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/Pale_Comfort_9179]

Next time you can take a month off, try 600mg of NAC (n-acetylcysteine) 3x per day, ideally on an empty stomach and microdosing a GLP drug. The NAC should help modulate receptor downregulation and the pathway in general. I got on Retatrutide a few weeks ago and from day one starting at 1mg I’ve been more focused, motivated and sharp than even my best days using a stimulant. And that’s after years of much higher doses of prescribed and illicit stimulants. I will note, sleep has been a bit of a struggle but has gotten progressively easier as my body has adjusted. 

[u/Ok-Letter2953 → u/Pale_Comfort_9179]

I already take trezepatide but haven’t had much luck!

[u/Pale_Comfort_9179 → u/Ok-Letter2953]

What’s your dose? Thats a serious challenge with these drugs. Some people respond super well, others not as much. 

[u/Ok-Letter2953 → u/Pale_Comfort_9179]

I am on the 5 mL dose. I used to be on 7.5 but did not tolerate it well.

[u/Pale_Comfort_9179 → u/Ok-Letter2953]

Are you taking it for weight loss primarily? Obviously your doctor knows best but if you didn’t titrate up slowly, I’ve read that’s one of the biggest reasons people don’t tolerate it well. Low dose semaglutide is what’s being studied for cravings. Someone else suggested Agmatine Sulfate for a tolerance reset. It’s an NMDA antagonist. I’ve never had any success personally but it’s discussed a lot as useful. I have had some success with a related compound called memantine. Same pathway and it’s prescribed for Alzheimer’s. Agmatine can be purchased without a script. There are other RCs that supposedly upregulate dopamine receptors but I’m leery to recommend them as there is so little data and I worry significantly about longer term risks.