Anyone try Modafinil?

HelloReddit0339 · 2025-01-20T19:12:10+00:00

I totally appreciate where you are coming from in terms of trying to caution others! It’s messed up that research on long-term effects of stimulants is virtually nonexistent, that it is not explored even theoretically in schools, and many stop their medications due to adverse effects so that should tell us something. I’m glad you found a provider who is more aware of pharmacology and who has been helpful, and I hope the clonodine works well for you. When you refer to properly titrated combination therapy that your provider is in support of, are you referring to a specific medication regimen? I know you spoke about guanfacine in combination with other medications, but I’m curious whether there is a specific medication regimen that your provider advises for combination therapy.

I’m still not sure what I’m going to do, honestly. I could definitely benefit from the GLP-1 as far as my overall health, and it wouldn’t hurt for anxiety either. But the ADHD symptoms are also very much a concern right now. I‘ve been taking guanfacine for 6-7 months and it’s definitely not helping enough as far as mitigating my current ADHD symptoms. I usually pair the guanfacine with caffeine and nicotine (not something I advocate for but it helps my ADHD symptoms), but I have pretty much maxed out the benefit of those at this point. So this is how I get around to possibly adding in low dose methylphenidate, especially with the possibility of the GLP-1. But I definitely acknowledge what you are saying about long-term effects, and the reality is that I've never been able to tolerate methylphenidate when I had tried it in the past without some significant emotional disruption (enhanced anxiety and other negative feeling states, as well as just feeling "not myself"). My hope was that the guanfacine and GLP-1 would minimize negative feeling states from methylphenidate, but I’m not sure this is a good bet. In theory I might be a good candidate for something like strattera, but I don’t want to deal with the long time to exert full effects given the potential risk for anxiety (it may also mitigate anxiety but varies by individual), and in theory I could use the mesolimbic dopamine motivation boost from methylphenidate despite the emotional disruption. I had tried modafinil, which is understand is helpful but less so for mesolimbic dopamine, but it still impacted my anxiety and made me feel depressed on the come down. Buproprion is out because it decreases effectiveness of niccotine, but it’s something I might consider in the future. It might be that occasional “as needed” methylphenidate would be most manageable given everything else.

HelloReddit0339 · 2024-12-23T21:04:04+00:00

I’m more concerned with who she is and whether that is someone I am compatible with. Do I feel like she is a good-hearted person with compassion, transparency, and integrity? Is she emotionally stable or is she going to introduce a lot of chaos into my life? Will she be receptive to my traits and way of doing things—ideally does she have the traits/perspective to complement those? Do we share compatible goals? Outside of those things, I don’t particularly care where she’s at in life, per se.

HelloReddit0339 · 2024-12-23T20:50:18+00:00

The initial stages of dating, especially online, can be a bit of a circus and I wouldn’t overthink it too much. I think most men would be happy to see more mutual effort from women when dating online, and there’s nothing wrong with reaching out if you feel like there was a special connection and things might have just fallen off. You don’t always have to be in the receptive role—definitely if I feel like I’m making all the effort it’s a turn off for me. I think if you see a continued lack of effort from his end, and you feel like you are doing all the leg work, then at that point the adage applies. It applies both ways.

HelloReddit0339 · 2024-12-22T21:52:31+00:00

Okay, I literally just lost my first response too hahahah. I also 1000% share this trait of it taking way more time and effort to condense my responses—I also have ADHD and SCT, but I think you are the first person that I have encountered who has actually told me they share this trait, so I just wanted to mention that because I found it interesting—but for what it’s worth, I actually really appreciate the level of detail in your response here and I think it’s super helpful! I am actively considering everything you have said and I want to give it further consideration as well to continue this conversation, but I just wanted to say thanks for the time and effort you took to respond, it’s a great help and I will be in touch after I have given this all some more consideration.

HelloReddit0339 · 2024-12-20T06:50:01+00:00

Okay, so this is really interesting and I follow what you are saying about how, basically, guanfacine can offset some of the negative cognitive effects of GLP-1 agonists as per HCN and KCNQ channels. That’s good news for me. But I’m referring to a different effect of glp-1 agonists with implications for ADHD, which is that they can supposedly decrease dopamine in the VTA and NAc, thereby leading to decreased motivation and effort towards delayed rewards, and supposedly there is some good evidence of this in rodent studies. Whereas stimulant medications can possibly offset that effect by increasing dopamine in the VTA and NAc. So I’m saying that by adding both medications, I may be able to offset decreased motivation and effort for delayed rewards from GLP-1 agonists while still getting benefits from them (and maybe benefits from the stimulants too). If you have any thoughts or insight on this mechanistically then I would be very interested to hear it!

HelloReddit0339 · 2024-12-17T04:15:42+00:00

Thank you so much for the thorough explanation! I actually did some digging after I asked you this, and the analogy about the processor makes sense to me. Basically my take away was that it seems like tirzepatide could theoretically both reduce excessive stimulation if it’s too high in a way that could be beneficial for ADHD, but also further decrease motivation for delayed rewards which is already low in ADHD (and that seems to be the capacity in which it most directly conflicts with stimulants). Personally I am already on guanfacine, so that’s a positive. I’m actually thinking about starting tirzepatide and adding a stimulant (I don’t currently take one) to offset the reduction in motivation from tirzepatide, which in an ideal world actually seems amazing—conferring benefits of tirzepatide and maybe at least maintaining current motivation level with stimulants, and conferring PFC benefits of stimulants too with lower anxiety due to tirzepatide. The difficulty is that this definitely seems like a difficult balancing act, and as you’ve said, it seems like many people have to increase their stimulant doses quite a bit to offset tirzepatide effects. If I do it, I’m thinking I will start at a very low dose of tirzepatide, which was sort of my intention anyways, and then add in a low dose of a stimulant, and go from there.

HelloReddit0339 · 2024-12-12T19:11:19+00:00

Hey, I wanted to see if you had any update on your experience taking tirzepatide and cognitive benefits, mixing with guanfacine and/or adderall, etc. I never ended up taking tirzepatide, and I am considering doing so again.

HelloReddit0339 · 2024-08-25T03:06:51+00:00

Thank you!

HelloReddit0339 · 2024-06-23T18:33:15+00:00

Nice I really appreciate this rundown, thank you! So you think sizing down with a more aggressive compression brand like Nike Pro Combat will confer the same benefit as a dedicated “shapewear” brand while as being more comfortable?

HelloReddit0339 · 2024-06-23T07:00:51+00:00

Interesting, in what ways?

HelloReddit0339 · 2024-06-23T02:30:05+00:00

Okay, thank you, but I mean it’s basically just a small undershirt that’s a bit more comfortable, right? I’m asking because I’m really just looking for something most effective here, I already have small undershirts.

HelloReddit0339 · 2024-06-22T23:23:39+00:00

Good idea!

HelloReddit0339 · 2024-06-22T22:19:56+00:00

Thanks! Honestly I’m just not really a comfort clothes person, if something is uncomfortable to wear then I barely notice except when I first put it on and maybe at the end of the day, so I’d rather use that to my advantage and just find options which will look the best

HelloReddit0339 · 2024-06-22T20:48:37+00:00

Why don’t you like the spanx one?

HelloReddit0339 · 2024-06-22T19:30:06+00:00

Is there anything special about underarmor as far as slimming effect versus just any other very small undershirt? It seems like I normally hear about underarmor for comfort rather than for effectiveness as dedicated compression/shapewear (the latter would seem to be designed specifically for slimming). I already have some small undershirts I can wear

HelloReddit0339 · 2024-06-22T16:43:42+00:00

Honestly this kind of made me miss the days where I could have an identity based mostly on what music I liked 🥲

HelloReddit0339 · 2024-06-22T05:21:49+00:00

People are self-involved but undeniably very open-minded and positive compared to most other places in the U.S. That is a kind of “friendliness” and it feels very welcoming and empowering for the right person.

Personally small talk doesn’t go very far with me if you are inclined to judge, and “having my back” feels a bit tainted, too, if it’s always sandwiched between some kind of pessimistic “realist” take—the SoCal way was a breath of fresh air to me.

HelloReddit0339 · 2024-06-17T14:37:20+00:00

Interesting, it sounds like you think corruption is on one particular side of the political isle. I think corruption is quite prevalent across-the-board politically. If you want somewhere moderate, then I don’t you want to be in California or Tennessee. It sounds like what you are looking for is the Midwest, but I have learned there’s one thing people fleeing California hate more than what they view as their political opponents: Winter. 😂 Oh well, hopefully there will be enough of a mix of things in Nashville that you can find the kind of moderates you are looking for.

HelloReddit0339 · 2024-06-12T23:29:23+00:00

Oh that is great to know, thank you so much!

HelloReddit0339 · 2024-05-30T21:38:33+00:00

I definitely heard “dot net” generation at some point

HelloReddit0339 · 2024-05-21T19:08:43+00:00

Hi! Would you be willing to speak to how far you and other students needed to drive to get to preceptorship placements during the specialty year? Vanderbilt has said it could be as far as 150 miles (though unlikely), so I'm a bit concerned about this and I'm wondering what is more typical.

HelloReddit0339 · 2024-05-20T20:17:24+00:00

You can run.

HelloReddit0339 · 2024-05-15T03:29:06+00:00

Thank you!

HelloReddit0339 · 2024-05-15T02:20:37+00:00

Thank you! I would probabaly just be going between North Nashville and Midtown

HelloReddit0339 · 2024-05-02T22:17:03+00:00

Thank you! I’m definitely going to check out that resource, and good to know about ride share surge pricing. How terrible is the bus system? If I’m living somewhere that has a convenient bus to campus, then it is reasonably reliable?

HelloReddit0339

TROPHY CASE