Stimulant meds just don’t work for some people, right?

Home Welcome to the ADDitude Forums For Adults Symptoms, Diagnosis & Beyond Stimulant meds just don’t work for some people, right?

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    • #204227

      Obviously nobody can give me actual medication advice, but it would help just to know others have been in a similar situation.

      The short(ish) version is, I do have a diagnosis but I haven’t had any luck to speak of with stimulants (Adderall, Concerta, or Vyvanse) and only mild changes with Strattera, so now I’m like…okay, what’s more likely:

      • that I actually have something else with a lot of overlapping symptoms (stuff like executive dysfunction, chronic lateness, procrastination, difficulty focusing, sensitivity to noise, brain feels like a damn pinball machine sometimes)
      • that I do have ADHD but I’m in the lucky 20% or whatever that aren’t helped by stimulants
      • or that I’m basically neurotypical (well, aside from the previously diagnosed depression and anxiety, because I have no doubts about those) and things aren’t actually harder for me than they are for everyone else but I want an excuse for my own laziness?

      I really don’t know, and I have no idea how to figure it out. I told my therapist a while ago that I needed a label in order to feel like it was okay to not hate myself for the ways I keep falling short of various expectations, and we’ve been working on that–I’ve been really trying not to hate myself in general, because I did that for years and it’s always been actively counterproductive, just making me miserable without making me any better at time management or anything else. But it’s still…I want a label I can believe in. I want to think there’s a reason, partly because it would be really nice if something could make it less hard for me to get things done, but also because I want to believe that it’s not just the way I am. I want it to be an issue with my brain chemicals, not just a character flaw, because that way maybe it doesn’t have to be all my fault.

      Part of the problem is that I sought out the diagnosis–I guess I did originally get diagnosed back in college when I had no concept of ADHD beyond the stereotype of the hyperactive little boy, and apparently then I <i>forgot</i> about that, but I kept coming across Tumblr posts about ADHD that resonated with me. So I did a decent amount of research and several self-tests, and eventually became pretty convinced that untreated ADHD was the actual root of my depression and anxiety because it all made a lot of sense. My therapist and the nurse practitioner who writes prescriptions both agreed I fit the criteria for ADHD, but then stimulant meds never gave me that “oh my god, is this what neurotypical people feel like all the time, they can just <i>do things</i> without feeling like they’re wading through mud??” moment that so many people talk about. Anything more than a small dose of Adderall just made me more unfocused, for instance (and caffeine doesn’t necessarily make me more alert, but it also doesn’t make me feel calmer). The prescriber then suggested maybe I didn’t have ADHD but didn’t really have other suggestions beyond “idk maybe anxiety” and I’m already treating that. So it’s easy to figure I might actually be faking it when I literally asked for the diagnosis, you know?

      Maybe I should be pursuing a different diagnosis. Maybe there’s something else I could be doing if it is ADHD but I don’t respond to stimulants. Maybe I should figure out whether what I really need is therapy or coaching, because I’m honestly not sure what I need or what I’m getting right now. For that matter I’ve been wondering if I should try to find a different therapist, because mine kind of goes “eventually it boils down to having self-discipline” and I’m like……..but how though. seriously how. I feel like I’m asking how to change a tire and you’re telling me that to change a tire I need to have a tire and change it.

    • #204394

      Several articles on this site refer to people – often women – who don’t respond to stimulants. I don’t respond to stimulant medications either; at least, if it’s working, it’s not doing much for me besides maybe a slight increase in focus. The doctor says I’m at a high dose. It’s not doing anything much for me.

      Can you keep taking the Strattera? What does Strattera seem to help with?

      You might want to get a true MD/Psychiatrist doctor who specializes in ADHD – at least until you know what works.

      Unfortunately, it takes more than medication to resolve the issues related to ADHD. I’m trying to line up an executive function coach so I know how to actually break up tasks and get work done. I want a coach who will let me meet with her on-call at least a few times in the beginning.

    • #204395

      I meant to say: it sounds as if you could use a different therapist. Why not try someone who has a different set of tools? It’s worth the experiment to try someone different.

      And it’s hard to tell if we have anxiety because of the ADHD, or if anxiety is the primary cause of the problems! IDK.

      The reason I’m getting an executive function coach is that most psychotherapists help with our self-esteem and relationship and communication and self-regulation etc., but they don’t seem to help with the practical tools and organization techniques.

      I’m right there with you. Let’s hope the “triple-threat” approach of dr, therapist, and coach actually works!

    • #204491


      My guess is that it’s option B, especially if you had a prior diagnosis.

      I once disregarded my teenage ADHD diagnosis as a fad from the 90s and I was just a neurotypical who sucked but at least knew it. Then last year came along and I discovered this website trying to understand my daughter’s language delay in terms of possible learning disabilities. (She’s not quite 2 1/2, so too young to be diagnosed, but I didn’t think it was just bilingualism because her listening fell behind too.) I worked with my therapist – ADHD and responds very well to stimulants but hates the side effects – to develop behavioral techniques in key areas, like having places for easily lost things, planning/scheduling rituals, lots of alarms, and stress toys for dysregulated emotions. After that was not enough and too hard to keep up, I went on Strattera and had that “this is what neurotypicals feel like” experience already with the starter dose.

      I don’t think that fast and amazing response to Strattera would have happened if I didn’t have behavioral techniques, therapy, daily exercise, or good sleep. So try adding these to the Strattera if you haven’t yet.

      Also look into other aspects of the chemical balance: hormones and food. Get your thyroid checked – thyroid issues can worsen ADHD symptoms or mimic them. If you get bad PMS/worse symptoms certain times of the month, try a good hormonal birth control to even you out. And research in kids suggests that omega-3s might help improve symptoms a bit, and artificial colors in food might worsen them a bit. None of these things seem to affect me personally, but to each their own body chemistry.

      Best of luck!

    • #204495

      By the way, the “this is what neurotypicals feel like” response to Strattera doesn’t extend to order and getting things done. I think those are complex issues that no brain chemistry change can magically fix. My house is still a mess and my to-do list is still long after over a month. The medication effect is mostly with regards to emotion regulation and voluntary shifts or maintenance of attention. But just having those two things easier to do makes a big difference in daily life with a 2 1/2 year old and increasing work responsibilities. And again, other things like sleep, exercise, hormones, food, and cognitive and behavioral stuff probably need to be working well too in order to get maximum medication effects even in these areas.

      Also, I quit Concerta and doubted my ADHD at age 24 because I did not sense it was doing much for me. Short-acting Ritalin definitely helped me think twice before speaking and voluntarily shift or maintain attention, but if I quit it I was grumpy and groggy, if I went back on it I was nervous and had palpitations (nervousness/full stomach is my only Strattera side effect), and it didn’t help that much to prevent expressing emotional overreactions. So I respond better to Strattera than stimulants, even though I read the opposite is more likely among us lucky ones.

    • #208031

      You might want to try and find a psychiatrist who works with ADHD and also practices functional medicine. I read recently that sometimes sleep apnea can look like ADHD, but then there are multiple problems that “mimic” adhd, including trauma. There is no simple answer to being a neurodiverse person, but please don’t think of it as a “character flaw.” After all, if the world was made up of 100% of people with a brain just like yours, then the behaviors you think of as “character flaws” might just be “normal!”

    • #208065

      Thanks for excellent information about how and what Strattera affects for you, @eyeonthesky.

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