Suggest Remedy For Fatigue When On Adderall

Posted on Wed, 25 Feb 2015

Question: Hey Doc, I'm a 25 year old male and I've been taking adderall since I was 11 when I was diagnosed with adhd. It's worked very well for me over the years but unfortunately I never learned to how to study without it. And lately it not only seems to be not working as well, but i've been experiencing a lot of fatigue after taking it. I'm in medical school right now, currently studying for my USMLE step 1 exam coming up in four weeks, as I have been for the last several months. I know that studying the way I do, a tolerance builds, and during my basic sciences I would handle that tolerance by taking a week off my medication after exams. Studying for step I haven't been able to do that, and now I'm running into some trouble as I feel that with my exam fast approaching, I just don't have the time to take a week off for receptors to downregulate and my tolerance to drop again. If four or five days without meds is the only way to resolve the issue, then that's what I'll have to do, but I was wondering if anybody had any advice on how to sort of re-sensitize my brain to the drug without risking the loss of so much valuable study time? Any and all suggestions are more than welcome. Thanks, XXXXXXX

Answered by Dr. Manisha Gopal (1 hour later)

Brief Answer:
clonidine can be tried- watch for low BP

Detailed Answer:
Hello,

Its a tricky situation & I can uderstand your concerns. The best results come with adderal and it does suit you as well but now we have to look other options..

There is another choice- you can go for clonidine. It is taken in a dosage of 0.1 mg ( 1-3 tablets should be sufficient for you).

Atomoxetine can also be taken but it takes long time to start action and we dont have that much scope.

There is a precaution which must be exercised while one is on clonidine- get your blood pressure checked regularly and if it falls below 90/60 mm hg-- stop clonidine.

I have been using this drug for the same purpose in many of my patients due to its low cost factor and have seen it working well.

You may read and also discuss this with your treating team.

Good luck.
Dr. Manisha Gopal
MD Neuropsychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Gopal (2 hours later)

Oh I hadn't thought about clonidine, thanks I'll definitely talk about to my doctor about that before clinicals. But for right now with the timeline I have, I'm very hesitant to try something new. Figuring out dosages, adjusting to a new medication, and dealing with insurance companies can sometimes take quite a while. I'm more looking for any vitamins or supplements that may help decrease tolerance over the next few days while I refrain from taking my medicine, and other stimulants. Any thoughts?

Answered by Dr. Manisha Gopal (10 hours later)

Brief Answer:
vit B 12, vit D and folate can be tried

Detailed Answer:
Hello,

You may try taking Vit. B 12 - this is a neurovitamin which will definitely have some role here as well.

Also,check Vit D and Folate levels- these are usually found low and supplementing them would be useful.

These are just side treatment and I cannot gurantee that they would work.

But I would like to tell you that I have seen clonidine working. I think you can try it without much issues...after discussing with your doctor.

Sorry, Im not aware about any dietary changes which may be helpful..

Wish you good luck.
please feel free to ask more questions for clarification.

Dr. Manisha Gopal
MD Neuropsychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Gopal (11 minutes later)

Thanks very much Dr. XXXXXXX I appreciate the advice. I'll go by the pharmacy and pick up some vitamins tomorrow, a trip I should've made long ago probably. Studying all day has me on a diet of coffee and powerbars for the most part, I'm lucky I haven't developed a deficiency yet, haha. And yes ma'am, I'll be sure to schedule an appointment to discuss giving clonidine a try as soon as I can. Thank you again, and take care.
XXXXXXX

Answered by Dr. Manisha Gopal (6 minutes later)

Brief Answer:
take apples, a small walk, salads to feel fresh

Detailed Answer:
Hello,
Good you told me you are eating power bars and coffee--they are exactly what you should be avoiding. They are not good for you..

Apple gives far more freshness compared to tea or coffee...
please stop / reduce these coffee and choclates for some time..(if you can !)

try taking a small break and walk in your room...you may even wet your hair to prevent sleep...
eat more salads,walnuts and almonds daily. They are good for brain.

Good luck for your exams!
Dr. Manisha Gopal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Gopal (4 hours later)

Yes ma'am. I know I have to start eating better and all, my lady's been telling me for weeks now. But as the big day draws near, I suppose it's time to do that now. So apples, salads, nuts, and almonds, got it! Thank you again for all the help Dr. XXXXXXX And your advice has not fallen on deaf ears, I'm going shopping tomorrow! Take care,
XXXXXXX

Answered by Dr. Manisha Gopal (3 hours later)

Brief Answer:
all the best for exams

Detailed Answer:
Hi

Good to hear you are ready for action..!

And nuts should preffrably exclude cashews ( you would know why- as they increase cholestrol)..
All the best for exams!!

Dr. Manisha Gopal

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar