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Old 09-14-14, 06:47 PM
00_kl250 00_kl250 is offline
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Unhappy Recent adult adhd diagnosis. Lots of questions

Hi All,

First off, thanks to all who take the time to read this and provide any feedback. I've scoured these boards for hours and read through others stories and would like to share mine.

I was recently diagnosed with adult ADHD almost three weeks ago. I did a series of testing with a psychologist. She determined that I do have adult adhd and suggested I try an ADHD med. She prescribed me Adder IR, 10mg twice a day but told me to play my dosage as needed, but not to exceed 30mg in one dose.

So a little history about me. I'm a 29yr old male, 6-1 225lb who exercises regularly and is in pretty good shape. My diet is pretty good, and I don't really drink that much anymore. But when I do go out with friends(maybe once in a month or two, I do divulge in alot of drinks). No illegal drug use. I used to chew tobacco and smoke cigarettes but quit 4 years ago this summer. I did have asthma when I was little but thought I grew out of it until I started crossfit. I quickly learned that I do have exercised induced asthma and have a symbicort inhaler I take pre work out and an abuterol inhaler that I take post workout if needed(i hardly have to take this). I was also diagnosed with acid reflux two years and they found that I had a hiatal hernia when doing an upper endoscopy. The doc put me on 60mg of dexilant, twice a day. My GERD symptoms include clicking of the throat, shortness or breath, feeling of something caught in my throat. I ended up in the ER before I knew I had GERD because I thought I was going to die(having a panic attack from GERD). It was also causing severe insomnia where I would wake up every hour or two during the night. I went and had a sleep apnea test done and they concluded i didn't have apnea but had insomnia so I talked with a sleep psychologist. He recommended that I see someone about my anxiety because when I'd get acid reflux I'd really start to freak out. I was at the point where I didn't want to drive alone because if my reflux kicked up I would have a panic attack. She has me on .5mg of clonzepam as needed. After I started taking dexilant my sleep got much better but i'll still freak out when my acid reflux is bad.

Over the past few months I started to ween off the acid reflux medicine(dexilant) and started taking magnesium supplement. Magnesium is much cheaper and I've read some things about PPI's and long term bone issues. I still take the clonazapem .5mg as need for anxiety.

So, I started on the Adderall two weeks ago. The first morning I ate breakfast and really didn't notice any difference after taking the 10mg. After about 4-5 hours after the first dose I felt anxious and tired and then I'd take another dose and the same thing. I'd get real tired around the 4-5hour mark after taking the dose. I did this for three days with basically the same results, the third night I hardly slept. Waking up like every 2 hours.

So the fourth day I didn't take any at all. I just wanted to go back to what my "normal" was. But that day I felt awful. Irritable , foggy mind, out of it, tired. I'm sure most of this was attributed to the awful sleep I got the night before.

The 5th day I did the same dosage to see if anything would change. 10mg two times a day. No difference from days 1-3.

The 6th day I took 20mg in the morning. WHAM. I felt like my mind was calmer. Instead of thinking about 100 things to do, I was able to set my mind on one project, work on it and move on to the next project. I didn't get distracted, day dream, or just sit back and think of everything I needed to do. I just got it done. I thought wow, maybe this is how everyone else lives a normal life. About 4 hours later I was extremely tired and irritable. I took a nap in the after noon and then worked out and felt better.

The 7th day I took 20mg early in the morning and the same success as the day before. Instead of being just tired, I noticed my acid reflux was absolutely horrible about an hour and a half of taking the medicine. I ate lunch and then took another 20mg around 1pm. Again, another 90min or so I could feel the effects wear off and I was extremely tired but my reflux was still awful causing terrible anxiety. Taking tums or rolaids did not help at all.

The 8th day I just took 20mg at around 8am. Again, I felt like I was able to get things done as on day 6 and 7, but again, about 90 min later i got real tired and acid reflux was terrible causing terrible axiety.

The 9th day I decided to take 30mg around 10:30am. All morning I felt very anxious but after about 30min of taking it I felt the same calmness and concentration as the 20mg, but a bit more. I would say about 2 hours after the does my acid reflux started to get really bad. This time I took some pepto bismal and it really seemed to help with the reflux. I felt like the meds lasted much longer, probably til about 6pm or so until I started feeling tired.

Day 10, about the same as day 9. The 30mg really helped with calmness of the mind and concentration but reflux and anxiety get real bad after a couple of hours, although the adhd symptoms seemed to be helped for about 6-8 hours.

Day 11, about the same as day 9 and 10. The 30mg really helped with calmness of the mind and concentration but reflux and anxiety get real bad after a couple of hours, although the adhd symptoms seemed to be helped for about 6-8 hours.

So in short:
5mg - no effects
10mg - no positive effects besides feeling anxious and tired a few hours after taking
20mg - worked decently at first but about 90min later acid reflux and anxiety are really bad. ADHD symptoms were not helped after 2 hours or so
30mg - works awesome for adhd symptoms. Almost 8 hours. Problem is I get reflux and anxiety after 90 minutes or so.

Here is a list of pro's/con's two weeks into the medication:

Pro's
-Not biting nails all the time. I’ve never seen my nails look so good.
-Ability to think of one task and get it done. Not sit around and get side tracked by 100 things or having issues starting tasks. I also feel myself being less impulsive, thinking things through more thoroughly before I do them. This is where I failed miserably on the test with the doc and have the most troubles in life.
-Calling people back. Before I would not answer calls because mind was preoccupied and it would take days to call people back

Con's

-Acid reflux and anxiety are aweful after 90min or so on 20/30mg. ADHD symptoms are no longer helped after 2 hours on 20mg. 30mg helps my symptoms for 6-8 hours but still have the reflux which causes axiety.
-Dehydration. Before meds i drank 120-180oz of water from 7am-3pm. Now when I drink as much I pee all the time. I poop about 4-6 times a day now. Feels like every time i eat I go poop soon after(sorry to be so blunt, don't know how else to put it!)
-Acid Reflux. Like i said I feel like acid reflux is worse on meds. Especially after first dose starts to wear off then it’s awful the rest of the day. This makes me take the clonazepam. Feel it more in hiatal hernia.
-Hard to maintain an erection. No drop in sex drive but hard to maintain erection. I feel like I don't get fully erect.


So my questions are:

1). Why is the reflux worse with adderall? I've tried many things, take food before I eat, take it after I eat, take it a couple hours after I eat, etc. I've also tried staying away from acidic foods as others have complained about it being rougher with the adderall. Today I took pepto bismal and it seems to have really helped so far with the reflux.

2). Is it normal to feel tired and irritable after the dosage starts to wear off? And when I mean wear off, I mean I notice I start going back to my old habits. Getting side tracked, thinking of 1000 things to do, not wanting to talk to people when they call because I'm thinking of something else at the moment, etc.
3). Sexual side effects. Not being able to maintain a full erection is a big problem for me. My wife is very understanding but there is more stress and anxiety on my end.

With the increase of acid reflux problems and the irritability and going back to my old ways after the medication wears off, I feel like this is just adding more stress and anxiety on myself. I've been taking more clonazepam because of the anxiety and I get really upset with myself when the medication stops working and I'm sitting there not getting anything done thinking about 1000 other things I should do instead of what is in front of me. I'm not suppose to see my doc until the end of the month but I think i'm going to schedule a meeting with him this week because I just don't know if this is how things are suppose to go.


All comments and suggestions are welcome. Thank you very much for reading this long winded post but I felt like I had to put out as much information as I could.
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Old 09-14-14, 11:59 PM
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Re: Recent adult adhd diagnosis. Lots of questions

Maybe I can help a bit.

The erection thing is totally what I get. I'm not an expert it I know what you're going through. It's good your wife is understanding. I would still rather take my meds. Maybe it's a case of just working with it a bit harder.

With the medication this is going to happen. Normally at this stage it's redose time.
The trick is to be taking the right dose before you crash. We all have to deal with this.

The reflux thing is interesting. One thing I've noticed is that since taking the medication my reflux is worse. Something to do with the stomach acids.

Hope this helps
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Old 09-15-14, 02:54 AM
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Re: Recent adult adhd diagnosis. Lots of questions

I have dealt with anxiety(unmedicated) for quite a while and managed it well(in comparison) before starting adderall again. A few years ago I took XR name brand with no significant problems..recently I decided to try IR because of my high metabolism and already having appetite issues(IR provides more control over that IMO) and the anxiety has g
become a bigger issue.

It does happen to be worse when my 2nd dose wears off(only want 2/day due to restlessness), so I plan to request a sleep aid or anxiety med i could take "as needed" in the evening.

Aside from that, a muscle relaxer she prescribed during the first visit relieves the back pain I experience(anxiety/tension associated), and it helps put me to sleep as well.

The only advice I can offer is getting in touch with your dr soon to schedule another appointment to discuss the anxiety issues and see what you can do. I did the same less than 2 weeks after the initial appointment and she was understandind, but all doctors are different. If you still want to medicate despite the cons, consulting with your prescribing dr is the best course of action..nevermind if it is "too soon".

These meds are meant to help us with our ADHD/ADD.. they arent a cure-all for pre-existing issues, and all meds xome with different side-effects which we all experience differently(if at all).

I hope that helps... i know the sort of drug adderall is puts a certain stigma on use whether on or off-label, but we should never be afraid to express concerns with our doctors. Their job is to help us.
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Old 09-15-14, 02:56 AM
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Re: Recent adult adhd diagnosis. Lots of questions

Sorry for typos, on my phone.
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Old 09-16-14, 12:56 AM
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Re: Recent adult adhd diagnosis. Lots of questions

Are you eating fast food?
When you sweat and your shirt gets wet, does it have a rancid smell to it?

When I was a fast food junkie eating Jack in the Box multiple times a day and always eating out, acid reflux was a huge problem. I'd buy the large bottle of calcium supplements and HAD to have them otherwise it was pain.

Careful with this because that acid can muck with your vocal cords and throat. My voice would go out and someone went as far to ask if I was at a rock concert (lost my voice).

Now I eat no fast food. I've lost 81 lbs too. Welfare will do that When I sweat, my shirts don't smell like chit. There is no oder.

Fast food is ******* knarly. It is bad. Period. So much sodium! Plus, hamburger is not really what we think it is. I am 100% certain fast food was the cause of acid reflux for me.
Fast food should be illegal more than 1 time a week. I don't know if this is the case with you because diet was not included.
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Old 09-16-14, 08:22 AM
00_kl250 00_kl250 is offline
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Re: Recent adult adhd diagnosis. Lots of questions

Thanks for the replies guys.

I called in and and moved up my appointment to tomorrow to discuss these things with my doctor.

ADayDreamer, I can deal with the general anxiety on it's own, the problem is when the medication flares up my acid reflux to the point that it causes me to have trouble breathing. That's when the panic starts to come in and I take the clonazepam. Without the acid reflux causing breathing issues i'm fine on that end. I'm by no means a doc or anything, but when I told my doc I was using the clonazepam for sleep, he wanted me to go to lunesta for sleep instead. Only use the clonazepam for anxiety/panic attacks. I think he was more concerned about the habit forming aspect of the clonazepam if using it for sleep. The lunesta has worked wonders with my insomnia, just as good as the clonazapem and he said there's not much concern about addiction.

NeedDirection, I don't eat much fast food or grease. I follow a paleo lifestyle for the most part, do have cheats here but my diet is pretty good.

Yesterday I decided that the anxiety/panic caused by reflux, caused by the adderall was just not worth it anymore. First time in about 10 days not having any in my system, and was I a mess. I could not concentrate on anything yesterday. I felt horrible at work because I couldn't just get one thing done, I was thinking about 100 different things, I wanted to rip my hair out. I also chewed up my finger nails again, something I haven't done in ten days. But I did not have any acid reflux or anxiety/panic.

This morning I decided to try 10mg again and see how it goes. Hopefully today produces better results ;(
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Old 09-16-14, 10:37 AM
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Re: Recent adult adhd diagnosis. Lots of questions

I don't have acid reflux but maybe try taking your adderall (20mg is what I take in the AM) on an empty stomach with milk. I've been doing this for the past few days and I notice it still his me strong about 30-45 minutes after and it doesn't make me crash about 3-4 hours after (as long as I eat small meals/snacks throughout my day), just a smooth comedown until I take my next dose (10mg). It sucks having a fast metabolism but I'm just glad my ADD is finally getting cured!
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Old 09-22-14, 07:55 PM
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Re: Recent adult adhd diagnosis. Lots of questions

Hi all, figured i'd give a little update since the last I posted.

The day after my last post, I decided I would give it one last shot and try 15mg since 10mg really didn't do much and 20mg caused a ton of acid reflux, which caused anxiety/panic thus negating all the positive effects of my ADHD.

BAM. Almost a miracle. My adhd symptoms were basically cured with little to no reflux. I also started taking my reflux medication a couple days later and the reflux is basically non existent.

I already had an appointment setup with my doctor and explained everything to him(minus the 15mg because that was the first day i did 15mg twice a day) and he suggested I try ritalin because according to him it's smoother than adderall. I went to 20mg twice a day for a couple of days, but I can tell the adderall is much more effective for my adhd symptoms than the ritalin. I've actually found the ritalin to only last about an hour or so then i feel much worse until my second dose, which I repeat the same cycle.

I called back the doc's office today and told them the 20mg ritalin twice a day isn't as effective as the adderall 15mg twice a day.

I've found for the ED, it's best to have not to have any adderall in my system for a few hours and then things seem to function properly


In case anyone ever reads this in the future that has acid reflux with adderall, here are some tips that I find really help out with symptoms. I know most of these are general tips for people starting out on adderall, but these really, really helped with my reflux:

1). Eat eat eat. My acid reflux is worse on an empty stomach. I guess I didn't realize how much less I was eating while taking the adderall every day until I take a day off.
2). HYDRATE. Can't say it enough. I drink about 120-180oz while not taking adderall during the day, I drink even more on the days I take it.
3). Take a day off once a week. I've found that if I take a day off after a week on adderall, it helps with my reflux tremendously.
4). Sleep. I know everyone says to get plenty of sleep, and they are all correct. I normally only get about 6 or so hours of sleep a night, but I need to add another hour or so to my schedule on adderall and it also helps out alot.
5). Make sure to exercise. For some reason, when I started taking my adderall, I stopped working out as much. BIG MISTAKE. I found that not getting exercise for more than 2 days really affected me and caused major stress and more anxiety. Maintain a normal workout schedule, and If you don't have one currently, start doing something. Go for a 20 minute walk every day, something. I can't stress enough how much keeping on a regular workout schedule has helped with acid reflux, general anxiety and sleep!

It's been a rough couple of weeks trying to figure out proper dosage and making life style adjustments to the medication. But, once I figured it all out I feel like i'm actually alive for the first time in a long time.

I'll post back in a few weeks with another update. Thanks everyone for all the advice!
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Old 09-23-14, 04:27 AM
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Re: Recent adult adhd diagnosis. Lots of questions

Re: the hiatal hernia, its imperative that you stay on a ppi or some other acid reflux med. You can take one at night if you are worried about it interfering with adderall. I have a hiatal hernia and have had acid reflux for years. I lost a bunch of weight and it seemed like the acid reflux went away. I thought I was cured and didn't take any meds for it for about 6 years. Fast forward to about 2 years ago during a check up and I now have barrets esophagus. I have to have biopsies every year to check for esophageal cancer bewcause barretts esophagus causes pre cancerous cells to form and left unchecked can become cancer. Its a scary place to be in because I never know when those results will come back positive. Laying down at night I experience spasms so that I have to sleep elevated. My point is if you don't feel the acid reflux you still have it and if you have a hiatal hernia and DO feel it you really need to be on medication. My untreated condition lead to the pre cancer situation that I am in and I had no idea it was even possible because my first GI doctor never told me of this possibility.
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Old 09-23-14, 08:24 AM
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Re: Recent adult adhd diagnosis. Lots of questions

Three years ago when I had my first upper endoscopy I had barretts esophagus. I took the dexilant for a year and had another endoscopy and the gi doc said it healed perfectly.

I tapered off the PPI because the last time I talked with my GI doc he mentioned a few things about PPI's and long term effects. According to him they don't have alot of information about long term use of medications like Dexilant. It has shown to increase weakness in bones in older people, so I figured I'd start backing off the dexilant to see how my reflux would be. It's also very expensive. Without insurance it's $400/mo for a supply but my insurance brings it down to $20. So if I lost my job or insurance, I wanted to find a way to keep the acid reflux under control without this expensive medication. I also started taking a magnesium supplement twice a day because he also said PPI's deplete the bodies magnesium supply. I got to the point where I no longer needed the PPI.

Fast forward a couple months and add adderall into the equation. My acid reflux came roaring back and have no choice but to take the PPI.

I may try and just do one dose at night, or maybe once every other night and see how things go from there.

I'm sorry you have the spasm in the hernia. I've only felt that a couple of times and it sucks. I don't have to lay elevated, but I know all the issues you're dealing with.
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