Adderall not working as well 6 weeks later?

[Anonymous]

I started Adderall 20mg noce a day, 6 weeks ago. This past week it has not been helping as well. I am still missing out on a lot of activities, especially in the afternoon.

I’m prescribed Adderall for fatigue, depression and inattention caused by autoimmune diseases similar to rheumatoid arthritis and psoriasis.

Is it normal that after 5 weeks it doesn’t help as much?

Is it normal that it doesn’t kick in until 3 hours after i take it?

I take the Adderall at 6:00 am. Is there a way to prevent the depression i get around 4:00 pm when it runs out?

What is the normal procedure for when it doesn’t work like it used to?

I am 37, 5’2″, 135lbs male, in case that’s needed…

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[Irishbookfairy]

Hi Dbacs, I used to take Adderall and it worked for me for awhile. It quit working because I went a week without it. Your issues that you have are common to many. For example, the depression you feel when the effect of the med runs out. This happens to me as well. I am currently taking Ritalin and I have found relief after searching for years. I take my first tablet at 8:30 am and a second one at 1:30-2:00. I would begin to feel depression around 6-7 every evening. My dr. Had me taking 1/2 a tablet T 5:30 to overcome this. He was not happy about this because he said it was best to take as little as I could. Well, the extra did help but I eventually quit taking that extra 1/2. My doc was right, he told me its better to experience a few hours of depression and all those glorious hours from a med that is well regulated.

I have learned to use that time to meditate or as a planning time for the next days activities. As you know meditating is so important to all of us with ADD/ADHD. Believe me if you begin to feel depression in the evenings and you go for a walk or just lie down and empty your mind you will feel so much better before going to sleep and when you wake up in the morning!! I am addicted to this quality quiet time away from my family. I just shut my door to my room, turn off my TV, keep one small lamp on, burn incense and meditate by simply zoning out. The depression goes away because my mind is not allowing it.

Now maybe your dr. Could adjust your doseage. Or switch you to extended release. I have no idea why it tables so long for your meds to work. Call your pharmacist please, they are so helpful.

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[g.laiya]

i started on adderall a few weeks ago for mod-sev add. i was started on 20mg xr to be taken at 7/730am. i also had sleep dysregulation, so he said it’s fine to set an alarm to take it and go back to sleep if i wanted – hoping to also improve the sleep dysregulation. anyway, i took it as prescribed, but wouldn’t wake up again til 1030 or so – over 3 hours later – and also felt it wearing off too early in the afternoon, generally btween 3-5 or so. i didn’t feel depressed as it wore off, but would start yawning a lot, followed by feeling progressively more scattered.

the first day i felt so tired by around 730 pm that i decided to have a cup of coffee. i figured the med was long out of my system, and it was such a small amount compared to what i usually would drink when i would feel that way, i thought it would be ok. i wound up having an anxiety attack -not as severe as i’ve had in the past, but very uncomfortable just the same. not fun! do not want to repeat that experience!

anyway, when i saw my dr next and told him what had happened he told me 2 important things. 1 is that even when the med is no longer active, it is still in your system and you are still going to be more sensitive to caffine. and 2, it only takes 1 hour for the med to start working – not 3 – i was not on the right dosage yet.

another thing, after i started taking the 2×20 mg xr in the morning, it was much better. by 830 am i didn’t feel the need or desire to stay in bed, i was alert,clear-headed, and functioning in the morning for the first time in my life. i also noticed i was much less irritable during the day while the med was active. and i was getting sleepy and ready to go to bed at a “normal” time. (i’m still wrapping my head around this drastic change….it feels very, very strange to me) but, it still seemed to wear off too early, and since i sometimes am at work until 6 or 7 (occasionally later) this was a problem. so he gave me some short-acting adderal to use late afternoon as needed. i haven’t tried it yet, but good to know it’s there if/when i need the extra coverage .

i’ve also noticed too that the amount/quality of sleep i’ve had the night before has a big impact. i know this is logical, but i think sometimes we forget (i know i do). the med is amazing – a huge help – but it’s not a “cure all”. it’s still important to get adequate rest, as well as good nutrition and exercise for a healthy mind and body.

yesterday i came home feeling really irritated and depressed (over some things i won’t get into now), so i convinced my kids to go to the pool with me. we went back and forth between the pool and jacuzzi, sometimes swimming, sometimes playing, sometimes stretching, sometimes just relaxing. and for those few hours i felt much more relaxed and at peace. a temporary fix, i guess, but at least it’s a healthy one. i imagine “moving meditation” would have similar effects, probably more profound – another tool in the toolbox to try

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[Anonymous]

Ok thanks for the info guys. That’s reassuring that other people experience the depression and poop out.

I hope my dr is ok with prescribing an extra one later in the day. I am missing out on a lot of things. People my age don’t go to bed at 4:00 pm.

The depression was very bad last night. I’m not sure what to do about that. But i did do more than usual yesterday, so maybe that contributed to it.

I take Adderall XR. I have a hard time talking to my doctor. I think i’ll list the problems and show him that. From seeing what’s been posted here it seems like he’ll understand. Plus he didn’t give me any refills so i’m thinking maybe he expects to need to change the dose?

The strange thing about this is I actually sleep better since i began the Adderall. I used to toss and turn all night, but now i sleep 6-8 straight hours, and i don’t need my old sleep medicine.

I have tried taking caffeine for the poop out at the end of the day but it doesn’t help. I always feel more tired and weak when i drink caffeine.

Does Ritalin have less side effects? Last longer, not as long?

What is the difference between Ritalin and Adderall in terms of side effects?

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[g.laiya]

re the depression, you may also want to talk to your dr about trying an antidepressant med. adderall is a stimulant, not an antidepressant, even though it helps some people like me with emotional regulation,and may ease symptoms of depression indirectly by helping with the other challenges we face. many adders have depression secondary to having add – especially ,i believe, if it went undiagnosed/untreated for many years. sometimes that depression lifts with out treatment specifically for deression as they get treament for add and learn to manage life better. sometimes treatment strictly addressing the add is not enough, and often there are other co-morbidities that need to be addressed.

i know patients with syndromes such as fibromyalgia that include symptoms such as severe fatigue and mental fog often have depression and/or anxiety as co-morbidities and those need to be addressed as well. some antidepressants are also used off-label to help some pain syndromes.

sorry i can’t help you re comparing adderall and ritalin as i have only tried adderall – and even this is relatively new. but hopefully you’ll get some more responses from other members here. and you can also check out other posts in the medication forums for more info.

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[Anonymous]

Ok thanks, i’ll ask about the antidepressant as well.

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[scrapper]

My DR. raised my adderall to 30mg aday. My meds kick in pretty quick. I dont have a problem with taking coffee all day long or tea, pop. I have noticed I poop out in the evening but try to make to the ymca to run, not been going as much as I used to but am getting back on track. I always feel better after working out. My problems seem to melt away. I drink about 1/2 a pot of coffee every morning, 2 ice teas at work and 2 pops, then 2 teas in the evening but I go to bed and sleep like a baby every night, only getting about 6 hours a night.I seem to have problems with anger and am stressed out with my minds ablities to not work correctly, lol, I am still learning about this problem. I wished I knew about this 45 years ago.

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[Anonymous]

Scrapper the anger stress issues might be from the caffeine.

I have been reading a lot about how the repeated use of caffeine increases adenosine and causes nor-epinephrine receptors to not work as well. Adenosine is the chemical that accumulates throughout the day which makes us tired and ready for bed. Nor-epinephrine receptors help us stay awake. When norepinephrine doesn’t work as well we also experience more pain especially in muscles and joints.

Adderall works by helping norepinephrine receptors function better. So if you lowered your caffeine intake you could actually make the Adderall work better.

It has worked for me. I was first taking a lot of caffeine to help with my fatigue but noticed i kept getting more and more tired and had more pain. My dr suggested to lower my caffeine intake to help my pain. I was a little tired at first when i lowered bit by bit, but only for one or two days at a time.

Coffee also imbalances serotonin. Serotonin is needed to control out temper. I used to drink a lot of energy drinks and would snap VERY easy. Once i stopped my short temper was gone.

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[Scattybird]

dbacs – interesting comments.

My Ritalin is great for my emotional regulation – basically I don’t ‘fly off the handle’ as much when I take it.

But taking it has reduced my caffeine intake enormously – and I hadn’t thought about it before, but I used to have all sorts of joint pains (mainly in my fingers) that I don’t get anymore. Actually I’d even forgotten it used to be a problem.

So maybe the benefits of reducing my caffeine intake (which was mostly strong coffee washed down by Red Bull!!) outweigh the benefits of taking Ritalin?

Certainly both factors together seem to be beneficial (although Rit and Adderall work slightly differently on the system I think?)

It’s possibly a catch 22 for those who don’t take prescribed meds and who rely on caffeine though. But there is evidence out there on line that caffeine and stimulants don’t mix.

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[g.laiya]

I have a long history of a love-hate relationship with coffee/caffinated beverages. when i was just about to begin grad school i started getting panic attacks, and one of the major triggers seemed to be coffee. for 2-3 years i was super cautious about ingesting caffeine trying to avoid these attacks. it was a huge struggle getting through the early years of grad school without anything stronger than black tea as a stimulant. then i started experimenting with decaf frapaccinos and was ok. one day they made me a regular frap by accident and i decided to try it. i was ok, so the ban was lifted. from then , my use of coffee/tea/cola/energy drinks would go up and down – sometimes extreme amounts, sometimes detoxing from it – depending on my circumstances.

i also have had progressively worse headaches- both frequency and intensity- over the years (though with some reprieve during pregnancy). i was concerned because i had heard some people get headaches with the stimulant meds. what a pleasant surprise when not only did i not get ha from the med – my headaches actually improved! since taking the adderall i no longer have daily headaches, and when i do get them they are not nearly as bad as i used to get – and not even a caffeine withdrawal headache. i’ve only had one really bad in the last 3 weeks or so since starting this new med and it was hormone cycle related.

but i also really understand the desire to add caffeine into the mix, i really do. even with the adderall active in my system, i still will feel like i need an extra boost, especially when faced with extensive paperwork…..like i will need to be doing later today…and am dreading….

but the fear of having another anxiety attack (like i had the first day i had a cup of coffee with the adderall in my system) stops me.

kind of makes me wonder if i am indeed on the right dose and/or if this is the right med for me….idk…..i don’t want to sound ungrateful as what i am taking right now has already made a drastic difference in how i function. just some things are still more of a struggle than i think it should be, you know? well, guess i’ll just stick with what i’m doing for now, see how it goes over the next few weeks or so.

and dbacs thank you so much for that info. even more reasons to avoid the (very strong!) temptation to add caffeine into the mix.

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[Irishbookfairy]

OK Guys,

What is the deal here with all the posts about caffeine? I had undiagnosed AD/HD for years and lived on caffeine. Now my Ritalin has given me a life, period. Basically I never even had one before and now I do. I too wake up and actually get out of bed in the morning. I still do not function at 100% and maybe never will. I can deal with that. I have two sons who were in speech therapy for four years each. They finally “graduated” at 80%. They still do not pronounce their “R’s” very well but people understand them now. That’s the beauty of it. I had to give up the lightening fast mind that could produce spectacular rhymes in a split second but I am now making decisions that are mature. It isn’t fun to realize I’m a grown up (a 46 year old one too!!) but at least I am now able to contribute to my family as a grown up.

With the caffeine though….I am wondering….I had my “awakening” back on May 25th and since then I have cut back on my Ativan intake by half and shortly after that I gave up a pretty bad smoking habit (nicotine). I was drinking lots of Gatorade and other sports drinks since I get dehydrated easily and the summer has been hot. For about 3 weeks now I have begun to drink coffee in the am and I’m slowly picking up the pace on caffeine drinks again. I have noticed that I’m going through emotional roller coasters or sometimes feeling nothing at all. I am beginning to have trouble with multi-tasking. Is there some kind of weird link?? My husband is always telling me I shouldnt drink so much caffeine or have so much sugar. Is the link between AD/HD and caffeine or is it between the meds and caffeine? The serotonin thing also…..I have absolutely no measurable serotonin in my body so I take a mega dose of Cymbalta WHICH also has norepinephrine …another chemical mentioned.

What do you guys think? Something for a Dr. To figure out? If so, which one? If you can think of anything I would greatly appreciate it.

P.S……My Dr. Said it was normal for all of us on meds to feel a let down when our meds run out on us. Simply being human cuz we don’t won’t to lose the edge the meds give us. He believes that learning different coping strategies helps with this. Like I mentioned earlier meditating is great and someone mentioned exercise as a form of moving meditation and you bet it is!! It’s actually a GREAT form of meditating! Good luck to all!!

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[shutterbug55]

I have been using Adderall for almost a year now. I am still using a minimal dose which has not changed in 6 months. I take 5mg in the morning, 5mg in the afternoon. It is as though this stuff was tailor made for my brain! I can concentrate on the right things, switch focus without the usual difficulty. I can focus without hyper-focusing. I can even use working memory for things like remembering phone numbers, taking directions from someone, and I have even (successfuly) experimented with a shopping list, which I was able to recall and use at the store.

I do notice at the end of the day, I run out of energy, but NOTHING like the energy drain I used to have while not taking meds. I have tried other medications and doses, but nothing works as well for me, as Adderall.

I worked with my doctor, and any time we tried a new medication, I would keep detailed notes in a journal about how it worked in my system.

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[Anonymous]

Irishbookfairy hard to say about the serotonin. Everyone is different. I would say if you are eating enough protein everyday then you should be fine.

I’ve read Serotonin is pretty much a downer for people with ADHD because it lowers L-Tyrosine (found in meat) supplies. The L-Tyrosine is there to be converted to dopamine, and the Adderall helps the dopamine receptors scoop up the dopamine better. Or something like that.

I have tried 5-ht which is a dietary supplement for serotonin, but it made me feel much more run down. It also made my autoimmune disorders worse. I then looked it up and it is recommended for people with health problems like mine to stay away from 5-ht and a lot of SSRI’s.

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[scrapper]

I love coffee, probly wont give it up? who knows, I know that it is not the cause of my anger. I’m sure it isnt. Caffeine is wonderful, I can tell when I take to much. I dont take anything extra other than the adderall. I have become pretty laid back after starting the adderall. I used to snap at stupid stuff, not so much any more. I usally laugh make a joke and try to find a answer .

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[Anonymous]

Just wanted to update my post. I was having problems with fatigue in the afternoon. I decided to try L-Tyrosine last week instead of talking to my Dr about an increase.

Big mistake !!! I felt like death ! gah. Migraines, hives, nausea, dizziness, tinnitus. Awful don’t do it !! Must have some kind of reaction with Adderall.

I saw my Dr yesterday and he prescribed a scored 7.5mg tab for the afternoon. It makes a big difference. I was nervous to ask him about it but he seemed to be expecting it. He also told me to come in each month because usually the dose needs to be adjusted a couple times to get the best results.

Its Strange, i didn’t realized i had so much stigma about ADD meds. Being on this medicine is not at all how society makes it out to be… People “tweakin” their brains out.

I’m glad to finally have something that helps. Its like i’ve stepped out of a black hole and can finally see how the world is for everyone else. Much clearer…

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