adderall
 

has anyone ever been prescribed adderall to help with concentration? anyone ever actually try it? if so what were your results?

I have no experience in this circumstance but I highly recommend staying away from adderall with an injured brain. It is essentially a legal methamphetamine mixture and will cause further imbalance to your already fragile neurobiology.

There are better options out there if you think a stimulant is what you need. Ritalin (methylphenidate), provigil are some safer options. Just remember your brain is trying to heal and messing with the delicate balance of neurotransmitters could be disastrous. Talk to a psychiatrist, or a doctor who knows your history, but in general stimulants are not to be taken lightly.

I've been taking a small dose of Adderall since December, and I feel like it has given me my life back. Before my TBI, I had already been dealing with Chronic Fatigue Syndrome for 10 years; the TBI made that condition even worse. It had gotten to the point where I almost couldn't even do part-time work, even though I was spending almost all of my other time resting. I was paralyzed with fatigue (both physical and mental) that robbed me of my life. Now I feel like I have gotten part of that life back, thanks to Adderall. At first I was concerned about anxiety, since I also have OCD and Panic Disorder, but so far, the Adderall has not made my anxiety any worse. The only negative impact it has had on my TBI is that occasionally I will end up pushing myself too hard and end up really feeling it the next day. When that happens, I rest until I am back to baseline. The Adderall has helped tremendously with both my physical and mental energy.

what dosage are you taking?

xr or regular?

have you noticed any dependence: ie when you are not taking it you can only function at a lower level than you could prior to beginning the medication?

injuredbut,

Have you tried some caffeine ? It is much easier on your system without anywhere near the risks.

mark: i haven't tried it (have stayed away from caffeine per your advice). what are the risks of adderall? my docs seemed to think there isn't any. however, i'm skeptical as well on that point.

I'd try caffeine before something as strong as Adderall.

What kind of concentration problems are you having ? How does it impact your daily life ?

i get completely exhausted after doing anything for more than one hour. this means i'm completely unable to do any work which is extraordinarily frustrating. it also means my life is in a complete holding pattern

Adderall vs. Caffeine
 

I've found that adderall can help some with attention and concentration. I was prescribed it however I do not take it regularly. I've had PCS for 2 years and early on in caffeine I actually noticed it made my symptoms worse and I felt more foggy, while on adderall they were made a little better particularly in terms of concentration ability. The comedown however was terrible, greatly exacerbated by my already terrible PCS symptoms. Caffeine made me feel much worse overall however because I saw no benefit. Now though, my symptoms aren't really affected by caffeine and it's a much easier way to have a quick energy boost using it. I avoid adderall because I feel it burns my mind out too much and I feel worse after. I only try to take it whenever absolutely necessary. Caffeine I use more casually. I do not recommend taking adderall every day, while caffeine is ok as long as it doesn't make your symptoms worse.

tbi survivor: thanks for the info. can you give me a bit of detail about your situation?

how long did you have concentration troubles?

what did it feel like?

what did adderall do to make it better (ie what did it feel like on adderall)?

what does the crash from adderall feel like?

are you + coffee now similar to what you were like prior to TBI?

You can try a dose of caffeine in the AM and it will be cleared by the evening. I don't drink coffee but occasionally take an 84 mg caffeine tablet just to get going on a bad morning.

Wellbutin May be an Option
 

While everyone's different and may find different approaches helpful, it's very wise to start with the safest approach and then work your way through various meds if needed.

Caffeine is one of the safest, as Mark has pointed out.

I have a complicated medical and neurological history, with lots of pre-existing severe fatigue prior to a TBI and whiplash. I had suffered a random assault in (in broad daylight) just over 2 yrs ago now. I have not recovered 100% yet.

I have also suffered moodswings since the assault which maybe the TBI and/or PTSD.
I control those with Depakote 24/7. I cannot be without an anti-epileptic drug (AED) for mood stabilization since the assault. I have used low-dose Depakote (375-500mg/day) for this. (Depakote also helps with my neuromuscular disorder and my headaches, thus it is the AED we'd chosen to use.)


As for stimulants-

I have tried: caffeine, Provigil, Nuvigil, Ritalin and Adderall.
Yet another option I am now trying: Wellbutrin (bupropion)

Some people do really well on one of the above.

I have found my brain function changes and we often must switch/rotate meds/approaches. It's very frustrating, Luckily, my specialists don't find this as frustrating as I find it.

The TBI left me extremely fatigued, with some periods of agitation.
When I am very fatigued for long periods, I can use Adderall at a very low dose, in the immediate release form. At the right time, it can be very helpful to me. If/when I am going through an agitated period, I do not touch Adderall.

Currently, we are trying Wellbutrin (bupropion) as an everyday med.
I have just started bupropion this week, so will see if it's helpful.
(Any stimulants are on hold when trying bupropion as they cannot be safely combined with bupropion.)

If you have medication coverage, most insurers will require a pre-authorization for each Ritalin and Adderall. Most also require a trial with Ritalin before moving to Adderall. These meds are quite expensive in generic form for a monthly supply without coverage.

I hope this info helps.

To Our Healing,
DejaVu

I've had concentration problems the entire 2 years I've had PCS. I always feel foggy-headed and my working memory is bad so it impairs my focus if I am presented with too much information at once. My brain gets "tired" more easily. While on adderall, my brain doesn't get as tired and I feel I have more cognitive ability to use all the brain power I have. Before I had these most recent concussion problems, I could take an instant release adderall or two and have no feeling of comedown other than slight tiredness. While having PCS this effect was greatly amplified, and is now still kinda bad. Also with PCS now if I have too much I might even have a bit of depression on the comedown. I think how negative an effect it will have will depend on how bad and what kind of symptoms you're having with your PCS. And about coffee, I'm not exactly the same as I was before as the mental energy effect it can provide is not nearly as strong for me now and I feel I have become more tolerant to the positive effects and more sensitive to the negative effects. But slowly, all of this is improving.

Dejavu, how did you feel provigil was in helping your fatigue in comparison to adderall. Also, did you feel like "yourself" on provigil or did you feel "drugged"? When I take adderall I feel like I'm "on" something and am considering asking my doctor about provigil for the fatigue and concentration instead. Hope you feel better, btw.

I did some reading about Provigil. That stuff is scary. When used consistently and long term, it disrupts the sleep cycle in ways similar to cocaine addiction. The cognitive and memory enhancement function is lost and memory function decreases below the baseline memory skills that existed prior to the Provigil.

Be very careful with it and use it only for times when there is a serious need to be on top of your game. The long term use symptoms sound similar to the foggy brain common to PCS.

I've been to two psychiatrists and they both suggests similar meds for focus/concentration/attention/impulsivity:

Stimulants: Vyvanse / Concerta / Adderall

Non-Stimulants: Intuniv / Kapvay / Strattera /Aplenzin

Mood Stabilizer(?): Wellbutrin / Efexxor / Elavil / Lamictal

I haven't tried them yet. Let me know if you had any luck with those listed above.

Provigil not for me
 

Hi tbi-survivor,

I had horrific headaches on Provigil. I also felt very spaced out.
Everyone is different though. Many people do well on Provigil.

I have felt more like myself on Adderall, as far as cognitive functioning goes.

With any/all stimulants, I have to watch for signs of agitation. If/when those signs show up, I discontinue the stimulant (if I had been taking one that day).

My doctor and I had chosen the short-acting formulations, whenever possible.
This way, I could choose to have the assistance of a stimulant early in the day and could choose the hours. (Yet, not daily.) That way, I did not overdo and the med did not interfere with my (messed up) sleep.

I will not use any stimulant on a daily basis.
I do not want to get into becoming addicted.
I also feel like there is not enough info. about the safety/effects of long-term use (of any of the stimulants).

There are lots of options for stimulating meds. Many more options than I have mentioned.

Thanks for the well wishes. I hope you feel better soon, as well. :)

Warmly,
DejaVu

Mindful Use of Stimulating Meds
 

I wholeheartedly agree with Mark.:)

There is not enough info on the long-term use of any stimulating med. The info that is available isn't very favorable for any stimulating med.

I will not use any stimulant every day.
If I use one, I choose a fast-acting stimulant, planning which hours I need it.
I will only choose morning hours so it does not interfere with sleep.
I also make sure I am in an environment conducive to focus, not an highly stimulating environment.
(For instance, I would not take a stimulant and then go to Walmart. I might take a stimulant and work on paperwork, read, etc. -- in a quiet environment.)

To Our Healing,
DejaVu

Medications
 

Hi Mystical,

Great lists of stimulants and non-stimulants.
I haven't seen your "mood stabilizer" list as designated mood stabilizers. These are generally classified as anti-depressants. For instance, Wellbutrin can be very agitating. Low dose Elavil is often used for pain and sleep. There is much talk about returning to the older tricyclic anti-depressants at higher doses to treat depression when SSRIs fail. Elavil is a tricyclic anti-depressant. (Tricyclics were popular before SSRIs were avail, SSRIs avail approximately late 1980's-1990's).

Mood stabilizers are usually anti-epileptic meds or lithium. The AEDs include: Depakote, Tegretol and some related AEDs are also tried as mood-stabilizers (Neurontin, Topamax, Lyrica, Keppra, etc.)

I have had some good luck with the more sedating SSRI meds for sleep and pain, less agitation.
(Citalopram, for example. however, citalopram is becoming increasingly controversial, as to effects upon the heart. I don't like using it with all that has come out about it over the past year or so.)

With the more energizing anti-depressants, I can become too agitated.

I am, however, giving low-dose Wellbutrin another try at this time. Carefully.

(I have an M.D. fairly experienced in using these types of meds in lower doses through "compounding" by a compounding pharmacist. We may go that route at some point.)

I have had good luck with low-dose Depakote, which is an anti-epileptic med, and a potent mood-stabilizer. It calms my brain so it's not as susceptible to overstimulation and evens out mood changes. I had needed Depakote immediately after my injuries, for the same reasons and for impulse control. Depakote can also help with headaches. It's been over two years now and I still need Depakote, I have tried tapering and discontinuing and find myself desperate. I am a mess without it.

We are each different. While a lot of information will state people with PCS primarily suffer from depression, I have found my own experience to be very mixed (more like Bipolar 2). I have to be very careful of the same meds as a person with bipolar 2. This may be the degree of PTSD involved for me. Not sure.

Caution and due diligence, as well as informed consent, are important with every medication. Consider both short-term and long-term potential effects.

Do the potential benefits outweigh the potential drawbacks?

To Our Healing,
DejaVu

I started adderol 3 weeks ago. 2.5mg in morning and noon. So far I have noticed a large improvement in my overall symptoms. I was on amantadine before and tried another drug similar to adderol without favorable results. My DR explained that all the stimulants are similar but hard to tell which one will show results based on unique hormones of each individual.

I have had some lows with this drug and good highs but so far benefits far outweigh drawbacks.

did you mean 25 mg or 2.5? are you using extended release? what symptoms did it help alleviate?

Injuredbutrecoverin,


I have the same problem. Can't do any work from using a computer to doing school work for no longer than an hour or two. After that, I am in pain from the work I have been doing.


Headaches, makes my dreamt feeling worse,etc.

And wouldn't caffeine make it worse? I thought we were suppose to stay away from caffeine?

Sam

Caffeine to increase alertness can be OK for those who do not crash from the effort.

Sam,

You crash from effort. Caffeine will not overcome that crash. If an hour of computer causes a crash or headache, limit computer time to 45 minutes. Better yet, Learn the subtle signs that you are about to hit your limit. When you notice that sign (difficulty focusing, needing to reread a line of text, etc), stop and take a break. You may be fine to change to a different activity until you notice that sign of impending overload.

2.5mg. It doesn't say extended release on it so don't think so. I cut a 5mg pill in half and take at 7am and noon. It helps with concentration, headaches, and most of all brain fog. Without it, I would have a very hard time working.

I am glad you are having good luck with low doses, todayistomorrow. :)


The immediate release formulations can be helpful, at least in the beginning.
If the med or dose is too stimulating, it will end in 4-6 hours, depending upon the medication.

If a sustained release formulation is too stimulating, it ends in closer to 8-12 hours, depending on the formulation.

While the immediate release is shorter acting, I find this beneficial in having control over the medication side-effects. I may find 4 hours of a stimulant is more than enough and it's time to stop. I have this option with a shorter-acting formulation. I can also choose to add on another 4 hours if I am up to it.

Once someone finds s/he is consistently utilizing multiple doses daily, and s/he wants to utilize stimulants to this degree, s/he can then move to the sustained release formulation for convenience.

:grouphug:
DejaVu

I had trouble with depression and (what I now know was) ADHD prior to my concussion in June 2014. I was on Welbutrin XL and Adderall ER (45 mg) before. I also had a prior sleep cycle disorder, so I was taking Ambien CR. Prior to my accident, I was already preparing to discuss possible changes to my Adderall Rx, because I was realizing that while I was doing better at work with concentration and distraction, I had almost no desire to do the hobbies and fun things after work. I was just kind of 'blah.' :plain:

After my concussion, my ADHD-related symptoms were much, much worse, and added to that were working/short-term memory problems, issues with word-finding, etc. Months later, fatigue was setting in pretty badly. Unfortunately, my lawyer sent me to a sports physiatrist who didn't take my concussion symptoms very seriously in the beginning. So, I went back to my original psychiatrist to discuss the Adderall. I'm a researcher, and once my mental functions improved a bit, I started looking into everything I could find on diet, supplements, neurotransmitters, etc. (including here on this forum :) ). Since Adderall is a dopamine agonist, and I already knew it helped my concentration before the concussion, my theory was that the ER I was taking in the morning had run out by the time my workday was over, and that's why I was out of steam in the evenings. My doctor gave me the ER because I could never remember to take the 2nd and 3rd doses of the IR. :p But, after my concussion, I finally HAD to get a smart phone, due to all of the reminders and alarms I had to set for myself. :rolleyes: I asked if I could give the IR another shot, but spread them out more, taking my last one near the end of the workday. I had read about later dopamine stimulant doses helping people to calm down on ADHD forums, so I hoped it wouldn't disturb my sleep (which had deteriorated after my concussion).

Lo and behold, that's exactly what happened! I actually upped my overall dose to 20 mg first thing in the morning, then 30 mg at 12:30 and another 30 mg at 4:30. If I know I'm going to be up late , I can take the last dose closer to 5:30. I take a smaller one in the morning since I usually have coffee. Doing this helped me to keep my improved mental faculties through the evening as well (helpful when you're a single mom of a tween son with ADHD and still have a house to run), and it actually did help me sleep better! I don't feel wired when I take it. Quite the opposite. My thoughts aren't racing at night when I'm trying to fall asleep. I feel a little more like myself. Especially since I now have at least some energy and desire back to do some of my hobbies again.

As for it being a form of meth and therefore damaging, I have read of current studies using minute amounts of meth as treatment for TBI. Who knew? ;)