My spouse is prescribed Adderall to help address his negative ADHD characteristics. He takes the generic form - D-Amphetamine Salt Combo, 20 mg in the morning and 10 mg in the afternoon. As I understand it, the main reason he chooses the generic form is he does not want to spend money on medication. In his view, Adderall-XR is too expensive. He has taken this medication for over a year, probably at least 2 years. Day in, day out.
There have been many changes in our lives over the past 10 years, complicated, in my opinion, by unaddressed ADHD. Until recently, he was able to keep his anger hidden and under control when the situation warranted. Now it oozes out everywhere and at everyone, thus he chooses to be by himself a lot; or he chooses to interact with new people, until they do something to irk him. I suspect that Adderall heightens his anger and aggressiveness. He is NOT physically aggressive nor verbally abusive - as in making demeaning comments or character assassination - but he is really in an angry and defensive mood most of the time.
Our family had experience with our son taking Ritalin when he was in elementary school. It worked great - but when it wore off after school, "The Afternoon Nasties" were very unpleasant for him, and for us. I feel this is happening with my spouse, too.
Generic Adderall etc
Submitted by sunlight on
Normal (not XR) Adderall generic lasts approx 4 hrs. Your husband is only medicated for 8 hrs a day, do you think that is long enough? Does he? Also 10mg is a pretty low dose (kids may take that much). There is an Adderall rebound effect - not everyone suffers from it (my husband doesn't, he just slows down as it wears off) - that might explain your husband's irritation and stress as it wears off.
By way of comparison my husband takes generic Adderall 4x per day and at a higher dose than 20mg. He specifically takes one at 5pm (we are early risers if you work back from there..) in order to be functioning optimally during the evening. My husband has a suboptimal response to stimulants, which on evidence is probably genetic, and doses such as 20mg *do not work* for him - he could chew 20mg every hour all day long and it wouldn't do anything for him. I am not suggesting this is the case for your husband, his psychiatrist should address the possibilities of inappropriate dosage.
Angry outbursts can come from a host of sources, it could simply be that his Adderall is wearing off and that is affecting him badly, or it could be he has an impulsive component to his ADHD and explodes because he is unable to think in advance of the impact or to know how to control his behavior. My husband is also impulsive and can explode (apparently) out of nowhere if he is not medicated. In fact it isn't out of nowhere, it is the result of built-up anxiety and frustration. He currently takes gabapentin as a mood modifier. Now anecdotes are not data but the first time he took gabapentin (1 low dose at night) he woke the next morning and (unsolicited) exclaimed "I haven't felt this happy in years" - talk about night and day, that was a wow moment. My husband also takes an anxiolytic - this also smooths his response to the world and allows him more time to formulate his reactions. I want to add that he has a very good diet, exercises most days and does everything "right" but he cannot function in a way that non-ADHD people expect over a sustained period without this level of medication. It is not unusual for a psychiatrist to add other medications, stimulants on their own just don't do it for many people. Has he asked his psychiatrist? If he is worried about cost (he probably is since you mention he believes the XR is too expensive) then some of these other meds can be inexpensive and he should be reassured that there is no stigma nor should he feel guilt if he needs them.
My thinking versus his thinking
Submitted by I'm So Exhausted on
Sunlight,
From my side of the fence, there is a lot going on for him. Very poor diet, poor eating habits, being overweight, denial that he has a lack of exercise, unwillingness to take good medical care of himself, unwillingness to spend money on medications. He does take Vitamin D, Co-Q10, Gaba, Fish Oil, and Genertic Adderall.
He won't pay to see a psychiatrist. He saw counselors, who suggested what he should take. He took that information to our family doctor who then wrote prescriptions and monitors the meds.
difference in cost?
Submitted by ellamenno on
I didn't realize there was a difference in cost between Immediate Release and the XR. I always pay the same co-pay regardless of what the dose has been. Check to see if you can change his prescription plan to include XR.
I am the ADHD wife, and I've been experimenting over the last 4 years with varying doses & types of medication. I didn't find any difference between regular Adderall and the generic. But the XR wears off more gradually, as opposed to the IR 'crash.' Your DH's irritability may be due to this crash.... For me, I get foggy, confused, tired, forgetful, and yes - irritated when my meds wear off.
I started off with low doses of Adderall, but increased to 60 mg per day. I switched doctors and the new doctor seemed alarmed that I was on 'such a crazy high dose' and reduced me to 30. Then realized it was not enough. Now I'm on 50mg of Vyvanse, which I don't think works as well as the Adderall, but I'm a bit less 'jittery' on it and I'm not as emaciated. I feel a lot more like 'me' now, which is comforting to me, but....not necessarily a good thing. My husband noticed I have more 'brain farts' now than when i was taking Adderall.
Dunno if this is helpful at all... it's after 5pm, and the fog is rolling in...
Ellamenno
Costs
Submitted by I'm So Exhausted on
Ellamenno,
Adderall XR is 3 to 4 to 5 times as expensive as Adderall. My husband is self employed and our medical insurance is major medical coverage with a small discounted price for our prescriptions.
He has a different mind set when it comes to spending money on medicine and doctors. If the choice were mine, he would take the XR. I would happily pay $5.00 a pill if it helped him.
Not sure if it is a male thing or a stubborn thing, this refusing to take good medical care of himself.
Adderall, You and Your Husband
Submitted by kellyj on
As far as the Adderall goes.......I've taken Adderall XR before and for the same reason your husband does not......it's expensive. I've been on Amphetamine Salts going on 7 years and the only difference I can tell between the two is that the Adderall comes on (titrates) into my system a bit more slowly right at first in the morning but between the two, I feel no difference. I'm on 60mg a day and it works great....no crashes or down sides what s ever. Some days I don't take the last 20mg if I want to relax and just go brain dead for the evening. Check out, Alpha Wave and watch TV. The second dose of 10mg would be worthless for me........I would crash on that little for sure. 40mg is the minimum amount for me to go all day and stay consistent which it does to a "T".
Having said this.....I hear from the language in your post a dangerous assumption in thinking. I'm not judging you or taking sides here....but thinking that a pill of any kind will make the kind of difference that sounds like you may be hoping for is like giving a crutch to an amputee and expecting them to run a marathon because that's all medication is....a crutch. A more positive way to put it would be to say that it gives someone like myself a terrific leg up that for me....has given me the ability to do things about my ADHD that were extremely difficult to do without it. Simply put......it makes doing everything easier but....the key word is doing. It doesn't do it for you. I've been in therapy for over a decade for my ADHD which involves a lot of effort and self discovery. It's hard work and not always easy and definitely not without some pain . Looking hard at yourself and your limitations is not always a pleasant experience.
All I can say here is strictly for myself mind you and I can't say this to you or anyone else how it is for you or your husband but.......without therapy of some kind, self help, research etc......taking Adderall or any medication without it is unrealistic in thinking it would do much to make any major impact. There is no cure, right? Thinking there is one is a false hope and assumption. There is no Penicillin to cure ADHD.
The good news is that modifying, changing, making improvements and feeling great are all obtainable...yes, yes, yes. But it requires a concerted effort on the person who has it to make those changes.
But again...speaking for myself. The biggest challenge for me is with other people. What they think, what they believe they see, unrealistic expectations, misapplied interpretations, incorrect assumptions, criticism, sarcasm, impatience, the feelings of being pushed and general nonacceptance. Nonacceptance of what is possible and nonacceptance of the amount of time it takes to make real noticeable changes. Changes come slowly over time.... a long time!! Acceptance, tolerance and a very wide birth for error and lots of time is what I need from my partner. When I don't get these things especially at times of stress. I get angry!! When I do get these things and don't get the list of fore mentioned assumptions and judgments. I rarely get angry. This has nothing to do with my medication. My medication does not cause me to get irritable or angry ever.
Thinking patterns
Submitted by I'm So Exhausted on
JJamieson,
Thanks for your input. I am 54 years old. I struggled with eating disorders from ages 19-35, and kept hearing "there is no quick fix." Took a long time. MY paradigm for my spouse is that his mind set applies the same logic to himself. He struggles - again MY paradigm - with being 'broken' rather than just accepting that an ADHD wired brain just 'is.' He cannot fix it - just has to learn to live with it. That makes him frustrated.
The symptom are the issue. His denial of them is the problem for me. He does not see that chronic lateness, time blindness, disorganization, procrastination, and/or trouble focusing on the topic at hand lead to chaos in our family life.
I have found it near impossible to just plan my daily life as if he is not in it. If he happens to get home on time, or happens to remember a special day, or happens to get a chore completed - then that is all well and good. But if not - I cannot just accept it is OK. NOT for a marriage. Accepting a friend or a neighbor or sibling with these symptoms is one thing. You can just go home if the issues cause strife. How to wrap up a marriage with all of them is just impossible.
There are no apologies, no understanding - what he desires is for me is to choose to not be affected by his symptoms. I do not see how I can do that and lead a happy, fulfilling married life.
Yes, I see that glasses help people with vision issues, anti-depressants help people with depression, wheelchairs help people who cannot walk - all those are necessary.
If I had to roll it up in one sentence - this is it "I feel controlled by his denial of the negative ADHD symptoms."
Side effects
Submitted by c ur self on
Off of it my wife seems to be less prone to outbursts, she sleeps better...I think her Adderall causes her to be less attuned to what is going on around her, and more susceptible to hyper-focus...She has less desire for conversation and intimacy while on it.
You Have Choices...Only Small Childeren are Truly Victims.
Submitted by kellyj on
This must be incredibly frustrating. I've been in your husband shoes before and denial does work to protect you but does nothing for the person that you are with. I'm 56 and been divorced twice and do know the consequences of this form of dealing with my ADHD. I saw this through my ex wives eyes and it can be overwhelming in trying to deal with your own frustrations and feeling hopeless and helpless to do anything about. Shutting down or better....learned cognitive dissonance (disassociation) is something that appears to be a very effective tool and one that people with ADHD also appear to do quite well....myself included.
I was thinking this very thing when I wrote to you along with thinking about the medication....I suspected as much at the very least.
All I can say to you is this. The more aware I have become about my ADHD...the less it bothers me. And the less it bothers me...the less it bothers those around me. The variations in my meds...ups, downs, crashes etc....are also easy for me to see and recognize so that I have control of my emotions and keep them from oozing out all over the place. This is what I meant when I said that my medication never is my reason for being angry or irritable. Do I notice some fluctuations due to my meds?.....only minors ones. When I'm stressed out and feeling helpless, hopeless and overwhelmed ie: depression? Everything seems like a big deal even the smallest ones.
If you are doing things to contribute to these factors, then you are part of the problem only as far as your ability to accept the situation allows. If you have reached the ends of your ability to accept his situation as it pertains to you....then that's it. Your not going to move any further in his direction and if he can't or won't move any further towards you....then it sounds like you are either going to accept this as acceptable and be OK...or, find this unacceptable and not be OK.
It sucks living in a world where everything is a negative. You can only change your part......positive, negative or leave. It's a harsh reality but living in between will just make you crazy. If he can't or won't move and you want to stay...change your side to a positive and see if he will respond and change too.....to the positive?
definitely
Submitted by lynninny on
My two cents: Most medications have side effects, and brain chemistry is a delicate thing, and drugs can effect everyone differently. (I am a teacher of teenagers and divorced from an ex with untreated ADHD after 12 years--so this is anecdotal). Given this, of course it is possible that ADHD drugs can have side effects and cause mood changes.
My ex always had anger issues and trouble with insomnia. I saw the ADHD meds coincide with an increase in both of these. Horrible rages, seething anger, and quick explosions (very fun). Constant fatigue. He also became a chronic insomniac, and started relying on higher doses of ADHD meds to wake up and function in the morning. He had a complete personality shift. And continued to deny that the Adderall had anything to do with it. I wondered if he was worried that reporting this to his doctor would result in having to discontinue the meds. Or if his ADHD-related, "I can't deal with this" issues, were just at work here as well. "I'll just keep going and can't deal with questioning this or talking about anything. Stop bugging me about it." In the end, I wished I had spoken to his doctor directly or been involved in an appointment, but at the time I was too intimidated by the prospect of my ex being mad at me if I questioned him and his doctor about these side effects.
If you suspect that these meds are affecting your spouse's moods and state of mind, you have every right to ask about it, and to ask him to talk to his doctor about it. I hope that he will listen to you. If your gut is telling you that something isn't right, then it isn't. Maybe he needs different meds or a different dosage. His doctor should know this is happening. Can you talk to your spouse about it in a non-confrontational way?
Best of luck to you.
Side Affects and Follow Up
Submitted by kellyj on
I wanted to follow up to my earlier post with a recent experience that I just had with my SO (significant other) that is related to this topic and to what I previously said.
First, there are no such things as "side affects" to any drug that you take. This is a false believe or thinking that we all are taught and accept as factual and legitimate. In reality, a drug does everything that it does to any one person not just the targeted remedy or cure that it is marketed to have on a targeted ailment or malady. When you take any drug, you get the "whole enchilada" which includes everything that any drug does to you, like it or not. When you look at it from this perspective, you then can weigh the benefits it has to you in helping you with your symptoms against the costs to you in every respect, including how this might effect those around you and how it changes your behaviors as you/it relates to them. And to a lesser degree but not excluding it's monetary cost as well.
Linniny gave a good description of the affects she saw associated with her ex taking Adderall. Base on her description.....despite any benefits that her ex may have been experiencing with his ADHD symptoms...the negative costs to him and others seemed clearly to out weigh any perceived benefits on his part. It appears easy to make the conclusion that Adderall was not a good solution for his ADHD symptoms looking at it from this perspective.
Really what we are talking about here is a drugs so called "side affect" to the user turning into all "side effects" or secondary effects the use of taking a drug has on you and everyone else that you have any dealings with on a day to day basis.
Speaking for myself and my own use of Adderal, it took me a while to figure out everything it was doing to me including what other people saw. In my case, the benefits are substantial and the only real negative costs to me are financial which I can afford and are well worth it. I think the down side to what what others around me experience are not from the "side affects" of the drug itself which I feel I manage well, but from the effective change it has on me and how they experience this change.
Specifically, I see myself spending less time investing my self into doing things that I used to do in an effort to manage my ADHD and the pull it had on me for stimulation and the constant pursuit of stimulating activities which were eating up much of my spare time. The "itch" that I couldn't scratch is not there anymore and so I don't go looking for ways to scratch it since I don't need to. To other's, this might appear like there is something wrong with me...I'm less energetic, less likely to engage them into conversation, less likely to be spontaneous and say.."let's go out and do something", more likely to pass on going places or doing things that they might want to do and be happier just to sit quietly at home and relax and read or watch a movie...or do more solitary activities which do not include them.
These changes I know have annoyed those who've known me because I am not the same in all the good ways as I used to benefit them. And....I know that I have have also felt annoyed from the fact that they want me to continue to be "my old self"....the guy who is ready for anything at the drop of a hat. Many times the feelings I have are more that " I wish people would just leave me alone" than " I can never find anyone to do things with."
I can't tell you the joy and comfort I get from not having those feelings like I have to be constantly on the go and trying to "scratch the itch". I feel like I have become more like everybody else and that alone makes me feel great! The cost to me for feeling this way is that others might not like the new me compared to the old me and I have to take responsibility and make the effort to make adjustments to accommodate others in a way that does not make them feel like I've disconnected from them and let them know how good it feels to be "a little more normal". This process in itself takes effort, self awareness and communication. It's the new....doing something about my ADHD and requires constant adjustment, compromise and management to be effective. I realize that it's a 24/7 job and will be this way forever. I have to keep this in mind when I fall short of meeting my responsibilities I have to others, but also accept that for those who cannot accept my new found freedom from suffering....that these people may reject me for appearing selfish to them in my unwillingness to be what they might need me to be for them... and understand there is no perfect world that any of us live in. I do also have a responsibility to others to compromise within my new found freedom up until it means being detrimental to myself. My best hope is that the people who care about me and what is also good for me will be willing to make a compromise themselves and adjust their own thinking accordingly and meet me half way.
This entire process could be viewed as "side effects" of me taking my Adderall.......all the good and all the bad viewed a a whole.....based less on what others do or don't want it to be for them but more importantly.....what I need it to be to feel better and live a happier life. Others wants versus my needs based on having to live with ADHD. I see that sometimes empathy comes harder from the "other" side of this equation, and sometimes acceptance and understating is what I really need more than anything.
The mother of a good friend once told me that in a marriage, "if it feels like you are always giving more than your spouse within the relationship.....in reality, you are probably giving just barely enough to make things work and you should remind yourself of this every time you feel this way." I think these are profoundly accurate words and ones that I do use for myself as often as I can. This also helps in keeping you from giving with an expectation of something in return which is another way to say "transactional" or "conditional love" which is not really love at all.