Interesting contrast though: for me leetcode, certain exams, and interviews often trigger hyperfocus. Studying and assignments, as well as day-to-day work, rarely do. I take a fair bit of medication so I can do my job. I'm trying to pivot towards something which more naturally engages my interest, maybe SRE or security work.
Interesting how we're all affected differently. I recommend skimming "delivered from distraction" if you haven't already, there are some good tips in there on how ADHD folks can deliberately create the right conditions for flow.
It’s just difficult for us to fit in to the system. Not only school, but a traditional 9-5 for me is difficult. Especially while not on medication.
Turn on, tune in, drop out
It is in the context of this society as we're fairly maladapted to it and struggle with a lot basic things that cause big problems in our lives.
I'm convinced this disorder is named after attention and hyperactivity because the children don't adapt well to school. At least not the traditional mass education model where kids sit in a class listening to lectures all day. There's probably a lot more we don't know about it. Some doctors I've seen think it's a made up illness created to sell amphetamines.
I encourage you to embrace the chemical imbalance as the reason. The medications do work and withdrawing from them isn't bad either (if you decide to take a pill holiday or extended non-use).
Finally, it's not about 'normal' focus. It's about you. If you're content with your productivity and behavior, then nothing is needed to change in your life. If you want to maximize your potential, then please consider medication. It doesn't go away (CBT never worked for me). Embrace your choice. Whatever you decide, is normal, it's your normal. That's perfectly acceptable.
Perhaps for you, but for others its a nightmare.
I can only assume one of two reasons:
1. They were on XR.
2. Abuse.
If it's another reason, maybe the formulation isn't the best for them because it's highly unlikely to have a 'nightmare' problem with getting off.
True but...on a probability basis, the two situations I gave are more than the majority of people's reason.
That's all I meant by what goes up must come down :)
I'm not trying to minimize your experience. I'm just trying to provide a more accurate framework on what's more statistically likely to occur within a population. That's all. Since others tend to be ignorant of the scientific facts on how this issue distributes among a population.
> This resulted me in one case coding straight for 7 hours.
This happened to me this weekend. It's truly scary in retrospect. I got a business idea thursday, and coded nonstop until Sunday. It's a rentable AI service for dating apps. I launched it and it's super neat imo, but I lost almost 8 lbs in that time because I didn't eat, drink water, and slept only when my thoughts started to blank out.
I am now focusing on rehabilitating by eating a lot and going to the gym. I got so skinny. I wasn't on any medication either.
Talk to your doctor, there have been many advances in ADHD meds and they all work differently on different people. Some people respond well to Ritalin, Some respond well to the generic. Some respond well the Adderal, or Vyvanse. For some people only the name brand formulation works. Some people any formulation works. Also, make sure you are at the right dosage. You can and do build up a tolerance over time. I try to take weekends off when I don't have anything in particular I need to do, and at least one or two weeks a year (normally when I go on vacation).
respectfully, I disagree with this. The last new therapy was atomoxetine, which is almost 20 years old now and not seen as terribly efficacious.
Everything else new has been some variation on mixed dextroamphetamine/amphetamine salts or methylphenidate. Vyvanse is just a pro-drug for dextroamphetamine.
The only novel thing in the pipeline is SPN-812, which may work similar to atomoxetine.
It’s definitely a relatively new development and a much more humanely effective drug than previous options.
— It is dextroamphetamine, which I’m inclined to believe is the more useful handedness. Levoamphetamine has more “body” effects. To the dextroamphetamine is bound a lysine molecule, and this together is an inactive powder. Enzymes in red blood cells are needed to cleave the lysine off and activate the dextroamphetamine. I’m quite certain that the dopamine rate-of-change detection mechanisms in the central nervous system cause very different behavioral and cognitive pattern cascades when it’s an almost imperceptively slow change, compared to an unhindered uptake of free amphetamine. Compare the difference in addiction potentials between faster and slower routes of administration of, say, nicotine - smoking fast, patches slow.
I'm not sure how much truth there is to this claim. As you mentioned, Lisdexamfetamine is just Dextroamphetamine bound to the amino acid, l-Lysine.
Once your stomach cleaves the l-Lysine, it yields free-floating D-Amp.
This mechanism of action isn't any different than most formulations of extended-release Dextroamphetamine, like Dexedrine ER spansules.
Additionally, Adderall and other standard mixed-isomer amphetamine salt formulations are a 75/25 mix of D-Amp/L-Amp, and the peripheral nervous system stimulation that L-Amp produces at that kind of dose (5mg for a 20mg pill) I would think to most wouldn't feel very noticeable at all.
Having gone through Adderall IR, Adderall ER, Vyvanse, and Dexedrine IR over the years, to me they all felt more or less the same (besides IR vs ER).
If for whatever reason Vyvanse happens to work better for some people, that's fantastic and more power to you, but the hype behind this is all marketing IMO. And, it's absurdly expensive without insurance.
It was the difference between $250/mo and $20/mo using Good Rx between generic Adderall/Dexedrine and Vyvanse.
This is incorrect. – With all due respect!
The action is enzymatic, and the enzyme is in red blood cells. It is slow. This is not the same as other “mechanical” time-release mechanisms. https://en.m.wikipedia.org/wiki/Lisdexamfetamine
Smoking, shooting, or squirting it up your ass won't do the trick. But injecting it would put it in direct contact with red blood cells, and so would rectal administration via absorption through rectal mucosa.
Lisdexamfetamine needs to pass through the GI tract where there's proper enzymatic activity.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805701/
"The environment in the rectum is considered relatively constant and stable and has low enzymatic activity in comparison to other sections of the gastrointestinal tract. In addition, drugs can partially bypass the liver following systemic absorption, which reduces the hepatic first-pass effect."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898170/
"Oral absorption of LDX was assessed in rat portal and jugular blood, and perfusion of LDX into isolated intestinal segments of anesthetized rats was used to assess regional absorption. .... LDX and d-amphetamine were detected in blood following perfusion of the rat small intestine but not the colon"
"The intact prodrug, LDX, was readily absorbed from the GI tract after oral administration, with relatively high levels of LDX detected in the portal blood of rats. When LDX was perfused into isolated segments of rat duodenum, jejunum, and ileum, it was absorbed into the systemic circulation; however, LDX was not absorbed during perfusion into colonic segments. These findings indicate that absorption of LDX occurs via carrier-mediated transport in the small intestines and are consistent with the physicochemical properties of LDX (ie, high aqueous solubility of greater than 0.85 g/mL within the physiologically relevant pH range of 1 to 812 and low lipophilicity [logP–1.75, unpublished data]), which would predict poor passive diffusion across biologic membranes"
But hey, here I am arguing on my weekend about why exactly putting a certain amphetamine prodrug up your ass won't work. What are we doing with our lives?
LDX was not metabolized in vitro by SGF, SIF, or trypsin, [so] any conversion of LDX to d-amphetamine in the GI tract in vivo is likely to be minimal. [...,] consistent with a model of absorption of predominantly intact LDX with subsequent enzymatic conversion to active d-amphetamine and l-lysine.
LDX was metabolized to d-amphetamine in rat and human whole blood but not in plasma. [Red blood cells] are responsible for the presystemic conversion of LDX to d-amphetamine.
LDX was metabolized to d-amphetamine by human RBCs but not by other blood fractions, such as white blood cells or platelets. Moreover, RBCs had a very high capacity for the metabolism of LDX. The rate of metabolism was not substantially reduced until concentrations of RBCs were reduced to 10% of normal hematocrit. Lysis of the RBCs also had little impact on the rate of metabolism of LDX, and nor did EDTA (a calcium chelator that inhibits the activity of calcium-dependent enzymes).
In conclusion, LDX is absorbed as the intact prodrug and converted to inactive l-lysine and active d-amphetamine primarily in the blood by RBCs.
It's fascinating isn't it? :)
I find the effect to be very very different.
Here's a graph of plasma concentration of free dextroamphetamine, time release capsules, and molecular-braked lisdexamfetamine: https://farm1.staticflickr.com/727/23028958560_2ae3ddc5bd_o....
For a 2019 review of novel molecules, see [1].
[0]: https://www.nature.com/articles/s41467-017-02244-2 [1]: https://doi.org/10.1080/14737175.2019.1628640
I think it's more that it doesn't work for as many people as does stimulant medication. But while it works on fewer people, for those that it does work on (myself and my partner included), it's very effective.
I take stimulants for idiopathic hypersomnia and I know things are a bit different for ADD folks, though.
Most ADHD people are also susceptible to RSD (Rejection Sensitive Dysphoria(?)) that can make us feel like the entire planet is crumbling when we experience even minor rejections. As in, suicidal ideation level pain that at some point we have to learn how to move through or just avoid relationships altogether.
Must be personal neurochemistry/predisposition. The breaking point hit when my partner showed me a video she took where she called my name 8 times standing right next to me trying to get my attention, and I had no clue. I was so zoned into the screen.
After seeing that I was like damn.
It's not just seeming like you don't care, but also putting the burden on others when they pick up your slack and frequently letting them down by things you do and/or don't do.
I'm glad that ADD/ADHD is more accepted now because I remember when the idea some people have problems focusing was immediately dismissed as laziness or a fault in character. I didn't even consider getting tested until far into adulthood because of the stigma.
That's how fast I lost focus. But on the other hand sometimes I can be extra-focused, with a prerequisite it's something I enjoyed -- where I truly focus on one single task nonstop, like I finally got the ebb and flow in a tranced out state. This resulted me in one case coding straight for 7 hours. It's not until my body started to crave for food or I don't know how long will this loose cannon shoot.
ADD is both a blessing and a curse to me. This is how I accquired coding and various IT skills since 13, all self-taught. But this also fucked me over exams, and my so life experience is greatly impacted. I also tried to play rhythm games to control focus, only to see it ultimately failed. The only thing I had to deal with it slightly is my Ritalin...only so slightly I can "normally" focus for an hour. I just hope things go right in the rest of my life.