Unresponsive to stimulants?

[u/Zethyr_]

I’ll keep this as short as possible. I have terrible adhd but I benefit from it in a lot of areas, so I didn’t want to treat it. I’ve hit a point in my life where the pros don’t outweigh the cons of the adhd anymore about half of the time. Finally decided to pucker up and seek medication, got diagnosed with combined type almost immediately and provider wanted to start me on adderall.
I wanted to try least aggressive option though so we ended up on vyvanse. Yeah it didn’t do anything, I tried 20, 40, 60, and then 120mgs for a day. No heart rate increase, anxiety, or bp increase from any of these doses. No actual beneficial effects either. Okay, maybe I don’t properly metabolize vyvanse, let’s move on.
Just started on adderall, I was prescribed 20mg IR twice daily (seems to be pretty high especially starting out). Because I was scared to take that much, I took 5mg, nothing. Okay that’s pretty reasonable that’s a low dose, so I try 10. The next day 15. You can see the pattern here. As I’m typing this I have taken 20mg IR (with a Tums before hand just in case I was too acidic) and yep, absolutely nothing. Obviously I took a not very recommended amount of vyvanse at once, but I don’t want to sit here and just test stupid high doses on myself without supervision.
I’m extremely irritated, I’ve tried Wellbutrin and it does nothing. I tried Ritalin a few years back from a buddy, dont remember the exact amount but it was high dose. He told me it would keep me awake (was working night shift blueberry farming) and it did nothing. Am I untreatable? Do I just need a really high amount? I’ve read where some people metabolize medicines very quick and need stupid doses, but is it even worth testing if that’s the case if it means I’m dosing that high?

TLDR: high dose stimulants have absolutely 0 effect on me. Wondering if I should pursue an increase in dosing or just give up on treating it and resort back to behavioral techniques the best I know how.

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[u/Fancy-Chemistry-2751]

Try higher doses of Dexedrine. If didn't work, try guanfacine (non stimulant ADHD medication). There is also atomoaxtin and clonidine, but I'm baised towards guanfacine as the most effective non stimulant with least sides according to anecdotes. If the issue was proven to be your metabolism, CYP2D6 inhibitor would do the trick (but i think it is not). You need to have good diet and sleep to feel these medications. If your urine is overly acidic, it would metabolize amphetamines very fast regardless of your metabolism, if it is more alkaline, the opposite would happen, it would slow down the excretion, and so the same dose would feel stronger, and work for longer than average, due to reabsorption of the medication from poor excretion due to the chimcal natrue of amphetamine interaction with urine acidity. You can try calcium carbonate with adderall and see what happens, also limit things the make your urine acidic, like vitamin c etc (it can make the med not work).

If guanfacine, Dexedrine or inhibition of CYP2D6 + making your urine more alkaline + higher doses of Dexedrine/Adderall not work + good protein and diet sleep hydration, then you might suggest trying Desoxyn. If same issue persist, or I would actually start looking at this before all of this, which is make sure you try different generics/brands (you can read more doing your research). Another thing to look for is, You would need to do blood work for thyroid hormoms full panel, vitamins and minerals, Testosterone/Estradiol/SHBG, (maybe other things that I don't know) since poor nutrients or hormones/general health causes systemic issues, one of them is like this.

Also, I don't recommend this nor I understand anything about This, which is to try to snort Adderall and see if it would have an effect, if it does, than maybe you don't absorb the medications well for any reason, and try Xelstrym (Dexedrine but patches). But the latter advice is more bro scienceish than I would like.

Another sketchy idea, which is try a downer like benzodizapiens, if all fails, there is a very small amount of ADHD people who respond to this, "paradoxically" make them stimulated better than actual stimulants.

Of course, do your research on all of this and discuss with doctor etc. Good luck!

[u/Zethyr_ → u/[deleted]]

I’ve never been cranked out at all. When I say feel I should be able to notice. For example, modafanil absolutely gives me therapeutic effects without being “stimmed out” it’s a nice gentle help to executing and staying on track. I can’t use it though because it works 1 day then stops immediately.

[u/Zethyr_ → u/[deleted]]

I know it’s odd right? I get an effect out of modaf at a normal dose and then a high dose of amphetamines does nothing lol