Hi everyone! I was diagnosed a few years ago in my early 30s, and started taking Adderall along with some different drugs for anxiety as well.
With Adderall and then Wellbutrin, even in small dosages, I notice that my HRV Stress (recorded on a Garmin 945 Forerunner) is significantly elevated for the entire day. When I used to take a midday and evening dose of (instant release) Adderall, it severely impacted my sleep. I also tried extended release taken in the morning, and that caused sleeping issues as well. So did an extended release of Wellbutrin.
Basically, any benefits those medications provide (and it didn’t really feel like it was helping) were offset by the bodily impact.
Has anyone had a similar experience with either of these medications? Any notable co-morbidities or changed metabolism or something that you identified as causing these symptoms? Did Ritalin or Strattera work for you when Adderall did not? I’ve been cycling through other non-stim medications with my provider, but haven’t found anything that provides benefits for ADHD (I’m currently on guanfacine and zoloft, which mitigates my anxiety at least).
Mydayis (dextro- and amphetamine salts) seems to be more stressful on me than Vyvanse. The extended release mechanism also varies things. But hey, there’s a new goddamn shortage every week and we go with what works well enough.
As it was explained to me, you basically got three options: amphetamines, methylphenidates, and the “other stuff” (Wellbutrin, strattera, qelbree, guanfacine etc). This is a purely anecdotal analogy and oversimplification of how stuff works as it was told to me:
Amphetamines (adderall etc) hit the front door in the front of the brain — more dopamine, intense concentrated focus. Methylphenidates (Concerta etc) hit the back door in the front of the brain — more norepinephrine, longer-lasting, more alertness. The Other Stuff is back of brain, like if you turned down the ambient noise of a room.
Long and short of it is that one of these three approaches will tend to work well for an individual with ADHD, but the other two not so much. It’s pure trial and error, and it sucks, but with a decent provider and time (and insurance) you can eventually settle on one at a particular dose. Best of luck!
This has been my experience as well.
Friendly interjection from Depression Lemmy.
Not so long ago I was discussing my meds with my psychiatrist and expressed to them that it felt like the medication wasn’t so much resolving the problem as it was redistributing the problems.
To my surprise the response was, “We’ll, yeah, pretty much.”
This didn’t help my depression much either. :|
Yeah, unfortunately meds don’t fix ADHD. They’re a treatment, not a cure. Meds are supposed to be used in conjunction with other treatments (such as therapy, as an example) to be most effective. I know, it sucks, but these are the cards we’ve been dealt.
Same from the depression side of things. I was really intending to share the part about medication redistributing issues. As even when something is working, it’ll always be unworking something else.
Fellow Garmin user with ADHD.
The HRV status feature on your Garmin is meant to track physiological stress. Not necessarily mental stress (although that can affect physiological things.) Unfortunately yes, when I’m on my ADHD meds (currently unable to source my Adderall XR) my HRV status is lower.
But functionally, I’m better when I’m on my ADHD meds. Yes my body has a heightened stress response (i.e. higher HR during the day when I’m on my meds) from the meds, but in my opinion that’s a necessary side effect of the ADHD meds. I’d rather be functional and capable and have a worse HRV than spend hours laying on the floor feeling like I can’t function because of my ADHD.
Your HRV status covers a rolling 4-week average. Given enough time on the meds, it will learn your new HRV trends and stop reporting you as “unbalanced.” It looks worse than it is right now because the initial period of getting on meds is making it look like your system is out of whack. Which honestly it kind of is, as it’s adjusting. Once you figure out the med combo for you, not only will your HRV settle down from getting used to the meds, but the score on your Garmin will also settle down as you spend more time in your “new normal” range.
Basically what I’m saying is: HRV on your Garmin is more intended to track the impact of training and exercise on your body, and not necessarily intended to track how medication changes affect the score. Personally I would take the Garmin readings with that grain of salt: the changes to your score are due to meds rather than exercise, so it’s sort of outside the intended use of the feature. Keep up with the meds and keep up with your normal training, but your Daily Suggested Workouts will probably be a bit easier while it recovers from thinking your status is Unbalanced.
Thanks for your response! What you’ve told me is accurate, and I have always taken all my Garmin measurements with a grain of salt. But the measurements of stress also coincide with actually feelings of immense stress, restlessness, anxiety, and extreme debilitating mental and physical fatigue.
I took Adderall for 2 years, starting with small doses and slowly titrating up after a few months of consistency. Over that time, the symptoms I describe began to start and become more severe. I did in fact have a nice stretch at the start where the Adderall was working well. I definitely didn’t jump ship at the first sign of physiological changes…only at the point where continuing with the Adderall was going to continue negatively impacting my life and work.
In my futile attempt to stop my post from running on and on with these bits of context, I omitted it and posted it…to a forum full of people that thrive on excessive amounts of context.
Okay yeah sounds like maybe Adderall isn’t the right med for you. When I have a period without Adderall and then resume taking it, I’ll have a few days/week where I’m headachey and barely hungry. But if I power through, those side effects will go away.
My psych has said that some people just don’t do well with Adderall and other ADHD meds are better for them. My best friend also has ADHD and she recently started Adzenys, which is a very recent med (no generics yet.) What I’m trying to say is there’s other types of meds out there and maybe something else will work better for you (side effects and maybe less impact on your HRV score.)
honestly, that sounds like overdose and mineral / vitamin deficency, some people will even lose hair because they just dont eat right.
I never understood how this feature on my Garmin, thank you for explaining it!
I like being a data nerd 🤓 Garmin’s help articles are pretty informative, this is the one about HRV if you’re curious for more: https://www.garmin.com/en-US/garmin-technology/health-science/hrv-status/
Vyvanse might work better, or perhaps modafinil. I was on modafinil for about six years and it was great. these days, I actually prefer ephedrine, I can buy it over the counter at the pharmacy. I don’t think that’s what you’re looking for though, but you can certainly try it
Oh, thanks for reminding me to take my meds.
Sorry if this isn’t what you’re looking for, but my answer is basically “no”.
I can take a 10mg Adderall 4 hours before bed, and fall right asleep. Sometimes, I can take a 10mg Adderall in the morning, and fall asleep at my desk at work, only 30 minutes later.
Adderall makes me feel relaxed and totally unstressed. I’ve never had HRV stress measured, though. What is the experience like, to you, when you are having high HRV stress levels?
Wellbutrin and most other SSRI’s and SNRI’s make me feel a little TOO relaxed. Some of them make me feel less conscious, and a little bit brain fogged. At the time, I described it as if my soul was detached from my body.
To me, methylphenidate (Ritalin) gives the same effects as Adderall.
Every body/brain is different. I tried three other meds for adhd before I landed on a combo that works for me. Strattera was extremely bad for me, but I know it’s amazing for other people. Sometimes you don’t really have a choice but to go through a few meds before you find one that works and is tolerable
When I noticed meds weren’t being beneficial anymore for me, I stopped taking them and started trying to spot where my focus-related issues were and how I could change them. It hasn’t been a smooth sail and requires a lot of discipline, but so far that helped me more than any medications.
I take Mydayis, Strattera and Zoloft every day. I’ve run the gamut of ADHD and anxiety drugs and this seems to work best for me.
- medication interaction could be a reason
- overdose
- you dont eat right (protein, fat, vegtables)
- you are insuline resistent
- in my case, i am grain allergic without knowing it, stopped etaing grains, that helped
- you could be out of salt and different minerals
so. you take uppers and downers at the same time. you take blood pressure altering meds. you take ssri while having adhd, AND stimulants on top.
a couple of things:
stimulants WILL speed up your metabolic rate. thats why they give you brain energy, and a bit of body energy. Its what you want. but the blood pressure thing interferes big time, as does the ssri. the ssri tries to slow your metabolic rate down, thats why it interferes with blood sugar levels, for example.
the salt thing is easy, just eat or drink salt. overdose is also easy, i just took half. eating is also easy, just eat right.
so essentially, what you are trying to do is not possible. it will get worse and worse and worse.
MY problem for anxeity was grain allergy.
you have a very high chance that your anxiety has a reason.
i did get of my antidepressants, and went to baseline, so i could get a feeling how stims work in combination with other substances, this went on for almost 2 years till i figured it all out.
(talk that through with your help provider… thats what i did. )
I garantuee you that what you do will not work at all.
try the salt and eat more good stuff, that cant harm you. but if this doesnt work, you have to reconsider. try taking less.
signs of food allergy:
bloating, stomach cramps. you need 60 sheets of toilet paper, stomach ache, migraines, heart arythmia, anxiety, drepression, skin problems, hair looks dirty, pimples, black spot under eyes, sore throat, dry thorat, white trush on tongue, panic attacs, paranoia thoughts, congested nose, vitamin deficency
yea, ssri does kinda complement adhd meds, because of serotonin dopamin relase and stuff.
but that still leaves the fact that one does speed up your system, the other slows it down.
keep in mind that salt and minerals could be also the culprit. salt is insanely important for proper heart function. and your body cant really deal with a sped up metabolism, sometimes, you are right on the edge, and the stims push you over.
oh, the guanfancine lowers your blood pressure. so, on stims, your heart needs to beat faster, because your body wants to have higher blood pressure.
normally, your heart would just beat STRONGER, you see? but it isnt allowed to beat with more force, so it has to beat faster.
you have an energy usage increase of 20-30 %. thats what stims do.
keep in mind that i am just an autistic dude with adhd that had problems with insuline resistance and stimulants, so i read a lot of stuff.
i just want to give you ideas, thats all. it doesnt mean that I know whats right or wrong.
ok, take care, you will figure it out.
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I don’t have a garmin, but methylphenidate (Ritalin) extended release gave me a high heart rate and exercise intolerance.
I’m on dexamphetamine now, that doesn’t seem to have the same issue.
For me, Vyvanse (lisdexamphetamine - a prodrug of dexamphetamine) caused the same side effects - high HR and working out felt bad. I stopped medication because it was a lot of stress for me.
one reason could be you were lacking salt. sounds stuüpid, but is very easy to test. just eat salt.
I was not lacking salt. My body was having a natural reaction to a CNS stimulant. Everybody reacts differently to pharmaceuticals, and I’m audhd which makes it worse.
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You’re not a doctor or you wouldn’t be playing it online. Please refrain from giving people unsolicited medical advice on the future.
No. people ask for help, I tell them what i think.
I didn’t give you medical advice. What I said about salt is Nutrition and common sense.
You don’t need to be a doctor to learn whats up with your body, how it works, what it needs, what stims do to it. doctors didnt tell you about salt, how stims speed up metabolic basal rate, why your hearth acts the way it does.
I took a spin on the pharma-go-round about 20 years ago. Went through just about every stimulant on the market over the course of two years. The only one to have a noticeable effect was Adderall… but the effect was panic attacks for routine issues at work. I was done at that point. I rawdogged reality for 25 years, how bad could it get?
Narrator: yes.
I went through some shit this past winter that basically required me to seek intensive mental health treatment. After one psychiatrist (who declared after 20 minutes of talking to me post-trauma that I didn’t have ADHD) and one useless APN that worked for the program I was in, I found a psychiatrist that listened… but he wanted to slow-walk the ADHD treatment due to severe depression and anxiety while the SSRI did its thing. After a few months of relative stability he wanted to try Lamictal… which promptly gave me hives. I said fuggit and asked for the DNA analysis. I’m not fond of getting put into yet another big database but shots in the dark take too long.
Sounds about where I’m at as well.
Did you get the results of the DNA test back, and get any valuable information from it?
No results yet, it just arrived yesterday lol. Fingers crossed it has some good info. Feels like I’ve been in a holding pattern for months.
Wait there is DNA analysis for ADHD?
I think it’s more to do with what drugs/classes will be effective/ineffective/dangerous based on known genetic markers. It’s not necessarily hard info, but it can inform the direction of treatment. I’m all for skipping as much of the pharma-go-round as possible.
Yeah, I’ve seen it talked about a fair amount.
Here is one of them, per Google: https://genesight.com/product/
Currently using Modafinil, which is rather bad on side effects and risks, hoping for an upgrade next month. So I had to work with that.
The Plan: Use it on about 50 days per year, and make them count. E. g. not on days full with unproductive meetings, but when I have a clear task and time to execute it. A task with high visibility. It’ll look to others as if I were rolling 200 days like that.
SSRI’s can cause issues with stimulant medications primarily for two reasons. They increase the effectiveness of the stimulant and they increase the level of serotonin in your blood. Too much serotonin is not good. Look up “seratonin syndrome” and see if you’re experiencing any other symptoms.
Those meds can be taken together but there probably needs to be a dosage adjustment to one or both of them.
Also, if you’re not already, avoid caffeine completely.
I haven’t taken sertraline and Adderall at the same time. But this is good information to know, I’ll look up the symptoms. Thanks!
Oh! Ok. Sorry, I misunderstood.
