A few months ago, I gave an overview of ADHD medications. Here is a quick recap. The most commonly prescribed medications to treat ADHD are methylphenidate (Ritalin), atomoxetine (Strattera), lisdexamphetamine (Elvanse), or dextroamphetamine (Adderall). They are all amphetamines, but they differ in how they are released into the system or what other chemicals they are combined with. Also, not all of them are available in all countries. For example, Adderall, the most commonly prescribed ADHD medication in the US, is banned in the EU.
My last post was right after I had just started taking Medikinet, a newer version of Ritalin. How did this medication affect me? In the beginning, it really did boost my concentration and focus. It also made me feel more relaxed and alert, and it got a little quieter in my head. Unfortunately, the help was short-lived. First, Medikinet needed to be taken twice a day, specifically after breakfast (never on an empty stomach) and around noon. This is a problem as I often don’t eat breakfast until late in the morning. Second, the so-called “rebound” (when the medication is wearing off/leaving your system) was horrific. I had severe anxiety and was clenching my jaw so tightly that I was worried I’d damage my teeth. I would wake up every morning with a horrific headache because the medication was out of my system. Other side effects included my heart racing or having an irregular heartbeat, shortness of breath, and losing the ability of gauging distances, so I’d be horrified riding in the car because I thought we’d hit something. I could no longer drive myself. Lastly, the dose had to be adjusted constantly because it would stop working for me. Within 4 months, I went from a 20 mg dose to a 60 mg dose per day. I finally had enough of this nightmare and decided to do some research.
Back in 2006, when I was still living in California, I stayed in a psychosomatic clinic for two weeks and, among other medications, was given Adderall. I didn’t know that Adderall is usually prescribed for ADHD, nor did I know I had ADHD. I did remember, though, how much quieter it was in my head. Alas, Adderall is not available in the EU, so I researched which medication available in the EU would be closest to Adderall. Lo and behold, I found Lisdexamphetamine, also available under the brand name Elvanse. I went to my doctor and asked if she could prescribe it for me, and I have been on it since October of last year.
So how does Elvanse/Lisdexamphetamine work? Well, for starters, it only needs to be taken once a day and can be taken on an empty stomach in the morning. The most noticeable effects, though, are how it works for me. It is considerably quieter in my head. I can focus and do my job again. In fact, I often experience hyperfocus now, which means I can get a huge amount of work done without losing my train of thought. The disadvantage is that I forget to take breaks or eat because, like all stimulants, it diminishes your appetite. I am organized again. Instead of starting 20 things a day and finishing none of them, I now do one thing at a time and finish it. I do not have a rebound, no headaches, and no heart palpitations or shortness of breath. The biggest side effects I have are dry mouth and my hands are shaking.
While my emotions are more regulated, they are also more noticeable, which is common with stimulants. This can get a bit tricky because stress can lead faster to an anxiety attack and I am hyper aware when attention is shifting to me, especially at work. Emotions like fear, anger, annoyance, or just nervousness lead to my blood pressure going up and my face turning bright red. So I am constantly monitoring my blood pressure and also had a 24-hour EKG done to ensure my heart is okay. Overall, though, I can honestly say that this medication allows me to function again in everyday life, especially at my job.
In December, I was also put on an antidepressant, namely another dopamine booster – Bupropion, also known as Wellbutrin in the US. These two medications are now creating enough dopamine and norepinephrine to allow an almost normal life again. I should mention that I do not take my ADHD medication on weekends or when I am on time off, so the additional dopamine from the Bupropion really helps.
While it may sound ideal, I can honestly say that it isn’t. In theory, the ideas of being hyperfocused, being able to really concentrate, having no appetite (losing weight), and getting an energy boost sound great, but in practice, it is hard. When your emotions are literally written on your face, when your heart starts pounding just because someone asked you a question in a meeting, and knowing that you are neurologically different unless you take a strong medication that falls under controlled substance laws, life can be daunting. But as of now, I’m taking one step at a time and hope that medication and cognitive behavioral therapy will allow me to have a normal life again.
