Some Actual Advice About ADHD Medication

I grew up with ADD and only just recently got diagnosed. Aside from all of the problems that come with even finding out that you have ADD in the first place (stigma, imposter syndrome, general fearmongering and clamour), the next problem, that I immediately ran into was pretty surprising for me as a long-time addict of the internet — it’s almost impossible to find advice about how to actually use ADHD medicine from people who’ve actually taken it.

Oh yes, you can search. But the top 20 results for like, all variations of adderall typical dose, adderall vs vyvanse, what does adderall feel like turned up either information that was vague at best, or resources from addiction centers focused on stopping you from using stimulants. I want to use stimulants. They work!! They help me!!

Thus, I started writing some advice that I’ve learned in the past few months of learning how my medication works. I hope this FAQ style post helps, and if people have things to add, please comment or message me! I would love to help expand this.

GENERAL NOTE: I am not a doctor. Listen to your doctor first, and don’t take advice from a stranger on the internet without cross-checking it with a doctor. This is just advice coming from my own experience as a person with ADD, and from things I’ve learned from my doctor and reading that I’ve done.

Getting Diagnosed Advice

• Psychiatrists and psychologists can prescribe you medicine, therapists usually cannot!
• Yes, you can just reach out to a psychiatrist and ask about being screened for ADHD. You usually don’t need a referral! Find one through your insurance.
• If you can’t find a good one through your insurance, online can work. I went through Ahead and while I had to pay out of pocket ($225), I got a provider and a diagnosis!
• I think this depends a LOT on where you are + what your family conditions are, because I’ve heard a lot of different stories. Advice I have though is: don’t be scared! If a lot of ADHD memes or Instagram-psychologist posts resonate with you, trust your gut and make an appointment. I was very nervous before mine and even made a list of things that I thought “supported my case” because I was so scared that she wouldn’t believe me, but my provider was really understanding.
• Forget the hyper-active young boy trope that comes to mind when people say ADHD. ADHD manifests in different ways between men and women, and the stereotypical ideas of what it is are usually just the symptoms seen in young boys. Because of this, ADHD is historically way under-diagnosed in women. If you’re a woman and feel that that you have difficulties with executive function even though you’re not really hyper-active or impulsive, go see a psychiatrist! And honestly, go see a woman psychiatrist.

Amphetamines vs. Methylphenidates Advice

• There are two classes of stimulants, amphetamines and methylphenidates. The amphetamines are Adderall and Vyvanse, and the methylphenidates are Ritalin, Concerta, Strattera, and others.
• There’s also one SNRI that can be used if either of those families don’t work: Wellbutrin. If you have both ADHD and anxiety (super common by the way), then you might think that Wellbutrin could be a better option for you, since SNRIs treat anxiety too! However, if you’re already taking something like Lexapro for anxiety, it’s usually better to take an amphetamine or methylphenidate alongside it instead of trying to combine them both into taking a single SNRI. Just like how a seperate shampoo and conditioner are always gonna be better than a 2-in-1 combo, two drugs that are both very good at what they do are usually better than taking one that kinda helps with anxiety, kinda helps with ADHD.
• Generic medications are the same as the brand name versions, just cheaper. They are literally FDA mandated to be the exact same. Please do not worry about getting generic “amphetamine/dextroamphetamine” instead of brand name Adderall™️. They will work the exact same and getting the generic will save you money.

“What Does It Feel Like” Advice

• One thing I was really scared of was that Adderall would be like they show it in TV shows — wiring you up and making you hyper-fixated on whatever you were doing in that exact moment for like 6 hours. I already do that!!!!! I do not need any more of that!!!! I’m happy to tell you that that’s NOT what it feels like, at least for me.
• Being on Adderall gives you — foreign enough as the concept sounds — the ability to control. Like, if your head always has a thousand thoughts pulling you in different directions of distraction — those are still there. But suddenly, you have the ability to say no to them — to just let them pass, and to stay in control of the train of thought you want to be on. You gain the ability to prioritize, and use your hyper-focus on the right thing instead of the wrong one.
• It does also have some side effects. Stimulants speed up everything in the body, so your body will process food and water faster than normal. However, because it’s also an appetite suppressant, it’s common to not feel hungry or thirsty while you’re on them — even though your body may very much need food and water!
• Sometimes, I feel jittery and nervous also as a side effect, like how I feel when I drink too much coffee, but I’m still learning about this + how to deal with it.

“How Do I Know Which Drug Is Right” Advice

• I dunno. Looking for advice on this one. Send me a message if you have something to say and I’ll update this post.

Dosing Advice (General)

• Most ADHD drugs come in either immediate release (IR) or extended release (XR) forms. IRs last usually 4–6 hours, and XRs last 9–12 hours, but both depend on your metabolism. If you have a fast metabolism, they’ll last for a shorter amount of time, and vice versa.
• You should start with (and your provider probably will give you this already) an IR drug. IRs last 4–6 hours, and you can experiment a lot more with them to find the right dose. Plus, if you wake up late in the day and still need to get work done you’re not SOL. Meaning: you can take them at 4pm if you need to, and you’ll still be able to sleep by 10. With XRs, it’s in your system for 12 hours, so if you don’t take it right in the morning, you either have to go without, or expect to not be able to sleep that night.
• XRs are convenient because it’s just one pill and the drug will automatically spread itself out over the course of the day! Because of that, you start with an IR to find your dose (like maybe you need 15mg, for example), and then your provider might want to switch you over to the XR version of that drug for that dose. However, you don’t have to if you don’t want to. For me, I liked having the finer control of timing when I took my Adderall IR, so I asked to stay on those, even though it’s more work to bring pills with you to work and stuff.
• For dosing: start small and work your way up. The numbers are different for each drug, and 15mg Adderall =/= 15mg Ritalin, or any other.
• Doses are usually talked about in terms of how much you take in a whole day. This confused me a bit because when people said they were taking 30mg Adderall, I thought they meant it all at once. You can (and should) spread your dose out over the day (see next bullet about crashing).
• If you take an IR med and “crash” (get super sleepy and tired) when it runs out, you should try building a curve into your dose so that the come down into the evening is smoother. For example, my dose is 20mg, and I take 10mg in the morning when I wake up, 5mg in the middle of the day, and 5mg around the end of the day when I’m wrapping up. I don’t really need it anymore when I’m done at work, but the curve seems to prevent a crash from happening, and I have a normal amount of energy for the rest of the evening.

Dosing Advice (Adderall Specific)

• The baby dose is 5mg. Start here, even though you probably won’t feel anything when you take it, just so that you can double check your body doesn’t have a weird reaction to it or anything before you go higher.
• The typical dose is 15–30mg but work up to it in 5mg steps. You’ll know you’ve gone too far if it’s still working, but your side effects like jitter are getting too much. It’s all very person dependent so make sure you find what works for you!

Dosing Advice (Others)

• Help wanted. Please comment your experiences!

“I Feel Anxious On My Medication” Advice

• Something I’ve noticed in my own experience is that sometimes it feels like there are three things at play: feelings caused by anxiety, feelings caused by ADHD, and feelings caused by when anxiety and ADHD happen at the same time.
• I’ve noticed that when I feel that my medication has heightened my anxiety, it’s usually because I was already anxious before, and then I took the medication. I’ve found that if I’m feeling anxious, I can avoid heightening it by trying to deal with the anxiety first, and then dealing with the ADHD (taking medication) once I’ve calmed down.
• If you’re feeling anxious, don’t take your ADHD meds. Practice mindfulness. Do breathing exercises. Feel the extents of your body. Ground yourself. List things around you. List things about who you are. List things that make you happy. Plan what you want to do with your day. Then — when you’re feeling better — take your ADHD meds.
• The dehydration that comes with being on a stimulant can also increase anxious feelings and related symptoms. Although you may not feel compelled to drink or eat, try to set external reminders, and go have a big glass of water if you’re feeling anxious.

“I Took Too Much And My Anxiety Is Going Crazy” Advice

• First of all, try a non-destructive cure. Expending energy with a run or other physical activity can help.
• If you have hyperactive or combined-type ADHD, I sometimes find it can be quelled temporarily by doing something impulsive (to regain control). Try something that feels dangerous but (hopefully) isn’t actually, like going on an aimless exploratory walk around town without your phone. Step into a hotel and try to blend in like you live there. These are just suggestions based on things that have worked for me, feel them out if you think they’ll work for you or not.
• This is very I am not a doctor, I am a stranger on the internet, please avoid trying this, or do so at your own risk advice, but I’ve been in this situation before. ADHD meds are stimulants. If you take too much and are feeling so anxious you might do something dangerous: alcohol is a depressant. I’ve been able to calm myself down before with a glass or two of wine. My doctor told me very much not to do this, but hey, it worked. YMMV.

Hat Tips

Thank you to Coleen (@siglingu on Twitter) for contributing her thoughts and advice! 💗

That’s what I’ve got. Have more advice? Can you help out with advice for other drugs? Please leave a comment or message me and I’ll be happy to add :)