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ludear,

It sounds like you have a pretty strong handle on what your symptoms are; I'm glad to know you're so self aware.

It sounds like the Concerta is working for you, at least somewhat. That's a good thing, stick with it. Your sense about the amphetamine salts is probably correct. Amphetamine and Methylphenidate (the active ingredient in Concerta/Ritalin) lasts roughly 4 hours in your system. The way Concerta is formulated, however, is such that your body has to break down a more complex molecule to access the active ingredient--this way it can be released more slowly throughout the day, so it's a smoother uptake and lasts a lot longer. It's likely that your friend's amphetamine salts is an instant release formulation, which means you get the full shot of the med immediately and it will be gone within 3-4 hours.

If you decide to investigate an amphetamine-based option, Vyvanse is formulated in a similar way to Concerta, and will take the edge off the ups and downs you'll get from an instant release med. You can get amphetamine salts in formulations that break down more slowly in your stomach, but they tend to be less effective than those that are bound at a molecular level.

[QUOTE=ludear;5121803]I have been reading some very terrifying things on the boards so sometimes I wonder if it is better to stop cold turkey than to try to figure out what my body works best with.[/QUOTE]

Can you tell me what sorts of things you've been reading? I have seen many fear mongers on the boards, and have seen many claims--most involve abuse of ADHD medications. If you're not getting what I call the 'euphoric effect' from your meds, which means that the meds give you an increased feeling of self worth or a rush of energy, you will not become addicted; most cases of abuse/addiction stem increasing one's dose in an uncontrolled way to chase this euphoria. If you are depending on the meds to wake you up or to make you feel like a decent person, your dose is too high and addiction becomes a very real possibility. When taking ADHD meds, you should have a better ability to focus, and an increased ability to follow through on what you start. Anything more than that is an effect that you won't be able to maintain without increasing your dosage on a regular basis, and may well lead to addiction.

As to warnings of permanently damaging side effects, tics, behavioural changes, psychosis, or brain damage--these are generally the result of abusive doses; tens, hundreds, or even thousands of times higher than therapeutic doses. Also, many stem from use of medications in small children; I'm always ambivalent about messing with the brain chemistry of a child, their brains aren't fully developed yet and more suceptible to damage from changes in biochemistry. It's always important to understand that taking any medication at any time does involve risks, but then so do things you would never think about like herbal tea and coffee (did you know that as few as 5 cups of coffee a day can lead to auditory hallucinations?).

It's important to note that the first amphetamine was formulated in 1887, and methylphenidate has been used to treat ADHD since the 1950s. Amphetamine has been used extensively to battle somnolence in the military and trucking industries since at least the 1930s (it's still used in military circles, but banned for truckers). These are not new and experimental drugs--their effects, properties, and long term effects have been very well studied and observed for decades (as opposed to many drugs that you will be prescribed for other maladies which might have been fabricated for the first time 5 years ago).

A couple of notes, though, if I may:

[QUOTE=ludear;5121803]. . . feel like a complete waste of space.[/QUOTE]

I have often been diagnosed with depression because on surveys I would admit to feelings of worthlessness or discuss not being able to get out of bed. I am similar to you in that I don't feel that I suffer from Dysthymic Disorder (clinical depression), I always described my depression as situational--I get depressed because I fail at something, I don't fail at things because I'm depressed. That said, I think it's important to work on altering your ways of thinking to avoid thinking of yourself as worthless or bad in some way, because internalizing some labels (bad, worthless, hopeless, pathetic, etc.) can lead to diminished motivation.

One of the biggest changes to my own self image over the last few years has been to judge my actions rather than myself. Simple alterations in thinking: "well that was stupid" instead of "god! I'm such a retard!" or "gah! what is wrong with me? I never do anything right!" can make a world of difference--despite the fact it sounds much the same. I'm to the point now where I even take the edge off the value judgement about my actions, it's amazing how much better 'silly' feels than 'stupid.' That's not to say that I don't continue to have high expectations of myself, but telling myself I was worthless had no motivational value, and actually served to erode my motivation by making me feel like there was no use trying.

Similarly, try to figure out why you struggle to get out of bed. Is it lack of physical energy (I interpret "complete flop" to mean this, but may be wrong)? Is it that you just don't have the mental/emotional energy to face the world or your job? On this same note, a few years ago, I felt trapped in a job that I couldn't face at least 2 or 3 times a month because my relationship with management was so dysfunctional. You wouldn't believe the difference it made to my outlook on life when I left and found something new, even though it paid me less.

Best of luck!





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