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.
-
the vacation lasted 6 days, all of which I took my meds.
-
all 6 days, I averaged less than 5-5.5 hours of sleep
-
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.
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…
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.
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.
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.
