5 replies to this topic

[khemix]

Ever since adding Guanfacine 1mg, taking Adderall XR 20mg has given me very positive effects without the mind racing and increased heart rate.
I find I only need 8 hours of sleep, I have more control over my impulses, and for the first time in my life I can pay attention without effort. Fatigue, lethargy, anhedonia are all gone. No longer am I glued to the bed or needing to blast music throughout the day so as to not doze off. If this is how "normal" people function, boy have I been missing out.

Now being a budding pharmacologist and a long time reader of nootropic forums, I know all too well of the seriousness of TOLERANCE. And for this reason I am very scared of continuing with the Adderall. I am not considering adding an NDMA antagonist because I don't want impaired memory. I will do magnesium though.

I don't want to restate a question that has been asked hundreds of times on the internet but I will spin it a little differently with a more theoretical twist. Suppose that I am ADHD. Some research says that this is because of faulty catecholamine transporter genes. So my DA and NE is for whatever reason not being released at optimal levels. Adderall causes release of more of these neurotransmitters and so my receptors respond by down regulating. But if my receptors were never recieving the optimal amounts anyway, why would they down regulate? The point is shouldn't Adderall over time reach an equilibrium that is above what my natural baseline is due to faulty transport?

I don't want to lose the focus and energy Adderall gives me. I don't care about euphoria or other recreational considerations, I only want to retain the improved focus. Is it wise to be using Adderall every day for this purpose? One fear is that I will return to baseline eventually but now with a crash.

[jadamgo]

The downregulation question is hard to answer. This is partially because the question contains hidden presumptions, such as faulty DAT/NET genes being the sole cause of ADHD. Those genes are implicated in ADHD, and we observe hyperexpression of DAT in both medicated and drug-naive patients. But causality is not proven. Also, other genes are related to ADHD, such as a variant of DRD4.

Anyway, the practical question ("can I take adderall every day without crashing?") is easier to answer. As long as you DO NOT chase the euphoria, you can find a stable, effective dose that will continue working for a good long time. But to be honest, you should not pick the highest effective dose. Rather, you should pick the lowest dose you can get away with -- the smallest amount of Adderall that you can take in order to function. It's assumed that you will be managing ADHD symptoms primarily with behavioral methods like time management and positive reinforcement of difficult (but important) behaviors. Adderall should only serve to clean up the remaining problems you can't manage with behavior modification.

We don't know the long-term effects of Adderall on humans. We know that in other primates taking Adderall or Vyvanse for long time periods, there is some brain damage when they take amounts resembling the human maximum dosage. However, studies using low-dose Adderall have not shown any brain damage even after extended use. And the practical experience of ADHD specialists is that most treatment-compliant adults taking ADHD medication can eventually find a low/no-side-effect dose that works well over the long term. These low-side-effect doses are often well below the maximum dose range that caused brain damage to animals.

Here's the real answer to the down-regulation problem: when truly restoring catecholamines to normal levels, the receptors DON'T downregulate very much. But upon flooding your synapses with excessive, huge amounts of dopamine and norepinephrine, the receptors will of course downregulate to compensate for the overdose of neurotransmitters. Ongoing problems with tolerance and side effects indicate that one is taking too much stimulant. (Why would you get side effects from restoring your body to normal functioning? The answer is that you DON'T get side effects! They indicate that you're causing a new problem while trying to solve the old one.) That's a symptom of poorly controlled ADHD -- it means someone is overusing the stimulant to compensate for a lack of effective coping skills.

So as long as you're taking care of your symptoms primarily with behavior modification and only using the medication at a low or medium dose, you can take Adderall and you'll probably be fine. Plenty of people have taken it for their whole life and not had problems. That's the benefit of using it responsibly instead of chasing euphoria.

Edited by jadamgo, 07 June 2012 - 12:41 AM.

[Joe Black]

this is gonna sound weird, and i would have rolled my eyes at someone telling me this lasf week, but any good p-doc should have in house free samples of nuvigil and a card to take to a pharmacy for even more, all free, aask him for it, i gave it a shot i i was doing 200mg of adderall previously and this works better. i shit you not. i did modifinil before back in the day, this isnt the same shit anyway, its like they perfected iit.

you have nothing to lose, im in day 2 of it and im dead set on offiallly switching to this, maybe get a tiny amt of desoxyn or dexamp's just in case i really need them.

also doing martial arts helps.

[Joe Black]

my 2cents.

if you wanna get high and study for 27hrs, and lose 20lbs go for adderall. i admit it feels good, sometimes it doesnt tho, sometimes ive fed it 40mg parachute just to keep from not witrdawing.

if you want ot feel what its to be a smart, confident, badass mfer but still feel normal and not high or socially awkward like high dose amps do you, then get nugigil, it combines with stims well and you can take the doses down of them alot mre than usual. any doc will give you free samples if they dont, they really suck, you migh try pretending to e asleep in the chair beore he walks in it cold help

Edited by Joe Black, 08 June 2012 - 09:41 AM.

[khemix]

I wonder if taking a short acting antipsychotic (ie. Geodon) in the night would prevent downregulation of DA receptors.

Another option would be doing 3 days adderall and 3 days nicotine patch. This way I would recieve two types of stimulation.

[zrbarnes]

Another thing to look at would be the CILTEP stack (artichoke + forskolin), which allowed me to lower my Adderall dose to 5mg (!). Tolerance was nearly non-existent, especially when combined with something like Magnesium L-threonate in the evening.