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Old 06-23-11, 07:29 PM
Ulotrad Ulotrad is offline
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Recent mild side effects with Adderall, going to talk to Psychiatrist. Worried...

Initially 10mg - 2 X a day
Upped to 20mg - 2 X a day

Been on 20mg - 2 X a day.

Doctor mentioned insomnia and sleep problems are common.
I have had these issues before Adderall (standard release) mind you.

After 3 months of seeing my Psychiatrist for 60X 20mg tabs, I started seeing my General Prac for refills.

Over the last 2 months I have noticed some mild issues.

Sleeping is a problem. Unless I force myself to sleep with Acetaminophen (500mg) + Diphenhydramine HCl (25mg) X2 I am incapable of falling asleep until very late hours (6-7AM).

Unless I force myself up with an alarm, I sleep for a typical 10 hours a night. 8 Hours of sleep, I often feel tired, but mind you I have to force myself up for 8 hours of sleep.

Like I said, I have had these issues for awhile. When I was REALLY young, (middle school), my mother forced me to prepare for bed at very early hours (6-7PM). She also over fed me (typically gave me a plate of food, then before I could stand up after eating it, she would put another plate and say "have seconds"). All of that combined, I would fall asleep very early, and typically wake up at 2-3AM. I would then watch TV till I had to get ready for school at 6AM.

That quickly broke, and I found my sleep schedule is totally screwed. With no outside interference (medication of any kind), my cycle is ~ 10-11 hours. That is, over the summer when I was a kid, I cycled through entire days over weeks. That is, some days I would go to bed at 3PM in the afternoon and others I would go to bed at 10AM.

It just cycled through with me being awake for 20-22 hours and sleeping for 10 hours.

The Adderall seems to be making it harder for me to control the insomnia and incredibly unproductive sleep cycles. I also have a very hard time with staying up for entire days. After that 22 hour mark, I am incapable of performing, unlike my peers who claim they go 2-3 days on coffee.

Before Adderall I was able to control it. Take 2 PM sleep pills at 10pm, I was dog tired / passed out at mid night.

Now, the PM sleep pills have an effect but I push through it. Even when I am "tired" from the PM sleep pills (CVS generic of Tylenol PM) I will either ignore it and keep working (I have so much work I think stress might be an issue), or I lie down in bed and just read. However, unless I have been awake for 14 hours or so, the sleep pills do not work.

In addition to that, as I have said, I have a lot of work. I am constantly, from the minute I wake up to the minute I fall asleep, doing school work. I teach at the same university I am attending graduate school.
It's a problem because I constantly get situations in which I need to be on campus at 8AM. It's a pain because, I didn't wake up until 4 in the afternoon the day before, and so I didn't go to sleep until 4AM.

WAY to much of this summer I have been working on 3-5 hours of sleep (typically 4). The Adderall helps get me through that but I fear this sleep issue is turning into a full blown disability.

In addition to the sleep issue, I have been getting bouts of anhedonia. Not really depression, but very strong lack of joy. Nothing brings me pleasure. It's clearly a rebound from a decrease in natural production of Dopamine. My General Prac told me it's something I just have to weigh against the benefits of Adderall however, this didn't start until after I stopped seeing my Psychiatrist for refills.

I have a VERY screwed up life, in that on the surface I look fine. Good-looking, hardworking and seem (at least that is why people tell me) to be relatively successful (at least for a graduate student HA), but ANYBODY who knows me, knows how ****ed up I am.
Inside, I am very angry. I despise my mother for the type of person she turned me into. I hate my father because he was abusive. My little brother was constantly favored over me. To this day, my father has taken my brother on over a dozen vacations to Vegas, the Bahamas several times and all over the country. I have never left Georgia. He has never invited me. Constantly scolds me for things he praises my brother for doing. I despise my brother for this. Beyond that, I have terrible self-esteem. I was constantly teased as a young kid for the way my mother treated me. My mother literally bought me pants and sent me as an 11 year old to school wearing things like these. http://kidsthosedays.com/wp-content/...gh-waters.jpeg. In a public school with no dress code, my mother forced me to dress as if there was a dress code. I was constantly teased as a young kid. Any friends I had (I had one at school) and tried to make otherwise were never allowed over to my house. Several times I tried to go to my one friendís house and my mother forbid it. 5 years I lived with her, and ALL I was allowed to do was go to school and come home. Strangely (or maybe not), that was NOT the case for my little brother (one year younger than me). I tried to play baseball. I saved the money to join the team and after she agreed to allow me to play and drive me, and after I signed up, she refused to take me. Drunkenly screaming ďI donít want to drive thereĒ. Yes, my mother and father were both heavy alcoholics. High school was just as bad, but for different reasons. Less teasing, but my self-esteem was destroyed. I made a couple of friends in high school but they turned out to beÖ ĎTypical high school kidsí and turned on me. Spread rumors about me, talked behind my back. Less teasing me to my face, but more of a gradual shunning. My last year in high school I was a ghost. Constantly hid in the bathroom to avoid going to the cafeteria. I did meet one girl in high school (I have never been unattractive, just weird). By the way, at this point in my life, I was removed from my mother and fathers house and lived with my grandmother for 3 years. Anyway, that girl was my first kiss and first girlfriend. We got together all the time after school. She invited me to see her parents. Anyway, she had dated one of those ďfriendsĒ I mentioned who turned on me when she was in middle school. I didnít live in this city at that time. A lot of these people had in fact been friends since they were really young and I didnít start at that high school until 10th grade. Anyway, he thought it would be a funny to screw with me by calling her and asking her out. She agreed. Called me the next day and told me. At that point he and his friends had already told me about it, laughing. I can only describe what happened as broke. I lost all emotional response at that point. Walking through the hall ways at school I ignored everybody around me. That was at the end of my 3rd year. The next year, my senior year, I literally went the entire school year without talking to any other students for any real reason. She tried to apologize to me and I just ignored her. No cryingÖ nothing.

I started college and it has been a few friends at first, they fall off and I return to that same loner personality.

My psychiatrist does not know any of this. My psychologist does. I was also hospitalized for attempted suicide, which occurred one night when my father got drunk and went on a rampage for hours while I remained hidden in my room afraid.
My sessions with my psychologist do not seem to have helped. I am still a loner, but not the kind I was in high school. I have a deep hatred for women but do not treat them badly. Itís almost like; I refuse to give any women any part of my attention. I typically just walk around with my head phones on and answer people or say hello when it is appropriate. I can put on a mask that makes my students think I am Ďnormalí.

That list goes on for several pages.
Anyway, my Psychologist put me through some psychopathy testing because of my lack of emotion and general ability to make people around me think what I want them to think about me. I still have strong empathy and he didnít classify me as having psychopathy (but I still have my doubts, for reasons like I said, go on for several pages, but include things that I do feel bad about like mild animal cruelty (was worse when I was really young living with my parents).

Regardless, my life is kind of dull. Lots of sleeps deprivation and stress. I was always able to find joy in my loner life. Typically in video games and television. I would study hard and watch TV for breaks. Never had any degree of depression (as NOTHING) lasted more than a few hours.

The Adderall is causing me to have anhedonia though. I am not lethargic but there is a lack of joy in things. Nothing I do (that used to work) works to bring me joy any more. When I take the Adderall this goes away for 3-4 hours but it comes back. Some days are worse than others. I donít have suicidal ideations so I donít think this lack of joy is going to really harm me, but I do have a general feeling of, ĎI donít care if I dieí. I have talked about it with my psychologist. Not suicidal but, ďdeath does not scare me, and I feel no reasons to liveĒ.

I want to get this anhedonia and sleep thing taken care of and I am going to see my psychiatrist to talk about it, but I am weary he will force me to get off of it and any ADHD medication, especially if it finds out about my other issues. I have not had any side effects from Adderall except the anhedonia and insomnia (while my psychiatrist knew about before I got on it).
The best way I can describe the way I feel is nobody knows what I am like truly or what I have been put through. Not even my family. Most of my family thinks I have had no problems as a kid or now. My psychologist is probably the only person who knows about most / any substantial amount of it. People who see me think I am happy (because I put on that mask) but I truly am not. Until now, I have been able to get through it by forcing joy by playing games and watching TV. That isnít working anymore through, and itís really starting to stack.
To give you an idea of how extreme my loner nature isÖ Unless I am teaching and forced into a situation in which I have to talk to somebody, I will literally go weeks or even around a month without saying anything to anybody. Those are extremes but it is very common for me to not talk to any person for days. So common itís a weekly occurrence. As for my loner nature being whatís stopping me from interacting with people, that isnít really the case. I have been working with my psychologist for a while now to get me past the reason I donít. I have a general hate for just about everybody. Not a hate, like I want to hurt them, but more like, I refuse to let anybody **** with me like I have been ****ed with for my entire life. I can interact with people fine, and do so when I am in a situation in which itís required. Interviews,Ö when I am teachingÖ Itís just a mask through. I have met a few people at this school that I am going to graduate school at and I do have a deep hate for them personally though. I told my psychologist what they did/ said about me and that I was upset about it, but I honestly fear he would have me committed if I told him how I truly feel about these two people (both girls who were talking about me to other people behind my back). Deep hatred / anger just wishing part of their lives could end up like mine. I even desired they would die. But I would never harm anybody. Itís ironic because, I was stabbed in the stomach when I was 19 and donít care. Couldnít care less what happened to that guy. I assume itís my deep hatred for women (working with my psychologist on).
Anyway, I am worried my psychiatrist will take me off of the medication through. What should I tell him?
I need to get it addressed because of everything I just mentioned. I truly fear I am going to be in a world of trouble if I have chronic anhedonia, but I donít want to give up the medication.
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Old 06-25-11, 11:58 AM
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Re: Recent mild side effects with Adderall, going to talk to Psychiatrist. Worried...

Quote:
Originally Posted by Ulotrad
Sleeping is a problem... I am incapable of falling asleep until very late hours (6-7AM).
This is not good. If your insomnia is this pronounced you need to talk to your doctor right away. Your doctor may decide to adjust your dose, so you take it earlier in the day and not late in the evening or afternoon to avoid insomnia. Or, your doctor may decide you need a mild tranquilizer drug to help you sleep, such as a benzodiazepine (Xanax, Klonopin, Valium), or a non-benzodiazepine (Ambien, Lunesta, Sonata). *Note: Benzodiazepines and non-benzodiazepines are meant for short-term use only, typically no longer than 4-weeks; long-term use may result in tolerance, dependence, or addiction.

You definitely need a proper nights rest to get the most out of your day without feeling fatigued all day. With improved sleep you may also notice your anhedonia symptom subside.

Sleep problems are common with stimulant treatment but they should not be this marked. If sleep problems persist even after adjustments to dose and timing, your doctor may find it necessary to stop stimulant treatment.

Quote:
Originally Posted by Ulotrad
My psychiatrist does not know any of this.
You should definitely make your psychiatrist aware of your issues. I would suggest that you allow your psychologist and psychiatrist to interact with one another so they can work together to make sure your getting the best possible treatment.

Quote:
Originally Posted by Ulotrad
Anyway, I am worried my psychiatrist will take me off of the medication through. What should I tell him?
Honestly, Adderall may not be appropriate for you. You may be better off with some other type of psychotropic medications such as anti-depressants or anti-anxiety medications. I may have missed it in your post but I did not see anything regarding your ADHD symptoms and why you feel you're benefiting from Adderall in terms of symptom relief.

Please consult this with your psychiatrist, your medication treatment may change but it's probably going to be for the better. If your psychiatrist knows the whole picture and knows what you're dealing with he will adjust your medications for a better treatment response.
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Old 06-25-11, 12:27 PM
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Re: Recent mild side effects with Adderall, going to talk to Psychiatrist. Worried...

^^ What Relax said. Your psychiatrist can property treat you or diagnose you if you aren't disclosing EVERYTHING that is or has gone on with you.

It really sounds as if there may be some other underlying issues or conditions that need to be treated or taken care of.

Adderall isn't for everyone. There are many other options available to treat ADHD. It would be best to talk to your psychiatrist, not your gp, about finding another treatment for your ADHD AND the other issues you've mentioned here. Insomnia is a side effect of Adderall, but most people can figure out when to dose themselves so that it is not a problem. If you aren't taking it too late in the day and are not sleeping, this probably isn't the medication for you. I am assuming that you are taking Adderall IR (pills) and not Adderall XR (capsules).

Go back and talk to your psychiatrist and give him/her full disclosure of your life, just like you did here. Without doing that, you are hindering your treatment.

I wish you the best.
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Old 06-25-11, 04:02 PM
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Re: Recent mild side effects with Adderall, going to talk to Psychiatrist. Worried...

I second what everyone else said.

Quote:
Initially 10mg - 2 X a day
Upped to 20mg - 2 X a day

Been on 20mg - 2 X a day.
This sounds... a little iffy to me, if you're having trouble sleeping. Adderall has a 10 hour half-life. Half is cleared from your body after about 10 hours. (This varies by individual, but it's roughly right for most people.)

So assuming you're taking 20mg at, say, 8am, and you take a second dose at say 2pm, 6 hours later... although you may not feel it anymore, about 2/3 of the first dose is still in your system (~13mg). The second dose will increase that by another 20mg, to about 33mg. 10 hours later, at midnight, you'll still have over ~17mg in your system.

8 hours after that, you'll still have about 6mg in your system when you take the next day's dose, bringing you to 26. At 2pm, ~17mg residual + 20mg, bringing you to 37mg.

10 hours later at midnight, you still have close to 20mg (your starting dose) of stimulants in your system when you're trying to sleep. (The increase levels off after 3-4 days.) I'm sure you see why this might be a problem.

Ask your doctor if it might be better for your second dose to be smaller, just a boost to keep your levels steady for the afternoon.
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Old 06-25-11, 07:53 PM
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Re: Recent mild side effects with Adderall, going to talk to Psychiatrist. Worried...

Have you considered having a sleep study done? They can be really informative and are great diagnostic tools. Additionally, have you had any blood work done recently? Labs can be revealing, too.

I used to struggle with insomnia in a much similar ways that you do. Unlike your situation, though, Adderall actually helps me sleep better. I still have the occasional bout with insomnia - early this week, for example, I had an absolute nightmare of a situation when I could not sleep. I went for something like 76 hours, during which I got about 3 hours of sleep. It was horrible. Incidents like that used to be much more common for me - maybe once or twice a month, and really wretched sleep the rest of the time. This is the first one since February.

I've pretty much swallowed anything a doctor or naturopath has recommended for sleep, at one time or another. I've yet to take a sleeping pill that works - I may get a little groggy, but I don't sleep. Or, if I do actually fall asleep, I'm awake again in an hour and feeling like h**l. Sleep hygiene - I practiced it like a religion. Didn't help there, either.

It may be worth it to try a different medication for your ADHD. There are other stimulants, and if the Adderall is having such an intensely negative effect on an already intolerable problem, it might be doing more harm than good. Instead of talking to your doctor extensively about the negative side effects, just give him/her a quick rundown, then ask about trying Ritalin, or dex, or something else. Make sure you tell them that you are having positive results from the medication, though, and that you do not want to discontinue treatment, but you feel another medication might work better for you and you want to explore your options. This is a perfectly reasonable request, and your doctor should respect that. A lot of people have found that Adderall isn't the right drug for them - but they do great on a different stimulant.

Really, I think it's in your best interest to try and separate any physical causes for your insomnia from the psychological ones. Sure, they're intertwined, but the physical ones are what you can treat the quickest and easiest.

Good luck. I really hope you can find your way through this.
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Old 06-26-11, 09:52 AM
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Re: Recent mild side effects with Adderall, going to talk to Psychiatrist. Worried...

"Sleeping is a problem. Unless I force myself to sleep with Acetaminophen (500mg) + Diphenhydramine HCl (25mg) X2 I am incapable of falling asleep until very late hours (6-7AM). "

What brand of Adderall do you take? You can usually find this on your prescription bottle. The brands are Barr, Corepharma, and Sandoz.


"Unless I force myself up with an alarm, I sleep for a typical 10 hours a night. 8 Hours of sleep, I often feel tired, but mind you I have to force myself up for 8 hours of sleep."

Speaking from personal experience, this is likely from the Diphenhydramine. Whenever I take it (either Unisom or Benadryl) I wake up feeling like I am stuck in as a "shell", as I like to describe it . I feel like I need to break through the "shell" to become something more than just a sluggish, irritable zombie. Combine that with an Adderall hangover, and you feel like crap.

"The Adderall seems to be making it harder for me to control the insomnia and incredibly unproductive sleep cycles. I also have a very hard time with staying up for entire days. After that 22 hour mark, I am incapable of performing, unlike my peers who claim they go 2-3 days on coffee. "

I frequently stay up like that in order to reverse my schedule (I work nights, so for my weekends I switch back to being awake during the day to spend time with my fiance).

Again, this is my experience and everyone is different. If you are taking
Barr brand, I find that after the med's effective time period has expired (4+ hours), several things happen. I slowly drift into zombie mode, having lost the mental acuity gained from the medication, and that soon shifts me into a trance-like state.

An example of what I mean: I get off of work, and browse the internet. As the Barr fades away, I find that I would start to blankly stare at websites, and then go "wait, what was I doing?". I would continue to do this for several hours until I consciously told myself "you are in idiot zombie mode, go to sleep".

The worst part about it is that it would keep me awake for several hours after my last dose, and that's with 15mg.

Corepharma is much easier to manage my sleep with. I feel it kick in, and I feel it saying goodbye. The effects leave and I am ready to sleep in roughly 30 minutes to an hour... unless I am deeply focused on something, like a video game or a report at work.

Once I stop focusing on something, I start to fade into sleep. Sometimes I may not feel really tired, but if I lay down to go to sleep then I usually drift off 10-15 minutes later. You just have to peel your brain off of whatever it is that you're doing and get ready for sleep.

If you're on Corepharma, then ignore that
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