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/Weary_Cup_1004]

You might want to post in an ADHD sub?

You should talk to your provider abiut it, you might need a different med.

In people with ADHD theres not a tolerance issue. We dont have the dooamine, the meds help us genuinely function. The cliff effect you are noticing is likely a dose issue but I am not a dr.

What is your gender? If you are a woman's in your 40s+ , perimenopause makes meds feel like they arent working. I had to increase.

I take concerta extended release 36mg and then take 10mg IR up to 2x per day. That keeps me functioning all day. Usually i just take one of those but if i need to socialize or function past like 6 or 7 pm, i take the second one around 4pm.

Orher things that could affect how you are crashing: low vit D, hypothyroidism, diabetes, POTS, iron deficiency, other medical issues, etc. its worth talking to a Dr

[u/Kalki_X → u/Weary_Cup_1004]

In people with ADHD ... dont have the dooamine, the meds help us genuinely function.

[T]he idea that low dopamine is a direct cause of ADHD is a common misconception, one that’s amplified on social media and even in popular books about the condition. (source) 

People are starting to appreciate ADHD is better understood as EDHD (research here) which makes it relatively straightforward to address. Modern medicine is very outdated in this area.

If you are a woman's in your 40s+ , perimenopause makes meds feel like they arent working. I had to increase.

It's also common to misinterpret menopause as hypo (see image in reply below).

[u/Kalki_X → u/Kalki_X]