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Daily Notes, 23 June 2023: medicine, neurodivergence
I’ve started some new ADHD medication. I’ve been taking Xaggitin (methylphenidate) for a little while, but while I’ve had some net positive experiences with it, I’ve felt the need to try another medication: Vyvanse (lisdexamfetamine dimesylate). Both are stimulants, which might seem strange — surely the last thing someone with ADHD needs is a stimulant! — which increase levels of neurotransmitters dopamine and norepinephrine in the brain. These neurotransmitters play important roles in your ability to pay attention, think and stay motivated.
Tonight’s post is a quick rundown of the medication I’ve been taking and how it’s affected me. It is not intended as medical advice but as personal reflection.
This was the first ADHD medication I tried at the start of titration. Initially it was a blessed relief. It didn’t seem to be doing anything, but I noticed after a few days a loosening of the muscles, a relaxing of the senses, a diminishing of photosensitivity. I take Sertraline for depression, too, so maybe that had something to do with it, but I felt better. Clearer. However, the old executive function issues persisted (albeit not as potently) and I was titrated up to 32mg.
I was experiencing a flattening of the benefits of 18mg, but 32mg increased the clarity. Essentially, I experienced the same as with 18mg, but I found the same longer-term — the deficits were still present.
This was probably the sweet spot. This dosage cut a lot of the deficits, but also introduced a tightening of the chest, albeit mildly. It’s the dose at which I felt most comfortable on Xaggitin.
This was the greatest dose, and enabled better focus. However, by this point, the ghosts of anxiety I’d re-experienced on 64mg reappeared fleshed out. Tight chest, tight mind. It was okay for a few days, but the anxiety (of which I have a significant history) lurched up from its swamp in all its claggy, dripping glory.
Overall, I found that the best dose of Xaggitin (64mg) wasn’t helping with depressive and anxious spiralling. My autism, shall we say, did not appreciate such emotional lurches. I knew I needed to try something else.
At time of writing, I have been taking Vyvanse (30mg) for three days. It is of course too early to tell what longterm impact it will have, but I do feel optimistic. My chest is open; I can exhale the world inside me.
Addendum: neurodiversity and neurodivergence — language matters
I have been alerted thanks to @neuroteachers to issues surrounding the language we use to discuss neurodiversity etc. Nick Walker explains it better than I can summarise: check out her post here.