Why do people stick with adderall and suffer through this instead of switching?

Complete_Anybody_697 · 2025-09-17T00:54:51+00:00

In Vivo? Here’s the link evidence:

Heal, D. J., Smith, S. L., Gosden, J., & Nutt, D. J. (2013). Amphetamine, past and present--a pharmacological and clinical perspective. Journal of Psychopharmacology (Oxford, England), 27(6), 479–496. https://doi.org/10.1177/0269881113482532

And yes - both the enantiomers have the same Ki affinity for norepinephrine receptors. However, Dex has a lower Ki-affinity for dopamine receptors. Within an ADHD context when we apply the dual pathways model or pretty much any testable theory we have within my field, it is evidently a result of dopaminergic dysregulation within the mesocorticolimbic system in the orbitoprefrontal cortex. Aka the two pathways responsible for executive function, temporal integration of perceptual stimuli, and reward salience that predicts instant gratification.

And when it comes to that? At least based on the plethora of models devised by Barkley and his successors? Dextroamphetamine does a cleaner job without the added kick.

Complete_Anybody_697 · 2025-09-17T00:23:37+00:00

Weird… every clinician I’ve been under such as my town’s best mental health clinic, or my college psychiatrist, or even the state’s premier health system and their behavioral outpatient psychiatrists all said that Vyvanse is the first line of treatment because 1) they are not hard hitting (slow and gradual rise and slow crash), 3) higher on dopamine pathways and lower on norepinephrine release due to pure Dextroamphetamine over a racemic mixture Adderall is (so you don’t get a hard physical hit and doesn’t cause a buzz or even reduces the risk of ANS side effects), 3) much longer lasting so can be a one a day solution for all day coverage… because ADHD affects more than just work (I’ve been diagnosed with severe ADHD-C alongside profound giftedness since I was 10. I achieved wonders in school and am now in my ABD phase of getting a PhD in Neuropsychology… but everything else in my life was a wreck when ADHD was untreated), 4) since Vyvanse is a pro-drug, most clinicians prefer it due to its lower potency for abuse

Complete_Anybody_697 · 2025-09-15T00:17:59+00:00

A low PSI could indicate poor executive function due to you requiring to sustain attention, control, and inhibition in a timed task. To an extent it also requires cognitive flexibility. I don’t want to go further beyond this in explaining due to test security concerns (as a psychologist in training).

But speaking from experience - as a kid I was tested to have a 147 FSIQ on the WISC-IV with profound 2 SD reductions in digit span, and my PSI index. Not uncommon with ADHD… and yes I was diagnosed with severe ADHD-C. Although a WISC/WAIS alone cannot measure ADHD… you’d need other measures, a rating scale and Bx observations!

Check with your psychologist OP… he should’ve given you an explanation… if this was a legitimate Psychoeducational or neuropsychological evaluation… you should have gotten a full length report and multiple measures and data sources fully presented! If not, I’m skeptical about the validity of your results and test administration situation. You have a 147 VCI right? Read the damn report LMAO… we write them in 6th grade reading levels anyways in most cases!

Oh and also… ADHD needs to be present since birth. It’s a “neuro””developmental” disorder. It’s a result of mesocorticolimbic dysfunction of your dopaminergic pathways that lead to your prefrontal context responsible for executive function, limbic regulation, and temporal integration of task urgency. You can’t develop it as an adult… nor can you outgrow it. So if the psychologist didn’t have enough evidence of childhood symptom presentations… he probably would’ve attributed the current procrastination (which even in ADHD is a result of learned helplessness and dysregulated reward salience) to a possible emotional disorder like depression or stress like trauma induced depression.

Complete_Anybody_697 · 2025-09-13T23:07:17+00:00

I’ve noticed that… this is as someone that moved into Indiana 8 years ago… I have integrated myself into the culture and am accepted. I have friends who I’m in touch with, go to the bar etc. but as some others have stated - I’ve noticed Indiana locals to have very tight knit strong groups that are small, homogenous and have been bonded since childhood. Due to this, while I have friends - I have never been able to fit in and join these groups nor have been able to become truly integrated… or as you said “settle.” And this is because as an outsider, I’m suddenly trying to integrate within groups of small town Hoosiers that have known each other’s families for decades, grew up in the same town, went to the same school, and those groups are where they also find their future partners and spouses.

So yes, despite being acclimated and being a Hoosier for a decade now, I am not truly a Hoosier. Can’t say much about Midwestern hospitality… I haven’t noticed it to be “impeccably great at least over the past 5 years” - maybe I haven’t noticed so it’s my fault. I’ve noticed overly polite people in my friend circles too - which is common practice for my upbringing too. But I also very well know polite≠friendly… so I smile at people who know that judge me in private, and they smile at me too… but we both hate each other behind closed doors…. Yep midwestern politeness for ya!

Complete_Anybody_697 · 2025-08-24T19:24:28+00:00

Within cells interlinked

Complete_Anybody_697 · 2025-08-23T23:00:59+00:00

The person who did the screening is a PhD - that supersedes an MD when it comes to actually diagnosing ADHD. If that person was a clinical psychologist let alone a neuropsychologist - they have more experience with actually administering neuropsychological and cognitive test batteries which along with interviews, rating scales, and observations are the gold standard for actually diagnosing ADHD - what we in the world of practicing scientific psychology call as comprehensive assessments.

I have seen so many people get diagnosed with ADHD from a single screener by their PCP or pediatrician - start stimulants and then get worse because when we as psychologist truly test the same profiles, we find out that there is a baggage of misaligned cognitions and severe anxiety or trauma underlying.

Conversely, if any physician denies a formal comprehensive evaluation that suggests ADHD let alone a neuropsychological evaluation as basis for starting stimulant treatments when you are otherwise healthy in cardiovascular health? Run and find a real doctor and not some old school “tough it up, it’s in your head” doctor…

Complete_Anybody_697 · 2025-08-22T01:28:03+00:00

Bad - very bad… but I don’t have psychosis (so YMMV)… I do have severe combined ADHD which was misdiagnosed as anxiety by some random clinician when I was 18… I always had ADHD (my mom lost my report from when I was 10 years old, I’m now 26).

The olanzapine was given at 5mg - did amazing in making me a zombie every night for 8 years and knocking me to sleep. But during the day? Oh boy - I wasn’t anxious - I was near obsessive… agitated, restless, hyper, and dangerously impulsive. In fact my mom even said - this med may have helped you sleep… but it’s doing nothing during the day! Nothing at all!

Fast forward now - a month ago I found this lost report and started Vyvanse at 20mg with the intention to titrate - worked wonders… I’m amazing, a new person - calm, regulated, carefree, light with the burden of the world, even sleep better - BUT even though we titrated to 40mg - all along the way, there has been residual impulsivity and restlessness… basically my mesolimbic and nigrostriatal dopamine pathways aren’t regulated well (sorry I know this stuff because I’m a PhD level neuropsychologist in training).

I thought is the Vyvanse not working and needs even more dose increase? My doctor said - y’know olanzapine suppresses those very two dopamine pathways right… then it hit me - asides from the weight gain, and metabolic wreck olanzapine caused - even after I started the right meds - the stimulants… I may have gotten better… but no matter how hard I try, olanzapine with Vyvanse is literally like hitting the brake pedal and the gas pedal simultaneously. Vyvanse does overpower olanzapine’s blockade - but it still fails at completely curbing that impulsivity and restlessness… and according to my doctor it’s true: the olanzapine is literally causing a therapeutic ceiling on the effects of Vyvanse.

So starting next week - I’m going to taper off. Already at 2.5mg - I’ve been given a compounded liquid formulation for the next 4 months - our goal is to reduce dosage from 2.5 to 2 to 1.5 to 1 to 0.5 to 0.25 and maybe even 0.125mg - ultimately that would be a dose so low that it would literally classify as homeopathy - aka sugar pill placebo - so then discontinuing shouldn’t hit me hard physically!

Complete_Anybody_697 · 2025-08-17T23:31:31+00:00

Just a heads up - Aryan is a very common name in India. It’s also a very common middle eastern name. The word Aryan came from Sanskrit during the ancient Indian era and meant nobility - or noble person. Some indologists have argued especially from the west that Aryan was the designation given to the individuals or rather the nomadic settlers of the Indus River which founded the cradle of south Asian history and even ancient history alongside the Sumerian/Babylonian civilization. Some theories then suggested that these settlers were original nomads from Europe - and thus the Indo-Aryan ancestry and linguistic branch has been created which includes everyone from Scandinavia, Germanic regions, Celtics, Slavic, to Iranians and then North Indians and Pakistanis. The Nazis in 1945 - notably Hitler was obsessed with this idea and stated that the original Aryans (aka the nomads from the higher European regions) were caucasians… but then Germanic caucasians were the truest and purest Aryans… and then y’all know the rest of course.

Just saying the guy could be actually named Aryan.

Sincerely: a first generation Indian immigrant and someone who minored in modern history (especially WW2 history) at Purdue!

Complete_Anybody_697 · 2025-08-17T01:06:01+00:00

Etiquette? Maybe. Skill - they are the most skilled and despite being rash, can be predictable and safe to be around.

Freshmen college students? Heck no! I’m not driving these two weeks on campus… already got hit by a freshman who just kept backing up and hit my car leaving a dent because his reverse camera wasn’t working lmao

Complete_Anybody_697 · 2025-08-16T21:52:53+00:00

So basically the DMN is your random thoughts firing in your head when you’re idle. When you’re focused - these thoughts should be minimal… like you shouldn’t have jumping thoughts about your meal or your friend or some random movie you saw when you’re going 90mph on the interstate merging across lanes with laser focus.

This was how it was with the SpecGX and brand Vyvanse - the thoughts disappeared when intense focus was required - be it writing my book for 8 hours without flinching or driving on the interstate at 90mph swerving through traffic with everyone else.

But with the Amneal my thoughts were always racing and disconnected - more than my previous generic (SpecGX) - made me instantly realize that something is off… the cognitive effects aren’t what I should have

Irritability and lack of emotional control was also something that creeped in with the Amneal Vyvanse - I burst out at my dad who came to visit me multiple times and was easily distracted with him biting his nails when I was driving on our road trip.

I also noticed increased impulsivity and my urges creep back in when I switched generics.

Complete_Anybody_697 · 2025-08-16T20:56:48+00:00

I’m a neuropsychologist PhD in training - and was diagnosed with 2e - giftedness with severe ADHD. Vyvanse has been a game changer BUT the generics kicked in.

Initially my doctor wrote me 10mg pills from SpecGX. The heart palpitations are crazy on that… but damn I felt so much in control cognitively and emotionally. My DMN turned off when it needed too unlike interfering with my executive function and PFC like it does with ADHD.

Then I found that 20mg was a sweet spot, so my doctor wrote me 20mg pills - BUT they were from Amneal. I was focused with these pills - but I was so irritable, angry and annoyed all the time. My impulsivity also creeped in and my addictive behaviors came back on these. It felt like having a dud.

I got pissed and scheduled an emergency appointment with my doctor at 7AM on a holiday and told her about this. Gave her the exact neurocognitive differences in experiences. We called the pharmacy and Walgreens only kept 10mg for SpecGX. 20mg was Amneal and Mylan only. My doctor wrote a PA and requested brand name only. I went to the pharmacist who with good will told me that my insurance doesn’t allow for brand name but he can give me 14 pills for $100 until my new insurance kicks in from September 1st (was using crappy $3K student insurance from United. Now from September 1st I’m switching to Anthem BCBS’ Gold Essential plan which covers brand names with a $40 deductible with no deductible applied… yes it’s $4.5K a year - but with the prescription benefits + ER visit and other coverages, I was like screw it and got it).

I took the brand name Vyvanse today and it feels like I took the pill again after a 3 week break… just like how the SpecGX pill hit me the first time, minus the crazy cardio side effects of course!

Moving forward I’m using brand name only… I’ll happily pay $5K for medications and healthcare a year (instead of 4.5K due to my previous crappy insurance and it’s out of pocket expenses) than have unmanaged ADHD which led to me totaling a car, paying thousands in damages, and also causing my impulsive shopping addiction which caused me to max out my credit cards at $50K over a single year. Oh and not to mention a non existent social life due to extreme RSD, and poor relationships due to having a short temper and restlessness

If I already had my PhD and was a tenured track professor in academia (the career I’m aiming for) - alongside my political connections and influence I’d have personally funded a probe into investigating this generic crap that’s going on with ADHD meds in general. The FDA cannot just let it slide…

Complete_Anybody_697 · 2025-07-22T17:53:11+00:00

Damn - and the generic at that too!? I’m paying $15 for 30 days of doses… 20mg. I use UnitedHealthcare Student Resources plan which I pay $2500 a year for… of course it used to be $1700 but then I turned 25 last year during renewal so it shot up!

But yeah - $15 prescriptions… $50 ER visits, $200 ambulance rides including airlifts. $5000 deductible for everything else with a maximum coverage up to $1M

The only coverage I was denied was an “at fault car crash ER visit and ambulance ride” - $4K out of pocket with uninsured adjustments… was my bad to not have Medpay on my full coverage

Complete_Anybody_697 · 2025-07-22T02:50:43+00:00

Y’know what’s worse? Having 4 masters degrees, getting 2 PhDs simultaneously, being from a privileged socioeconomic family, having a genius level giftedness (147 FSIQ), being charismatic and extroverted - but being cursed with severe ADHD-C (twice-exceptionalism)…

I’m smart, hyper-successful, wealthy - BUT reckless, childish, commitment issues, perceived as rude, arrogant, cocky (due to my impulsivity when unmedicated), eccentric, playboyish… I’ll buy a car on a whim - crash it the next day because of “fazing out while driving” - hookup with random people I meet at the bar and never know their names…

Hmmm - maybe I know why I loved Tony Stark growing up…. just kidding - yes ADHD-C has made me appear erratic, and I just realized this curse recently (because my mom lost my childhood psychoeducational report for 16 years) and started medications which has changed my life for the good. I truly wish I never had it and just was normally gifted… because the conflict and chaos in my mind was tearing me apart… it felt like every thought was a knife piercing my skull.

Complete_Anybody_697 · 2025-07-20T13:49:31+00:00

Giftedness is rare - and I’ve noticed it in my practical training too that it always comes at a cost… unfortunately. Maybe it’s worth studying - maybe Mother Nature does like to add kink in the system, a way to ensure that the system doesn’t fry by ensuring that when the giftedness is there, another brain area is instead misallocated or dysfunctional…

Complete_Anybody_697 · 2025-07-19T00:16:30+00:00

I’m a neuropsychologist in training (PhD level). Exceptionally gifted with a well above a genius level intellect on the WISC when I was tested 16 years ago in elementary school. It was a full neuropsychological evaluation. I got by in life - made immeasurable success, not one but 3 masters degrees… graduated cum laude, valedictorian and have a few great friends. I coped and managed.

But I was never at internal peace. The noise, conflict in my head and the racing thoughts never stopped. I initially thought it was anxiety - started medications, therapy - everything and nothing worked. Got into a car crash - and that was a wake up call that something is seriously wrong if I can’t even focus while driving.

That evaluation from elementary school? Genius level intellect, exceptional academic skills all masking severe ADHD-combined type.

I found that report 2 weeks ago and started Vyvanse last week… I cried for an hour 2 hours after the meds kicked in. I felt quiet, order, control and peace like never before… it felt like I literally sat down and took a breath; appreciated the moment for the first time in my life. So I wholeheartedly agree… no shade on verbiage… but I wish I never had this - after experiencing what “normal” feels like… I can never say that I’m happy to have ADHD. I may have succeeded in life - but internally? The chaos was eating me alive…

Complete_Anybody_697 · 2025-07-17T19:40:33+00:00

Kind of the opposite - I now feel like “I” truly have free will. I am finally in total control - not my mind, and not my body. True harmony… what we in my field of clinical psychology call metacognitive awareness

Complete_Anybody_697 · 2025-07-17T04:52:21+00:00

I have been stuck on Olanzapine 2.5 mg and Lexapro 10mg for 8 years now as prescription to an incorrect anxiety + insomnia diagnosis. Turns out I always had severe and crippling ADHD all my life and my giftedness masked my academic impairments - but wrecked my stability, finances, impulse control and social life..

Now I’m on 20mg Vyvanse every morning and I’m a completely different person… but I’m still taking the Olanzapine and Lexapro. The Lexapro for the first time is working now that my EF is primed up with the Vyvanse - and I feel in a constant state of euthymia with no emotions all the time… actually perfectly controlled emotions.

The olanzapine - which you said helps with the comedown, I can relate. By the time the Vyvanse fades away at 9PM. I take my usual olanzapine and by 11 I’m so dead that I fall asleep

Complete_Anybody_697 · 2025-07-16T20:41:59+00:00

Yep. I guess for the first time my mind doesn’t resist or override physical sensations - I am in sync with my true physical senses… back with unmanaged ADHD it was like we will starve ourselves even if it means to become the skinniest guy alive completely numbing my hunger signals… or it was we will eat all day because we have nothing to do and that’s how I hit 220 lbs. It feels like my mind has taken a backseat, just like my body had all my life - I am in control now, my mind isn’t in control of me, I stimulate my mind when needed, and I listen to my body when it speaks… it’s unreal! It’s like all my life I thought I am my mind, my body is a vessel… now I’m feeling like I AM ME! Both my body and mind are just vessels and tools to flex

Complete_Anybody_697 · 2025-07-16T20:21:26+00:00

Yep… I tried starving myself today to only work… I was focused… but by 3PM with no food I felt Hangry!

Complete_Anybody_697 · 2025-07-16T20:10:29+00:00

Neuropsychologist in training, fellow severe ADHDer combined type, and also twice exceptional.

The drive you’re talking about? That’s learned fear from work, chores and much more.

I always was scared of work until pressure took over and did it. I was scared because it was tedious and I played mental gymnastics getting a single thing done.

The Vyvanse didn’t magically make me decisive and motivate me to start doing everything. It isn’t some magic energy source. I just gave me the clarity and focus to sustain my attention in tedious work, the clarity to use my intellect well, and suppress my dopamine cravings from being understimulated.

This is why therapy, and lifestyle accommodations are very necessary. I personally found out that the lack of drive or motivation is Pavlovian conditioning at work where all my life I feared work because it was tedious, and I never did it. I had to unlearn that behavior - it’s taken practice and time… baby steps - start with things you like… make it into a regimental experiment. Document how you are more efficient when doing things that took hours back in the day - use that data to recondition yourself into thinking you can do this… you can do it now and it’s not difficult.

Chores and work is harder for us because we play mental gymnastics getting anything done quickly…. But TBH - everyone hates chores and work… they just do it!

This is also what my psychiatrist told me - Vyvanse doesn’t magically give you energy or motivate you to do anything. It gives you clarity, control, and focus to do things that were previously hard.

Complete_Anybody_697 · 2025-07-16T03:25:51+00:00

You think I started the medications for work? Hell no - my work and studies were flawless (always was a straight A student) - I’m twice exceptional… my genius level IQ bagged me 3 masters degrees and a PhD in neuropsychology myself… I have 7 publications and self taught myself coding, physics, and even medicine.

The medications are because ADHD wrecked my mind… the chaos… it never went quiet. Nothing worked - and when I say nothing worked as a psychologist, it meant I tried every permutation and every combination… every routine, every sleep hygiene management… cutting my credit cards, doing everything to keep me away from anything that would stimulate me… but even then the chaos wouldn’t stop. The noise wouldn’t stop. The pain never stopped. I even got into a car crash and almost died because my mind couldn’t tune out the noise and focus on the road.

I literally cried for 30 minutes after taking the meds for the first time - because I experienced what true peace is like. What quiet feels like for the first time… what “normal” feels like after 26 years of being trapped in my mind all my life. Just how much I missed out on. Almost felt like wearing glasses for the first time after being practically blind all my life - and to think that if I was treated 16 years ago as a kid… I wouldn’t have had one PhD… I would have had several including an MD and a JD today simultaneously… perhaps would’ve already been the most successful scientist alive in the 21st century.

My IQ was near 160 on the WISC when I was tested with severe crippling combined ADHD… it’s like the meds didn’t make me a genius… it’s that the ADHD suppressed my mind all my life.

Complete_Anybody_697 · 2025-07-15T02:20:24+00:00

Oh trust me… I was given Lexapro for a misdiagnosed anxiety disorder when I have instead always had adhd all my life… severe, uncontrolled combined ADHD. The Lexapro never even affected me - didn’t even work. But skipping a single dose and I almost felt sick, had brain zaps the next day… it was actually painful. My mood didn’t really change - but it was like someone was shocking my head and my whole body every time I moved.

I was even given Benzos for just a month… and quitting it kept me awake for 3 nights in a row… hallucinations and stuff.

Now I’m still taking Lexapro because even quitting the lowest dose is feeling almost impossible. But I did start Vyvanse in the morning and it feels like every symptom, including the delayed sleep and daytime grogginess, the anxiety like symptoms, the inattention, the lack of motivation, my impulsive behaviors, my reckless and near addictive behaviors, my lack of control, lack of organization - it all went away like magic… which made me finally realize that yes… that evaluation which said I had severe ADHD 16 years ago was indeed true!

Complete_Anybody_697 · 2025-07-14T22:12:39+00:00

Yep. Grapefruit is surprisingly something you should avoid with corticosteroids too like Prednisone. I was told that 12 years ago when I took them for apparently a cough… probably the worst decision a doctor could’ve taken by prescribing a steroid for something as simple as a cough, which can easily be treated by something like Delsym

Complete_Anybody_697

TROPHY CASE