This question goes out to anyone who's had to go through some sort of medication figuring-out regimen, or knows someone who has. I'm not talking about having strep throat and going to the doctor and getting an antibiotic prescribed, because that's a one-and-done sort of thing; I'm talking about the process of figuring out some sort of individual long-term meds mix.

The short version of the question: what sort of buffer space do you need to create in your life, for how long, to account for side effects while you're trying to figure out the right combination of meds? I'm thinking about things like "make sure you can handle your responsibilities without several days of sleep," or "be prepared for an entire month of non-productivity," or "be prepared to have to force yourself to eat for a trial of up to 3 weeks," which I can then translate into things for myself like "don't start trying medications a week before quals when I need sleep and the ability to study," or "be aware you may insult relatives in the Philippines by not eating all the food they've prepared for you."

The longer version goes like this: I'm (finally) interested in trying medication for my ADHD, and I'm very new and uncertain about the "medication" thing -- I was the 15-year-old who refused painkillers after her appendectomy, that sort of thing. But I've been reading and reading and think, okay, okay, maybe it's worth a try, it'll help all my other coping mechanisms work better. So I'm over the "medications are eeeeeeevil" hump, or at least dealing with it reasonably, and now the question is figuring out what meds to take.

A week and a half ago, I went to a doctor at the student health center at Purdue and got a prescription for Strattera, a long-acting non-stimulant drug which isn't a controlled substance. I started taking it, and within a few days my mental focus had appreciably improved... and I was struggling to get more than 3 hours of sleep a night, and my appetite had dropped dramatically. Not good when you're taking an overload of classes, dancing 4 days a week, and training for a half-marathon; sleeping and eating are sort of important for these things.

So I stopped Strattera (and gradually started sleeping over the next few days, which was a huge relief). I wrote the doctor and said hey, can I maybe get something shorter-acting, like a stimulant (Ritalin, whatever) that I'd take in the morning and have out of my system by bedtime? And the doctor said:

  1. We don't prescribe stimulants here at the student health center because of their potential for abuse, but you can go elsewhere to get that prescription.
  2. That's a normal side effect; keep trying the drug for at least 2 consecutive weeks and see if it gets more tolerable.

Faced with 2 weeks of extreme sleep deprivation during a 4-week class session, I balked and haven't started taking the Strattera again yet, because I just can't see how I can reasonably pull off my workload and exercise regimen on anything less than my current capabilities (which depend on getting sleep and eating food). So now I'm thinking "okay,  I need to figure out a long timestretch for calibrating meds by creating at least a full month in my life where I can go without sleeping or eating and not totally screw up something," and looking at my summer and fall calendar packed with travel and conferences and quals and thinking "oh crap, such a month is never going to happen." I live alone and struggle to monitor myself already.

So I'm at a loss for what to do. I know the meds are supposed to help you instead of hinder you, and that they will help me when (if) we find the right combination, but I don't want to drop any balls because I'm being slammed by side effects from the wrong combinations we try before then. I'm going to try calling some of the other places on Monday to see if they'll help me try the short-acting meds, but beyond that I'm not sure how to prepare life-wise to handle them. I don't know how to go about thinking about this, preparing for this, buffering for this, and I know I have a tendency to buffer life too little (run close to 100% of my capacity, so anything that doesn't work as optimistically as predicted creates a huge pile-up traffic jam in my life).

People with medication calibration experience: how the heck do you do this?