The Complete Guide to Long Term Adderall Use
Adderall and related medications can be a godsend to those suffering from severe ADHD. But many people without ADHD use Adderall to improve their performance at school or work. Furthermore, many of these people don’t understand that Adderall is a powerful drug, and certain precautions need to be taken if you plan on using it for long periods of time. The following guide is a primer on what you need to know about taking Adderall over a long period of time. Read on to learn how to slow the formation of tolerance, ways to potentate its effects, how to maintain your health while using it, and ways to improve your experience on it.
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Slowing Adderall Tolerance
Keep in mind that while there are steps you can take to slow its rate of growth, you will inevitably build a tolerance to Adderall’s effects. The higher the dosage you take and the more often you take it the faster this tolerance will build. You should therefore take the smallest effective doses with as little frequency as possible.
Your body builds a tolerance to Adderall for two reasons:
Reason 1: Excess calcium (Ca++) influx into certain brain cells
Amphetamine tolerance is caused by excess Ca++ influx through the NMDA receptor gated calcium ion channels on the outer membranes of dopamine cells. Tolerance can be temporarily staved off therefore, by taking NMDA antagonists, which prevent excess Ca++ influx into the neuron. This process will also prevent brain damage caused by excess Ca++ influx such as Excitotoxicity. Therefore, if you are using Adderall you should be supplementing with Magnesium. (see below)
Supplements Which Act as NMDA Antagonists
Magnesium: Magnesium is an excellent supplement for slowing the buildup of tolerance to Adderall. The most bioavailable forms of Magnesium are citrate, glycinate, and taurate. Magnesium citrate acidifies the GI tract more than the other two forms, which will have a negative effect on the absorption of amphetamine.
DXM: Magnesium should be plenty for most, but DXM is another option. Found in Robitussin or Delsym, this chemical is also an NMDA receptor antagonist and can help slow the buildup of amphetamine tolerance. Keep your doses small, and NEVER take it Adderall as both meds significantly raise blood pressure. Take it in the evening or on off days only.
Memantine: Memantine acts as a partial NMDA antagonist by putting an upper limit on Ca++ influx. It is currently approved by the FDA in the US and the European Medicines Agency for treatment of Alzheimer’s. Because of this, it can be hard to obtain without a doctor’s prescription.
Acanprosate: Acamprosate is a drug approved in the US and Europe to treat Alcohol Dependence. Like Memantine, it acts as an NMDA receptor antagonist. However, it also requires a prescription and can be hard to obtain.
Reason 2: Adderall Causes Down-Regulation of Dopamine Receptors
Dopamine is one of your brain’s many neurotransmitters. Neurotransmitters are what your brain cells use to communicate with one another. Different neurotransmitters serve different functions. Dopamine plays a role in reward seeking, motivation, mood, attention, working memory, and learning.
Adderall prevents your brain from breaking down dopamine causing an excess amount to be present in your brain. This is why Adderall creates a feeling of well-being, enhances motivation, and improves attention/memory. When your brain is subject to this effect for long periods of time, it compensates by decreases the amount of dopamine receptors present on your neurons.
Having lower amounts of dopamine receptors causes you to receive less of an effect from the dopamine your brain releases. This greatly contributes to not only the tolerance people build to Adderall, but also the withdrawal symptoms heavy, long time users experience.
Luckily there are many supplements which are known to cause an up-regulation in dopamine receptors. These types of supplements can fight the down-regulation Adderall causes.
Supplements Which Up-regulate Dopamine Receptors
Sulbutiamine: Sulbutiamine is a synthetic derivative of thiamine which can easily cross your blood-brain barrier. Studies have shown that sulbutiamine increases the density of dopamine receptors. Many people take Sulbutiamine as a nootropic to improve mood and memory. It is readily available online.
Inositol: Inositol is a vitamin-like substance found in many plants and animals and is used to treat a wide range of cognitive disorders such as bipolar depression and obsessive-compulsive disorder. Studies have shown that chronic inositol consumption increases striatal D2 dopamine receptor density.
If the benefits you’re receiving from your prescribed dose are beginning to wane, you should consider taking steps to increase the potency of your current dose before going to your doctor to get it increased.
Three Factors Determine Adderall Potency
1) Stomach Acidity – Low pH weakens absorption. You can use alkalinizing agents to lower the stomach pH and improve absorption. Taking amphetamines sublingually can help by bypassing the stomach entirely, but the blood’s pH will still have an impact. More alkaline blood will slow down the rate at which the kidneys filter out the amphetamine molecule, prolonging the duration of its effects.
2) Neurotransmitter Inhibition – Amphetamines cause the brain to be flooded with the neurotransmitter serotonin, dopamine, and norepinephrine. The brain attempts to normalize levels of these neurotransmitters by issuing inhibitory signals. Drugs which slow the release of GABA (the brain’s primary inhibitory neurotransmitter) such as caffeine will potentiate the effects of Adderall.
3) Monoamine Oxidase – The brain releases enzymes to metabolize any neurotransmitters as soon as they are released. This process is known as monoamine oxidation when it happens to monoamines. A monoamine oxidase inhibitor (MAOI) prevents the brain from releasing these enzymes, which causes these neurotransmitters to remain for a longer duration. This effect is very potent, and you SHOULD NEVER combine a prescription MAOI with amphetamines or any other stimulants. This could kill you.
Ways to Potentate Adderall
- Alkalinizing Agents: Adderall absorbs better in less acidic gastrointestinal conditions. You can decrease the acidity of your GI tract by taking one or two tums or half a teaspoon of baking soda (mixed with water) about an hour before consuming the amphetamine. Be careful not to take too much baking soda, as its chemical reaction with stomach acid can cause nausea and vomiting.
- Caffeine: Blocks adenosine, which is a molecule that suppresses activity in the central nervous system. Increases activity of many of the same neurotransmitters that Adderall increases levels of including dopamine, serotonin, and norepinephrine. Don’t use too much caffeine with Adderall, as this raises heart rate considerably and can certainly be dangerous.
- L-Tyrosine: Increases dopamine levels, directly potentiating Adderall. While this will undoubtedly increase the effects of Adderall , it will most likely increase physical side effects more than it will improve the experience.
This is because it causes more dopamine to be made in the peripheral nervous system than the central nervous system. It also increases activity in the sympathetic nervous system to a greater degree than it provides mental stimulation.
- Nicotine: If you’ve ever smoked while on Amphetamine you know that doing so potentiates the effects of Adderall for a short time. Cigarettes contain small amounts of weak MAOIs, which are responsible for this effect.
Maintaining Your Health
We still have much to learn about the health effects of long term Adderall usage. Some have raised the possibility that using Adderall for long periods of time can lead to brain damage and cardiovascular problems, but neither of these claims have yet been proven. If you’re committed to using Adderall over a long period of time it’s best to ensure your lifestyle avoids the common pitfalls associated with stimulant use.
- See if your doctor will prescribe you Dexedrine instead of Adderall. Dexedrine is purely the d-amphetamine molecule while Adderall is a mixture of the d and l-amphetamine molecules. Dexedrine has fewer physical side effects than Adderall.
- Make sure you adopt a healthy diet and get exercise. Eating a poor diet and not exercising will only exacerbate the negative physical side effects associated with Adderall use.
- Be sure to drink a large amount of fluids when using Adderall as you will become dehydrated at a quicker rate when taking it. Being dehydrated will greatly increase the severity of the comedown or “crash”, and is a generally unhealthy state to be in.
- Don’t skip meals when using Adderall. In the same way that not drinking enough fluids will, skipping meals while on Adderall will cause the comedown to be much worse.
- Jaw clenching and tooth grinding are common side-effects of amphetamine. If you already have poor dental hygiene these side effects will only increase the severity of any potential dental problems. Be sure to practice impeccable dental hygiene when using Amphetamines for long periods of time.
- Some studies have suggested that Adderall can speed up aging by increasing oxidative stress on neurons and by decreasing glutathione. Be sure to eat a diet that is high in antioxidants, and consider supplementing with NAC and riboflavin. (Needed by glutathione reductase)
- Adderall tends to accelerate skin aging, especially among smokers. This effect can be mitigated by using a quality protective moisturizer.
- To counter Adderall’s vasoconstrictive effects, you should consider taking supplements which improve circulation. Horse chestnut, butcher’s broom, and cayenne are all good choices.
Improving the Experience
Some supplements don’t necessarily potentiate amphetamine or slow the rate at which tolerance builds; however, they ameliorate one or more of its negative side effects.
L-Theanine: If you experience any anxiety from Adderall this supplement could be a godsend. It doesn’t potentiate Adderall, but many people find it to be very effective at greatly reducing any anxiety caused by the drug. L-Theanine is not at all addictive, and is very healthy as a long term supplement because it ameliorates the effects of stress on the body and has been shown to be neuroprotective. Start by taking 100mg, and increase your dose in 100mg increments until you feel an effect.
L-Arginine: This supplement expands blood vessels and improves blood flow. It is commonly taken with Adderall to lessen the severity of sexual side effects (the oft feared ‘stim dick’) and can cure the feeling of cold in extremities that can sometimes be caused by Adderall. Some claim that taking large doses of around 3 grams can also potentiate Adderall.
Adderall Induced Insomnia
If you find that Adderall induced insomnia is a recurring problem, take a high dose of vitamin c, or consume a beverage which will acidify the GI tract. This will increase the rate at which your kidneys excrete any remaining Adderall in your blood stream. GABA and Melatonin are also useful supplements to help with insomnia.
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