If you talk to a psychiatrist, like I have, they will mention stimulants as a treatment for ADHD (Attention Deficit Hyperactivity Disorder). Commonly “Adderall” or “Ritalin” for example. While researching various other topics and bouncing ideas around with people online, I’ve run into a fair number of other novel, off-label, or less considered medications that can help with ADHD symptoms, while also addressing some comorbidity such as anxiety and depression.
Antiandrogens
1. Finasteride
Methods
Open‐field behaviors were evaluated by exploratory and motor behaviors. Dopamine and its metabolites were assayed by liquid chromatography‐mass spectrometry. Tyrosine hydroxylase mRNA and protein expressions were determined by real‐time qRT‐PCR and western blot, respectively.Results
It was found that in adolescent male rats, administration of finasteride at doses of 25 and 50 mg/kg for 14 days dose dependently inhibited open‐field behaviors, reduced contents of dopamine and its metabolites in frontal cortex, hippocampus, caudate putamen, nucleus accumbens, and down‐regulated tyrosine hydroxylase mRNA and protein expressions in substantia nigra and ventral tegmental area. However, there was no significant change of these parameters in early developmental rats after finasteride treatment.Conclusion
https://onlinelibrary.wiley.com/doi/full/10.1111/cns.12781
These results suggest that finasteride inhibits dopaminergic system and open‐field behaviors in adolescent male rats by inhibiting the conversion of testosterone to dihydrotestosterone, and imply finasteride as a potential therapeutic option for neuropsychiatric disorders associated with hyperactivities of dopaminergic system and androgen.
I have anther post about my first hand experience with Finasteride, and indeed I was able to apply it for my own ADHD treatment temporarily. To me the efficacy is as good as Adderall. https://transicarus.com/surprise-treating-adhd-using-finasteride-why-isnt-this-better-studied/
Antidepressants
The study referenced below indicates some efficacy with NRI, SNRI, DNRI, and TCA anti-depressants for the treatment of ADHD.
The range of positive responders was 0% to 75%. Desipramine, bupropion, venlafaxine and tomoxetine appeared to be equally effective and fluoxetine and sertraline produced no response.
https://www.ncbi.nlm.nih.gov/books/NBK67960/
2. Atomoxetine (NRI class)
Atomoxetine, sold under the brand name Strattera, among others, is a medication used to treat attention deficit hyperactivity disorder (ADHD).[7] It may be used alone or along with psychostimulants.[8][9] Use of atomoxetine is only recommended for those who are at least six years old.[7] It is taken by mouth.[7] It was approved for medical use in the United States in 2002.[7]
https://en.wikipedia.org/wiki/Atomoxetine
3. Other NRI class
A norepinephrine reuptake inhibitor (NRI, NERI) or noradrenaline reuptake inhibitor or adrenergic reuptake inhibitor (ARI), is a type of drug that acts as a reuptake inhibitor for the neurotransmitters norepinephrine (noradrenaline) and epinephrine (adrenaline) by blocking the action of the norepinephrine transporter (NET). This in turn leads to increased extracellular concentrations of norepinephrine and epinephrine and therefore can increase adrenergic neurotransmission.
NRIs are commonly used in the treatment of conditions like ADHD and narcolepsy due to their psychostimulant effects and in obesity due to their appetite suppressant effects. They are also frequently used as antidepressants for the treatment of major depressive disorder, anxiety and panic disorder.
https://en.wikipedia.org/wiki/Norepinephrine_reuptake_inhibitor
4. Venlafaxine (SNRI class)
Some open-label and three double-blind studies have suggested the efficacy of venlafaxine in the treatment of attention deficit-hyperactivity disorder (ADHD).[15]
https://en.wikipedia.org/wiki/Venlafaxine
5. Other SNRI class
Serotonin–norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant drugs that treat major depressive disorder (MDD), anxiety disorders, obsessive–compulsive disorder (OCD), social phobia, attention-deficit hyperactivity disorder (ADHD), chronic neuropathic pain, fibromyalgia syndrome (FMS), and menopausal symptoms.
https://en.wikipedia.org/wiki/Serotonin%E2%80%93norepinephrine_reuptake_inhibitor
6. Desipramine
It may also be useful to treat symptoms of attention-deficit hyperactivity disorder (ADHD).[7] Evidence of benefit is only in the short term, and with concerns of side effects its overall usefulness is not clear.[8]
https://en.wikipedia.org/wiki/Desipramine
7. Other TCA class
The TCAs are used primarily in the clinical treatment of mood disorders such as major depressive disorder (MDD), dysthymia, and treatment-resistant variants. They are also used in the treatment of a number of other medical disorders, including anxiety disorders such as generalized anxiety disorder (GAD), social phobia (SP) also known as social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), and panic disorder (PD), post-traumatic stress disorder (PTSD), body dysmorphic disorder (BDD), eating disorders like anorexia nervosa and bulimia nervosa, certain personality disorders such as borderline personality disorder (BPD), neurological disorders such as attention-deficit hyperactivity disorder (ADHD),[5] Parkinson’s disease[6] as well as chronic pain, neuralgia or neuropathic pain, and fibromyalgia, headache, or migraine, smoking cessation, tourette syndrome, trichotillomania, irritable bowel syndrome (IBS), interstitial cystitis (IC), nocturnal enuresis (NE),[7] narcolepsy, insomnia, pathological crying and/or laughing, chronic hiccups, ciguatera poisoning, and as an adjunct in schizophrenia.
https://en.wikipedia.org/wiki/Tricyclic_antidepressant#Attention-deficit_hyperactivity_disorder
8. Bupropion
It is also uncertain whether bupropion is safe or effective for treatment of ADHD in adults, as the available evidence comparing bupropion to placebo for treatment of ADHD is of low-quality.[40]
https://en.wikipedia.org/wiki/Bupropion
From first hand experience, I can say Buproprion was quite effective for my ADHD and depression; however, I had a bad (possibly allergic) reaction to it – namely extreme oral pain and sores, which went away when discontinued. I tried titrating Buproprion and tried many brands/release times without luck in solving the reaction problem.
Atypical Antipsychotics
9. The Dopamine Dilemma: Using Stimulants and Antipsychotics Concurrently
However, atypical antipsychotics have been shown to treat ADHD symptoms.22–25 Specifically, risperidone was shown to improve attention and hyperactivity,26 and aripiprazole has been shown to improve cognitive functioning.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898838/
Researching Antipsychotics for ADHD treatment; apparently it is not unusual – about half of kids are being treated with antipsychotics for ADHD. This seems to be a problem without a known cause in over-prescribing. From first hand experience trying antipsychotics as a novel treatment for atypical depression, it did raise my happiness index, but did not help with ADHD, and caused memory issues during use.
ADHD Comorbidity with Anxiety/Depression
As mentioned in my other post about ADHD being a dopamine disorder, there is a common overlap with ADHD and Anxiety/Depressive disorders.
It is interesting to note that the typical first line antidepressants (SSRI) show zero efficacy for treatment of ADHD; indicating it is not the same as depression or anxiety.
Some people interpret this as people with ADHD being unmotivated or undisciplined. Speaking from personal experience as someone without anxiety, but atypical depression and ADHD, I am extremely productive and use almost every hour of every day productively (and have for decades). I just struggle with mundane/uninteresting tasks, but am constantly busy doing things. I might spend hours designing a complex multi-dimensional vector algorithm to solve a novel problem, but struggle to do something like make a phone call. I just don’t want to do certain things even if they are simple or easy; because they are too simple or too easy.
My ADHD also prevents me from doing things like playing video games or watching movies or tv shows without also doing other things at the same time – they are just not interesting enough to deal with.
ADHD Addictive Behaviors
Interestingly, people with ADHD are generally more prone to addictive behaviors due to low dopamine function – trying to increase it.
Conversely, I have so little addictive personality that every addictive substance I’ve used in my life has not caused a repeating pattern or desire to use often. Basically the effects are so limited and unrewarding that it hasn’t been interesting enough to repeat on any regular basis; if repeated it does not seem to have the same effect and becomes uninteresting. This probably sounds like a benefit, but it’s quite boring that things have such minor and unremarkable impact.
I’m not sure how to interpret my personal first hand non-addictive experiences coupled with ADHD; other than to say, my dopamine system is really really broken, maybe more than even most ADHD brains. Please leave a comment if you have any insights into a possible explanation!