I (25f) am recently diagnosed (April 2023) and still figuring out meds. My primary started me on qelbree which was a total mess and the worst month of my life. After being referred over to a psychiatrist because my doc was uncomfortable prescribing anything other than non-stimulants, my psych started me on adderall. It was a godsend from day one. I noticed an immediate decrease of stress and uptick in being able to actually get things done which helped with a whole slew of related mental health struggles. We have gone through a few different dosages, and I am currently at 15 XR in the morning and 5mg IR in the evening. I am thinking, sleeping, and working better than I have for as long as I can remember, though not without some issues when the drug leaves my system.
Now to the point- About two weeks ago, I went on vacation and the week after was trash as far as the meds working. I felt terrible, and all of the issues that adderall was helping with came back with a bang. The issue has since mostly resolved itself, but I am trying to figure out what caused the problem so that I can keep myself from spiraling in the future. I will include some details below and would appreciate any ideas or thoughts from your experience.
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the vacation lasted 6 days, all of which I took my meds.
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all 6 days, I averaged less than 5-5.5 hours of sleep
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I consumed alcohol the last 2 days out of the 6 with the last evening possibly exceeding what I should have. I do not drink more than once a month usually
-food consumption was normal and I did not eat anything out of the ordinary.
-the last day of the trip, I noticed that I was not feeling as focused with my evening dose. The morning that I left, I was back to feeling like trash mentally as I had prior to starting these meds back in May.
-because I have heard hormones could impact things, I ended my period half way through the trip. I do not remember having any issues following other periods.
Please let me know what you guys think.
Meds don’t cure anything, it just makes it easier, so when our routines get thrown off, we’re still going to have the same challenges. Be kind to yourself.
After starting meds, it made me way more sensitive to having my routine thrown off for some reason. I just took a vacation and I was all over the place mentally and not able to enjoy it like I should have. I get overwhelm, sensory overload, and I just wanna go home back to my comfort zone. I didn’t used to feel like that before when it was zoloft instead (but had to stop zoloft for other reasons).
How much sleep do you usually get?
The amphetamines can be a great benefit but all they are really doing is boosting or concentrating what you’ve already got.
If you’re going hard on vacation, doing more physically taxing stuff, experiencing more stimulation your going to notice that depleted feeling you get when the Adderall wears off gets worse.
At least that’s how it goes for me. YMMV and feeling like crap could be down to more than one thing. It’s also normal to develop a tolerance to amphetamines but it’s best to rule out everything else you can before messing with a dosing regimen that’s been working well for you.
Realistically I get 7-7.5 a night since starting the meds. I have only been on this dosage for about a month now. At that time it had only been about 2 weeks. This has let me to think that it was something other than tolerance when paired with the fact that that I am doing better now.
I has a meeting with my psych a few days ago and he was kind of stumped about how I was down for like 6 days after the trip buy am not functioning well again. He said to just go another month and see what happens. I guess I will try tracking.
I wouldn’t expect tolerance to be a major issue after a few weeks, and I would be very hesitant to mess with a dosing regimen that was producing positive results. These are powerful drugs and a minimum effective dose is what you want.
I wouldn’t think an hour less would would make a huge difference either… but perhaps cumulatively.
It certainly sucks to pay for vacation with an equally long period of feeling shitty.
(I’m assuming you meant now functioning well again)
But give it all some time. It makes sense to want to get out in front of the problem, but focusing on the wrong metrics is easy if you’re still defining the problem.
You’ve got a brand new brain, consider the first few months a shakedown run. Have fun with it, but try to creep up on the limits of your performance gradually. Don’t get to discouraged by setbacks, it’s not uncommon to spend months fine tuning the meds… I spent a year trying different medications, usually spending a month or more at the initial dose. And I’ve had the dose adjusted both up and down in the years since.
Definitely bring it up with your doctor if it happens again. Don’t be afraid to point out that it’s happened before or that you’re concern hasn’t been adequately addressed… most doctors are happy to explain their reasoning, they just don’t always expect people to care.
You’re absolutely right about the fact that hormones can affect ADHD symptoms. Of course, we don’t know what actually happened, but it could be that the combination of travel and stress made you more hormonal than usual, thus affecting med effectiveness (progesterone would do that).
It could also be just stress alone. Like another poster said, meds don’t take the ADHD away, just make it manageable. The interruption in routine could be enough to cause this havoc.
Another option is acidic food and drink as that can interfere with Adderall effectiveness. Stress can also increase the acidity of your stomach.
You may want to track how bad the ADHD symptoms are along with your cycle, mood, routine, etc (yes, I realize it’s hard to track anything with ADHD, but there are apps to help). This way you can start seeing trends for the future.
My guess? Sleep deprivation. I’m not a doctor, but I personally have found that sleep debt wrecks my brain chemistry, for up to twice the number of days I got less than 8 hrs of sleep (or whatever my baseline is at that time). Losing at least an hour a night for six nights in a row would definitely make me garbage for at least a day or two, probably more like a week.
Granted, ADHD is not the only issue I have that for which this is relevant, but even NT people have trouble focusing when they’re really tired, sooo…
My unsatisfying guess is that nothing affected it, the work the meds had to do got harder.
I always struggle to return to day to day life after a nice vacation
I would say lack of sleep and tolerance are you two main culprits. I know for me when I don’t get enough sleep I feel like my meds are completely useless. Plus your tolerance of your Adderall can slowly reduce the efficacy of your meds to the point that it doesn’t take much to feel like they aren’t working.
Were you drinking carbonated beverages, caffeine, or anything with vitamin C around the time that you took your dose? These can reduce the efficacy of the medicine.
Beyond that, you definitely needed more sleep. Adderall is not a sleep replacement, and it will not help you as much if you aren’t giving your body adequate rest. Your body will also adjust to your dose over time, and the dose will need to be increased a little bit.
For now, focus on getting adequate sleep whenever possible, and remember to drink enough water. Give your body what it needs to function at its best, and the meds will be more effective for you in return. If this isn’t enough, then it’s time to discuss a dosage increase until you can find and maintain a therapeutic dose.
Just a guess based on my experience with Adderall: for me, Adderall primes the “motivation” pump, but I need to have a direction for the flow or I go all over the place. You were directing the flow until you went on vacation, and then you were still taking the meds, but there wasn’t the impetus to direct the flow. (And, there shouldn’t have been–you were on vacation!)
So, in addition to other suggestions, could the following week been getting readjusted to directing the flow? I’m glad it was a temporary issue, though!
