Adult ADHD meds- Need thoughts, opinions, experiences ahead of appointment tomorrow please

[freckles20]

I have recently been diagnosed with ADHD (primary inattentive with hyperactive traits).

After waiting for 18 months on the NHS for an appointment, I paid to go privately (and saw the same consultant privately that I'd have seen on the NHS ).

Tomorrow I have another meeting with the same psychiatrist to discuss medication.

His report suggested Atomoxetine (Strattera an SNRI) or Guanfacine as an initial suggestion. He also mentioned Vyvanse or Elvanse as a possibility.

I'm aware that the first two are non stimulants, and the second two are stimulants.

I am supposed to have done some research but I'm a bit overwhelmed by it all.

I already take sertraline which is and SSRI. If possible I would like to keep taking it and I'm unclear if that's ok with the first two options.

I appreciate that everyone is different, and that I need to listen to his advice. But I'm mindful that every appt. is very expensive and for each prescription I have to pay a prescribing charge and also pay for the medicine myself.

Once (or if), we settle on a medication and a dose the consultant can pass me back to the NHS and my GP will prescribe. But the longer it takes and the more options we try the more skint I'll become!

I would love some thoughts from other people with adhd- especially wrt any medications that did or didn't work for you, or anything else that maybe I should know.

ATM the symptoms that make life must difficult for me are horrendous procrastination, lack of motivation, brain fog, disorganisation, forgetfulness, short term memory loss. My brain has a thousand tabs open and I am chaos personified!

I have had no issues with substance abuse, I don't drink alcohol and am in generally good health. I had bloods, an ECG, BP and heart health check and all was fine. I am in my mid 40s.

I initially didn't like the thought of stimulants but having heard how much difference they make to some people I feel more keen to try than. I did previously. But then I worry that I'm expecting too much.....

Any thoughts would be very gratefully received.

Don't worry about your morning cup of tea. I had been drinking 4+coffees a day and had to give it up to go on elvanse and seriously do not miss the coffee!!

My initial reaction to starting on elvanse was disappointment that I didn't feel anything amazing happen. Then I realised that I only had one tab open at a time all day at work. I'm now on 60mg, in a split dose to try to mitigate the crash and its working well. I finally feel like a grown up. I've actually run out and waiting for a new prescription and I'm currently baffled as to how I used to function pre medication. And the answer is, I didn't. Not really.

Regarding expense. I've realised that the cost of the private prescription is mpre than balanced out by all the coffees I'm not buying, the impulse purchases I'm not making and the late fines I'm not incurring. Definitely a good investment!!!

I would definitely recommend medication. It’s life changing for me.

@TallulahsCurse

I wouldn't ever recommend medication, especially not as an adult.

Based on what, exactly?

@WhenZoomWasJustAnIceLolly

I would definitely recommend medication. It’s life changing for me.

Same. More so than my CPTSD meds. I’m still not “normal” because I have a hectic life as a single parent of 3, one who also has ADHD and Autism, but I’m a lot better than I was.

@WhenZoomWasJustAnIceLolly I shall report back!

The consultant said that so much is down to individual brain chemistry. I was listening intently but can't clearly recall what he said 😵‍💫- but I think it was along the lines on Elvanse addressing a lack of dopamine, whereas Concerta addresses non adrenaline?

I am so happy for you that you found meds life changing.

@Notlostjustexploring that's a great point wrt the expense! Also feeling less chaotic would be priceless to be honest.

It has also occurred to me that although I don't have currently have insomnia my adhd causes sleep issues as I just love that time of night when everyone is asleep and I can hyper focus on something. Then my adrenaline kicks in and I don't sleep until 3am.... So my sleep is poor anyway.

Thanks for your input @ToughTittyWhompus. You haven't said anything about why.

Everyone has an opinion, and everyone is entitled to one.

I have given this a huge amount of thought and in my own case I feel confident that it is in my best interests to explore how I might benefit from medication. To not try would be to accept my life as it is- and I don't want to do that.

I'm glad other people have found medication beneficial too.

I respect your decision though, and hope that you can respect mine.

Ive tried methyphenidate and now im on elvanse. Im also on prozac
I think they have improved quite a few of my synptoms, but it took quite a while for me to settle on them and im not sure that its the right dose or medication for me really, or whether i just need to manage my expectations a bit better. It hasnt made me as normal as id thought it would

I’m asking PP why she doesn’t recommend medication, especially as an adult, as there has been a poster on other Adult ADHD threads saying the same despite not having ADHD, and just coming out with random clap trap that isn’t evidence based - it’s a different username every time but I’m almost certain it’s the same poster.

@ToughTittyWhompus I have ADHD, and have been diagnosed since childhood. I've tried medication and it is horrendous imo. I also am a specialist teacher working with learners ages 5-19 with ADHD and on the whole no parents, or older children who have been able to give their opinion have wanted or stayed on the meds either.

@ToughTittyWhompus

I’m asking PP why she doesn’t recommend medication, especially as an adult, as there has been a poster on other Adult ADHD threads saying the same despite not having ADHD, and just coming out with random clap trap that isn’t evidence based - it’s a different username every time but I’m almost certain it’s the same poster.

And if you're referring to me, I've never changed my username.

DD is 21 and takes Elvanse alongside Citalopram for stress and anxiety. She has taken both since mid teens and they were life changing for her - they allow her to work, study and live normal life. She is away at uni now but when she is home we would all know about it if she missed the Elvanse - no impulse control, no concentration, generally unpredictable. She likes herself better with the medication too.

@TallulahsCurse I can sort of see your point but I do think it's a very personal thing.

There's a big part of me that wonders how my life would have gone if I'd been diagnosed in childhood and medicated in my teens / early twenties. I was extremely reckless and impulsive and the only thing that stopped me from completely fucking up my life was the fact I was "naturally bright" so I somehow managed to do okay in school and pick a good apprenticeship/ career path.

But the situations I used to get myself in!! The debt. The teenage pregnancy. The divorce before I was 25. The friends I've failed to maintain relationships with. The good men / good relationships I've completely fucked up....

Then I have to balance that with all the good memories and outcomes I have because of my impulsiveness / recklessness. I walked out of a job that paid the mortgage, nice car, funded foreign holidays based on a gut feeling and a whim with no savings in the bank and no back up plan. It worked out, and now I have my dream business and I can work when & where I want, and thanks to the meds, I can actually do it justice and focus on it and juggle such a massive thing with being a single parent and running a home.

So it's tricky I guess. Would I have quit my job if I was medicated? Probably not. Would I have made a success at the business if I was unmediated? Probably not.

Pros and cons to everything and what's right for one person at one time might not be the blanket answer.

I suspect my DD has adhd (it runs in families and she's exactly like me except probably worse). I've decided not to pursue private diagnosis and meds just yet, and instead she's on the 2 year NHS waiting list and I'm undecided if we'll medicate just yet. I know for sure they'd help with a lot, but I also know that there's something about me that just isn't there anymore when I'm medicated? As a 29yo single mother trying to run a business, removing my impulsiveness / recklessness / constant need for new shiny shit / chaotic life and thoughts and feelings is probably a good thing... but I'm not sure I need to do that yet for an 11 year old who only needs to worry about things I can support her with.

Sorry for the ESSAY!!!

OP I was working and couldn't reply before your appointment but I hope you find success with Elvanse and it brings some calm and quiet and focus (if that's what you need). Do let us know how you get on!

Day 1 Elvanse for me, I remember playing Michael Jackson on full blast and completely gutting my house from top to bottom, cleaning every available surface and doing about ten loads of laundry but that has never been repeated and it's probably a good thing lol. Stay away from tiktok / mumsnet / probably your phone in general because if you're like me and it hits you quite hard, you'll not be able to drag yourself away.

Keep a water bottle beside you and remember to drink.

Experiment with foods and what kinds / when to eat them.

I still drink tea and did switch to decaf coffee but honestly I rarely crave either now. I'll have a hot chocolate if I really feel like a hot drink.

The biggest things it does for me now I'm all settled is give me the ability to actually do the things I want to do, makes me able to focus on one thing and drown out all the background noise, and makes me able to make far more logical choices rather than just behaving however I'm feeling in that moment. I'm far more patient and just less 'emotional' in general, which I think was really the root of a lot of my problems before.

[quote TallulahsCurse]@ToughTittyWhompus I have ADHD, and have been diagnosed since childhood. I've tried medication and it is horrendous imo. I also am a specialist teacher working with learners ages 5-19 with ADHD and on the whole no parents, or older children who have been able to give their opinion have wanted or stayed on the meds either.[/quote]
Interesting. I have one friend who came off the medication as it increased their anxiety too much, and another who takes it but not daily. Everyone else i know that has been prescribed it finds it either somewhat beneficial or really helpful.

If someone doesnt get on with the medication noones going to force them to keep taking it. You dont get withdrawal in the same way as you would from SSRIs

@TAmumto3 thanks for sharing your daughter's experience, I'm glad she has found it helpful.

@yaldy similarly I can't decide whether I'd like to turn back the clock and erase my adhd influenced past. I've had a lot of fun, some brilliant adventures and taken advantage of most a lot of opportunities because I'm kind of comfortable flying by the seat of my pants.

I managed half decent school grades and a degree. Although studying was hellish.

But it's becoming more and more difficult to live with and I need some help.

I have really tried to manage my expectations wrt medication but I can't seem to help having high hopes that it will make life a lot easier.

I've spent most of this evening desperately hoping that tomorrow is different to today. That I will finish one task before starting five more, that I don't loose my car keys more than 10 times, that I don't eat all of the cake followed by all of the biscuits when I need a boost, that I finally tidy away the piles of crap in my house, start my Christmas shopping, send my work invoices, that I don't wildly miscalculate the correct time to leave in order to be on time for my first appointment.

Sigh, the reality is likely to bring me crashing down to earth with such a bang and feeling more hopeless than ever 🤯.

I have everything crossed for you for tomorrow @freckles20!

I didn't get in with stimulants and have taken bupropion instead (off label sometimes given for adhd in adults). I don't take anything now abs just manage it myself through meditation/mindfulness/ exercise.

@freckles20 I can definitely do a lot of that stuff much easier when I take my meds.

The key for me is to go into the day with a plan of what I want to get done. This can be really difficult at first. I almost went back to the psych because I really thought they made everything worse at first (hyperfocus on stupid shit!!) and I was scared I'd been misdiagnosed or something but I needed to build up a tolerance and learn how to actually control this new me.

A good example is my friend once described me as being like a high pressured hose with nobody holding on to it, so I'm all over the place spraying everywhere and the pressure runs out so it's just lying in the grass all lifeless until the pressure picks up and I'm all over the place again. (It was actually a video and it was spot on but that's the best way I can describe it).

For me the meds make it so someone is holding the hose. But I do have to actively direct the person holding the hose or else they'll just point it at whatever they want.

That was the hardest adjustment (for me - I'm sure people will be different). I spoke to a friend in the US who is on the American equivalent and she said she needs to be quite strict with making lists and I found that to be correct.

Things I could never do before because they were monotonous and boring suddenly became super easy and rewarding, so I'd find myself hunting the house for clothes / towels to wash because the whole process of wash > dry > fold each item individually was kinda relaxing. Same with spreadsheets and making super detailed plans with fancy formulas for work stuff. Cleaning the bathroom or organising drawers. Basically the dull, thankless, thoughtless drudgery became strangely rewarding, (do long horrible task > get dopamine aka what most people feel!) and I had to learn that if I wasn't careful I'd just 'waste' the most productive part of the day on stuff that, while necessary and helpful, didn't really need to be done right now. Folded washing is great but I'm supposed to be working!!

So that's my tip I think. Your plan sounds great, but make sure the hardest bits come first and start putting things in place so you can make the most of your day.

If your list was mine:

Starting/ finishing tasks much better!

Losing car keys? Yeah... put a bowl somewhere or designate a drawer for keys / bank cards etc and get into the habit of putting them there the second you come in. I can't say if the meds really help with losing stuff or not because when I started them I found a home for everything (which the meds def gave me the motivation to do as I explained above). Try Mari Kondo?

Cake & biscuits: I literally have to set an alarm on my phone so I don't forget to make the kids dinner. I just don't think about food at all or ever really fancy anything and I'll actually take days off the meds if I have a fancy birthday dinner or something planned because I know if I don't I won't enjoy it / eat much. I often take a Sunday off just to eat lots of food and get nutrients in me.

Piles of crap: yep the meds help tremendously with this. Like I said, I Kondo'd everything months ago and it's still looking really nice now.

Xmas shopping: I'm still procrastinating

Invoices: slightly easier but I still have to make a conscious effort. List, list, list!

Miscalculated time for app: are you sure you're ACTUALLY miscalculating or are you actually just overly optimistic to the point it's dangerous lol? Like... 20mins on a good day with 0 traffic and every light green.... so you leave 20mins before because of course it'll be fine and I cannot imagine anything worse than me arriving 15mins early and them being 15 mins late and having to wait all that time (stomps foot!!). Because that is me and unfortunately I still kinda struggle with this. I'm just extremely overly optimistic and the meds haven't really helped with that I don't think... however I'm not late because of lack of organisation / missing keys / I didn't dry the kids school uniform as much.

Obviously you might be the complete opposite to me, but I remember being exactly like you and desperately hoping they'd work like this magic bullet but completely unsure of what was realistic or not and being worried I was building them up too much in my head. So hopefully this paints a rough picture. Basically they're not miracle workers and you still have to make a conscious effort to change behaviours, but they definitely help so much with a lot of the struggles. They have genuinely changed my life for the better.

Hth

Methylphenidate didn't work for me. I was just as dizzy but felt like a speed addict.

I don't like taking daily stims but if they'd massively helped I'd have stuck with them.

Didn't see a massive difference in symptoms unfortunately

Generic Adderall for me. 20mg am and 10mg pm. It’s not magic but it helps a lot.

My son takes the same except a slow release in the morning. For him it really is like magic.

The nice thing is that they’re not particularly expensive, relatively.

BTW there’s always one person on an ADHD thread who knows every single person in the world with ADHD and can confidently say that meds don’t work. It’s the internet - you can say or be anything you like.

For me the meds make it so someone is holding the hose. But I do have to actively direct the person holding the hose or else they'll just point it at whatever they want.

That was the hardest adjustment (for me - I'm sure people will be different). I spoke to a friend in the US who is on the American equivalent and she said she needs to be quite strict with making lists and I found that to be correct.

Very similar for me. The change for me is that although I’ve always made lists, now I actually do the stuff on them.

I can still sometimes get totally off track eg I’ll focus on something non-work-related on a work day, and lose half the day to it. But usually it’s something that needed doing, and I do it well, and fortunately I work for myself so it’s ok.

My house is much tidier and more organised. I find it much easier to make decisions so I am quicker to book a trip or buy something we need for the house or whatever, whereas in the past I’d dither. I’m more confident.

Not my experience but a colleague's

paedspoliticsbiscuits.wordpress.com/2019/05/15/how-i-found-my-tribe/

What would u recommend then?