I've posted before (http://paleohacks.com/questions/28369/hack-options-for-adhd#axzz1TJOVOIlT) about non-drug options for Adult ADHD and I've resided to the fact that I may need to try the medication for a short period. I am extremely reluctant and have a lot of concern regarding a potentially mood altering drug, however, it is really effecting my work and home life, and has for a while, and I am at my wits end. So a couple of questions for those who do take ADHD medication:
1) Which one do you take and why? 2) I previously had IBS. Will this effect my healthy gut bacteria? 3) I've never had trouble sleeping or falling asleep. How will taking medication effect my sleep? 4) Any suggestions, tips or tricks while on this medication?
Background: Been Paleo for a year and have seen small benefits. I have tried both high carb and low carb and many of the suggestions from my previous post. And before you say that ADHD is over diagnosed, I agree with you 100%, but this is something I have been dealing with since I was a kid but ignored it because I was still successful professionally. However, it is increasing getting worse.
asked byhemanvt (5773)
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on July 27, 2011
at 07:10 PM
I wasn't diagnosed until I hit 50 although I now can look back and see clear evidence of certain ADD traits throughout my childhood. Evidently, the hormonal disruptions of menopause were all it took to completely knock me off kilter and blow all my previous coping strategies out of the water. (Just as an FYI, my ADD is what is sometimes called the "inattentive" type as opposed to the ADHD with hyperactivity and seems to be the more common version in women.)
I went on Ritalin LA 20mg several years ago (LA stands for Long Acting because it is the timed-release version). I also had some trepidation about this type of drug - and you will now NEVER pry those pills out of my grasp - at least until I don't have to work in an office every day! Sometimes I find myself about 11:00am dithering around going "WHAT is the matter with me today?" and that is when I realize I forgot to take my pill. And no, I am NOT addicted - quite often on weekends when I don't have anything in particular to accomplish I will not take it.
The difference has been HUGE in my ability to focus on my work (I was on the verge of getting fired and now I have a Star Performer award) and I have not noticed any physical effects at all - no problems with taking with food or not, feeling jittery or anything. I even have a prescription for the generic version of Ritalin - methylphenidate - in a 10mg size that I can take if I feel I need a "boost" in the afternoon or for a long day. While some people may be more sensitive to the effects of stimulants than others, I have never had an issue falling asleep at the proper time even if I took the smaller pill late in the afternoon.
I would definitely say that if your ADD is affecting your quality of life, then go for it. After all, you can always quit if you don't like the way it makes you feel, but if you don't at least try, you can't know how much better you could be.
on September 17, 2011
at 04:15 PM
Like you, I resisted going the drug route, but have finally resigned myself to it, at least temporarily. I never even considered the idea I might have ADD until several months ago when my pastor and a client independently suggested it, because I'm not in the least bit hyper, and that's the stereotype. Not hyper externally, that is -- my brain has been in multitasking overdrive as long as I can remember. So two days ago I went to a doc and got diagnosed with inattentive ADD. (According to my responses, she said I was in the 99th percentile of men my age. I win!)
So now I'm on my third day of Vyvanse, an outrageously expensive amphetamine which kicks in 2 hours after you take it and lasts 14-16 hours. (From what I gather, the 2 hour thing is to cut back on abuse, since abusers don't get an immediate high from it.) So far so good. I wouldn't say my focus is great yet, but the hamsters in my head have definitely slowed down on their wheels. I've got a little more bounce in my step, and am noticeably happier and more confident. There are still things I'm worried about -- especially financial difficulties that my inability to focus got me into -- but those thoughts aren't overwhelming like they were. I still have to work on the behavioral stuff, but I seem headed in the right direction.
The list of side effects for Vyvanse was pretty short, and the only one I recall being clearly gut-related was constipation, because it tends to dry you out. But on a high-fat diet that's not likely to be an issue, and I drink a lot of water anyway. Sleep hasn't been a problem so far. Most of my sleep problems before were caused by the whirling thoughts, so calming those down may actually help me sleep better.
I don't really like the idea of taking a drug for the rest of my life -- especially one that costs $5/day -- so I hope eventually I can wean myself off this with quality diet, exercise, sun, etc. But I wasn't able to do those things as I was, because the whirling thoughts and the anxiety and depression that tended to accompany them made it too easy to fall off the wagon too often. Carb cravings were a big issue too, and when you give in to carb cravings, it's almost always with something like chips or ice cream, not a baked sweet potato. Then the blood sugar rush and crash only exacerbates the problem. If the drug can keep me stable enough to stick to the program for a while, maybe eventually I won't need it, or can at least cut back on it.
I'll check back in a couple weeks and report how it's going.
Well, after almost four weeks on Vyvanse, I only have positives to report (except the price). The first day, I felt "high," like on a major dose of caffeine, when you have a little too much bounce in your step and can kind of feel your hair growing. (I've never taken any other stimulants, so that's all I can compare it to.) Since then, though, it's leveled out nicely. I started on a fairly low dose of 30, and went to 60 after the first week, and that seems fine. There were two days that I knew were going to be extra stressful and disorganized, so I took 90, and didn't see a major change, so I'm probably about right at 60.
It's hard to describe the effect, but the best I can come up with is to say the wheels in my head have slowed down. If something was on my mind before, it might come "through" my consciousness once a minute or so, depending on how much it was bothering me, so I was multitasking from one thought to the next every second sometimes. (One time I made the mistake of fully answering the question, "You're so quiet, what are you thinking about?" Beginning of the end of that marriage.) Now all those thoughts are still there, but they don't keep circling to the forefront without permission nearly as often. I can still think about them when I want to, but they're much more under control. It's like my brain is more a filing cabinet and less one big unsorted inbox.
Emotions are more controlled too. Of course, that's because emotions are driven by thoughts, so if worrisome thoughts aren't bombarding you every couple seconds, the corresponding emotions won't be driven as hard. I'm not emotionless at all; if I think about something sad/scary/pleasant/funny/annoying, I feel those emotions. But they seem more appropriate to the circumstances, and aren't nearly as likely to become a vicious cycle of negative thoughts and emotions leading to despair. Looking back at some journals I wrote in the months before I got diagnosed, I can see that happening. I'd write my impressions of an event on Friday, and they'd be generally positive, and by Monday I'd be half-convinced Friday was a disaster and nothing could be done to fix it, even though nothing had happened in the meantime to change my mind, except the wheels spinning and overheating.
On the organization/ambition side of things, I've still got a long way to go. I've been a terrible procrastinator and have never learned any self-discipline when it comes to meeting deadlines or looking for work (I'm self-employed). (To make a long story short, I'm smart enough that I've always been able to get away with that, at least enough to satisfy teachers in school and stay just ahead of the bill collectors since.) But I'm making some progress on that, and at least I can see that progress is possible now. I told my doctor that it feels like I was operating at 10% of potential before, and now I might be up to 20-30%. Learning new work and life habits will take longer, but they'll be necessary to get me the other 70-80%.
I'd never have gotten off 10% without the drug, though. I've been trying for 20+ years, without knowing what the problem was. Low carb helped, gluten-free helped, treating it as adrenal fatigue helped a little, happy times like falling in new love helped, the distraction of a new job or home helped. But none of them got me over the hump to where I felt like I was really handling it; and whenever life threw me a curve ball, pure willpower wasn't enough to keep me on the diet or whatever that had been helping a little. Now I think I really can handle it through the ups and downs -- and I still have worries, some of the worst being the financial hole dug by my previous inability to get things done, so it's not like everything is rosy yet -- but the bad stuff doesn't seem like doom and the good stuff seems attainable.
I'm not going to become one of those people who thinks everyone who's having a bad month or who feels stressed should get a prescription for something. But I'll never again look down on those who do. I was never suicidal, so I can't say it saved my life, but it's already making my life a lot more worth living.
on July 27, 2011
at 07:22 PM
Go for it. It's easy to tell if ADD meds work for you, the effects are immediate, and if they don't work or the side effects are bad you can discontinue use with no withdrawal, etc. I can't tell you how many people I've known who have seen huge benefits from medication.
I am considering meds again also (ADD-PI, haven't been hyperactive since I was a kid). I was on Ritalin as a child and it didn't work all that well, but I would like to try Adderall or Straterra.
ADD was probably an advantage if anything in the Paleolithic, but for a modern life it can cause significant performance and relationship problems, and contribute to depression. Don't be afraid to try something that helps just because it's a 'drug'. All these drugs are doing is allowing those of us with slightly 'different' brains to function at the level of other people, when necessary. :)
on October 29, 2011
at 10:04 PM
ADHD meds let me get things done...but the downside is they kill my ability to socialize, go out and make friends with everyone in the room, ect. :/ They also seem to have detrimental impacts on my mood.
on July 27, 2011
at 10:01 PM
I'm a 30 year old male and I've been taking Adderall for about 3 years. My dose is pretty high, about 40mg on days when I take it, which is when I need to get work done. I know I'm not addicted because on non-work days I have no desire to take it - quite the opposite, in fact.
Getting on the paleo diet has had no affect on my ADD symptoms. No dietary intervention or pattern has, to my knowledge, ever changed anything for me ADD-wise. I stick to the diet for its other benefits.
Without Adderall, doing graduate-level work would be out of the question. So I accept the numerous side effects of the drug: it cuts into my sleep, resulting in all-nighters more frequently than I'd like to admit. I say 'numerous' because messing sleep up is such a deep problem. I'm not sure what all of the consequences are, but I know its not good.
I talk and think a lot about setting up a situation where I wake up at 8a and use Adderall to maintain a 9 to 5 work schedule, but that's never happened. I've always been a night owl, rarely productive before 5p or so.
Dr K suggested that longterm stimulant use can mess with leptin signaling, but he didn't go into detail, and I'm not sure if there is anything to his claim. But you might want to look into that.
I've only tried Adderall, Ritalin, and Focalin. Adderall was clearly the best, providing boosts in focus, creativity, and it quiets the spinning 3D kaleidoscope that usually houses my thoughts. Ritalin was only good for reading, but not writing or thinking. Focalin was useless.
A very smart friend of mine, who is a PhD student in evolutionary biology, recommends the book Scattered Minds by Gabor Mate. I just started it, and can't really comment. But if my friend recommends it, then I'm quite certain that it will be insightful. So that's a resource if you are looking for one.
Hope that helps. Good luck.
I don't usually like webmd, but I found this little article about supplements and ADHD helpful:
They limit themselves to stuff that has been studied with controls with clear findings, which has its tradeoffs, but the results make sense. They suggest:
zinc & fish oil;
NOT st johns wort;
Tentatively - ie with additional supporting evidence:
melatonin, genko, ginseng, inositol, & GABA.
on November 24, 2011
at 03:21 PM
Do you still drink coffee in your paleo diet?
Also, it makes me really sad to see so many people accepting of Ritalin, adderall, like they are okay to use. Remember when you were young and naturally were exciting about everything? Well there are plenty of 70 year olds who still find joy and can do things. The answer is you're overall health, Ritalin is just leading you to be burnt out eventually.
on November 24, 2011
at 02:42 PM
You're going to have to see how the different meds affect you. I work psych, and frequently many of my patients are diagnosed with severe ADD.
Stimulants are a problem (as you know) with sleep disturbance and impulsivity. It might not be a problem for you.
Another drug to consider, and much less problematic is Guanfacine (Intuniv, Tenex). Many find success with this, as it's not a stimulant, and sleep disturbance isn't an issue. Orignially a blood pressure drug, if you have low blood pressure, than this might not work for you. It's greatly associated with increases in prefrontal cortex enhancement of working memory in both children and adults. However take this at bedtime, as mild sedation occurs (which is usually helpful).
Diet-wise I mirror some of the previous comments: High fat, lower carb, borderline ketogenic diet. GAPS.
on November 24, 2011
at 01:04 PM
My ADD was severe. I was finally diagnosed as an adult at 24 and then took Ritalin on and off for the next 13 years. However, I began feeling like after such long-term use it was starting to exacerbate my mood issues/disorders; anxiety, depression etc., so I eventually stopped taking it. As a result I lost my job since I just couldn't function at work. Rough times. But I didn't go back on Ritalin as I felt that, where it had once actually helped with my depression/anxiety, it was now making them worse.
Anyway, I had already 'instinctively' wondered about ADD as possibly linked to food issues so I began to research and eventually tried LC (which I couldn't stick to because I had relentless cravings). Finally I came across VLC/ZC and tried it more out of desperation than anything else. I substituted all those vegies for more fat and protein and the cravings became tolerable enough to overcome.
After a few days my mood became amazingly calm and my brain fog lifted! My body however stayed feeling very lethargic for around 4 weeks, but, I was so relieved to not be feeling that brain fog and depression that I kept going. After around 3 months I could almost say that I had 'forgotten' what it was like to have ADD.
If I do cheat for whatever reason (usually because I start to forget what the harm of eating certain foods feels like) I then 'remember' quick smart again what having ADD is like!
on November 24, 2011
at 05:07 AM
Before you give up on alternatives, I've been saying about some vitamin supplements that seem to have good blends and they could work rather quickly (possibly within a week).
Calcium, with magnesium and vitamins D & C can help, also the omegas, preferably in a powder. I have personally seen CalMax, NutraCal, or I Need To Focus (from Solomon & Samson) work well and fast for kids (and adults) who couldn't focus too well.
on July 27, 2011
at 10:50 PM
Adderall has amphetamine aspartate which is bad like aspartame.
I'd try getting dexedrine prescribed instead.
on July 27, 2011
at 08:32 PM
Also recently diagnosed with adult ADHD. I've been on Adderrall IR 30mg/d for a year now and it has dramatically helped me get things done.
The one concern you have that I can address is sleep. Like most stimulants, the key is just to not take it close to bed. Because I take instant release (cheaper, out of patent), I make sure not to dose after 2pm or so, to get to sleep at 10 pm.
My biggest concern about the drug is the possibility of it amping up cortisol levels, like other stimulants can. This is why I take breaks from the medication when it's not necessary for me to get things done.
on July 27, 2011
at 08:04 PM
I don't know if ADD/ADHD meds are different for adults than they are for children. That said, my son was diagnosed at 6 with ADHD. I did not want to medicate him but he was failing the 1st grade and I got the feeling from the pushing of his school that they had no interest in working with him unless we got him on medication. I eventually learned he has Asperger's Syndrome, not ADHD and I pulled him from public school, quit the meds and schooled him at home. But anyway, he took Adderall for about 2 years which helped him to focus and get his school work done. We had him stop the Adderall because after his early success with it, I was noticing some aggressive behavior, bad temper issues. We switched him to Concerta which worked well for focus and he took that for about 2-3 years with no issues before I took him out of public school and stopped the meds.
As a side note - I took his Adderall once to see how it affected me, I wanted to see what it does. I think if you don't have ADD/ADHD it's really just speed. I thought my heart would pound out of my chest and I couldn't sit still- our house was never as clean as it was when I took that stuff. My son said it did not do that to him, he said it slowed everything down for him.
on July 27, 2011
at 07:53 PM
Age 40 female marathon runner, crossfitter and Paleo; I've been taking a small dose of Adderall (7.5 mg) once in a.m. and once in p.m. (if needed to focus at work) on weekdays only, since being diagnosed ADD in college. I don't like the fact that I "take drugs" but the benefit of being able to stay on task has made it worthwhile. Since switching to Paleo in March 2011, I've noticed that my daily mood level stays even throughout the day, no morning coffee spike followed by a crash, then a post lunch coma, followed by another sugary afternoon snack "high." Because my history with Adderall has always been consistent, I can only attribute this nice even level of energy throughout the day to Paleo. If your doctor knows what he or she is doing, you will start on a relatively low dose for a few weeks, then return to the doctor for an evaluation. That process will be repeated as necessary until the right level works for you. For what it's worth, I like the fact that I can choose whether or not to take my p.m. dose as opposed to taking one dose in the morning that lasts all day. Some days, I simply don't need the medication in the afternoon. Usually this happens if I've had a good run or crossfit session in the morning. Ironically, on the days where I don't exercise, I usually do have to take my p.m. dose. Since it is a low dose and I never take it after 3pm, I have not experienced any difficulties sleeping. Also, I avoid caffeine. Hope this info has been helpful and best of luck with whatever you decide to do!
on July 27, 2011
at 06:33 PM
I too suffer with adult ADHD. I have taken Straterra which worked moderatly well, but it makes me quiet. I normally would have a headache off and on for 2 weeks or so when restarting the med. It does go away though. Which is SO NOT ME, I talk all the time. The straterra allwed me to actuallt think before I spoke and I did not feel like I had 10 different thoughts/conversations going on in my brain at a time. So this is a good one if you want a non stimulant, not a controlled substance. I just started taking Ritalin 20 mg Long acting. Like you ADD has really started to affect my home life. This should be taken twice a day but for now I am only taking it once a day, to kinda ease into it. I am seeing good results from it. As long as I dont take it after 5pm I don't have probs with sleep, hope this helps ya. deziray
on September 16, 2012
at 03:05 AM
Part of becoming Paleo was an endless search to 'separate' my hashi's thyroid symptoms from my ADD. (inattentive type) They are so incredibly similar and even share some direct correlations! I do much better on just the Paleo, but I still cannot give up my adderall entirely. I have cut down quite a bit, though. I am on the same 15mg dose I was 3 years ago.
Med breaks are key. Often when it's not a real busy week I would not take it at all, and I would not take it at least one weekend day, if not both. Now, I generally only need it about 2-3x a week. Before Paleo I literally had to take it every day or suffer the consequences! I'm also doing the autoimmune protocol of eliminating eggs, nightshades, dairy, nuts and wheat/gluten. Most of that has to stay gone, for me.
No, I don't like the idea of taking it but so far I take one regular (not the extended-release) in the morning around 9am - I feel it about 1 hour later. I have no issues with sleep unless I don't take my thyroid meds for a few days! Then my 10:30pm - 6:30am pattern is ruined by being awake until 2am.
I am hoping that once I get a better grip on being Paleo (only at it for about 2 months) I can find ways to get off the meds entirely. But until that day comes I have zero shame. Taking the pill is a lot better than getting a divorce or drinking myself into an early grave!
on July 28, 2011
at 01:02 AM
I've taken Concerta for about 7 years. It was seriously a godsend for me. Like it just allows me to stop, organize myself, get shit done effectively and not feel like I'm 2 steps behind everyone else and always scrambling to keep up and failing to remember important things. It also really helped my sleep, before I would lie awake for hours thinking and fidgeting. I also tried Strattera (no effect at all) and twice-daily Ritalin (interfered with sleep) and Adderall. The Concerta works the best and has very few side effects. I don't take it every single day or for long periods without, say, a week off, because I don't want my current dose to become less effective. The only thing I've found is that I have to eat breakfast and wait about an hour before I take it, otherwise I get kind of nauseated. If I take it and skip breakfast (it does have an appetite suppressant effect, after all) then I will overeat later, which is probably a combination of rebound hunger from the meds wearing off, and overcompensating for the missed breakfast. Otherwise, no unpleasant side effects. I know many here hate all psych meds but if you genuinely have ADD they can really improve your life. Like someone else said, ADD probably didn't matter back in the paleolithic but it can be a huge hinderance today.