AddLemmus

Really doesn't work with my life. Extreme, sudden expenses, such as a 6k health insurance debt, hit me with as much surprise as a sudden project that pays 20k within 20 days. I just got to roll with it and hope it stays in the + somehow.

He seems completely incompetent altogether. I expressed concern that a stimulant would not be right for me, as even coffee has an extreme effect when taken after a long pause. But everybody, GP, therapist and psychiatrist, insisted that we should try MPH or AMP, as it is so much better, even though the whole prescription process is complicated for a schedule 2. And it worked out great from the very start.

He seems to worry about the wrong things. To rather let a patient in his care suffer with 3rd choice meds for months (?), followed up unmedicated than take the chance that you might be a 1%er who abuses it. For which there isn't even much indication, as you have a prescription.

However, if I really try to give him the benefit of a doubt: A quick search shows that there are some risks in combining weed and medical stimulants. The positive effect can be reduced, and cardiovascular risks of stimulants increase. So, without medical training, I don't know if that means that you have to search for alternative for either of those first (switch either the pain meds or the ADHD meds), and then continue treatment for both, or if it really is so risky that you absolutely must keep one of the conditions untreated. As far as I understand, weed is rarely the only option and, at best, only slightly better than the next best alternative. For ADHD, on the other hand, MPH or AMP or so much better than the next best alternative. I tried Modafinil myself, and the side effects were severe.

So maybe his tone was just off, and he should have explained those careful considerations for the best therapy options, rather than be like "eek junkie, get out until you are clean".

I might be completely wrong here, it's literally what spins off in my head after 2 minutes of search.

GP and therapist also said that methylphenidate is the way to go, without alternative, even. But the psychiatrist said that for adults, lisdexamfetamine is slightly better, both regarding best effect and lowest side effects. A quick web search seems to support that, as well as what people in this community, who tried both, said.

One disadvantage is the insurance: If I try some day to have it covered, it's quite likely that they insist to pay only for the cheaper methylphenidate, and only switch if there are significant problems.

I found this German source for dosage and finding the right medication very good: https://www.adxs.org/de/page/232/eindosierung-von-medikamenten-bei-adhs#content-241-elvanse-lisdexamfetamin

I can relate to the paralysing "what ifs".

I started with 5 mg, which had a significant, great effect for 4 hours, then crash. I worked up from there and think that 12 mg is the right one for now.

I followed this guide in German, and agree from experience that starting with 30 mg or even 20 mg is not a good idea: https://www.adxs.org/de/page/232/eindosierung-von-medikamenten-bei-adhs#content-241-elvanse-lisdexamfetamin

Interesting is their take that the right window +/- 5 mg must be hit, otherwise too low of an effect or very unpleasant side effects.

For Modafinil, I also went with 1/8th of a normal dose for a while, working up over months to 1/2.

I noticed that I can be a bad friend, at times. Need to unload for hours, too impatient to listen, and when I do it out of politeness, I won't pay attention.

With some friends, I suspect that they just have the pity to be like ChatGPT, like "That's so relatable!", "Wow, that IS an interesting day you had there!", "So funny! Glad I missed South Park to listen to your much funnier ramblings!"

At times, I had a like-minded friend, and we would just take turns talking for roughly the same duration, like an unspoken agreement.

It's actually the normies who can't even do laundry without a little neurotransmitter bottle from mommy frontal cortex. We fight demons every day.

First test: 5 mg (~ 15% of 30 mg) at 8:30 am.

It kicked in really hard, like a thick line of quality speed. It didn't feel like something that a doctor would prescribe. Got a lot done, then hard crash at 12:30, lying down and dozing off for 20 minutes. The mental effect was at least as good as it was with Modafinil: I tackled the most urgent todo without mental effort and little chores just "happened". But with a high like from recreational drugs.

Maybe what contributed was that I did a quick, but intense workout.

So it was perfect - a very safe dose, yet also the productivity boost I needed for the day. 10 mg might also have been fine, but taking the entire 30 mg (or even 20) would have been a mistake. Certainly no risk to not feel anything.

I wonder if I should take another 2.5 mg for the afternoon, or just use tea and coffee as usual.

This strange effect regarding intensity and duration was no surprise - I observed that with other medication and drugs before, the doctor understood it and took it into account, thus the individualised instructions.

I don't know why he does what he does, but he said that I should find the ideal dose, which often is between two capsule sizes. He encouraged me to take any dose lower than 30 mg for the first month, and after he sees me again to fine tune it by dissolving in water.

I dissolved it in some water in a protein shaker with marks, so I can take exact 3 mg doses (10 % steps).

Only thing I don't like about this is that children are in the house, and there should not be deadly poison water standing around anywhere. The capsules are in a lockbox.

When that happens, I do manage to finish the sentence by appending grammatically correct tokens, like an LLM, though

Thanks! I'll play it safe and would rather start with 5 than 10 mg.

Not sure if related, but I have absolutely no problem getting things in the household done when I'm voicechatting with a friend. Odd as it is, videos that don't require watching while listening (e. g. youtubers that just talk into the camera) also work, but podcasts don't (must be mental).

When I can't get my "fix", no friends with time online and no interesting video of that type, I end up searching for it so long that I get too little sleep, rather than just do the 15 minutes work without.