Middle age male

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Hello,

I am posting to seek feedback to try new treatment for attention deficit (Diagnosed 20 years ago, but had it worst as a child), so far I have tried:
1. Ritalin (IR, also generic methylphenidate): 10 mg every 3h. Best drug treatment I ever had, this drug gave me the freedom to study, it showed what “free will” really meant. Unfortunately, it stop working (even at 20 mg dose 3 times day) after 5 years of use
2. Concerta: 36, 54, 72 mg: tried after Ritalin, minimal if any effect, crashed after 4h, small pick up for a couple of hours
3. Adderall: 5-10 mg 3 times a day: it definately helped some (lasted about 4.5h), stop because I tried 15mg (or 20 mg?) and had problems with paranoia and weight loss
4. Dextroamphetamine: 10 mg 3 times a day: helps a little better than than Adderall, effect lasted 3.5-4h.
5. Vyvanse: was worked up to 70 mg, works reasonably well, 2nd only to methylphenidate-IR
6. Intuniv: Dont remember the dose, no benefit – made me sleepy, also developed “frozen shoulder” 2 weeks after starting treatment, unclear if the intuniv cause it or not
7. Strattera: It worked at 60 mg, good drug for attention with minimal effect on emotions/behavior. However, I had to stop because I developed retrograde ejaculation and testicular pain.
8. Wellbutrim: This was the first treatment I received (22-23 years ago), it help some, but for some reason the psychiatrist took me off

The last 5 years have involved Vyvanse and generic Dextroamphetamine sulphate. Generally, the therapeutic effects of these are probably about 50% of what they were when I was on methylphenidate. I manage to do ok, mostly because I dont have to learn much NEW material, but build on my existing skills. Any suggestions to try a different agent? Also, are there others here who have been treated for decades and have experience a substantial loss of efficacy that takes place with aging?

[Penny Williams]

Since Ritalin was the best for you, and you’ve had a break from it, you may be able to go back on it with success.

There are two types of stimulants: amphetamine (Adderall, Vyvanse, Evekeo…) and methylphenidate (Ritalin, Concerta, Quillivant…). Almost everyone does well on one type or the other, but not both.Since a methylphenidate is the best you’ve used, it makes sense to stick to that type most likely.

A Patient’s Primer on the Stimulant Medications Used to Treat ADHD

Penny
ADDitude Community Moderator, Parenting ADHD Coach, Podcaster & Author, Mom to teen w/ ADHD, LDs, and autism

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