Hawdy y'all. Another amphetamine inspired thread from meateor, imagine that. The way I see it though, there's a lot of ADHD folks out there with no real idea what their psychiatrist is giving them, or how to properly use it. Hell, maybe we'll even attract some traffic. This post is fucking massive, but I've tried to make it as digestible as possible. So without further adieu...
IMPORTANT NOTE: I'M NOT A FUCKING DOCTOR. I'm not licensed to recommend, dispense, or provide advise on any drug. I don't even have a college degree. Everything posted below is personal experience and advice. Consult your doctor before even considering anything in this post.
1. What is this guide, and who is it for?
This guide is for the not-necessarily-drug-literate who take amphetamine, whether they're diagnosed ADHD or not. There'll be a handful of protips for those with ADHD, but this will still apply if you haven't got it. Basically, if your pharmacist just handed you a bottle full of pills and told you to take x-amount per day, and you have no idea what that means, then this is for you. I'll cover the basics, what you should expect and prepare for, what precautions you should take, and a few tips for amphetamine usage.
This is not necessarily intended for those well experienced with drugs, or those who take large doses of amphetamine recreationally. In other words, it's not for most people on Zoklet. Keep in mind that I wrote it with average people in mind. It also doesn't apply to methamphetamine or any other substituted amphetamine.
2. What is amphetamine?
Amphetamine belongs to a group of drugs called stimulants. Long story short, it increases your heart rate, blood pressure, constricts your veins, and increases alertness, wakefulness, focus, and motivation. Stimulants' ability to increase focus and motivation are why they are prescribed. That being said, they have a complicated relationship with ADHD, the mechanics of which are not totally understood.
Amphetamine is one of a handful of drugs prescribed for ADHD. If you have Adderall, Dexedrine, or Vyvanse, you have amphetamine. If you're not sure, google the name of your prescription. Wikipedia can point you in the right direction.
Now we're going to get a tiny bit science-y. The three drugs I mentioned earlier (adderall, dexedrine, vyvanse) are three slightly different types of the same drug. For chemistry geeks I've detailed the differences in the spoiler below, but here's what you need to know.
Adderall (75%/25% d/l-amphetamine) - Classic ADHD drug. Produces physical and mental stimulation. The physical stimulation gives some people a "dirty," or jittery feeling in their body.
Dexedrine (100% d-amphetamine) - Also classic, though less widely known. More mental stimulation per milligram, but it lacks the kick in the ass that adderall has. Strange feeling drug. I, for one, can take a nap while on it, which I could never ever do with adderall.
Vyvanse (100% lis-d-amphetamine, XR) - Same makeup as Dexedrine, but it has a little attachment molecule that makes it so your liver has to process it before your brain gets its hands on it. Long story short? Extended release Dexedrine, which can't be circumvented.
Spoiler: Click to toggle
All this has to do with chirality. Dextroamphetamines tend to be more responsible for mental (CNS) stimulation, whereas levoamphetamines create body stimulation. This relationship is so profound that, for example, pure dextroMETHamphetamine is a rarely prescribed ADHD drug, while levoMETHamphetamine is available over the counter as a decongestant. Mix the two in certain proportions, and you get street meth.
Adderall is roughly 75% dextro and 25% levo. You'll feel this when you take it. I actually don't like adderall, as I find the body stimulation to be distraction. Dexedrine and Vyvanse, on the other hand, leave out the levo. These drugs feel wildly different.
If you don't know what chirality is, look it up.
3. What to expect from amphetamine.
This is a pretty big question, which I'll answer in parts based on time. I'll also add notes at the end of each section for first-time or very new amphetamine users, as well as those with ADHD. Keep in mind these time denotations only apply to an average oral dose of instant release amphetamine, such as adderall or dexedrine. Adderall XR, dexedrine XR, or Vyvanse will all have different time frames.
Come-up: 0-45 minutes
The first thing you'll notice is generally a sort of buzzing feeling. It's a bit hard to describe. It's like having a little buzz of electricity in your spine, like mild goosebumps. You'll feel, perhaps, a bit jittery and more awake. The actual come up depends on the drug. Adderall can be very buzzy and jittery, dexedrine is a much smoother transition. The effects of the drug feel quite profound as you continue the transition. You'll feel very alert and "up."
First timers: Everything I just said, but a bit more extreme. You'll feel extremely motivated, sociable, and talkative.
ADHD: In addition to what I just said, you'll feel a bit strange, especially your first time. Your thoughts will begin to align and restructure themselves. They will become more linear and manageable. This transition generally feels amazing, but can be a bit off-putting if you're not ready for it.
Plateau: 1-4 hours
You'll level off a bit from the initial effects, and reach a level of stimulation that is, hopefully, comfortable to you. Increased alertness, motivation, attention span. Be wary of getting distracted during this phase, as it can be disastrous. I'll elaborate later. You'll often experience dry mouth, jaw clenching, and tics (nail biting, pencil chewing, foot tapping, etc.) General euphoria. Little repetitive things that annoy you regularly may be more annoying. Personal example, if I have headphones on and the cord drags against my skin I find it much more annoying on amphetamine. Nothing major, just a fun sidenote.
First timers: Simply amazing. Four hours of euphoria and friendliness. The first time I took adderall felt a bit like what I always imagined MDMA to feel like. (Imagine how excited I am to get my hands on some MDMA now, hah.) Don't get attached to this feeling though, it will be one of the last times you get it this good from amphetamine.
ADHD: Enjoy being productive. You'll be engaged, perhaps for the first time, by things you aren't necessarily interested in. That being said, the whole 'getting distracted' thing applies doubly to you. You're used to focusing on multiple things at once, and that behavior will get you into trouble here. As I mentioned before, I'll include more on this later.
Taper and Comedown: 6+ hours generally.
After a while, the effects of the initial dose will begin to wear off. This is why instant release amphetamines are prescribed to be taken 2-3 times a day. You'll start to notice the stimulation tapering off. This doesn't necessarily feel bad, but since the pleasant stimulation is wearing off, it is a bit bitter. After the effects wear off a bit more, you may experience a comedown. Adderall comedowns are worse than Dexedrine or Vyvanse comedowns for sure. Generally the comedown is the exact opposite of how you felt on the drug, though perhaps to a lesser extent. You'll feel foggy, unmotivated, and perhaps depressed or anxious. You'll want to sleep, which will be difficult, as there is still some stimulant left in your system.
First timers: Comedowns may be a bit worse for you.
ADHD: No special notes.
Tips for comedowns:
Keep in mind that comedowns are dose-dependent, so keep your dose low if at all possible. Comedowns are also tolerance dependent, though if you can avoid tolerance then do so.
Understand that you only feel shitty because of the drug. Comedowns are healthy and necessary.
Eat a nice big meal, now that you can. This will help ease your stomach and let you sleep.
Exercise can also help you sleep, and make the comedown less severe.
Alcohol, marijuana, and benzodiazepenes (anxiety drugs) can help ease a comedown too. I'd recommend a couple of beers to set you straight. Alcohol tends to ease most of the effects of a comedown quite well. Just be careful you don't stay up all night drinking. Weed can make the shitty body feeling go away, but be careful for paranoia.
Be careful with sleep aids. Any antihistamine, benadryl especially, can help you sleep off a comedown. However, in some people, taking antihistamines and amphetamines can cause restless legs syndrome symptoms. I've been up all night a handful of times because of this.
4. Preparing
There's a lot to cover here, so we'll start with preparation and routes of administration.
Preparation? I've never had to prepare to take a prescription before!
Well, yeah. Preparation. Amphetamine is a powerful drug, especially in those who aren't used to it. It causes a very reliable, yet profound set of effects. Preparing is more about taking a few precautions, and will make your time that much more enjoyable. Here's what you can do.
Eat.
Stimulants are generally pretty great at banishing your appetite. Later in the day you'll really feel it if you don't at least eat something. I recommend a decent, medium sized meal before taking your dose. Then try to eat something light, like a good salad, during the day. You may be different of course, but even the thought of greasy, heavy food while on amphetamine makes me want to vomit. A nice salad is definitely palatable though. Experiment and figure out what works.
BRING WATER!
And only water will do. You'll know exactly what I mean once it kicks in.
Ever smoke weed? Know how your mouth gets dry? Well, it's generally not quite that bad, but you're gonna be thirsty. If you're in school all day, carry one or two 24oz water bottles with you. Refill them between periods, be prepared. You're also going to be pissing. A lot. Inform your teachers/professors in private that your medication makes you leak like a sieve and they're generally more than accommodating. If not, fuck em. Piss in a bottle in the middle of class and they'll catch on. If you're going to be in a situation where you can't drink water and piss it out liberally, then maybe skip a day.
Feel good beforehand.
From my experience, amphetamine will make a shitty mood better, but not a shitty feeling. Sick? Hit or miss. Sometimes you'll feel much worse, sometimes much better. I guess it depends on how sick you are, but definitely avoid it when you have a fever. The one time I would NEVER EVER take amphetamine is when you're hung over. I've made that mistake my fair share of times, expecting the stimulant to clear out the cobwebs. It doesn't work. It makes that shitty-weird-bogged-down feeling 100 times worse. Smoke some weed or hair of the dog it, both work fine.
Temperature.
This tends to be worse for adderall than dexedrine, but temperature is going to be important. Try to keep cool while on amphetamine, as it makes overheating exponentially worse than when you're not on it. You're also at risk of dehydration and greater neurotoxicity (relax, check spoiler) when your body temperature is high. If you start to feel feverish, which does happen, a few ibuprofen tends to clear it up. My room is generally pretty hot, so I tend to keep a fan running at all times. As with water, if you know that you're gonna be sweating all day, maybe skip your dose. Another thing I've found is that adderall, especially later in the day, can cause me to feel a bit cold. I assume this is due to vasoconstriction (the opposite of why booze makes you warm). If this happens, try not to pile on the blankets.
Spoiler: Click to toggle
Yes, I mentioned neurotoxicity. Amphetamine's neurotoxicity is very low, though present, at therapeutic doses. It becomes a tiny bit worse when your body temperature is high, though still generally negligible unless you take the stuff for years and years, or at very high doses.
Antacids.
Antacids are pretty popular among those who take amphetamine. The idea is that since amphetamines are metabolized (processed by your body) better in acidic environments, reducing acid increases potency. I'm inclined to agree that this works as a pretty safe potentiator, but that's not necessarily why I recommend antacids. If you get any sort of acid reflux, especially if you have GERD or a similar disorder, amphetamine can indirectly cause symptoms. I assume it's due to eating less. Keeping a few tums handy can improve comfort.
A good shit.
As silly as it sounds, try to give yourself an hour or so after taking your first daily dose before you have to leave. Your mileage may vary, but I generally end up taking a good, satisfying shit while I'm coming up. It's almost like clockwork. If I don't get to take my shit it's not the end of the world, but it's quite uncomfortable.
That's all I have off the top of my head. If you think of anything feel free to speak up.
5. Dosage and Routes of Administration
IMPORTANT NOTE: All doses I mention are for instant release adderall/dexedrine. Vyvanse doses are much higher, as 2.5mg of vyvanse is roughly equal to 1mg of dexedrine. Adderall/Dexedrine XR dosages will be different as well.
Chances are, if you just got a bottle of pills for the first time, you're prescribed 5-10mg twice a day or something near that. This is quite a low dose; a lot of people will use upwards of 100mg at oncerecreationally. Realize though, that recreational amphetamine use isn't necessarily beneficial for focus.
Prescribed doses generally go from 10mg to 60mg per day. In someone with no tolerance, 40-50mg at once would likely be uncomfortable. Higher than that and I'd imagine it'd get dangerous in sensitive individuals. Your mileage may vary wildly.
Unless you have severe ADHD that requires immediate intervention, the first thing that I would encourage you to do is to NOT start taking whatever you're prescribed. Take less. Start with 5mg once in the morning and see how that treats you. For a some, a small dose of amphetamine is enough to put them in the right mindset to keep focusing even after the drug has worn off. I have seen my girlfriend geek out off of 5mg before, whereas I take 30mg to get up. If you can take less than prescribed, good, you'll build up less of a tolerance and lower your chance of addiction. You'll also have some left over for a rainy day
Now, if your tolerance is low, 5mg should do something for you. If it doesn't do enough, however, feel free to take another 5mg. If that doesn't get you there, take the rest of your daily prescription when you're supposed to (early afternoon, generally.) A couple of things to keep in mind:
Less is always better for therapeutic uses. Less tolerance, addiction, and comedown at night.
The first few times you take it will be amazing, and it will never be that good again. It's okay, you're not a junkie.
Don't take more than prescribed. Your psychiatrist knows you better than I do. If you think you need more, bring it up to them.
Avoid taking stimulants later in the day. I generally try to figure 8-12 hours between my last dose and trying to sleep.
Now, dosage will also depend on something called a route of administration. A route of administration (RoA) is basically a fancy way to describe how you take the drug. You've probably heard of snorting, or inhaling drugs through your nose. That's referred to as insufflation. Smoking something isinhalation. Another term to know is bioavailability, which is what percentage of a drug you absorb through a given route. Higher bioavailability (BA) is almost always better. RoA's are rated on a few things, including their convenience, their BA, their onset duration, and effect duration. All of these different factors are influenced when the RoA is changed. In the spoiler I've detailed a handful of RoA's, but if you want the tl;dr version, here's what you need to know:
Swallowing your pills is fine and average in every way.
Snorting your pills is fun, but a bit of a waste generally. Adderall is best to snort, dexedrine is mediocre.
It's best just to swallow Vyvanse. Because of its chemical structure, it must be processed by the liver before becoming active. This means that if you snort it, it won't kick in noticeably faster at all.
For highest bioavailability, rectal administration is best.
Don't IV (inject) amphetamine pills. They are mostly binder and filler, and you risk shooting non-water soluble gunk into your precious veins.
