Why does Adderal work so well for a while then start losing it's effectiveness? I am having the same issue. I can't take Ritalin because the come-down from that stuff leaves me sobbing in the middle of the floor. I can't take Strattera because not only does it prevent me from sleeping, it turns me into a horribly mean person. I took Focalin once, but it wasn't very effective. I tried Concerta, but since Concerta is just extended release Ritalin, it had the same effect on me.

I am also on Prozac for Obsessive Compulsive Personality Disorder and Nexium...plus a bunch of antihistamines for allergies. What other kinds of medications can I take with all the other prescriptions I have taken? I also would like to stay away from medications that have a tranquilizing effect on my libido... :o

Oh man, I'm sorry to hear about your medication troubles. I work with a number of individuals with ADD and ADHD and have seen firsthand how devastating a wrong medication or dosage can be on a person. Let's start at the beginning, have you been diagnosed with a particular subtype of ADD?

Secondly (this is a more personal question, you by any means do NOT have to answer it if you don't want), but have you been tested for having Tourette's? The reason I bring that up is that ADD and OCD are often at opposite ends of the spectrum, but Tourette's can exist with either one. In a sense, it acts as a "bridge" between OCD and ADD.

From what you've mentioned so far, I would have to say that stimulant medications may be the completely wrong class of meds for you and may be counteracting some of your anti-depressant drugs.

Why does Adderal work so well for a while then start losing it's effectiveness? I am having the same issue. I can't take Ritalin because the come-down from that stuff leaves me sobbing in the middle of the floor. I can't take Strattera because not only does it prevent me from sleeping, it turns me into a horribly mean person. I took Focalin once, but it wasn't very effective. I tried Concerta, but since Concerta is just extended release Ritalin, it had the same effect on me.

I am also on Prozac for Obsessive Compulsive Personality Disorder and Nexium...plus a bunch of antihistamines for allergies. What other kinds of medications can I take with all the other prescriptions I have taken? I also would like to stay away from medications that have a tranquilizing effect on my libido... :o

I guess you could call it Adult ADD without physical hyperactivity. I am not sure if it classifies as a subtype of ADD nor did I know that there WERE subtypes of ADD. You learn something new every day.

I have never been tested for Tourette's, but I don't have OCD...I have OCPD - Obsessive Compulsive Personality disorder...I think. Well, that's what my doc thinks, anyway. I only match like five of the symptoms of OCPD, because I am in no way miserly with my money and I definitely do not forsake entertaining activities to work. If anything, I am an extreme opposite of those two. Also, I am not inflexible when it comes to ethics, values and morals...mostly because I am have a difficult time remaining consistent.

I am definitely a perfectionist to the extreme. I am obsessed with organization and (oddly) stationary (notebooks, pens, office supplies, organizers), though I can never manage to organize myself. I HATE throwing anything away because, in my experience, a lot of things I threw away I have ended up needing at a later date. I am EXTREMELY stubborn but not rigid (I think). I will delegate tasks, but it annoys me if the task isn't done perfectly...and I end up redoing after the person has gone.

Now, here is what doesn't fit into the diagnosis: I become addicted and obsessed with entertainment. I get addicted to television shows that I record on my DVR and watch over and over or I have books that I want to read over and over. These obsessions/addictions are ALL CONSUMING. If I don't give in to the desire to rewatch/reread these shows/books/movies, I will feel horrible depression that leaves me sobbing on the floor.

I am also a super control freak. Being out of control scares the crap out of me. I never sit in the passenger seat of the car, I always have the remote, and I always push the shopping cart. Alcohol and drugs terrify me because you lose control.

Is this OCPD? Is there something else in there along with OCPD? I wish I could figure it out so I can treat it. There are no ADD specialist in the state where I live, and the support group takes place once a month in a city 35 miles away. I am on Adderal right now, 60mg a day. It is working, but I fear that 6 months later, it will lose effectiveness again.

Sorry about misreading OCPD for OCD. There are a number of similarities as far as underlying causes go for those 2 disorders, but the symptoms can be quite different. Based on your description, you definitely seem to be more of the "OCPD" type.

I see you've tried several ADD medications with little avail. However, I did not see Dexedrine (Dexamphetamine) on the list. There have been reported cases that I know of where Ritalin (methylphenidate) failed, but Dexedrine worked very well. This was in cases of OCD (not OCPD, mind you), but again, the underlying mechanisms of the two disorders are relatively similar. It may be worth a shot...

Additionally, Dexedrine is a more chemically "pure" substance than Ritalin and definitely more "pure" than Adderall (which is a mixture of four different amphetamines). Not only is this purity often more effective, but it also means fewer possible interfering drug interactions, especially if we are throwing antidepressants and allergy medications into the mix. You might want to check with your doctor about maybe trying Dexedrine in place of Adderall or other stimulants. Just make sure that the antidepressants you are taken aren't MAOI's (Monoamine Oxidase Inhibitors), but it sounds like the ones you are taking are not. These can negatively interfere with Dexedrine and some other stimulants' mode of action.

As far as the other drugs you're taking, I wanted to point out that medications that control stomach acid such as Nexium can actually alter the absorption of stimulants such as Ritalin and make them less effective. If you often take Nexium this may be an underlying cause for the stimulant medications ineffectiveness. If you can handle it, I might recommend staying away from any type of antacid while taking stimulants. I know that some antihistamines can interfere with this as well, but I'd look at the Nexium first.

Finally, antihistamines (I'm not sure which type you're taking) can sometimes amplify the drowsiness when taken together with drugs such as Prozac. Probably not a life and death issue, unless it involves driving. Be careful with this one!

Good luck. Keep me posted!

Alright, just to clear up this ignorance, because its gnawing at me.

Dexedrine is not more "pure" than Ritalin, its not more "pure" than Adderall. To begin, Dexedrine is completely different than methylphenidate (Ritalin), and its different than dextro-methylphenidate (focalin). Methylphenidate acts more peripherally, though for persons where ADHD is caused by the reverse action of the protein that regulates dopamine flow in the synapses, it corrects this, similarly to amphetamine (but has counter-effect when combined with amphetamine). Now, furthermore, Adderall is a combination, and is produced as such because levo-amphetamine has a longer half life, though it acts more peripherally. Dexedrine is simply a single formulation without the inclusion of that left isomer, instead it is entirely the right isomer, which acts primarily on dopamine. The reason it works better for some is because the symptoms of ADD / ADHD come from a dopamine deficiency, or understimulation without a peripheral component. For those with that peripheral component, where the PNS is understimulated as well, Adderall becomes more effective because it can also target that understimulation. Just as those with ADHD caused by more of a PNS understimulation without as much relevance to CNS understimulation, methylphenidate becomes more effective for them.

Just had to clear that up.

If your going to discuss the drugs, you might as well know how they are different, and more than them just having different brand names and working with varying levels of efficacy for people. Sorry if it sounded a little bit blunt, but ignorance is my pet-peeve.

If your going to discuss the drugs, you might as well know how they are different, and more than them just having different brand names and working with varying levels of efficacy for people. Sorry if it sounded a little bit blunt, but ignorance is my pet-peeve.

Then you must get ****ed off a lot because we are all ignorant in some way shape or form.

"Facts" can easily be twisted by perspective. It is common to find studies that will contradict one another. There is no easy answer when we are talking about the toxic stuff we are putting in our system to help with our various conditions.

maybe it boils down to "sometimes you feel like a nut, sometimes you don't"
.....everyday can't be the same.

I find adderrall burns my B vitimns down, and if I take B complex everyday it's better.
....but I'm not a machine...just human.
I know I won't feel the same every day.

I'm a Philosophy major, so I believe everything we think we know is a best guess. And to be honest, I'm not trying to sound like a dick when I correct people, but at times, it can be frustrating. I'm for giving people the best information possible, and if it requires me researching and finding sources to support my claims, I'm more than willing because it means it will be that more helpful for the person asking the questions, and helpful to myself, because I may be learning something new.

Regardless, we're getting off-topic here.

Edit: On a side note, Socrates responded to claims that he was the wisest man in Athens by saying that those who think they know something are the least wise of all, because in reality we all know nothing, and those who know they know nothing are the wisest of all. Just thought it was semi-relevant.

what are you trying to say there, dark code?
....don't like the almond joy theory? hahaha!


it's the corner stone of all philosophy!

Regardless, we're getting off-topic here.

Edit: On a side note, Socrates responded to claims that he was the wisest man in Athens by saying that those who think they know something are the least wise of all, because in reality we all know nothing, and those who know they know nothing are the wisest of all. Just thought it was semi-relevant.

I agree. I sent you a PM to discuss this a bit.

Diphenhydramine (Benedryl) antagonizes Adderall - It will reduce its effiency SIGNIFICANTLY [not sure if that's one of the antihistamines you're taking]. I have yet to see any evidence saying other antihistamines do the same; however, after taking allegra, zyrtec, and lortadine (Clartin) i've found that it seemed to reduce the effects also (but that's me personally can't say its proven).

No offense, taken, DarkCode. When I mentioned "chemically pure", I was referring to enantiomeric purity of the drug. I should have been more specific though, thanks for clarifying for everyone in your post.
Also, thanks for providing the additional insight surrounding the specific targets of the different stimulants.

Two quick question about the modes of action of these drugs that came to mind from your post:

1.) Since Vyvanse is the chemical "prodrug" to Dexedrine (i.e. Dexedrine coupled to the amino acid lysine for delivery purposes), is there a functional difference between the two drugs, or is the structural difference merely for delivery purposes?

2.) Do methylphenidate and amphetamines counteract each others' effectiveness because they compete for a shared receptor or enzyme, or do they each have different molecular targets which, once activated, result in chemical signals that offset one another (or is it something entirely different altogether)?

Sorry if this takes the thread off on a boring tangent, but I'd love to learn more about these things if anyone has any insight on the matter....


Alright, just to clear up this ignorance, because its gnawing at me.

Dexedrine is not more "pure" than Ritalin, its not more "pure" than Adderall. To begin, Dexedrine is completely different than methylphenidate (Ritalin), and its different than dextro-methylphenidate (focalin). Methylphenidate acts more peripherally, though for persons where ADHD is caused by the reverse action of the protein that regulates dopamine flow in the synapses, it corrects this, similarly to amphetamine (but has counter-effect when combined with amphetamine). Now, furthermore, Adderall is a combination, and is produced as such because levo-amphetamine has a longer half life, though it acts more peripherally. Dexedrine is simply a single formulation without the inclusion of that left isomer, instead it is entirely the right isomer, which acts primarily on dopamine. The reason it works better for some is because the symptoms of ADD / ADHD come from a dopamine deficiency, or understimulation without a peripheral component. For those with that peripheral component, where the PNS is understimulated as well, Adderall becomes more effective because it can also target that understimulation. Just as those with ADHD caused by more of a PNS understimulation without as much relevance to CNS understimulation, methylphenidate becomes more effective for them.

Just had to clear that up.

If your going to discuss the drugs, you might as well know how they are different, and more than them just having different brand names and working with varying levels of efficacy for people. Sorry if it sounded a little bit blunt, but ignorance is my pet-peeve.

That's kind ofa bummer, since ADD/ADHD and allergies are relatively frequent comorbids and all. I guess you can't have everything in life at once.

Diphenhydramine (Benedryl) antagonizes Adderall - It will reduce its effiency SIGNIFICANTLY [not sure if that's one of the antihistamines you're taking]. I have yet to see any evidence saying other antihistamines do the same; however, after taking allegra, zyrtec, and lortadine (Clartin) i've found that it seemed to reduce the effects also (but that's me personally can't say its proven).

Vyvanse and Dexedrine are pretty much the same but people will more than likely notice vague differences between them why? nothing works exactally the same - there's too many variables at play for everything to work perfect 100% of the time. Vyvanse starts off as Lisdexamphetamine - (just a fancy name for Lysine bonded to the (+)-Dextroamphetamine Enantiomer and once metabolized forms Dextroamphetamine + Lysine (but seperated) from there it breaks down similiar (if not the same) as dexedrine would.

ignorance is my pet-peeve.


that's unfortunate.
....you can't ask people not to be ignorant.
all you can do is teach them.

Also, whatever you hate about others, is also true about yourself, just as whatever you love about others is also true about you.

...but, I'm sure you knew that already.

also, a word of caution: sometimes, I'm pretty ignorant myself.

.........like daily.

I forgive myself for learning the lesson tho.

....do you?

ignorance is my pet-peeve.


that's unfortunate.
....you can't ask people not to be ignorant.
all you can do is teach them.

Also, whatever you hate about others, is also true about yourself, just as whatever you love about others is also true about you.

...but, I'm sure you knew that already.

also, a word of caution: sometimes, I'm pretty ignorant myself.

.........like daily.

I forgive myself for learning the lesson tho.

....do you?

You have a Batgirl avatar and thus will always be forgiven. ;)

Someone above mentioned allergies. I have begun to find it funny that doctors, etc. still look at BP, ADHD, etc. as simply a mind disorder as opposed to a whole body one. I think once the pharmaceutical companies collapse like Wall St. does and we are forced to start over..a new breed of neurologists, researches, etc. will begin to push the whole body idea more.

I don't see pharmaceutical companies collapsing any time soon lol. People will always need their pillz, tis why I chose to major in the field =P

No offense, taken, DarkCode. When I mentioned "chemically pure", I was referring to enantiomeric purity of the drug. I should have been more specific though, thanks for clarifying for everyone in your post.
Also, thanks for providing the additional insight surrounding the specific targets of the different stimulants.

Two quick question about the modes of action of these drugs that came to mind from your post:

1.) Since Vyvanse is the chemical "prodrug" to Dexedrine (i.e. Dexedrine coupled to the amino acid lysine for delivery purposes), is there a functional difference between the two drugs, or is the structural difference merely for delivery purposes?

2.) Do methylphenidate and amphetamines counteract each others' effectiveness because they compete for a shared receptor or enzyme, or do they each have different molecular targets which, once activated, result in chemical signals that offset one another (or is it something entirely different altogether)?

Sorry if this takes the thread off on a boring tangent, but I'd love to learn more about these things if anyone has any insight on the matter....

In reply to #1, the fact that it is a pro-drug only affects the delivery mechanism of the drug into the blood stream. Instead of dextro-amphetamine being absorbed through the stomach lining and upper-digestive tract, the lysine is broken from the dextro-amphetamine molecule in the liver and then absorbed into the blood stream before reaching the blood plasma barrier and crossing it. The problem with this is that it increases the molecular weight of the drug which means that your going to have to take a higher percieved mg dose to achieve the same effects which means issues with insurance. However, some people have talked about the drug lasting longer. I'm not sure as I've not looked into it too much, but it could be that because the drug avoids that first pass through the liver in part, where part of the drug absorbed into the blood stream directly reaches the liver and is metabolized before it even reaches the brain. You could also see it as lasting longer because the process to remove the lysine from the molecule requires more time, and activity of enzymes in the liver which can make higher doses have a percieved delayed onset because of this.

2) What I was getting at with this was the study that came out not too long ago about a dopamine transporter protein in the brain and a possible genetic defect in people with ADD / ADHD. The protein transporter will run in reverse making it behave as if there was something such as amphetamine already present. Because the transporter is acting in reverse it pushes dopamine out into the synapse (space between neurons) which is what happens to normal people when taking amphetamine (dopamine is pushed into the synapse where it is rapidly absorbed causing the drug's euphoric and stimulating effects, in part, on dopamine-2 receptors). The study talked about how the dopamine being pushed out would happen at an exaggerated rate causing a clouding of the dopamine signaling system (dopamine, like other neurotransmitters is released naturally to help regulate systems in the body, the protein defect causes the system to run on overdrive in a sense). Here's the quote from the article (I'll post the link) which talks about the role of amphetamine / methylphenidate in this all:

To their surprise, the investigators also found that amphetamine blocks the leak of dopamine through variant transporter. Normally, amphetamine does just what the mutation does — it causes the dopamine transporter to run in the reverse direction.

The findings offer a new perspective on a conundrum in the ADHD field — the fact that two of the medications that successfully treat the disease have opposing effects on their molecular target, the dopamine transporter. With the normal dopamine transporter, methylphenidate (Ritalin) blocks the ability of amphetamine (Adderall) to make the transporter run backward, yet both drugs are equally beneficial to patients with ADHD.


But when the transporter runs backward of its own accord — as it does with this rare mutant version — both agents act as blockers and stop the leak of dopamine.


source: http://www.mc.vanderbilt.edu/reporter/index.html?ID=6540


I lost the link I had of the actual study, if one of you wants to find it, that'd be great.

I don't see pharmaceutical companies collapsing any time soon lol. People will always need their pillz, tis why I chose to major in the field =P

I just can't help but think that one major institution fell because of greed and unethical practices so it's not a stretch to think another might. Especially considering the pharms might be worse than Wall St.

Anyhoot it's amazing that we still don't know why it works for some, doesn't for others and why it can stop working at any time.

What is the brand name for this medicine?

No more Benedryl? Oh, sweet Lord! My allergies are horrible!

I just can't help but think that one major institution fell because of greed and unethical practices so it's not a stretch to think another might. Especially considering the pharms might be worse than Wall St.

Doubt it. Pharms are more like grocery stores such as Safeway. People will ALWAYS need food, so you can guarantee that even if they all collapsed today, tomorrow you'd have new SaferWay branches selling food again.

Same with pills. People aren't just going to stop buying pills.

I agree that the greed is there, both with food and med companies, but in this case if they all agree to fix their prices, we can't do much about it. Unless they start giving out meds and asking to pay for them later, like furniture or a house.

Anyhoot it's amazing that we still don't know why it works for some, doesn't for others and why it can stop working at any time.

People are just that different. It's very hard to do a proper experiment on humans because of that. In an ideal experiment you are trying to find a variable (such as effectiveness of medication) and holding all other variables (such as diet, sleep, exercise, gender, age, race, medical history, etc.) the same between the people the meds are being tested on. That really is impossible.

People are just that different. It's very hard to do a proper experiment on humans because of that. In an ideal experiment you are trying to find a variable (such as effectiveness of medication) and holding all other variables (such as diet, sleep, exercise, gender, age, race, medical history, etc.) the same between the people the meds are being tested on. That really is impossible.

I would also think the fact that we still don't really know what causes these things makes it more difficult.

Yup. Not knowing fully how the brain works makes trying to fix the brain even harder.

And trying to figure out how it works has the same problems with experiment. That's why psychology and sociology are "soft" sciences (as opposed to physics, chemistry, and biology being "hard" sciences). Whenever you do an experiment you get "soft" results, such as correlations which mean X and Y happen at the same time, but you can't say X causes Y. It takes a lot of these experiments to say for sure "okay, it looks like X and Y happen a lot together" and then you need to devise another experiment to see if Y happens without X or X without Y. Not easy.

I looked up Dex and it is listed as a stimulant. Is that anything like Strattera? If so, I can't take it. Strattera turned me into a very VERY mean person.

I looked up Dex and it is listed as a stimulant. Is that anything like Strattera? If so, I can't take it. Strattera turned me into a very VERY mean person.
No, Strattera is not a stimulant. Dex is a stimulant though so is Adderall as well as Ritalin.

regarding the mixing of allergy meds.
I take allegra and adderall xr daily, allergra at night with b.c. pills and xr in morning, I feel like the xr is working less. Is it possible it is frin the allegra?

I looked up Dex and it is listed as a stimulant. Is that anything like Strattera? If so, I can't take it. Strattera turned me into a very VERY mean person.

Actually, if Strattera DIDN'T work for you, and you DON"T have adhd inattentive type, there is actually a really good chance that dexedrine or vyvanse would work quite well for you.

Read my post in here "Doing a test" I can relate.