How is Lisdex for you? I've recently been considering asking my doc if I can try it out.
I'm currently on a rather high daily dosage of Medikinet CR (2x30mg + another 1x20mg on long days if anyone's curious). It works but too inconsistently. It's also rather expensive here in the Netherlands.
I started with 50 mg, and I experienced a heavy effect for first couple weeks: very calm and clear thinking, but the focus was too heavy - I often fell into “deep thinking / introspection sessions” with my body frozen and an unfocussed stare. It could happen in the middle of a conversation. I thought I would need a lower dosage, but this initial heavy effect was gone soon, and the focus became milder.
Now I am on 50 mg. The medicine stimulates my focus and makes me more enthusiastic about activities, which can be annoying since I need to control not to apply my new powers on wrong or useless activities. I am also very verbose for couple hours after taking a pill. I would not say I am completely cured from ADHD. In the evenings, positive effect disappears, so I need to plan accordingly.
I avoid drinking coffee in the morning now, as the combination of two stimulants makes me shaky, I experience muscle tension, and it affects my ability to interact with people.
We tried 70mg with the doctor as well, but it made me aggressive and grim in couple months without noticeable improvements over 50mg. To manage tolerance I often skip taking pills on weekends. I also lost a few kilograms, which is good.
All in all, I am only half satisfied with the result - based on what I read I expected a better effect. I think my type of ADHD may be addressed with more sophisticated medication. Unfortunately, in Germany there are not a lot of other options to try, and my doctor seems to lack experience in treating ADHD. I try to combine pills with diet, exercises, and sleep management.
Thank you for the detailed response! There does indeed seem to be a lot of hype surrounding Lisdex in the more common places were ADHD is discussed.
With regards to the effects this particular type of medication has on your behaviour, you have essentially described me - but on Medikinet, on those odd days when it decides to just work that way.
In the Netherlands we have a specialised ADHD treatment centre called ADHD-Centraal. I've been extremely impressed with their methods, their high level of competence, and with their care and involvement. The fact that they really know what they're doing also shows in the tiny practical adjustments they've made to their workflows to accommodate or even compensate for "the likes of us"!. I'll gladly provide you with direct contact details for you to pass on to your doc or call directly if you believe there's something to be gained in that.
Unfortunately, as you mention, the medication options are limited and at some point you're going to run out of things to try.
The main reason I'm not on Dextroamphetamine is that it registers on the quick saliva drug test that the Dutch police carries. It is amphetamine after all. When that happens, you'll get fined for driving under influence, and won't be allowed to drive for a few hours which is very annoying. The bigger problem is that if you're ever involved in an accident and the presence of amphetamines in your system was registered, you might even get a criminal record plus the insurance might decide not to pay out. Impractical to say the least...
Long acting or slow release Methylphenidate medication - such as the Medikinet I'm on, is only partially covered by Dutch health insurance. Legislators have decided that the short acting variants are identical and that anything else is essentially a luxury. They would quickly change their minds if you'd lock them in a room with me when I'm suffering from disastrous rebounds every hour on short acting Ritalin :)
I got it from my doctor and have been taking it for a year after trying Methylphenidate which did not show any positive effect on me.