Disclaimer

I am not a doctor, and this is not medical advice. This is purely for educational purposes, based on my personal understanding and experience with ADD/ADHD medications. If you're considering or currently taking medication, consult a qualified medical professional for personalized guidance.

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Understanding ADD/ADHD Medications: Stimulants

All right, let's talk a little bit about ADD/ADHD medication. We're going to focus specifically on stimulants—the different classes of stimulants—and some of my personal experiences with their effects.

Overview

There are two primary treatments for ADD/ADHD: stimulant and non-stimulant medications. These medications help manage symptoms such as:

• Difficulty focusing
• Hyperfixation
• Impulsivity
• Restlessness
• Difficulty with task completion
• Emotional dysregulation

Classes of Stimulant Medications

We're only going to discuss stimulant medications today, as they are the ones most commonly prescribed. Within the stimulant category, there are two primary classes:

1. Methylphenidates
2. Amphetamines

How Stimulants Work

Stimulant medications primarily affect neurotransmitters linked to motivation, alertness, and focus. The primary neurotransmitters they influence are dopamine and norepinephrine, and possibly serotonin.

Methylphenidates

Methylphenidates work by blocking the reuptake of dopamine and norepinephrine.

• What is reuptake? It’s the brain’s process of reabsorbing neurotransmitters after they’ve been released. Blocking reuptake means these chemicals stay in the brain longer, enhancing their effects.
• Primary medication: The most well-known methylphenidate is Ritalin, which is often prescribed to children newly diagnosed with ADHD. There are others, but Ritalin is the most widely recognized.

Amphetamines

Amphetamines work through three mechanisms:

1. Blocking the reuptake of dopamine and norepinephrine (like methylphenidates).
2. Directly increasing the release of these neurotransmitters.
3. Inhibiting monoamine oxidase (MAO), an enzyme that breaks down neurotransmitters. By inhibiting MAO, more neurotransmitters remain in the brain for longer periods.

Primary Medications:

• Dextroamphetamine-based: The most well-known amphetamine medication is Adderall (a mix of amphetamine salts).
• Lisdexamfetamine-based: This includes Vyvanse, which differs in that it must be metabolized first before becoming active in the body. This makes its effects smoother and more gradual, reducing spikes and crashes.

Personal Experience: Benefits of Medication

For me, the biggest benefit of ADHD medication has been improved focus and task initiation. I can get things done even when I don’t necessarily feel like doing them. Instead of overthinking or getting overwhelmed, I can simply get up and start—rather than procrastinate or spiral into avoidance.

Another unexpected benefit? It helps me avoid hyper-focusing on the wrong things. I used to get stuck in negative thought loops, replaying frustrating moments or ruminating on emotions under the guise of “figuring them out.” But in reality, I was just stuck. The medication helps me recognize those feelings, acknowledge them, and then say:

"These feelings are valid. Let’s take a breath to feel them. Okay, now we have a life to tend to and work to get done. Let’s get started."

One of the most surprising effects is that it helps me feel more like myself—a hard thing to describe, but just a sense of being more in tune with the person I want to be in the world. And perhaps the biggest relief? That moment of realization:

"Oh wow, it doesn’t have to be so hard."

Motivating myself and completing tasks used to feel like a Sisyphean effort—as if I were constantly pushing a boulder uphill. I could do it, but it was exhausting. The medication doesn’t make life effortless, but it makes it manageable.

Important Considerations

1. Stimulants Are Addictive

These medications can be habit-forming. While prescription stimulants differ significantly from methamphetamine, they should still be used cautiously.

2. More Is Not Always Better

Taking a higher dose does not necessarily mean better results. In my experience, excessive doses led to:

• Increased agitation and frustration
• More aggressive driving
• Shorter temper
• Increased likelihood of snapping at people
• A "brain burnout" feeling—exhaustion, as if staring at a screen all day

3. Typical Doses

• Methylphenidates (e.g., Metadate, Ritalin): Starting doses are usually 10-20 mg, then adjusted as needed.
• Adderall: Can start as low as 2.5-5 mg, then increase to 10 or 20 mg.
• Vyvanse: Similar dosing patterns apply.

4. Medications Are Not Magic Pills

These medications are tools, not cures. They don’t “fix” ADHD, nor do they erase all challenges. Even with medication, I still:

• Lose my keys.
• Struggle to find things.
• Feel restless at times.
• Have difficulty focusing some days.
• Get distracted by the wrong things.

But despite those challenges, they help tremendously. They provide just enough clarity and structure to make managing ADHD easier, not effortless.

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This was just a brief overview of stimulant medications, their effects, and key considerations. Always monitor side effects carefully and adjust medication under the guidance of a psychiatrist.