Alright, as promised here’s part two of my reply:

Diet

Your diet is important to focus on as an ADHDer, especially if you’re noticing that you are skipping meals due to the stimulants reducing your appetite.

Make sure that you’re hitting your daily protein intake consistently. Proteins are made of amino acids and amino acids are the building blocks for neurotransmitters.

If you aren’t getting enough protein in your diet then, over time, you’ll find that the meds won’t be working effectively because your brain is running on an empty tank, neurotransmitter-wise.

(If you switch to amphetamine-based medication, keep in mind that acidic foods/drinks will inhibit the absorption of the meds and things like vitamin C acidify your urine which will cause the amphetamine in your system to crash.)

Burnout

Burnout is a heck of a thing. Note that this section is going to be primarily personal anecdotes and based on other people’s reports.

When you’re talking stimulant meds while burnt out, it’s important not to push yourself too hard. Having stimulants on board means that you’re going to be much more likely to be able to push through but doing this can deepen the burnout and prolong it. No bueno.

It’s really tricky to puzzle out the effects of burnout. There are days when I feel like my meds are doing literally nothing and that’s a reflection of my baseline level of burnout.

Let’s take sleep deprivation as an analogy here:

If you are sleep-deprived, stimulants will help your cognitive function however they aren’t ever going to fully compensate for the sleep deprivation. It’ll probably help to some extent but if you’re seriously sleep deprived then there’s no amount of stimulants that will resolve the underlying cognitive impairment.

Burnout is similar to this in a lot of respects (as are other factors like depression.)

Ultimately, your ADHD symptoms will be worsened if you are in burnout and the effectiveness of stimulant meds will definitely feel as though they fluctuate, or they might not have a noticeable effect at all, until you’re out of burnout/you have made significant strides towards recovering from burnout.

Autism in relation to ADHD

Autistic ADHDers tend to be more sensitive to stimulant meds than pure ADHDers, from people’s reports.

Autistic ADHDers often report “the autism” coming out more when appropriately medicated. I think this can be attributed to a lot of things but if your ADHD is unmedicated then it’s easier to be oblivious to your autistic traits; you’re much less capable of keeping track of the score, so those social faux pas you make are much more likely to slip by your recognition and your memory but when you’re medicated it’s the inverse. If your brain is in a constant flurry, bouncing from one thing to the next, or if you are constantly vagueing out because of inattentiveness, then being appropriately medicated will suddenly allow you to focus in on your special interests and you’ll be better able to sustain your focus which can make you feel “more autistic”. A lot of ADHDers, especially unmedicated ones, use social interaction as a way to milk dopamine out of life but when you are medicated that urge for seeking out novelty and social interaction will be reduced and this can manifest as being more inwardly focused and socially withdrawn, which can feel like your autistic traits are being amplified. Often AuDHDers stim more and they can have heightened sensory sensitivity when on stimulant meds too.

I have other half-finished thoughts about the AuDHD experience but I’m struggling today.

I think that a pure ADHD experience of appropriate medication is one where a lot of the worst symptoms are alleviated and their general function is markedly improved.

The AuDHD experience is more complex, broadly speaking, and the experience of being medicated for ADHD is generally not as stark a contrast because there are a lot of reasons why autistic folks struggle with stuff like executive dysfunction and task initiation. With regards to task initiation some of the confounding factors are autistic inertia, difficulty with task switching, and perseveration and these can be underlying causes for difficulty with task initiation. What this means is that treating the ADHD with meds doesn’t necessarily result in a huge shift in how much difficulty an AuDHDer has with task initiation compared to the experience of an ADHDer who isn’t autistic.

Anyway, this turned out to be more of a ramble and it was less structured than I would have liked but I hope it’s helpful to you all the same.

So you’re familiar with stimulant usage which means that it’s going to colour your experience somewhat.

Generally when people first start on a stimulant, there’s a short term experience of mild euphoria that people who are naive to stimulants don’t really have a frame of reference to understand it by but that typically passes within a couple of days and I’d say at the most a week.

A pure ADHD experience of first going onto stimulants is going to vary depending on the person, their neurochemical makeup, and their response to whichever meds they get put on but AuDHD definitely complicates the experience imo. (FWIW I’m an AuDHDer on stimulant meds who has gone through nearly the entire gamut of meds prescribed for ADHD and I have a grasp of psychopharmacology, so feel free to pick my brains if you like.)

The typical experience of stimulant meds for a pure ADHDer is typically one where the person feels some brief, mild euphoria but the predominant experiences are:

• Clarity of thought
• Feeling as though your thoughts are more orderly and organised
• Increased ability for task initiation*
• Improved executive function
• Feeling like you’re better able to “get through the day”
• Improved impulse control
• Typically, less “dopamine-chasing” behaviours and less compulsion for behavioural addictions (e.g. impulse buying, binge eating etc.)
• Reduced emotional reactivity

Typical side effects are:

• Decreased appetite
• Increased heart rate
• Mild insomnia
• Increased anxiety

Typically if you are on a stable dose for about a week, your side effects will settle down.

With this in mind, I would recommend staying on a stable dose for at least a week, taking it at a regular time each day, before you start forming your opinions of methylphenidate (unless the side effects are unmanageable.)

*Improved task initiation is a bit of a tricky thing to define the experience of and to identify in yourself, especially if you are late diagnosed and/or burnt out. I’ll elaborate at the end of the comment.

I’m particularly sensitive to the norepinephrinergic effects of meds, and the first-line stimulants are quite strong in this respect. I had to cut out caffeine because in combination with stimulants it was causing me too many anxiety-related side effects.

Without caffeine it’s much more manageable and I feel less gacked.

Taking stimulants on an empty stomach is not a good idea. Try to have something with protein in it and maybe eat before you take your stimulants, if possible. If not, smoothies or protein shakes are your friend.

According to Russell Barkley, one of the foremost experts in ADHD, methylphenidate works for about 40% of ADHDers and amphetqamine-based stimulants work for about another 40% of ADHDers (which sounds astoundingly low but that success rate is the envy of other psychiatric meds). What this means is that there’s a decent chance that methylphenidate might not be the right one for you and that’s okay. With this in mind, I wouldn’t jump to conclusions about your ADHD status based on your initial experience of only one medication.

Within a couple of days I took it again, but being good and eating in the morning with no coffee. I couldn’t even tell if it was working. I may have taken it another time soon after and did not notice a difference, so I stopped taking it.

Often the experience of stimulants meds, when they’re at the right dose, is quite subtle and you may not notice the impacts it has on your behaviour but the people around you might notice improvements or you might find that there are less dishes piling up in the sink and that you’re going to the gym more consistently etc.

As for task initiation, there’s often a sort of lag or a “stickiness” to this for a late-diagnosed ADHDer. (If you are burnt out this is a confounding factor too.) Essentially, as an ADHDer, you have probably had to drag yourself through doing the tasks you hate and you’ve almost certainly built up a serious, deep-seated negative association because of a lack of dopamine. ADHD meds help with the lack of dopamine and they make starting on tasks easier however you should expect that it will be a long-term process of shifting your attitude towards those tasks that you particularly struggle with or dislike. You should find that it’s easier to get started on those tasks and that you’re more capable of seeing them through to the end however if the cumulative effect of literally forcing yourself to do these tasks over years and years is negative then there’s going to be a significant adjustment period because your psychology won’t just magically adjust instantaneously, despite your brain chemistry making things easier for you.

What this looks like in practice might be that you are still really resistant or reluctant to start on those undesirable tasks and so you continue to put them off as you did prior to being medicated but if you set your mind to it, you should find that doing those tasks feels much easier than you expected.

I’ll reply in another comment about how AuDHDers tend to experience stimulant meds and how burnout and diet have an impact on what the meds do once I can muster the brainpower.

The amount of habits and ability to manage stuff that comes with taking adhd is kind of ironic considering what having adhd is like.

I personally am hesitant to even try, late self-dx audhd who can’t really access even the diagnosis due to gender and the way neurodiversity is viewed for women. I know I embody the classic meme level audhd inattentive woman.

My child also didn’t have a great experience trying to fit in the neurotypical world with meds, I suppose this is a part of what made both of us go full in on communism. Having to suffer highs and lows and physical symptoms just to fit in the capitalist model of high performing citizens just sits wrong with me now.

But if there were less high stakes and more easily available options to try I am not saying it wouldn’t be nice to not burn out from everyday life. Just ended a 6 month work period and have now slept for a week straight and still eternally tired and down. I know why now, but it’s still not amazing. We can’t really choose to not take part either because we all need to eat and have housing.

What we did with my son was we got protein shakes and powders to have the easiest most accessible way to nutrients while he was medicated, it worked mostly (not always). It can get a bit expensive though, I know I struggled with buying those for every morning, but otherwise he would not eat at all, hates breakfast. In the end he decided to just be adhd and be supported in other ways for now, the demands on habits to be able to medicate were something he just couldn’t get done.

It did help him focus at school, but he told me later he also had some palpitations and heart things with them that he ignored as he wanted so much for the meds to “fix him”. He said he never really felt anything as such, but his mood did get less predictable and one of the meds made him dangerously depressed. But that can happen, something else might have been a better fit.

But afaik there was no “high” apart from mood changing a bit after he had been on them longer. Appetite he did struggle with as he already often forgets to eat. Same with hydration.

It’s a pretty big task to take on and navigate, all the solidarity for you in your journey

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This sounds like either too high a dose or the wrong drug for you. I used Ritalin for years and then Concerta, which is a slow-release version. It fucked with my sleep and appetite and mood too much. So now I’m on Strattera, which is a non-stimulant. It helps me concentrate and I otherwise don’t really notice any effects. I’m also AuDHD instead of just ADHD, so that probably makes a difference too.

Took a few basic pharmacokinetics classes in uni but far from an expert. Food intake and drug uptake into the body can be very closely related, does the medication say anything about taking with food? Low amounts of food in the stomach can lead to quick absorption into the body, maybe that’s why you are having the jittery effects? Note that food and certain types of food can also increase absorption into the body, but that doesn’t seem to apply here. Some food/drug interactions only change the rate at which the drug is absorbed, others change the total amount.

I’d also recommend taking a dose as consistently as possible and not on/off because even when you’re not feeling effects directly there is still drugs in your system and might still be providing pharmaceutical benefits. You’re trying to keep that drug serum level within the range between “not having any actual effect” (too long between doses) and “jittery stimulant feeling.” (taking too high of a dose on an empty stomach perhaps?)

Drugs are usually designed/prescribed so that taking it at the prescribed schedule will keep you in that range, some are better than others at this, even in the same class of drugs. If you keep getting that jittery feeling even with consistent dosing I’d talk to your doctor about trying something else.

I don’t feel anything at all, as in like, I don’t feel high, or jittery or anything like that. I feel “normal.” I do, however, feel completely different than when I don’t take it, like, my actual “normal” which is completely lethargic, brainfogged, unable to focus in on something enough to make a decision or complete at task. It doesn’t effect my eating at all, but I basically eat because I enjoy the sensation of eating food, and not because I’m hungry anyways, lol.

It sounds like maybe you are on too high of a dose? Idk though. I’d talk to you psychologist about that.

You’re either not adhd or on too high a dose.

The main effect for me is just feeling space between my thoughts, being able to grab them, choose which ones to keep and which ones to throw away. It makes it easier to line up a coherent series of thoughts.

ADHD meds can take some getting used to, and funnily enough, routine helps you to level out how they cause you to feel.

There are a lot of different meds, and some might work better for you than others.

If it’s alright to ask, what were your prescribed?