Senior Veteran (male)
Join Date: Feb 2008
Location: Edmonton, Alberta, Canada
Re: Ideal drug holiday frequency/duration?
The reason your doctors and pharmacist are unspecific regarding the tolerance issue is that there is no established rules in this regard. Just as dosage and specific pharmacology vary wildly from person to person, so too does the likelyhood, rate and level of tolerance to amphetamines and other stimulant meds.
Tolerance is an established fact (at least as far as science establishes 'fact'), it does occur. Unfortunately, there is simply no way to know how likely you are to develop tolerance; indeed, while most people tend to become tolerant to these meds, some experience no tolerance at all, while some actually become sensitized, and need to lower their dose over time. I suspect that someday, we'll actually understand the science of tolerance, but at present, we don't even understand the precise mechanism of action of amphetamine, so it's impossible to make predictions.
Because it's impossible to tell ahead of time the likelyhood of tolerance, it's impossible to set down any hard and fast rules regarding 'holidays.' My shrink advises against them entirely, but I've seen many people swear by them. I know it's not the answer you're seeking, but no one is going to be able to answer a question that depends so heavily on your own particular brain chemistry. Just as with establishment of the ideal medication and dose for treatment of ADHD, tolerance avoidance holidays are going to be straight up trial and error.
As to improving efficacy, it's known that taking amphetamines with acidic food or drink reduces the effect. I suspect, though can't claim to truly know, that non-acidic foods that produce a net acidic response by the body (most meats and grains) will likewise reduce efficacy. Beyond that, clean living has been shown in many studies to reduce the severity of ADHD symptoms, specifically, eating a proper diet, low in refined sugars, saturated fats and chemical additives, getting sufficient sleep, drinking alcohol in strict moderation and getting enough exercise (sounds like fun, I know). ADHD sufferers also tend to do better in structured environments, so following an established routine as closely as possible will help.
Any other drugs or strategies will be anecdotally based. You will find in many places people claiming scientific evidence for one remedy or another, but those people are generally trying to sell you something, and their 'science' is questionable at best. It's best to do your own research in those regards, giving weight only to those scientific studies that are published in peer-reviewed journals, in my experience, those that are not are aware that their 'science' won't stand up to scrutiny.
As far as additives that make sense to me, apart from those that would fall under the 'clean living' heading (vitamins, omega-3s), you may consider supplementing L-Tyrosine, as it is a precursor to L-Dopa, which is a precursor to dopamine, which is a precursor to norepinephrine. Taking more L-Tyrosine will not necessarily result in production of more dopamine and norepinephrine, as there are several rate-limiting processes at play, but I suspect being deficient in L-Tyrosine may well lead to lowered levels of those all important neurotransmitters.
So, probably both more and less than you were asking for, I hope it wasn't too overbearing, and I hope it helps. Best of luck.