8 replies to this topic

[greensweater]

I have had ADHD my entire life, and have previously taken ritilin and adderal, which I last took about 8 years ago. Recently, school has become more demanding, and I need some help to stay on track. I have never taken a non stimulant drug, but may be open to it, especially if it is something that I can take only when it is needed like I can with the stimulant drugs.

My only concern is cardiotoxicity and other negative vascular effects, keeping that in mind, what are my best stim and non stim choices?

[Ark]

EFA
Bacopa
Provigil
L-thenaine
Semax
taurine
green tea
Paractam

Edited by Ark, 19 April 2011 - 08:56 AM.

[TophetLOL]

Modafinil is something to try but its pretty expensive no matter how you get it. Honestly I think green tea has become a hype thing, while it is good it has allowed the market to be invaded by junk so care must be taken in finding good tea

Edited by chrono, 19 April 2011 - 05:43 PM.
removed drug references

[VoidPointer]

methylphenidate is generally considered as the 'safest' ADHD drug. This is because it has a large amount of empirical data(collected from over 50 years), and does not have the same potential neurotoxicity issues that amphetamines have.
you have already used the most effective meds, so anything else will be a step down. Strattera sucks, Wellbutrin only has about 25-50% of the efficacy of stims, and Modafinil has not been shown to be more effective than stims.

Exercise really is the only other option.

[chrono]

VoidPointer summed it up pretty nicely. I'd add that modafinil also doesn't present the psychological problems inherent to the more potent DA/NE psychostims (feels much more "transparent," while still serving much the same function). TBH I haven't looked into the cardiac implications of any of these yet, so I can't comment on that aspect.

As for non-stims, I'd also agree that strattera and wellbutrin are hit-or-miss, and will probably have other emotional effects that you might not be looking for. I have a similar bias for being able to take something "as needed," and not having to wait a month for it to work, and get a migraine if I miss a dose (my experience with wellbutrin).

Another fairly recent addition to the options is guanfacine, a blood pressure med that's been around since the 70s. It's an alpha-2 agonist that's been shown to enhance cognition even in healthy people...from the studies and anecdotal reports (see ADDforums), it seems indicated more for hyperactivity than inattentiveness/motivation, though some still find it helpful. It starts working immediately, but reaches peak effectiveness sometime in 1-2 weeks. I was prescribed this recently, but haven't started taking it yet.

Finally, the nootropics we discuss here are applicable to the treatment of motivation, attention, energy, etc. as well. It will most likely require much more experimentation and adjustment to find something that works, but every little bit helps ^_^

[aLurker]

First of all, +1 for methylphenidate in terms of safety and proven efficacy, dextromethylphenidate (Focalin) may have less side effects for some. Modafinil isn't nearly as well studied but may be preferable depending on your response.

The reason I decided to write this post was the following (my emphasis added in bold):

Another fairly recent addition to the options is guanfacine, a blood pressure med that's been around since the 70s. It's an alpha-2 agonist that's been shown to enhance cognition even in healthy people...from the studies and anecdotal reports (see ADDforums), it seems indicated more for hyperactivity than inattentiveness/motivation, though some still find it helpful. It starts working immediately, but reaches peak effectiveness sometime in 1-2 weeks. I was prescribed this recently, but haven't started taking it yet.

Any cites for that claim? I only found this: Lack of effects of guanfacine on executive and memory functions in healthy male volunteers

Please let us know about your experience with guanfacine btw since anecdotal accounts here are rather rare, I hope it helps!

[aLurker]

I managed to find this study (click on headline for full text):

Guanfacine, But Not Clonidine, Improves Planning and Working Memory Performance in Humans

ABSTRACT

The present study compares, using a double-blind, placebo controlled design the effects of two alpha2-agonists, clonidine (0.5, 2, and 5 mug/kg) and guanfacine (7 and 29 mug/kg) on spatial working memory, planning and attentional set-shifting, functions thought to be dependent on the "central executive" of the prefrontal cortex. Blood pressure and the subjective feeling of sedation were affected equally by clonidine and guanfacine. The 0.5 mug/kg and 5 mug/kg doses of clonidine disrupted spatial working memory, but the medium dose had no effect. The 0.5 and 2 mug/kg doses of clonidine increased impulsive responding in the planning test. The 5 mug/kg dose of clonidine slowed responding at effortful levels of planning and attentional set-shifting tests. The 29 mug/kg dose of guanfacine improved spatial working memory and planning. Guanfacine had no effect on attentional set-shifting. These data indicate that guanfacine improved planning and spatial working memory, but clonidine dose-dependently disrupted performance. It is possible that the greater selectivity of guanfacine for alpha2A-adrenoceptor subtype may underlie its differences from clonidine.

I'll also include this part since the abstract doesn't specify:

Subjects

Six separate groups of healthy and equally intelligent (as indicated by WAIS-R Vocabulary subtest and verbal fluency tests) (Borkowski et al. 1967; Wechsler 1992) young (23-35 years of age, n = 55) university educated volunteers took part in the study.

[spider]

I managed to find this study (click on headline for full text):

Guanfacine, But Not Clonidine, Improves Planning and Working Memory Performance in Humans

ABSTRACT

The present study compares, using a double-blind, placebo controlled design the effects of two alpha2-agonists, clonidine (0.5, 2, and 5 mug/kg) and guanfacine (7 and 29 mug/kg) on spatial working memory, planning and attentional set-shifting, functions thought to be dependent on the "central executive" of the prefrontal cortex. Blood pressure and the subjective feeling of sedation were affected equally by clonidine and guanfacine. The 0.5 mug/kg and 5 mug/kg doses of clonidine disrupted spatial working memory, but the medium dose had no effect. The 0.5 and 2 mug/kg doses of clonidine increased impulsive responding in the planning test. The 5 mug/kg dose of clonidine slowed responding at effortful levels of planning and attentional set-shifting tests. The 29 mug/kg dose of guanfacine improved spatial working memory and planning. Guanfacine had no effect on attentional set-shifting. These data indicate that guanfacine improved planning and spatial working memory, but clonidine dose-dependently disrupted performance. It is possible that the greater selectivity of guanfacine for alpha2A-adrenoceptor subtype may underlie its differences from clonidine.

I'll also include this part since the abstract doesn't specify:

Subjects

Six separate groups of healthy and equally intelligent (as indicated by WAIS-R Vocabulary subtest and verbal fluency tests) (Borkowski et al. 1967; Wechsler 1992) young (23-35 years of age, n = 55) university educated volunteers took part in the study.

Thank you, aLurker.

[The Immortalist]

I have had ADHD my entire life, and have previously taken ritilin and adderal, which I last took about 8 years ago. Recently, school has become more demanding, and I need some help to stay on track. I have never taken a non stimulant drug, but may be open to it, especially if it is something that I can take only when it is needed like I can with the stimulant drugs.

My only concern is cardiotoxicity and other negative vascular effects, keeping that in mind, what are my best stim and non stim choices?

I've done some research and I've found that ADHD symptoms can be reduced with a ketogenic diet. However please do your own research first before you try it.