I've lived with mild Tourette's all my life (I'm in my 20s).
I take guanfacine IR 3 times a day to manage that, but still have some mild tics that I control.
Unknown to me until this year, I also have ADD. I was diagnosed through a therapist, then psychiatrist. Looking back at my childhood and life, a lot of things made more sense.
I tried Adderall through a friend (before I saw the psychiatrist for a prescription) because I wanted to know if stimulants would make a difference.
I tried 10 mg 15 mg, and 20 mg Adderall XR. I took the 15 mg dosage for a period of a week, and a few times on and off, with no change in response.
The 15 mg was my sweet spot, and was the first time in my life I felt like I could CONTROL when I wanted to focus and on what, and whether or not I wanted to be anxious, etc. I also noticed that it improved my tics.
After seeing my psychiatrist, I was prescribed 36 mg Concerta.
The first two days were great. I felt the same benefit that I did when I tried Adderall. Amazingly, my Tourette's disappeared entirely, which I had never experienced in my life. However, by day 3, I felt mild sedation and dulling on the same dose. Day 4 got substantially worse.
My doctor had mentioned to me, that after day 3 or 4, I might need to take another 36 mg Concerta dose later in the afternoon (roughly 4 hours after the initial dose). I tried this on Day 5. This was horrible. My body was physically very stimulated, but mentally the brain fog was still there, as was the discomfort. I went back to one dose after that.
Today is Day 7, and the sedation is still there. I find that I'm slower with reading, forget things very quickly, and feel dull and emotionally vacant. It really does feel like being a "zombie", the way I've read other people describe their experience.
I'm confused as to why I responded so well the first 2 days, and why my Tourette's are still non existent on this medication. I'm entirely sedated and unable to function properly, but my Tourette's are gone. However, the first two days, I was able to function optimally and was content and focused. Higher doses seem to make things a lot worse.
Does anyone have any idea what this means in regards to my neurochemistry? Does this mean that I need more norepinephrine stimulation rather than dopamine? Are my dopamine receptors overstimulated compared to norepinephrine receptors? I know that methylphenidate has a 1:1 impact ratio on DA:NE, while Adderall is 1:2 from what I've read. I've also read that methylphenidate has a stronger impact on dopamine in adults than it does on children (at least in a mouse study, which not translate and I could not find any other publications validating that).
Anyone have any experiences? Ideas? I don't think it is right for me to say that I don't respond to the methylphenidate family, because I saw a fantastic response the first two days. I'm more interested in why this effect diminished and what's actually going on with my brain?