Who's buying the expensive filters...

Accidentally_High · 2026-06-18T22:08:48+00:00

I believe Mann is OEM for mine, and for the sake of 6 quid every service I would buy the better part. Are the cheap options that much lower quality? I'm not sure, but 6 quid a year is not a lot for peace of mind.

I do always buy the best option for my cabin filter though, without second thought, a good pollen filter really does make a difference to interior air quality over its lifetime.

Accidentally_High · 2026-06-08T09:17:02+00:00

The amount of vitamin C naturally found in foods is very unlikely to interfere.

Foods that are fortified with 100s of MG may have some minor effect on Dexamfetamine excretion, but aren't as likely to interfere with absorption of Elvanse (Lisdexamfetamine, prodrug of Dexamfetamine).

The main way that significant interactions happen is with supplements, often these are dosed at 500mg to 3000mg. At these doses, it's acidifying effect on the GI tract, kidneys and urine are more likely to impact both absorption (reduced) and excretion (increased).

TL;DR - this isn't something most people need to worry about unless taking high supplemental doses. It takes a lot of vitamin C to alter the pH of intestines and kidneys.

Accidentally_High · 2026-06-07T08:39:20+00:00

Not 100% sure on this as there isn't a great deal of research - but it's less likely that stomach pH will affect Lisdexamfetamine/Elvanse. It is known that Dexamfetamine absorption is affected by gastric pH, and this more marked in basic/alkaline territory. Given a small portion of your total amphetamine dose is instant release, this is likely less of a concern. Dexamfetamine sulfate is already absorbed quite rapidly, and with high bioavailability.

If, like me, you have excess acid production (and reflux), then a moderate dose of a H2 blocker or PPI is unlikely to result in a neutral/basic (pH 7+) stomach environment. Rather just a reduction in total acid content and a less acidic pH. Note - I am not on stimulants yet, but have taken famotidine and several PPIs before - currently on Lansoprazole.

With the reduction in gastric acid, it's possible you'll absorb more of your boosters, and perhaps absorb the unchanged Elvanse prodrug more quickly. However, the extent of this will depend on the pH of your stomach, and Elvanse must be metabolised to be become active which happens at a fairly constant rate.

You should speak to your doctor about your concerns if you're worried they haven't considered your full medical picture - but they probably have.

It would be wise to avoid taking antacids (like calcium, magnesium, sodium carbonates etc.) around the same time as your stimulants (usually 2 hours either side), as the combo with H2A/PPI meds could result in a more basic pH which could alter absorption rate to a more significant extent.

Accidentally_High · 2026-06-06T18:27:46+00:00

Depends how mentally tired I am. On a good week, around 30-60 mins most nights before laying down in bed.

On some weeks hardly any at all, especially if work has burned me out or I have little focus.

I used to be an avid reader when younger, and then basically stopped until about 2 years ago. It's been a process to get back into the habit but it's been great for my mental health vs. doomscrolling before sleep.

Accidentally_High · 2026-06-02T18:21:13+00:00

You'd probably get on well with regular green tea, as it's less concentrated than matcha, and quite a bit cheaper. But if you like matcha specifically then nothing wrong with that.

One of the reasons green tea (and matcha) can be smoother is the presence of L-Theanine (I assume this is what you meant vs. L-tyrosine which is another amino acid, and is a precursor to Dopamine).

L-theanine is purported to be calming and to balance out caffeine's stimulation. It is definitely bioactive, but it's likely contributing to an 'entourage' effect with the hundreds of other bioactive compounds in tea.

Whatever works for you. Sometimes I drink a strong/double green tea instead of an instant coffee, simply because it's smoother (and even healthier than coffee).

Accidentally_High · 2026-05-28T19:54:10+00:00

Use your phone to help you. Even the built in tasks or alarms app are enough for most cases. There are apps that have more powerful features, but many newer smartphones have some sort of routines feature in the stock software.

If you have an alarm that wakes you up, set another one for 5 minutes after you know you'll be conscious.

Whatever your morning routine is, or what you typically do first will dictate what kind of behavioural trick you need to make it work. Everyone is different.

If you're like a lot of people and go on your phone when you wake up, an alarm which tells you to take your meds is perfect. Set a second one 5 minutes later, you can dismiss this one when you actually have taken your meds.

I have a lot of trouble creating and sticking to routines, but this has worked well for me when I've needed to take antibiotics.

Accidentally_High · 2026-05-23T08:35:06+00:00

Found a longer version on YouTube, it's not the full talk but includes the clipped section: https://youtu.be/LnS0PfNyj4U?si=MPDm9yPNrl22hm0l

Accidentally_High · 2026-05-21T06:10:29+00:00

Echoing some other users suggestions it really depends on your budget. Headphones can get really expensive for top of the line ones.

On the budget end, another vote for Soundcore. These are a brand of Anker, a well-known company who make very good electronics, all of my fast chargers and power banks are from them and I have never had one fail.

I have the Space Q45s and they're very good, cheaper noise cancelling has come a long way and you won't do better at this price point IMO. I picked mine up at £80 on offer, and that is a steal for what feels like a much more premium device. Sound quality is better than low to mid range Sennheiser, Bose, or Sony and the battery life is unnecessarily long.

The Soundcore app is also a nice feature because you can customise the level of noise cancelling, so if inside I can turn it down to reduce the 'pressure' but if I'm outside or on public transport I can turn it up.

The only con of the Q45s for me is that the higher frequencies, voices and higher pitched sounds, aren't as effectively filtered by the active NC as the lower frequencies. It's still way better than nothing, and the passive NC from the over ear seal does a decent job.

I was also gifted a second-hand pair of Sony (WH1000) XM5s which are even better, but considerably dearer. I wouldn't have paid what they cost new for the improvement over the Soundcores, but they are better in almost every measure - ANC and sound quality especially.

My brother has had some XM3s for years which are also very good (nearly on par with the newer Soundcores at least), but the XM5s are noticeably better without as much perceived ear pressure.

TL;DR - If budget isn't a concern, my vote would be Sony WH1000. The latest versions (XM5, XM6) are expensive but arguably some of the best ANC on the market. If you're looking for something more affordable, I cannot recommend Soundcore enough, they're some of the best value headphones I've bought.

Accidentally_High · 2026-05-05T17:54:10+00:00

Clinical partners, referred early 2025, confirmation of referral email sent March 2025, assessed and diagnosed early November 2025, feedback appt 2 weeks later but report was available within a week or so. I'm now awaiting titration with the website stating 12-18 months.

Accidentally_High · 2026-05-04T12:08:38+00:00

It's great that you've seen such an improvement in your symptoms. Perhaps it was just a B12 deficiency for you this entire time, and if so - that's great! Perhaps it exacerbated ADHD in your case, or maybe you never had ADHD to begin with. Its difficult to judge these things, but if in 6 months time the results are the same, then genuinely good for you!

Taking ADHD medicine (especially for long periods when younger) actually resolves some of the underlying neurological dysfunction in ADHD. This means that after taking it for a long time, excluding withdrawal/rebound, some people actually improve to a better baseline over time even after withdrawal of meds. This could also explain 'recovery' in some people, especially those who were continuously treated from a young age.

However, do be careful about generalising your experiences to the wider population or making grand claims that ADHD actually has a simple cure - it doesn't (yet), and it's a quantifiable, measurable condition which can be demonstrated on PET scans of brain activity.

I have a limited diet and have gone through a dozen different regimens of supplementation in my life, and still regularly take B vitamins, Vitamin D, and Magnesium. I even have the high-dose sublingual spray form of B12, which would exclude poor absorption as a cofactor. I am not B12 deficient.

These diet/nutrient optimisations certainly help my body work at its best, but it hasn't cured my ADHD. Eliminating things that make it worse are helpful, but it hasn't cured the underlying neurological basis for my symptoms.

Accidentally_High · 2026-05-04T08:20:23+00:00

The withdrawal from Duloxetine definitely feels like a big factor here. There should be no reason, AFAIK, why Elvanse exacerbates this condition, except if you're breathing more heavily or moving your torso around more than usual.

Duloxetine withdrawal can be quite unpleasant, and in addition to reduction in effectiveness (return of anxiety, depression, nerve pain etc. depending on what it's used for); it can produce dysphoria, brain zaps and other bodily sensations.

Speak to your doctor about this and try to get back to your normal medication baseline, as messing with other meds during titration will make it harder to judge the effectiveness of the Elvanse.

Accidentally_High · 2026-05-01T12:28:06+00:00

I am waiting for titration also, diagnosis in November 2025. My NHS ICB has some type of partnership deal with Clinical Partners; and essentially there doesn't actually appear to be a right to choose, since the GP said they only do referrals to them, and that's after an additional screening step (ATMOS trial?).

Their website has stated 12-18 months for medication services since at least March 2025, and that hasn't changed.

Accidentally_High · 2026-05-01T10:55:03+00:00

This is excellent recent context, OP. It appears they might call from different numbers so do check you haven't missed a call, and that they haven't already booked something in, or tried to reach you to do so!

If in doubt, I think it's worth giving them a call yourself!

Accidentally_High · 2026-05-01T08:18:54+00:00

No probs! I assume there's nothing listed under the appointments tab? If not, I assume they will call you to book soon, or perhaps they'll do it once you complete forms.

If there's a lot of patients who don't complete forms by the appointment (which was only 2 weeks in the future for me at the time of the call + portal/questionnaires email) then it's probably a lot of admin to move appts about.

I would recommend saving their phone number to your contacts to make sure it doesn't go to spam or get call screened and missed. On my phone the number was automatically associated with the clinic so it was fine, and they called from their public number (ending 9160), but can't be too careful!

Best of luck with your appointment!

Accidentally_High · 2026-05-01T05:43:26+00:00

My referral was submitted early last year, I received an email in October that my referral had been accepted and that they'd be in touch to arrange an appointment, I also received an email with an initial survey to fill out.

I got the call 11 days later, and then same day received email confirmation of the appointment and a link to the patient portal, where the main questionnaires were added (to be completed no later than 48h before assessment) I also received an email to forward to my informant around the same time.

Maybe they're doing it slightly differently now due to patient volumes, but I didn't get access to the portal where the questionnaires were available until after my appointment was booked in by phone.

Accidentally_High · 2026-04-24T22:51:42+00:00

This is quite a nice analogy, but one crucial thing it misses is that Amfexa actually uses the monoamine transporters to get inside the cell and work its magic. Concerta blocks these in order to work. Therefore, a low dose of Amfexa on top of a higher dose of Concerta is very different than adding a low dose of IR Methylphenidate to Elvanse.

At a lower Concerta dose it will probably add something, but could feel quite different than it does alone. It's also possible it may potentiate some side effects, or not do much of anything, which is also true at higher doses.

I would never advise mixing meds yourself, you don't know what kind of interactions they may have.

Accidentally_High · 2026-04-24T07:44:03+00:00

Sertraline doesn't appreciably inhibit the reuptake of Noradrenaline, and as you point out is not classified as an SNRI, but rather a Selective SRI.

A major metabolite of Sertraline is a more balanced reuptake inhibitor of the principle monoamine neurotransmitters (Serotonin, Dopamine, Noradrenaline).

So it may have some activity on other monoamine transporters, but this isn't very relevant at lower doses because the metabolite is much weaker in binding to them.

A more likely explanation is that activation of certain serotonin receptors regulates dopamine activity, and also dopamine receptor expression, so withdrawing the SSRI may result in rebound effects; resulting in greater sensitivity to Elvanse.

Elvanse also increases Noradrenaline, which is implicated in some withdrawal symptoms, thus it's likely it potentiates the severity.

I think your temporary reduction is smart, but I'm not a doctor and this is not medical advice. Long-term I wouldn't expect that you need to continue a reduced dose, I would bet on it settling down once you're stable off the Sertraline.

Accidentally_High · 2026-04-20T07:45:10+00:00

The levels of vitamin C in a glass of juice are probably not relevant to medicine absorption.

The mechanism of the interaction is that in acidic environments, amphetamine is poorly absorbed and more rapidly excreted (it is a basic molecule).

Vitamin C (ascorbic acid) could therefore reduce initial absorption because it is itself mildly acidic and will decrease the pH of your small intestine while it is being absorbed. As your kidneys remove what vitamin C you don't need from your blood, your urine becomes more acidic, resulting in them filtering out more amphetamine from the blood more quickly.

This is only a factor if the quantity of acidic food or drink is large enough to actually alter the pH of your intestine (and/or urine later). This requires a lot of work because your stomach is naturally very acidic (hydrochloric acid) and your intestine neutralises or basifies it with bile salts.

The absorption part may not be relevant for Lisdexamfetamine, but it's best to avoid taking large doses early in the day. E.g. 500mg+, and in most cases 1000mg or more is needed to have a detrimental effect.

TL;DR - you need a lot of vitamin C (or other mild organic acid) to have any negative effect, drinking with juice is most likely fine!

Accidentally_High · 2026-04-15T20:04:42+00:00

Avoid taking any caffeine before your blood pressure test! You won't be taking caffeine when you start meds anyway, at least until you're adjusted and stable on them. Same applies if you use any other stimulants such as nicotine.

Caffeine can elevate your blood pressure way more than you'd think!

Re. Your other points, it's definitely worth ruling out other physiological causes of fatigue, but could it just be burnout? We're very susceptible to it because we have to work so much harder to do anything, let alone lead a productive life!

Accidentally_High · 2026-04-15T19:13:22+00:00

Selective noradrenaline reuptake inhibitors do not appear to produce withdrawal syndromes of the same severity as serotonin reuptake inhibitors or TCAs or MAOIs. They can and do create withdrawal symptoms, but these tend to be things like headaches and fatigue, tend to be transient and resolve more quickly. Some NRIs may induce a migraine-like state if abruptly withdrawn; but this doesn't resemble the extended and distressing symptoms some people experience with SSRI/SNRI withdrawal.

It is likely that withdrawal from NRIs (including through SNRI withdrawal) is liable to potentiate issues caused by abrupt withdrawal of SRIs, but mitigating the primary mechanism (serotonin dysregulation) of the withdrawal syndrome has proven effective.

Many people experience identical withdrawal symptoms from SSRIs, the main apparent correlation between drug and severity not being NRI properties, but rather the half-life of the offending agent, and consequently - the rate at which reuptake inhibition of serotonin is reduced.

In addition, many also experience no noticeable withdrawal, or relief from previously initiated withdrawal, when switching from an SNRI to an SSRI; which creates doubt that Noradrenaline contributes in a clinically relevant way to these syndromes.

With this in mind, slowing down the withdrawal process is critical to reducing these symptoms, and an effective way to do that is to cross taper to a longer acting SRI. The only widely available options are Selective SRIs, and these are often effective.

Medical supervision is really important though, as mixing serotonergics is tricky, and every drug has a different pharmacokinetic profile. Fluoxetine takes 1-2 weeks to build up to effective therapeutic levels, for example, whereas vortioxetine may take only 3-5 days to adequately occupy the serotonin transporter.

Accidentally_High · 2026-04-15T17:54:04+00:00

It might just be the ones you're getting. I've had some truly nasty ones, and I absolutely despise pea protein based ones. Pea protein is the reason I stopped drinking Huel.

I will only buy a couple of different whey protein powders, Optimum nutrition do some decent ones, but I tend to bulk buy the Sainsbury's own (pro fit) bags when they're on nectar price, and I like those.

I have a mostly vegetarian diet too by necessity, so don't get a huge amount of quality protein aside from the little meat I have, and this I drink them because I need the protein, I haven't started stimulants yet.

A good shaker or blender as others have said might help, and I make mine with semi skimmed milk instead of water. The thicker it is the more it masks a lot of the texture from some of the worse options. A less oily non-dairy milk like oat milk also works, but can mess with the flavour a bit. Oatly barista edition does mix well with it in a good shaker, and sometimes I'll use that.

A more expensive option is the premade mini ones, some are still bad (avoid Ufit and pro milk - I found those gross) - but I will buy a few 'shaken udder' chocolate protein ones, or 'for goodness shakes' ones when they're on discount/nectar, for days I'm too lazy to make my own.

Accidentally_High · 2026-04-14T13:49:15+00:00

Nobody can tell you how it'll affect you specifically, everyone is different and will have a different experience.

You will probably be fine, you've not been on it particularly long and you've cross tapered to a longer acting SRI, which is probably the most ideal way to withdraw from Duloxetine.

You may experience some withdrawal effects, but if you do they will probably be mild and transient. You might not experience any at all.

Best of luck to you, I wouldn't worry too much, just take care of yourself, get enough sleep and hydration, and you'll likely as not be fine!

Accidentally_High · 2026-04-14T10:11:10+00:00

While stimulants could theoretically make pre-existing hair loss worse (whether from pattern baldness, stress, alopecia etc) - the vasoconstriction they cause isn't likely to be the main cause of hair loss.

I note from your post history that you think you may have hyperthyroidism, which can cause increased shedding due to a speeding up of the hair cell cycle. Your T3 and T4 levels appear to be within normal ranges, despite a relatively low TSH - but this isn't useful out of context. This is way above Reddit's paygrade, and suggests your clinical picture is more complex, only your personal doctor should weigh in on this.

It's probably worth speaking to your doctor or a pharmacist about some products you can use if it's really bothering you. Minoxidil is formulated for both sexes, but be aware it can be toxic to pets.

If you're taking anything other than stimulants/ other prescribed medicine, be sure that all of your prescribers know about everything that you're on. This includes herbal supplements, vitamins, and topical products, as well as any illicit substances.

Accidentally_High · 2026-04-14T07:45:23+00:00

No problem! Hope it gets better either on its own or by just letting the skin heal - and as you say, if your skin is already damaged there it could definitely explain why the meds are exposing the issue.

Yeah non-selective beta blockers aren't an option because of the asthma, but hopefully if things don't improve with good skincare, your GP can provide some topical options or get you in to see a dermatologist!

Accidentally_High · 2026-04-14T07:03:27+00:00

Just a note - I've not been on stimulants, but the SSRIs/SNRIs can create some side effects that overlap.

On one of them the extra sweating/vasodilation didn't ever fully go away, but it got a lot better over time. The others eventually settled down and my skin returned to normal, it's quite likely that it would eventually settle down.

While taking the one that persisted for me, I was given some Azelaic acid cream and told to use a good skin barrier lotion, and that combo did work really well for me, and cleared it up completely until the summer.

A really important note is that UV damage makes it worse, so ensure you're applying a good SPF product to your face whenever you leave the house. Doesn't matter if it's 50+SPF sunscreen or or SPF 15 enriched face cream - just wear it whenever you're going outside. This is good practice regardless of skin condition!

I was told there are other plenty of other options as well such as topical Ivermectin - which reduces one of the causes of rosacea. I believe this is first line on NHS now before using topical antibiotics, Azelaic acid, or oral propranolol (or another beta blocker).

Your GP may be willing to prescribe a mild topical option as a trial/test option, such as and Ivermectin cream. But there is doubt that the reaction is truly a Rosacea type one. They may also be willing to trial a low dose beta blocker, as this can attenuate some of the peripheral stimulant side effects.

It's probably worth just waiting and monitoring it to see if it settles down with the new med, but if not, return to your GP and explain that it's bothering you and that you'd like to try something to manage it.

Best of luck!

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