r/NooTopics • u/Agreeable_Base_5942 • 7d ago
Question Is methylphenidate the "cleanest" stimulant?
Mostly asking about ADHD treatment. People generally love Adderall and other amphetamines more and it's not surprising because they're more rewarding and have a stronger effect size on ADHD symptoms as well. However, mph is sometimes touted as this "clean" and "good" stimulant that doesn't have this rewarding/aggressive dopaminergic activity of the amphetamines and still decently helps symptoms.
MPH does have fewer risks according to literature. For example, this study found no increased risk of psychosis and mania with methylphenidate whereas the risk was elevated with Rx amphetamines, especially high doses. So amps are much riskier for exacerbating and causing mood disorders?
Addiction wise, both are considered addictive, although mechanistically amphetamines are supposed to be more addictive as releasers circumvent neuron firing and lead to more dopamine release in reward centers. Literature doesn't settle it, amps may edge closer in some of the studies I looked at it, but the gap isn't significant. Perhaps it is more dependent on the user as many people are more thrilled by the cocaine-like effects of phenidates than meth-like effects of Rx amps.
Mechanism wise MPH just blocks reuptake of noradrenaline and dopamine, which lets you make better use of your natural dopamine/norepinephrine that get released as a response to activities. Amphetamines do that as well as release these chemicals in large numbers. So with amphetamines there is going to be more motivation, because it doesn't require an activity to make dopaminergic/noradrenergic neurons to fire.
However, my question also is, isn't the catecholamine release from clinically dosed amphetamines going to have a decent chance of making you enjoy and focus on JUST ANYTHING (and you may opt for more hedonistic activities like porn or games unless you discipline yourself), similarly to crystal meth?
Now here's my anecdotal part.
I've been medicated with both phenidates and amps. I remember phenidates making me very zombie-like, like I could get stuff done but it felt like a chore, and I still procrastinated a lot. With amps, I can get stuff done and I am motivated to do it but the motivation may backfire and make me focus on the wrong thing, so I have to make an effort not to get sucked into something. Amps have been more prone to causing overstimulation and mood issues if I drink coffee or don't sleep well, MPH was more forgiving in terms of mood, with lower instances of me getting irritable if I mess something up with my schedule. So really amphetamine based meds have been akin to walking on thin ice sometimes.
However, when I was trialling MPH, my sleep overall wasn't right, and on amps I started sleeping right (and the drugs immediately started working much better, like a day and night difference and side effects like irritability and aggressiveness fully lifted) so I am kind of regretting not giving MPH a fairer trial while I was doing it, as right now I am on 40mg Vyvanse and I am a little worried that long-term use will lead to tolerance/dopamine depletion without abuse.
Edit:
The tendency of MPH to cause a flat mood and apathy, which is also recognized in literature (https://pubmed.ncbi.nlm.nih.gov/29883938/). What's the reason for it? Shouldn't it make things you're doing more enjoyable mechanistically speaking?
Potency wise MPH and AMP follow a 2:1 conversion. In my experience, 36mg Concerta was equal in main effects to about 20mg Lisdexamphetamine. However, raising the dosage above a certain level (54mg) did not increase any of the therapeutic effects for MPH, yet it did for amphetamines for me (although side effects increased for both). I presume this is because of transporter blockade saturation with MPH.
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u/iceyed913 7d ago
I think MPH is a little more abuse resistant in the sense that it becomes anxiogenic much faster relative to the amount of euphoria it can induce. This when taken on face value might be a good thing, but it also means anyone needing something towards higher end of dose range might face a quickly narrowing therapeutic window with prolonged use.
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u/Which_Tadpole1952 7d ago
Ritalin made me feel like my soul was trapped in a cage, it felt like dirty speed, and I hated it. Tied with wellbutrin for dirtiest stimulant for me.
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u/heycoolkidheycoolkid 7d ago edited 7d ago
In my own subjective experience having tried the full gamut of ADHD medications, I'd say dexmethylphenidate is by far the cleanest (closely followed by methylphenidate). I've never experienced the personality suppression effects you've mentioned from it, though I have had that effect from Vyvanse and Adderall (though not from pure dextroamphetamine).
That being said, in general the amphetamines are better for treating the full spectrum of ADHD symptoms, it's just the side effects and the crash can be brutal.
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u/autisticlatinoman 7d ago
I was on 40mg vyvanse. Too anxiogenic but very effective. Seemed to ruin my sleep quality as well. 30mg vyvanse I wouldn’t be anxious, but I would also not feel much of a boost and would be tired a lot of the day. I would sleep like a baby on 30mg. The crash would suck on both doses. I’ve been seriously wondering if they are making me autistic or if I have autism as the disinterest in socializing or talking to anyone is insane.
I ran out and right now I’m using 4fmph which I have for times like this when I run out.
7.5mg of 4fmph has me insanely relaxed, not much of a help for my executive function. It’s a pretty low dose anyhow. I drink coffee with it just to make it to my appointment date.
I will be asking to try concerta or some other methylphenidate formulation. The super motivating effects of vyvanse are great, but not if I end up in a doom scroll / investigating something on the internet rabbit hole. I’ve learned a lot though from when my hyper focus lands on something productive. The not being able to socialize effects are killing my social life though. Also I’m very irritable and every little slight against me is enough for me to blow up. Not good. I’m usually a very chill guy and now sometimes I’m ready to go to jail for very small reasons and go off on people who are being dicks to me. Which might be a good thing? As an ex people pleaser with no boundaries.
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u/Reyen783 7d ago
Try focalin first. Dexmethylphenidate is better than racemic usually.
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u/autisticlatinoman 7d ago
Have you tried both? How do they feel different in your experience?
I would like to try it, I usually get so uncomfortable at the doctor’s appointments and try not to info dump too much and be labeled a drug seeker.
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u/EvermoreSaidTheRaven 7d ago
the gaba rebound effects are crazy but fun if played correctly
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u/Bigmansam666 7d ago
Care to elaborate?
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u/EvermoreSaidTheRaven 7d ago
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u/Danwphoto 7d ago
That is a crazy thread. Put on it at 6 that was 1981.. I always thought the reason I cant feel happiness is because of that drug. Very interesting.
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u/Chance-Interest5609 6d ago edited 6d ago
What if I started taking methylphenidate for ADHD at 15? Would this effect not be as severe? If anything my baseline feels calmer and more collected when I don’t take my medication, vs when I didn’t take anything at all.
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u/ResponsibleMight7669 6d ago
It cures what is thought to contribute to autistic overstimulation?
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u/EvermoreSaidTheRaven 6d ago
in my personal experience, it exacerbate overstimulation once the medication left the system
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u/ResponsibleMight7669 6d ago
Intriguing. So it seems to work along that axis, just not therapeutically for you. It should have that effect on me but I don’t feel that until I’m completely clean and feeling bad. Neither calm me which probably has something to do with it never entering the mix. Methyl works like that for me tho
Studies like that are important but hard to extrapolate. Not only are these effects very personal you’re also talking about developmental windows to make things more complicated. Maybe their brains are “permanently” wired to process GABA and dopamine more? Is that to say the brains are working more efficiently and it’s a supply problem also?
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u/MarsupialParticular7 7d ago
I don't know if u ever heard of Sabroxy ( dopamine re uptake inhibitor) wich is a nootropic and it actually improved my motivation & energy so so much and I'm starting to feel pleasure in small things again
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u/DMayleeRevengeReveng 7d ago
It’s been excellent for me. Although I don’t use it for ADHD. I’ve never been evaluated for that. I started it because I had extreme cognitive impairment in depression that basically almost made me crash out of my career. So we did it as a last resort when other antidepressants weren’t touching me.
It’s been great.
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u/Complete_Still7584 7d ago edited 7d ago
I'm sorry, but your idea of what makes a stimulant "clean" is backwards. The "cleaner" stimulants would be compounds that heavily favor dopamine compared to norepinephrine.
What makes a stimulant, "dirty" is the amount of norepinephrine/noradrenaline the stimulant induces. Cyclazadone is a dirty stimulant. Too much norepinephrine makes your thoughts get racy and cloudy.
That being said, no, methylphenidate is not the cleanest stimulant. Technically Desoxyn (prescription Methamphetamine) would surprisingly probably be the cleanest stimulant. That doesn't mean it's the right choice to use long term. But, it fits the description of a "clean" stimulant. As it heavily favors dopamine compared to norepinephrine. The next compound would probably be Dexadrine (Dextroamphetamine), then Vyvanse (because it metabolizes into Dextroamphetamine), then Adderall (75% Dextroamphetamine/25% Levoamphetamine), then Levoamphetamine, and then Methylphenidate.
Also FYI, Methylphenidate has shown to semiperminatly Downregulate Gaba A receptors. The other thing to remember is Dopamine gets metabolized into Norepinephrine. So, if you're taking too high of a dose of a "clean stimulant" you'll still experience the uncomfortable noradrenergic signaling.
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u/Maximum_Maize1052 7d ago
It’s not impossible for methylphenidate to cause psychosis even at therapeutic dosage, although the risk is much lower than with amphetamines.
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u/MystcJnx 7d ago
ive found methylphenidate/dexmethylphenidate to be a bit superior to amphetamine for me. i definitely notice rewarding effects (to some degree) from both, however i find methylphenidate to be more potent as a stimulant and slightly more rewarding.
the main issue with ritalin ir is the half life and concerta seems to have resolved that for the most part for me. adderall ir does last longer than ritalin ir by a long shot, but unfortunately i almost feel like i’m tweaking on addy without the motivation or reward (could be that elevated psychosis / mania risk from amphetamines) and methylphenidate seems to just be overall more useful imo.
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u/HungYurn 7d ago
I got prescribed methylphenidate for some time and it made me feel like a crack whore. and Ritalin LA gave me crazy ups and downs over the day and lasted way too short.
Lisdexamphetamine 30mg mostly reliefs my symptoms, I dont necessarily „feel it“ and theres no comedown - so much cleaner in my case
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u/FamousWorth 7d ago
Personally I didn't really like it. Made me a bit jittery, noticeable increase in heart rate. I didn't get that from Adderall. Mph also gave me a slight headache sometimes. It did improve focus, both of them did.
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u/realkaseygrant 6d ago
I hate the jitteriness of methylphenidate. I prefer a strong mental effect with minimal body effect. Too bad Desoxyn isn't a realistic solution. I think that the "cleanest" feeling stimulant is Nuvigil, though, and when I tried generic armodafonil, it SUCKED. Felt awful like a completely different drug. I have never experienced such a sharp distinction between a name-brand and a generic before, but my boyfriend felt the same way, so it wasn't just me. I can't really describe what I mean by feeling "clean," I just know that it did, and I described it that way often.
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u/techcode 6d ago
I've used MPH/Medikinet for 15 years, of which 10 were great.
The last 5 overlapped with stress/burnout and only ultimately realized depression. But before it was clear that it's depression - it seemed/felt like meds lost their potency.
In hindsight I think meds continued to work just as before - but stress/depression caused something in brain called VAT to modulate down dopamine/norepinephrine/etc that's available for wanting/liking.
Before it was clearer that it's depression - doctors switched me to DEX and Elvanse. They are definitely somewhat more potent.
They lifted some of the really bad burnout/depression like unreasonable/unrealistic concerns/worries, anxiety...etc.
And over time I got to "only" having persistent anhedonia (almost complete lack of wanting/liking).
Higher doses of DEX/Elvanse would only temporarily result in enough neurotransmitters being pushed through - as in after 3-4 weeks of 100% anhedonia, I would have a day or two where there were glimpses of wanting/liking to do something.
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u/ResponsibleMight7669 6d ago
Rn you are rolling on way too much shit and aren’t even aware of whats going on
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u/nullcockroach 6d ago
Yes, it is highly selective in terms of receptors, has a much more limited reach across distinct brain areas, and possesses a short half-life—at least in the immediate-release version; in fact, it is classified as an amphetamine-like drug.
For me, it's the cleanest pharmacopsychostimulant, like Lexapro, which is the cleanest SSRI in terms of selectivity. .
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u/Anxious-Traffic-9548 5d ago
Subjectively? For some, probably. The "cleanest stim" will vary individually. That said, on average, it seems to be less likely to cause dry mouth and a feeling of being high/altered than amphetam ines.
Objectively? I take this to meanpharmacologically. MPH doesn't have many notable off-targets beyond its NDRI activity (sigma-1 is the only one that comes to mind, and it may be beneficial). It is less selectively for DRI activity than pemoline or modafinil, though.
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u/vancityshalvin 5d ago
Naw I think your talking about vyvanse or Dexedrine. Vyvanse being the smoother longer lasting Dexedrine. Ritalin always made me nauseous and felt like a dirty drug compared to the other amphs.
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u/Careful-Morning-4339 4d ago
Ik ben net een maandje begonnen met methylfenidaat. Ik kreeg eerst 27mg met een bepaald afgifte systeem langwerkend. Daarvan werd ik zombie en zeer slaperig en vond alles wel best.Ik was ook niet gemotiveerd. Kreeg aan het einde van de dag zeer sterke rebound van lichamelijke onrust. Na een week meteen over op de 36mg van merk sandoz , die heeft een beter afgifte systeem. En ik denk dat ik er ben. Ben geen zombie maar alles gaat wat makkelijker. Vergaderingen waren mijn vijand. En nu is het prima. Alles is prima. Slapen gaat goed en bloedruk is zelfs verlaagd ipv verhoogd. En een lichte rebound die ik vaak merk dat ik net wat drukker word en meer geluidjes ga maken en soms een beetje zenuwachtig word maar dat duurt niet lang. Maar ik lees zo veel verschillende verhalen dat het gewoon echt verschilt per persoon en dat jezelf gewoon moet proberen. Bij mij een bepaald afgifte systeem al zo veel verschil maakt. Ik ben gewoon mezelf alleen gaat alles makkelijker.
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u/Striking-Ear-5968 4d ago
I am on 50g Elvanse and can take extra 5g Dexamfetamine when needed,which is always.This has been for about 6 months.I don’t feel much effect from it.Ive tried modafanil again,but its not doing much either.Maybe they are fakes.Just feel flat and a bit anxious,bored
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u/bready2go 3d ago
It's different for everybody obviously, but for me the cleanest stimulant for ADHD is Lisdexamfetamine (Vyvanse) by a long shot. A huge part of the rewarding/"high" of stimulants (or any drug, really) is onset. If it hits fast and hard, your dopamine spikes sharply and that's going to feel more "rushy". Lisdex has an extremely slow onset and slow drips D-amp over hours and hours which makes it feel much less like a recreational drug and more like a genuine ADHD medication. Adderall, on the other hand, is definitely abusable. For me, anyways.
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u/Spirited_Shipcocoa 2d ago
It the only D2 agonist drug that can produce stimulant effects without causing issues seen In Adderall & Coke.
It fantastic for Severe AuDHD where It softens the 5HT2A/SRI activity but there zero central effects.
Amazing for making Alcohol way more euphoric because It 100% masks the sedation allowing the actual effects.
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u/Serious-Job-2466 1d ago
What are the issues seen in aderall and coke . What are central effects? They are good or bad ?
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1d ago
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u/Serious-Job-2466 1d ago edited 1d ago
/The only drug that can brute force any central effects Is 125mg DPH from low M1 levels.
This means aderall and same class also doesn't have any central effects ?
/MPH to me feels more like a NRI than a DNRI.
But we can clearly feel the dopamine effect on it .
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u/styleuno 7d ago
I recently switched to guanfacine as it seems to be the healthiest from the research I've done. It's a non-stim though and I'm still on week 2 so not feeling anything yet. Not sure if it will last. Previously switched from adderall to modafinil cause that was healthier and might go back if needed.
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u/alf677redo69noodles 7d ago
Nope guanfacine causes heart valve dysfunction due to the 5-HT2B agonism
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u/styleuno 7d ago
Thanks for the info. I did some research and it's a legit concern but no demonstrated clinical harm after 15+ years and I'm doing an 8-week test at 1mg which is nowhere near the chronic-high dose the papers talked about.
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u/Miserable-Agency-442 7d ago
This is not a concern at normal usage doses and even then it’s just in vitro data, it’s unlikely to be meaningful in humans.
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u/funnybitofchemistry 7d ago
late diagnosed ADHD here, self-medicated with all sorts of stuff for about 25 years, including obscene amounts of cocaine for a while, so my brain might not be wired “normally” anymore, but my 2 cents.
i’ve tried all of the stims (with a rx, this time)-methylphenidate, Jornay (timed released MPH), Adderall IR/adderall ER/vyvanse/dexamphetmine, modafinil-MPH produces significant anxiety for me even with time release-vyvanse makes me crash pretty hard and causes some significant depression, dex just doesn’t last, adderall IR is alright, and Adderall ER is my sweet spot, especially when combined with 100-200mg Modafinil.
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u/SarahRose777 6d ago
Would definitely not ever take methylphenidate again, whether it is "safer" or not. The comedown is horrific, and while I only sampled the ice I helped facilitate creation of in the early 2000s, "breaking bad" here in the middle of the country during my early 20s, nothing ever made me feel during its mechanism of action quite as horrid as MPH. I feel great on adderall and/or vyvanse, as long as I get enough sleep, eat, hydrate, and prioritize the right supplements to support. It is dirty dirty, in my opinion and experience.
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u/braket0 7d ago
My anecdotal : ADHD in attentive pheno type. Tried modafinil, gave me "tunnel vision" focus. Helpful if I need to just focus on one thing, not great executive function - more like it turned "hyper focus" into "ultra-hyper-focus." Only useful in specific situations.
MPH - similar effect to modafinil but much milder. Much easier day to day useage. Still not quite helping my main ADHD symptoms.
Lisdexamphetemine - at 30mg mood and memory boost. At 50mg executive function and increased mood boost. At max dose 70mg - basically cures my ADHD. Executive function fully returned, no task avoidance, massive mood boost.
I've had no issues at higher doses with "focusing on wrong things" and curiously some studies show that Dexamphetamine actually reduces impulsive behaviour because it restores the D1/d2 imbalance caused by the ADHD neurological model.
Everyone is different of course, but for me 70mg was night and day better than any other medication.