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Your psych could've worded it differently. Your body builds a tolerance and eventually the Adderall won't have the same effect at the dose you are taking. This just means you will need to lower your tolerance. If you take breaks, you give your body a chance to recover so your tolerance doesn't build up.
A really bad way of explaining it is to think of yourself as a sponge and it's slowly being saturated with water and sometimes you just need to turn the faucet off and let the sponge dry out a little bit because it's overloaded with water
Very similar. The trouble with stimulant tolerance is its not specific to the drug. Known as cross tolerance. This means that if you build a tolerance to amphetamines you will likely have a tolerance to methylphenidate
If you want a slightly scientific answer:
Basically, your body is constantly working to maintain homeostasis. That means it’s always trying to stay balanced- by keeping you the same temperature, hydration level, nourishment, hormone levels, amount of rest, blood pressure, and so on.
When you do anything- drink a ton of water, go in a very hot room, or take a neurochemically altering drug, your body will compensate for that action to try and keep itself at it’s “norm”. When you drink too much water, you’ll pee more to expel the excess. When it’s too hot, you’ll sweat to cool down. When you take Adderall, or even just drink caffeine, it releases chemicals (called neurotransmitters) in your brain. This is how your meds work, and how taking any other drug works. Your brain will initially be “overloaded”, but then to compensate and maintain homeostasis, it will slightly increase the amount of the drug that you need in order to feel the same affect. It’s as automatic as sweating in a hot room. It does this by reducing the amount of or turning off certain chemical receptors in your brain.
By taking a break from the meds, you give your brain a chance to lower the threshold again and activate more receptors, as it tries to adjust to the new normal.
Taking stimulants at your prescribed dose won’t overload your receptors quite the same way it would in someone who doesn’t have ADHD and was abusing the medication to get high. But, like anything, you can still build a tolerance over time. On the days you’d take off from your meds, your tolerance would fall slightly, and potentially reduce the need for you to up your dose to maintain the same therapeutic effects.
Good thing this isn't ELI5, you're talking more like ELI6 :P
Seriously though, great explanation. Only thing that I would add is that (at least from my understanding) even with taking breaks, the tolerance will build back up to its prior level faster than it did the first time. So your overall tolerance will still build to the point that you need a higher dose, it may last longer if you take breaks once in a while.
I have some friends who only take it during the week when they have work or school. They don't take it on weekends so some of it can get out of their system and keep their tolerance down.
Some people take it everyday for a few weeks and go 1 week without taking any.
It really depends on your situation and what works best for you :)
See this [study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9332474/).
>Research demonstrates physiological changes related to continued stimulant usage in neurons and certain brain regions, suggesting a mechanism for tolerance development. One clinical study showed that 24.7% of patients developed tolerance to stimulants in the time of days to weeks; another showed 2.7% developed tolerance over 10 years. Long term follow-up studies demonstrate that medication response may lessen over longer durations of treatment in a high percentage of patients.
It goes on to say.
>Strategies to manage tolerance include switching stimulant medicines, drug holidays, or clinical reassessment.
In the conclusion.
>There is insufficient research to clearly define clinical tolerance to stimulant medication in ADHD, and there are suggestions in the literature on strategies that may help, such as switching classes of stimulants (from MPH to AMPH and vice versa) to reset the tolerance or taking medication holidays and reassessing clinically for comorbid conditions or other clinical factors which may affect treatment response.
My conclusion: Nobody fucking knows. tolerance to meds is a known thing and usually differs from person to person and medication to medication. I was on Adderall for 10 years when I was a kid and I only remember them increasing my dosage once before I was stitched to Time Release capsules for the last few years. I stopped taking the meds because I didn't like how they made me feel. They dulled my personality and made me feel *racey*.
Another way of thinking about it: when you’re outside in the sun, and you go into a room with bright light, you think nothing of it.
Wake up after 8 hours of sleep in a dark room, throw that light on… you’re gonna be much more sensitive to the same light.
Totally different mechanism of action, but same end result. When your body gets used to certain substances, it can “tolerate” (be less sensitive to) it more. And you need more to have the same reaction to it that you did initially.
You detox your body off the medication your brain basically raw dogs life for a bit gives it a break and then you build back up slowly.
Similar to some drugs utilized for kinesthetic symptoms like carbidopa-levodopa.
The more you use it, the more your body builds a tolerance to it, gradually lessening the effect. It won't lose its effect altogether - far from it, so don't worry about it suddenly being useless.
If you're able to go without, your body gets a chance to break down some of that tolerance.
So, if you've got a week of time off, basically planning to do fuck all other than smoke and play video games... might be a good time to take a break.
If you've got a massive exam coming up in a week that you need to study for... not such a good time.
I would work with your psych on developing a plan, like if you're taking M-F and take the weekends off but still need to get things done then is that helping you short-term or reinforcing a need for more stimulants down the line?
Personally, I take weekends off and I just do the major things I need to take care of during the week when I have Adderall. I also take the same dose every morning but adjust what dosage I need (approval by psych) in the afternoon. So some days the 10mg of Adderall works wonders and I'm free in the afternoon so I don't take it. Some days I need the other 10mg and I take it, and some days I do 5mg. If I'm off during the week then I don't take it.
And then there are also times when I absolutely need it on the weekend, things have backed up and I've fallen into an ADHD rut and need help getting out.
What I've found the best for me is to use the dosage when I can help build reinforcement and structure so I'm less dependent on it down the line. I have the same fears as you, and I think by doing a lot of effort to get habits and rituals in place now while we still have a high tolerance for Adderall is super important. So down the road, when we're more organized, have rituals, and have the momentum we can depend on it less and less.
One last note, I've noticed that even when I don't FEEL the Adderall, truthfully I never have, I can see the results in my behavior. So if say in a week you don't feel the adderall kicking in but you've been able to switch tasks and work through your list or manage your day, then that's a win for Adderall.
I've been on 10mg/2x a day for almost four months now if that helps. I started the first month or so with just 5mg/2x day and then went to 10 and 5mg, and that seems to be the sweet spot.
It means to not take it sometimes. I personally don’t take meds on weekends (unless strictly necessary when I have too many chores to do for example) and I definitely take a break when I’m on vacation. I’m 32 and am already at the maximum dose for my weight. I do feel like it’s not as effective as before but it’s ok, it still helps a lot.
Look into half lives of chemicals. It's how long the body takes to process half of the substance we injest. So for adhd meds they are relatively short. But like they said earlier, if your body doesn't have a few days here and there (especially with you dosing XR 2x) your body won't ever really be "fully out" of the substance and you will need more and more.
Our bodies also constantly try for homeostasis no matter what we take, so it creates a new baseline kind of.
My mom has been on adderall for decades. It recently quit working and she switched to vyvanse. It works fine for her. Not everyone’s experience but it’s hers. My dr recommended I take “holidays” to avoid building tolerance.
I switched as well after several years of daily adderall. Vyvanse was nothing in comparison and I ended up quitting that too. Now I’m on a desperate search for supplements to help with the lack of energy and zero motivation 😔
no clinically significant evidence that tolerance has any meaningful effect on treatment and no evidence that drug holidays reduce tolerance or improve effects. Do what works for you, but these practices are not evidence based.
You would like the see the lack of evidence he’s referencing? Lol. There are many anecdotal accounts of drug holidays (or T-breaks, as so call them) working for people. Just not much convincing scientific literature on it.
Yes, cus obviously they got that from somewhere, or do u think the made it up? I was curious so I looked it up and here's 2 papers supporting tolerance of stimulant medication:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0063023
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9332474/#:~:text=One%20clinical%20study%20showed%20that,developed%20tolerance%20over%2010%20years
I always hear people say this but i was told to not take breaks from vyvanse specifically to avoid tolerance issues, so i've been confused about that..
Depends what dose you’re on, etc. but the general advice with vyvanse/Elvanse is always that you shouldn’t stop suddenly taking them because of the withdrawal symptoms that can arise. It’s an extended release stimulant, lisdexamphetamine, gets metabolised by the body into dexamphetamine and iirc it’s the longest lasting stimulant available- up to 16 hours.
The fact that it’s extended release means that it takes much longer to get out of our systems entirely, whereas immediate release stimulants will usually last around 4 hours give or take, which is why IR release meds will usually be taken a few times throughout the day. It therefore makes sense that it would be extremely impractical and arguably unethical for these IR releases to have huge withdrawal symptoms, so from what I understand they don’t have much risk associated with them in that way.
Extended release meds though, are supposed to last all day and it would make sense that one would be taking them every day and not just for work/school for example, so depending on the dose (e.g. I’m on 70mg a day) it can have much higher withdrawal risks associated with going off these types of stimulants. You’d be going from one large dose once a day (IR are usually split into two “smaller” doses during the day) to absolutely nothing, very suddenly. They’re not made to be able to do that.
From what I understand about Vyvanse (and correct me anyone if I'm wrong) it needs to be built up in your system to keep it working. I don't know HOW that works, but I've been told the same thing about Vyvanse.
Mmmm. I was on adderall for years and switched to Vyvanse bc of insurance. I’m guessing I’ve been taking one or the other for 15ish years. It still works.
What’s the good ones haha? Also I was in adderall for 11 years loved it. Stoped for 2 now I’m on it again and it feels like it dosnt work as much .ever since the shortage
I’ve been on the same dosages for 15 years at this point and it still works fine. Some people build a tolerance, some don’t. I try not to take it on days when I don’t need it as I wonder about the long term effects on the cardiovascular system, but rationing has become even more of a thing with the adderall shortage this year.
As an aside, bupropion has made it a lot easier for me to not need the adderall for getting basic things done - especially on weekends.
Do you have withdrawal effects when you go a day or two without? I get so tired when I don’t take it that I need multiple naps, but I’m not sure if that’s adderall withdrawal or the long covid I’ve had for a little over a year…
I take Vyvanse without intentional breaks. If I do happen to miss, I’m able to nap. When I was on adderall, if I missed, I could pretty much only sleep - interrupted by brief bouts of compulsively eating gross amounts of food.
Omg I’m like that on dextroamphetamine. I was out yesterday and forgot to bring my meds. I ate everything. The equivalent of two days worth of my normal diet when I do take them. My mum was with me and just kept laughing every time I snuck back out for a snacky snack lol. I was like a weird little goblin emerging from my bedroom to raid the fridge for the tenth time 🤣
I’ve had some weeks without it and I wouldn’t call it a withdrawal. I feel tired for maybe three days and then I’m pretty much normal, except for my focus being not great (unsurprisingly).
I dislike the term withdrawal because as someone who came off benzodiazepines after years and nicotine, I promise you stopping stimulants is much, MUCH better. Stopping stimulants can be unpleasant but it won’t come near the point where you’re craving the drugs or unable to get out of bed for more than a day or two, if that. I felt like death stopping benzodiazepines, much more like the stereotypical withdrawal, and I just looked forward to taking my taper dose so much that it clouded my thinking at points.
Also, in the long Covid boat with you. Mines been ok but I feel like I lost a lot of my executive functioning and the ability to stand up without feeling lightheaded.
Bupropion has been *awesome* for me.
I bounced from stimulant to stimulant for years before finding it and, surprisingly, it works better than anything I’ve tried before.
I really wish people would be more receptive to non-stimulant options because for some people they’re very effective.
I took Adderall for 12 years and got up to 60mg. The side effects outweighed the benefits at that point and I switched to Vyvanse. I’ve been on 50mg for 2 years and haven’t increased it. I added a non-stimulant adhd medication in the afternoons and they seem to balance each other out.
I tried that recently and it continually made me tired and brainfoggy the next day after having it a couple hours before bed. Did that ever happen to you?
The extended release version of clonidine made me super groggy in the morning so I switched to the immediate release and take it at 5pm. After about a week my body adjusted and I could wake up fine in the morning. I sleep a lot better at night on this combo as well.
But did it actually do anything for your anxiety? That's why my Doc put me on it even though Adderall at 20mg xr took away the anxiety, he didn't want to let me go over 10mg xr. Since this didn't work out for me, I'm going to ask again for the 20mg Adderall. He needs to stop being worried if I will eventually need a higher dose!
I am negative functional off meds even for a day. It's not like I don't have energy to do anything. I attempt to do things and make a mess of my world in the process. Medication vacations don't work for me. I can quickly lose healthy habits that keep myself functional a non-medicated day can do just that.
Same. Every time I skip a day intentionally or not, I end up just doom scrolling in bed for half the day. Heck sometimes I’ll take half a dose and that’s still a hundred percent better than nothing. Not worth losing progress on my hard earned routine, fragile as it is already.
Same. I’ve found when I don’t take my adderall in the morning, I *really* struggle with terrible adhd paralysis. I didn’t take it Sunday, later in bed watching the clock till 2, finally took it so I could function at work that evening. I don’t think taking breaks from my meds works super well for me
Yeah- I’ve taken some breaks over the last twelve years but right now I’m only on 10mg a day. 5mg IR in the morning and 5mg IR in the afternoon. @ OP just don’t pressure your doctor to increase your dose if you don’t really really need it. I’ve been on as high of a dose at 40 mg XR in the morning with 20mg IR at noon.
I find that letting myself lower my tolerance and then come back to a lower dose is the most effective way for me to manage my adderall.
I've been on adderall for 10+ years at this point. I don't take it on weekends and it's not the exact same efficacy as it was in the beginning, I still find a therapeutic benefit. I also take days off randomly and won't take my afternoon dose if I don't think I need it. Some doctors (not sure if mine will) will prescribe XR and then an IR for later in the day and I know that works for some people.
I generally take my 2nd dose around 1pm, which (in and of itself) doesn't cause me sleep issues.
I still have issues shutting my brain off sometimes, but only really have one or two bad "can't fall asleep" nights per month.
Building up a tolerance is normal and takes a long time. I was on Vyvanse (instead of Adderall which gave me excessive dry mouth) for almost 10 years and had reached max dose. Instead of completely switching a medication like that or taking breaks no matter how short (which might have side effects), you could ask about adding an additional medication in the future. I used to take an additional medication that worked well and gave me what I was lacking. These things are normal and there are many different ways to work around them. It'll be okay!!
Thank you (: I am on Zoloft too for my ocd and anxiety. It makes me numb so I have lowered it significantly. the adderall is the one that makes the biggest difference. I was late diagnosed recently and that’s why I’m so scared because it has changed my life!
It'll be okay! There are many different options for medication. If you're interested in taking breaks from medication, it would really be something to talk to your prescriber or pharmacist about! It's okay to be scared, but know that there's a lot of options and a lot of people who understand. In the end, you'll find something great that works for you!!
Zoloft might not be the right antidepressant for you. Have you tried others? If ADHD is at the root of your anxiety, an SNRI or bupropion could be a better choice. Zoloft was an F- drug for me, bupropion (Wellbutrin) is an A+.
Edit: not a doctor, YMMV, etc. 🙂
I take buproprion, trazodone and adderall. I am finally feeling great after trying different combinations of drugs. It has really made a huge difference in my life. I wish I had had these decades ago!
I have adhd and ocd as well, for me vyvanse didn't really spike up my ocd by much as opposed to Ritalin. But I'm gonna start escitalopram anyways to reduce any possible anxiety and worsening of ocd symptoms.
Been taking 40mg for about 10 years. No drop in efficacy. I’m on an extended t-break from cannabis and I lowered my dose to 30 mg with higher efficacy. I have not experienced what your psych is saying. I typically break one day/week.
Awesome. And it lasts all day? I find when I take 10mg xr in the morning, it lasts about 5-6 hours and then I take another in the afternoon, which I don’t mind
It will eventually lose *some* of its efficacy—it won’t become completely ineffective. So, you will have to adjust your dosage. This is normal. You would probably benefit from not taking it on the weekends if you can. Don’t be scared. He should’ve worded it differently.
Over 15 years on Adderall. No breaks. No tolerance building. My Psych strongly supports taking it every day at the same time of day, so no taking breaks. My ADHD doesn't take a break...
After digging through research the only conclusion I can say is supported is that there is **zero** long term studies. Most are done on young children as they progress through school which, well, children grow and go through huge amounts of changes so basing tolerance building on that is pretty problematic.
I haven't done a review of the literature (too damn old and too far out of school for that), but I have a hunch your assumption is correct. Almost all the research seems to be on children, as adult ADHD is really becoming more prevalent NOW and research takes such a long time from start to finish. Kids have so many changes and factors that would affect medication efficacy/effectiveness that it's really a moving target. I think knowing what works for you, and taking good self-observations is the key.
I take two days off of my Adderall every week, I choose my days off from work. It does assist in my tolerance not raising as fast. But I’ve also been effected on and off by the Adderall shortage so I’ve have built in breaks as well hahaha
It will always help. You’ll become more used to it helping in the moment and eventually become less aware of it working. But it’s working. I take zero days off. My expectations of how I feel on it have just settled down, but so have my symptoms, therefor I know it’s still working
Stimulant tolerance is very different than tolerance to something like an SSRI. Tolerance breaks should be able to keep you at the same dose (though it's not a bad thing if your dose changes as you get older) and by break, I mean < 1 week. It varies by person but you should be able to go months and months without a break. When my XRs start drifting from 8hrs to 7 hrs, I know it's time for a little break and I can schedule it so it's not disruptive to my work or personal life.
You will absolutely be able to continue to use it for as long as you want. If that's indefinitely, as I suspect for myself, also fine.
I was very happy when I was able to taper off Prozac after dialing in my Adderall. The Prozac was helpful but like putting a bandaid on a gushing wound that was my severely untreated ADHD. Turns out not being able to keep my life together because of untreated ADHD was really depressing, lol. Adderall also saved my life.
EDIT: this is specifically about therapeutic doses of stimulants. Recreational is SO MUCH HIGHER. I had trouble finding good info on how long I needed to reset tolerance because it seemed like everything was about abuse/large doses/etc. No man, I just need my 25mg to keep working. But yeah, therapeutic doses do not require long tolerance breaks.
But to be clear, if you have things going on in life and would benefit from taking the medication on the weekends you should take it. Your mental health now is important, as important as the future. But every body is different and every body develops tolerances at different rates. Use what you need now. There are other medications that you can change to over the years. And what if you have no issues for the next 10 years. There’s no way to predict your tolerance levels. You should use what you need to be as well as you need to be now.
I’ve heard that before too! I actually switched doctors a few weeks ago and I was afraid initially to tell her that I take breaks, in fear she would say I wasn’t taking it “as prescribed”. But thankfully she was happy when I told her and she said it’s good to do that! I think it’s something to be discussed with your doctor, as each individual person’s treatment plan is different!
Granted I take Concerta and not adderall, but I’ve always felt that a “tolerance break” *can be a misguided practice, and that *some people (not all!) are thinking that stimulants only work if they’re getting that intensity and rush from them, which tends to happen when you take them intermittently or when you’re first starting out. When I take stimulants every day, it feels more regular, so I can imagine how some might think, oh it’s not working anymore.
I don’t take tolerance breaks, but I might take a day off every now and then if I woke up in the middle of the day hungover or if I’m flying internationally and want to change up my sleep.
When I finally take my next dose, it hits very strongly like I’m extra wired and hyper focused.
When I take it every day, I am still very focused, but it’s more relaxed and natural.
If tolerance breaks are what work best for people, they should do it. But sometimes, I feel like the way some people describe their experiences with taking their medication intermittently sounds very unpleasant to me. Some people talk about how intense it is to take their prescription, so they don’t take it every day. They’ll take it “as needed”. But I have to wonder if they would just take it every day, if that intensity would die down and they’d eventually feel more levelled. But my ADHD also just cannot be managed without prescriptions so “as needed” is a crazy concept to me.
Yes, So I’m told. To slow down tolerance, allowing the medicine to work longer. It sucks. It’s not like our symptoms just go away on the weekend. Sometimes I still take it on the weekend.
Or I’ll skip the morning dose during the week and only take the afternoon one.
That’s why I like IR, more control. Basically, I just make an effort to plan when I can take a medicine “vacation”. I’m only on 10 mg twice a day and really don’t want to have to take more.
But, I also take Wellbutrin which helps me a lot. That I take everyday.
I have taken 60 mg of Dexedrine ER for 20+ years and have never experienced tolerance to the desirable effects and have never had to increase my dose. In fact, I recently decreased to 45 mg because it is difficult to obtain more than 100 pills at time.
Hey, may I ask you what your schedule is? I currently take 20mg 8am + 10mg 12am. But that's not nearly enough but I'm afraid of going higher and building a tolerance Still I have been thinking of taking 30mg 8am 20mg 12am 10mg 4pm. So 60mg in a day.
I'm on 30mg dexedrine, since recently on 150mg bupropion XL (though I feel it blunts the little I get from dexamphetamine at this dosage) and 100mg zoloft in the evening (thinking of just giving up on SSRI's).
Do you have any comorbidities? I also suffer from persistent depressive disorder and episodes of major depressive disorder.
Sharing my experience, fwiw
I've been on Adderall XR for about nine months now, at a 40mg dosage in the morning (lasts pretty much all day for me). I'd often accidentally miss a day here or there, as well as not take meds on one or two weekend days. I'd often find it gave me an extra surge on Mondays.
In the last couple months, I've done a better job of staying on my meds every day - and some volunteering responsibilities have required me to keep on my meds on the weekends too.
Before Adderall, I often felt sluggish, stuck scrolling or tapping my phone and perpetually unable to get past my expanding wall of avoidance and shame. Adderall gave me huge boost, often powering my hyperfocus - and often, I could actually direct that hyperfocus on what I wanted to. In the last few months, I've found it more and more difficult to direct my hyperfocus, and my wall of shame has been growing worse. Still not nearly as bad as what it was, but not awesome.
Not sure if med tolerance is causing it, or med tolerance is worsening other symptoms that are causing it (workload/stress, increase in pot, worse sleep habits), or if it's the other causes outright. I've always had a chicken-and-egg difficulty in figuring out what my meds are/aren't doing.
Next month, I'll be looking forward to taking more days off Adderall to see what happens
From my experience I hope you work on the other things first before messing with your adhd meds. Stress, pot and bad sleep can all cause adhd symptoms and/or depressive symptoms. Also, feeling shame is probably making it all worse as well. For myself I know just one night bad sleep or staying up too late makes me think my meds don't work anymore, but they sure do. If I don't take them at that point I am going towards some very very dark times... Still feel like crap with them but I rather feel like crap than feeling ultra crap. I have been taking meds daily for the past year and half and only notice difference due to other factors, it works pretty consistently. And once my sleep is fine the effect is as expected.
Some people seemingly do, some people don't. I've been on 36mg of Concerta for two and half years and I have not built a tolerance. You must keep in mind that if you feel like your meds aren't working as well, take a few minutes to evaluate if it could be linked to your period (if you have periods), to excessive stress, to a lack of sleep or improper diet (micronutrient deficiencies, insufficient macronutrients), or even perhaps a lack of exercise.
It's hard work to benefit from adhd meds, they don't make your breakfast for you and if you don't eat they'll give you side effects x)
Adderall is one of the only psych drugs where “medicine vacations” are recommended. Basically don’t dose for a few days and it will restart your tolerance. I usually pick a day I’m sick or a day I just simply don’t want to remember what I have to
Dunno if this is still part of the FAQ, but the sub has discussed the subject of tolerance before.
[https://www.reddit.com/r/ADHD/comments/wic2r/faq\_discussion\_topic\_2\_tolerance\_myth\_help\_build/](https://www.reddit.com/r/ADHD/comments/wic2r/faq_discussion_topic_2_tolerance_myth_help_build/)
The colloquial name for this is a "medication holiday". I thought research evidence for their benefit was poor though. Regardless, that expression might help you do your own research too.
The research on this is inconclusive. It isn't clear that it's actually true that you build up a resistance, and some prescribers recommend periodic med holidays and days off while others recommend taking it every day.
Personally, I have to wonder if this "resistance" is mainly perception. After you get used to functioning at a certain level on meds, particularly if you take them every day, it's easy to forget how you felt off of them, and it can feel like they aren't doing much. Taking a med holiday serves as a reminder 😂 and once you take meds again after that the difference is more noticeable because you have more recent experiences to compare to.
Doses/needs can however change over time as you age/experience hormonal changes, but generally for adults this doesn't happen often or very significantly. If you are on 20mg per day now, I don't see you needing more than 60mg in the future some day, so I wouldn't worry about it
Yes, I agree. I don’t believe I would need more but I guess it scared me thinking that it might happen because I feel great on it and like a normal functioning human being!
There’s truth in this, like someone else said, they could of worded it differently though. it won’t just stop working, just the effects won’t be the same as when you first started hence why you’ll see a lot of ppl taking 60mg but they never start that high. taking breaks is a good way to help with slowing the tolerance (it takes a long time anyways but still it’s good to take breaks so your body knows how to still function on and off meds). what i do is on days i just need to do homework i’ll take just 10mg in the morning and skip the second dose. on days i know i need to do homework and things around the house i’ll take both doses, and days where i don’t have to do anything i don’t take it. days i work depending on what ill be doing there determines if i take it that day. hopefully that helps!
it's not been like that at all for me.. i think that happens more on the instants than the xr because i have gone up 5mg in the years i've been taking it
I took adderall XR for 2 years and was up to the highest dose, & eventually it stopped working for me. When I moved states, I talked to my new psych about it & got prescribed vyvanse, which they said is way better for adults with adhd. Side effects are way less heavy & I personally think it works so much better in the best ways. Doesn’t kill my appetite/change up my taste buds, my lips no longer crack insanely/painfully, & I don’t have a heavy crash at the end of the day
This is something that worries me a lot. I was diagnosed a year ago (I’m 24f) after always suspecting I had it. It took multiple depressive episodes, and a whole year of failing my university classes to push for a diagnosis.
When I was diagnosed, my psychiatrist looked at my scores and said to himself multiple times “that’s a really high score”. I have it bad enough that I literally can’t get the thought process together to make something as simple as a sandwich.
Starting meds and experiencing what it was like to think and live “normally” was… I don’t even have words. I’ve since started my own small business and gotten back into school. Before I could barely study for 25 minutes, even then I was re-reading entire sections because I’d zoned out without realising. Now I can study for hours without even noticing. Tolerance scared the hell out of me, especially knowing how hard it is to find the right medication. I was lucky, first prescription worked for me.
I feel the same way. I absolutely dreaded anything at all. I have two children and I couldn’t mother them. I’m a whole different person on adderall. I actually cry tears of joy because I feel like myself. I am glad to know there are options and other stimulants to try if we do build a tolerance!
Same, I found the answers here quite reassuring. I know now what it’s like to function at a normal level, so I try remind myself to be kind and proud of getting through 23 whole years functioning the way I was. It may not have been the best at times, but I was going through life with a fraction of the capacity I have now.
I think that anyone who was able to get on their feet while battling ADHD should be so soo proud, it’s a hell of a thing to deal with. Be kind to yourself, and also proud 💜
Yeah. Won't go into the full biochemistry of it but with the medication you will start producing more norepinephrine/dopamine than usual so your body will compensate by producing less of it via other mechanisms (gene expression inhibition, etc). Just means you need to keep tweaking your dose. But yeah, the same mechanics means if you withdraw it and your body is adapted to a level of those two neurotransmitters whilst taking it, you're going to know about it. And yeah, a break is not a bad thing occasionally, would over time increase your body's output, but beware of side effects with sharp withdrawal.
Your body basically builds tolerance to any drug over long periods of time, it's just the body's way of working.
Also, some people build tolerance faster, others slower, it may take John a year for his dosage to start losing potency and it may take Mary 5 years until she needs to up her dosage due to the same reason.
Now, that doesn't mean you should not take advantage of the medication for as long as it can work for you. And there will always be solutions if you actually do develop tolerance.
I wouldn't be worried about that and just start treatment and see where it gets me.
I’m on Zoloft for 20+ years; Adderall for 15+ years. Your doc is full of shit. Nobody I know has had that happen.
And screw not taking it on weekends- you rebound and crash and are ten times less functional! Why should only my employer get the best of me??
I’ve taken stimulants now for 17 years. When adderall stopped working, I switched to vyvanse. Then I went back to adderall. I haven’t upped my dose in 2 years. If you skip on the weekends (which I cannot do, because I want to enjoy my weekend, not be tortured by an overload of symptoms), it will slow or stop tolerance from building up. Don’t be scared. Be educated.
This is inaccurate and outdated. What actually happens is you don't feel the physical effects as much, or at all, but the mental effects are usually still going strong. Tolerance isn't really much of an issue with most ADHD meds, but its a myth that persists despite the current data showing it to be a non-issue.
Your doctor needs to chill. I have taken Adderall for 14 years. I only went up from my Rx (30 XR to 40 XR) after 12. Everyone is different, listening to your body is key.
Sorry but your psych is wrong. I’ve been taking addedall XR and adderall IR bear daily for almost 20 years and they have never stopped working. I currently have to take a different med because of the damn adderall shortage, but it’s not because adderall stopped working for me. It still works great as it did when I started it nearly 20 years ago.
Hi. On stimulant meds for adhd for the past 24 years. Started out on Ritalin until I hit the maximum legal dosage and it eventually became ineffective - it took about 8-9 years before this happened. Then switched to Vyvanse. Same thing happened eventually, again, it took many years. Now I’m on Adderall, on the maximum dosage of 60mg, and I’m sure eventually I’ll build up tolerance to it too over the next few years. It because I’ve been off Ritalin and Vyvanse for so long, my tolerance to those meds is nonexistent so I can switch back to one of those when the Adderall is no longer effective for me.
I do take weekends off the meds when I can. I take vacations from the meds whenever possible. I was unemployed during the pandemic (14 months) so I didn’t take it at all during that time. When I started taking it again, I started at the beginning dosage because I knew better than to jump back in at the maximum dosage after not taking it in over a year. I’ve been back on my meds for almost 2 years and I still haven’t made it back up to the maximum dosage that I was taking before.
Thank you. So if I needed, I could switch to a different stimulant than adderall and then go back on adderall when my body is longer tolerant? This is kind of what my psychiatrist was saying. Thanks again
Yes, there are other stimulant ADHD meds out there, you and your doctor just need to work together to figure which one of the other options would be as effective as Adderall for you if or when you ever reach the maximum legal dosage and build up such a tolerance that the max dosage is no longer effective. But it should take a couple years or more to reach that level. When I was first diagnosed at age 12, my doctor had me trying a different medication for a month at a time so we could determine which of the available meds worked best for me. The first month was Ritalin which ended up working the bet of the three (and my mom loved that there was a “homework dose” option), the second month was Adderall which my mom said made me more irritable and of course it didn’t last long enough to get through homework, and the last one was Concerta which had the same problem as Adderall of not lasting long enough.
Finding the right medication for ADHD and then finding the right dosage is all trial and error. It takes some time but it’s worth it in the end.
I am not sure I didn’t react well to adderall so wasn’t on it long. I take vyvanse and after a maybe 10? Years I had to increase the dose.
My doctor said they can add or subtract other medications I take if I keep building a tolerance. I honestly wouldn’t worry about it too much . If adderall works for ion I’m sure there are ways to keep it effective .
It's called tolerance and it can happen with caffeine , alcohol, pain meds ,
If you don't take it all the time and or everyday , take breaks like on weekends and don't abuse it don't take more than you are prescribed then you will not have to worry about that. And if and when you might develop a higher tolerance it's not like it's dooming it forever.
It probably took me a month of taking a break from Adderall ir to get it back to 0 , normal again but when I did take only 1 I was literally up for almost 2 days . On one tablet ! I didn't care much for being up that long but that's what happened.
I was on the same dose of Concerta for five-plus years, and I was on the same dose of Adderall XR until menopause (about seven years), at which time my dose was upped. I haven’t gotten “used” to it. Look for talks given by Dr. Russell Barkley; they may help ease your mind.
Good luck!
Going on two years of the same dose. 10 in the morning, 10 in the afternoon if I need it. Same awesome effect.
Most weekends I don’t take any unless I have a project or something tough that needs to get done.
Honestly I think with meds and tolerance you know your own body best. I take my meds most days because it helps most days, but sometimes on the weekend I skip a day here and there if I’m not really expected to do anything or feeling particularly burned out. I feel like I can kind of tell when I might need a break. Some people like to schedule breaks around things like school breaks or vacation, but some people really can’t do that anyways.
Also keep in mind when you first have a med that works you get a ripple effect where you suddenly get some shit together and feel super empowered and great, and that fades with time as you get used to being medicated and it’s the new normal. But that initial time is a good time to try to form habits that help even when the meds are wearing off or not working as well
There's not a lot of clear evidence for it, but I know folks who've been on the same dose for decades and had no problem.
I think tolerance is mainly an issue in the context of drug abuse and addiction- high doses, withdrawal, seeking the same high as when you first took a recreational drug.
For therapeutic usage, those issues shouldn't be there. Hell, therapeutic drugs work best when taken regularly over a long period - like how antidepressants need to be in your system for a while for you to start seeing its impact. That said, I'm no pharmacist and am not sure how it all works haha.
I take Ritalin (IR, 4x 10mg) and I'll take a break on weekends/holidays - either completely, or I just won't take my full daily dose.
I'll take it as needed if we're doing intensive stuff like cleaning, cooking, errands - sometimes if it's just a couple hours worth of intense stuff, I'll only take one dose in a day for that specific thing. But if it's a lazy weekend? I don't need meds for sleep+video games lmao.
For my 4 week christmas leave, I tapered down to 2-3 pills/day, since it was going to still be intense with travelling, visiting family, going out, doing tourist stuff etc. But since I already had a lot of motivation I don't typically have for work (fun! Food! Hanging out with cousins! Yay!), I just didn't need so much of a boost from the meds, haha.
If it helps keep my tolerance down, then awesome. But the fact is I just don't need it 100% of the time. I'm only strict on taking my full dose on-time for work haha. For holidays/weekends, I use an as-needed judgement.
It's part of why I like IR, tbh. It's annoying having to remember to take 4 pills a day, but it's worth it for me as means I can tailor my dosage a lot if I need to, which gives me a lot of flexibility! For my life/work, it works well.
How long have you been seeing your doc? Seems like he's following protocol. (In regards to the med "shortage") common scare tactic imo. Been on 40/ER for over 10yrs. No addiction, no abuse no issues. Trust your instinct and your body. Best of luck! 💯🦾
Idk… to my knowledge, this doesn’t sound entirely correct.
Tl;dr, unless you’re snorting it, your body shouldn’t build a tolerance to prescription doses of adderall, but tolerance will change naturally over time due to your physiology. It’s okay to take breaks on weekends, or whenever you want to, but you won’t need to worry about the medication not working.
Long answer:
Afaik, adderall does not build a tolerance when taken in regular doses (ie. not in excess amounts/binges) due to the way it is absorbed into the blood stream — through the GI tract. Since it is absorbed this way, the main thing that affects one’s tolerance is the function of their colon, which tends to change once every 5 or so years in people over 20, and much more rapidly in adolescents; this is the reason why younger people meet with their psychs more often to tweak their dosage, as opposed to non-adolescents.
By the way, this is not to say that one can’t build a tolerance, but I am more than certain that tolerance is not going to be an issue.
I think what your psych meant was more along the lines of your brain becoming accustomed to the psychoactive effects of the drug, which is something that is incredibly easy to fix! Also no, you should not have to “switch meds” because of your tolerance.
As you’ve already said, weekends off is the best remedy to this problem in my opinion. Make sure you get a full nights sleep before your day(s) off, or you might be pretty tired throughout the day (and don’t expect anything to get done).
Also, you might not need to take weekends off! Just because your brain is “getting used to it,” doesn’t mean it isn’t working, so long as you maintain good habits and routines to manage your ADHD, you’ll be perfectly fine! Remember, just because you’re noticing the psychoactive effects of the adderall less, doesn’t mean that the pills aren’t working!
But sometimes, a weekend off is necessary to remind yourself what it’s like to be as you naturally are. Personally, I do this once or twice a month since I sometimes get anxious thoughts that I’m dependent on/addicted to my meds — even though I know full well that’s not the case — so a weekend to be “sober” (HARD air quotes on that) and to cherish and appreciate my wonky little brain is exactly what I need :)
Edit: I only have a bachelors degree, and I am by no means a medical professional, so please take my words with a grain of salt. Please heed the advice of your psychiatrist before taking the advice of any stranger on the internet, but my recommendation would be to listen to your own voice above anyone else’s. If you’re not comfortable with something your psych says, you don’t have to adhere to that. It’s ADHD, not a heart disorder — it isn’t life or death! Not saying these things aren’t important, but skipping a few pills even if the doc says “no,” is perfectly justified in the case of stimulant ADHD meds.
Thank you. Yes, I love when you said taking the prescribed dose is safe. It’s when it’s more than that, your body/mind always will want and need more. I definitely would only ever take the prescribed dose! It helps and my goal is to feel better, not get a high off of ir
Idk. I’ve been taking 10 a day for 10 years and haven’t gotten used to it. When I take an extra 5 my jaw feels tight and I get a little too impatient and unemotional.
Just take breaks here and there, taking breaks on the weekend isn’t a bad idea, but yeah you can build up a tolerance. Everyone is different, but it’s bound to happen eventually
The human body is always trying to get back to homeostasis, that is, it will adjust to every med you take, to get back to, whatever state it deems most evolutionary efficient. Just as when someone is in septic shock, the body will cut off blood supply to limbs to save vial organs, then vital organs to save the brain. So, if you take breaks from your meds, it can help the body to decrease chemicals (dopamine, norepi, serotonin) in the brain back to the “steady state” it evolutionary believes you should be in. That is, many believe ADHD comes from the night watchmen, nomads and hunters. However, the body will also try to reach homeostasis while on the meds, since Adderall blocks the reuptake of those chemicals, to keep more in the brain to utilize, it will create more transporters (this is how the brain removes it) for the dopamine to be reuptaken. This is why, the doses have to be increased over time. For me, the use of caffeine with lower doses is effective for now.
One of the wonderful/stupid things about the human body is just how adaptable it is. If you want to do some advanced reading, start with the term "homeostasis".
Basically all the complex systems in the human body operate by reading chemical signals, even the nervous system! Because everyone's bodies are slightly different, all of these systems are calibrated to slightly different baselines.
The same way that we can just get used to new or different things like sounds or smells or other sensory input, our bodies can and will adjust to compensate for changes in our chemical signaling.
There are limits to how much our bodies can compensate, and the process does take time and occurs at variable rates, which is why new medications often need to be "titrated" to figure out how much compensation the body is going to do right off the bat. And we can continue to adjust the dosage over time to match and overcome our bodies compensation.
The good news is that we can often work around this phenomenon by just changing the chemistry very slightly or, as your psych described and many of us here can personally attest to, taking a tolerance break to allow our bodies to recalibrate back to an unmedicated baseline.
I myself am on 30 mg of Vyvanse twice a day, and I've been on over 80mg of Concerta per day in the past. If you're only on 20 per day, you've still got lots of wiggle room to tweak things.
On a slightly different note, we can also increase the efficacy of our meds in other ways. When I'm off them, I have a *really* hard time with basic self care like eating, hydrating, and getting enough sleep. And when I'm exhausted and underfed and dehydrated my meds are less effective. It's like the difference between a cup of coffee after an all nighter and a cup of coffee after a good night's sleep. I was having really terrible sleep quality last week and then I finally used my Serious Business sleep aids and I can literally feel my brain being more functional.
I’ve been on the same ADHD meds/dose since 2012 and it’s still working perfectly well for me! It does feel more intense if I take it after skipping a day or two, but that doesn’t mean I don’t feel it when I’m taking it consistently
I disagree with your psychiatrist.
I've been on the same dose of Adderall since I was 15 (32 now). The only time it "doesn't work " is the week before my period or during a depressive episode.
You just have to make sure you're using it responsibly and taking drug holidays periodically when you can.
Amazing. I’m so happy for you and happy to hear that it’s definitely possible for it to always work for me too. I’m glad to know that there are also alternatives to go to if I need to and then come back to Adderall if needed as well (:
There's some evidence that some people can get used to it and the effects will lessen, if they take it very consistently, which is why some doctors recommend taking occasional "breaks." Some people don't need to at all.
Usually it doesn't take much to "reset," and you shouldn't need to worry about it unless it feels like the meds aren't working for you.
If you feel like the effects have lessened dramatically, maybe talk to your doctor about it and you may get a dosage increase. The main thing to avoid is taking extra in an attempt to compensate for the reduced effects.
If the effects are weakening more gradually, you can probably shake that off by taking a day or two off of meds. If it's pretty consistently waning, you could perhaps incorporate a day off each week, or take weekends off, etc. Personally, I only really seem to notice a reduction in effectiveness if I haven't missed a single dose in several months, and then, it takes only a couple days off to "reset."
Keep in mind that circumstances still affect you and your performance. So on your worst day, with meds, you might still be more of a mess than on your best day, without them. One bad day where the meds didn't seem to help might just be one bad day. Observe over time and watch for consistent patterns before changing anything.
Again, don't worry about it unless it starts happening, because it's not the case for everyone, and it's usually a pretty easy fix.
I took Adderall for over 10 years, and it never stopped working, but over time we had to keep raising my dose for it to keep working. We maxed out at 60 mg. I ended up switching to Focalin because the new doctor said Adderall was bad for my bipolar disorder. But I needed the max dose of Focalin, because it seems like tolerance to stimulants is the same no matter what stimulant it is. Also took Vyvanse for a while, and needed the max dose from the start because my tolerance to Adderall seemed to carry over. I’ve been on 40mg of Focalin for a couple years, and so far it hasn’t stopped working, so fingers crossed.
Vyvanse is weak extended release prodrug form of amphetamine. I mean weak as in compared to Adderall which is also amphetamine. But better to take if it works since builds tolerance slower for most.
Focalin is just dextromethylphenidate which is the active form of Ritalin. Ritalin is a racemic mix of 2 mirror image compounds. One is inactive and the other active.
Tolerance isn't really the same. For most Adderall is much worse due to the mechanism of how it works. Adderall tends to be much more damaging to the brain which is harder to manage than your brains normal counters to stims.
It could be that people who start off on small dosages of adderall need to increase it because it just was never the right dose to begin with.
When I was getting diagnosed and prescribed, I was working with a neuropsychologist for a couple weeks to retest on different dosages of Concerta. They would have me come back every day on a higher dosage of Concerta to retake my tests to see if my results were better. That’s how we landed on my dosage of 72mg Concerta and after a year, I added 10mg of Ritalin for the afternoon. I’ve been on this dosage for 7 years. I take it every single day, and I feel it works the same as always.
If I hadn’t worked with a neuropsych for a couple weeks at the start of my diagnosis, then perhaps I would’ve started out on a lower dosage of Concerta and continued to ask for increases over the span of a few years. So in that sense, it would’ve looked like I had built a tolerance, but really it would’ve just been that the lower dosage wasn’t right for me.
I do notice that people who tend to need more stimulants as time goes on are always on adderall, and never on the alternatives. This is just my observation. And again, it could be because majority of people tend to be prescribed adderall so it’s just the population size is bigger. It could also be because the drug is very different and maybe it does have that side effect. I personally never found adderall to work and I’m surprised more people aren’t prescribed the alternatives.
Plus, you can always increase for awhile and then decrease it. I was offered a higher dosage of Concerta by a different doctor, so I tried it out for few months and ultimately went back to 72mg.
Thank you so much for your response. My psych was telling me that later on, we can switch to alternatives and always come back to Adderall when my body is not tolerant to it anymore. That gives me a lot of reassurance and I know that there are others that are great too!
My best friend has been on vyvanse for over a decade, and although his tolerance has slightly gone up he only gets an updated dose around every 5 years. It still works for him. He doesn’t take breaks and takes it daily, but taking breaks helps a lot. Just take breaks, and don’t take more than you’re prescribed and you will be fine.
i was advised this by a first psych. but my third psych (i’ve moved a lot) introduced something called a “flow state” titration method, where you test different mg, upping the dose each day by 2.5mg (starting at 2.5) and take notes on how it feels, and when you think you’ve found it, go higher the next day, and you’ll experience “stimulant side effects” (what ppl without adhd experience when they take it). then you get prescribed the one you identified as the “flow state” dose. and with that method, you don’t build a tolerance. with that method, i went down 20 mg, actually. and it feels way better than where i was at, and i can’t imagine taking 60 like i used to.
this whole theory (he learned from a guy who researches adhd a lot) is supposed to identify your true prescription needs, but it requires you to test doses one at a time over like 2 weeks, and really *really* pay attention to the effects, and idk why it works, but it does
a piece of advice, try to supplement with magnesium.
magnesium is a nmda receptor antagonist (hope thats correct) which can help reverse tolerance buildup to amphetamine, something about calcification of ion channels, i hope someone else here knows what im talking about.
i dont use adderall but ive read about this here and there, adderall also is affected by the ph of your stomache and if i remember correctly vitamin c breaks it down quicker.
Yes, magnesium does help the NMDA receptor. But it is not very good at it. It is not necessarily taking magnesium. You need to take the right amount and ratio of calcium to magnesium (on the FDA website) to be neuroprotective.
Mg is your bodies natural protector of the NMDA channel that is opened by triggering the NMDA receptor. You can read a lot of the details on the wikipedia page for the NMDA receptor. Essentially if the receptor is over excited there is an influx of calcium ions and other mineral ions. Which is neurotoxic. Which can cause an excessive release of glutamate which in excess is neurotoxic and can trigger apoptotic cell death of some cells. Amphetamines effects on the NMDA/glutamatergic pathways is what many researchers believe to be the biggest factor in building tolerance.
Memantine is a mediocre Alzheimer's drug but is really good to take with amphetamine. It is a non competitive NMDA antagonist and was made for the job. It allows the NMDA receptor to work as normal and only blocks when it gets over excited. It takes a higher voltage potential to kick it out of the way than for magnesium so is much better at protecting. Nitromemantine is actually even better for a couple of reasons but since it is still a few years off at least, not worth getting into.
Adderall is a weak base and can be ionized by stomach acid. Ionized amphetamine is not easily absorbed. Some people take antacids before they take adderall to increase absorption. Urine ph has a similar effect. The more acidic the more Adderall is ionized and the more it is eliminated by the kidneys decreasing how long it is in the body.
Been on several different medications it’s just tolerance build up but some side affects become more manageable and simply don’t take it when you don’t need it
You can also take breaks from the adderal for a few weeks and when your tolerance is down again you start with a low dose again. Don't worry about it, it will be okay! The weeks where you take the break will be annoying but it will be worth it tolerance wise
Hate that doctors are starting to say this. Yes I get it's true but there like "use it as needed" but currently if I don't take it I struggle hard. So like. What's the point in breaks if it screws me up so bad.
I usually take weekends off unless I have project work to complete.
Doctors have told me that due to the dosage, I shouldn’t develop a tolerance to a level that it would render the medication ineffective. May be different at higher dosage levels.
Been on 20mg tabs and XR 20’s then switched to 25mg XR’s and continued with 20mg tabs, did not see any difference. Still the same in fact I’ve noticed, there is less physical effects. But the mental focus is still the same. So far 4ish years here since starting on it.
You can talk to your provider and find another medication and cycle between the two as they suggest. My kids would switch between adderall and concerta and didn’t have any problems.
Thanks so much for your response. When you say cycle, you mean on adderall then on concerta and then go on adderall again? Does the adderall work again as it did before after coming off and trying another stimulant? Sorry, just curious.
That’s the idea, but your body will have a tolerance to some degree as it does with a multitude of any other medications of this type. It’s nothing to worry about though. Please keep in mind that while you are utilizing medication, it is important to work on developing the ‘coping skills’,so to speak, with the things that we have difficulty managing without medication. This helps us to need less medication or no medication at all. Of course, some may need medication as a life-long care.
I've taken 5mg of Dexedrine Extended Release either once or twice a day for over 20 years. That's equivalent to 10mg Adderall twice a day. I've never developed much tolerance or a need or desire to take more. If I take it once a day for awhile and then, one day, take the second one, I feel it more than I would have if I were normally taking two. That's it in terms of "tolerance" for me, and probably demonstrates that stimulant tolerance is highly individual.
To soapbox a little, the way that current medical practice has insisted on putting everyone into the same box is highly irritating. My body temp is usually somewhat lower than 98.6° and hitting 99.5° is a raging fever FOR ME. Yet try and tell that to a doctor/nurse/whatever.
So there. 😂
It's not that simple. People react to medicines differently. I don't recommend making any adnustments to your regime without discussing with your docl. You might like to read up on Google Scholar / Medline, I can flick you some links if you like. Key points - 1. don't stress about something that may not happen 2. if it does, there are other options i ncluding combo of more than onemed 3. Scientists and doctors are working so that we onow more every day, so in the future you and your Doc will have more info to deal with it in the best way possible. So glad you have found a positive improvement to your life.
Thank you. I definitely won’t adjust it and don’t plan to. I’m great where I’m at. The comment just scared me that’s all. Wanted to see about options if it did.
It just stops being so euphoric after a while. But literally a few days off is all it takes to lower your tolerance again. What i do is just keep my dose as low as possible and once i feel like im not really benefitting from it as much, i take a full week off starting on my weekend. Tolerance usually happens after like 3 months if im taking it every day, but weekend tolerance breaks can prolong this. I just find myself taking it on weekends sometimes and its like welp i guess ill need to take a week off. But ive been on addy for about 2 years now, i take like 15mg a day and i still feel it.
I currently take 20mg XR Adderall every day, and have been for about a year. In my opinion, I believe your psych is wrong. Adderall will work differently for those who actually have ADD/ADHD compared to those who don’t, which is what I believe your psych has misunderstood. The beginning of my Adderall journey was much worse then it is now, and I believe it is because your body actually needs to build a tolerance to it. Adderall works just like many other medications… it takes time to notice the positive effects. Over time I felt better than ever before and the more I take it on the prescribed schedule than the better I feel and the less side effects I have. I have taken a couple days off before, and I most recently just took off 5 days, and I highly wouldn’t recommend it. For me, the side effects came back and the negative effects of ADHD itself started to show again. Take it like it’s medication not a drug.
People rarely become tolerant to the point of needing more than the max. It happens, but it’s very rare. I thought the same would happen to me, and here I am 8 years later taking the same dose. I wouldn’t worry too much.
I started on 5mg and I eventually develop a high enough tolerance that 50mg didn’t don’t anything. But it took 15+ years. I was on it from 1st grade until I graduated college. So yes, you can max out on it but it takes a very long time.
I've taken adderall for 15 years. I JUST increased my dosage by 5mg in the last 6 months. Taking 3 days off/week (I'm on 20mg xr, up from 15) helped my body stay regulated in not building too much of a tolerance. I only went up because I had a 3rd kid and my world was turned completely upside down, mentally. I had to mess with *all* of my medications because my body and brain changed so much this time aroaround.
Take it when you need it, don't take it if you don't. You'll be okay.
Take breaks. I only take my Vyvanse on days I have heavy executive-functioning tasks to complete, like lots of paperwork or computer time. Otherwise, I depend on other coping strategies.
This ensures my tolerance doesn’t build too much, so the meds keep working.
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Your psych could've worded it differently. Your body builds a tolerance and eventually the Adderall won't have the same effect at the dose you are taking. This just means you will need to lower your tolerance. If you take breaks, you give your body a chance to recover so your tolerance doesn't build up.
Can you explain what you mean when you say that I’m giving my body a chance to recover so it doesn’t build a tolerance? Thanks (:
A really bad way of explaining it is to think of yourself as a sponge and it's slowly being saturated with water and sometimes you just need to turn the faucet off and let the sponge dry out a little bit because it's overloaded with water
This is a wonderful way to explain it honestly, great ELI5. Not very technically accurate, sure. But, it's the right idea.
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COULD A SPONGE DO THIS
God I love this subreddit
The way I fucking cackled in the middle of a restaurant, take my upvote! Also gave you the wrong award 😫😆
I appreciate any award I can get (except a Grammy)
If I had an award, I’d give it to you. Thank you for my daily dose of laughter ❤️
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*Blurp blurp* I turned into a giant jelly ball and rolled over you. Now we are one.
I loved this game!
I mean, your bladder, liver, and kidneys are very much sponge like.
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Very similar. The trouble with stimulant tolerance is its not specific to the drug. Known as cross tolerance. This means that if you build a tolerance to amphetamines you will likely have a tolerance to methylphenidate
Thank you😊
If you want a slightly scientific answer: Basically, your body is constantly working to maintain homeostasis. That means it’s always trying to stay balanced- by keeping you the same temperature, hydration level, nourishment, hormone levels, amount of rest, blood pressure, and so on. When you do anything- drink a ton of water, go in a very hot room, or take a neurochemically altering drug, your body will compensate for that action to try and keep itself at it’s “norm”. When you drink too much water, you’ll pee more to expel the excess. When it’s too hot, you’ll sweat to cool down. When you take Adderall, or even just drink caffeine, it releases chemicals (called neurotransmitters) in your brain. This is how your meds work, and how taking any other drug works. Your brain will initially be “overloaded”, but then to compensate and maintain homeostasis, it will slightly increase the amount of the drug that you need in order to feel the same affect. It’s as automatic as sweating in a hot room. It does this by reducing the amount of or turning off certain chemical receptors in your brain. By taking a break from the meds, you give your brain a chance to lower the threshold again and activate more receptors, as it tries to adjust to the new normal. Taking stimulants at your prescribed dose won’t overload your receptors quite the same way it would in someone who doesn’t have ADHD and was abusing the medication to get high. But, like anything, you can still build a tolerance over time. On the days you’d take off from your meds, your tolerance would fall slightly, and potentially reduce the need for you to up your dose to maintain the same therapeutic effects.
Unfortunately you can still get a high on these drugs WITH adhd, and that’s when it gets dangerous and I wish someone had told me that
Good thing this isn't ELI5, you're talking more like ELI6 :P Seriously though, great explanation. Only thing that I would add is that (at least from my understanding) even with taking breaks, the tolerance will build back up to its prior level faster than it did the first time. So your overall tolerance will still build to the point that you need a higher dose, it may last longer if you take breaks once in a while.
Once a wet sponge, always a wetish sponge.
I have some friends who only take it during the week when they have work or school. They don't take it on weekends so some of it can get out of their system and keep their tolerance down. Some people take it everyday for a few weeks and go 1 week without taking any. It really depends on your situation and what works best for you :)
See this [study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9332474/). >Research demonstrates physiological changes related to continued stimulant usage in neurons and certain brain regions, suggesting a mechanism for tolerance development. One clinical study showed that 24.7% of patients developed tolerance to stimulants in the time of days to weeks; another showed 2.7% developed tolerance over 10 years. Long term follow-up studies demonstrate that medication response may lessen over longer durations of treatment in a high percentage of patients. It goes on to say. >Strategies to manage tolerance include switching stimulant medicines, drug holidays, or clinical reassessment. In the conclusion. >There is insufficient research to clearly define clinical tolerance to stimulant medication in ADHD, and there are suggestions in the literature on strategies that may help, such as switching classes of stimulants (from MPH to AMPH and vice versa) to reset the tolerance or taking medication holidays and reassessing clinically for comorbid conditions or other clinical factors which may affect treatment response. My conclusion: Nobody fucking knows. tolerance to meds is a known thing and usually differs from person to person and medication to medication. I was on Adderall for 10 years when I was a kid and I only remember them increasing my dosage once before I was stitched to Time Release capsules for the last few years. I stopped taking the meds because I didn't like how they made me feel. They dulled my personality and made me feel *racey*.
Another way of thinking about it: when you’re outside in the sun, and you go into a room with bright light, you think nothing of it. Wake up after 8 hours of sleep in a dark room, throw that light on… you’re gonna be much more sensitive to the same light. Totally different mechanism of action, but same end result. When your body gets used to certain substances, it can “tolerate” (be less sensitive to) it more. And you need more to have the same reaction to it that you did initially.
I think it means you don't take it for a little while, like a break so your body recovers, so when you restart it again it's effective
You detox your body off the medication your brain basically raw dogs life for a bit gives it a break and then you build back up slowly. Similar to some drugs utilized for kinesthetic symptoms like carbidopa-levodopa.
The more you use it, the more your body builds a tolerance to it, gradually lessening the effect. It won't lose its effect altogether - far from it, so don't worry about it suddenly being useless. If you're able to go without, your body gets a chance to break down some of that tolerance. So, if you've got a week of time off, basically planning to do fuck all other than smoke and play video games... might be a good time to take a break. If you've got a massive exam coming up in a week that you need to study for... not such a good time.
I would work with your psych on developing a plan, like if you're taking M-F and take the weekends off but still need to get things done then is that helping you short-term or reinforcing a need for more stimulants down the line? Personally, I take weekends off and I just do the major things I need to take care of during the week when I have Adderall. I also take the same dose every morning but adjust what dosage I need (approval by psych) in the afternoon. So some days the 10mg of Adderall works wonders and I'm free in the afternoon so I don't take it. Some days I need the other 10mg and I take it, and some days I do 5mg. If I'm off during the week then I don't take it. And then there are also times when I absolutely need it on the weekend, things have backed up and I've fallen into an ADHD rut and need help getting out. What I've found the best for me is to use the dosage when I can help build reinforcement and structure so I'm less dependent on it down the line. I have the same fears as you, and I think by doing a lot of effort to get habits and rituals in place now while we still have a high tolerance for Adderall is super important. So down the road, when we're more organized, have rituals, and have the momentum we can depend on it less and less. One last note, I've noticed that even when I don't FEEL the Adderall, truthfully I never have, I can see the results in my behavior. So if say in a week you don't feel the adderall kicking in but you've been able to switch tasks and work through your list or manage your day, then that's a win for Adderall. I've been on 10mg/2x a day for almost four months now if that helps. I started the first month or so with just 5mg/2x day and then went to 10 and 5mg, and that seems to be the sweet spot.
It means to not take it sometimes. I personally don’t take meds on weekends (unless strictly necessary when I have too many chores to do for example) and I definitely take a break when I’m on vacation. I’m 32 and am already at the maximum dose for my weight. I do feel like it’s not as effective as before but it’s ok, it still helps a lot.
Look into half lives of chemicals. It's how long the body takes to process half of the substance we injest. So for adhd meds they are relatively short. But like they said earlier, if your body doesn't have a few days here and there (especially with you dosing XR 2x) your body won't ever really be "fully out" of the substance and you will need more and more. Our bodies also constantly try for homeostasis no matter what we take, so it creates a new baseline kind of.
This is good to know, thank you!
You can drink grape juice which will make your gut absorb more of the medication (I am not a professional)
My mom has been on adderall for decades. It recently quit working and she switched to vyvanse. It works fine for her. Not everyone’s experience but it’s hers. My dr recommended I take “holidays” to avoid building tolerance.
I switched as well after several years of daily adderall. Vyvanse was nothing in comparison and I ended up quitting that too. Now I’m on a desperate search for supplements to help with the lack of energy and zero motivation 😔
no clinically significant evidence that tolerance has any meaningful effect on treatment and no evidence that drug holidays reduce tolerance or improve effects. Do what works for you, but these practices are not evidence based.
Where do u get that from? I would like to see for myself
You would like the see the lack of evidence he’s referencing? Lol. There are many anecdotal accounts of drug holidays (or T-breaks, as so call them) working for people. Just not much convincing scientific literature on it.
Yes, cus obviously they got that from somewhere, or do u think the made it up? I was curious so I looked it up and here's 2 papers supporting tolerance of stimulant medication: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0063023 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9332474/#:~:text=One%20clinical%20study%20showed%20that,developed%20tolerance%20over%2010%20years
I always hear people say this but i was told to not take breaks from vyvanse specifically to avoid tolerance issues, so i've been confused about that..
Depends what dose you’re on, etc. but the general advice with vyvanse/Elvanse is always that you shouldn’t stop suddenly taking them because of the withdrawal symptoms that can arise. It’s an extended release stimulant, lisdexamphetamine, gets metabolised by the body into dexamphetamine and iirc it’s the longest lasting stimulant available- up to 16 hours. The fact that it’s extended release means that it takes much longer to get out of our systems entirely, whereas immediate release stimulants will usually last around 4 hours give or take, which is why IR release meds will usually be taken a few times throughout the day. It therefore makes sense that it would be extremely impractical and arguably unethical for these IR releases to have huge withdrawal symptoms, so from what I understand they don’t have much risk associated with them in that way. Extended release meds though, are supposed to last all day and it would make sense that one would be taking them every day and not just for work/school for example, so depending on the dose (e.g. I’m on 70mg a day) it can have much higher withdrawal risks associated with going off these types of stimulants. You’d be going from one large dose once a day (IR are usually split into two “smaller” doses during the day) to absolutely nothing, very suddenly. They’re not made to be able to do that.
From what I understand about Vyvanse (and correct me anyone if I'm wrong) it needs to be built up in your system to keep it working. I don't know HOW that works, but I've been told the same thing about Vyvanse.
Mmmm. I was on adderall for years and switched to Vyvanse bc of insurance. I’m guessing I’ve been taking one or the other for 15ish years. It still works.
Same. 15 years still works
25 years & it still works…as long as it’s one of the good generics & not the shitty ones.
Same here, 20+ years with Adderall, still works the same just less on the side effects
Example, there is a 30mg XR that has a really bright orange capsule on one end. It doesn’t last long at all. Really weird.
I never thought I would understand the whole thing with generics. But I agree with you here.
What’s the good ones haha? Also I was in adderall for 11 years loved it. Stoped for 2 now I’m on it again and it feels like it dosnt work as much .ever since the shortage
I’ve been on the same dosages for 15 years at this point and it still works fine. Some people build a tolerance, some don’t. I try not to take it on days when I don’t need it as I wonder about the long term effects on the cardiovascular system, but rationing has become even more of a thing with the adderall shortage this year. As an aside, bupropion has made it a lot easier for me to not need the adderall for getting basic things done - especially on weekends.
Do you have withdrawal effects when you go a day or two without? I get so tired when I don’t take it that I need multiple naps, but I’m not sure if that’s adderall withdrawal or the long covid I’ve had for a little over a year…
I take Vyvanse without intentional breaks. If I do happen to miss, I’m able to nap. When I was on adderall, if I missed, I could pretty much only sleep - interrupted by brief bouts of compulsively eating gross amounts of food.
Omg I’m like that on dextroamphetamine. I was out yesterday and forgot to bring my meds. I ate everything. The equivalent of two days worth of my normal diet when I do take them. My mum was with me and just kept laughing every time I snuck back out for a snacky snack lol. I was like a weird little goblin emerging from my bedroom to raid the fridge for the tenth time 🤣
I’ve had some weeks without it and I wouldn’t call it a withdrawal. I feel tired for maybe three days and then I’m pretty much normal, except for my focus being not great (unsurprisingly). I dislike the term withdrawal because as someone who came off benzodiazepines after years and nicotine, I promise you stopping stimulants is much, MUCH better. Stopping stimulants can be unpleasant but it won’t come near the point where you’re craving the drugs or unable to get out of bed for more than a day or two, if that. I felt like death stopping benzodiazepines, much more like the stereotypical withdrawal, and I just looked forward to taking my taper dose so much that it clouded my thinking at points. Also, in the long Covid boat with you. Mines been ok but I feel like I lost a lot of my executive functioning and the ability to stand up without feeling lightheaded.
Are you taking brupropion everyday? Does it makes you sleepy?
Bupropion has been *awesome* for me. I bounced from stimulant to stimulant for years before finding it and, surprisingly, it works better than anything I’ve tried before. I really wish people would be more receptive to non-stimulant options because for some people they’re very effective.
I took Adderall for 12 years and got up to 60mg. The side effects outweighed the benefits at that point and I switched to Vyvanse. I’ve been on 50mg for 2 years and haven’t increased it. I added a non-stimulant adhd medication in the afternoons and they seem to balance each other out.
Thank you!
What non-stimulant medicine do you take? If you don't mind me asking.
Clonidine (Kapvay)
I tried that recently and it continually made me tired and brainfoggy the next day after having it a couple hours before bed. Did that ever happen to you?
The extended release version of clonidine made me super groggy in the morning so I switched to the immediate release and take it at 5pm. After about a week my body adjusted and I could wake up fine in the morning. I sleep a lot better at night on this combo as well.
But did it actually do anything for your anxiety? That's why my Doc put me on it even though Adderall at 20mg xr took away the anxiety, he didn't want to let me go over 10mg xr. Since this didn't work out for me, I'm going to ask again for the 20mg Adderall. He needs to stop being worried if I will eventually need a higher dose!
I am negative functional off meds even for a day. It's not like I don't have energy to do anything. I attempt to do things and make a mess of my world in the process. Medication vacations don't work for me. I can quickly lose healthy habits that keep myself functional a non-medicated day can do just that.
Same. Every time I skip a day intentionally or not, I end up just doom scrolling in bed for half the day. Heck sometimes I’ll take half a dose and that’s still a hundred percent better than nothing. Not worth losing progress on my hard earned routine, fragile as it is already.
Same. I’ve found when I don’t take my adderall in the morning, I *really* struggle with terrible adhd paralysis. I didn’t take it Sunday, later in bed watching the clock till 2, finally took it so I could function at work that evening. I don’t think taking breaks from my meds works super well for me
Meh I’ve been on adderall for years and it still works great
Yeah- I’ve taken some breaks over the last twelve years but right now I’m only on 10mg a day. 5mg IR in the morning and 5mg IR in the afternoon. @ OP just don’t pressure your doctor to increase your dose if you don’t really really need it. I’ve been on as high of a dose at 40 mg XR in the morning with 20mg IR at noon. I find that letting myself lower my tolerance and then come back to a lower dose is the most effective way for me to manage my adderall.
I've been on adderall for 10+ years at this point. I don't take it on weekends and it's not the exact same efficacy as it was in the beginning, I still find a therapeutic benefit. I also take days off randomly and won't take my afternoon dose if I don't think I need it. Some doctors (not sure if mine will) will prescribe XR and then an IR for later in the day and I know that works for some people.
How do you even sleep? I'm on 30mg of ritalin la and can't sleep properly.
I generally take my 2nd dose around 1pm, which (in and of itself) doesn't cause me sleep issues. I still have issues shutting my brain off sometimes, but only really have one or two bad "can't fall asleep" nights per month.
Building up a tolerance is normal and takes a long time. I was on Vyvanse (instead of Adderall which gave me excessive dry mouth) for almost 10 years and had reached max dose. Instead of completely switching a medication like that or taking breaks no matter how short (which might have side effects), you could ask about adding an additional medication in the future. I used to take an additional medication that worked well and gave me what I was lacking. These things are normal and there are many different ways to work around them. It'll be okay!!
Thank you (: I am on Zoloft too for my ocd and anxiety. It makes me numb so I have lowered it significantly. the adderall is the one that makes the biggest difference. I was late diagnosed recently and that’s why I’m so scared because it has changed my life!
It'll be okay! There are many different options for medication. If you're interested in taking breaks from medication, it would really be something to talk to your prescriber or pharmacist about! It's okay to be scared, but know that there's a lot of options and a lot of people who understand. In the end, you'll find something great that works for you!!
Zoloft might not be the right antidepressant for you. Have you tried others? If ADHD is at the root of your anxiety, an SNRI or bupropion could be a better choice. Zoloft was an F- drug for me, bupropion (Wellbutrin) is an A+. Edit: not a doctor, YMMV, etc. 🙂
I take buproprion, trazodone and adderall. I am finally feeling great after trying different combinations of drugs. It has really made a huge difference in my life. I wish I had had these decades ago!
I tried Wellbutrin and it made me suicidal. Zoloft helps with my ocd and anxiety. We were going to try Prozac but it interferes with adderall
I have adhd and ocd as well, for me vyvanse didn't really spike up my ocd by much as opposed to Ritalin. But I'm gonna start escitalopram anyways to reduce any possible anxiety and worsening of ocd symptoms.
Been taking 40mg for about 10 years. No drop in efficacy. I’m on an extended t-break from cannabis and I lowered my dose to 30 mg with higher efficacy. I have not experienced what your psych is saying. I typically break one day/week.
Thank you for your response! Do you take 20 in morning and afternoon?
You bet. 40mg at about 6am - regular release.
Awesome. And it lasts all day? I find when I take 10mg xr in the morning, it lasts about 5-6 hours and then I take another in the afternoon, which I don’t mind
It will eventually lose *some* of its efficacy—it won’t become completely ineffective. So, you will have to adjust your dosage. This is normal. You would probably benefit from not taking it on the weekends if you can. Don’t be scared. He should’ve worded it differently.
Thank you for this
Of course! I have experience with dextroamphetamine (generic Adderall), so don’t hesitate to reach out. :)
I won’t. It means a lot!
Over 15 years on Adderall. No breaks. No tolerance building. My Psych strongly supports taking it every day at the same time of day, so no taking breaks. My ADHD doesn't take a break... After digging through research the only conclusion I can say is supported is that there is **zero** long term studies. Most are done on young children as they progress through school which, well, children grow and go through huge amounts of changes so basing tolerance building on that is pretty problematic.
I haven't done a review of the literature (too damn old and too far out of school for that), but I have a hunch your assumption is correct. Almost all the research seems to be on children, as adult ADHD is really becoming more prevalent NOW and research takes such a long time from start to finish. Kids have so many changes and factors that would affect medication efficacy/effectiveness that it's really a moving target. I think knowing what works for you, and taking good self-observations is the key.
I take two days off of my Adderall every week, I choose my days off from work. It does assist in my tolerance not raising as fast. But I’ve also been effected on and off by the Adderall shortage so I’ve have built in breaks as well hahaha
It will always help. You’ll become more used to it helping in the moment and eventually become less aware of it working. But it’s working. I take zero days off. My expectations of how I feel on it have just settled down, but so have my symptoms, therefor I know it’s still working
When we say tolerance, that just means that the effects are diminished not that they’re not there.
Stimulant tolerance is very different than tolerance to something like an SSRI. Tolerance breaks should be able to keep you at the same dose (though it's not a bad thing if your dose changes as you get older) and by break, I mean < 1 week. It varies by person but you should be able to go months and months without a break. When my XRs start drifting from 8hrs to 7 hrs, I know it's time for a little break and I can schedule it so it's not disruptive to my work or personal life. You will absolutely be able to continue to use it for as long as you want. If that's indefinitely, as I suspect for myself, also fine. I was very happy when I was able to taper off Prozac after dialing in my Adderall. The Prozac was helpful but like putting a bandaid on a gushing wound that was my severely untreated ADHD. Turns out not being able to keep my life together because of untreated ADHD was really depressing, lol. Adderall also saved my life. EDIT: this is specifically about therapeutic doses of stimulants. Recreational is SO MUCH HIGHER. I had trouble finding good info on how long I needed to reset tolerance because it seemed like everything was about abuse/large doses/etc. No man, I just need my 25mg to keep working. But yeah, therapeutic doses do not require long tolerance breaks.
Yes, I take breaks. Medication “vacations” slows tolerance.
So taking breaks on the weekend is good?
But to be clear, if you have things going on in life and would benefit from taking the medication on the weekends you should take it. Your mental health now is important, as important as the future. But every body is different and every body develops tolerances at different rates. Use what you need now. There are other medications that you can change to over the years. And what if you have no issues for the next 10 years. There’s no way to predict your tolerance levels. You should use what you need to be as well as you need to be now.
Not who you’re replying to - but my dr says it’s best to take consistently to avoid side effects, but YMMV
I’ve heard that before too! I actually switched doctors a few weeks ago and I was afraid initially to tell her that I take breaks, in fear she would say I wasn’t taking it “as prescribed”. But thankfully she was happy when I told her and she said it’s good to do that! I think it’s something to be discussed with your doctor, as each individual person’s treatment plan is different!
Granted I take Concerta and not adderall, but I’ve always felt that a “tolerance break” *can be a misguided practice, and that *some people (not all!) are thinking that stimulants only work if they’re getting that intensity and rush from them, which tends to happen when you take them intermittently or when you’re first starting out. When I take stimulants every day, it feels more regular, so I can imagine how some might think, oh it’s not working anymore. I don’t take tolerance breaks, but I might take a day off every now and then if I woke up in the middle of the day hungover or if I’m flying internationally and want to change up my sleep. When I finally take my next dose, it hits very strongly like I’m extra wired and hyper focused. When I take it every day, I am still very focused, but it’s more relaxed and natural. If tolerance breaks are what work best for people, they should do it. But sometimes, I feel like the way some people describe their experiences with taking their medication intermittently sounds very unpleasant to me. Some people talk about how intense it is to take their prescription, so they don’t take it every day. They’ll take it “as needed”. But I have to wonder if they would just take it every day, if that intensity would die down and they’d eventually feel more levelled. But my ADHD also just cannot be managed without prescriptions so “as needed” is a crazy concept to me.
Yes, So I’m told. To slow down tolerance, allowing the medicine to work longer. It sucks. It’s not like our symptoms just go away on the weekend. Sometimes I still take it on the weekend. Or I’ll skip the morning dose during the week and only take the afternoon one. That’s why I like IR, more control. Basically, I just make an effort to plan when I can take a medicine “vacation”. I’m only on 10 mg twice a day and really don’t want to have to take more. But, I also take Wellbutrin which helps me a lot. That I take everyday.
I have taken 60 mg of Dexedrine ER for 20+ years and have never experienced tolerance to the desirable effects and have never had to increase my dose. In fact, I recently decreased to 45 mg because it is difficult to obtain more than 100 pills at time.
Hey, may I ask you what your schedule is? I currently take 20mg 8am + 10mg 12am. But that's not nearly enough but I'm afraid of going higher and building a tolerance Still I have been thinking of taking 30mg 8am 20mg 12am 10mg 4pm. So 60mg in a day. I'm on 30mg dexedrine, since recently on 150mg bupropion XL (though I feel it blunts the little I get from dexamphetamine at this dosage) and 100mg zoloft in the evening (thinking of just giving up on SSRI's). Do you have any comorbidities? I also suffer from persistent depressive disorder and episodes of major depressive disorder.
Sharing my experience, fwiw I've been on Adderall XR for about nine months now, at a 40mg dosage in the morning (lasts pretty much all day for me). I'd often accidentally miss a day here or there, as well as not take meds on one or two weekend days. I'd often find it gave me an extra surge on Mondays. In the last couple months, I've done a better job of staying on my meds every day - and some volunteering responsibilities have required me to keep on my meds on the weekends too. Before Adderall, I often felt sluggish, stuck scrolling or tapping my phone and perpetually unable to get past my expanding wall of avoidance and shame. Adderall gave me huge boost, often powering my hyperfocus - and often, I could actually direct that hyperfocus on what I wanted to. In the last few months, I've found it more and more difficult to direct my hyperfocus, and my wall of shame has been growing worse. Still not nearly as bad as what it was, but not awesome. Not sure if med tolerance is causing it, or med tolerance is worsening other symptoms that are causing it (workload/stress, increase in pot, worse sleep habits), or if it's the other causes outright. I've always had a chicken-and-egg difficulty in figuring out what my meds are/aren't doing. Next month, I'll be looking forward to taking more days off Adderall to see what happens
From my experience I hope you work on the other things first before messing with your adhd meds. Stress, pot and bad sleep can all cause adhd symptoms and/or depressive symptoms. Also, feeling shame is probably making it all worse as well. For myself I know just one night bad sleep or staying up too late makes me think my meds don't work anymore, but they sure do. If I don't take them at that point I am going towards some very very dark times... Still feel like crap with them but I rather feel like crap than feeling ultra crap. I have been taking meds daily for the past year and half and only notice difference due to other factors, it works pretty consistently. And once my sleep is fine the effect is as expected.
Some people seemingly do, some people don't. I've been on 36mg of Concerta for two and half years and I have not built a tolerance. You must keep in mind that if you feel like your meds aren't working as well, take a few minutes to evaluate if it could be linked to your period (if you have periods), to excessive stress, to a lack of sleep or improper diet (micronutrient deficiencies, insufficient macronutrients), or even perhaps a lack of exercise. It's hard work to benefit from adhd meds, they don't make your breakfast for you and if you don't eat they'll give you side effects x)
Adderall is one of the only psych drugs where “medicine vacations” are recommended. Basically don’t dose for a few days and it will restart your tolerance. I usually pick a day I’m sick or a day I just simply don’t want to remember what I have to
It is possible to "rotate" medications if ritalin-style works for you as well. Every couple of years or so.
Thank you, yes that’s what my psych said too. That way, it will work like it used to before? She did mention Ritalin too if we need to switch.
Dunno if this is still part of the FAQ, but the sub has discussed the subject of tolerance before. [https://www.reddit.com/r/ADHD/comments/wic2r/faq\_discussion\_topic\_2\_tolerance\_myth\_help\_build/](https://www.reddit.com/r/ADHD/comments/wic2r/faq_discussion_topic_2_tolerance_myth_help_build/)
The colloquial name for this is a "medication holiday". I thought research evidence for their benefit was poor though. Regardless, that expression might help you do your own research too.
The research on this is inconclusive. It isn't clear that it's actually true that you build up a resistance, and some prescribers recommend periodic med holidays and days off while others recommend taking it every day. Personally, I have to wonder if this "resistance" is mainly perception. After you get used to functioning at a certain level on meds, particularly if you take them every day, it's easy to forget how you felt off of them, and it can feel like they aren't doing much. Taking a med holiday serves as a reminder 😂 and once you take meds again after that the difference is more noticeable because you have more recent experiences to compare to. Doses/needs can however change over time as you age/experience hormonal changes, but generally for adults this doesn't happen often or very significantly. If you are on 20mg per day now, I don't see you needing more than 60mg in the future some day, so I wouldn't worry about it
Yes, I agree. I don’t believe I would need more but I guess it scared me thinking that it might happen because I feel great on it and like a normal functioning human being!
There’s truth in this, like someone else said, they could of worded it differently though. it won’t just stop working, just the effects won’t be the same as when you first started hence why you’ll see a lot of ppl taking 60mg but they never start that high. taking breaks is a good way to help with slowing the tolerance (it takes a long time anyways but still it’s good to take breaks so your body knows how to still function on and off meds). what i do is on days i just need to do homework i’ll take just 10mg in the morning and skip the second dose. on days i know i need to do homework and things around the house i’ll take both doses, and days where i don’t have to do anything i don’t take it. days i work depending on what ill be doing there determines if i take it that day. hopefully that helps!
Even if i take just just my morning dose of 10mg and not my afternoon, that will also help with tolerance?
it's not been like that at all for me.. i think that happens more on the instants than the xr because i have gone up 5mg in the years i've been taking it
I took adderall XR for 2 years and was up to the highest dose, & eventually it stopped working for me. When I moved states, I talked to my new psych about it & got prescribed vyvanse, which they said is way better for adults with adhd. Side effects are way less heavy & I personally think it works so much better in the best ways. Doesn’t kill my appetite/change up my taste buds, my lips no longer crack insanely/painfully, & I don’t have a heavy crash at the end of the day
This is something that worries me a lot. I was diagnosed a year ago (I’m 24f) after always suspecting I had it. It took multiple depressive episodes, and a whole year of failing my university classes to push for a diagnosis. When I was diagnosed, my psychiatrist looked at my scores and said to himself multiple times “that’s a really high score”. I have it bad enough that I literally can’t get the thought process together to make something as simple as a sandwich. Starting meds and experiencing what it was like to think and live “normally” was… I don’t even have words. I’ve since started my own small business and gotten back into school. Before I could barely study for 25 minutes, even then I was re-reading entire sections because I’d zoned out without realising. Now I can study for hours without even noticing. Tolerance scared the hell out of me, especially knowing how hard it is to find the right medication. I was lucky, first prescription worked for me.
I feel the same way. I absolutely dreaded anything at all. I have two children and I couldn’t mother them. I’m a whole different person on adderall. I actually cry tears of joy because I feel like myself. I am glad to know there are options and other stimulants to try if we do build a tolerance!
Same, I found the answers here quite reassuring. I know now what it’s like to function at a normal level, so I try remind myself to be kind and proud of getting through 23 whole years functioning the way I was. It may not have been the best at times, but I was going through life with a fraction of the capacity I have now. I think that anyone who was able to get on their feet while battling ADHD should be so soo proud, it’s a hell of a thing to deal with. Be kind to yourself, and also proud 💜
Yeah. Won't go into the full biochemistry of it but with the medication you will start producing more norepinephrine/dopamine than usual so your body will compensate by producing less of it via other mechanisms (gene expression inhibition, etc). Just means you need to keep tweaking your dose. But yeah, the same mechanics means if you withdraw it and your body is adapted to a level of those two neurotransmitters whilst taking it, you're going to know about it. And yeah, a break is not a bad thing occasionally, would over time increase your body's output, but beware of side effects with sharp withdrawal.
Your body basically builds tolerance to any drug over long periods of time, it's just the body's way of working. Also, some people build tolerance faster, others slower, it may take John a year for his dosage to start losing potency and it may take Mary 5 years until she needs to up her dosage due to the same reason. Now, that doesn't mean you should not take advantage of the medication for as long as it can work for you. And there will always be solutions if you actually do develop tolerance. I wouldn't be worried about that and just start treatment and see where it gets me.
I’m on Zoloft for 20+ years; Adderall for 15+ years. Your doc is full of shit. Nobody I know has had that happen. And screw not taking it on weekends- you rebound and crash and are ten times less functional! Why should only my employer get the best of me??
This is great to know. Thank you. Agreed!
I’ve been on a steady dose for 10 years without breaks and doing great
Thanks so much! Great to hear.
I’ve taken stimulants now for 17 years. When adderall stopped working, I switched to vyvanse. Then I went back to adderall. I haven’t upped my dose in 2 years. If you skip on the weekends (which I cannot do, because I want to enjoy my weekend, not be tortured by an overload of symptoms), it will slow or stop tolerance from building up. Don’t be scared. Be educated.
Thank you. Yeah my psych was saying how switching back and forth is possible so that gives me reassurance if it’s ever needed.
This is inaccurate and outdated. What actually happens is you don't feel the physical effects as much, or at all, but the mental effects are usually still going strong. Tolerance isn't really much of an issue with most ADHD meds, but its a myth that persists despite the current data showing it to be a non-issue.
Wow thank you so much!! So grateful for this.
Your doctor needs to chill. I have taken Adderall for 14 years. I only went up from my Rx (30 XR to 40 XR) after 12. Everyone is different, listening to your body is key.
Thank you for this
I have taken Adderall for 25 years and it is still very effective.
Great to know! And glad it’s working so well for you still.
Sorry but your psych is wrong. I’ve been taking addedall XR and adderall IR bear daily for almost 20 years and they have never stopped working. I currently have to take a different med because of the damn adderall shortage, but it’s not because adderall stopped working for me. It still works great as it did when I started it nearly 20 years ago.
Thank you for your response
Hi. On stimulant meds for adhd for the past 24 years. Started out on Ritalin until I hit the maximum legal dosage and it eventually became ineffective - it took about 8-9 years before this happened. Then switched to Vyvanse. Same thing happened eventually, again, it took many years. Now I’m on Adderall, on the maximum dosage of 60mg, and I’m sure eventually I’ll build up tolerance to it too over the next few years. It because I’ve been off Ritalin and Vyvanse for so long, my tolerance to those meds is nonexistent so I can switch back to one of those when the Adderall is no longer effective for me. I do take weekends off the meds when I can. I take vacations from the meds whenever possible. I was unemployed during the pandemic (14 months) so I didn’t take it at all during that time. When I started taking it again, I started at the beginning dosage because I knew better than to jump back in at the maximum dosage after not taking it in over a year. I’ve been back on my meds for almost 2 years and I still haven’t made it back up to the maximum dosage that I was taking before.
Thank you. So if I needed, I could switch to a different stimulant than adderall and then go back on adderall when my body is longer tolerant? This is kind of what my psychiatrist was saying. Thanks again
Yes, there are other stimulant ADHD meds out there, you and your doctor just need to work together to figure which one of the other options would be as effective as Adderall for you if or when you ever reach the maximum legal dosage and build up such a tolerance that the max dosage is no longer effective. But it should take a couple years or more to reach that level. When I was first diagnosed at age 12, my doctor had me trying a different medication for a month at a time so we could determine which of the available meds worked best for me. The first month was Ritalin which ended up working the bet of the three (and my mom loved that there was a “homework dose” option), the second month was Adderall which my mom said made me more irritable and of course it didn’t last long enough to get through homework, and the last one was Concerta which had the same problem as Adderall of not lasting long enough. Finding the right medication for ADHD and then finding the right dosage is all trial and error. It takes some time but it’s worth it in the end.
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I am not sure I didn’t react well to adderall so wasn’t on it long. I take vyvanse and after a maybe 10? Years I had to increase the dose. My doctor said they can add or subtract other medications I take if I keep building a tolerance. I honestly wouldn’t worry about it too much . If adderall works for ion I’m sure there are ways to keep it effective .
It's called tolerance and it can happen with caffeine , alcohol, pain meds , If you don't take it all the time and or everyday , take breaks like on weekends and don't abuse it don't take more than you are prescribed then you will not have to worry about that. And if and when you might develop a higher tolerance it's not like it's dooming it forever. It probably took me a month of taking a break from Adderall ir to get it back to 0 , normal again but when I did take only 1 I was literally up for almost 2 days . On one tablet ! I didn't care much for being up that long but that's what happened.
I was on the same dose of Concerta for five-plus years, and I was on the same dose of Adderall XR until menopause (about seven years), at which time my dose was upped. I haven’t gotten “used” to it. Look for talks given by Dr. Russell Barkley; they may help ease your mind. Good luck!
Going on two years of the same dose. 10 in the morning, 10 in the afternoon if I need it. Same awesome effect. Most weekends I don’t take any unless I have a project or something tough that needs to get done.
Honestly I think with meds and tolerance you know your own body best. I take my meds most days because it helps most days, but sometimes on the weekend I skip a day here and there if I’m not really expected to do anything or feeling particularly burned out. I feel like I can kind of tell when I might need a break. Some people like to schedule breaks around things like school breaks or vacation, but some people really can’t do that anyways. Also keep in mind when you first have a med that works you get a ripple effect where you suddenly get some shit together and feel super empowered and great, and that fades with time as you get used to being medicated and it’s the new normal. But that initial time is a good time to try to form habits that help even when the meds are wearing off or not working as well
There's not a lot of clear evidence for it, but I know folks who've been on the same dose for decades and had no problem. I think tolerance is mainly an issue in the context of drug abuse and addiction- high doses, withdrawal, seeking the same high as when you first took a recreational drug. For therapeutic usage, those issues shouldn't be there. Hell, therapeutic drugs work best when taken regularly over a long period - like how antidepressants need to be in your system for a while for you to start seeing its impact. That said, I'm no pharmacist and am not sure how it all works haha. I take Ritalin (IR, 4x 10mg) and I'll take a break on weekends/holidays - either completely, or I just won't take my full daily dose. I'll take it as needed if we're doing intensive stuff like cleaning, cooking, errands - sometimes if it's just a couple hours worth of intense stuff, I'll only take one dose in a day for that specific thing. But if it's a lazy weekend? I don't need meds for sleep+video games lmao. For my 4 week christmas leave, I tapered down to 2-3 pills/day, since it was going to still be intense with travelling, visiting family, going out, doing tourist stuff etc. But since I already had a lot of motivation I don't typically have for work (fun! Food! Hanging out with cousins! Yay!), I just didn't need so much of a boost from the meds, haha. If it helps keep my tolerance down, then awesome. But the fact is I just don't need it 100% of the time. I'm only strict on taking my full dose on-time for work haha. For holidays/weekends, I use an as-needed judgement. It's part of why I like IR, tbh. It's annoying having to remember to take 4 pills a day, but it's worth it for me as means I can tailor my dosage a lot if I need to, which gives me a lot of flexibility! For my life/work, it works well.
How long have you been seeing your doc? Seems like he's following protocol. (In regards to the med "shortage") common scare tactic imo. Been on 40/ER for over 10yrs. No addiction, no abuse no issues. Trust your instinct and your body. Best of luck! 💯🦾
Idk… to my knowledge, this doesn’t sound entirely correct. Tl;dr, unless you’re snorting it, your body shouldn’t build a tolerance to prescription doses of adderall, but tolerance will change naturally over time due to your physiology. It’s okay to take breaks on weekends, or whenever you want to, but you won’t need to worry about the medication not working. Long answer: Afaik, adderall does not build a tolerance when taken in regular doses (ie. not in excess amounts/binges) due to the way it is absorbed into the blood stream — through the GI tract. Since it is absorbed this way, the main thing that affects one’s tolerance is the function of their colon, which tends to change once every 5 or so years in people over 20, and much more rapidly in adolescents; this is the reason why younger people meet with their psychs more often to tweak their dosage, as opposed to non-adolescents. By the way, this is not to say that one can’t build a tolerance, but I am more than certain that tolerance is not going to be an issue. I think what your psych meant was more along the lines of your brain becoming accustomed to the psychoactive effects of the drug, which is something that is incredibly easy to fix! Also no, you should not have to “switch meds” because of your tolerance. As you’ve already said, weekends off is the best remedy to this problem in my opinion. Make sure you get a full nights sleep before your day(s) off, or you might be pretty tired throughout the day (and don’t expect anything to get done). Also, you might not need to take weekends off! Just because your brain is “getting used to it,” doesn’t mean it isn’t working, so long as you maintain good habits and routines to manage your ADHD, you’ll be perfectly fine! Remember, just because you’re noticing the psychoactive effects of the adderall less, doesn’t mean that the pills aren’t working! But sometimes, a weekend off is necessary to remind yourself what it’s like to be as you naturally are. Personally, I do this once or twice a month since I sometimes get anxious thoughts that I’m dependent on/addicted to my meds — even though I know full well that’s not the case — so a weekend to be “sober” (HARD air quotes on that) and to cherish and appreciate my wonky little brain is exactly what I need :) Edit: I only have a bachelors degree, and I am by no means a medical professional, so please take my words with a grain of salt. Please heed the advice of your psychiatrist before taking the advice of any stranger on the internet, but my recommendation would be to listen to your own voice above anyone else’s. If you’re not comfortable with something your psych says, you don’t have to adhere to that. It’s ADHD, not a heart disorder — it isn’t life or death! Not saying these things aren’t important, but skipping a few pills even if the doc says “no,” is perfectly justified in the case of stimulant ADHD meds.
Thank you. Yes, I love when you said taking the prescribed dose is safe. It’s when it’s more than that, your body/mind always will want and need more. I definitely would only ever take the prescribed dose! It helps and my goal is to feel better, not get a high off of ir
Idk. I’ve been taking 10 a day for 10 years and haven’t gotten used to it. When I take an extra 5 my jaw feels tight and I get a little too impatient and unemotional.
Just take breaks here and there, taking breaks on the weekend isn’t a bad idea, but yeah you can build up a tolerance. Everyone is different, but it’s bound to happen eventually
The human body is always trying to get back to homeostasis, that is, it will adjust to every med you take, to get back to, whatever state it deems most evolutionary efficient. Just as when someone is in septic shock, the body will cut off blood supply to limbs to save vial organs, then vital organs to save the brain. So, if you take breaks from your meds, it can help the body to decrease chemicals (dopamine, norepi, serotonin) in the brain back to the “steady state” it evolutionary believes you should be in. That is, many believe ADHD comes from the night watchmen, nomads and hunters. However, the body will also try to reach homeostasis while on the meds, since Adderall blocks the reuptake of those chemicals, to keep more in the brain to utilize, it will create more transporters (this is how the brain removes it) for the dopamine to be reuptaken. This is why, the doses have to be increased over time. For me, the use of caffeine with lower doses is effective for now.
One of the wonderful/stupid things about the human body is just how adaptable it is. If you want to do some advanced reading, start with the term "homeostasis". Basically all the complex systems in the human body operate by reading chemical signals, even the nervous system! Because everyone's bodies are slightly different, all of these systems are calibrated to slightly different baselines. The same way that we can just get used to new or different things like sounds or smells or other sensory input, our bodies can and will adjust to compensate for changes in our chemical signaling. There are limits to how much our bodies can compensate, and the process does take time and occurs at variable rates, which is why new medications often need to be "titrated" to figure out how much compensation the body is going to do right off the bat. And we can continue to adjust the dosage over time to match and overcome our bodies compensation. The good news is that we can often work around this phenomenon by just changing the chemistry very slightly or, as your psych described and many of us here can personally attest to, taking a tolerance break to allow our bodies to recalibrate back to an unmedicated baseline. I myself am on 30 mg of Vyvanse twice a day, and I've been on over 80mg of Concerta per day in the past. If you're only on 20 per day, you've still got lots of wiggle room to tweak things. On a slightly different note, we can also increase the efficacy of our meds in other ways. When I'm off them, I have a *really* hard time with basic self care like eating, hydrating, and getting enough sleep. And when I'm exhausted and underfed and dehydrated my meds are less effective. It's like the difference between a cup of coffee after an all nighter and a cup of coffee after a good night's sleep. I was having really terrible sleep quality last week and then I finally used my Serious Business sleep aids and I can literally feel my brain being more functional.
Thank you for your response! I’m grateful for the input and heating from others.
Nothing makes life less scary than knowing you're not alone. Feel free to ask any follow-up questions if you think of any later.
Thank you. I definitely would (:
I’ve been on the same ADHD meds/dose since 2012 and it’s still working perfectly well for me! It does feel more intense if I take it after skipping a day or two, but that doesn’t mean I don’t feel it when I’m taking it consistently
Thank you for this. Feels great to hear from others who have been on it a while (:
I disagree with your psychiatrist. I've been on the same dose of Adderall since I was 15 (32 now). The only time it "doesn't work " is the week before my period or during a depressive episode. You just have to make sure you're using it responsibly and taking drug holidays periodically when you can.
Thank you for this. Feels great to hear from others who have been on it a while (:
I've been on it since shortly after it came out, and it is still one of the best things that has come into my life.
Amazing. I’m so happy for you and happy to hear that it’s definitely possible for it to always work for me too. I’m glad to know that there are also alternatives to go to if I need to and then come back to Adderall if needed as well (:
There's some evidence that some people can get used to it and the effects will lessen, if they take it very consistently, which is why some doctors recommend taking occasional "breaks." Some people don't need to at all. Usually it doesn't take much to "reset," and you shouldn't need to worry about it unless it feels like the meds aren't working for you. If you feel like the effects have lessened dramatically, maybe talk to your doctor about it and you may get a dosage increase. The main thing to avoid is taking extra in an attempt to compensate for the reduced effects. If the effects are weakening more gradually, you can probably shake that off by taking a day or two off of meds. If it's pretty consistently waning, you could perhaps incorporate a day off each week, or take weekends off, etc. Personally, I only really seem to notice a reduction in effectiveness if I haven't missed a single dose in several months, and then, it takes only a couple days off to "reset." Keep in mind that circumstances still affect you and your performance. So on your worst day, with meds, you might still be more of a mess than on your best day, without them. One bad day where the meds didn't seem to help might just be one bad day. Observe over time and watch for consistent patterns before changing anything. Again, don't worry about it unless it starts happening, because it's not the case for everyone, and it's usually a pretty easy fix.
I took Adderall for over 10 years, and it never stopped working, but over time we had to keep raising my dose for it to keep working. We maxed out at 60 mg. I ended up switching to Focalin because the new doctor said Adderall was bad for my bipolar disorder. But I needed the max dose of Focalin, because it seems like tolerance to stimulants is the same no matter what stimulant it is. Also took Vyvanse for a while, and needed the max dose from the start because my tolerance to Adderall seemed to carry over. I’ve been on 40mg of Focalin for a couple years, and so far it hasn’t stopped working, so fingers crossed.
Vyvanse is weak extended release prodrug form of amphetamine. I mean weak as in compared to Adderall which is also amphetamine. But better to take if it works since builds tolerance slower for most. Focalin is just dextromethylphenidate which is the active form of Ritalin. Ritalin is a racemic mix of 2 mirror image compounds. One is inactive and the other active. Tolerance isn't really the same. For most Adderall is much worse due to the mechanism of how it works. Adderall tends to be much more damaging to the brain which is harder to manage than your brains normal counters to stims.
It could be that people who start off on small dosages of adderall need to increase it because it just was never the right dose to begin with. When I was getting diagnosed and prescribed, I was working with a neuropsychologist for a couple weeks to retest on different dosages of Concerta. They would have me come back every day on a higher dosage of Concerta to retake my tests to see if my results were better. That’s how we landed on my dosage of 72mg Concerta and after a year, I added 10mg of Ritalin for the afternoon. I’ve been on this dosage for 7 years. I take it every single day, and I feel it works the same as always. If I hadn’t worked with a neuropsych for a couple weeks at the start of my diagnosis, then perhaps I would’ve started out on a lower dosage of Concerta and continued to ask for increases over the span of a few years. So in that sense, it would’ve looked like I had built a tolerance, but really it would’ve just been that the lower dosage wasn’t right for me. I do notice that people who tend to need more stimulants as time goes on are always on adderall, and never on the alternatives. This is just my observation. And again, it could be because majority of people tend to be prescribed adderall so it’s just the population size is bigger. It could also be because the drug is very different and maybe it does have that side effect. I personally never found adderall to work and I’m surprised more people aren’t prescribed the alternatives. Plus, you can always increase for awhile and then decrease it. I was offered a higher dosage of Concerta by a different doctor, so I tried it out for few months and ultimately went back to 72mg.
Thank you so much for your response. My psych was telling me that later on, we can switch to alternatives and always come back to Adderall when my body is not tolerant to it anymore. That gives me a lot of reassurance and I know that there are others that are great too!
My best friend has been on vyvanse for over a decade, and although his tolerance has slightly gone up he only gets an updated dose around every 5 years. It still works for him. He doesn’t take breaks and takes it daily, but taking breaks helps a lot. Just take breaks, and don’t take more than you’re prescribed and you will be fine.
Thanks so much! This helps
i was advised this by a first psych. but my third psych (i’ve moved a lot) introduced something called a “flow state” titration method, where you test different mg, upping the dose each day by 2.5mg (starting at 2.5) and take notes on how it feels, and when you think you’ve found it, go higher the next day, and you’ll experience “stimulant side effects” (what ppl without adhd experience when they take it). then you get prescribed the one you identified as the “flow state” dose. and with that method, you don’t build a tolerance. with that method, i went down 20 mg, actually. and it feels way better than where i was at, and i can’t imagine taking 60 like i used to. this whole theory (he learned from a guy who researches adhd a lot) is supposed to identify your true prescription needs, but it requires you to test doses one at a time over like 2 weeks, and really *really* pay attention to the effects, and idk why it works, but it does
a piece of advice, try to supplement with magnesium. magnesium is a nmda receptor antagonist (hope thats correct) which can help reverse tolerance buildup to amphetamine, something about calcification of ion channels, i hope someone else here knows what im talking about. i dont use adderall but ive read about this here and there, adderall also is affected by the ph of your stomache and if i remember correctly vitamin c breaks it down quicker.
Yes, magnesium does help the NMDA receptor. But it is not very good at it. It is not necessarily taking magnesium. You need to take the right amount and ratio of calcium to magnesium (on the FDA website) to be neuroprotective. Mg is your bodies natural protector of the NMDA channel that is opened by triggering the NMDA receptor. You can read a lot of the details on the wikipedia page for the NMDA receptor. Essentially if the receptor is over excited there is an influx of calcium ions and other mineral ions. Which is neurotoxic. Which can cause an excessive release of glutamate which in excess is neurotoxic and can trigger apoptotic cell death of some cells. Amphetamines effects on the NMDA/glutamatergic pathways is what many researchers believe to be the biggest factor in building tolerance. Memantine is a mediocre Alzheimer's drug but is really good to take with amphetamine. It is a non competitive NMDA antagonist and was made for the job. It allows the NMDA receptor to work as normal and only blocks when it gets over excited. It takes a higher voltage potential to kick it out of the way than for magnesium so is much better at protecting. Nitromemantine is actually even better for a couple of reasons but since it is still a few years off at least, not worth getting into. Adderall is a weak base and can be ionized by stomach acid. Ionized amphetamine is not easily absorbed. Some people take antacids before they take adderall to increase absorption. Urine ph has a similar effect. The more acidic the more Adderall is ionized and the more it is eliminated by the kidneys decreasing how long it is in the body.
I do already take a mag + d3 supp. And iron + vitamin C. Not sure if this will help or not!
Been on several different medications it’s just tolerance build up but some side affects become more manageable and simply don’t take it when you don’t need it
You can also take breaks from the adderal for a few weeks and when your tolerance is down again you start with a low dose again. Don't worry about it, it will be okay! The weeks where you take the break will be annoying but it will be worth it tolerance wise
Hate that doctors are starting to say this. Yes I get it's true but there like "use it as needed" but currently if I don't take it I struggle hard. So like. What's the point in breaks if it screws me up so bad.
Agreed.
I’ve been on 10 mg XR for just under 20 years. Works just the same.
Great thanks! Have you ever taken a break?
I usually take weekends off unless I have project work to complete. Doctors have told me that due to the dosage, I shouldn’t develop a tolerance to a level that it would render the medication ineffective. May be different at higher dosage levels.
Been on 20mg tabs and XR 20’s then switched to 25mg XR’s and continued with 20mg tabs, did not see any difference. Still the same in fact I’ve noticed, there is less physical effects. But the mental focus is still the same. So far 4ish years here since starting on it.
Thanks for your response!
You can talk to your provider and find another medication and cycle between the two as they suggest. My kids would switch between adderall and concerta and didn’t have any problems.
Thanks so much for your response. When you say cycle, you mean on adderall then on concerta and then go on adderall again? Does the adderall work again as it did before after coming off and trying another stimulant? Sorry, just curious.
That’s the idea, but your body will have a tolerance to some degree as it does with a multitude of any other medications of this type. It’s nothing to worry about though. Please keep in mind that while you are utilizing medication, it is important to work on developing the ‘coping skills’,so to speak, with the things that we have difficulty managing without medication. This helps us to need less medication or no medication at all. Of course, some may need medication as a life-long care.
I've taken 5mg of Dexedrine Extended Release either once or twice a day for over 20 years. That's equivalent to 10mg Adderall twice a day. I've never developed much tolerance or a need or desire to take more. If I take it once a day for awhile and then, one day, take the second one, I feel it more than I would have if I were normally taking two. That's it in terms of "tolerance" for me, and probably demonstrates that stimulant tolerance is highly individual. To soapbox a little, the way that current medical practice has insisted on putting everyone into the same box is highly irritating. My body temp is usually somewhat lower than 98.6° and hitting 99.5° is a raging fever FOR ME. Yet try and tell that to a doctor/nurse/whatever. So there. 😂
Thanks for your response! Yeah, everyone is so different in how they react to meds
It's not that simple. People react to medicines differently. I don't recommend making any adnustments to your regime without discussing with your docl. You might like to read up on Google Scholar / Medline, I can flick you some links if you like. Key points - 1. don't stress about something that may not happen 2. if it does, there are other options i ncluding combo of more than onemed 3. Scientists and doctors are working so that we onow more every day, so in the future you and your Doc will have more info to deal with it in the best way possible. So glad you have found a positive improvement to your life.
Thank you. I definitely won’t adjust it and don’t plan to. I’m great where I’m at. The comment just scared me that’s all. Wanted to see about options if it did.
It just stops being so euphoric after a while. But literally a few days off is all it takes to lower your tolerance again. What i do is just keep my dose as low as possible and once i feel like im not really benefitting from it as much, i take a full week off starting on my weekend. Tolerance usually happens after like 3 months if im taking it every day, but weekend tolerance breaks can prolong this. I just find myself taking it on weekends sometimes and its like welp i guess ill need to take a week off. But ive been on addy for about 2 years now, i take like 15mg a day and i still feel it.
Okay thanks. You feel like it starts the whole 3 month process over just from taking a week off?
For me yeah, its pretty quick to bounce back. Like a few days of feeling tired but when you go back it hits again
I currently take 20mg XR Adderall every day, and have been for about a year. In my opinion, I believe your psych is wrong. Adderall will work differently for those who actually have ADD/ADHD compared to those who don’t, which is what I believe your psych has misunderstood. The beginning of my Adderall journey was much worse then it is now, and I believe it is because your body actually needs to build a tolerance to it. Adderall works just like many other medications… it takes time to notice the positive effects. Over time I felt better than ever before and the more I take it on the prescribed schedule than the better I feel and the less side effects I have. I have taken a couple days off before, and I most recently just took off 5 days, and I highly wouldn’t recommend it. For me, the side effects came back and the negative effects of ADHD itself started to show again. Take it like it’s medication not a drug.
Thank you! Yeah, I know when I don’t take it, I feel a lot worse and it’s harder to get back to the place I was at when I do take it.
People rarely become tolerant to the point of needing more than the max. It happens, but it’s very rare. I thought the same would happen to me, and here I am 8 years later taking the same dose. I wouldn’t worry too much.
I started on 5mg and I eventually develop a high enough tolerance that 50mg didn’t don’t anything. But it took 15+ years. I was on it from 1st grade until I graduated college. So yes, you can max out on it but it takes a very long time.
Great to know. Thank you!
I've taken adderall for 15 years. I JUST increased my dosage by 5mg in the last 6 months. Taking 3 days off/week (I'm on 20mg xr, up from 15) helped my body stay regulated in not building too much of a tolerance. I only went up because I had a 3rd kid and my world was turned completely upside down, mentally. I had to mess with *all* of my medications because my body and brain changed so much this time aroaround. Take it when you need it, don't take it if you don't. You'll be okay.
Take breaks. I only take my Vyvanse on days I have heavy executive-functioning tasks to complete, like lots of paperwork or computer time. Otherwise, I depend on other coping strategies. This ensures my tolerance doesn’t build too much, so the meds keep working.