Rethinking ADHD Treatment: The Power of Non-Stimulant Medication
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- Опубликовано: 14 ноя 2023
- Explore ADHD treatment beyond stimulants with Dr. Tracey Marks. Dive into the world of non-stimulant medications like Qelbree, and their potential to improve executive function and work productivity in adults with ADHD. Uncover the impact of executive dysfunction and discover strategies to enhance focus and manage symptoms effectively.
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Video references
Price MZ, Price RL. Extended-Release Viloxazine Compared with Atomoxetine for Attention Deficit Hyperactivity Disorder. CNS Drugs. 2023;37(7):655-660. doi:10.1007/s40263-023-01023-6
Faraone SV, Gomeni R, Hull JT, et al. Executive Function Outcome of Treatment with Viloxazine Extended-Release Capsules in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Post-Hoc Analysis of Four Randomized Clinical Trials. Paediatr Drugs. 2021;23(6):583-589. doi:10.1007/s40272-021-00470-2
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"...that 15 minute quick call can ruin your productivity for the rest of the day..."
I screamed YES at the top of my lungs when I heard this! OMG WTF?! I totally thought I was alone but this is a thing?! Thank you thank you thank you!!!
same for me my dude!
Surely no one would actually be unaffected and just pick up from where they were?
@@racheloldridge4986 its about the whole day, not just 30 min after the call
Someone please explain this to my boss! A two-minute email is NOT something I can do in the middle of another task.
❤❤❤YESSSSS Ditto!!! She just explained my day in a way I could never clearly express❤ Also didn't realize my meds cause me to get things done in hyperfocus mode and any interruptions derail my day!!!!
Set Shifting wow jacking up my day.
Wow, you just described my whole life. So you mean I'm not insolent, lazy, disrespectful, inattentive, rude, uncooperative, unproductive, won't pay attention and refuse to follow instructions or transition from one task to another? I was taught that I was just incorrigible and spent the first 40 years of my life fawning or disassociating to cope.
Yup. Me too. Plus 20 years. I've spent the last year and a half since Dx unravelling the damage. Not done yet but it's a remarkable feeling to have such a dramatic positive shift.
(I'm on Strattera and take Provigil when I absolutely need help staying on task, which isn't often.)
This. It's ruined my self esteem and contributed to massive family rifts and issues between my mom/parents and I.
Right? Don’t forget the RSD - rejection sensitivity disorder 😣 wonder how different my life would have been had I known about rsd 20-30 years ago
I feel this.
Thank you so much for the great information. Are there any herbal supplements you can take for ADHD?
Thank you! I have significant difficulty set shifting. Neurotypical people do tend to think it’s “dramatic” and such. I currently work at a company that encourages constant disruptions and they don’t understand how that throws me off. They can’t fathom how your whole day gets ruined by that. Fortunately, I have a few interviews elsewhere lined up. I’m tired of fighting for accommodations and being told, “This is just company culture.” 😕
L-Thenanine can help with that as well.
Good for you for advocating for yourself and then moving on. It sounds like they're never going to get it! I wish you much luck!
Answer Teams, work your emails, attend constant meetings, other webinars too, answer calls, take the notes about the call, and do your OWN work, impossible! The distractions are countless.
@@autobotdiva9268 Thank you! I might look into that!
@@mastersinmenopause Thank you so much! ❤️
Untreated trauma and a frozen nervous system causes problems with focus and organization, no one is treating this, it's getting designated to the adhd basket. We're also judging productivity by very recent environmental demands in a post industrial setting.
If you are already predisposed to adhd, depression, or bipolar, trauma can make these much worse. Trauma also manifests like these as well.
It's important to remember that just because other things can mimic or worsen ADHD it doesn't mean ADHD isn't real and deserving of treatment. So many of us have been gaslighted about that. 🤔🧐Some things that have helped me understand & heal trauma even withOUT a therapist:
- Pete Walker's Complex Trauma: From Surviving to Thriving
(he also has short articles on his website : - )
- Bessel Van der Kolk's The Body Keeps the Score
(there are many RUclips videos and articles about his concepts for those who don't like books)
- googling things like "how to calm the nervous system after trauma" and trying things out (e.g. the 5-4-3-2-1 technique, simply taking a walk, or looking at nature)
- For CPTSD trauma from a tricky childhood, the following channels by licensed therapists have TURBOCHARGED my healing in a way numerous therapists IRL never did:
- Patrick Teahan
- Ingrid Clayton
- Dr. Ramani.
Putting productivity expectations in the broader context of other cultures and human history definitely helps me. ❤
💯, everyone is on meds nowadays.
What about bupropion? It is not a stimulant and approved for ADHD. I need Auvelity (mainly the Bupropion part) to address executive dysfunction, or amphetamines like Vyvanse are counterproductive. With no other medication alongside stimulants, I will hyperfocus on harmful/useless things, spending hours down the wrong rabbit holes.
I love u tay zonday, weirdly overjoyed to see you out here representing the neurodivergents.
Is that why we got Chocolate Rain?
From what I’ve researched Bup effects everyone differently. In my few experiences trying it out, it caused me insomnia which prolonged over a week and that’s when I had to let it go
It's the medicine that worked for me the best by far. Stimulants help me relax and sleep or ill act just like you do. Alas bupropion had too many adverse side effects for me :(. Never heard off "Auvelity" though. I'll ask my therapist about it. Thank you for sharing!
@@jawansbI unintentionally stalk this dude, because he watches all the same well known and lesser known channels I watch. He always seems to pop up everywhere 😂.
I had no idea set shifting was the term for it! I always described it as “I can’t easily start or finish tasks, but I’m great in the middle of them! And if you disturb me, it’s the same thing over again.” Now I don’t need to use that long description! 😂
I really like your description too though :)
Exactly, people always say that AD(H)D ers are only great at starting things, but I also feel I am best at the middle part. Starting is hard, there is nothing there yet, and you have to do preparatory work that does not give rewards yet. In the middle part things take shape, which is very rewarding, lot's of tasty dopamine. The end part is cleaning up, polishing, and doing reporting and administration. This things require high concentration and accuracy, but are not rewarding, and therefore extremely hard. In this stage you also see very clearly what could be better, which gives the feeling it will never be good enough, which is extremely discouraging.
Wait what? Stimulants aren’t very useful for executive dysfunction? NO WONDER I felt like they were useless to me. I struggle way more with executive dysfunction than with hyperactivity or attention. Omg I can’t wait to ask my doctor about this.
Same. I find stimulants actually reduce my executive functions 😮 😢
I think the phone call scenario is a perfect example. For me, there's also a risk that the hyperfocus will switch TO the phone call, and then, whatever I'm doing falls to the wayside. Incidentally, the time in my life where I had to focus the most was writing my dissertation on brain dynamics and phase transitions in brain states... albeit in ASD, but the general principle applies to to all brains. ADHD brain wants to latch on when it DOES get something engaging, and it's hard to break that, but when it is, the hyperfocus is reoriented towards whatever broke it.
THEN getting BACK to writing, or whatever work, is extremely hard once again. It's fatiguing.
This is so my life! Every day, all day, especially at work! Thank you for describing me! I am going to pass this information on to some coworkers! My job is so much harder because of this "set"!
My nursing career suffers because of this! As I have gotten older, it's had gotten so bad I get in trouble at work for being too slow in getting my work done! I get interrupted throughout the entire work day. The majority of the time it starts when I arrive n doesn't stop until my shift is done. Then....I have to finish all the stuff, which I didn't get done, that wasn't the actual "hands on" pt care. 😢
I'm so discouraged! What can I do to help myself?!! 😕
Yes exactly, just like me latching on to Tracey's videos right now when I should be going to work already LOL... I'm off now! 🙂
@@hbaker5905 Nursing is such a high-demand profession I wonder if you could find different settings/specialty areas that require fewer interruptions? I know someone who was a hospice nurse and found the slower pace and emotional connections extremely rewarding. Maybe nursing forums would be able to offer additional ideas? Best wishes to you! ❤
I never knew set shifting was a think and nearly cried once you described it. I have SO much trouble doing that that if people disrupt anything I'm doing it sends me into an anxious spiral. So I will definitely ask my doctor about Qelbree!
Thank you for giving me a name for my struggles! I have such a hard time with set shifting, and no one seems to understand how difficult it is for me to switch between tasks, especially if it's unexpected. Just like you said, it can absolutely mess up the rest of my day, but it feels like even people who should know better write me off as exaggerating. It is so helpful to hear someone validate that yes, it CAN be that bad, and I'm not just being dramatic!
I promise you ,the struggle is god damn real...
I was a good student till 15 years of age, on my 16rh birthday,I got a laptop.
I always had above 95percent attendance,after the laptop
I use to fricking bunk the mid term exams just to play games,.
Because I didn't had the power to switch from gaming to doing anything else...but my friends laughed about that,saying I'm just lazy...
No I have a terrible disease called ADHD.
Shifting from 1 activity to others are the toughest thing to do!
I had to edit because I had lost concentration while typing and had typed greatest in place of toughest😅
my mind didn't get quiet and the intrusive thoughts didn't stop until I got real stimulants. Vyvanse was my first one i tried. I have control over thinking. Nothing pops in on its own and repeats/loops, being all annoying. What do I want to think about? I can choose. So I choose not to think about stuff that bothers me. BTW, I'm almost 40, and this is the first time I got to see what it's like to have control over thoughts. This is a big deal, because my mood is greatly affected by my thoughts.
Thats kind of how i describe it, if anything i think the "Getting quiet" for alot of people is actually just overstimulation from too high a dosage.
For me at the right dosage it does absolutely nothing to limit my flow of thoughts, it just speeds me up enough mentally to catch up to them and organize/prioritize
@@therideneverends1697 interesting about the overstimulation. i know when I feel overstimulated, i feel agitated/jittery/speedy, and sometimes twitchy eyelid, and uncomfortable in my skin, but my mind isn't quiet when I feel like that.
@@BigIndianBindi-jy1cz For me overstimulation feels like extreme lethargy and tiredness, that "Uncomfortable in your skin" feeling and difficulty thinking clearly/extreme irritability
Do you also have ocd or Bipolar?
At 31 I actually got diagnosed with ADHD this year and got prescribed Strattera and it’s been working well for me. Started at 25mg and could immediately notice a difference in my attentiveness and ability to organize thoughts better(I like to say that it kept my cats all into one space).
After 6 months I actually asked for a higher dosage(40mg) and it has been wonderful. Immediately felt like I could maintain focus on my many tasks all day and my coworkers have noticed that I don’t “buffer” nearly as often while I’m trying to think of the word or thing I was about to say.
Yes I guess that is why I talk so fast sometimes????
So strange that I didn’t observe any difference in myself even after more than a month with 40 mg :(
@@ece8893 every body/brain is different. If one medication doesn’t work for you, a different one may work better. I was just lucky to find one that works for me on the first try.
Much like taking supplements or vitamins, they’re designed to bridge the gap that your body isn’t able to fill naturally, but if your brain has the lane of traffic already erected and functioning, then there’s nothing for that medication to do.
My experience with Vyvanse has been relatively positive, I have been taking it for over a year. I was diagnosed with attention deficit disorder (ADD), but the non-hyperactive version. I tend to have a low energy drive, which makes me procrastinate and overthink, and I have low self-esteem, and I often keep to myself. But when I started taking Vyvanse 40mg, I actually became more energetic, and I no longer procrastinate. I also noticed that my self-esteem improved, and I am more willing to engage in conversations with people. I think it's safe to say that Vyvanse helps me break out of my shell.
Thank you Thank you Dr Tracey. I'm 53 now and received a diagnosis as a fluke when visiting my Dr a few times and having breakdowns. Between the ADHD and set shifting and now menopause, I am so exhausted. My son is 13 now and has been diagnosed with ADHD and Autism.
I wish I had known all of this when I was growing up. It explains lots of poor, impulsive decisions over the years. But I thank you for helping me understand all of this so I can get a hold of my own mind to help my son. Thank you😢
It’s sounds like adhd is a fucking issue it is not it’s not a illlness sorry we are fucking different but if you can’t except that your son doesn’t have a problem
Thank you for talking about set shifting. I hadn't heard the term before, but I instantly recognize it as one of my MAJOR symptoms.
I was diagnosed with ADHD since my teenage. Spent my whole life fighting ADHD. Also suffered severe depression and mental disorder. Not until my mom recommended me to psilocybin mushrooms treatment. Psilocybin treatment saved my life honestly. 8 years totally clean. This is something that really need to be used globally for treatment of certain health challenges.
Congrats on your recovery. Most persons never realizes psilocybin can be used as a miracle medication to save lives. Years back i wrote an entire essay about psychedelics. they saved you from death bud, lets be honest here.
Can you help me with the reliable source 🙏. I'm 56 and have suffered for years with addiction, anxiety and severe ptsd, I got my panic attacks under control myself years ago and they have come back with a vengeance, I'm constantly trying to take full breaths but can't get the full satisfying breath out, it's absolutely crippling me, i live in Germany. I don't know much about these mushrooms. Really need a reliable source!! Can't wait to get them.
YES very sure of Dr.alishrooms. I have the same experience with anxiety, depression, PTSD and addiction and Mushrooms definitely made a huge huge difference to why am clean today.
Ive done shrooms last month in my house. It taught me how severely traumatized I was from alcohol. I healed from many mental traumas from my past and was able to forgive, let go. Shrooms to me is a remedy not a vice. I even felt more refreshed the morning after. So no hangovers. No depression mood for days. No anxiety.I now have a more calm mind
How do I reach out to him? Is he on insta
I just started crying when you gave that example of the 15 minute thing. It's so real.
❤️
Set shifting.... I have tried to explain this to people my whole life and no one has seemed to ever understand! Thank you for giving me the words to explain myself to others!
If someone is deeply engaged in a demanding set of tasks, any interruption could disrupt the progress. A co-worker on software design and debugging made that point when somebody stopped by to ask "a quick question."
She is amazing and a God send! Great presentations. Very educational. Her videos are captivating. I always look forward to her sessions. I wished I had her for my personal counseling.
Wow, thank you! ❤️
@@DrTraceyMarks Agreed, your content & presentation style are exactly what I've been needing all these years, so grateful! At 50+ now I'm on SSDI for a seizure condition (really should be for TBI if not for atty & judge😬), yet ADD/executive function symptoms are the most debilitating. Docs (at least any covered by ins) don't know to help & just throw Rxs at me. Once I'd see improvement my ins. would remove it from their formulary. I've been a guinea pig for 30+ years & feel like I'm failing as an adult, despite high IQ, hard work & conscientious attitude when the energy is there. TYSM for educating so many & hopefully bringing empathy & understanding! ❤🙏🥲
So watched this when you first posted this and it was like a lightbulb. I talked to my psychiatrist and landed on guanfacine (my insurance wouldn’t cover qelbree and it’s now approved for adults) I take it at night and my Vyvanse in the morning and I know these comments always sound cheesy or fake but it has truly changed my life and I would not have looked into this without your video.
The threshold to start things or going back to things are SO MUCH LOWER. I can just do the dishes. I know longer get stuck in long social media spirals (I still get distracted but it’s easier to get back on task where before it felt impossible)
Also the drop in focus/executive function during my luteal phase is FAR LESS. I was even able to cook the few days before my period and I have been keeping up at work!!!! No more excuses and “call in sick” days.
I just…… thank you!!!!!!!! 🎉
I NEEDED THIS VIDEO TODAY!! THANK YOU!! I don’t have meltdowns often, but I had a total breakdown yesterday sobbing because my life feels so unorganized and I don’t know what to do! I don’t want to up my prescription of Adderall, because I already know from experience that doesn’t help. Everything you said is so spot on because the things I’m struggling with the thing ls you said aren’t covered by the stimulant. I will definitely talk to my doctor about that this month when I have to go back in. THANK YOU!! I thought I was just burnt out or depressed, even though I don’t actually feel depressed.
God Bless you Doctor!! My life has been going downhill and I finally see that there might be a light in my future! I guess people don't quite understand how difficult living with adhd can be.
So hard…
Thank you, Dr. Marks! Your description of problems with set shifting, and how stimulant medications aren't ideal for dealing with that issue, could have been written specifically for me! At least 80-90% of my ADHD challenges are with set shifting. That, plus the fact that I don't tolerate stimulants well because I have a heart condition, means I am definitely going to talk to my psychiatrist about Qelbree!
Dr Tracey Marks always hits the nail on the head with her descriptions of psychiatric suffering. She goes above and beyond.
I’m so glad I kept pushing for another option. I’d taken Adderall for 2.5 of the 3 years that I’ve been diagnosed. I was frustrated that the meds only lasted long enough for me to give 100% to my employer, leaving my personal life up in the air.
I’ve been taking Qelbree since June and it has been a game changer. I’m thankful that I’ve had a positive experience with it.
Would you mind explaining briefly in what ways it helped?
Did your insurance cover it? Mine currently isn't.
What changed for you on that medicine?
@@Waevform I found that I was better regulate my emotions (anger is a big one for me). I’d been able to sustain routines (working out, eating enough food, daily journaling/planning), was getting consistent sleep thanks to my sticking to a sleep schedule, not AS forgetful, and had better impulse control.
Since my original comment, my insurance has stripped me of Qelbree and forced me to take Straterra before I can get it back. Months of progress have gone down the drain and I’ve been struggling because the stuff doesn’t work. Everything I mentioned above, I haven’t been able to do for the past couple of weeks. Fun times.
@@Elle-om4nf They covered it for months…until right before thanksgiving when they decided it wasn’t medically necessary because I hadn’t taken straterra first. Now, I’m suffering through straterra (not working for me at all) while I wait for the appeal process. I don’t have words strong enough for how much this sucks.
I am amazed at Dr. Marks comprehension of the difficulties we face. This video resembles those made by people with ADHD to help each other.
That’s great. I completely get the phone call distraction. It’s high enough to get focus on something to have it interrupted. It can spoil my whole day sometimes.
I have been given diagnoses of 5 personality disorders. Borderline, Attachment, depressive, histrionic, and another I can’t remember the name of. I have been left just on Escitalopram in the U.K. with no other help. I’m trying different things because I want to feel better. I also am dependent on opiates after surgery 13 years ago. I am also HIV positive in that I did have an AIDS diagnosis 24 years ago and survived obviously, but I have so many problems which I can only try to get help for because no one will help me.
I’ve always have problems with getting distracted. For example, I have been learning how to write music, but even though I love to compose I can never finish anything. I have 100’s of unfinished songs and pieces of music. I’m sorry, I know this is a lot and I don’t know if anyone will read this, but I do hope so.
I’m trying Brahmi to help me focus and have a little less stress and it does help it seems. I hope it will help me.
Is there anyone out there who could help me go on a better track?
I have so much to give to the world.
I used to have the same problem with music. I never finished anything! Had loads of ideas, I guess that was the fun and exciting part. Actually getting something finished was the boring and mundane part so I didn't bother.
I was going to say Benzo meds because they hit the Gaba receptors, but it sounds like that is what you are currently taking. (calming the brain)
Have you tried taking a non-stimulant with a Benzo?
I’m currently taking a very low dose of Gabapentin with Adderall and it has killed my creativity.
So I’m all for asking my Doctor about non-stimulants now.
If you haven't done trauma therapy, look into it. I know nothing about your life, but even if you don't have childhood trauma, your experience in the medical system was traumatic. I've been very surprised how much easier it is to manage my adhd and physical illnesses after dealing with unaddressed trauma. It just makes your whole life harder.
Good luck!
What I'm finding is that it doesn't matter how much education we have on ADHD. No doctor wants to treat it or even talk about it.
Yeah it’s really hit or miss. My therapist fully believes I have it, but my psych NP treats it like a joke.
I never heard of set shift.
Some time ago, before i started concerta i was telling my relative therapist, that things are so difficult that between any task i had to take my phone, scroll, and then when i felt better, could continue the task t hand.
This meant, i always, always, sat in the car for 15‘ doing nothing, to be able to continue that.
I lost so many hours!!!
But now its all in the past! Its a miracle.
I started concerta & tyrosine, which totally breaks the cycle of endless background thinking and feeling, it makes the brain go silent!
The tyrosine i mean.
It has to be taken in 2x doses to hve effect all day -7am and 13:00 … i only need 10% of the 500mg pill at every dose.
Be aware, dosage and timing is everything.
Also, tyrosine completely erased the 17:00-19:00 crash and end of day emotional depressive vulcano .
The concerta on its own did not help with the hyperactive thinking feeling sadness.
It helped me be functional physically, but it did not help in the inner/thinking part of the functioning.
Tyrosine is like a body double, this is how i would compare it.
The equivalent of your best friend shadowing you and where your brain knows it does not need to worry because your are taken cared ..!
After 4 months i still cant beleive this endless torturous burden was lifted just like that.
Still, i myself dont beleive it.
Hi Dr. Tracey! Thanks for this video 🥳 I was switched from Vyvanse to Atomoxetine. I have Anxiety and later was diagnosed with Autism and noticed such a big difference with my fidgets and tics. This video is super helpful for those looking for other options. ❤️
THANK YOU, Dr Marks 😊
Being recently dx at 62yr old, im learning what it actually means. I appreciate your videos 💜
Thanks so much for this video! My biggest struggle with ADHD is executive funcitioning e.g. task initiation, being able to visualize the steps of a task and how long it will take, especially with long projects and it completely debilitates me. It causes me major procrastination and task avoidance issues. I was so disappointed when the stimulants helped with focus but didn't help with any of these other issues so I still have major issues with consistency. The first day I took atomoxetine I felt like I was finally in control of what I paid attention to and could take or leave things that usually completely consumed my attention. However, unfortunately I wasn't able to take it regularly and fully titrate it to a stable does because it had a host of side effects like excessive day time sleepiness. I hope to restart it and be consistent this time. I really hope it will help with my executive dysfunction.
What time of day did you take your dose? Some people do well with taking it at night to take advantage of getting better sleep with drowsiness, but for some reason my body reacts to this medication with exactly the opposite (insomnia) if I take it within 12-14 hours of bedtime. But now I’ve been taking it for almost a year now and it was the first prescription I’ve ever tried to help with managing ADHD, after trying for decades and failing at every other alternative (I’m 25 and my parents didn’t want me to try meds when I was younger). It has made a huge difference but I do wish it didn’t have side effects, especially sleep disturbance and dry mouth in my case.
my 22 year old has a hard time with EFD also. so i make his weekly lunch menu for work BUT he has to pack his lunch. set a timer on google nest for him to do so. if i didnt make him a list, the bag would be full of chips and juice and them come home and binge eat.
This is exactly what I’ve been trying to explain to my therapist and doctor about the type of adhd I have. Thank you for this
Making a video while being a bit sick - respect!!!! You are a treasure!
thank you very much, it's nice to see someone with a MD giving sound medical advice in an easy to understand way.
Learning about this because of my son’s recent diagnosis. Also learning about myself and my own childhood struggles. You are a gift to social media! THANK YOU!!🙏
I swear. You are smart as hell and you describe things to a “T”, just perfectly. You talk about things that other “Dr.’s” seem to avoid or just won’t get straight down to the nitty gritty. I have a host of issues, lol, (issues resulting from specific, long lasting incidents/problems) but never saw anyone for them. But, I sure wish I could talk to you a couple of times. You’d get it and I know you could fix me right up. It’d be so nice to feel good again..
I love your channel. Thank partially to you I have be officially diagnosed and now receiving treatment for my ADHD. Im on a non- stimulant medication and it definitely has helped with my executive dysfunction. Thank you 😊
Dr. Marks - you have helped change my life! I even got my own Psychiatrist watching your videos. Thank you so much, you are a beautiful person inside and out! Sincerely, Leslie from Nashville
You gave my struggle a name. Set shifting and I’m the worst at it. THANK YOU for your to the point never rambling highly helpful and necessary videos. I feel less broken understanding myself.
Thank you, Dr. Tracey. You're a super high-functioning wonderful human being.:) I trust your advice above the rest.
Thank you- I struggle with executive dysfunction daily and it can be very exhausting. I have the struggle of task shifting and get very frustrated if my hyperfocus is disrupted. I can make me look bad to others and is very embarrassing. I will be talking to my doctor soon about medications to help.
Set Shift is my biggest hinderence and its very difficult to manage in my job. Its been an unamed mystery to me until this video. Thank you so much for putting a name and validity to my daily struggle.
Tracey thank you so much for your work on this channel. It's been instrumental in my mental health journey and really helped me when other things could not. Over the years, I have learned that I have both ADHD and ASD. (I also have dyslexia & dyscalcula to boot) and because of my learning disabilities, "traditional" research was really difficult for me, so having content like yours in visual + video format was literally a god send, and I don't think I could've gotten this far in this amount of time without your help. Appreciation and love to you 🙏🏼
Dr. Marks, thank you for your engaging videos and your knowledge of mental health in general. It is so impactful how you present your information as well as how much time it takes to put in for content creation. A+
I'm an adult with ADHD and I've been on Atomoxetin for a couple of months now and I can absolutely conform everything you said. The other drugs have made me feel like I'm in hyperfocus 24/7 until I ultimately ran into some kind of Problem and stopped taking them for a day or two. Thanks for explaining, that it may have been those forced set shifts, of which I get loads every day, that made it feel like the stimulants aren't working.
I'm a guy and I was on atomoxetin for a few weeks, and it gave me weird sexual side effects. like delayed ejaculation, which is... ejaculating before the actual feeling good feeling of it comes. It was strange and messy to not get a warning that it was gonna happen.
@@BigIndianBindi-jy1cz Bro wtf that's crazy
@@BigIndianBindi-jy1cz Well, um thanks for mentioning that. I experience the exact same thing. It's like bro, I'm not done here, why you makin a mess? Also when I don't take a pill, it stops happening the same day. It's really weird and kinda annoying, but the stuff is doing so much for me, that it's a small price to pay.
This is such a perfectly timed video. I'm on my 4th day of Qelbree right now, and compared to my experience on Wellbutrin, I feel pretty damn good. I was so against the idea of getting on another anti-depressant / non-stimulant medication after my experience with Wellbutrin. I just thought "I don't have depression, so what's the point in taking it?" -- But after just a few days of taking Qelbree I'm feeling a lot better in terms of emotional regulation, my mood is higher, I'm getting a lot of stuff done & the best part is that I don't have the side effects of Wellbutrin. Wellbutrin made me feel hooorrible, on my 3rd day I was practically disabled by the side effects & couldn't even get up to do anything. Next week I'm gonna be upping my dose of 200mg to 400mg & I'm honestly excited to see how things will go from there.
Really? I thought qel took weeks to start seeing affects?
@@jamesf8783It takes weeks to reach therapeutic levels. However, medication usually starts working instantly (same day) and will alter your mental and physical wellbeing very rapidly. For me, I feel the effects of Wellbutrin within a few hours after taking it.
@@jamesf8783in the video she said one week
@@jamesf8783 For me I am seeing improvements much sooner. I'm sure max efficiency will hit within 2 weeks or 3. But for me it was almost immediate. Might be because I'm sensitive. Last night I got laundry done while I was tired, that's something I'd never do willingly without some internal influence like a substance LOL. Big wins.
Did you start with a trial set too? I loved the idea that I was able to test dosage and decide for myself. 400mg seems to be my lane. I will say, I was tired as hell the first one or two days of starting and switching the dose lol. Lots of naps.
WOW! This is AWESOME! I've been taking Strattera for years because the side effects of stimulant medications have always been so horrible for me that they outweighed any of the benefits that I got from them. But even at the incredibly high dose I take, I've always felt like while it's good, it's not as helpful as I would like for it to be. This new medication could really be a major game changer for me! Thanks so much for bringing this to my attention, Dr.Marks! I am most definitely going to be talking to my doctor about giving this a try!
Sameeeee
Same here. My job requires huge amounts of Set Shifting and boom! An entire day is cooked.
Thank you Dr Marks for this information. I have executive dysfunction problems and this video will help me talk to my Dr about treatment options for me. Thank you!
Should be noted that while I believe Quelbree can be very helpful and should be looked at as a solid alternative to stimulants- I’ve experienced awful migraines getting started, missing a dose or two (like when I’ve ran out and had to wait on insurance) and tapering off. It’s not that I wouldn’t recommend, but the migraines should 100% be mentioned as it’s not uncommon and I know some ppl might have a severe sensitivity to that. Anyways great video! More ppl should know about these options!
Sad but glad to see this response. I tried strattera and instantly brings about all-day-long headaches that don't stop unless I stop the drug. And even after 3-4 weeks, zero notable benefit in attention. Not worth it imo.
Same
My problem with all of the non stimulants also is the inflexibility,
with stimulants you just take them when you need or want them, need to go to work or school? go for it, want to paint, draw, do whatever your hobbies are? go for it, but dont want to take any that day? then dont. Theres no ill effect and they will work just as well when you do want to.
I want to have the ability to modulate my mental state as needed for the situation at hand, IR adderall or dexadrine let you do that, the long acting stuff kind of takes it away but atleast you can skip days,
stuff like this? not on my radar, i dont want to have the freedom to choose my state of mind limited.
Stratera never worked for me as a kid. Waited over a month with no results. Had to go back to stimulants
I started Qelbree about a six weeks ago. I had some drowsiness/constipation side effects but they passed after a few weeks. There is very clear executive function improvement. I'm less overwhelmed, less impulsive and more aware of my mood and energy levels. I've been able to time box activities and avoid day-long hyper focus (Pomodoro) . Still struggle to do the boring things but every week is better than the last. I'm sleeping better, too.
I took Zoloft (sertraline) before with similar side effect profile. This works better than that.
If Zoloft works better for you than Lexapro, and you have ADHD / depression, Qelbree could be an option.
"Problems with Set Shifting", executive dysfunction 🤯
Feels like the other half of a puzzle I have been trying to understand about myself for ages
This is literally life changing, thank you 🙏
Thanks for this. I’m waiting to have my initial assessment, addressing EVERY SINGLE THING you mentioned. It’s a struggle…affecting my job performance, management, organization and overall quality of life. Thanks Dr. Tracey!You have a NEW SUB’!
Thank you so much for your videos. You really help me understand and identify the traits I have. Even though I was diagnosed with ADHD in 3rd grade. I’m thankful for that because it made me aware in my life to be aware of not sticking to jobs. There is so much more to learn. I’m 49 and in all the years I would have loved to hear the things you are taking about now. I’m thankful for you Dr. Tracey. Thank you so much. You really make a positive difference. I understand so much more now.
You are the reason i never got on Xanax. I'm watching friends try to quit these sorts of drugs and am so thankful i found you and that i listened!
Why
I was diagnosed at age 52. The diagnoses was one of the best days of my life. I at least knew what was "wrong" with me. My next milestone was finally finding the right medication for me. I currently use a stimulant as well as a non stimulant. I know it works
Yes this is entirely me! I love & appreciate you for spreading awareness on mental health in away others can understand, in all ur videos are so informative ! Thank you again! ❤
This is the exact video I needed to see, answering the exact burning question that has been plaguing me. I can't stand stimulants and the blunting that comes with it and like Dr. Marks said, does nothing for executive function. I'm going to ask my doctor about these non stimulants, it honestly feels like the executive stuff is an even bigger issue than the focus, tho I guess they do go hand in hand. Perfect presentation, thanks Doc! 😊
Psychedelics are just an exceptional mental health breakthrough. It's quite fascinating how effective they are against depression and anxiety. Saved my life.
Can you help with the reliable source I would really appreciate it. Many people talk about mushrooms and psychedelics but nobody talks about where to get them. Very hard to get a reliable source here in Australia. Really need!
Yes, dr.sporessss. I have the same experience with anxiety, depression, PTSD and addiction and Mushrooms definitely made a huge huge difference to why am clean today.
Is he on insta?
Yes he is. dr.sporessss
Microdosing helped me get out of the pit of my worst depressive episode, a three year long episode, enough to start working on my mental health.
Wonderful information, thanks Dr. Tracey.
Thank you for being such a kind soul ❤
This was perfect timing! I’ve been wanting to get back on medication and I want to try stimulants but I’m worried about the side effects. I already have low appetite and I know going on stimulants will really affect that even more. Thank you for opening up the conversation about other options outside of stimulants. 💜
Don’t go on stimulants if you already have a low appetite. I workout and play football and 230 lbs and I still force my self to eat if I don’t forget to completely
Depends on if you have innattentive adhd or hyperactive adhd
I’ve found that Adderall gets me going, less concerned about what to do. But going from Admin to customer relations and back again, I get overwhelmed and floored. (Anxiety goes into overdrive)
I appreciate the broader perspective on the add-ons.
Consider trying dexadrine, its very similar but with a bit less of a "Lock on" feeling, if thats causeing you a problem
I coach college students with ADHD and this is a very helpful overview of the possible meds they may be using. Thank you!
I love your videos! I've never felt more understood in my life....and I've never understood myself as well as I have after watching these videos and I have studies ADHD A LOT!
Thank you for this! I've been thinking about getting back on meds. I tried so many several years ago before landing with Vyvanse. It worked for a bit, but, just like you described, it seemed to lose effectiveness over time. I know I tried Strattera, but I can't remember why I decided to discontinue it. I'm going to talk to my therapist about Qelbree & see what she knows about it. Everything you described about executive functioning is where I'm lacking, especially set shifting! I lost my last office job because I couldn't shift between tasks efficiently.
Just started on Adderal xr and though I like how it makes me feel it doesn't really do much for getting me reorganized or motivated at all, and I feel fried the day after.
Dr. Marks thank you your thorough analysis and the options. I also appreciate that there is now a new option for ADHD. ❤
Wow, this was so spot on helpful to me. Thank you so much! The set shifting wasn't something I'd ever heard about--but boy do I struggle with it. Thank you. Huge hugs.
Thank you for the update!
I'm really sensitive to psych meds, and I completely tanked on atomoxetine. I hope something like Quelbree will be available to me in the future - especially if I end up developing intolerable side effects with my skin with lisdexamphetamine like I did with methylphenidate. I really hope I don't because we're running really low on options re meds for me.
All the best - I'm glad new treatment options are on the horizon!
If your in the US and some parts of europe desoxyn is an option, alot of times skin side effects come from peripheral stimulation, same stuff that raises heart rate, BP, drys the mouth ect. Desoxyn has the least peripheral effect of any prescribed stimulant.
i take Intuniv (guanfacine) and its like a night and day difference. my biggest adhd issue is impulsivity and intuniv has worked wonders. i used to buy stuff from amazon i didnt need like every day (i guess id get a dopamine hit when receiving packages) and since taking the medicine i literally havent bought anything in almost 2 years. i know that sounds weird but its huge for me (and my bank account). also helps with focus at work and keeps me from zoning out and surfing the web when i should be working which was a big problem. i should mention i was on adderall and even the max dose (60mg iirc) did not help me at all. i didnt notice any benefit from it
hi i was wondering how many mg you are taking. do you tske before bed? i am but only 1mg. thinking i want to try 2mg
@@mariaromanell hi, i take 2mg before bedtime
@@mikegagerthank you. I'm scared of side effects but i will probably nove to 2mg soon
@@mariaromanell i honestly didnt notice much difference moving to 2mg. try it out you can always go back to 1mg if you get some side effects. only thing i had was some bouts of low blood pressure (i would get dizzy when i would stand up) but those only lasted a couple of weeks
Im really appreciating the visuals and edits. Thank You 👀🎯👀
Glad you like them! 👍🏽
You are the best! Everything you say is on point and has helped me greatly. Thank you so much for your fantastic content!
Thanks a bunch. So happy to help.
you sound sick, wish you speed recovery Dr Tracey♡
This set shifting is really hard on me. I usually tell my husband to not interrupt me anytime because the feeling is like being on a highway and suddenly appears a wall and then to not crash you stop the car instantly. My head aches and I can never go back to the things I was doing, even if it’s something silly, like playing a game on cellphone
i have the same when im doing some recreational activity to wind down, and then my mother calls. if i pick up the call it completely derails my brain, and once i hang up i’m just untethered😭
Thank you for your content. Your presentation alone brings a sense of well being.
My pleasure and thank YOU!
From Germany here. Because I don't tolerate most med classes like SSRI or SNRI, I was prescribed aurorix for depression as a last resort. It also has an effect on norepinephrine + serotonin even though I know that it's a different med class. Back then, I wasn't diagnosed as an adhder but what I told my psychiatrist happened with me beyond the treatment of depression was something she never believed me. I had less severe - what I now know to be - adhd symptoms and was functioning so much better in nearly every aspect of my life throughout the time I took it. After I was taken off aurorix, all my non-depression related symptoms returned. I was diagnosed with adhd three years ago and what you explained about Qelbree and the effect it has on norepinephrine and serotonine makes so much sense. You have no idea how validating this video is to me after years of medical gaslighting. Thank you.
I tried strattera. It didn't work for my focus, but it did help my emotions come under check. I can only do my job and stay focused on it with a stimulant (after cycling through MANY of them to find one that works well for me with minimal side effects). Trust me I've tried.
Continuing, I was able to combine a stimulant med with stratterra, and it worked great except it didn't treat my anxiety. So instead of straterra i am on the smallest possible dose of Zoloft PLUS the stimulant med and it works the best for me. To boot, the Zoloft treats my anxiety symptoms really well and my other crazy moods. No strattera now but it helped me calm down enough for long enough to help me a lot.
I'm kinda in a similar boat as you, except I Don't have issues with anxiety. It has worked great for my hyperactive symptoms and emotional regulation, but has done NOTHING for my inattentive symptoms. The anxiety that I used to mask is gone, so I can't brute force my way through set shifting and focusing anymore. I love what Strattera does help with, but right now I'm a cool, calm airhead. I'm hoping a stimulant will help, or maybe Qelbree will; I'll ask my psychiatrist
I'm on a combination of buproprion and atomoxetine, and while I definitely miss that "in the zone" feeling I got my stimulants, everything else is so much better with this combo. I'm better organized, less impulsive, and more in control of my emotions.
Bupropion inhibits the enzyme that metabolizes atomoxetine thereby increasing its effects. Have you noticed this in taking them together?
I felt that task shifting for a 15 min call. I started working at 6 today. I had a meeting at 10. It’s almost 3 in the afternoon and I’m just now pulling my focus back to work.
I love your work, Dr. Marks.
I have taken Intuniv and that helped a lot!
same here
I love the fact that medicine is moving away from stimulants. They always made me agitated after a while. I decided to wean off of them but then noticed I couldn't think anymore! This subsided after a couple of weeks, but I decided to live medication-free. What helps me is regular weight training and aerobic excercise, calcium/magnesium/k2 in the evening, oligomeric grapeseed extract, ceylon cinnamon extract, ginger juice, eggs (yolks) for choline, fish oil, some other vitamins/minerals - all backed by medical research. As well as reminders on my phone.
Yeah but how to keep doing those with adhd :c
@@soiremashe probably doesn't have ADHD if she's able to buy and track all those supplements AND do two different types of workouts AND set and follow reminders. Ridiculous how some people diagnose themselves and then tout how they don't need actual treatment lol. She doesn't need the meds because she doesn't have ADHD.
@@the.modern.cookie I have been properly and elaborately diagnosed, so quite rude and ignorant of you to make assumptions. I also did not say I did all of that every day without fail. And as these strategies and supplements work, the symptoms get suppressed and manageable and everything gets easier. It has been a process of years, but I stay positive. Learned helplessness does you no favors.
@@soirema see reply above
@@cleansoapmind Learned helplessness does no one any favors but neither does telling people fish oil will fix their problems
This is absolutely true. As soon as I can focus something takes me away
Amazing video as always!! So informative. I will definitely be asking my doctor about Qelbree
Can you make a video on HSPs(Highly Sensitive People)?
I love learning about treatments. I was diagnosed at 36 and adderall has worked so well. I don’t have many side effects so I’m grateful for what it’s done for me. I don’t believe on being on it for life but for right now stimulants are working for me
There’s nothing wrong with staying on it for life, don’t let other people (or yourself) treat you like a drug addict.
Thank you Dr. Marks 🙏🏾
I was diagnosed with ADHD when I was 6. This is the first time I’ve heard anyone talk about set - shifting. Also I’m on my fourth week off my ADHD stimulant Concerta due to the nation wide shortage. It was so hard at first but this video is helpful. Thank you
Wow I am practically the model for what you just described in terms of set shifting problems. If I do get knocked off of my task then I often find myself doing dopamine drip activities like watching videos until I can pull myself out. I've often thought if only I was getting just a smidge and more dopamine I could get back on track a lot easier, and this qel--- medication sounds almost like the perfect thing for me. Does it tend to help people with ADHD who have a lot of minor memory problems like forgetting where they set their keys or that they've got produce that needs to be cooked in the fridge?
Thank you for this. I've been on strattera for awhile, but it does feel like it's only been so-so. Like, I can tell when it ends during the day. I've spoken with my doctor about wanting to try new medications after the holidays, to see if I can find something better for me.
I've saved this to remind myself.
Try Qelbree if you can. After about 6 weeks, this has provided the biggest benefit to my overall mental well-being and executive function of any medication I've tried. Hard things are still hard but they are more approachable. (I am cotreating with mental health therapy as well - learning coping strategies and changing one's mindset, etc.)
Tracey - THANK GOD SOMEONE MENTIONED THIS !!! No one has ever ever said it, I’m always thinking about it and recently decided to put boundaries in with what jobs and social engagements i will accept, because i CANNOT switch between tasks, without going mad. No one believes me. They think I’m just being selfish or eccentric. And some are cruel to me- they just deny i experience what I do. So But I’m going ahead with it because i need to stay (somewhat) sane, and make life bearable. If i have to interrupt the day to go somewhere, I cannot get back on track- the day is DESTROYED. Im best when i do one thing all day or for days at a time. Someone said it !!!! Yay!! (I wont be taking drugs though- but your saying it out loud and naming this problem is something wonderful for me because now I can go looking on the internet for others with this.). Oh my. What a relief.
You have not talked about Autism, as there is link to some of what you are talking about. I was on Straterra(and the side effects were not great) but its effect was not as good as my vyvanse and dexamfetamine, I found them more effective. Also my executive function issues have more to do with my autism than my ADHD, I have a physicists and psychologist helping me with both ADHD and my Autism. As some background, I was diagnosed as an adult(late 40s) and also have Dyslexia / Dyscalculia.
This was a great video, really happy I ran across this channel :)
I have adhd. Non stimulants so far don’t do a damn thing. Tried stratera for a month and it only made me very, very sick. (Like, on-par with what had me referred to a gastroentologist, put on omeprazole, go through an endoscopy and colonoscopy, and now being screened for crohns since they can’t get me off the omeprazole that at least reduces some of that pain as there’s nothing really linked in my diet to switch instead.) I’ve now been taking qelbree for a week and there’s still no improvement (and it probably makes my gastrointestinal track still sick, just not as sick as the stratera.)
I don’t have ADHD (at least I don’t think I do) and set shifting is incredibly difficult for me. I can’t imagine what it’s like for someone with ADHD.
Maybe you do have ADHD.
I would say that my difficulty with set shifting is almost constant and probably my worst ADHD symptom.
Thank you Dr. Marks for seeing us and sharing helpful info. You are very insightful.
I didn't tollerate the suggested non stimumant meds. I havent tried Qelbree though.
I'm going to look into that last one. I'm already on a high dose of one medication, and on the highest they'll give me for vyvanse, and I still have a lot of issues that just make it impossible for me to do regular tasks for long periods. I struggle so much with doing regular things I just..I'm looking for a way to live better. I appreciate your putting these videos out, because for me personally it has helped me have more control over my life.
Atomoxatine made me really sleepy, even if I took it before sleep. That's it, nothing else. So did Venlafaxine. Very specific kind of sleepy, not like anything else.
The only drug that helped me was Pirazidol (pirlindol), I have big problem doing things, anything, even washing a single plate or swiping breadcrumbs off the table. It feels like a boot on my neck stepping me into the ground the moment I even think of doing something. That feeling was gone on Pirazidol. I got distracted from a video game by a lecture on my other screen. Unheard of. Never before. I did more learning and work in 2 months I was taking it than I did last in 5 years. Problem is, it stopped working after 2 months 😞 I've tried every SSRI available in this shithole. No other MAO inhibitors either (except for like, Parkinson's ones, but they refuse to prescribe me that). Stimulants illegal. Buprion illegal. Idk what to do. It's getting worse.
I also had a question about bupropion. Right now it's the only medication I take for my ADHD. I'm 69 and was only diagnosed a little over a year ago. My official diagnosis is "ADHD, adult residual type," and my PCP and I weren't exactly sure what that meant. My PCP and I also discussed types of medication which would be best - stimulant or non-stimulant - and decided that given my age and the possibility of a negative interaction with some of my other meds, specifically my BP meds, a non-stimulant would be best for me. I've been taking bupropion ever since. I started with 150mg and then after 2 months or so it was increased to 300mg. The psychiatrist initially suggested atomoxetine. I'm not sure the bupropion is helping. It's evened out my moods, but I still have issues with focusing and executive function. Is atomoxetine better for that? I just wonder about the pros and cons, and maybe a side by side comparison of each med. I don't want to just waltz into my next appointment and tell my PCP to switch my medication, but if the bupropion is not really helping me then maybe I should switch. Not asking for a diagnosis, just a recommendation for a next step. And yes, I am seeing a therapist.
You should definitely talk with your doctor if your medication isn't working. Your therapist may even be able to help you figure out which one might be better for your symptoms. A licensed counselor diagnosed me, and because she kept up on her knowledge about medications because mental health was her field of interest, she was able to tell me which one she thought I should try first so I could tell my doctor, and it worked great for me for a long time. SO many doctors don't know or are highly misinformed about everything ADHD (not saying yours is, but in general).
Just tell your doctor what you've written in your comment; it made perfect sense to me. Maybe he or she would even watch this video, or maybe just the part about the current and new medications? Have them compare the two you talked about, and ask if there's any others you could try that might be better, but do your own research ahead of time, too... don't go in blind. I had a problem with the length of time my medication was working, and was hesitant to talk to my doctor, but I did some research and when I finally did talk to her, she was very open to letting me try something different. And when that one didn't work, we tried another one, which is what I take currently.
It's completely normal to have to try different medications until you get the right one, or sometimes it's the right one, but not the right dose, or short vs. long acting. Sometimes that process can be frustratingly long, but you definitely shouldn't just keep taking something that's not helping you. Your doctor won't know if you don't say anything, and if they don't know, they can't help you. It's a different story if you say something and they don't try to fix it... then I would find a new doctor. 😊
I wanted to add, because there are so many genes involved in ADHD, I've always had the theory that maybe that's why certain medications work for some people and certain ones don't. 🤔 In my case, Vyvanse and Adderall have worked great, but Ritalin did absolutely nothing for me. Well, good luck... I hope everything works out for you! 😊
Wow thank you for this information. Its very helpful.
🤦🏾♀️ Thank you for providing clarity and a name for my issue. Set shifting....