Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, well-researched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions. Subscribe if you're curious about how neuro atypical brains can optimize their functioning in our shared, and somewhat strange, world.
Dr. Kruse has posted talks in both the "live" and the "video" sections of this channel. Thumbnails on ADHD topics have a pink background, and those on more general mental health topics have a purple background. A small collection of ADHD-Trump videos have an orange background.
You're welcome to email him with topics you want discussed, people you think he should interview, or if you would prefer a weekly RU-vid Live option other than Tuesdays at 3:00 pm Hawaii Time.
Started a week ago, the first meds i tried for adhd. Im so tierd on it, dry mouth and lack of appetite. I fell more relaxed but its not helping on the adhd symptoms as procrastination etc. I get more sleep wich was needed.
Thoughts?? I've been taking Wellbutrin and buspar for 10 and 8yrs respectively... Also been on remeron for 10yrs. Recently i find my PTSD nervousness/anxiety/depression and all ADHD symptoms are all out of control. My executive dysfunction is having a dysfunction. But my Drs won't entertain changing them. I'm on Max dosage for both. Instead they just keep adding more medications like, benzos and MULTIPLE nerve medications. I'm down to a very unhealthy weight bc i have no appetite and so much nausea from all the medications. Bc of that I'm lethargic and fatigued all the time regardless of how much sleep i get. Any suggestions???
I'm currently taking Cymbalta for generalized anxiety, fibromyalgia pain and ADHD. While I've only been taking it for three weeks I can tell a marked improvement in all three. Thank you for this thorough breakdown of it's effects and treatment uses, very helpful.
It’s very simple so if you have ice cream and ADHD is vanilla ice cream borderline ice cream is like Ben & Jerry’s there you go that’s simple when you are in a BPD relationship you feel like it is the first time you’ve stepped into hell as regards to a relationship that’s romantic
I took it a couple times for temporary anxiety and it was effective but made my hands tingle which is one of the very bad effects and they told me to stop immediately
I took it years ago, I believe in the years you speak of in your generics video…I felt weird and stopped. Tried again and stopped. Maybe I’ll try it again.
Based on your clinical experience, for a patient not working well with Vyvanse and other stims and not well with Strattera, would you typically go for Cymbalta or Modafinil?
Out of curiosity. Has a patient of yours ever taken Bupropion+Vyvanse+Methylphenidate (at the same time), and if so, how well has he or she tolerated it? Thanks
None come to mind. I have some patients who alternate days of methylphenidate and amphetamine products, but not too many ever who took them simultaneously. But if the doses are low enough I would expect that combination to be tolerable for many people.
@@dr.johnkruse6708 I experimented a lot with that combination and came to the conclusion (of course everyone is different!), that 50mg of vyvanse and 37.5mg of bupropion has an extreme calming effect on me that doesn't feel anywhere close to being a stimulant (like methylphenidate does), but rather an anti-depressant (which btw never worked for me for some reason...). Increasing the dose of bupropion to 75mg or even 112.5mg increases the emotional side of your feelings and it is definitely possible to have some control over this effect (less bupropion more of the calmness effect, more bupropion increases the emotional aspect). Interestingly when I leave out the vyvanse or the dose is too low, bupropion just causes brain fog and extreme tiredness. I don't know why, but that's what it is. Unfortunately this combination doesn't fix my daytime fatigue and general tiredness, which methylphenidate would in doses >=60mg, but I don't tolerate this dose in this combination, because my HR is like >100bpm (and I also think that methylphenidate decreases the seizure threshold and you want to be able to vary the bupropion dose at least up to 150mg as explained above). 10+10mg early in the morning and late afternoon is fine and tolerable, but not the same as 60mg. Now I'm thinking if modafinil would fix that issue, because it appears as if modafinil is kind of less harsh on cardio and works more gentle than methylphenidate, but I haven't been able to convince my doc about it, because here modafinil is only registered for narcolepsy which I lack the official diagnosis for...
@@dr.johnkruse6708 I experimented a lot with that combination and came to the conclusion (of course everyone is different!), that 50mg of vyvanse and 37.5mg of bupropion has an extreme calming effect on me that doesn't feel anywhere close to being a stimulant (like methylphenidate does), but rather an anti-depressant (which btw never worked for me for some reason...). Increasing the dose of bupropion to 75mg or even 112.5mg increases the emotional side of your feelings and it is definitely possible to have some control over this effect (less bupropion more of the calmness effect, more bupropion increases the emotional aspect). Interestingly when I leave out the vyvanse or the dose is too low, bupropion just causes brain fog and extreme tiredness. I don't know why, but that's what it is. Unfortunately this combination doesn't fix my daytime fatigue and general tiredness, which methylphenidate would in doses >=60mg, but I don't tolerate this dose in this combination, because my HR is like >100bpm (and I also think that methylphenidate decreases the seizure threshold and you want to be able to vary the bupropion dose at least up to 150mg as explained above). 10+10mg early in the morning and late afternoon is fine and tolerable, but not the same as 60mg. Now I'm thinking if modafinil would fix that issue, because it appears as if modafinil is kind of less harsh on cardio and works more gentle than methylphenidate, but I haven't been able to convince my doc about it, because here modafinil is only registered for narcolepsy which I lack the official diagnosis for...
@@dr.johnkruse6708 I experimented a lot with that combination and came to the conclusion (of course everyone is different!), that 50mg of vyvanse and 37.5mg of bupropion has an extreme calming effect on me that doesn't feel anywhere close to being a stimulant (like methylphenidate does), but rather an anti-depressant (which btw never worked for me for some reason...). Increasing the dose of bupropion to 75mg or even 112.5mg increases the emotional side of your feelings and it is definitely possible to have some control over this effect (less bupropion more of the calmness effect, more bupropion increases the emotional aspect). Interestingly when I leave out the vyvanse or the dose is too low, bupropion just causes brain fog and extreme tiredness. I don't know why, but that's what it is. Unfortunately this combination doesn't fix my daytime fatigue and general tiredness, which methylphenidate would in doses >=60mg, but I don't tolerate this dose in this combination, because my HR is like >100bpm (and I also think that methylphenidate decreases the seizure threshold and you want to be able to vary the bupropion dose at least up to 150mg as explained above). 10+10mg early in the morning and late afternoon is fine and tolerable, but not the same as 60mg. Now I'm thinking if modafinil would fix that issue, because it appears as if modafinil is kind of less harsh on cardio and works more gentle than methylphenidate, but I haven't been able to convince my doc about it, because here modafinil is only registered for narcolepsy which I lack the official diagnosis for...
@@dr.johnkruse6708 I experimented a lot with that combination and came to the conclusion (of course everyone is different!), that 50mg of vyvanse and 37.5mg of bupropion has an extreme calming effect on me that doesn't feel anywhere close to being a stimulant (like methylphenidate does), but rather an anti-depressant (which btw never worked for me for some reason...). Increasing the dose of bupropion to 75mg or even 112.5mg increases the emotional side of your feelings and it is definitely possible to have some control over this effect (less bupropion more of the calmness effect, more bupropion increases the emotional aspect). Interestingly when I leave out the vyvanse or the dose is too low, bupropion just causes brain fog and extreme tiredness.
Thanks Dr John! I'm a big fan of your channel, and it is my go-to for seeking a broader view of the best way to address adhd that I have been struggling with since my teens. You rock.
I started to believe him, until I noticed the YT "blue banner" on the screen...this ALWAYS indicates pre-approved, protected lies. EVERY time. Doing more research...
Pre-approved simply means RU-vid checked that I am an actual board certified doctor. They don't scan the content. Your sweeping generalization is inaccurate, and probably not a very helpful guide for you in sorting out what is true in life. You can use your own eyes and ears to observe what I have described regarding pupil dilation, decrease body movements, and increased coherence of speech. If you can come up with a better explanation for these occurring together, great.
I have been researching bpd and npd to see if my girlfriend has bpd or npd only to realize that I now think I am the one with bpd. I am also diagnosed adhd and depression.
Female, 5 weeks pregnant, 29 years , ADHD, anxiety and depression Struggling with everything, no motivation mostly, powerless What is the best ttt for her ?
@@dr.johnkruse6708 In general for the first time, do you recommend stimulants or non-stimulants, I saw two doctors one prescribed stimulant and the other, prescribed non-stimulants, and I didn’t purchase any of them because I am so worried
8:56 I have ADHD which is impulsive dominant with no attention impairment, and I suffer from delayed ejaculation, I want to explain what could be the ADHD related causes. 1. Too much ejaculation and sex keep the physical sexual tension low in my body, so while I want the excitement, my body isn't recovered from last ejaculation. 2. When not on meds everything I do is more intense, not calm, my voice, my motorics, and also my grip, which can cause the "death grip syndrome" look it up. 3. For erection I need to be on my sympathetic state, which is natural to me, no problem, I'm excited.. for ejaculation on the other hand, I need to calm, relax, be focused in the sensation and let go, and I got so much in my head during sex, so many unimportant details, so many overthinking about my partenr, the sex, what happend before it, that sometimes after working for hours I just give up without cumming, if the other partner cum before me I feel like I saved, salvation. Tell me what you think doc
It sounds reasonable. Lots of physical and psychological factors contribute to sexual performance, and as you point out, there is a delicate balance between sympathetic nervous system effects for erections and parasympathetic for orgasm/ejaculation.
The worse side effects from drugs like this are not from acute or short-term effects. They are the effects after years or protracted withdrawal which is a type of cns dysfunction caused by long term use or caused with discontinuation of it. I hope it helps people but I've learned that studies showing low side effects doesn’t mean it won't ruin people's lives.
Hey doctor. This medicine worked pretty well for me as I couldn't tolerate the side effects of stimulants. Oddly enough other SNRIs would make me hypomanic or extremely anxious but this Qelbree seems to be a lighter boost that helps me to focus.
Before my diagnosis I've experienced a period of my life when through a strategy I was finally able to be *autonomously* productive and during that time period I was experiencing very high levels of happiness and even euphoria. These feelings are definitely something that is missing during my days on medications and my hypothesis has always been about a lack of Serotonin inhibited by the medication itself. I really wish I'll be able to experience that type of pride and happiness for my accomplishments, including the relatively smaller ones because now after 40 years undiagnosed even the small successes can be absolutely huge for me and I really want to experience that reward in Serotonin
Your gauge measuring Pre-reward gets increased so you can then EVEN get off your butt to do something in the first place (Procrastination).....and then the accomplishment reward feels less than normal ...but otherwise could most ADHD'ers do anything without meds in the first place ? what does the word "autonomously" mean ?
Unethical to diagnose someone you ever examined. You snort. He’s a teetotaler. You never watched his videos of his children telling them “no alcohol, drugs or cigarettes.” You get no referrals, except to the medical board. Click bait.
What is unethical about commenting a diagnosis that is written entirely based on observable behaviors, when I have made clear I am using the video evidence in the public domain. There is far more information, in more settings, over a greater time span, corroborated by more individuals than you could ever obtain for almost any individual with an in person evaluation. The objective evidence is there that he uses stimulants.
My wife made accusations against me in 2020 that involved SA on my daughters. I was cleared of wrongdoing and it led to our divorce. I found out that she had been taking and abusing adderall for years but since it was prescribed the court wouldn't do anything. 3 and a half years later the accusations have persisted and expanded to neighbors, imaginary people etc. She constantly has accused me of planting cameras in her car and home, hacking her devices and stalking her. She has accused me of persuading other people to stalk her as well. About a month and a half ago, she accused me of abusing my daughters again. Ive found out that she has had the police at her home nearly 20 times in a year and a half. The police investigated her claims and suspect she was coaching my girls (they are 6 and 8 now). CPS found the same thing. We now have an ad litem who is investigating as well. Im fighting for custody of my girls now and it seems likely i will get it. It's been a nightmare and absolutely destroyed my family. My daughters tell me that mommy says people are watching them through AC vents and planted cameras. Is it possible she could get better?
In my experience, completely stopping Adderall is essential, and many people do have their psychosis resolve with antipsychotic medications. Best wishes, it sounds like you have had many horrible years.
@@dr.johnkruse6708 yes, sometimes that works, and sometimes subtitles keep me on track. you have one hell of a monotone though. oh oops, impulse control - no filter!
I'm not a mind reader regarding other doctor's prescribing practices, but I have seen some doctors always go with non-stimulants first. Some are very worried about potential adverse effects from stimulants. Some do it intentionally as a test - that someone can't be "trusted" with stimulants unless they have made a good faith and prolonged effort with other approaches.
The question of dosage is highly relevant to this research, and it's hard to know what is a meaningful range to study, and for what duration. Nobody smokes a whole pack of cigarettes at the same time.
This should be updated and socialized wide. I am a nurse and have topically seen trumps pupils and actions and would have argued same. Please consider this forward nationally in some way
I would love for this information to be more widely shared, but numerous mainstream media organizations in the past didn't want to hear it, and organized psychiatry and mental health groups didn't want to get involved in anything immersed in politics. I was just interviewed today by political commentator David Pakman, for his vlog, prior to the first 2024 Biden-Trump debate.
@@dr.johnkruse6708 try Meidas touch. They are three brothers. One a lawyer. Tuned in. Down to earth, honest and open. Bring lots of content in a natural way. Ben Meiselas older brother. About 2 mil listeners. Branches out with other lawyers, Southern district Ny. , Miami, Washington. Interesting groups. They would die for your updated content. They have a well recognized reach and ramping up.
Doctor, what do you think about the combination of amantadine and atomoxetine? I have been searching online for a long time but have not found any research on the combination of these two drugs. I am currently taking atomoxetine, which is very effective for my concentration, but I still have no motivation to do anything. I am considering adding amantadine to increase my dopamine. There are almost no mainstream ADHD treatment drugs in my country, and stimulants are also strictly prohibited, so I am considering amantadine. And it's very cheap
To me it sounds like a reasonable option to pursue, but without knowing your precise individual history, I can't make specific medical recommendations.
If I took St. John’s wort for 2 days (500mg per day) and want to stop after day 2 and start 12.5mg of Zoloft tomorrow (day 3). Is there a risk of serotonin syndrome with such short time frames and low dosage?
Anything is possible, but St. John's wort should leave the body fairly quickly, and for most people this would be a quite low dose of sertraline (Zoloft). To be super sure, some people would wait a few days in between, especially since it is likely to take a few weeks to see benefits for mood or anxiety from sertraline, so a few days delay is unlikely to have a major detrimental effect.
I “suck” glutathione that has been suspended in liposomes. 2ml is enough, it improves REM sleep. This is life changing if you are awake in the second half of the night and longing for sleep. There is more than one brand but don’t choose the cheapest.
Yes, the official psychiatry organization also claims that you can't make an accurate diagnosis without an in person evaluation, but that is an assertion unsupported by facts. Video evaluations of certain mental health conditions have been shown to be as reliable and accurate as in person evaluations. With Mr. Trump we have far more information, in far more situations, corroborated by far more witnesses, than one could obtain from hours and hours of in person evaluation. And for ADHD, every defining symptom is an observable behavior - we don't need to know what the individual feels, thinks, or is motivated by. So nope, this isn't speculation. If you accept our diagnostic criteria, he meets the full definition of ADHD.
I was addicted to adderal for almost 7 years. When i couldn't get it, i would use street meth but it wasn't the same for me. Adderall made me want to get things done but meth just made me feel like it's a party, made me want to talk to people and have a good time.
