Not to be too depressing, but there are two factors that can contribute to this honeymoon phase that I'm aware of:
1. Weight change, either bulking on muscle or fat can change your optimal dose for medication... And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake.
2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life.
Both of these are addressable though, in the first path any significant weight changes should be monitored by your doctor (go to your doctor regularly, blood pressure should be monitored while on stimulants) and ideally the medication adjusted up... for the latter, well, it's a pile of poo but if you're able to stick with it your doctor will likely take you on a tour of different methyl*s until you find one that works - then, try your damnedest to never let your insurance force you off of it.
> 1. Weight change, either bulking on muscle or fat can change your optimal dose for medication... And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake.
Stimulant medications are strong appetite suppressants, and if not specifically paid attention to, the usual concern is weight loss.
To the point that an actual medically approved use of certain stimulants is for weight loss. You can in fact be prescribed meth (Desoxyn in the US when it's coming from a pharmacy and not the backseat of a 1996 Chevy Caprice) by your doctor for obesity if nothing else is working for you.
Speaking to personal anecdotes, while unmedicated there's always been a certain quantity of accidentally skipped meals, with medication I could go the day without eating much of anything and not be particularly bothered.
On the other hand, I'm better at sticking to structure with medication and eating at normal mealtimes more often, even without a hunger impulse. I do still wind up having to mentally (or otherwise) tally what I've eaten in the evening and sometimes shoveling in a pile of extra calories because it obviously wasn't enough.
So there are pulls in both directions, but IMO I'd say the weight loss is more likely to accidentally happen.
> 2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life.
The usual advice I've always been told is to not take it if there's times you don't need it. If I'm going out to have fun for the day on a weekend, or taking an unstructured vacation for a week or the like, I typically don't take it.
I don't think it fully resets those resistances, but it's allowed me to continue to get a noticeable benefit out of a steady, middle of the road prescription.
> for the latter, well, it's a pile of poo but if you're able to stick with it your doctor will likely take you on a tour of different methyl*s until you find one that works
Best thing one can do is take chelated magnesium. Choline and fish oil help as well, but definitely take chelated magnesium every morning.
It helps prevent a tolerance build up (in turn helps prevent one from getting an increase in dosage) and helps replenishes the magnesium depleted from ADHD medication. Magnesium deficiencies are also common in those with ADHD who do not take medication. So if you're taking medication, the deficiency is caused by two sources.
>"1. Weight change, either bulking on muscle or fat can change your optimal dose for medication... And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake."
Idk. I never gained much weight and ate a lot but the rilatin i take makes my appetite plummet completely.
I eat a lot less during the day.
>"2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life."
I hope this won't be me. I think i am already largely resistant but i hope i can lose it and will try to go back to taking breaks.
> And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake.
In my experience, it's totally the opposite. More exercise, more activity, and less caloric intake... leading to weight loss.
You can avoid becoming resistant to the medication by taking "holidays". I usually do this Friday-Sunday most weeks. A daily alternative can be wellbutrin or aplenzin as well.
Also most people can get away with generics so even without insurance the meds are cheap. The psych visits will cost $300-400 a pop though....
Most of these are still schedule 1s though, so if an insurance change forces you to a new GP you can get the prescription yanked - there's no guarantee of access to methylphenidate in the US, there aren't any over the counter methylphenidates and any other acquisition route would probably break the law (like buying it in Mexico or from a friend).
That said, at some point it's going to be worth it to just pay out-of-pocket for five minutes of your old GP's time to write a new script if things are dire... but the fact that this barrier can exist is troubling to me since being in that ADHD hole makes it so much easier to get over these barriers.
For some folks wellbutrin/bupropion can be used to treat ADHD. It is schedule IV so access is easy and generics (I think generics kinda suck for me with this med) are very cheap. Does it work as good as stimulants? Nope, but its certainly easier to get and can help some people.
I feel going to a GP to get a very restricted stimulant is a uphill battle. Go to a ADHD specialist psych. Despite having diagnosed ADHD since I was ~6, my GP looked at me like I was crazy when I explored getting back on meds. I went to see a specialist instead.
My personal experience here is a bit limited - I grew up in the states but after college I emigrated up to Canada so... yea I generally get scripts from my gp up here for a full year's supply at a time and end up paying something like 1/30th of a cent (CAD) per pill for it. While I was in the states I had to fight to keep my script when I transitioned from my parent's insurance to my employer's in college, and ended up paying 9$/pill for a few months but I accessibility was always maintainable without ever seeing a psych except for initial diagnosis in middle school.
My experience with US ADHD medical providers is that they require an appointment every 3 months where you get another 3 scripts (with 2 being dated for the future months). One let me go a whole year without having an appointment but I also didn't ask for a script every month. Generics stimulants have been cheap with and without insurance (or with GoodRX).
After I moved and got a new GP and asked for a stimulant prescription, they wanted me to come in every single month and do a urine drug screen even if I provided info from my former providers. I switched to an ADHD specialist right after that. It's much more expensive but they treat me with respect.
Yeah I have to go in monthly to get mine as well. Thanks to college kid abuse and the opiate crisis doctors cover their ass when it comes to writing stimulant scripts. This means monthly visits (and they get $300 each time) and sometimes drug tests.
1. Weight change, either bulking on muscle or fat can change your optimal dose for medication... And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake.
2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life.
Both of these are addressable though, in the first path any significant weight changes should be monitored by your doctor (go to your doctor regularly, blood pressure should be monitored while on stimulants) and ideally the medication adjusted up... for the latter, well, it's a pile of poo but if you're able to stick with it your doctor will likely take you on a tour of different methyl*s until you find one that works - then, try your damnedest to never let your insurance force you off of it.