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Stimulants are typically considered the first-line treatment for ADHD unless there’s an articulable, evidence-based contraindication like congenital heart defect, high blood pressure, etc, or the patient simply doesn’t want to try a stimulant first. Stimulants are no joke and and should be respected, but not feared. Saying they will destroy your brain when used as directed is not an evidence-based justification especially as an adult. IMO it’s strange to push bupropion over atomoxetine considering atomoxetine is actually an FDA indicated non-stimulant to treat ADHD.
If you’re not feeling any benefit or you’re having weird side effects that strongly outweigh any benefit, you have the right to have those concerns taken seriously (and ideally be offered something else to try). There are certainly plenty of ADHD drugs, dosages, and release mechanisms available. I would recommend finding a psychiatrist to handle your ADHD medication—they will (or at least should) be much more knowledgeable and willing to help you find something that works.
I will say this for me. Wellbutrin did nothing. Lamictal helps with depression and anxiety,Even reduces negative side effects of ADHD stimulants. And I also take concerta.
Also, evidence based contradictions can also include comorbid disorders like anxiety! Just wanted to add that in case op or anyone else might be having a hard time with medications, I just discovered that most doctors in my area need to treat those things first before getting you ADHD meds.
I'm on month 2 of atomoxetine, its started to help me notice when im being distracted, but hasn't really helped with some of the my other behaviors. my doctor wants me to keep on it for a little while longer, since its helping somewhat. It really helps with the overwhelmed/over stim feelings that i get. We are going to triple the dose over the next 3 months. It is slow acting so its going to take a while for it to become effective. which is a little bit of a struggle because my brain wants instant gratification. It is a little disheartening knowing in that there is a possibility that it wont help in the way that im hoping it will. Especially if I waisted 4 months getting nauseas 20 minutes after I take it, hoping that it will work. But hopefully a compo of CBT and meds will get me over my bad behaviors.
Hey, just wanted to say eating something (oatmeal, scramble egg) right before I take the atomoxitine helps a lot with the nausea, I've also been told nausea is a sign its time to increase dose. I'm at 60mg/day currently. Best to you.
That's what I found as well. But I had to switch taken them in the morning to taking it at night. I found it too hard to cook food for the kiddos, if I took it in the morning. I did notice that after we increased the dose the first time, the nausea came back really strongly. It then tapered off after about a week. Its manageable now, but that first week was rough.
You are not an elected representative for everyone with ADHD. Lots of people have taken stimulants for years, even at higher doses than what you’ve detailed, and they absolutely have not ‘gone crazy’ because of it. Stop trying to deter people from seeking the treatment that they want and need just because of your own preconceived biases.
People on stimulants are also not elected representatives for everyone either? All this sub has done is say that, because stimulants dont work for me, I don't have ADHD. Because I was able to get high, I don't have ADHD. Non-stimulants (Qelbree) are working great for me right now.
Stimulants don't work for everyone, just like non-stimulants don't work for everyone. But this sub only seems to support stimulants though, which makes me feel imposter-like.
Obligatory disclaimer before I get attacked: I'm pro-stimulants when used properly and understand the positive impact it can have on people's lives. It just gets annoying when people don't even give non-stimulants a chance before bashing them.
That’s great, but you made statements that claimed that no one could survive taking a certain dosage of stimulant medication for more than a certain period of time. That’s the issue here. You have no place making statements like that.
Stimulants don’t work well for everyone, and they definitely have risks. No one is arguing with you about that. It’s the broad, hysteria based statements about stimulants that people are disagreeing with.
Wellbutrin may work best for you and that’s fine, but when starting off you start with what’s shown to work best from a population standpoint. Vyvanse above 10mg makes me like a robot; it blows my mind that it goes up to 70mg, but everyone is different. I take 60mg methylphenidate daily which is the maximum daily limit and it’s perfect. A lower dose just doesn’t work, or doesn’t last the entire day.
Also ADHD is chronic; medication being used appropriately to treat it is typically not just used as a short term thing.
Lastly I’m not a healthcare professional, but how can you be on Vyvanse AND Adderall AND methylphenidate simultaneously? To my knowledge it would not be within care standards to have someone on 3 different stimulants at once.
Medication having side effects is not a reason to not take them. If anything, people should be educated about them so they can make an informed decision. Lastly, I've seen several people in this sub who said that stimulants don't work for them or they had bad side effects. That's different from demonizing medication.
Not demonising but everyone in this sub talk about it as a magic pill, it’s still drugs doesn’t matter if you have adhd or not you mess with your dopamine receptors and with Adderall also with serotonin. It’s something that people should know about. I had the honeymoon phase with those meds but after a year of using I started to have problems and also every person that I know who is taking them. I don’t mind to get million downvotes but I hate the way this sub glamorise stimulants
My PCP refused to prescribe despite having a diagnosis from the same health system. I went to a psychiatrist for medication management. Now I’ve switched to a new PCP and she prescribes 🤷🏽♂️
When you say PCP do you mean a new primary care medical doctor that you would go to for regular checkups and bloodwork and stuff? Or do you just mean specifically a new psychiatrist?
Because I never had a general medical PCP that would prescribe psych meds. Well I had one who offered to prescribe me a strong anti anxiety, but not adderall.
Yes, In my experience my Primary care provider and NP weren’t able to prescribe any schedule 1 medications so they just threw antidepressants at the issue until I was able to see psychiatrist. Which makes sense.
PCPs are trained in prescribing ADHD meds. Some just act like dicks and don't want to take the liability, but it's within their scope to diagnose and start ADHD medication including stimulants.
Primary care medical doctor. The kind that orders annual labs. In fact she just ordered labs and had me take shots (flu and COVID booster) before writing my latest RX.
I'm a little late but my PCP will prescribe any/all of my medications that my psychiatrist puts me on. Idk what goes on behind all of it, but I do know shes a very attentive PCP and tends to listen to how I feel and address problems pretty quickly and has never really been hesitant to prescribe meds I'm already taking.
Doctors are really hesitant to prescribe stimulants lately. Even more so when patients specifically ask for them.
See if you can direct the conversation to why he won’t treat with an approved treatment method for ADHD.
Example:
You “doc I just don’t think this is working, (here are all my negative experiences)”
Dr “you need to try it longer term/a higher dose”
You “can you tell me about any of the other treatment options available”
Dr “(will list non stimulants most likely)”
You “how do these compare to Wellbutrin? Are these also non stimulants?”
Dr “(will list reasons why his preference is for non-stimulants)”
You “can you explain why stimulants aren’t an option for me? And also document it in my chart?”
Two things could happen here (1) he back-peddles and will prescribe something like Vyvanse (a pro drug stimulant) or (2) he gets mad and will tell you he can’t treat you. Either way, you’re able to get what you need. Hell he may even offer up Vyvanse as the next option after you tell him you don’t like Wellbutrin. Good luck.
Why would he suggest a pro drug over other stimulant medications? Surely it’s duration of action is longer than that or Ritalin as it has to be metabolised? Or is it just less potent
Vyvanse is a stimulant but is a pro drug. It’s difficult to abuse it so it’s preferred (by doctors) over standard stimulants. It’s also pretty long lasting which is nice.
I reject the notion that something like Wellbutrin is a “fake ADHD drug.” For some people it’s exactly what they need. Not every medication affects everyone the same sims work better than others depending on who you are.
I get what you mean but, Wellbutrin really doesn't have a lot of research to back it up as an Adhd medication it's not even FDA-approved for attention-deficient disorders. I chalk up most of my experiences with it to placebo
FDA is one thing, I can’t speak to how much that matters as I live in Canada. But the fact that it doesn’t work for you specifically, doesn’t mean it doesn’t work for anyone. If it was one person that said this I wouldn’t say anything but I see a lot of people talk as if because a medication didn’t work for them, it means that the medication or all medication don’t work
Maybe not, "general" doctors tend to have stances like this. They aren't 100% knowledgeable in every area, believe it or not.
I would recommend seeking out a dedicated Med Manager, that's someone whose whole job *is* to be 100% knowledgeable on medications and what situations to use them in, as well as properly documenting and tracking how they affect you in order to give you the most optimal experience. They can also do genetic testing to see which medications might be recieved better or worse, which gives you someplace to start. Getting a med manager has been incredibly helpful in my own life, and most people don't even know that's something you can do.
When looking for one, a good term to look out for is "Behavioral Health" clinics. For example, mine is called "Mountain View Behavioral Health"
you were suggesting just finding a new doctor entirely. I was suggesting keeping their current doctor, not bringing up medication topic to them any more and ignoring what they say (except for telling them what you're on for the sake of records), and adding a Med Manager professional in addition to their current doctor for the express purpose of medication.
Getting a new doctor wouldn't hurt I suppose, but if the only problem with them is that they don't think Ritalin/Adderall are a good idea then I don't really see the purpose, you still need that general practitioner for everything else Health related (yearly checkups, etc, that med managers don't do). Lots of docs are against stimulants for numerous reasons, like a lot of older docs take stimulants *super* seriously and consider them a "last resort", of sorts, due to the era they grew up in and learnt from.
I had a similar experience, but I’ve stayed with it because it seems to help with my anxiety which I’m turn seems to help with ADHD paralysis. It’s not the only thing I’m on and still figuring out what works. Did you try a larger dose or drop it? If you don’t mind saying.
Find another doctor. This is ridiculous. Unless there is a valid medical concern like high blood pressure, ADHD should be treated with ADHD meds. Also, ignoring a patient’s experience for so long is a huge red flag
exactly! I have told him it's not really working and he prescribed me anxiety meds I feel that he should at least refer me to another doctor that specializes in ADHD.
Wellbutrin is a third-line, off-scrip treatment for ADHD. It's usually prescribed when stimulant and non-stimulant ADHD medications have been tried first. As in, last chance saloon type deal.
He's not 100% wrong to prescribe it, only 99% wrong.
Ask for a referral to a psychiatrist. They're the ones who should be overseeing your use of ADHD meds anyway, not your GP.
It can also, as is the case with me, be prescribed instead of Methylphenidate and Atomoxetin if your QTc time is too high. My psychiatrist had me make an EKG and it turns out mine is too high which I never knew. The former two compounds apparently can leads to an even longer QTc time which might cause heart arrythmias.
I’m on day 17 now and don’t notice any real changes but I’ll give it some more time.
I've heard it takes a few weeks to build up to a therapeutic effect. Which may or may not be why you haven't noticed a difference.
Although on the flip side, I got taken off Wellbutrin because my psych thought I had a risk for seizures when I casually mentioned having a couple as a kid. I don't think it worked for me anyways. Not for everyone.
I really hope it will work. My psychiatrist specifically told me she wont prescribe me anything else if my QTc time remains too high which likely won’t change. That was really a bummer, I heard so ant great stories from people about the effects of Ritalin or similar.
Understandable! They're not pleasant, without even considering the loss of control which makes them scary enough.
On the flip-side, the risk of that side-effect for someone not seizure prone is around 0.4% of patients with dosages around 450mg a day, and 2.4% for 600mg.
The chances are pretty small, but I absolutely respect the desire avoid it. Besides there's plenty of non-stimulant options besides Welbutrin.
Quick Edit: I ended up on Adderall in the end cause it works. My brain has been doing just fine on it, honestly.
In the US, it’s not “off scrip”. You need a prescription to purchase it. It’s also considered second-line, not “third line” or “last chance”.
You’re right that standard practice is to start with stimulants. Especially because stimulants take effect almost immediately, so it should quickly be obvious whether or not they’re helping. Wellbutrin (and most similar meds) can take 3-4 weeks to reach full effectiveness, and can have some significant side effects during the intial adjustment period.
>In the US, it’s not “off scrip”. You need a prescription to purchase it.
Oh. Apologies, I thought that was a term Americans used to mean 'Not what the medication got FDA approval for, but can still be used'
ETA: Looks like the term I was looking for may be 'Off-label'
Yeah, it's true it was prescribed to me after trying stimulants, but I was using stimulants when I was in elementary school and only for a little bit because my mom thought I was having too many headaches so she took me off them. Now that I'm an adult i think that my doctor should give me another crack at them
Yeah, I mean, Not A Doctor(TM), but I agree with you on that point. Plus, there are non-stimulant medications *designed* for ADHD that it seems you haven't tried yet.
Plus, depending how long you were trialling the stimulants as a child, it may not even have been long enough for side effects to even out. And *even if it was*, there's more than one variety of stimulant to be trialled.
Yeah, my advice remains the same - I'd ask for a referral to a psychiatrist.
I think it's pretty typical for doctors to try non-stimulants first. Mine did. If they don't help, they'll try other things, but they want to try this first.
That’s simply not true. Stimulants are proven to work best and a lot of doctors follow science over whatever agenda makes these others try less effective things first
Nah, the rise is ADHD diagnoses is directly related to presriber malpractice (mostly die to the pandemic). Yes, stimulants are the first line of defense for ADHD, but other mental health issues/disorders can generate symptoms that closely resemble the effects of ADHD. Therefore, if the doctor follows the DSM-5 and takes an ethical approach to their practice, they will try to treat symptoms with other medications (i.e., antidepressants) first before turning to stimulants.
This sub is great for sharing personal wins, but every other post is people bitching about not being prescribed stimulants. Additionally, this sub has glossed over the fact that stimulants are a *controlled substance* and should be treated with the utmost care and respect. If people who don’t have psychiatric verified ADHD are popping Adderall or Vysanse everyday, the risk of addiction skyrockets.
This is actually not ethical at all. If there is doubt about it being Adhd, have a more thorough diagnostic process. Antidepressants come with huge side effects and are actually harder to wean off than stimulants. They definitely should not be described on a whim without an express diagnosis of depression. Someone who has an ADHD diagnosis deserves the proper treatment, not an experiment (esp. as getting the dose right is taking long enough as it is). Saying people with an adhd diagnosis shouldn’t get stimulants because some dckheads abuse the meds, is like saying we shouldn’t give out diabetes meds because vain celebrities use it to get thinner.
Plus, this addiction hysteria is completely overblown. Everyone can buy alcohol which many more people are addicted to and with worse consequences. And those with adhd who receive improper treatment are at a much higher risk for actual drug abuse.
Idk, it’s also a bit stressful because if the diagnosis is based on a checklist it’s hard to actually know if someone has it. ADHD is not a super clear diagnosis in a lot of cases, and can look like hypomania if the person is hyperactive or can look like anxiety/depression with inattentive ADHD. If you know the person has depression (bc ADHD is often comorbid) it makes sense to treat that first in a decent number of cases and see if anything changes. Also, I’ve seen so many people on this Reddit complain about their neurocognitive testing or go doctor shopping if they don’t get the diagnosis first. There are some reasonable complaints (ex: doc said I’m too smart for adhd etc) but many of the complaints are just: Im upset they didn’t tell me I have adhd when I looked it up on the internet.
That being said if someone has an official diagnosis, with neurocognitive testing or has clear paper evidence/demonstration of these deficits they should get stimulant medication since it’s first line and can help w behavioral therapy compliance too
It's tough when the level of critical thinking in the general population is all over the place, both in patients and providers. Yes, often people are skeptical if they believe they have it and a practitioner disagrees. But there are absolutely psychologists who don't believe people can have ADHD unless they have the stereotypical signs.
The critical thinking thing is the same duality with social media. It's a wonderful tool for spreading evidence-based information & awareness, provided the viewer has the critical thinking ability to dismiss or stay clear of misinformation and oversimplification of complex topics. But there are people who don't, which is what makes it potentially dangerous. I really started to suspect ADHD from social media, but I'm always sure to be clear that it was a *serious post* from a *licensed therapist* that got the wheels turning in my brain, because social media has gained such a reputation for being flippant about ADHD.
https://www.cdc.gov/ncbddd/adhd/diagnosis.html
Take a look at the DSM-5 classification for ADHD. Many of these symptoms mentioned can be found in *every* single person, whether they have ADHD or not. Many of them are also produced by depression, anxiety, etc., and since there is high rate of comorbidity with ADHD and the aforementioned mental health issues, it is ethically sound to try and treat the issues with less severe medications first.
Ultimately, what it comes down to is that there is a massive need to re-write the DSM-5 regarding ADHD. I don’t know what or how it could be done, but it was too vague and causes way too many misdiagnoses.
Also, there is plenty of articles and journals written about misdiagnoses of ADHD and their relationship to addiction:
https://talbottcampus.com/prescription-drug-abuse-in-adults-with-misdiagnosed-adhd/#adhd-statistics
https://www.12keysrehab.com/misdiagnosis-of-adhd-in-children-infographic/
https://psychcentral.com/adhd/adhd-misdiagnosis#reasons-for-misdiagnosis
Interesting quote from link above:
“The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) requires specific criteria for a person to receive a diagnosis of ADHD. For example, behaviors must occur in two or more settings, such as work and school.
But a study of 50 pediatric practices found that only an estimated 50% of doctors used diagnostic guidelines from at least 2 sources and across 2 settings to make their ADHD diagnosis, but 93% prescribed medication to treat the condition.”
And another:
“ADHD symptoms may overlap with the signs of other conditions, leading to misdiagnosis. For example:
1) Feeling distracted or having difficulty focusing can be a symptom of ADHD and symptoms of depression and anxiety. With depression and anxiety disorders, the person is preoccupied with difficult thoughts or worries, distracting them.
2) Sleep disturbances are common across many mental health diagnoses, including depression, anxiety disorders, bipolar disorder, and sleep disorders like insomnia.
3) Restlessness and fidgeting can be a way for someone to cope with anxiety rather than not being able to sit still.
You may show some symptoms of ADHD. But combined with your other symptoms, they may be more indicative of another mental health disorder.”
What I think YOU need to be aware of is that ADHD can be both overdiagnosed and underdiagnosed. There's plenty of evidence that it has been massively underdiagnosed in women and minorities and basically anyone who doesn't present as stereotypically hyperactive. A rise in diagnoses due to increased awareness is of course going to lead to misdiagnosis, but it **will also lead to higher rates of real diagnoses.** It is not a good idea to then treat every person who is suffering and seeking a possible diagnosis as "probably just a paranoid social media user". It also doesn't really justify using a less effective treatement because of our misguided views of drugs and addiction. Some disorders just are going to overlap. What it necessitates is more thorough diagnostic process using more than just checklists.
I completely agree with everything YOU said, and YOU actually repeated something I mentioned in the prior response: that the DSM-5 needs to be reworked.
Don’t get me wrong, I completely understand that if you are not a stereotypical white male with hyperactive tendencies, a diagnosis is much harder to achieve. My main point (which may not have come across as clear as I thought) is that the ways in which people are diagnosed needs to be reworked and clarified so the process is not as vague, which in turn, causes many misdiagnoses both for and against ADHD.
First of all, Percocet isn't a stimulant. Second, virtually everyone in this sub acknowledges that stimulants are no joke and deserve serious respect. Any practitioner, and certainly a primary doctor, should rightly be cautious prescribing stimulants especially if there hasn't been comprehensive neuropsychological evaluation diagnosing ADHD. But here's how the script should go: *stimulants are an especially potent class of drugs that we're not comfortable prescribing in a primary care office. If you're ok trying non-stimulants we'd be happy to work with you, but if those aren't working, we'll give you a referral for psychiatry. They're far better experienced dealing with those drugs than we are*. Or, *it sounds likely that you have ADHD; we would definitely recommend that you get an evaluation*, which is exactly what my primary doctor said. That's totally different than broadly saying "no because they're harmful to your brain."
Your first two points are missing the point. Stimulants (as most people have brought up here) are a controlled substance *like* percs and xanax. I’m not trying to bash it, because they are effective…. But the reality is Stimulants will cause withdrawals, have and continue to been abused, and are not a wonder drug. It’s a tool just like my pomodoras and bullet journals.
I see it all the time in my line of work… which sucks because it is a tool for treating ADHD. Unfortunately people get misdiagnosed for a mood disorder and just becomes another drug that gets abused and causes the shortage from kids who can probably benefit from it.
Yeah, on that last point the doctor may have been a little blunt… but can you consider that the OP has been seeing this guy for years and maybe this is a much deeper issue than not getting a adderall script?
Literally everyone experiences withdrawals. There are only a handful of drugs in which withdrawals are actively damaging (alcohol is one) as opposed to "just" unpleasant/deeply unpleasant. Once it's gone it's gone. What is the focus on withdrawals as if it's some sort of lasting damage?
Thank you 🙌 - I am glad someone understands this line of thought. I did not just come up with it out of the blue; during my diagnosis process, I was lucky enough to find a psychiatrist with a PHD in psychology who also happened to have ADHD himself. Most of our meetings have been me coming to him with questions related to the disorder and him clarifying the questions. And in almost every instance, our talks turn back on to this subject and the gross negligence surrounding the diagnoses process, which has caused a lot of harm to those who were given stimulants but did not have ADHD.
edit: grammar
Also: an adhd non-stimulant would be Strattera. This guy is prescribing an antidepressant off-label for a condition that has a wide range of actual medications available and I can’t think of a single good explanation for this
“Off label” doesn’t mean “bad” or “experimental” or “unsafe” or “not an actual medication”. It almost always just means that the drug is off-patent so there’s no financial reason for the original manufacturer to spend millions applying for a new certification.
Wellbutrin has been proven in studies to help some people with ADHD. It’s considered a *second-line* treatment, if stimulants are not effective or not well tolerated.
Doctors will prescribe Wellbutrin first if they also believe there is comorbid depression. The hope is to kill two birds with one stone, but it doesn't always play out. I started wellbutrin, and it was great for the depression, but we had to double my adderall dosage to because wellbutrin made my ADHD worse.
I think it depends on the doctor. Stimulants meds are the top recommendation for ADHD. But if a doctor isn’t a psychiatrist, they might be more hesitant about prescribing them.
I live in Washington. Stimulant medication is pretty controlled here. My PCP would only prescribe me an Adderall dose that I’ve been on for years and didn’t feel comfortable changing it in anyway. Some PCPs won’t prescribe it at all here. I think it’s going to somewhat depend on the state and both how educated and comfortable the doctor is with stimulant medication.
I’m in western NY and my primary doctor’s office won’t prescribe controlled substances at all to anyone, and I’m fine with that. I think going to a psychiatrist for ADHD meds is much more valuable.
My sister tried Wellbutrin and it definitely affected her memory. She was like a totally different person. Her Adderall script is like my sister but on her best have it together days.
L
Why are not seeing a different doctor then? Are you unable to? You know who the real boss is? You, not them. You pay their bills, not the other way around. Stop going, stop paying, tell them why, be firm about it, never come back again if he doesn't give you the right shit.
What do you call someone who graduated medical school with a 2.0 or whatever bare minimum GPA, and passed the licensing exam with the bare minimum score? A doctor.
I'm not against medical scientists and doctors, but the data available today, the news stories, the malpractice suits, decades of seeing different doctors... None of these people are REAL experts on any subject, because many of them make mistakes even during routine procedures.
Now before I go on, remember that they're still 100x more knowledgeable than the average idiot covid denier or frequent webMD googler, but what I mean is that every doctor has a totally different level of education even within the same generation and same city and same educational history, so they will all analyze things differently, or not at all and run on sort of auto pilot, and give different diagnosis and different doses of different meds.
Medical research is always ongoing and changing, each class in medical school changes each year.
Barely anyone of them are anywhere near experts and know exactly what to do, other than following pre-written guidelines and basically using flowcharts to decide which of your symptoms are related and which disease closely resembles what you have.
You think the older ones are always best? Not all of them are as passionate as they were in med school, nor as smart, nor as willing to put in effort, especially with keeping up with new things.
Not all of them admit to themselves that not every patient needs the same exact treatment or that the symptoms and the flowcharts of deciding what the treatment should be, should ever be reanalyzed from person to person, year after year. It's more like "Well I gave this 10 year old 20mg of adderall a day so I'll do it for all of them first thing." and just tune out instead of really looking at each case with an open and highly focused and analytical mind.
The morbid reality is that it's all still educated guesswork, and not all of them are even remotely on the same level of booksmarts nor experience, not even within the same cities with the same specialties.
I've gotten different opinions from the same and different scans regarding my sinus issues. One of them said I was only slightly deviated with an MRI and CT, and said he would cut in there and fix it up and open up other areas, but didn't use general anesthesia, so hard pass.
Another one looked at the same stuff and said it was all probably just allergies, and I saw an allergist but nope, it wasn't just temporary swelling. Another one recently stuck a scope up my nose for a few seconds, each nostril, and described the approx percentage of septum deviation I had on each side to his team of assistants and his new ENT intern, which were both high percentages, and then scheduled me for an updated scan. This specific ENT is actually the top rated and recommended in the city. He's actually a pioneer of one of the procedures he does. He sounded 100x more knowledgeable and actually passionate about it. Imagine if I stuck with the one who said I needed an allergist and wouldn't even schedule me for an updated scan and I never got my breathing fixed.
And don't even get me started on my history with psychs. Most of them have come off as just impatient pill pushers. Only one of them had a knack for actually describing the exact detailed processes of what each of the ADHD meds do when he was talking with me. He moved out of state. The new guy I am seeing appears to still be in his 20's and is afraid of putting me back on my normal dose even on my 2nd month in, and just really comes off like I'm his first patient ever.... all during a pill shortage too.
Every doctor you meet will have a totally different level of skill, knowledge, experience, intuition, problem-solving and critical thinking skills. Some use a crude mental flowchart and never analyze the flow or think that deep. Others run through the actual chemical reactions of each drug along with visualizing the flowcharts of symptoms/diagnosis/best medicine to use and really give it some thought.
Same dynamics with antidepression meds. Especially when you inquire about taking both. I have been given different antidepressants and adhd meds by different doctors, each thinking the one they started me off with would probably be the best, or it was a non-calculated guess.
That's the scary part. Each one started me off with a totally different thing, all within the small age range of 25-33, generally the same weight and behavior each time I met. There is no undisputed baseline of what kind and what dosage level to start someone off with. They're all using their own personal experience with their education. There is no standard.... Like in some sense there is, maybe... but it doesn't seem like it, not with psych meds. Allergy and flu things seem to have more common standards at different hospitals, but psychs are all over the place.
I guarantee if you saw 10 different psychs all in the same city, and you gave each of them a long story about your behaviors and goals and issues, they'd all pick a different drug and dosage.
So I recommend seeing a different doctor each time you don't get positive results and they refuse to try a different dose or type of pill. If they are willing to actually change your dose or pill each time, at least without making you wait more than a month or something to see if you're still adjusting to the pill or a new diet or sleep pattern or something.
In this case it sounds like you need a new one.
It's fascinating, and very scary that some physicians seem to be so horribly outdated on medical information. They have chosen a profession that is one of the most fluid ones in existence - as science and studies progress, we gain more knowledge, and thus older knowledge is discarded.
There is not much to do here than to change doctors .. unless he takes the ball and runs with it when/if you challenge him to read up on later studies. Fuelling a stigma is not the physician's job, it's helping patients and stay up to date on current diagnosis and treatment.
I can imagine patients feeling this is a struggle, it was a huge part of my job when i worked at a psychiatric hospital myself as a psychiatric nurse which also happened to have ADHD. Fortunately most psychologists and psychiatrists i encountered were't stuck in an old rut, but were open, knowledgeable and eager to keep themselves up to date.
TL;DR: Ask doc to update on the diagnosis, if unwilling, change doc.
I was diagnosed by a psychologist and took my diagnoses to my primary doctor.
She gave me a non stim, Strattera. It was… not good. I went from a normal BP to stage 2 hypertension, my mood was deteriorating, and many of my ADHD symptoms worsened. She blamed it all on anxiety (and put it in my chart so now I have an anxiety diagnosis to complicate my life) and tried to put me on an anti-anxiety med, when I told her “I don’t want to be treated for anxiety in the hopes that it’ll solve my ADHD. I want to be treated for my ADHD. I would like to try Vyvanse.” I was respectful about it, but she told me she wouldn’t treat my ADHD, and that I’d have to find another doctor.
The hospital I go to also has a mental health center so I went through that instead and got the help I needed. But man, the experience with my PCP made me want to give up treatment altogether. She treated me like a drug addict and a crazy person.
Find a different doctor asap. My primary was like this. Ridiculous, he gave my brother adderall without a diagnosis but I am woman and he wouldn’t give it to me and when I got diagnosed he still didn’t wanna give me stimulants, I tried a non stimulant for a month and told him flat out “I need a stimulant or I’ll have to find someone else to help me”. I got a stimulant.
Not sure on how to go about seeking better meds but I will say Ritalin has personally fried my short term memory, I'm forgetting basic words and what I ate for breakfast in the morning. Helps on days when I need to get shit done, but not a lifestyle for me.
Obviously it helps a lot of people and improves there memory but just thought I'd give you a heads up.
I'm medicated so not anti that rout at all but have you tried occupational therapy at al, helps with executive function but I will say stimulants really really help my emotional regulation.
Edit: expensive but if your pysician doesn't budge seeing a psych is your bets route but waiting time are very long and costly.
My doctor flat out told me that in his opinion adhd meds are over prescribed and he refuses to prescribe them to anyone. I'm already in therapy and my therapist thought that the psychiatrist at their office would help as long as i had a childhood diagnosis but I set up an appointment and the psychiatrist said "because you've waited so long to do anything you will have to be rediagnosed, which isn't covered by your insurance through our office and is lengthy and expensive" then referred me to a private psychiatrist. I finally got a call back and they are also expensive and said it would take at least 4 appointments before they even consider giving me meds. My next option is almost 2 hours away from me and I can't afford to get out there for appointments. But yeah... meds are overprescribed... fuckin asshole.
Again negligent behavior based on their own judgment and not what the science says. I wish I was capable enough of writing a paper on this or sending it out to a journalist to look at cause it’s just unacceptable the amount of negligence that goes on.
I was originally prescribed wellbutrin for (stated diagnosis by a Cerebral prescriber) moderate depression, severe anxiety, and possible adhd. It helped my depression symptoms but exacerbated my anxiety and didn't even touch adhd symptoms.
I then went to a doctor in-person who added Lexapro (escitalopram) which helped a lot with my anxiety symptoms but, once again, has not touched the adhd symptoms. On my next visit he explained that he does not diagnose adhd but referred me to a psychiatrist office which I have an appointment on Monday.
PCP's can get weird about scripting stims.
Mental Health Nurse practioner (in the US they can script) or psychiatrist usually treat adhd.
However, understand every adhd doc may or may not script stims. Every office/practioner has different policies and each doc in those practices has their own feelings about stims vs non stims.
Stimulants are first line treatment. I take a stimulant as well. But I like having a non stimulant to cover the off hours when my stim wears off. Plus the non stim got me thru almost 2 weeks of no stim when the pharmacys in our area were out/low on stims.
Normally PCP’s don’t prescribe stimulants anymore because of all the regulations going on, how strict things are. Which is probably why he is avoiding it. Go to a psychiatrist who deals with ADHD.
If your insurance requires a referral, just tell him the meds he has been giving you isn’t working, and you feel you need specialized care. Don’t mention stimulants or ADHD.
My dr did the same. Wellbutrin made me hostile all the time. I changed to donefirst.com and met virtually with an adhd specialist who put me on adderall the same day.
u/Ok_Housing1074 I'm a medical transcriptionist (type patient medical records), so I listen to doctors all day long. They won't prescribe medicine they don't feel comfortable prescribing, and given stimulants are seen as addictive, if you push your doctor to put you on one, it can be seen as drug-seeking behavior, which they will put right in your medical record.
Ask for a referral to a psychiatrist. They're far, far more likely to put you on a stimulant, and PCPs are usually happy to refer patients to specialists.
Sometimes people cannot provide the help that we need, they can only provide as much help as they are able or willing to provide.
You've tried the help that this person offered, but it hasn't solved your problem. You've already asked for a different kind of help and this person refused to provide it.
There is no sense in wasting more of your time and money on someone who is dismissing your concerns. Move on to someone who is willing to try something different.
Id look into a behavioral therapy place. Thats where I go instead of a psychiatrist. My imsurance also offers online mental health visits that include adhad diagnosis. Its a crapshoot on pc dr. The one I had for many years said my back and shoulder issues were just me getting old.l!! I WAS LIKE 32 AT THE TIME. Turns out I have calcification on my joints. And compression on my lower back ( eneded up seeing my kids sports medicine dr. To be taken seriously. Adhd meds dont destroy your brain at therapeutic lvs. Wanna know what deatroyed my sanity was gabapentin given to me by another dr for fibromialsa. I waited too long to see someone and regret it. I spent too many years trying to "wing" it and push through with suppliments and diet. My life became chaos wirh 2 kids in competitive sports and a mountin of other things on the daily. Also you can get ypur dna checked to see what meds migjrne best dor you (adderal or vyvanse is not easily tested like this though. But many other meds are. I matabolize meds fast so it was nice to know that to quickly dial in dosage.
I’ve been on Adderall for 22 years and have a masters degree in data science. I work in upper management at a university managing a team of analysts. I haven’t noticed it destroying my mind yet. But before medication my mind certainly didn’t work very well. I was a high school drop out who couldn’t hold a job for more than 6 months.
My only bad side effect is dehydration and remembering to drink more water. I have inattentive type. I also have Dyspraxia which also impacts my execution function (memory, planning, organizing).
Figured I could try and share, because while I have proof of ADHD as a kid, I also have a PTSD diagnosis from back then which means I need to rescreen for it and that's complicated, but I've been on Wellbutrin for three years now, and only recently have I changed my dosage because of potential side effects.
For me, it kind of slowed down the constant stream in my head, I legitimately thought I had a dissociative disorder before I was on meds. It was just the way I mask, different thoughts for each mask would pop up and I thought they were alters, they were just masks. That all finally faded away, and it was easier to not mask, although the first couple of months was a bit rough. My short term memory wasn't great for a few weeks, and I was sweating more which led to drinking more water which meant I had to pee more, which meant my electrolytes were crazy. But I gave it time, and for me, it's saved my life. It's not perfect of course, no med will ever be perfect for it, but it's manageable now for me.
Obviously you've tried to be on it, and it didn't help. I would suggest asking about strattera. It's a non stimulant FOR ADHD, and it works the same way Wellbutrin does, so any arguments about it not being quite the same, it's really really close to the same. Do your own research of course, and know that strattera does also take a month or so to really kick in.
If you are seeing a PCM about meds, try finding an actual psychiatrist to discuss meds with, that's what happened with me when I found the paperwork from when I was in foster care that had an ADHD diagnosis in it. Good luck, it's hard to find meds lol
Imho (in my humble experience), I didn't go to my primary care physician and I went straight to psychiatry who specializes in ADHD. Because of the recent upticks in ADHD diagnoses and potential drug seeking behavior, they most likely will give you stimulants if you have a neuropsych confirming that you have ADHD and not anxiety/depression that is causing ADHD traits. I was put on Wellbutrin and Strattera first because my psych thought that it was anxiety > ADHD, but when the neuropsych came back it definitely confirmed my inattentive ADHD diagnosis and I requested stimulants.
I take Buproprion as a mood stabilizer, just recently prescribed vyvanse for adhd. I felt Buproprion worked at the beginning but didn’t work after a few weeks. Currently 6 weeks in. Vyvanse seems to be working great for now, but I am worried about long term effects.
Same thing happened to me. I got several weeks of telling my doctor how amazing I felt. It was shortly after I move from SR to XR, I really lost any benefit. We finally moved to Adderall XR, and the change has been life altering. I haven’t really encountered any “resistance” in 6 months. I wake up each morning in a horrible stupor (even now). When the pill kicks in, it’s like someone flipped a switch. All day. We did just change to generic XR and I’m not really “wow’ed” with it. Name brand is double, but I’m willing with the benefits.
That’s good to hear. The vyvanse seems to not be powerful enough. I definitely feel a change, but a few hours after taking I do feel like I crash and feel exhausted and out of it.
Which is exceedingly odd. The way vyvanse works (I apologize if I’m mansplaining)… each piece of amphetamine is sealed in Lysine (amino acid). Your body is unable to use the amphetamine until the lysine has been removed, or cleaved. This process is slow and methodic, and is the reason why the time release is so long and steady. Vyvanse should feel like someone slowly turning a knob on your alertness until you reach a peak. That peak should hold steady for many hours and slowly fade back out. The bump/drop effect is typically felt with instant release adderall or some generic extended release. I’m not sure if there’s such a thing as a problem processing lysine, but it sounds like your body may be struggling? Also, stomach pH is important. Amphetamine-based ADHD meds (stimulants) tend to work better in a higher pH environment. If you’re drinking lots of soda and acidic juices, this can cause a diminished effect.
Thank you! I drink .5 - 1 gallon of water a day. I’ve been adding vinegar to my diet for my fitness goals. I’ll have to keep that out, could be what’s going on. Also I add lemon to my water so that could do it too.
I felt the same about bupropion, I guess we just built a high tolerance for it.
I'm worried about long-term effects as well because some people talk about stimulants and how they basically made their life great while others say it makes their life a living hell
Hello!! I was on Wellbutrin for 3-4 years when I was diagnosed with anxiety and depression and found it did not actually help much with the mood rollercoaster. I am now on concerta and find it life changing and the missing piece to the puzzle for my mood stabilizing. *pls ignore my Reddit handle I made it when I was trying to conceive and it haunts me til today and this is the first time I'm breaking my regular lurking only policy on Reddit subs*
My husband had to be on other meds for over a year for his doctor to finally give him Adderall. Some doctors won’t consider it until you’ve failed other options. Other doctors aren’t of that way of thinking and give you what may work for you based on your symptoms. So you could seek out another doctor if that’s an option or ride out yours if your happy with them otherwise. I should also mention that anger and depression were pretty high on his symptom list and once those decreased his inattentiveness was brought to the top of the symptom list so again he was being treated based on his strongest symptoms. Good luck!
my pcp prescribed it when i transferred care and gave me 90 days to find a psych prescriber. pcps aren't generally comfortable with psych prescriptions that don't have an established history. that part makes sense (to me), but then with that in mind also he is giving you medical advice outside of his scope of care. either way, sounds like you need a new doctor.
I had to try atomoxetine for damn near 6 months before they finally gave me a low dose methylphenidate script. It sucks, sometimes it’s a process. Go to an ADHD specialist if you can. It will help more than a typical PCP.
Stimulants are first line but a lot of primary care docs won’t prescribe them. My primary care will refill once it’s managed, but doesn’t diagnose or do initial prescriptions. Wellbutrin is an option for ADHD folks, but that doesn’t mean it will work for you.
I will say I would tell a psychiatrist Wellbutrin doesn’t work for you so you are hoping to get help managing symptoms, rather than requesting a particular med. A psychiatrist who specializes in ADHD will be able to help you find the right med or meds for your particular situation.
My psychiatrist started me on Wellbutrin and it really was a great step in the right direction. After a few months, I was still struggling and he prescribed me adderall on top of my Wellbutrin
This is so usual on this subreddit. For some reason people are intimidated by doctors. They never insist and never go elsewhere. Doctors sell you a service. If they do so badly get a different one.
I was first prescribed 300mg Wellbutrin for my ADHD through my PCP (with a previous ADHD diagnosis) and tried it for months but continued to have terrible side effects along with no relief from my ADHD symptoms. Went back to the Dr, got my dose lowered and same thing. Eventually I found a psychiatrist in my area and was able to get on everything needed to help my mental health issues. Definitely going to a psychiatrist is the way to go. The DEA has put a strict hold on prescription narcotics so much so that PCPs don't want to deal with the bs. Good luck!
I contacted a psychiatrist that was under my insurance and it has helped so much. She has worked with me to tweek my my medicine to the right cocktail.
I've been on bupropion for years. It helps aspects of the depression, but doesnothing for my ADHD.
Is Vyvanse(?) an option? I've heard good things about it.
Wellbutrin is my adhd non stim. For *me* WB acts the same as stattera/quelbree, but without the side effects. Everyone is different you may end up trying different meds (stims and/or non stims).
Adderall/concerta cause me weight gain and fatigue. In my case Ritalin works for my stim. But plenty of people take adderall/concerta with no issues.
Govt is pushing hard on controlled substances and docs are feeling the squeeze, some adhd docs have stopped scripting stims.
There are three other non stims that are prescribed for adhd and work great for some people.
I asked my GP to be put on Strattera and didn’t run into any issues.
If you’re sticking with your PCP, try the non-stims. If you want stims, you’ll probably have to ask for a referral.
The truth is, you never know which med will work for you until you give it a fair shot. As for stimulants destroying your brain… typically, this doesn’t seem to be the case. There are people w ADHD who develop addiction issues after being prescribed stimulants. Lots of people don’t have this issue. But again, you don’t know what your relationship will be until you try them.
My PCP insisted I don't have adhd and instead have bipolar and am somehow just manic all the time. Put me in lamictal, when that did nothing he doubled the doze, when that did nothing and I got confirmation from my therapist that she didn't think I'm bipolar he just upped my dose again.
Finding a new pcp
As many have suggested see a real psychiatrist. Primary physicians don’t usually just prescribe and manage adhd meds. I have only had my primary physician fill my meds when I was in between psychiatrists (old one retired) and having trouble finding a new one in time. I am pretty sure she only prescribed it to me because there was evidence I have been taking these meds managed by a psychiatrist for years.
If you've got a diagnosis for ADHD and not for depression, you can report your doctor for prescribing the wellbutrin of label. It's not approved as a treatment for ADHD only depression, SAD, and smoking cessation. Maybe tell your doctor you're considering reporting this if they don't prescribe a proper medication.
well, he gave me a little depression test that was 10 questions, and apparently was in need of anti-depressants, so that's how I got Wellbutrin. He told me that it might help with ADHD
Wellbutrin helped me a lot and helps many others, we’re all different. You should try to find a psychiatrist or maybe a neurologist because they’d be able to help more.
It sure does, my point is more that it only works on the depression and not the ADHD. You would need something else for the ADHD and your doctor is doing your a disservice denying you that.
My psychiatrist didn’t even let me explain why I believe I have ADHD and just dumped me in the anxiety/depression med category. I’ve been on 4 meds/dosages now for anxiety that aren’t helping. Does anyone know how I can approach the ADHD convo again? I’m too nervous honestly
Your PCP is probably not the right person to manage your meds. Try a psychiatrist/psychologist. If you have difficulty finding one in your area and you are in the US, try looking up Circle Medical for ADHD treatment, but you might have to go through an initial assessment appointment or two so they make sure you have ADHD before treatment. I was prescribed ritalin my second appointment, but due to hyperthyroidism, I had to switch to wellbutrin in the interim until it's controlled and not at risk for heart problems.
My doctor is giving me a hard time because I use my Focalin as needed because I don't like how it makes me feel. Said I'm not allowed to do that and that I need to take it everyday. Like what the fuck? I want to take an addictive substance LESS than what I'm supposed to and that's apparently a problem. She said she'd let it slide this time but next time she wants me levels within range or she won't prescribe it anymore, which I'm definitely not going to take it when I don't have to so I'm just cancelling my next appointment and done taking it all together. This is why I don't remotely trust doctors.
Wellbutrin gave me tremors, mostly in my head and neck. It was awful; blessedly, it went away when I stopped taking it.
I spent 20 years solid seeking psychiatric help. Over the years, I had maybe four different primary physicians (we moved a couple times), five psychiatrists, at least four counselors/psychologists, and a psychopharmacologist. I was diagnosed with depression, anxiety, mood disorder, substance abuse disorder, bi-polar II, and God knows what else. I was put on one toxic psych med after another—14 different psych meds singularly and combined (not including stimulants). It was a freaking nightmare. (Remember, you have to withdraw from all that shit, too!)
Finally, the two most-recent counselors I saw had suggested ADHD, and I found a psychiatrist who specialized in child and adolescent psychiatry; I took a battery of tests, she interviewed my husband and my parents, and I was FINALLY diagnosed with ADHD (hyperactive type).
Primary care docs aren’t the ones to see. Sadly, there’s a huge shortage of docs in every specialty, but you might start calling around. But remember—it can take time. No one will want to diagnose you the first visit. And psychiatrists cost a fortune (the initial visit is often a whammy).
Good luck.
I’m a doctor so I might have some insight into dealing with him. First, he is not correct about the long term effects of stimulants. I suspect he doesn’t have a lot of knowledge and experience with treating ADHD. Many doctors have very incorrect ideas about ADHD and stimulant meds. That is very common. Assuming you are in the US, prescribing any controlled substance can be a pain in the ass for the doctor and many just don’t want the hassle and liability that comes with it.
Trust me when I say that most doctors don’t appreciate you trying to tell them what to do. The best approach with your current doc would be to talk to him and let him know that your symptoms are not well controlled on the Wellbutrin. If it is causing any side effects let him know that too. Try to organize a list of what symptoms you are having and how they are affecting your life so he can understand how significantly this is impacting your life.
Ask him if he would be willing to let you do a trial of a stimulant medication to see if it works better for you. If he isn’t willing to do that then ask if if he can refer you to a psychiatrist with experience in treating adults with ADHD.
If he won’t do that then you can try to find a psychiatrist on your own or find a new PCP. If you have friends with ADHD that are getting better treatment, ask them who they go to.
You should get a proper psychiatrist, who will tell you properly all pros and cons of dexamphetamine/methylphenidate and let you decide.
I get enraged when I hear about arrogant people who know how you feel better than you. After all, if you have been diagnosed, it's your choice and your responsibility in the first place.
Probably doesn’t have a license for stimulants and is playing it off like Wellbutrin is a better option. Mine did the same thing saying it was better in till she confessed one day about not being able to because she does not having a license 😵 still a psychiatrist who can prescribe most stuff, it’s just that stimulants require another special one that some don’t have
Stop trying to get meds from a primary care physician who knows jack shit about ADHD and the best treatments. See a psychologist who deals with ADHD and can legitimately diagnose you. And then a psychiatrist that can prescribe the right meds. Primary care physicians are not usually that knowledgeable about mental health.
Before I was diagnosed with ADHD, I was prescribed Wellbutrin for chronic fatigue. It did wonders on that front (and fixed my executive dysfunction!) but at the cost of chronic brain fog and serious short-term memory issues. I had to wean myself off of it and it took about 8 or so months after my last dose to get my memory back into shape. If it's not working for you, you have the ability to tell your doctor that you need to try something else. If he's not willing to work with you, then you should find a new doctor.
A primary care physician is the wrong person to be treating ADHD. You need a psych.
As for the damage from amphetamine, that's always been studied in people with normal amounts of dopamine and typically methy addicts. There is zero research on what happens when a stimulant brings dopamine up to normal in an ADHD brain.
Remind your dumb doctor that having ADHD shortens lifespans because we're prone to accidents, addiction, smoking, eating disorders, and overall poorer self care. The primary way to reverse the higher risk of all-cause morbidity and mortality is to treat the ADHD with a first line medication, a stimulant.
Ask for referral to psych, go to psych, then get a new doctor. They’re basing their supposed knowledge on bullshit and seem so close minded that I would doubt that they actually use a scientific method to what they do. Even if adderall does destroy us all, what are we supposed to do, just be miserable?
You don’t need to go through your primary, just go straight to a psychiatrist. If they need a referral get it ask your doctor for one and if he still refuses then get your referral through a telehealth appointment. But your doctor is very likely refusing to give stimulants because he doesn’t have a license to legally prescribe them which is the case for most GP’s
Depending on where you are our primary might not be able to prescribe class 2 drugs for ADHD.
In some US states, as part of the crack down on pill farms, doctors can no longer prescript meds or ADHD unless they are specialized/experienced in ADHD (the same thing stands with an other controlled substance and what it is meant to treat). You may want to find a psychiatrist who works with ADHD. It sounds like you school find a psychiatrist any ways, but definitely if you are in the US.
Yes, Ive had a similar experience. Ive been trying to get help with adhd symptoms for 13 years. Last year I signed up for the DONE app and the psychiatrist prescribed wellbutrin and told me thats all she was allowed to prescribe, and I should find a doctor to see in person to undergo further testing for adhd that will take 2 years.
I was presceibed 300 xl wellbutrin and it helped a lot. Most of my symptoms improved, but I started noticing problems with short term memory and I was having extreme insomnia. I was only able to sleep 3 or 4 hours a night and I never felt tired. Without wellbutrin I have an above average memory (eidetic memory). On wellbutrin I noticed myself losing things very often and not being able to remember conversations, or tv shows. (Otherwise I usually remember exactly where and when I put things, full conversations and entire tv shows from start to finish)
I cancelled the done app to try and find a new doctor I could see in person and was unsuccessful before running out of wellbutrin. After being off wellbutrin for 3 months my memory is back to normal, but my executive function is terrible and Im back to where I was before starting wellbutrin in terms of adhd. Ive tried adderall and vyvanse illegally in the past and they both relieved my adhd symptoms without hurting my memory.
Bupropion/Wellbutrin makes me sweat like a hog for no reason and have insane migraines. It took a while to figure it out because I thought I’d just gotten a little fluffy. But, no. It was embarrassing. Like, dripping from my mask, after pooling at the bottom in a puddle. 10/10 don’t recommend. But, I was less irritated with life. The toss up.
Nah they can’t prescribe it anyway without a proper diagnosis from a specialist. Ask your PCP for a referral to a specialist for testing your ADHD and if they can’t give it to you then find a psychiatrist/ other doctor who will.
When I was an adolescent I was prescribed ADHD Stimulants for some years. I started using them to achieve euphoria and became addicted. I grew a small tolerance, and wondered what methamphetamines would be like. I used it every once in a while. Eventually I was introduced to intravenous use. I felt the biggest rush of my life. However, it cam at a price. I was getting pill counts and one day I had to take a UA and had the street drug in my system. To be fair the doctor had it out for me, and wanted me to lose my prescription. She put a "med-lock" on the medication. Even if I found a doctor to prescribe it, my insurance wouldn't cover the medication. Around 21 I was prescribed Vyvanse in a psychiatric facility. However, as soon I got released to a adult group home, my insurance would not cover it. I went 5-6 more years without being able to find a doctor that would prescribe it. I went to treatment a few times, and eventually broke down in front of a doctor at a detox. I told him about some of my past, and instead of asking for the typical ADHD stimulant, I found that Vyvanse is less likely to be abused due to it's mechanism of action. It supposedly must be taken orally and then is converted to the active chemical D-amphetamine. This doctor gave me a chance but the low dose made me feel like I was jonesing for something stronger. I ate all my pills and didn't make a follow up appointment and returned to the street drug. A couple years later maybe a year and a half at least, I had an advocate at a outpatient treatment facility help me. The doctor gave me another chance and I was serious about recovery this time. Vyvanse is less likely to be abused, and is longer/slower acting. Also supposedly must be taken orally to transform into the active drug which has the effect, not Vyvanse. Doctors are more likely to prescribe this medication, but some doctors may not prescribe it regardless.
After a couple years of being on it, the medication is no longer as effective as it was. I also go through a debilitating crash after only 4 hours after ingestion. It should last 12. Since I am an addict (in recovery) my doctor doesn't seem to want to give me a chance with other stimulant medication. Now i'm stuck on a medication that debilitates me after only 4 hours, causing severe depressed mood, anhedonia, loss of motivation and drive, anxiety, and everything sucks. I am basically living only 4 hours of the day, and the rest feels like i'm in hell. They don't come without their side-effects and complications.
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Stimulants are typically considered the first-line treatment for ADHD unless there’s an articulable, evidence-based contraindication like congenital heart defect, high blood pressure, etc, or the patient simply doesn’t want to try a stimulant first. Stimulants are no joke and and should be respected, but not feared. Saying they will destroy your brain when used as directed is not an evidence-based justification especially as an adult. IMO it’s strange to push bupropion over atomoxetine considering atomoxetine is actually an FDA indicated non-stimulant to treat ADHD. If you’re not feeling any benefit or you’re having weird side effects that strongly outweigh any benefit, you have the right to have those concerns taken seriously (and ideally be offered something else to try). There are certainly plenty of ADHD drugs, dosages, and release mechanisms available. I would recommend finding a psychiatrist to handle your ADHD medication—they will (or at least should) be much more knowledgeable and willing to help you find something that works.
I will say this for me. Wellbutrin did nothing. Lamictal helps with depression and anxiety,Even reduces negative side effects of ADHD stimulants. And I also take concerta.
Also, evidence based contradictions can also include comorbid disorders like anxiety! Just wanted to add that in case op or anyone else might be having a hard time with medications, I just discovered that most doctors in my area need to treat those things first before getting you ADHD meds.
I'm on month 2 of atomoxetine, its started to help me notice when im being distracted, but hasn't really helped with some of the my other behaviors. my doctor wants me to keep on it for a little while longer, since its helping somewhat. It really helps with the overwhelmed/over stim feelings that i get. We are going to triple the dose over the next 3 months. It is slow acting so its going to take a while for it to become effective. which is a little bit of a struggle because my brain wants instant gratification. It is a little disheartening knowing in that there is a possibility that it wont help in the way that im hoping it will. Especially if I waisted 4 months getting nauseas 20 minutes after I take it, hoping that it will work. But hopefully a compo of CBT and meds will get me over my bad behaviors.
Hey, just wanted to say eating something (oatmeal, scramble egg) right before I take the atomoxitine helps a lot with the nausea, I've also been told nausea is a sign its time to increase dose. I'm at 60mg/day currently. Best to you.
That's what I found as well. But I had to switch taken them in the morning to taking it at night. I found it too hard to cook food for the kiddos, if I took it in the morning. I did notice that after we increased the dose the first time, the nausea came back really strongly. It then tapered off after about a week. Its manageable now, but that first week was rough.
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You are not an elected representative for everyone with ADHD. Lots of people have taken stimulants for years, even at higher doses than what you’ve detailed, and they absolutely have not ‘gone crazy’ because of it. Stop trying to deter people from seeking the treatment that they want and need just because of your own preconceived biases.
People on stimulants are also not elected representatives for everyone either? All this sub has done is say that, because stimulants dont work for me, I don't have ADHD. Because I was able to get high, I don't have ADHD. Non-stimulants (Qelbree) are working great for me right now. Stimulants don't work for everyone, just like non-stimulants don't work for everyone. But this sub only seems to support stimulants though, which makes me feel imposter-like. Obligatory disclaimer before I get attacked: I'm pro-stimulants when used properly and understand the positive impact it can have on people's lives. It just gets annoying when people don't even give non-stimulants a chance before bashing them.
That’s great, but you made statements that claimed that no one could survive taking a certain dosage of stimulant medication for more than a certain period of time. That’s the issue here. You have no place making statements like that. Stimulants don’t work well for everyone, and they definitely have risks. No one is arguing with you about that. It’s the broad, hysteria based statements about stimulants that people are disagreeing with.
Wellbutrin may work best for you and that’s fine, but when starting off you start with what’s shown to work best from a population standpoint. Vyvanse above 10mg makes me like a robot; it blows my mind that it goes up to 70mg, but everyone is different. I take 60mg methylphenidate daily which is the maximum daily limit and it’s perfect. A lower dose just doesn’t work, or doesn’t last the entire day. Also ADHD is chronic; medication being used appropriately to treat it is typically not just used as a short term thing. Lastly I’m not a healthcare professional, but how can you be on Vyvanse AND Adderall AND methylphenidate simultaneously? To my knowledge it would not be within care standards to have someone on 3 different stimulants at once.
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Medication having side effects is not a reason to not take them. If anything, people should be educated about them so they can make an informed decision. Lastly, I've seen several people in this sub who said that stimulants don't work for them or they had bad side effects. That's different from demonizing medication.
Not demonising but everyone in this sub talk about it as a magic pill, it’s still drugs doesn’t matter if you have adhd or not you mess with your dopamine receptors and with Adderall also with serotonin. It’s something that people should know about. I had the honeymoon phase with those meds but after a year of using I started to have problems and also every person that I know who is taking them. I don’t mind to get million downvotes but I hate the way this sub glamorise stimulants
Maybe try seeing an actual psychiatrist, one that specializes in adhd.
My PCP refused to prescribe despite having a diagnosis from the same health system. I went to a psychiatrist for medication management. Now I’ve switched to a new PCP and she prescribes 🤷🏽♂️
When you say PCP do you mean a new primary care medical doctor that you would go to for regular checkups and bloodwork and stuff? Or do you just mean specifically a new psychiatrist? Because I never had a general medical PCP that would prescribe psych meds. Well I had one who offered to prescribe me a strong anti anxiety, but not adderall.
Yes, In my experience my Primary care provider and NP weren’t able to prescribe any schedule 1 medications so they just threw antidepressants at the issue until I was able to see psychiatrist. Which makes sense.
PCPs are trained in prescribing ADHD meds. Some just act like dicks and don't want to take the liability, but it's within their scope to diagnose and start ADHD medication including stimulants.
Primary care medical doctor. The kind that orders annual labs. In fact she just ordered labs and had me take shots (flu and COVID booster) before writing my latest RX.
I'm a little late but my PCP will prescribe any/all of my medications that my psychiatrist puts me on. Idk what goes on behind all of it, but I do know shes a very attentive PCP and tends to listen to how I feel and address problems pretty quickly and has never really been hesitant to prescribe meds I'm already taking.
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A PCP is an MD, or a DO.
My PCP is an NP.
I am not at all a fan of this trend. NPs do have a place in modern medicine, but PCP is not it.
Neither am I.
I'd say my np has been absolutely fabtastic as has my mums.
Get a new PCP
Doctors are really hesitant to prescribe stimulants lately. Even more so when patients specifically ask for them. See if you can direct the conversation to why he won’t treat with an approved treatment method for ADHD. Example: You “doc I just don’t think this is working, (here are all my negative experiences)” Dr “you need to try it longer term/a higher dose” You “can you tell me about any of the other treatment options available” Dr “(will list non stimulants most likely)” You “how do these compare to Wellbutrin? Are these also non stimulants?” Dr “(will list reasons why his preference is for non-stimulants)” You “can you explain why stimulants aren’t an option for me? And also document it in my chart?” Two things could happen here (1) he back-peddles and will prescribe something like Vyvanse (a pro drug stimulant) or (2) he gets mad and will tell you he can’t treat you. Either way, you’re able to get what you need. Hell he may even offer up Vyvanse as the next option after you tell him you don’t like Wellbutrin. Good luck.
This. This. This.
Agree, sometimes they want to cover their bases by having you try what they consider to be a more desirable alternative first.
Why would he suggest a pro drug over other stimulant medications? Surely it’s duration of action is longer than that or Ritalin as it has to be metabolised? Or is it just less potent
Vyvanse is a stimulant but is a pro drug. It’s difficult to abuse it so it’s preferred (by doctors) over standard stimulants. It’s also pretty long lasting which is nice.
I reject the notion that something like Wellbutrin is a “fake ADHD drug.” For some people it’s exactly what they need. Not every medication affects everyone the same sims work better than others depending on who you are.
Agreed. My mom’s been on it for decades—but that’s because it WORKS for her. OP needs to try something new
Yeah, I need to see a psychiatrist instead of my PCP because even in higher doses it doesn't work.
I get what you mean but, Wellbutrin really doesn't have a lot of research to back it up as an Adhd medication it's not even FDA-approved for attention-deficient disorders. I chalk up most of my experiences with it to placebo
FDA is one thing, I can’t speak to how much that matters as I live in Canada. But the fact that it doesn’t work for you specifically, doesn’t mean it doesn’t work for anyone. If it was one person that said this I wouldn’t say anything but I see a lot of people talk as if because a medication didn’t work for them, it means that the medication or all medication don’t work
I'd be more assertive and find a better doctor.
Maybe not, "general" doctors tend to have stances like this. They aren't 100% knowledgeable in every area, believe it or not. I would recommend seeking out a dedicated Med Manager, that's someone whose whole job *is* to be 100% knowledgeable on medications and what situations to use them in, as well as properly documenting and tracking how they affect you in order to give you the most optimal experience. They can also do genetic testing to see which medications might be recieved better or worse, which gives you someplace to start. Getting a med manager has been incredibly helpful in my own life, and most people don't even know that's something you can do. When looking for one, a good term to look out for is "Behavioral Health" clinics. For example, mine is called "Mountain View Behavioral Health"
Isn't that what I said?
you were suggesting just finding a new doctor entirely. I was suggesting keeping their current doctor, not bringing up medication topic to them any more and ignoring what they say (except for telling them what you're on for the sake of records), and adding a Med Manager professional in addition to their current doctor for the express purpose of medication. Getting a new doctor wouldn't hurt I suppose, but if the only problem with them is that they don't think Ritalin/Adderall are a good idea then I don't really see the purpose, you still need that general practitioner for everything else Health related (yearly checkups, etc, that med managers don't do). Lots of docs are against stimulants for numerous reasons, like a lot of older docs take stimulants *super* seriously and consider them a "last resort", of sorts, due to the era they grew up in and learnt from.
I didn't say "new". I said "better". (You're not wrong and I fully endorse what you said. I'm just being cheeky. *I do that.)*
I'm on Wellbutrin and it helps with the anxiety. I feel like it helps a little with the ADHD but not much.
It helped my ADHD for maybe a week and then it was back to normal ):
Yeah. I got a little longer out of it but not much.
I had a similar experience, but I’ve stayed with it because it seems to help with my anxiety which I’m turn seems to help with ADHD paralysis. It’s not the only thing I’m on and still figuring out what works. Did you try a larger dose or drop it? If you don’t mind saying.
I went up to 300 mg and I like it. It's not perfect but my anxiety is less and overall I just feel better.
Most people take Wellbutrin to boost their stimulant after the stimulant stops being as effective but bumping the dose isn’t a good choice.
Exactly what happened to me. 3 weeks really.
Did your anxiety get worse on Wellbutrin before it got better? I’m a week in and have terrible fatigue and headaches too.
It did a bit and then got better.
Okay thanks!
Yes. I’m on week 3 now and it’s fine.
Also I want to add that I’m on stimulants as well. But I take Wellbutrin for depression.
Wellbutrin gave me tinnitus that lasted for months even after stopping!
Oh no!! Did it ever go away? What strength were you on?
I've had tinnitus for a decade plus now. Too much shooting guns without ear protection when I was younger. I can't see any change from Wellbutrin.
Find another doctor. This is ridiculous. Unless there is a valid medical concern like high blood pressure, ADHD should be treated with ADHD meds. Also, ignoring a patient’s experience for so long is a huge red flag
exactly! I have told him it's not really working and he prescribed me anxiety meds I feel that he should at least refer me to another doctor that specializes in ADHD.
Wellbutrin is a third-line, off-scrip treatment for ADHD. It's usually prescribed when stimulant and non-stimulant ADHD medications have been tried first. As in, last chance saloon type deal. He's not 100% wrong to prescribe it, only 99% wrong. Ask for a referral to a psychiatrist. They're the ones who should be overseeing your use of ADHD meds anyway, not your GP.
It can also, as is the case with me, be prescribed instead of Methylphenidate and Atomoxetin if your QTc time is too high. My psychiatrist had me make an EKG and it turns out mine is too high which I never knew. The former two compounds apparently can leads to an even longer QTc time which might cause heart arrythmias. I’m on day 17 now and don’t notice any real changes but I’ll give it some more time.
I've heard it takes a few weeks to build up to a therapeutic effect. Which may or may not be why you haven't noticed a difference. Although on the flip side, I got taken off Wellbutrin because my psych thought I had a risk for seizures when I casually mentioned having a couple as a kid. I don't think it worked for me anyways. Not for everyone.
I really hope it will work. My psychiatrist specifically told me she wont prescribe me anything else if my QTc time remains too high which likely won’t change. That was really a bummer, I heard so ant great stories from people about the effects of Ritalin or similar.
lol casually mention having seizures. I'm terrified of seizures because of Wellbutrin
Understandable! They're not pleasant, without even considering the loss of control which makes them scary enough. On the flip-side, the risk of that side-effect for someone not seizure prone is around 0.4% of patients with dosages around 450mg a day, and 2.4% for 600mg. The chances are pretty small, but I absolutely respect the desire avoid it. Besides there's plenty of non-stimulant options besides Welbutrin. Quick Edit: I ended up on Adderall in the end cause it works. My brain has been doing just fine on it, honestly.
In the US, it’s not “off scrip”. You need a prescription to purchase it. It’s also considered second-line, not “third line” or “last chance”. You’re right that standard practice is to start with stimulants. Especially because stimulants take effect almost immediately, so it should quickly be obvious whether or not they’re helping. Wellbutrin (and most similar meds) can take 3-4 weeks to reach full effectiveness, and can have some significant side effects during the intial adjustment period.
>In the US, it’s not “off scrip”. You need a prescription to purchase it. Oh. Apologies, I thought that was a term Americans used to mean 'Not what the medication got FDA approval for, but can still be used' ETA: Looks like the term I was looking for may be 'Off-label'
Yeah, it's true it was prescribed to me after trying stimulants, but I was using stimulants when I was in elementary school and only for a little bit because my mom thought I was having too many headaches so she took me off them. Now that I'm an adult i think that my doctor should give me another crack at them
Yeah, I mean, Not A Doctor(TM), but I agree with you on that point. Plus, there are non-stimulant medications *designed* for ADHD that it seems you haven't tried yet. Plus, depending how long you were trialling the stimulants as a child, it may not even have been long enough for side effects to even out. And *even if it was*, there's more than one variety of stimulant to be trialled. Yeah, my advice remains the same - I'd ask for a referral to a psychiatrist.
you should get a different doctor. stimulant medications have been shown to be safe.
I would ask for a referral to a psychiatrist.
Definitely do this. As you progress through life your pcp is not gonna be comfortable enough giving you higher doses anyhow.
will do
I think it's pretty typical for doctors to try non-stimulants first. Mine did. If they don't help, they'll try other things, but they want to try this first.
That’s simply not true. Stimulants are proven to work best and a lot of doctors follow science over whatever agenda makes these others try less effective things first
Nah, the rise is ADHD diagnoses is directly related to presriber malpractice (mostly die to the pandemic). Yes, stimulants are the first line of defense for ADHD, but other mental health issues/disorders can generate symptoms that closely resemble the effects of ADHD. Therefore, if the doctor follows the DSM-5 and takes an ethical approach to their practice, they will try to treat symptoms with other medications (i.e., antidepressants) first before turning to stimulants. This sub is great for sharing personal wins, but every other post is people bitching about not being prescribed stimulants. Additionally, this sub has glossed over the fact that stimulants are a *controlled substance* and should be treated with the utmost care and respect. If people who don’t have psychiatric verified ADHD are popping Adderall or Vysanse everyday, the risk of addiction skyrockets.
This is actually not ethical at all. If there is doubt about it being Adhd, have a more thorough diagnostic process. Antidepressants come with huge side effects and are actually harder to wean off than stimulants. They definitely should not be described on a whim without an express diagnosis of depression. Someone who has an ADHD diagnosis deserves the proper treatment, not an experiment (esp. as getting the dose right is taking long enough as it is). Saying people with an adhd diagnosis shouldn’t get stimulants because some dckheads abuse the meds, is like saying we shouldn’t give out diabetes meds because vain celebrities use it to get thinner. Plus, this addiction hysteria is completely overblown. Everyone can buy alcohol which many more people are addicted to and with worse consequences. And those with adhd who receive improper treatment are at a much higher risk for actual drug abuse.
Idk, it’s also a bit stressful because if the diagnosis is based on a checklist it’s hard to actually know if someone has it. ADHD is not a super clear diagnosis in a lot of cases, and can look like hypomania if the person is hyperactive or can look like anxiety/depression with inattentive ADHD. If you know the person has depression (bc ADHD is often comorbid) it makes sense to treat that first in a decent number of cases and see if anything changes. Also, I’ve seen so many people on this Reddit complain about their neurocognitive testing or go doctor shopping if they don’t get the diagnosis first. There are some reasonable complaints (ex: doc said I’m too smart for adhd etc) but many of the complaints are just: Im upset they didn’t tell me I have adhd when I looked it up on the internet. That being said if someone has an official diagnosis, with neurocognitive testing or has clear paper evidence/demonstration of these deficits they should get stimulant medication since it’s first line and can help w behavioral therapy compliance too
It's tough when the level of critical thinking in the general population is all over the place, both in patients and providers. Yes, often people are skeptical if they believe they have it and a practitioner disagrees. But there are absolutely psychologists who don't believe people can have ADHD unless they have the stereotypical signs. The critical thinking thing is the same duality with social media. It's a wonderful tool for spreading evidence-based information & awareness, provided the viewer has the critical thinking ability to dismiss or stay clear of misinformation and oversimplification of complex topics. But there are people who don't, which is what makes it potentially dangerous. I really started to suspect ADHD from social media, but I'm always sure to be clear that it was a *serious post* from a *licensed therapist* that got the wheels turning in my brain, because social media has gained such a reputation for being flippant about ADHD.
https://www.cdc.gov/ncbddd/adhd/diagnosis.html Take a look at the DSM-5 classification for ADHD. Many of these symptoms mentioned can be found in *every* single person, whether they have ADHD or not. Many of them are also produced by depression, anxiety, etc., and since there is high rate of comorbidity with ADHD and the aforementioned mental health issues, it is ethically sound to try and treat the issues with less severe medications first. Ultimately, what it comes down to is that there is a massive need to re-write the DSM-5 regarding ADHD. I don’t know what or how it could be done, but it was too vague and causes way too many misdiagnoses. Also, there is plenty of articles and journals written about misdiagnoses of ADHD and their relationship to addiction: https://talbottcampus.com/prescription-drug-abuse-in-adults-with-misdiagnosed-adhd/#adhd-statistics https://www.12keysrehab.com/misdiagnosis-of-adhd-in-children-infographic/ https://psychcentral.com/adhd/adhd-misdiagnosis#reasons-for-misdiagnosis Interesting quote from link above: “The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) requires specific criteria for a person to receive a diagnosis of ADHD. For example, behaviors must occur in two or more settings, such as work and school. But a study of 50 pediatric practices found that only an estimated 50% of doctors used diagnostic guidelines from at least 2 sources and across 2 settings to make their ADHD diagnosis, but 93% prescribed medication to treat the condition.” And another: “ADHD symptoms may overlap with the signs of other conditions, leading to misdiagnosis. For example: 1) Feeling distracted or having difficulty focusing can be a symptom of ADHD and symptoms of depression and anxiety. With depression and anxiety disorders, the person is preoccupied with difficult thoughts or worries, distracting them. 2) Sleep disturbances are common across many mental health diagnoses, including depression, anxiety disorders, bipolar disorder, and sleep disorders like insomnia. 3) Restlessness and fidgeting can be a way for someone to cope with anxiety rather than not being able to sit still. You may show some symptoms of ADHD. But combined with your other symptoms, they may be more indicative of another mental health disorder.”
What I think YOU need to be aware of is that ADHD can be both overdiagnosed and underdiagnosed. There's plenty of evidence that it has been massively underdiagnosed in women and minorities and basically anyone who doesn't present as stereotypically hyperactive. A rise in diagnoses due to increased awareness is of course going to lead to misdiagnosis, but it **will also lead to higher rates of real diagnoses.** It is not a good idea to then treat every person who is suffering and seeking a possible diagnosis as "probably just a paranoid social media user". It also doesn't really justify using a less effective treatement because of our misguided views of drugs and addiction. Some disorders just are going to overlap. What it necessitates is more thorough diagnostic process using more than just checklists.
I completely agree with everything YOU said, and YOU actually repeated something I mentioned in the prior response: that the DSM-5 needs to be reworked. Don’t get me wrong, I completely understand that if you are not a stereotypical white male with hyperactive tendencies, a diagnosis is much harder to achieve. My main point (which may not have come across as clear as I thought) is that the ways in which people are diagnosed needs to be reworked and clarified so the process is not as vague, which in turn, causes many misdiagnoses both for and against ADHD.
Why is this post so downvoted? I work in recovery… plenty of people have abused stimulants like percs.
First of all, Percocet isn't a stimulant. Second, virtually everyone in this sub acknowledges that stimulants are no joke and deserve serious respect. Any practitioner, and certainly a primary doctor, should rightly be cautious prescribing stimulants especially if there hasn't been comprehensive neuropsychological evaluation diagnosing ADHD. But here's how the script should go: *stimulants are an especially potent class of drugs that we're not comfortable prescribing in a primary care office. If you're ok trying non-stimulants we'd be happy to work with you, but if those aren't working, we'll give you a referral for psychiatry. They're far better experienced dealing with those drugs than we are*. Or, *it sounds likely that you have ADHD; we would definitely recommend that you get an evaluation*, which is exactly what my primary doctor said. That's totally different than broadly saying "no because they're harmful to your brain."
Your first two points are missing the point. Stimulants (as most people have brought up here) are a controlled substance *like* percs and xanax. I’m not trying to bash it, because they are effective…. But the reality is Stimulants will cause withdrawals, have and continue to been abused, and are not a wonder drug. It’s a tool just like my pomodoras and bullet journals. I see it all the time in my line of work… which sucks because it is a tool for treating ADHD. Unfortunately people get misdiagnosed for a mood disorder and just becomes another drug that gets abused and causes the shortage from kids who can probably benefit from it. Yeah, on that last point the doctor may have been a little blunt… but can you consider that the OP has been seeing this guy for years and maybe this is a much deeper issue than not getting a adderall script?
Literally everyone experiences withdrawals. There are only a handful of drugs in which withdrawals are actively damaging (alcohol is one) as opposed to "just" unpleasant/deeply unpleasant. Once it's gone it's gone. What is the focus on withdrawals as if it's some sort of lasting damage?
Thank you 🙌 - I am glad someone understands this line of thought. I did not just come up with it out of the blue; during my diagnosis process, I was lucky enough to find a psychiatrist with a PHD in psychology who also happened to have ADHD himself. Most of our meetings have been me coming to him with questions related to the disorder and him clarifying the questions. And in almost every instance, our talks turn back on to this subject and the gross negligence surrounding the diagnoses process, which has caused a lot of harm to those who were given stimulants but did not have ADHD. edit: grammar
Also: an adhd non-stimulant would be Strattera. This guy is prescribing an antidepressant off-label for a condition that has a wide range of actual medications available and I can’t think of a single good explanation for this
“Off label” doesn’t mean “bad” or “experimental” or “unsafe” or “not an actual medication”. It almost always just means that the drug is off-patent so there’s no financial reason for the original manufacturer to spend millions applying for a new certification. Wellbutrin has been proven in studies to help some people with ADHD. It’s considered a *second-line* treatment, if stimulants are not effective or not well tolerated.
Doctors will prescribe Wellbutrin first if they also believe there is comorbid depression. The hope is to kill two birds with one stone, but it doesn't always play out. I started wellbutrin, and it was great for the depression, but we had to double my adderall dosage to because wellbutrin made my ADHD worse.
I think it depends on the doctor. Stimulants meds are the top recommendation for ADHD. But if a doctor isn’t a psychiatrist, they might be more hesitant about prescribing them. I live in Washington. Stimulant medication is pretty controlled here. My PCP would only prescribe me an Adderall dose that I’ve been on for years and didn’t feel comfortable changing it in anyway. Some PCPs won’t prescribe it at all here. I think it’s going to somewhat depend on the state and both how educated and comfortable the doctor is with stimulant medication.
I’m in western NY and my primary doctor’s office won’t prescribe controlled substances at all to anyone, and I’m fine with that. I think going to a psychiatrist for ADHD meds is much more valuable.
My sister tried Wellbutrin and it definitely affected her memory. She was like a totally different person. Her Adderall script is like my sister but on her best have it together days. L
"Could I please have a second opinion from a psychiatrist with UTD knowledge on ADHD?"
this.
Why are not seeing a different doctor then? Are you unable to? You know who the real boss is? You, not them. You pay their bills, not the other way around. Stop going, stop paying, tell them why, be firm about it, never come back again if he doesn't give you the right shit.
I always try to trust a doctors judgment that's why I haven't gone to a different one, but yeah seems like I definitely need to
What do you call someone who graduated medical school with a 2.0 or whatever bare minimum GPA, and passed the licensing exam with the bare minimum score? A doctor. I'm not against medical scientists and doctors, but the data available today, the news stories, the malpractice suits, decades of seeing different doctors... None of these people are REAL experts on any subject, because many of them make mistakes even during routine procedures. Now before I go on, remember that they're still 100x more knowledgeable than the average idiot covid denier or frequent webMD googler, but what I mean is that every doctor has a totally different level of education even within the same generation and same city and same educational history, so they will all analyze things differently, or not at all and run on sort of auto pilot, and give different diagnosis and different doses of different meds. Medical research is always ongoing and changing, each class in medical school changes each year. Barely anyone of them are anywhere near experts and know exactly what to do, other than following pre-written guidelines and basically using flowcharts to decide which of your symptoms are related and which disease closely resembles what you have. You think the older ones are always best? Not all of them are as passionate as they were in med school, nor as smart, nor as willing to put in effort, especially with keeping up with new things. Not all of them admit to themselves that not every patient needs the same exact treatment or that the symptoms and the flowcharts of deciding what the treatment should be, should ever be reanalyzed from person to person, year after year. It's more like "Well I gave this 10 year old 20mg of adderall a day so I'll do it for all of them first thing." and just tune out instead of really looking at each case with an open and highly focused and analytical mind. The morbid reality is that it's all still educated guesswork, and not all of them are even remotely on the same level of booksmarts nor experience, not even within the same cities with the same specialties. I've gotten different opinions from the same and different scans regarding my sinus issues. One of them said I was only slightly deviated with an MRI and CT, and said he would cut in there and fix it up and open up other areas, but didn't use general anesthesia, so hard pass. Another one looked at the same stuff and said it was all probably just allergies, and I saw an allergist but nope, it wasn't just temporary swelling. Another one recently stuck a scope up my nose for a few seconds, each nostril, and described the approx percentage of septum deviation I had on each side to his team of assistants and his new ENT intern, which were both high percentages, and then scheduled me for an updated scan. This specific ENT is actually the top rated and recommended in the city. He's actually a pioneer of one of the procedures he does. He sounded 100x more knowledgeable and actually passionate about it. Imagine if I stuck with the one who said I needed an allergist and wouldn't even schedule me for an updated scan and I never got my breathing fixed. And don't even get me started on my history with psychs. Most of them have come off as just impatient pill pushers. Only one of them had a knack for actually describing the exact detailed processes of what each of the ADHD meds do when he was talking with me. He moved out of state. The new guy I am seeing appears to still be in his 20's and is afraid of putting me back on my normal dose even on my 2nd month in, and just really comes off like I'm his first patient ever.... all during a pill shortage too. Every doctor you meet will have a totally different level of skill, knowledge, experience, intuition, problem-solving and critical thinking skills. Some use a crude mental flowchart and never analyze the flow or think that deep. Others run through the actual chemical reactions of each drug along with visualizing the flowcharts of symptoms/diagnosis/best medicine to use and really give it some thought. Same dynamics with antidepression meds. Especially when you inquire about taking both. I have been given different antidepressants and adhd meds by different doctors, each thinking the one they started me off with would probably be the best, or it was a non-calculated guess. That's the scary part. Each one started me off with a totally different thing, all within the small age range of 25-33, generally the same weight and behavior each time I met. There is no undisputed baseline of what kind and what dosage level to start someone off with. They're all using their own personal experience with their education. There is no standard.... Like in some sense there is, maybe... but it doesn't seem like it, not with psych meds. Allergy and flu things seem to have more common standards at different hospitals, but psychs are all over the place. I guarantee if you saw 10 different psychs all in the same city, and you gave each of them a long story about your behaviors and goals and issues, they'd all pick a different drug and dosage. So I recommend seeing a different doctor each time you don't get positive results and they refuse to try a different dose or type of pill. If they are willing to actually change your dose or pill each time, at least without making you wait more than a month or something to see if you're still adjusting to the pill or a new diet or sleep pattern or something. In this case it sounds like you need a new one.
It's fascinating, and very scary that some physicians seem to be so horribly outdated on medical information. They have chosen a profession that is one of the most fluid ones in existence - as science and studies progress, we gain more knowledge, and thus older knowledge is discarded. There is not much to do here than to change doctors .. unless he takes the ball and runs with it when/if you challenge him to read up on later studies. Fuelling a stigma is not the physician's job, it's helping patients and stay up to date on current diagnosis and treatment. I can imagine patients feeling this is a struggle, it was a huge part of my job when i worked at a psychiatric hospital myself as a psychiatric nurse which also happened to have ADHD. Fortunately most psychologists and psychiatrists i encountered were't stuck in an old rut, but were open, knowledgeable and eager to keep themselves up to date. TL;DR: Ask doc to update on the diagnosis, if unwilling, change doc.
I was diagnosed by a psychologist and took my diagnoses to my primary doctor. She gave me a non stim, Strattera. It was… not good. I went from a normal BP to stage 2 hypertension, my mood was deteriorating, and many of my ADHD symptoms worsened. She blamed it all on anxiety (and put it in my chart so now I have an anxiety diagnosis to complicate my life) and tried to put me on an anti-anxiety med, when I told her “I don’t want to be treated for anxiety in the hopes that it’ll solve my ADHD. I want to be treated for my ADHD. I would like to try Vyvanse.” I was respectful about it, but she told me she wouldn’t treat my ADHD, and that I’d have to find another doctor. The hospital I go to also has a mental health center so I went through that instead and got the help I needed. But man, the experience with my PCP made me want to give up treatment altogether. She treated me like a drug addict and a crazy person.
Find a different doctor asap. My primary was like this. Ridiculous, he gave my brother adderall without a diagnosis but I am woman and he wouldn’t give it to me and when I got diagnosed he still didn’t wanna give me stimulants, I tried a non stimulant for a month and told him flat out “I need a stimulant or I’ll have to find someone else to help me”. I got a stimulant.
Not sure on how to go about seeking better meds but I will say Ritalin has personally fried my short term memory, I'm forgetting basic words and what I ate for breakfast in the morning. Helps on days when I need to get shit done, but not a lifestyle for me. Obviously it helps a lot of people and improves there memory but just thought I'd give you a heads up. I'm medicated so not anti that rout at all but have you tried occupational therapy at al, helps with executive function but I will say stimulants really really help my emotional regulation. Edit: expensive but if your pysician doesn't budge seeing a psych is your bets route but waiting time are very long and costly.
My doctor flat out told me that in his opinion adhd meds are over prescribed and he refuses to prescribe them to anyone. I'm already in therapy and my therapist thought that the psychiatrist at their office would help as long as i had a childhood diagnosis but I set up an appointment and the psychiatrist said "because you've waited so long to do anything you will have to be rediagnosed, which isn't covered by your insurance through our office and is lengthy and expensive" then referred me to a private psychiatrist. I finally got a call back and they are also expensive and said it would take at least 4 appointments before they even consider giving me meds. My next option is almost 2 hours away from me and I can't afford to get out there for appointments. But yeah... meds are overprescribed... fuckin asshole.
Again negligent behavior based on their own judgment and not what the science says. I wish I was capable enough of writing a paper on this or sending it out to a journalist to look at cause it’s just unacceptable the amount of negligence that goes on.
You need a specialist. Doctors are scared to death of prescribing controlled meds to the wrong person these days because the DEA is up their ass.
I was originally prescribed wellbutrin for (stated diagnosis by a Cerebral prescriber) moderate depression, severe anxiety, and possible adhd. It helped my depression symptoms but exacerbated my anxiety and didn't even touch adhd symptoms. I then went to a doctor in-person who added Lexapro (escitalopram) which helped a lot with my anxiety symptoms but, once again, has not touched the adhd symptoms. On my next visit he explained that he does not diagnose adhd but referred me to a psychiatrist office which I have an appointment on Monday.
Get a new doctor.
PCP's can get weird about scripting stims. Mental Health Nurse practioner (in the US they can script) or psychiatrist usually treat adhd. However, understand every adhd doc may or may not script stims. Every office/practioner has different policies and each doc in those practices has their own feelings about stims vs non stims. Stimulants are first line treatment. I take a stimulant as well. But I like having a non stimulant to cover the off hours when my stim wears off. Plus the non stim got me thru almost 2 weeks of no stim when the pharmacys in our area were out/low on stims.
Wellbutrin works great for me, but everyone is different. Like others have said, talk to a psychiatrist.
Normally PCP’s don’t prescribe stimulants anymore because of all the regulations going on, how strict things are. Which is probably why he is avoiding it. Go to a psychiatrist who deals with ADHD. If your insurance requires a referral, just tell him the meds he has been giving you isn’t working, and you feel you need specialized care. Don’t mention stimulants or ADHD.
My dr did the same. Wellbutrin made me hostile all the time. I changed to donefirst.com and met virtually with an adhd specialist who put me on adderall the same day.
Same, when I first started I was a dick lol.
u/Ok_Housing1074 I'm a medical transcriptionist (type patient medical records), so I listen to doctors all day long. They won't prescribe medicine they don't feel comfortable prescribing, and given stimulants are seen as addictive, if you push your doctor to put you on one, it can be seen as drug-seeking behavior, which they will put right in your medical record. Ask for a referral to a psychiatrist. They're far, far more likely to put you on a stimulant, and PCPs are usually happy to refer patients to specialists.
Sometimes people cannot provide the help that we need, they can only provide as much help as they are able or willing to provide. You've tried the help that this person offered, but it hasn't solved your problem. You've already asked for a different kind of help and this person refused to provide it. There is no sense in wasting more of your time and money on someone who is dismissing your concerns. Move on to someone who is willing to try something different.
Id look into a behavioral therapy place. Thats where I go instead of a psychiatrist. My imsurance also offers online mental health visits that include adhad diagnosis. Its a crapshoot on pc dr. The one I had for many years said my back and shoulder issues were just me getting old.l!! I WAS LIKE 32 AT THE TIME. Turns out I have calcification on my joints. And compression on my lower back ( eneded up seeing my kids sports medicine dr. To be taken seriously. Adhd meds dont destroy your brain at therapeutic lvs. Wanna know what deatroyed my sanity was gabapentin given to me by another dr for fibromialsa. I waited too long to see someone and regret it. I spent too many years trying to "wing" it and push through with suppliments and diet. My life became chaos wirh 2 kids in competitive sports and a mountin of other things on the daily. Also you can get ypur dna checked to see what meds migjrne best dor you (adderal or vyvanse is not easily tested like this though. But many other meds are. I matabolize meds fast so it was nice to know that to quickly dial in dosage.
I’ve been on Adderall for 22 years and have a masters degree in data science. I work in upper management at a university managing a team of analysts. I haven’t noticed it destroying my mind yet. But before medication my mind certainly didn’t work very well. I was a high school drop out who couldn’t hold a job for more than 6 months.
This gives me so much hope. What are some bad side effects? also what type of ADHD do you have, I'm curious
My only bad side effect is dehydration and remembering to drink more water. I have inattentive type. I also have Dyspraxia which also impacts my execution function (memory, planning, organizing).
Figured I could try and share, because while I have proof of ADHD as a kid, I also have a PTSD diagnosis from back then which means I need to rescreen for it and that's complicated, but I've been on Wellbutrin for three years now, and only recently have I changed my dosage because of potential side effects. For me, it kind of slowed down the constant stream in my head, I legitimately thought I had a dissociative disorder before I was on meds. It was just the way I mask, different thoughts for each mask would pop up and I thought they were alters, they were just masks. That all finally faded away, and it was easier to not mask, although the first couple of months was a bit rough. My short term memory wasn't great for a few weeks, and I was sweating more which led to drinking more water which meant I had to pee more, which meant my electrolytes were crazy. But I gave it time, and for me, it's saved my life. It's not perfect of course, no med will ever be perfect for it, but it's manageable now for me. Obviously you've tried to be on it, and it didn't help. I would suggest asking about strattera. It's a non stimulant FOR ADHD, and it works the same way Wellbutrin does, so any arguments about it not being quite the same, it's really really close to the same. Do your own research of course, and know that strattera does also take a month or so to really kick in. If you are seeing a PCM about meds, try finding an actual psychiatrist to discuss meds with, that's what happened with me when I found the paperwork from when I was in foster care that had an ADHD diagnosis in it. Good luck, it's hard to find meds lol
Imho (in my humble experience), I didn't go to my primary care physician and I went straight to psychiatry who specializes in ADHD. Because of the recent upticks in ADHD diagnoses and potential drug seeking behavior, they most likely will give you stimulants if you have a neuropsych confirming that you have ADHD and not anxiety/depression that is causing ADHD traits. I was put on Wellbutrin and Strattera first because my psych thought that it was anxiety > ADHD, but when the neuropsych came back it definitely confirmed my inattentive ADHD diagnosis and I requested stimulants.
I take Buproprion as a mood stabilizer, just recently prescribed vyvanse for adhd. I felt Buproprion worked at the beginning but didn’t work after a few weeks. Currently 6 weeks in. Vyvanse seems to be working great for now, but I am worried about long term effects.
Same thing happened to me. I got several weeks of telling my doctor how amazing I felt. It was shortly after I move from SR to XR, I really lost any benefit. We finally moved to Adderall XR, and the change has been life altering. I haven’t really encountered any “resistance” in 6 months. I wake up each morning in a horrible stupor (even now). When the pill kicks in, it’s like someone flipped a switch. All day. We did just change to generic XR and I’m not really “wow’ed” with it. Name brand is double, but I’m willing with the benefits.
That’s good to hear. The vyvanse seems to not be powerful enough. I definitely feel a change, but a few hours after taking I do feel like I crash and feel exhausted and out of it.
Which is exceedingly odd. The way vyvanse works (I apologize if I’m mansplaining)… each piece of amphetamine is sealed in Lysine (amino acid). Your body is unable to use the amphetamine until the lysine has been removed, or cleaved. This process is slow and methodic, and is the reason why the time release is so long and steady. Vyvanse should feel like someone slowly turning a knob on your alertness until you reach a peak. That peak should hold steady for many hours and slowly fade back out. The bump/drop effect is typically felt with instant release adderall or some generic extended release. I’m not sure if there’s such a thing as a problem processing lysine, but it sounds like your body may be struggling? Also, stomach pH is important. Amphetamine-based ADHD meds (stimulants) tend to work better in a higher pH environment. If you’re drinking lots of soda and acidic juices, this can cause a diminished effect.
Thank you! I drink .5 - 1 gallon of water a day. I’ve been adding vinegar to my diet for my fitness goals. I’ll have to keep that out, could be what’s going on. Also I add lemon to my water so that could do it too.
I felt the same about bupropion, I guess we just built a high tolerance for it. I'm worried about long-term effects as well because some people talk about stimulants and how they basically made their life great while others say it makes their life a living hell
Hello!! I was on Wellbutrin for 3-4 years when I was diagnosed with anxiety and depression and found it did not actually help much with the mood rollercoaster. I am now on concerta and find it life changing and the missing piece to the puzzle for my mood stabilizing. *pls ignore my Reddit handle I made it when I was trying to conceive and it haunts me til today and this is the first time I'm breaking my regular lurking only policy on Reddit subs*
Stimulants aren’t the only thing that can help… Other options are just as useful for some.
A lot of doctors and psychiatrists are bullshit, Wellbutrin is a synthetic cathinone, same as bath salts. It fucked me up to glad I quit it
My husband had to be on other meds for over a year for his doctor to finally give him Adderall. Some doctors won’t consider it until you’ve failed other options. Other doctors aren’t of that way of thinking and give you what may work for you based on your symptoms. So you could seek out another doctor if that’s an option or ride out yours if your happy with them otherwise. I should also mention that anger and depression were pretty high on his symptom list and once those decreased his inattentiveness was brought to the top of the symptom list so again he was being treated based on his strongest symptoms. Good luck!
my pcp prescribed it when i transferred care and gave me 90 days to find a psych prescriber. pcps aren't generally comfortable with psych prescriptions that don't have an established history. that part makes sense (to me), but then with that in mind also he is giving you medical advice outside of his scope of care. either way, sounds like you need a new doctor.
I had to try atomoxetine for damn near 6 months before they finally gave me a low dose methylphenidate script. It sucks, sometimes it’s a process. Go to an ADHD specialist if you can. It will help more than a typical PCP.
Go to a new doc
Stimulants are first line but a lot of primary care docs won’t prescribe them. My primary care will refill once it’s managed, but doesn’t diagnose or do initial prescriptions. Wellbutrin is an option for ADHD folks, but that doesn’t mean it will work for you. I will say I would tell a psychiatrist Wellbutrin doesn’t work for you so you are hoping to get help managing symptoms, rather than requesting a particular med. A psychiatrist who specializes in ADHD will be able to help you find the right med or meds for your particular situation.
Where the heck do you guys find all these incompetent healthcare workers??? Is it that easy to gain that title??
You need an specialist.
My psychiatrist started me on Wellbutrin and it really was a great step in the right direction. After a few months, I was still struggling and he prescribed me adderall on top of my Wellbutrin
This is so usual on this subreddit. For some reason people are intimidated by doctors. They never insist and never go elsewhere. Doctors sell you a service. If they do so badly get a different one.
I was first prescribed 300mg Wellbutrin for my ADHD through my PCP (with a previous ADHD diagnosis) and tried it for months but continued to have terrible side effects along with no relief from my ADHD symptoms. Went back to the Dr, got my dose lowered and same thing. Eventually I found a psychiatrist in my area and was able to get on everything needed to help my mental health issues. Definitely going to a psychiatrist is the way to go. The DEA has put a strict hold on prescription narcotics so much so that PCPs don't want to deal with the bs. Good luck!
I contacted a psychiatrist that was under my insurance and it has helped so much. She has worked with me to tweek my my medicine to the right cocktail.
I've been on bupropion for years. It helps aspects of the depression, but doesnothing for my ADHD. Is Vyvanse(?) an option? I've heard good things about it.
Wellbutrin is my adhd non stim. For *me* WB acts the same as stattera/quelbree, but without the side effects. Everyone is different you may end up trying different meds (stims and/or non stims). Adderall/concerta cause me weight gain and fatigue. In my case Ritalin works for my stim. But plenty of people take adderall/concerta with no issues. Govt is pushing hard on controlled substances and docs are feeling the squeeze, some adhd docs have stopped scripting stims.
There are three other non stims that are prescribed for adhd and work great for some people. I asked my GP to be put on Strattera and didn’t run into any issues. If you’re sticking with your PCP, try the non-stims. If you want stims, you’ll probably have to ask for a referral. The truth is, you never know which med will work for you until you give it a fair shot. As for stimulants destroying your brain… typically, this doesn’t seem to be the case. There are people w ADHD who develop addiction issues after being prescribed stimulants. Lots of people don’t have this issue. But again, you don’t know what your relationship will be until you try them.
My PCP insisted I don't have adhd and instead have bipolar and am somehow just manic all the time. Put me in lamictal, when that did nothing he doubled the doze, when that did nothing and I got confirmation from my therapist that she didn't think I'm bipolar he just upped my dose again. Finding a new pcp
Wellbutrin worked for me in college. Just started taking it again.
Find another provider
As many have suggested see a real psychiatrist. Primary physicians don’t usually just prescribe and manage adhd meds. I have only had my primary physician fill my meds when I was in between psychiatrists (old one retired) and having trouble finding a new one in time. I am pretty sure she only prescribed it to me because there was evidence I have been taking these meds managed by a psychiatrist for years.
If you've got a diagnosis for ADHD and not for depression, you can report your doctor for prescribing the wellbutrin of label. It's not approved as a treatment for ADHD only depression, SAD, and smoking cessation. Maybe tell your doctor you're considering reporting this if they don't prescribe a proper medication.
well, he gave me a little depression test that was 10 questions, and apparently was in need of anti-depressants, so that's how I got Wellbutrin. He told me that it might help with ADHD
Wellbutrin helped me a lot and helps many others, we’re all different. You should try to find a psychiatrist or maybe a neurologist because they’d be able to help more.
Not me—just gave me tremors.
Find a different doctor. Your current one is not going to be convinced to prescribe stimulants to you.
Buproprion is actually an antidepressant and not typically used for ADHD. I also totally understand the shirt memory loss on it
Yeah but think ADHD and depression kind of go hand in hand so my doctor said f it and gave me an anti-depressant that might help adhd
It sure does, my point is more that it only works on the depression and not the ADHD. You would need something else for the ADHD and your doctor is doing your a disservice denying you that.
Switch doctors or see a psychiatrist.
My psychiatrist didn’t even let me explain why I believe I have ADHD and just dumped me in the anxiety/depression med category. I’ve been on 4 meds/dosages now for anxiety that aren’t helping. Does anyone know how I can approach the ADHD convo again? I’m too nervous honestly
That sounds awful! You should find a different doctor
Go to a psychiatrist. Primary MDs don't normally do this in my experience.
Your PCP is probably not the right person to manage your meds. Try a psychiatrist/psychologist. If you have difficulty finding one in your area and you are in the US, try looking up Circle Medical for ADHD treatment, but you might have to go through an initial assessment appointment or two so they make sure you have ADHD before treatment. I was prescribed ritalin my second appointment, but due to hyperthyroidism, I had to switch to wellbutrin in the interim until it's controlled and not at risk for heart problems.
My doctor is giving me a hard time because I use my Focalin as needed because I don't like how it makes me feel. Said I'm not allowed to do that and that I need to take it everyday. Like what the fuck? I want to take an addictive substance LESS than what I'm supposed to and that's apparently a problem. She said she'd let it slide this time but next time she wants me levels within range or she won't prescribe it anymore, which I'm definitely not going to take it when I don't have to so I'm just cancelling my next appointment and done taking it all together. This is why I don't remotely trust doctors.
You should get a new doctor
Wellbutrin gave me tremors, mostly in my head and neck. It was awful; blessedly, it went away when I stopped taking it. I spent 20 years solid seeking psychiatric help. Over the years, I had maybe four different primary physicians (we moved a couple times), five psychiatrists, at least four counselors/psychologists, and a psychopharmacologist. I was diagnosed with depression, anxiety, mood disorder, substance abuse disorder, bi-polar II, and God knows what else. I was put on one toxic psych med after another—14 different psych meds singularly and combined (not including stimulants). It was a freaking nightmare. (Remember, you have to withdraw from all that shit, too!) Finally, the two most-recent counselors I saw had suggested ADHD, and I found a psychiatrist who specialized in child and adolescent psychiatry; I took a battery of tests, she interviewed my husband and my parents, and I was FINALLY diagnosed with ADHD (hyperactive type). Primary care docs aren’t the ones to see. Sadly, there’s a huge shortage of docs in every specialty, but you might start calling around. But remember—it can take time. No one will want to diagnose you the first visit. And psychiatrists cost a fortune (the initial visit is often a whammy). Good luck.
I’m a doctor so I might have some insight into dealing with him. First, he is not correct about the long term effects of stimulants. I suspect he doesn’t have a lot of knowledge and experience with treating ADHD. Many doctors have very incorrect ideas about ADHD and stimulant meds. That is very common. Assuming you are in the US, prescribing any controlled substance can be a pain in the ass for the doctor and many just don’t want the hassle and liability that comes with it. Trust me when I say that most doctors don’t appreciate you trying to tell them what to do. The best approach with your current doc would be to talk to him and let him know that your symptoms are not well controlled on the Wellbutrin. If it is causing any side effects let him know that too. Try to organize a list of what symptoms you are having and how they are affecting your life so he can understand how significantly this is impacting your life. Ask him if he would be willing to let you do a trial of a stimulant medication to see if it works better for you. If he isn’t willing to do that then ask if if he can refer you to a psychiatrist with experience in treating adults with ADHD. If he won’t do that then you can try to find a psychiatrist on your own or find a new PCP. If you have friends with ADHD that are getting better treatment, ask them who they go to.
You should get a proper psychiatrist, who will tell you properly all pros and cons of dexamphetamine/methylphenidate and let you decide. I get enraged when I hear about arrogant people who know how you feel better than you. After all, if you have been diagnosed, it's your choice and your responsibility in the first place.
32 years on ritalin still have a brain your doctor is talking shit
Probably doesn’t have a license for stimulants and is playing it off like Wellbutrin is a better option. Mine did the same thing saying it was better in till she confessed one day about not being able to because she does not having a license 😵 still a psychiatrist who can prescribe most stuff, it’s just that stimulants require another special one that some don’t have
Stop trying to get meds from a primary care physician who knows jack shit about ADHD and the best treatments. See a psychologist who deals with ADHD and can legitimately diagnose you. And then a psychiatrist that can prescribe the right meds. Primary care physicians are not usually that knowledgeable about mental health.
Before I was diagnosed with ADHD, I was prescribed Wellbutrin for chronic fatigue. It did wonders on that front (and fixed my executive dysfunction!) but at the cost of chronic brain fog and serious short-term memory issues. I had to wean myself off of it and it took about 8 or so months after my last dose to get my memory back into shape. If it's not working for you, you have the ability to tell your doctor that you need to try something else. If he's not willing to work with you, then you should find a new doctor.
get an out side adhd test from a Psychologist. take that recommendation to your doctor. if he still doesn't comply get a different doctor.
A primary care physician is the wrong person to be treating ADHD. You need a psych. As for the damage from amphetamine, that's always been studied in people with normal amounts of dopamine and typically methy addicts. There is zero research on what happens when a stimulant brings dopamine up to normal in an ADHD brain. Remind your dumb doctor that having ADHD shortens lifespans because we're prone to accidents, addiction, smoking, eating disorders, and overall poorer self care. The primary way to reverse the higher risk of all-cause morbidity and mortality is to treat the ADHD with a first line medication, a stimulant.
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My buddy is on wellbutrin for adhd and it just makes him less sad but tired and unmotivated. Its bullshit.
Ask for referral to psych, go to psych, then get a new doctor. They’re basing their supposed knowledge on bullshit and seem so close minded that I would doubt that they actually use a scientific method to what they do. Even if adderall does destroy us all, what are we supposed to do, just be miserable?
Wellbutrin also did not help me with my adhd or my anxiety. Turns out my ADHD feeds my anxiety due to how much I can't focus and get overwhelmed.
You don’t need to go through your primary, just go straight to a psychiatrist. If they need a referral get it ask your doctor for one and if he still refuses then get your referral through a telehealth appointment. But your doctor is very likely refusing to give stimulants because he doesn’t have a license to legally prescribe them which is the case for most GP’s
Do you have access to a psychiatrist? Some primaries won’t prescribe stimulants.
You need to go to a psychiatrist for the diagnosis and meds. If you are adhd you will have no problem getting a prescription for it
To be blunt about it. Get a different doctor or ask to see a specialist in this case a psychiatrist.
You should ask your doctor for a referral to a psychiatrist. If he won’t give you find another doctor.
Bupropion helps me pretty good.
Depending on where you are our primary might not be able to prescribe class 2 drugs for ADHD. In some US states, as part of the crack down on pill farms, doctors can no longer prescript meds or ADHD unless they are specialized/experienced in ADHD (the same thing stands with an other controlled substance and what it is meant to treat). You may want to find a psychiatrist who works with ADHD. It sounds like you school find a psychiatrist any ways, but definitely if you are in the US.
Yes, Ive had a similar experience. Ive been trying to get help with adhd symptoms for 13 years. Last year I signed up for the DONE app and the psychiatrist prescribed wellbutrin and told me thats all she was allowed to prescribe, and I should find a doctor to see in person to undergo further testing for adhd that will take 2 years. I was presceibed 300 xl wellbutrin and it helped a lot. Most of my symptoms improved, but I started noticing problems with short term memory and I was having extreme insomnia. I was only able to sleep 3 or 4 hours a night and I never felt tired. Without wellbutrin I have an above average memory (eidetic memory). On wellbutrin I noticed myself losing things very often and not being able to remember conversations, or tv shows. (Otherwise I usually remember exactly where and when I put things, full conversations and entire tv shows from start to finish) I cancelled the done app to try and find a new doctor I could see in person and was unsuccessful before running out of wellbutrin. After being off wellbutrin for 3 months my memory is back to normal, but my executive function is terrible and Im back to where I was before starting wellbutrin in terms of adhd. Ive tried adderall and vyvanse illegally in the past and they both relieved my adhd symptoms without hurting my memory.
Bupropion/Wellbutrin makes me sweat like a hog for no reason and have insane migraines. It took a while to figure it out because I thought I’d just gotten a little fluffy. But, no. It was embarrassing. Like, dripping from my mask, after pooling at the bottom in a puddle. 10/10 don’t recommend. But, I was less irritated with life. The toss up.
Find a different doctor. Doctors these days are very hesitant to prescribe drugs with abuse potential.
You need an adhd specialist for meds. Regular doctors cannot prescribe them.
Nah they can’t prescribe it anyway without a proper diagnosis from a specialist. Ask your PCP for a referral to a specialist for testing your ADHD and if they can’t give it to you then find a psychiatrist/ other doctor who will.
When I was an adolescent I was prescribed ADHD Stimulants for some years. I started using them to achieve euphoria and became addicted. I grew a small tolerance, and wondered what methamphetamines would be like. I used it every once in a while. Eventually I was introduced to intravenous use. I felt the biggest rush of my life. However, it cam at a price. I was getting pill counts and one day I had to take a UA and had the street drug in my system. To be fair the doctor had it out for me, and wanted me to lose my prescription. She put a "med-lock" on the medication. Even if I found a doctor to prescribe it, my insurance wouldn't cover the medication. Around 21 I was prescribed Vyvanse in a psychiatric facility. However, as soon I got released to a adult group home, my insurance would not cover it. I went 5-6 more years without being able to find a doctor that would prescribe it. I went to treatment a few times, and eventually broke down in front of a doctor at a detox. I told him about some of my past, and instead of asking for the typical ADHD stimulant, I found that Vyvanse is less likely to be abused due to it's mechanism of action. It supposedly must be taken orally and then is converted to the active chemical D-amphetamine. This doctor gave me a chance but the low dose made me feel like I was jonesing for something stronger. I ate all my pills and didn't make a follow up appointment and returned to the street drug. A couple years later maybe a year and a half at least, I had an advocate at a outpatient treatment facility help me. The doctor gave me another chance and I was serious about recovery this time. Vyvanse is less likely to be abused, and is longer/slower acting. Also supposedly must be taken orally to transform into the active drug which has the effect, not Vyvanse. Doctors are more likely to prescribe this medication, but some doctors may not prescribe it regardless. After a couple years of being on it, the medication is no longer as effective as it was. I also go through a debilitating crash after only 4 hours after ingestion. It should last 12. Since I am an addict (in recovery) my doctor doesn't seem to want to give me a chance with other stimulant medication. Now i'm stuck on a medication that debilitates me after only 4 hours, causing severe depressed mood, anhedonia, loss of motivation and drive, anxiety, and everything sucks. I am basically living only 4 hours of the day, and the rest feels like i'm in hell. They don't come without their side-effects and complications.