Senior Veteran (male)
Join Date: Mar 2005
Re: Ideal drug holiday frequency/duration?
May I add to my trusted friend, "Thurnor's," reply.
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.
My experience: I've developed a tolerance to how Adderall makes me feel. It no longer makes me feel good or bad. On the other hand, Adderall continues to control my ADHD symptoms better than ever.
Thunor: 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.
Thunor: 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.
A) I have on numerous occasion taken "accidental" holidays. I run out to work without my meds, function just fine, and discover I hadn't taken my meds back home when my wife yells at me, "you didn't take your meds."
B) On other occasions, I run off without my meds, do a high speed 180, screech into the driveway, yell, "woman, where's my freaking speed?" She yells back, "right where it always is."
What's the diff between A) & B)? Brain load. We can talk about "load" later.
Thunor: As to improving efficacy, it's known that taking amphetamines with acidic food or drink reduces the effect.
Me: Maybe, maybe not.
Thunor: 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.
Me: Above parsed" "Maybe, maybe not.
Thurnor: 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).
Me: Absolutely, positively, beyond all doubt - reasonable and otherwise, FACT.
ADHD sufferers also tend to do better in structured environments, so following an established routine as closely as possible will help.
Me: I do much better as long as I am the architect of my structured environment. "Established routine" is a relative thing. Each day my business pops the unexpected in my face. I thrive on it.
Recently (June 1) I hired a "nuts & bolts" manager. Corporate types title him "General Manager." I swear "Bill" (real name) is as freaking ADHD as me. I can't work with the guy. So I don't. "Bill, take care of this 'stuff,' bye." At day's end, "stuff" is done - perfectly.
The diff between Bill and Bob (me). Bill comes into my office while I'm on the blower with a customer trying to intimadate me. The cus claimed I billed for services never rendered. I told cus, "Bill will inspect the work first thing in the AM. If legit, we'll fix it. Otherwise, I putting a contractors lean on your property." Bill sees I'm unaffected, asks me, "how do you do it?" I replied, "it's fun." Phone rings. It's cus. "Check is in the mail." Blah, blah, blah, happy ending - this day, this time. More often than not, no happy ending. Still fun.
Bill, needs to be told, "what to do" NOT "how to do it." I'm the same. Bill has trouble dealing with people on a emotional level. I get it off on it. Both of us are as ADHD as can be.
Thunor: 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.
Me: Their 'science' is BS at best.
Thunor: "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."
Me: Absolute FACT.