Does stressful sustained mental focus burn through the meds more quickly?

[Anonymous]

I was recently diagnosed with inattentive ADD (ie sustained mental focus hurts my brain!!). I went to the Dr. to ask about ADD and try out stimulant medication because I was unable to keep up in my new high level health care professional career. I’m a really good student because my time is nearly unlimited as a single full time student who does not work. The Vyvance has been really effective for organizing me at home (as long as I use special ADD strategies in addition) and makes me a much more coherent speaker. However, I still feel pretty scattered at work. I still topic jump and forget little things. I am still slow. I am not “going to lose my job” slow, but…..I know the work is even going to become more hectic the longer I work here and I’m already stretched to capacity. maybe slow is a bad habit??? I’ve been slow at every activity for my entire life. seriously.. I even brush my teeth slowly. I get lost in thought doing anything. I talk quickly, but think slowly… yeah. bad combo.

my mom is in awe because apparently she has never worked a 12 hour day in her life and doesn’t think she could ever due to fatigue. She completes part time worth of work at home in full time all day nearly every day hours.. yeah..guess who I got this from.

Although, definitely worthwhile benefit than before meds. I have been tempted to go to work without the meds to see what happens, but I’m kind of terrified to do that as I know for the fact that the meds clear my thinking in daily life. I work 11-12 hour days without a break. I work through lunch. back to back to back. Somehow my colleagues can do this amount of work in 8 hour shift…but..well anyway.. It is better than the 6 hours of work I was doing in 11 before meds.

I am finding myself spacing out at my desk before 5pm. I take the Vyvance 50mg at 7:30am (I’m a good girl and eat it with protein).. I can feel it starting to work at about 8:30am. So I am getting less than 9 hours of effect from the time I swallow the pill. I get 11 hours of effect when I am not at work. However, there is the just plain exhaustion from normal human mental fatigue.

ok..sorry.. to the point! sad the meds don’t last all day!

the point……… Do the stimulant medications have a shorter period of effect when you are under stress and performing constant mental endurance?

I am considering asking my Dr. for a dexedrine boost to take at 4pm for work only.. however, I certainly don’t want to OD myself on stimulants!

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[Anonymous]

bump topic.

I am really curious.

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[nellie]

Ok just a thought here, maybe you’re just really tired? That sounds like a long day and I know if I had to focus that long I’d be exhausted, meds or no meds. I’m not sure they would help you if you are tired. My doctor told me that if you are tired meds in general don’t work as well and has asked me if I’m stressed at times when I said the various ones weren’t working. So not sure that’s an official answer, but figured I’d at least keep the topic alive

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[Anonymous]

Ok, here’s my take on it. The meds don’t last for any shorter or longer in your system, but I guess they are like pain killers in that if you have a lot of pain, you get breakthrough pain sooner than if you only have a little bit of pain and take the same dose of pain killers. Also even if you have pain killers on board, you will still feel pain if you stab yourself – meds can only do so much. So maybe you get breakthrough ADHD symptoms if you put more stress on your body. You metabolise the meds at the pretty much the same rate but the meds can only do so much work at any given time and if you are putting your brain under stress then you are probably reaching the medication’s limit. I don’t know what the maximum dex dose is per day, so you’d have to ask your doc about a short acting dose. Sounds like a good idea if the dose is within suitable range. Another thought is that stimulants make your body work a bit harder, like increasing your heart rate, so add mental effort on top of that (on one of your work days) plus more physical effort than a day off, and you have a body that is under more “strain” and will feel the consequences of that sooner than a “relax” day.

I am only guessing though. I am sure that you do metabolise things a bit quicker when active, but I don’t know that it would have such a profound effect on how long the medication lasts. It shouldn’t make hours of difference.

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[Anonymous]

Thank you both for the replies

Nellie, I am definitely tired..exhausted and sleep deprived even. I am a pretty extreme night owl and it is very difficult for me to fall asleep before 1am even with prescription hypnotics. Then in the morning, my body is still asleep and dragging my body to work is difficult. That drive to work makes me nervous. Thus, I’m going into these 12 hour days on 5 hours of sleep. I know this is a big problem. I’m experimenting with my circadian rhythm by taking melatonin a few hours before bed to trick myself into getting sleepy at a regular time. I had some success with this yesterday and got nearly 7 hours of sleep (still woke up a few times). Driving to work wasn’t scary that morning at least. Since I am usually an 8-9 hours of sleep kind of girl, I need to further work on this. I’m thinking about doing a sleep study. So you make a good point about the meds not really working due to the exhaustion because they are working outside of work.

Krazykat- pain meds are a good example. After I was in the car accident, I hated the opiates because I felt like they were just sugar pills that made me slow and tired. almost completely useless. However, I took them one day 4 months after the accident because I wanted to go walking and had some pain….and.. pain was gone and I felt kind of stoned and happy. (yeah..next time I just used ibuprofen!).

you both gave good reasons why I’m still scattered at work, while no longer scattered at home.

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[nellie]

Just another thought, what about exercise to help with sleep? It’s something I’ve been meaning to get on board with because my sleep is messed up as well. My family doctor & psychologist have both told me to get into a regular exercise routine, and the psych especially stressed it was paramount for people with ADD to get regular exercise both for sleep benefit and cognitive function. So I’m guessing meds would be more effective if our bodies were functioning at maximum efficiency. Although, I’m assuming with such long days exercising must be hard for you to fit in.

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[Anonymous]

It is definitely a good thought. Even though it is really hot over here, I’ve been taking long walks at night and climbing a really steep hill. and trying to go hiking every other week. oh and I go dancing all night every other week. nothing is going to happen in the AM for me lol. I need to get over my hatred of gyms. I get so bored and frustrated at gyms. You are right that I felt a bit better a day after one of the long walks or hikes. More evidence about how I need to exercise. stir up the brain juices!!!!!!

there is definitely something going on, when my focus is much improved on my days off. then tumbles at work.

thanks Nellie

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