Stimulants haven't worked - what other meds worked for you?

[WinterDeWinter]

What it says in the title, really - I've been through 18-54mg of Concerta and am now on 70mg of Elvanse <grinds teeth> having started on 20mg. This has taken years because i've kept losing the motivation to keep going back when there's no reward <bitter laugh> so keep having to start again when the symptoms become overwhelming again and I force myself to follow up.

They've insisted I step through all the dosages before moving onto the medication group www.webmd.com/add-adhd/adhd-nonstimulant-drugs-therapy . I think the next step will be to try non-stimulant ADHD-specific meds (Strattera), but the other options they might consider seem to be the BP-lowering meds like Clonidine or the ADHD-impacting anti-depressants like Desipramine (Norpramin, Pertofrane),Imipramine (Tofranil), Nortriptyline (Aventyl, Pamelor), and Bupropion (Wellbutrin).

Have any of these worked/not worked for you? Can you tell me about side-effects I am already very tired of slowly increasing dosages for no benefit (but increasing jitteriness and/or anxiety) before moving onto the next so I would definitely be up for 'having a preference' at my next appointment ;-)

Thank you all very much in advance for any insight you can offer - and while I'm here, thank you too for the many threads I've lurked on for many years - and particularly for my first 'scales falling from the eyes' moment about 5 years ago on a thread about hidden ADHD in both young, and middle-aged women.

It's been a very emotional ride - so much grief for all the toxic shame I felt at not somehow being able to translate my 'braininess', for want of a better word, into achievement, and also for the very real impact of that shame, and my attempts to head it off, on my close relationships.

But having the pieces of what was often a quite terrifying puzzle fall into place, - knowing that at least some of it isn't 'me', and that while I have some power to understand and divert my responses to the ADHD, the ADHD itself is foundational - has been absolutely life-changing. I've been able to make use of therapy now. I don't know what I would have done with the massive spike in symptoms during menopause without my diagnosis, and overall I am so, so much better for having met you all!

Grr that should say 'going onto the next medication group

also apols if I don't come back for a while - I have finally had to put a block on MN and Twitter for what are probably obvious reasons

Oh dear, are you all off having productive lives?

😬

Hi, sorry to hear the meds you have tried have not been effective.

I was diagnosed with ADHD in January and started on Elvanse 20mg which then increased to 30mg. Initially they seemed to work well, but over a couple of months seemed less effective. I was also starting to get terrible migraines every few days, jitteriness and anxiety. The psychiatrist wanted to increase my dose, but I didn't want to. He then wanted to try Concerta but to be honest I couldn't face the titration period and having more potential side effects.

So I decided to go into an antidepressant - escitalopram, 10mg. It's actually worked well in stabilising my mood, and I feel much calmer. I still have challenges with lack of motivation and my physical and mental energy being quite up and down, but overall I feel a lot better than I did before. I think my mood being better has resulted in me making positive changes in my lifestyle, and also I have less negative self talk which always helps!

Thanks so much @Limesparkle that's very helpful to hear about escitalopram and the knock on positives.

@Limesparkle when you talk about titration, what would that involve?
I was only diagnosed recently and my doctor's first drug to to try is Concerta. Have been on it for about a month- he just said to take 18 mcg for the first 10 days, then 36 mcg from then on. No mention of increasing dose further.

He said if the side effects were too bad, the next one to try would be Elvanse.

I haven't had any side effects, but haven't ANY noticeable effects! I'll keep taking it until my appointment at the end of October, but will ask about trying something else as this just seems pointless.

Thank you @WinterDeWinter for a useful and timely thread. I will look up the antidepressants you named, as I haven't had too much luck with the ones I've tried so far.

Hi,

I was diagnosed a few years ago. I tried Elvanse first but didn't feel great, so then tried Concerta XL. It was great, but getting to the higher doses that otherwise would have really helped totally exacerbated my anxiety (I was already on Sertraline for this). My psychatrist added Guanfacine (Intuniv) which really helped, so I've been on this combo of 54mg Concerta, 1mg Guanfacine and 100mg Sertraline pretty happily for the last year or so. Although I do see a marked drop-off in effectiveness/increase in anxiety around my period.

I can completely empathise with you regarding the shame and grief - ADHD is tough. My meds have changed my life, but they haven't solved everything - I still have to work hard not to let the ADHD take over at times, and have to remind myself that I can't do what everyone else can, or at least not in the same way/same timeframe. And therapy helps too.

I really hope you find what works for you. I feel fortunate that my (female) psychatrist is really open to listening and trying different combinations that work for me (although obviously none of it is cheap - I'm currently trying out Delmosart instead of Concerta, as this is the brand that my GP would prescribe, saving me a lot of money. Although both are Methylphenidate, they release differently and so far Delmosart is making me far more anxious, so I'm not sure it'll work for me). It can be exhausting but I hope there's a drug/combination of drugs that will work for you.

Hi,

I was diagnosed a few years ago. I tried Elvanse first but didn't feel great, so then tried Concerta XL. It was great, but getting to the higher doses that otherwise would have really helped totally exacerbated my anxiety (I was already on Sertraline for this). My psychatrist added Guanfacine (Intuniv) which really helped, so I've been on this combo of 54mg Concerta, 1mg Guanfacine and 100mg Sertraline pretty happily for the last year or so. Although I do see a marked drop-off in effectiveness/increase in anxiety around my period.

I can completely empathise with you regarding the shame and grief - ADHD is tough. My meds have changed my life, but they haven't solved everything - I still have to work hard not to let the ADHD take over at times, and have to remind myself that I can't do what everyone else can, or at least not in the same way/same timeframe. And therapy helps too.

I really hope you find what works for you. I feel fortunate that my (female) psychatrist is really open to listening and trying different combinations that work for me (although obviously none of it is cheap - I'm currently trying out Delmosart instead of Concerta, as this is the brand that my GP would prescribe, saving me a lot of money. Although both are Methylphenidate, they release differently and so far Delmosart is making me far more anxious, so I'm not sure it'll work for me). It can be exhausting but I hope there's a drug/combination of drugs that will work for you.

Hi,

I was diagnosed a few years ago. I tried Elvanse first but didn't feel great, so then tried Concerta XL. It was great, but getting to the higher doses that otherwise would have really helped totally exacerbated my anxiety (I was already on Sertraline for this). My psychatrist added Guanfacine (Intuniv) which really helped, so I've been on this combo of 54mg Concerta, 1mg Guanfacine and 100mg Sertraline pretty happily for the last year or so. Although I do see a marked drop-off in effectiveness/increase in anxiety around my period.

I can completely empathise with you regarding the shame and grief - ADHD is tough. My meds have changed my life, but they haven't solved everything - I still have to work hard not to let the ADHD take over at times, and have to remind myself that I can't do what everyone else can, or at least not in the same way/same timeframe. And therapy helps too.

I really hope you find what works for you. I feel fortunate that my (female) psychatrist is really open to listening and trying different combinations that work for me (although obviously none of it is cheap - I'm currently trying out Delmosart instead of Concerta, as this is the brand that my GP would prescribe, saving me a lot of money. Although both are Methylphenidate, they release differently and so far Delmosart is making me far more anxious, so I'm not sure it'll work for me). It can be exhausting but I hope there's a drug/combination of drugs that will work for you.

Oops, not sure why that posted three times! 🙄

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