How do stimulants like Adderall affect chronic fatigue syndrome and fibromyalgia. What are the potential benefits and risks of using CNS stimulants for CFS/ME and FM. Which stimulants show promise in treating fatigue, cognitive issues, and pain in these conditions.

Understanding Stimulants in CFS and Fibromyalgia Treatment

Chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM) are complex conditions characterized by debilitating fatigue, cognitive difficulties, and often widespread pain. In recent years, central nervous system (CNS) stimulants have gained attention as potential treatment options for managing symptoms in these disorders. This article explores the use of stimulants like Adderall, Ritalin, and others in CFS and FM, examining their potential benefits, risks, and the current state of research.

Common Stimulants Used in CFS and FM Treatment

• Adderall (amphetamine/dextroamphetamine)
• Ritalin (methylphenidate)
• Vyvanse (lisdexamfetamine)
• Provigil (modafinil)
• Dexedrine (dextroamphetamine)

These medications, primarily used to treat attention deficit hyperactivity disorder (ADHD), have shown potential in addressing some of the core symptoms of CFS and FM. But how exactly do they work in the context of these conditions?

The Mechanism of Action: How Stimulants Affect CFS and FM Symptoms

Stimulants primarily work by increasing the activity of certain neurotransmitters in the brain, particularly dopamine and norepinephrine. This enhanced neural activity can lead to several effects that may benefit CFS and FM patients:

1. Increased alertness and wakefulness
2. Improved concentration and focus
3. Enhanced motivation and cognitive function
4. Potential reduction in fatigue
5. Possible pain mitigation

Additionally, some stimulants can have cardiovascular effects, which may be beneficial for patients experiencing orthostatic intolerance, a common comorbidity in CFS. These medications can constrict blood vessels, increase blood pressure, and elevate heart rate, potentially improving circulation and reducing symptoms related to low blood pressure upon standing.

Can stimulants help with pain in CFS and FM?

While primarily known for their effects on energy and cognition, some studies suggest that stimulants may also have a positive impact on pain levels in CFS and FM patients. This could be due to their influence on neurotransmitter systems involved in pain perception or indirectly through improved overall function and reduced fatigue. However, more research is needed to fully understand the pain-modulating effects of stimulants in these conditions.

Research Findings: Stimulants in CFS and FM Clinical Trials

Several studies have investigated the use of stimulants in CFS and FM, with mixed but promising results. Let’s examine some key findings:

Vyvanse in CFS: A Promising Study

A small, placebo-controlled, double-blinded study focused on Vyvanse (lisdexamfetamine) in CFS patients yielded encouraging results. The study found that Vyvanse not only improved cognitive function but also had positive effects on fatigue and pain levels. This suggests that next-generation amphetamines like Vyvanse may offer a multi-faceted approach to symptom management in CFS.

The Synergy Trial: Combining Stimulants with Nutritional Support

The Synergy trial explored a novel approach by combining methylphenidate (Ritalin) with a nutrient formula containing mitochondrial and immune boosters. While the trial didn’t meet its primary endpoints due to a high placebo response, it highlighted the potential of combining pharmacological and nutritional interventions in CFS treatment.

Long-term Ritalin Use in CFS

A long-term assessment of Ritalin in CFS patients revealed that approximately one-third of participants experienced significant benefits, including a 50% improvement in fatigue and concentration. This suggests that for a subset of CFS patients, stimulants like Ritalin may offer substantial and sustained relief.

The ADHD Connection: Overlapping Symptoms and Treatment Potential

An intriguing aspect of stimulant use in CFS and FM is the apparent overlap with attention deficit hyperactivity disorder (ADHD). Some researchers have noted a higher prevalence of ADHD-like symptoms in CFS and FM patients, raising questions about shared neurobiological mechanisms and treatment approaches.

How common is ADHD in fibromyalgia patients?

One study employing an ADHD self-test found that nearly 50% of fibromyalgia patients tested positive for ADHD. This striking finding suggests that ADHD-like symptoms may be significantly more prevalent in FM than in the general population. It also raises the possibility that treatments effective for ADHD, such as stimulants, might be beneficial for a subset of FM patients.

Case reports have further supported this connection. One report involving three ME/CFS/FM patients with ADHD found that psychostimulants produced substantial improvement in their symptoms. Another case study described a woman with long-term treatment-resistant fibromyalgia who experienced excellent benefits from dextroamphetamine treatment.

Stimulants Beyond CFS and FM: Insights from Cancer-Related Fatigue

The potential of stimulants to address fatigue extends beyond CFS and FM. Research in cancer-related fatigue (CRF) provides additional insights into the efficacy of these medications for managing severe fatigue:

What does research on cancer-related fatigue tell us about stimulant use?

A 2010 Cochrane Review examining psychostimulant effectiveness in cancer fatigue reported increasing evidence that psychostimulant trials provide improvement in CRF at a clinically meaningful level. This suggests that the fatigue-alleviating effects of stimulants may be applicable across various conditions characterized by severe fatigue.

A subsequent 2015 Cochrane review focusing on fatigue in palliative care found that modafinil and methylphenidate may help improve fatigue in patients with very serious illnesses. The review also identified several other compounds, including dexamethasone, methylprednisolone, acetylsalicylic acid, armodafinil, amantadine, and L-carnitine, as potential candidates for further study in fatigue management.

Expert Opinions: What Do CFS and FM Specialists Say About Stimulants?

Medical professionals specializing in CFS and FM have varying opinions on the use of stimulants, reflecting the complex nature of these conditions and the individualized responses to treatment. Here’s what some experts have to say:

Dr. Jacob Teitelbaum’s Perspective

Dr. Teitelbaum states that stimulants including Ritalin and Dexedrine “can be very helpful for many people with CFIDS” (Chronic Fatigue and Immune Dysfunction Syndrome, another term for CFS). His experience suggests that these medications can play a valuable role in managing symptoms for a significant number of patients.

Dr. Charles Lapp’s Approach

Dr. Lapp has found success with stimulants and focuses on three main options: methylphenidate (Ritalin), dexamphetamine (Dexedrine/Adderall), and modafinil (Provigil). His use of multiple stimulant options highlights the importance of individualized treatment approaches in CFS and FM.

Dr. Lucinda Bateman’s Observations

Dr. Bateman has observed that CNS stimulants tend to be more effective in fibromyalgia-type patients. She notes, “The more pure CFS you have, the less you can fix it with a stimulant.” This insight underscores the heterogeneity of these conditions and the need for tailored treatment strategies. Dr. Bateman also raises concerns about medication sensitivities, a common issue in CFS and FM patients.

Dr. Alan Pocinki’s Cautionary Approach

Dr. Pocinki acknowledges the potential benefits of stimulants for fatigue and cognitive dysfunction but emphasizes the need for careful monitoring. He states, “You can’t prescribe stimulants without keeping a careful eye on how they impact other aspects of the illness. They can make rest and sleep more difficult, or worse, they can precipitate the dreaded push-crash cycle.” This highlights the delicate balance required when using stimulants in CFS and FM patients.

Potential Risks and Side Effects of Stimulant Use in CFS and FM

While stimulants show promise in managing certain symptoms of CFS and FM, they are not without risks and potential side effects. It’s crucial for patients and healthcare providers to be aware of these concerns:

What are the main risks associated with long-term stimulant use?

• Addiction potential: Although the risk of addiction is reportedly low when taken as prescribed, long-term use of high doses can lead to dependence.
• Sleep disturbances: Stimulants can interfere with sleep patterns, potentially exacerbating fatigue in the long run.
• Cardiovascular effects: Increased heart rate and blood pressure may be problematic for some patients.
• Mood changes: Some patients may experience anxiety, irritability, or mood swings.
• Appetite suppression: Weight loss and nutritional deficiencies can occur.
• Tolerance development: Over time, patients may require higher doses to achieve the same effects.

Additionally, the “push-crash cycle” mentioned by Dr. Pocinki is a particular concern for CFS patients. Stimulants may mask fatigue, leading patients to overexert themselves and subsequently experience a severe crash in energy levels.

Individualized Treatment: The Key to Successful Stimulant Use in CFS and FM

Given the complex nature of CFS and FM, as well as the potential risks associated with stimulant use, an individualized approach to treatment is crucial. Several factors should be considered when contemplating stimulant therapy for these conditions:

How can healthcare providers determine if stimulants are appropriate for a CFS or FM patient?

1. Comprehensive evaluation: Assess the patient’s overall symptom profile, including fatigue severity, cognitive issues, pain levels, and comorbid conditions.
2. Consideration of ADHD symptoms: Screen for ADHD-like symptoms, as patients with these features may be more likely to benefit from stimulants.
3. Cardiovascular health: Evaluate the patient’s cardiovascular status to ensure stimulants can be safely administered.
4. Sleep patterns: Assess sleep quality and patterns, as stimulants may exacerbate existing sleep disturbances.
5. Medication sensitivities: Consider the patient’s history of medication sensitivities, which are common in CFS and FM.
6. Treatment goals: Clearly define the objectives of stimulant therapy, whether it’s improving cognitive function, reducing fatigue, or addressing other specific symptoms.
7. Monitoring plan: Establish a comprehensive monitoring plan to track benefits and potential side effects over time.

By carefully considering these factors, healthcare providers can make more informed decisions about whether stimulant therapy is appropriate for individual CFS and FM patients.

Future Directions: Advancing Stimulant Research in CFS and FM

While existing research on stimulant use in CFS and FM has shown promise, there is still much to learn about optimizing these treatments for patients. Future research directions may include:

What areas of stimulant research need further exploration in CFS and FM?

• Long-term efficacy and safety studies: Most current research focuses on short-term outcomes. Longer studies are needed to understand the sustained benefits and risks of stimulant use in these chronic conditions.
• Combination therapies: Exploring the synergistic effects of stimulants with other treatments, such as cognitive behavioral therapy, exercise protocols, or nutritional interventions.
• Biomarker identification: Investigating potential biomarkers that could predict response to stimulant therapy, enabling more targeted treatment approaches.
• Novel stimulant formulations: Developing new stimulant medications or delivery methods that may offer improved efficacy or reduced side effects for CFS and FM patients.
• Comparative effectiveness studies: Directly comparing different stimulants and dosing strategies to optimize treatment selection.
• Neuroimaging studies: Utilizing advanced brain imaging techniques to better understand how stimulants affect neural function in CFS and FM patients.

As research in this area continues to evolve, it’s likely that our understanding of stimulant use in CFS and FM will become more nuanced, leading to more effective and personalized treatment strategies.

Complementary Approaches: Integrating Stimulants with Other CFS and FM Treatments

While stimulants can be beneficial for some CFS and FM patients, they are often most effective when used as part of a comprehensive treatment plan. Integrating stimulant therapy with other evidence-based approaches may enhance overall outcomes and quality of life for patients.

What complementary treatments can be combined with stimulants in CFS and FM management?

1. Cognitive Behavioral Therapy (CBT): CBT can help patients develop coping strategies and manage the psychological impact of chronic illness, potentially enhancing the benefits of stimulant therapy.
2. Graded Exercise Therapy (GET): Carefully supervised exercise programs may improve overall function and stamina when combined with appropriate stimulant use.
3. Sleep hygiene interventions: Addressing sleep disturbances through behavioral and environmental modifications can complement the wake-promoting effects of stimulants.
4. Nutritional support: Optimizing diet and addressing any nutritional deficiencies may enhance energy levels and cognitive function in conjunction with stimulant use.
5. Stress reduction techniques: Practices such as mindfulness meditation or yoga may help mitigate some of the potential side effects of stimulants, such as anxiety or restlessness.
6. Pain management strategies: For FM patients, combining stimulants with other pain management approaches, such as low-dose naltrexone or acupuncture, may provide more comprehensive symptom relief.

By adopting a multifaceted approach to treatment, healthcare providers can tailor interventions to address the diverse symptoms and individual needs of CFS and FM patients.

Patient Perspectives: Living with CFS and FM on Stimulant Therapy

While clinical studies and expert opinions provide valuable insights into stimulant use in CFS and FM, the experiences of patients themselves offer crucial real-world perspectives. Many patients have shared their journeys with stimulant therapy, highlighting both the benefits and challenges they’ve encountered.

What do CFS and FM patients say about their experiences with stimulants?

Patient experiences with stimulants in CFS and FM tend to vary widely, reflecting the heterogeneous nature of these conditions. Some common themes emerge from patient reports:

• Improved cognitive function: Many patients report significant improvements in focus, concentration, and mental clarity when using stimulants.
• Increased energy levels: Some patients experience a notable boost in energy, allowing them to engage in more daily activities.
• Enhanced quality of life: For those who respond positively, stimulants can lead to improved overall functioning and a better sense of well-being.
• Variable effectiveness: While some patients find sustained benefits, others report that the effects of stimulants diminish over time or are inconsistent.
• Side effect management: Patients often describe a process of finding the right balance between symptom relief and managing side effects like insomnia or anxiety.
• Concerns about dependency: Some patients express worries about becoming reliant on stimulants for daily functioning.

Stimulants For Chronic Fatigue Syndrome and Fibromyalgia

Stimulating the Central Nervous System For More Energy, Alertness and Even Calmness (?) in ME/CFS and FM

Most of the pharmaceuticals used to increase energy in chronic fatigue syndrome (ME/CFS)  (Vyvanse, Ritalin, Adderall) are amphetamines or have amphetamine-like structures. Amphetamines have been used in the past to elevate mood, reduce feelings of fatigue and increase alertness, concentration and motivation.

The cardiovascular effects have led them, at times, to be used in orthostatic intolerance as well.  In general, they constrict the blood vessels and increase blood pressure and heart rates.  They may also increase blood glucose levels.

Historically, amphetamines were used to treat everything from asthma to obesity to hyperactivity to neurological disorders, but abuse problems have restricted their use today to conditions such as attention deficit disorder.  When taken correctly the risk of addiction is reportedly very low but taking large doses of stimulants over a long period of time can cause addiction. Sleep and energy levels can be negatively affected in ME/CFS and FM as well.

Central Nervous System Stimulants May Be Helpful…

in chronic fatigue syndrome (ME/CFS) and fibromyalgia because they increase alertness, concentration, motivation, and energy and can assist with circulatory problems.  One study suggests they may be able to help with fatigue and pain as well.

Plus, the disorder stimulants are most commonly used in – attention hyperactivity deficit disorder (ADHD) – appears to be common in fibromyalgia and probably ME/CFS. One study which employed an ADHD self-test found that almost 50% of FM patients tested positive for ADHD.

ADHD (Attention Deficit Hyperactivity Disorder) May Be Common in Fibromyalgia

Studies

One small placebo-controlled, double-blinded ME/CFS study found that Vyvanse, a next-generation amphetamine, not only improved cognition but fatigue and pain, as well. The Synergy trial which incorporated methylphenidate/Ritalin with a nutrient formula containing mitochondrial and immune boosters would have been successful were it not for the high placebo response found.  A long-term assessment of Ritalin in ME/CFS found that about a third of patients received significant benefits including a 50% improvement in fatigue and concentration.

Stimulating Results in Vyvanse Chronic Fatigue Syndrome (ME/CFS) Treatment Trial

A case report involving three ME/CFS/FM patients with ADHD found significant psychostimulants produced substantial improvement.  Another case report indicated that one woman with long-term treatment-resistant fibromyalgia received excellent benefits from dextroamphetamine.

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A 2010 Cochrane Review examining psychostimulant effectiveness in cancer fatigue reported: “There is increasing evidence that psychostimulant trials provide evidence for improvement in CRF at a clinically meaningful level”.  Another 2015 Cochrane review of studies for people with very serious illnesses reported that modafinil and methylphenidate may help improve fatigue in palliative care.  (The review suggested that dexamethasone, methylprednisolone, acetylsalicylic acid, armodafinil, amantadine, and L-carnitine should be studied further.) These trials do not, however, address the possible long-term effects of the drug.

Doctors Report

Chronic Fatigue Syndrome (ME/CFS) Physicians Report – Dr.Teitelbaum states stimulants including Ritalin and Dexedrine ‘can be very helpful for many people with CFIDS’. Dr. Lapp has found success with stimulants as well and focuses on methylphenidate (Ritalin), dexamphetamine (Dexedrine/Adderall), and modafinil (Provigil).

Dr. Bateman finds CNS stimulants are more effective in fibromyalgia-type patients. She says “The more pure CFS you have, the less you can fix it with a stimulant” and she raises the problem of sensitivities to drugs.

Dr. Pocinki notes “For patients who are complaining of fatigue or cognitive dysfunction, stimulants like Provigil, Ritalin or Adderall may be prescribed to boost energy and improve focus and concentration… However, you can’t prescribe stimulants without keeping a careful eye on how they impact other aspects of the illness. They can make rest and sleep more difficult, or worse, they can precipitate the dreaded push-crash cycle.”

In 2002 Glenda H. Davis, MD, and Patricia Stephens, CNC, reported that ADHD medications can provide an “unlikely source of relief” in FM through their ability to alleviate fatigue, improve cognition and reduce pain.   They cautioned, though, against self-medicating and urged FM patients to seek out good practitioners.

Dr. Jon Kaiser, an alternative-focused MD, who has or had ME/CFS at one time – he improved using rest, pacing, micronutrient therapy, physical therapy, and an aggressive stress reduction program – believes that stimulating drugs in combination with micronutrients can help revive the mitochondrial functioning in ME/CFS patients.  Once that mitochondrial wake-up has been achieved, the drug is no longer needed.

Dr. Murphree, an alternative health-focused MD, agrees that psychostimulants can boost energy levels but asserts that long-term use – which the clinical trials do not address –  is “a disaster for most folks, but especially so for those with fibromyalgia and or chronic fatigue syndrome (CFS/ME)“.

Focusing on the effects of psychostimulants on the adrenal glands, Murphree, pointing to a long list of possible side effects, argued that “Whipping the exhausted horse harder and harder isn’t the answer – eventually your fatigued adrenals, like the exhausted horse, will give out, no matter how hard you try to stimulate them. ” Similarly, Dr. Paul Cheney  (now retired) believed that while SSRIs and stimulants could be beneficial in the short term in the long term they could ‘fry your brain’.

Central Nervous System Stimulants in Chronic Fatigue Syndrome (ME/CFS)

Find out more about stimulants and ME/CFS/FM.

• Lisdexamfetamine dimesylate (Vyvanse)
• Methylphenidate (Ritalin/Concerta)
• Methylphenidate + mitochondrial enhancing supplements

From Cocaine to Adderall, Do They Work?

Part of living with CFS is wrestling with the appeal of stimulants — prescribed and not.

It’s 1:00 a.m. on a work night. There are 2 hours to close, 3 hours until clean up’s done. If you choose to brave the kebab shop queues on your way home, the total work-to-bed pipeline will be no less than 4 hours.

The next day, you wake up plastered to your pillows. You watch the clock turn from 2:00 p.m. to 3:00 p.m., jumping to 7:00 p.m., before inexplicably reading 9:30.

You try to get up, but your joints creak, and your brain drops into your belly. When you attempt to form a sentence, it comes out curly and incomprehensible.

You lie back down, shirking phone calls and gathering an army of unread text messages.

All of your friends and enemies are out drinking, dancing, and harnessing their youth. If you manage to get out of bed, you can join them. The hard part is just getting up.

As someone whose FOMO is more clinical than their chronic fatigue, I couldn’t go on spending my days like Grandpa Joe in “Charlie and the Chocolate Factory.” Missed night out after missed night out, my resentment for my tiredness grew.

Then, I found my golden ticket.

Cocaine wasn’t entirely off my radar. But it wasn’t something I ever committed to until I decided it could be a performance-enhancing tool.

I was stuck in Scotland, where prescribed Adderall is more or less unheard of. Coke seemed like a reasonable route to energy and endurance — a way to cope.

And so I began.

On days I felt exhausted, I would arrange several lines around a matcha latte and resurrect myself with a stimulant seance.

I thought I had my chronic fatigue in remission. All of a sudden, I could keep up with all the other 20-somethings.

I got myself out of the bath and to the bar (for more than 2 hours!). I broke up with the couch, ghosted DoorDash, and finally washed my pajama pants.

Work and play –– for the first time ever, I had it all.

I became a delusional crusader of health and wellness. Doing yoga, going for long walks, and sipping my oat milk-turmeric blends, I felt like I had elevated to a higher plane and had no problem preaching it to my friends.

I turned my nose up at the smokers heading outside for their smoke breaks, while I was escaping every hour on the hour for a coke break.

“No, I can’t have coffee. It’s not good for my condition,” I would say.

“You’re literally on cocaine,” they would counter.

Chronic fatigue syndrome (CFS) is an elusive and difficult to diagnose disorder characterized by unrelenting tiredness. People with CFS experience extreme fatigue following mental and physical activities.

Brain fog, memory issues, joint pain, and sore throat are also common symptoms.

CFS can co-occur with mental health disorders, autoimmune diseases, and sleep disorders. Because of this, treatment for one of the above may offer relief.

But, for some, there’s no long-term recovery. Instead, they’re left to do the impossible: strike the perfect subjective balance between activity and rest.

Some doctors prescribe stimulants, like Adderall, Vyvanse, and Ritalin — all commonly used to manage symptoms of attention deficit hyperactivity disorder (ADHD) — to people with CFS who don’t respond to other treatments or who experience symptoms of both CFS and ADHD.

But how well do these actually work? Does the research around them back up my personal use of a stimulant (albeit, a non-legal one) to manage CFS?

A 2014 study, expanding on a 2006 trial, suggests Ritalin may help to relieve fatigue and improve cognitive function for people with CFS.

A small, older 2003 study suggests Dexedrine, another stimulant prescribed for ADHD, might have similar effects for people with CFS.

Sounds like an easy fix, right? Not necessarily.

Before considering stimulants for chronic fatigue, think about the nature of your symptoms.

If you experience insomnia or sleeplessness, for example, stimulants might only serve to make things worse.

Even for people with CFS who don’t experience sleep disorders, ADHD meds (or, if you’re like me, cocaine) may feel like the answer in the early hours. But they’ll catch up with you.

After several weeks of consistently using cocaine, I crashed — hard.

It doesn’t matter if you buy your energy boost in a trendy café or skulk for it in a dark alley –– all stimulants work by, well, stimulating your central nervous system. This results in an increase of certain neurotransmitters in the brain.

But as the stimulant wears off and neurotransmitters return to their previous levels, you might be left with even worse fatigue (not to mention irritability).

A number of people in the CFS community also report experiencing high blood pressure, dizziness, digestive issues, and insomnia after using stimulants. Some attribute these symptoms to adrenal fatigue, a condition most medical experts don’t recognize.

Regardless of the underlying process that causes them, these symptoms won’t do you any favors if you’re dealing with CFS.

With such inability to sleep, you can easily find yourself putting a bandage over your health issues, suspended in an endless cycle of Ambien and Adderall.

If your doctor has prescribed you Ritalin or Adderall, use it as intended, and try to avoid the temptation of believing more is always better.

The advice “take rest” can be, um, annoying.

In this work-first world, some people wear overexertion and burnout like a badge.

What’s more, not all of us can afford to find a new job with fewer demands and stay afloat –– especially when fronting bills to see endocrinologists and other specialty doctors.

It’s no secret that we live in a stimulant-dependent society. We’re expected to do the most, even when we’re feeling the worst.

“Take rest” can be an impossible ask on top of an already impossible condition.

So, are there any other ways to augment energy levels without risking addiction or adrenal insufficiency?

Some people swear by natural nootropics or medicinal mushrooms, like cordyceps and lion’s mane, for beating brain fog and other symptoms. But research around these approaches is limited, and healthcare professionals aren’t always open to discussing them.

That said, there’s some research to suggest that coenzyme Q10 (CoQ10) and nicotinamide adenine dinucleotide (NADH) are safe to take long-term, and they may reduce fatigue in people with CFS.

I’ve had sleep issues since I was 12 years old, before I even had my first drink (unless you count the 0.2 ounces of vodka and orange Gatorade I’d mix myself after school before watching “The Real World”).

Growing up, I never had any stimulants prescribed to me, I kept away from cups of Kona coffee, and I was even light on the sugar. But insomnia still manifested.

Eventually, it became something I would use to justify my exhaustion, my rage, my propensity to addiction. The worst part is: It still haunts me, even when I do everything right.

Unfortunately, even if you lighten your workload and perform self-massage every night, managing chronic fatigue is a life-long process for many people.

There’s no flowery or pretty takeaway from all of this.

You may have to accept that your days of being able to go from the gym, to work, to the grocery store, to a friend’s place, across state lines, then back home for a nightcap are over.

Or your doctor might prescribe you a stimulant that rebirths you and doesn’t make you curious about any of the stronger stuff.

Everyone is different.

I still get tempted to give myself an illegal boost around significant events, like weddings, holidays, and bachelorette parties. (Who wants to be on a party boat with Grandpa Joe?) Occasionally, I give in –– and I forgive myself.

Lastly, remember: Tired people can party, too –– we just pay a higher cost.

Kiki Dy is a copywriter, essayist, and yoga instructor. When she is not working, she is probably shortening her life span in some fun-filled manner. You can contact her via Twitter, which she intends to use professionally despite her username.

Adderall, Coffee, Cocaine and Chronic Fatigue Syndrome: An Unsettling Romance – Drink-Drink

Part of living with CFS is struggling with the attraction of stimulants—prescribed and not.

It is now 1:00 am, work night. 2 hours left before closing, 3 hours before cleaning. If you choose not to queue at the kebab shop on your way home, the total pipeline from work to bed will be at least 4 hours.

The next day you wake up stuck to your pillows. You watch the clock turn from 2:00 to 3:00, jump to 7:00, and then inexplicably show 9:thirty.

You try to get up, but your joints creak and your brain sinks into your stomach. When you try to make a sentence, it turns out to be curly and incomprehensible.

You lie back down, dodge phone calls and collect an army of unread text messages.

All your friends and enemies drink and dance and use their youth. If you manage to get out of bed, you can join them. The hardest part is just getting up.

Started with self-treatment

As someone whose FOMO is more clinical than chronic fatigue, I couldn’t continue spending my days like Grandpa Joe in Charlie and the Chocolate Factory. Missed night after missed night, my resentment at my fatigue grew.

Then I found my golden ticket.

Cocaine was not completely out of my sight. But I never got around to it until I figured it might be a productivity tool.

I’m stuck in Scotland where prescribed Adderall is more or less unknown. Coke seemed like a smart route to energy and stamina – a way to get by.

And I started.

On days when I felt exhausted, I would line up a few lines around a cup of matcha latte and resurrect myself with a stimulating session.

I thought I had chronic fatigue in remission. All of a sudden I was able to keep up with all the other twenty year olds.

I got out of the bath and into the bar (more than 2 hours!). I left the couch, looked at DoorDash, and finally washed my pajama pants.

Work-play – for the first time I had everything.

I became a delusional health and wellness advocate. By doing yoga, taking long walks, and sipping oat milk and turmeric blends, I felt I had risen to a higher level and had no problem preaching to my friends.

I turned up my nose at smokers going outside for a cigarette break while I ran every hour for a cocaine break.

— No, I can’t have coffee. This is not good for my condition,” I would say.

“You’re literally on cocaine,” they objected.

What is chronic fatigue syndrome?

Chronic Fatigue Syndrome (CFS) is a subtle and difficult to diagnose disorder characterized by persistent fatigue. People with CFS experience extreme fatigue after mental and physical exertion.

Headache, memory problems, joint pain and sore throat are also common symptoms.

CFS may be associated with psychiatric disorders, autoimmune diseases and sleep disorders. Because of this, treatment with one of the above may bring relief.

But for some, there is no long-term recovery. Instead, they are left to do the impossible: to find the perfect subjective balance between activity and rest.

Can stimulants really help with CFS?

Some doctors prescribe stimulants such as Adderall, Vyvanse, and Ritalin—all of which are commonly used to treat symptoms of attention deficit hyperactivity disorder (ADHD)—for people with CFS who do not respond to other treatments or who experience symptoms of both CFS and and ADHD.

But how well do they actually work? Does the research around them support my personal use of a stimulant (albeit illegal) to treat CFS?

A 2014 study expanding on a 2006 study suggests that Ritalin may help relieve fatigue and improve cognitive function in people with CFS.

Small, Senior 2003 study suggests that Dexedrine, another stimulant prescribed for ADHD, may have similar effects for people with CFS.

Sounds like an easy solution, right? Not necessary.

Before considering stimulants for chronic fatigue, consider the nature of your symptoms.

For example, if you are experiencing insomnia or insomnia, stimulants may only serve to make things worse.

Even for people with CFS who don’t have sleep disturbances, ADHD medications (or, if you’re like me, cocaine) may seem like the answer in the early hours. But they will chase you.

Facing the consequences

After a few weeks of constant cocaine use, I fell down hard.

Whether you’re buying an energy boost at a trendy cafe or hiding behind one in a dark alley, all stimulants work by, well, stimulating your central nervous system. This leads to an increase in the amount of certain neurotransmitters in the brain.

But as the stimulant wears off and the neurotransmitters return to their previous levels, you may be left with even more fatigue (not to mention irritability).

A number of people in the CFS community also report high blood pressure, dizziness, digestive problems and insomnia after using stimulants. Some attribute these symptoms to adrenal fatigue, a condition that most medical experts don’t recognize.

Regardless of the underlying process that causes them, these symptoms will do you no good if you are dealing with CFS.

With this inability to sleep, you can easily bandage your health problems suspended in the endless cycle of Ambien and Adderall.

If your doctor has prescribed Ritalin or Adderall for you, use them as directed and try to avoid the temptation to think that more is better.

Are there alternatives?

The advice “take a break” can be, ahem, annoying.

In this work-oriented world, some people wear overexertion and burnout as a badge.

Moreover, not all of us can afford to find a new job with less demands and stay afloat, especially when we have to pay bills to endocrinologists and other specialized doctors.

It’s no secret that we live in a stimulant dependent society. We must do our best even when we feel the worst.

“Rest” may be an impossible request in addition to an already impossible condition.

So, are there other ways to increase your energy levels without risking addiction or adrenal insufficiency?

Some people swear by natural nootropics or medicinal mushrooms such as cordyceps and lion’s mane to combat foggy and other symptoms. But research on these approaches is limited, and healthcare professionals aren’t always open to discussing them.

However, there is some research to suggest that coenzyme Q10 (CoQ10) and nicotinamide adenine dinucleotide (NADH) are safe for long-term use and may reduce fatigue in people with CFS.

I still don’t have the answers

I’ve had trouble sleeping since I was 12, before I had my first drink (not counting the 0.2 ounce vodka and orange Gatorade I mixed myself after school before watching “Real World”).

As a child, I was never prescribed any stimulants, abstained from cups of Kona coffee, and never even ate sugar. But insomnia still showed up.

Eventually it became something I would use to justify my exhaustion, my rage, my addiction. The worst thing is that it still haunts me even when I’m doing everything right.

Unfortunately, even if you make your job easier and self-massage every night, for many people managing chronic fatigue is a lifelong process.

On the bottom line

There is no flowery or pretty conclusion from all this.

You may have to come to terms with the fact that your days of walking from the gym to work, to the grocery store, to a friend’s place, across state lines, and then back home for a late night drink are over.

Or your doctor may prescribe you a stimulant that will revive you and not make you curious about anything stronger.

Everyone is different.

I still have the temptation to give myself illegitimate support for big events such as weddings, holidays and bachelorette parties. (Who wants to go boating with Grandpa Joe?) Sometimes I give up – and I forgive myself.

Finally, remember: tired people can have fun too – we just pay more.

Stimulants: types, symptoms and effects of use

Not all stimulants are drugs, but many psychostimulants are addictive when abused or used for non-medical purposes. Distinguish between medicines, publicly available products and products, as well as prohibited substances. Some pharmacological agents can have a psychostimulant effect, although they themselves are not stimulants – for example, antidepressants, eleutherococcus.

Dependence on psychoactive drugs – physical and mental. In addition to the desire to constantly take the drug in order to be “in good shape” and feel a “rush of strength”, drug addicts experience unpleasant physical sensations – a withdrawal syndrome characteristic of psychostimulants.

WHAT ARE STIMULANTS
Stimulants are substances that have a direct effect on the central nervous system, changing the mental state of a person. They belong to the group of psychotropic (psychoactive) substances that primarily affect mental activity. The effect on physical activity – for example, muscle tone, increased gesticulation, etc. is less pronounced when taking drugs or drugs.

The main properties of stimulant drugs and legally available drugs include:

Acceleration of thought processes.
Rapid removal of feelings of fatigue, drowsiness.
Improved performance.
Improved mood.
Increased sensitivity to external stimuli (eg noise, colors, light).
Increasing sociability.
Actions of psychostimulants are based on the enhancement of excitatory processes in the brain, stimulation of the central nervous system. It is important to understand that all types of stimulants give only the appearance of increased mental activity – they do not provide energy, but release reserves, thereby depleting the body.

TYPES OF PSYCHOSTIMULATORS
CNS stimulants can be divided into the following types:

Medicines. Drugs used for medical purposes – Deoxin, Dexedrine, Adderall and Adderall XR, Ritalin, Provigil and other drugs in the form of tablets or capsules.
Stimulant drugs. This is a group of amphetamines, related substances (ephedrine, phenylpropanolamine), synthesized drugs (ecstasy, ephedron), cocaine.
Publicly available licensed stimulants. These are tea, coffee, caffeine energy drinks, Pepsi and Coca-Cola, nicotine in the form of tobacco, cigarettes, chewing gums.
types of stimulants
Types of stimulants

Also, psychostimulants can be classified according to the degree of legality:

Completely prohibited for circulation (narcotic drugs, psychotropic substances and their precursors, the circulation of which is prohibited on the territory of the Russian Federation). These are cocaine, cathinone (an alkaloid found in the khat shrub), synthetic cathinones (mephedrone, ephedron and other cathinone analogs obtained artificially).
Prescription drugs (Schedule II and III). Amphetamine and its derivatives (except for levoamphetamine are currently included in Schedule I, i.e. prohibited for circulation in the territory of the Russian Federation), dextramphetamine (Adderall), ephedrine, methylphenidate, mesocrab, feprozidine.
Allowed. Caffeine found in coffee, tea, energy alcoholic and non-alcoholic drinks, nicotine (tobacco products).
Please note that Lists I, II, III and IV in the Russian Federation are different from similar lists in other countries. If you have taken and continue to take certain psychostimulant drugs (drugs) as prescribed by a doctor in the United States or Eurozone countries, then when entering the territory of the Russian Federation, you should clarify in advance whether the substance is prohibited for import or circulation in Russia. Otherwise, criminal liability for the transport of drugs is possible.

DRUG DEPENDENCE?
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MEDICAL USE OF STIMULANTS
Indications for the use of psychostimulants in medicine:

Attention deficit hyperactivity disorder. A developmental disorder in children, in which there are problems with concentration, there is increased motor activity and excitability. Methylphenidate, dexamphetamine are prescribed.
Narcolepsy. A disease of the nervous system in which drowsiness occurs with attacks of sudden falling asleep. Assign levamphetamine (Adderall), methylphenidate, mesocarb.
Depression. In depressive states (atypical, resistant depression), psychostimulants can be prescribed – Adderall, levoamphetamine, dexedrine.
Management of schizophrenic negative symptoms. Amphetamines are used.
Bronchial asthma, rhinitis. Ephedrine is used, from which ephedron can be obtained.
AIDS. To increase cognitive functions, reduce weakness, methylphenidate is used.
Obesity. In the treatment of obesity, it is possible to take deoxin.
It must be understood that in Russia, most of these medicinal stimulants are either completely prohibited or sold strictly by prescription. Some patients buy medicines authorized abroad and import them illegally into the Russian Federation, or they buy medicines on the black market.

Psychostimulant substances for medical and non-medical purposes can be used:

To suppress withdrawal symptoms in people dependent on alcohol. Contribute, incl. and the removal of depressive syndromes after detoxification in the treatment of alcoholism in a hospital, at home.
To improve general mood in severe apathy.
To reduce the sedative effect of taking analgesics, reducing the need for narcotic analgesics.
To improve the condition in case of administration of drugs that have a depressant effect on the nervous system.
To increase efficiency and relieve drowsiness (caffeine).
“AT RISK GROUP”, OR HOW DEPENDENCE OCCURTS
“Risk group” includes:
Students, schoolchildren using drugs or drugs to stimulate thought processes during periods of increased stress (sessions, exams).
People who are overweight and use psychostimulants to combat obesity (for example, a deoxin analog is prescribed in the US).
Athletes, hard physical workers to relieve fatigue, incl. chronic.
People of creative professions to increase efficiency, inspiration.
Bad company, incorrect delimitation of work and rest time, nocturnal lifestyle, increased mental and physical stress can cause the start of the use of stimulant drugs. Mental dependence occurs after 2-5 doses, depending on the type of drug, dose, conditions of use.

An increase in mental abilities, a “rush of energy”, a quick removal of overwork, elimination of drowsiness and pleasant sensations – all this leads to the next dose. In the future, physical dependence on psychoactive substances develops, since the brain itself is no longer able to release the required amount of neurotransmitters. If the addict does not receive stimulant substances, then a “withdrawal syndrome” or “withdrawal” occurs with severe pain in the heart, muscle pain, and mood swings.

EFFECTS FROM ADMINISTRATION: STAGES OF IMPACT OF PSYCHO-Stimulating Substances on the Body
After the use of stimulant drugs, mood improves, mental activity increases, drowsiness disappears. There is no fatigue – a person may not feel the need to eat, sleep for several days. At the same time, aggressiveness appears – the addict cannot soberly assess emerging situations, possible dangers. After the end of the action of stimulating drugs (up to 48 hours), severe fatigue and exhaustion set in – there is a feeling of complete devastation of the whole organism. The addict becomes irritable, anxious. Even if you are awake for 2-3 days on your own, a person will no longer be able to fall asleep.

An overdose of stimulants is indicated by the following signs:

Delusional states.
Visual and auditory hallucinations.
Pupil dilation.
A sharp increase in blood pressure, heart rate.
Sweating.
Tremor.
With withdrawal syndrome (withdrawal syndrome), dependent people experience the following conditions:

Insomnia, sleep disorders.
Increased fatigue with little mental and physical exertion.
Tremor, chills, inability to perform simple tasks requiring coordination.
Arrhythmias.
Substance use can be diagnosed by external signs, urinalysis, biochemical blood tests, as well as ultrasound and ECG.

Insomnia – the most common consequence of stimulants of
insomnia is the most common consequence of stimulants of

The consequences of dependence on stimulants: what threatens the use of
with prolonged use of drug psychostimulants and stimulants -narcotics: 9 arise:

Mental dependence on psychostimulant substances or drugs that have a corresponding effect on the central nervous system.
Physical dependence with severe withdrawal symptoms.
Insomnia – a person with an overdose cannot fall asleep for several days, despite extreme overwork.
Exacerbation of mental illness.
Stimulant psychosis.
Changes in physiological parameters – increased heart rate, increased blood pressure, tachycardia, heart failure.
Irritability, aggressiveness both towards others and towards oneself.
Catatonic syndrome.
Delusional ideas, amental syndrome.
Depressive conditions.
Substance or drug addicts can be identified by their characteristic appearance. Patients have a significant damage to the teeth by caries, reduced body weight. Outwardly, the addict looks older than his years, has a painful skin tone.

STAGES OF TREATMENT FOR PSYCHO-Stimulants
Treatment for dependence on stimulant-drugs is carried out in several stages:

Detoxification. Removal of stimulants from the body is performed in a hospital. For this, antagonist drugs are used that contribute to the accelerated withdrawal of psychostimulants. At the same time, detoxification maintenance therapy is prescribed. Phenozepam is prescribed to disturb sleep.
Maintenance therapy. After the withdrawal of drugs and the general recovery of the body with the help of vitamins and additional drugs, psychotherapy is carried out. Psychological classes in the narcological clinic are carried out on an outpatient basis. The main task of psychotherapy is the exclusion of relapses, the assistance of a psychotherapist in overcoming mental dependence on stimulants.
Further rehabilitation. Socialization of patients will take time and a visit to a psychotherapist. In the narcological clinic, the doctor will be able to help in finding one’s own destiny, returning to a normal life without psychostimulant drugs.
Typically, the minimum duration of treatment is 3 months. During this period, a comprehensive recovery from addiction is carried out. The doctor prescribes individual treatment depending on the type and timing of the use of psychostimulant substances, the degree of impairment of the patient’s physical and mental health.

If you have discovered that a relative or close person is addicted to psychostimulants, and you want to help in overcoming the disease, then you should not self-medicate. For example, to help with stimulant withdrawal and insomnia, sleep disturbances, it is unacceptable to give barbiturates as sleeping pills, as this can subsequently lead to the development of dependence on several substances at once.