[Slytherin44]

Hey everyone,

My Quick Background:

Text-book ADHD here. Been on med's since second grade. Currently 24. Very driven and overachiever. Ex-Investment Banker and graduated with highest honors.

My Medication Situation:

I have been on adderall everyday for over 15 years. Due to such, the tolerance I have built up resulted in me being on:
- 60MG XR in the morning
- 10MG IR every 4 hours throughout the day
- 30MG XR at 4PM

Throughout the years - I have been on many types of ADD medications - including Straterra, Focalin, Vyvanse, Intuniv, Concerta, ect... Nothing worked, and we always went back to adderall.

I took advantage of down time after leaving my most recent employment to go off all the meds to see if I even still have ADD or if I am just physically dependent on the meds. After an extremely difficult two months of withdrawal, I reached baseline with no meds. The ADD symptoms came back. I then went back on adderall, at a very small dose.

I am now having to increase it again (after 3 months of the small dose) because I am running into the same problem I had for the last 15 years of my life - the decreasing efficacy of this medication on me.

My Problem:

1) I don't want to keep upping the doses of adderall again
2) The adderall corrects my behavioral symptoms of ADHD, but as tolerance builds, focus becomes way harder. Even with high doses of adderall - I often have a racing mind and complete inability to be "in the present" and focus on what I am doing. For example - I can't read a page of a book without my mind thinking of 50 different things - resulting in me not remembering anything I read. I feel like I am always in fog of racing thoughts.

My Solution:

I am going to be try Modafinil, with a lower dose of adderall and see if this gets rid of the fog and creates a more sustainable and stable situation.

Does anyone have any experience in making the switch from adderall to adderall + modafinil or just from adderall to straight modafinil?

[lowinmood]

I haven't a clue, but best port of call is to see a psychiatrist and switch safely,but presume you've already done that.

[Slytherin44]

Yes - I am doing all this under the guidance of a doctor who is working very closely with me on such

[AncientMelody]

Have you tried the modafinil? How are things going?

[Slytherin44]

I have. I am not noticing any significant change on 100mg in the morning (along with 30mg of adderall).

It is worth noting that I have also switched antidepressants from Lexapro to Brintellix during the recent weeks.

[pinkflower17]

I changed from Adderall to Vyvanse (which you said you already tried and didn't have success with), but for the same reasons - needing to up the dose due to almost two decades on Adderall. What I also did is add Brintellix and Wellbutrin. Wellbutrin has been used for years off label to treat ADD/ADHD with moderate success and Brintellix is in the process of applying for an indication for ADD - inattentive type. The combo seems to be working. I've been on the same dose of Vyvanse for about 9 mos now and it's still for the most part holding me.
Maybe something to discuss with your doc?
Good luck.

[Slytherin44]

Pinkflower - thank you for sharing this. That is a combination I have never heard of (specifically someone being on Wellbutrin and Brintellix simultaneously). I will definitely bring this up to my doctor about potentially trying this.

[yoyomaster]

1) That's a pretty high dose of Adderall - have you tried using something like low-dose memantine to reverse tolerance? Even magnesium can help with tolerance.

2) Modafinil isn't quite as effective as Adderall for ADHD. Search "modafinil vs adderall" in google and you'll know what I mean.

4) Have you considered Strattera?

[AncientMelody]

Frankly I'm a little envious that you're able to get modafanil. I have excessive daytime sleepiness, awaiting my sleep study for a formal diagnosis. I did a trial month of modafanil and it's really helped me at work. But if I don't have narcolepsy on the sleep study (and I don't have a typical narcolepsy picture) then I probably won't be able to get the modafanil approved