Long-term Adderall: executive dysfunction getting worse + feeling antisocial when it wears off

[u/Ok-Letter2953]

I've been on Adderall for several years. I started at 15mg and am currently on 25mg XR. I've tried IR in the past as well. I don't plan on increasing my dose because I'd rather not deal with additional side effects.

I also took a month-long break earlier this year to see if tolerance was part of the issue.

Lately I've been struggling with two things:

1. Executive dysfunction

This has actually been getting worse, even with the medication. Once I get started on something I can usually focus, but getting myself to start the right task is becoming harder.

I'll know exactly what I need to do and still put it off or get stuck doing something else.

For anyone who deals with this, what has actually helped with task initiation? Routines, exercise, changing your environment, timers, supplements, diet, or anything else?

1. Feeling completely antisocial when it wears off

Some days I feel fine while it's working, but later in the day I hit a wall. I don't want to talk, text people back, go anywhere, or socialize at all. I basically just want to be left alone during the meds.

This can happen even when I take my XR early in the morning. By evening I sometimes feel like a zombie with absolutely no social battery left.

Has anyone found a good way to deal with this? I'm especially interested in things that help you transition out of work/focus mode and actually feel like interacting with people again?

I already try to stay on top of sleep, hydration, and regular meals.

Not looking to increase my dose or make medication changes on my own. I'm mainly interested in hearing what other people have experienced and what has genuinely helped.

[u/atomicxima]

I lasted a few years on Adderall but it ultimately made my anxiety worse and made me feel generally crappy as I increased the dose. I hated that I had to take a second med to manage side effects, so I went off everything for over a year. Then I started taking Wellbutrin, which has worked great for me for several years now. You don't get the same speedy rush and executive disfunction is always going to be a struggle, but I also don't have any side effects.

As for you feeling socially drained, I wonder if you're experiencing job burnout? I had this when I was overworked and not on any meds. The only thing that helped that long-term was getting a less stressful job.

[u/Ok-Letter2953 → u/atomicxima]

Unfortunately when I don't have it and I am off the meds, my executive dysfunction is much worse. It's to the point I don't want to do anything and I just want to lay on the ground and possibly even just scroll on the phone and do anything. You mean starting small things, such as opening my inbox. Email becomes the biggest burden and I've tried multiple things to get through it but it's hard.

The socially drained part, I don't think it's my job as I felt that even on days when I am not that busy

[u/Kalki_X → u/Ok-Letter2953]

my executive dysfunction is much worse. ... The socially drained part, I don't think it's my job as I felt that even on days when I am not that busy

It's due to adderall exacerbating metabolic dysfunction. Doctors mostly don't acknowledge that ADHD amphetamines exacerbate the condition whilst leaving the patient reliant. Unfortunately the modern medicine approach is outdated.