ADDition

Blog about personal experience with ADHD by Robert Dawson

Quick update

I've decided to stay at 36mg because I felt more nausea on 54mg. This is unfortunate because I felt more productive on 54mg. Although, that could be coincidence. And the difference wasn't drastic.

But even on 36mg, I feel nausea sometimes. I feel slightly nauseous now. I need to figure out what contributes to it or why it happens at all. Google hasn't helped me so far, but I'll look again.

Overall, though, this week at work I was very productive, so I'm glad Concerta seems to be working.

Oh, and I didn't drink as much caffeine this week, which is good for my heart! And no noticeable withdrawal.

Finally, I should note that I slept a fair amount this week, more on average than last week and more consistent.

36mg

I slept 5 hours last night. I stayed up to update my iPhone operating system to iOS 5. I love it! But I didn't sleep enough. And I feel horrible, worse than I would have expected given this relatively small amount of sleep deprivation. It feels like I've been awake for days. My body aches for sleep. This is a pattern.

Anyway, this morning, I went to my doctor for my first checkup. It helped that I prepared my observed changes and concerns. She listened, wrote almost everything I said down, and prescribed a one-month supply of 36mg, the dose I'm taking now in two capsules. And she told me that I could try 54mg if I'd like to see the effect. I'm basically experimenting on myself with professional supervision. But that's how it goes short of an MRI or other such direct brain-based observation. So, since I have only 6 18mg capsules left and already have my new prescription, I'll try 54mg one day this weekend.

She says that 36mg and 54mg are the most common doses and that I might see improvement with another increase. My two worries, I told her, are that I will have less appetite, which is now easily manageable, and that I will focus more, which, while being the point of taking the medication, can be a real problem if I focus on the wrong things. Wrong = want. Right = should.

And I asked about discontinuing Concerta on weekends. She said that some people do that, but that I might feel moody and tired. So, I'm not sure about that. My goal is to do more with less and, over time, to do more with nothing, on my own.

Concerta: changes and concerns (updated)

I recently listed changes I've noticed on Concerta and a set of concerns. Here is an update with a new effect and a new concern, both about the same annoyance I've noticed recently, which is nausea.

Effects of Concerta

  • Much better focus
  • Slight loss of appetite
  • Verbosity
  • More sensitivity to sound
  • Less moody
  • Nausea

Concerns about Concerta

  • Are there any potential long-term problems associated with using Concerta?
  • Will I develop a tolerance to Concerta?
  • What might be causing nausea?
  • Can I not take Concerta on weekends?

I've experienced slight nausea in the afternoons. It may be associated with caffeine intake, since I usually drink coffee in the afternoon, but I have also felt nauseous before drinking coffee. Or, maybe it takes a while to feel nauseous after drinking caffeine.

What's odd, though, is that I typically drink a pre-workout mixture that has caffeine and I don't recall feeling nauseous during or after workouts. I guess it's possible that working out prevents nausea. Hmm. Hopefully, I'll find out tomorrow morning when I see my doctor again.

Concerta

This morning, I went to see a psychiatrist about ADD. She told me that I definitely have ADHD (I distinguish between ADD and ADHD because, by her facial expressions, she seemed to clearly suspect hyperactivity, along with impulsiveness and risk-taking) and prescribed Concerta, 18mg to start. Unfortunately, at the CVS pharmacy, I was told that Medco, which handles my prescription insurance, requires the doctor to fax back written authorization specifying that Concerta has been prescribed for ADD.

She said I can take another 18mg pill after 2-3 days if I don't see improvement. I asked about side effects and how I would know if it's working as well as when I've taken too much. She said side effects include loss of appetite and sleeplessness, I will know it's working if I can focus for extended periods (although, she pointed out, deciding what to focus on is my call), and I will know it's too much if I feel jittery and/or a racing heart, conditions that shouldn't last more than about half an hour.

I told her that I am taking piracetam, which I gather from her expression she had never heard of, and 5-HTP, which she clearly had. After prescribing Concerta, she told me to stop taking everything else. I assume vitamins are okay.

I also asked about caffeine and she said that it's okay but I might not want as much of it, since the attention-enhancing effects of caffeine will hopefully be replaced by Concerta's. I will take her advice. But I feel compelled to mention that WebMD's Medscape website indicates that I should expect no adverse reactions when combining Concerta with piracetam. So, it might be okay to take both, but I will play it safe and maybe try a lose dose of piracetam with Concerta later if Concerta helps. I think each works on a different pathway or mechanism in the brain.

Piracetam - Day 2

This morning before work, I took the same dosage of piracetam, roughly 4,200 mg, with Alpha-GPC. Here is what I felt throughout the day.

9:10 am
My MindSparke score is somewhat lower than yesterday, down to 3.7 from 3.9. I felt distracted throughout, but I did manage to finish all 20 blocks without interruption. And, although I felt distracted while trying to complete each block, it was in the sense that I felt more aware of other thoughts, if that makes sense, and not in the sense that I wanted to do something else, as is usually the case. So, I think my mind is more aware of itself but my impulsivity seems lower than usual.

It's interesting to think about how I feel right now. I feel in "the zone" or more focused on each activity, but the feeling is mild. Or maybe it's profound and I just don't realize it yet. I'll drink my morning coffee and see how that affects me differently, if at all. The half-life of piracetam is 4-5 hours, so I have until noon to experiment. I guess this also means that, if it does help me focus, I'll need to take an afternoon dose as well.

5:03 pm
Today has been unproductive. I have had a slight headache off and on. I felt better after lunch, although very sleepy before grabbing my afternoon caffeine boost. So, lack of sleep is definitely catching up. Tomorrow morning, I will try half as much piracetam and I will bring another dose for the afternoon.

My sense is that piracetam does not help with motivation but does encourage a "flow" state or sustained focus.

Recent observations

Here are my recent observations about my ADD.

Times distracted, associated activities, and observations

  1. In the late afternoon, I seem to have less focus. I assume this is a combination of my natural circadian rhythm and caffeine intake. Drinking more caffeine, enough to feel the boost, if that's even possible given my intake, would get me through the afternoon, but I would feel more tired in the evening.
  2. Partly because of brain training and cardio, mornings aren't as productive. So I need to do these things quicker, since the point is to help manage ADD.

Rate of distraction (1-10)

  1. I rate late afternoon distraction as 5. I still get stuff done, but it takes a lot of effort.
  2. Morning exercise gets a 3. That's because I seem more productive overall lately and I have faith that morning exercise will help.
  3. I rate this week's overall productivity as 7.

What I eat, when, and the effect, if any, on ADD

  • This week, I ate less meat than usual, but more protein in the form of powdered whey. I was more productive this week, and maybe the lack of digestive effort allowed blood flow to stay more upstairs than usual, but I can't be certain, especially since it wasn't that much less meat. But it does make sense that less time to digest allows for more mental energy. I wonder if more chewing would help. Hey, it's oral digestion!

Progress with ADD-related problems

Rapidly changing interests

This week wasn't so bad. I'm not sure why.

Inconsistent productivity

I was less productive the first half of the week, but much more productive (compared to lately) the last half. Part of that was a quick deadline. I like having deadlines. And I need structure. But not too much, of course.

And I finished a book! I finished Irrational Man. It was pretty good. I learned that I want to read Sartre.

Winding conversations

I think I'm doing better with this lately. I seem better able to stay on topic or veer less widely. I'm not sure why. Brain training comes to mind, but I can't be sure and I don't know why, specifically.

Moodiness

This week, I was really down one day. That was because I felt rejected by something small and ultimately insignificant. The rest of the week proved fairly upbeat.