scripted to just take multiple 10mg IRs a day instead of the entire Vyvanse dosages for other medical reasons & potential need to rest. Mentioning rest: a non-negligible portion of people on an otherwise perfectly working Vyvanse dosage seem to need a mild-moderate sleep aid towards the end of the day. & where you may think that just indicates a lowering of the dosage, that is mostly wrong & ruins the “otherwise perfectly working” aspect.

I only mention all of this unsolicited advice/information as I’ve for far too long now, & with medical practitioners in family, seen anecdote after anecdote of people prescribed Adderall (IR or ER) eventually trying pure DextroAmphetamine IR (previously known as Dexedrine, now Zenzedi, & of course generic) - or ER like Vyvanse - & finding that it works much, much better than Adderall. Typically from a standpoint of less irritability/jitteryness/emotional blunting & more focus & ability to change task to task if needed. For whatever reason though (obviously, industry money slushing around related), Adderall is prescribed at a ridiculously higher rate than pure DextroAmphetamine. There’s also a decent amount of people who’ve only heard the term Adderall & don’t know DextroAmphetamine exists. Finally, that in some rare cases, meth is genuinely the correct drug for treatment. I honestly think if you’re being prescribed an amphetamine, doctors should have to inform you of all amphetamine based medication able to be prescribed for your condition & the potentially pros/cons comparisons - but I am nobody in this world.

Depends on the country. In Europe, it's not so easy. In the UK, the last I checked, it was contraindicated for long-term use, meaning it could be used for smoking cessation but not for long-term ADHD treatment.

> similar to amphetamines

Wellbutrin has a very different mechanism of action, and a different effectiveness profile. I wouldn't say it's "similar to amphetamines" in any clinical sense.

I was diagnosed fairly young (some time Once I left for college though, my life fell apart. I had no one to make sure I was on a schedule and taking my meds. I basically quit taking my meds, struggled to attend class & do assignments, and nearly flunked out of school a couple times.

I loathed myself. I thought "what good am I, if I can't function without the pills?" This was a toxic mindset, but I stuck to it through college and for a few years after. I think the only thing that saved me from total ruin was the fact that I found tech work so engaging that it never felt like a chore to me, and I was able to succeed despite my false start.

Being off the meds forced me to develop a lot of coping mechanisms I never learned as a kid. I externalized a lot of my executive function into reminders, calendars, and habits. I cut away all unnecessary tedium in my life. I became addicted to coffee, because (surprise!) stimulants helped my symptoms & dealing with life in the workforce.

About a year ago though, I decided to start on meds again. They aren't a silver bullet for me of course (the real silver bullet all along was having my mom's structure and support in my life), but they help a lot and I can notice the difference. It's so much easier to deal with necessary tedium when I have the meds in my toolbox again. I don't feel the need to be on them 24/7 (probably a good thing), but it's nice to know I can take them and not feel shame about it anymore.

Nothing like this should happen. They will improve your sleep and your symptoms will get better over time without medication.

If you get tolerance, take magnesium and NAC.