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I'd like to talk about Adderall.
A bit of background: I've had ADHD symptoms my whole life (though the hyperactive part greatly diminished in adulthood), but was never treated because I (a) won the lottery of fascinations (math and computers) and (b) have enough raw intelligence that I was able to excel academically through undergrad. Ever since I started grad school, however, my difficulty with focus has plagued my work, and though I managed to muddle through, I'm much less successful than you might otherwise expect, and my subpar (per my own standards, I guess) productivity at work has negatively impacted my mental health. I've been lucky if I can get a couple hours of productive work in a day -- and I don't mean "I had to go to meetings and that interrupted my flow state" (though there's that too) but "I got distracted by some math problem / thinking about a video game / reading a forum / etc and lost a couple hours with nothing to show for it". I've self-medicated a bit with coffee in the past, but I haven't used it as much recently as after a hiatus, I noticed that drinking enough to make any dent in my problem was also enough to cause me sleep trouble the following night (even if I only had it in the morning) and was very much not generally worth it. Somehow I'm still productive enough to keep a senior software engineer job without (many) complaints from management or coworkers, but I'm always feeling like I'm on the verge of failing to adequately do my job.
So my wife persuaded me that just maybe my persistent difficulty focusing on tasks is due to ADHD rather than being incorrigibly lazy. I saw a psychiatrist and she prescribed Adderall, 10mg up to 3 times daily. The pharmacy finally filled the prescription and I started taking it yesterday (Wednesday).
I took two doses yesterday: one at about 10:30 AM when I started work, and one at about 2:30 PM, about 20 minutes after I noticed the effects starting to wear off. The first dose was weird: it helped very noticeably with my ability to focus on a task, my ability to get started on a larger new task (previously I'd have to wait for the perfect moment psychologically for this), and my ability to maintain focus when switching tasks while waiting for a coworker to do code review. On the other hand, I got the jitters - as if I'd had too much coffee, or was very nervous about something, except that I wasn't nervous, I just had the somatic symptoms (this was really confusing). (Other than these jitters my fidgeting/pacing decreased.) The second dose had the same cognitive effects as the first, but without the jitters. I had as many productive hours in one day yesterday as I typically have in three (though it's worth noting that my usual distribution is highly uneven) and got a commensurate amount accomplished.
Miracle drug, right? Well, remember how drinking too much coffee would give me sleep troubles? Yeah, that. I had a hard time winding down last night (even though the mental effects had otherwise worn off), took longer than usual to fall asleep, and woke up in the wee hours of the morning and couldn't get back to sleep. This is not totally out of distribution for me (in fact it's similar to something I've had happen two or three times in the last month without any drugs) but it's suggestive. I'm pretty tired now, but not "I'm a zombie and can't function" tired, at least at the moment -- again, a bit unusual for how little sleep I got but not out of distribution. I really hope this goes away (or I can find a dosing regime that doesn't do this to me) because I really want to be consistently productive for once in my life.
My psychiatrist suggested when prescribing that I could cut the dose in half if I felt "high" or had significant side effects after the first few doses, or that I could try taking only one dose if it was effective enough to get me started on the right foot and I didn't crash after it wore off (which I didn't). I'm planning to take one or two 5mg doses today and see if it's still as effective; I don't want to screw up my currently fragile sleep even more.
Does anyone else here have experience with Adderall for ADHD? With insomnia as a side effect? With dosing (looking online, 10 mg per dose is a bit higher than normal for an initial dose)? Obviously I'll bring all the details to my psychiatrist next week for my followup, but there's bound to be some people here with the right experiences and insight to get some initial feedback or suggestions.
I only have access to methylphenidate, but the effects are much the same as what you described.
For the jitters and comedown, I strongly recommend l-theanine/green tea. Works wonders for me, and it made a nigh intolerable yet necessary medication only extremely aggravating. Adderall is supposed to be more pleasant, but the same applies. Alternatively, beta blockers help too, at least with the palpitations.
And as for insomnia, well, it's a potent stimulant. No way to really get around it short of building a tolerance, but you can ask for a sustained or extended release version that you take in the morning and which will hopefully wear off before you hit the hay.
I ordered an l-theanine supplement (green tea also has caffeine, I don't want to mix that in and I'm not a huge fan of the flavor anyway) on your advice; the palpitations and insomnia [edit: I think some of the insomnia is secondary to palpitations continuing way past the other effects] sucked (at least the serious jitters were only with the first dose). Would you recommend taking it with the Adderall or in the evening?
It's safe enough, so whenever the symptoms start is fine. I usually have a cup of green tea right after taking my methylphenidate, and then once again when the comedown begins.
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I have nothing to add, but just wanted to say that I appreciate the writeup since I am in a pretty similar situation to you (pre-adderall). I actually have a stash that a colleague gave me, but haven't experimented with it yet because I'm expecting pretty much exactly the outcome you've had so far. Maybe the solution is to just take it on Fridays only?
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