ADHD meds and HPPD

[Oldmate]

So I have ADHD and HPPD. ADHD was diagnosed this year, HPPD has been there for about 7 years.

I currently take Strattera, which helps regulate my emotions, and Chlonidine, which helps me sleep. Strattera does make my visual snow a little worse, but it makes me care about it a whole lot less, so it's a net positive.

The thing is, Strattera doesn't help with my concentration problems. I'm really struggling to complete my degree. I'm desperate to finish it so I can actually start earning money or go into a masters that can get me into a more specilaised profession.

But I'm frightened of starting something like Ritalin. I don't know what it'll do to my visuals. I can deal with it if it makes it worse for a day or two. But I'm frightened of a permanent change.

Other stimulants have negative effects on me. I don't like drinking coffee because it makes it worse temporarily. I accidentally took cough syrup with pseudoephidrine in it (thought it didn't have any) and that made for an anxious time.

Who here knows what happens in the brain with Ritalin and ADHD? Anecdotal evidence is appreciated, but there are so many factors that could skew the results that I'm cautious about solely relying on it. Peer reviewed info is greatly appreciated. If you did try Ritalin post diagnosis and you have ADHD , please post your experience.

I also take Androforte for Androgen Deficiency. May not be relevant but thought it was worth including

 

[Onemorestep]

Most add meds can cause a temporary (As long as used in small doses) spike in hppd symptoms. I found I had to stop the add meds I had been on my whole life because that spike was uncomfortable and anxiety inducing enough that my attention was worse on them than off.

 

ritalin, however, is another beast altogether. It is the only ADD med on the market, as far as I know, that can CAUSE hppd. This has to do with Ritalin effect on the serotonin pool IMO. It is remarkably close in structure to cocaine, which caused a mild increase in hppd for me back in 2016. I have tried Ritalin once since getting hppd, and it really screwed up my brain chemistry permanently. I was doing great at the time and on Keppra (which was working better than I could have imagined; hppd was essentially gone). After a single 10mg dose of Ritalin the keppra no longer worked and I had an extreme relapse into hppd. 
 

interestingly, the Ritalin followed the same schedule as when I took lsd for onset of symptoms. I felt a little weird the following day but it wasn’t until day 3 that I had the return of hppd. It was the same with lsd for me and my onset. 
 

As for focusing, I’ve found a few things that help me.

 

selegiline: 1-3mg per day orally. An MAOI that only effects mao-b when under 10mg. This drug attaches to the enzyme that “digests” dopamine which leaves more in the synapse. And since that digestion process is how you make norepinephrine and 5-hydroxydopamine (a toxic metabolite of dopamine) the effect is a smooth increase in dopamine and antioxidant effect without traditional adrenaline based anxiety.

 

After 10mg, selegiline completely attaches to all mao-b enzymes to achieve full  inhibition and then they start to attach to the less preferred mao-a. 
 

10mg is a LOT Though and not comfortable to get to. Hell 5mg is too much for me. Too much dopamine which leads to anxiety. You will never need to go to a point where mao-a in being inhibited.
 

mao-b inhibition, which provides dopamine, comes with none of the traditional dangers and food sensitivities you see with mao-a inhibition. You will not need to avoid foods on selegiline as you would with normal Maois on the market.

 

the best (and worst) part about selegiline is there isn’t a comedown: your brain is constantly manufacturing the enzyme that breaks down dopamine. But selegiline binds to this enzyme PERMANENTLY. You will eventually excrete the inhibited enzyme and replace it with a normal one but this takes 2 weeks to do so fully. 
 

this sounds like a bad thing because who wants to be on an add med for two weeks straight? But that’s not what this is. Selegiline is prescribed as an antidepressant and doesn’t feel like a traditional add med. it has been the closest thing I have found to fixing the hypothesized dopamine deficit in add people instead of just doing a bandaid with harmful (and neurotoxic) amphetamines/amphetamine analogues. In fact it’s a healthy alternative; selegiline has been shown to increase lifespan when taken at 1mg daily due to its antioxidant effect on the dopamine system.
 

selegiline builds up in your system because of what I explained about the enzyme inhibition. It took a few days of dosing for me to notice it. If you don’t like the medication in the early stages, you simply stop taking it and within 24 hours. If you stop after prolonged use, it can take a few days to lower. 
 

I have been on selegiline for 1 year to date as of thanksgiving.

source: prescribed by doctor. You can however find it online in liquid forms but I have not looked. 
 

bpc-157: this has been the most important part of my recovery from a lifetime of add medication use. It is starting to look more and more like there is a semi permanent (and maybe permanent) post acute withdrawal syndrome associated with the use of ADD medication. Bpc has been shown to positively influence the dopamine sustem and being it back to its natural homeostasis. It’s so does this with the gaba system. this drug is responsible for a huge part of my recovery and has allowed me to regain motivation and even surpass that which I had before add medications. 
 

It has a remarkably safe profile and very few anecdotal negative reports with thousands and thousands of users. Unfortunately, One of the three serious negative reports I have come across is one this website. As far as I know, only myself and two others here have tried it. One of them had an extreme anhedonic reaction that has taken a lot of time to get better. I have some theories about what happened, but what will caution is that you SOURCE YOUR BPC CAREFULLY. The peptide industry is unregulated and anything that’s made in China is not to be trusted. I use American research labs for mine and have taken probably 10 vials worth from them, so take that for what you will. I’m actually on a cycle of theirs right now. 

I created a thread about bpc, where to find it, and how to use it on this website. Just search for it.

source: American research labs 

 

nsi-189: this is an experimental antidepressant made by neural stem that failed its phase II (III?) clinical trials but only because they couldn’t prove it more effective than placebo, which is bullshit seeing as the placebo effect is very strong. And so is this stuff. I can’t tell you what the mechanism of action is since it’s proprietary, but it has had a very positive effect on my ability to experience pleasure and reward. This is a risk though, as nsi is not without risks and side effects for some. This medication requires a lot of research before taking so you know what to do if anything goes wrong. Through my own experience it feels excitatory but I do not know through which system. I do not take this everyday, as I am one of the unfortunate people that get anxiety through prolonged usage. I am still able to take it once a week in low dose however and have for about 18 months. 
 

source: originally online nootropics website that has since closed. I bought several years worth and have yet to put a dent in it.

memantine: acts as an nmda antagonist and dopamine agonist. Can be used to reduce/delay the increase in tolerance to drugs. I use this for NMDA rebound about once a month. I started at once every two weeks, 3 mg. Now I do once every month at 3-10mg. This is primarily to boost glutamate signaling in the NAC (reward center of the brain) reward circuit which leads to more sensitized pleasure response.

source: originally online nootropics website that has since closed; now I get it prescribed from doctor

 

low dose naltrexone: I take 5mg of naltrexone daily to upregulate my opioid system and increase pleasure. Any more than this causes depression for me. I started this initially to reduce microglial based inflammation to great success and kept it in for the mood enhancement. 
source: originally online nootropics website that has since closed; now I get it prescribed from doctor

dl-phenylalanine: increases dopamine and natural endorphins. Can be used in conjunction with selegiline to great effect. Needs to be cycled as tolerance builds rapidly. No withdrawal to speak of only diminishing returns. 

Source: amazon; bulk supplements
 

all of these drugs are available to buy OTC but not in store (maybe do-phenylalanine). I do recommend you do your own research and consult with your physician. I’m not a doctor and can only say what has worked for me backed by scientific/anecdotal research. Ymmv as always.

 

cheers,

oms

Edited November 26, 2019 by Onemorestep

[VisualDude]

Interesting that selegeline helps you.  I've used it and it was helpful.  Problem was doctor moved and other docs were afraid.  By the time I tried it again, it wasn't all that helpful.

I have RLS bad.  Doesn't bother me but bugs others including my wife.  First time using selegeline, it stopped and the change was so significant that at night my wife kept worrying I had died since I had never been so still.  Later docs tried Abilify and the restlessness came back (had been much quieter for months after selegeline).  Trying selegeline again had no effect on RLS.

Typical with HPPD (and the like), one change can make something that worked no longer work.  Just like 1 dose of Ritalin rendering Keppra useless.

 

As for ADD and ADHD.  It very much involves distraction.  Seeking quiet settings is vital for study or accomplishing anything.  Meds that 'quiet' can help provided they don't sedate too much.  Then there is CBT to learn to observe when one starts to wander, then step back.  It takes work but it helps.

Dopamine can quiet but it can stimulate.  Same with Testosterone.  Both are know to help with focus, though T more with pursuing goals.

IMO it is not a coincidence that some with HPPD have low T just as do most with a mild brain injury.

[Henry]

I've been taking 30mg Vyvanse for a little while, so far so good. I personally find it didn't affect my HPPD much, if at all.

[Onemorestep]

Good to hear it’s working out. You should look into antioxidants for the 6 hydroxydopamine metabolite. This is what causes the damage from amps. 
 

running cycles of bpc-157 while taking breaks from the amphetamines should help with any weird DAWS effects. 
 

memantine should help prevent tolerance. Can have side effects tho but not for all.

 

[SS1]

What would the best combo be for someone who needs to take their adhd meds? -right now I'm taking concerta and want to add on stratera but then I developed HPPD (not from concerta). Is there anything that can counteract any worsening of HPPD from adhd meds? 

[Snap-Nettieboi]

I'm not sure SS1. I think I've just found out that I contracted HPPD after years upon years of thinking there was something simply not right with my head. Visual snow has been worsening, and I take Methylphenidate which was just recently upped to 28mg as an extended release. It keeps me awake and although it does not help my focus entirely it does help some. I have taken quite a few different kinds of ADHD medications since I was 8 and I believe I got depersonalization/derealization disorder from using Ritalin. I can be false when it comes to my claims because I too am not a doctor of any sort however I now realize I was experiencing those symptoms after taking it for years. I also took an ADHD medication I cannot remember however it caused excessive picking at my skin and the doctors eventually created an altered version of that medication which caused no picking side effects. About a year and a half to two years ago I started picking up dab pens and using carts on a regular. After using and abusing for about 6 months I moved onto actual bud which seemed to work better and feel cleaner. I stopped feeling as foggy but still foggy. After that I used wax for a while and then shrooms and I used cocaine once as well. Both times I used my brain felt much foggier and the visual snow worsened. I'm not sure where I stand with HPPD as of right now or whether my symptoms are not real or whether my claims are false. I'm struggling to understand how to even comprehend what my brain feels but I realized I wasn't the only person to feel what I was feeling when I went to college. I found a group of people who are my friends now that also seemed to have some of the same symptoms. We dubbed it "space" but I think I see now that it is actually HPPD. In truth, some of my friends have done more drugs than I have but none have been on ADHD meds as long as me or at all. We all have a mutual understanding of what we are experiencing but I believe I am experiencing it worse than them. The visual snow and depersonalization has been scaring me recently however. And my mental state is declining rapidly. I had a friend call suicide prevention a week ago because I fell into alcoholism and my drunk ass poured my mind out to him while I was crying on the floor and he was generally worried about me. I know he wouldn't have made the call unless he thought it was serious and although I don't remember what I said at all really I do remember clearly the last thing I said before I passed out was "don't call the cops." The moral of this story is you should talk to a doctor if you find that HPPD is starting to affect your mental health because it can get so very much worse either immediately or over an extended period of time. Please seek help if you feel this way.

[Becca]

I Unfortunately have the same problem you do. I believe I have HPPD and I am trying to get through school with a poor ability to concentrate, debilitating brain fog, DP/DR, and anxiety. I could tell my Adderall was making my symptoms worse but I had no choice but to take it. When I wouldn’t take it I had little-to-no symptoms. I figured I could just take it until Christmas break and figure it out from there… now I have the symptoms all the time, whether I take my adderall or not. It might only affect me bc I got my HPPD from mdma but definitely be careful. Could be worth trying though if you are really struggling. Just proceed with caution. 
 

what I found helped ease my symptoms is going on a histamine free diet and taking Famotidine. I got my HPPD after recovering from long covid so sometimes it’s difficult to determine if I have long-covid or if it’s HPPD but I believe it might be a delightful little combo. Could be worth trying as well. As far as ADD symptoms, I’ve seen a lot of people mention taking magnesium. Maybe try looking into that as it’s pretty cheap

[Snap-Nettieboi]

It is really good to know that someone else out there is going through the same struggles that I am with HPPD. I agree that the ADHD medication leads to further and worsened symptoms as I have been trying my best to come up with research notes and trying to find opportunities to lessen my symptoms. I can only imagine the affects that Adderall instead of methylphenidate is causing for you. Thank you so much for the suggestions I have already found them on Amazon and I am going to be ordering them as soon as I am done typing this. I'm desperate for an answer or possibilities of a cure. If you would like to talk further about this you can add me on snap its my username. Thank you very much for the suggestions I'm glad that you gave me somewhere to start.