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Comment by user68858788 | Hacker News Reader

As someone with ADHD that definitely gets dopamine from novelty, is there actually anything that can be done? Adderral and vyvanse work for a couple days and then I build a tolerance. The only indefinite solution is to completely remove all distractions from my area (internet, games, food) but that’s never been sustainable for me. Moderation, rewards on completion, and other mental tricks don’t work for me. Crisis is a good motivator, such as overwhelming student loans, but I’m back to being unfocused now that those are under control.

At this point I’ve mostly accepted my success is severely limited by ADHD.

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> Adderral and vyvanse work for a couple days and then I build a tolerance

Have you been able to go through titration and dose adjustment with a (competent) psychiatrist? When starting or restarting meds it's expected for the first few days (or more) to have a more obvious impact. After your body has adjusted to being on the meds, if the meds aren't helping (or are outright making things worse, like making you sleepy), you could just need a higher dose. The adjustment period is a bit different than the issue of proper long term tolerance.

There's a fair few options as far as stimulant meds go, and the combinations of drugs, release profiles, and dosages can take a bit of iteration to find what works.

There’s also nonstimulant medications used for ADHD but they're generally less effective than stimulant meds, but we're all different and maybe they'll help?

I haven’t been to a psychiatrist in five years. It wouldn’t hurt to go back and see what they say. Thanks for giving me some hope!

Please do! It took my mate like a year and a half with an amazing psychiatrist to settle on a regimen.

I'd recommend having a look through some ADHD groups; they're full of knowledge and tips and tricks that can help you self advocate.

A psychiatrist should have explained to you upon prescribing these meds that the first few days may feel like rocket fuel and that thereafter they may feel great (or can make it worse), and they should have advised you to keep a diary about your meds so at your next appointment you can review the impact the meds had and any related struggles like remembering to take your afternoon meds (if you had them, for example).

Whatever happened with your last psychiatrist that left you with no helpful meds, no guidance on determining whether the meds are working for you or not, and no follow up to boot is so unacceptable.

A little bit of self advocacy can go a VERY long way, though. Things like asking to book the next appointment at the end of your current appointment, and asking if there's any particular side effects you need to watch out for until your next appointment can mean the difference between what happened to you last time and you finding meds that actually work. You shouldn't have to remind them to do any of that but it can really help.

Sorry, I ranted a bit! I just really hope you find a psychiatrist who will actually just do their job and work with you to figure it out! Finding meds that actually help is quite achievable.

I appreciate a good rant, thank you! You’ve moved me and I’ll definitely be scheduling something soon. I was unprepared to self advocate the first time I worked with a psychiatrist, but now I have a bit more experience and some clear goals, thanks to you.

Thanks again for taking the time to help out a stranger!

I really hope it all works out for you! I'm sure it will; you've got this! :)

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