I’ve been asked to explore alternatives to medications such as Concerta and Ritalin. Below I will share some basics that can help both adults and children with ADHD.
Much contemporary literature suggests that ADHD is characterized by insufficient circulating dopamine in the brain and pharmaceuticals like Methylphenidate (Ritalin, Concerta) which is essentially a dopamine reuptake inhibitor will very specifically address this issue and in some cases provide some remarkable and even life changing effects in terms of motivation, focus and the ability to get tasks done that seemed impossible before. There is no doubt, these medications are effective but as with many engineered and synthesized chemicals there are side effects. So there is almost always a trade-off.
Is there an alternative?
The short answer is yes, but it is multifaceted and probably slightly and sometimes significantly different for each person but there is much overlap in terms of what will definitely be of benefit as a foundation from which to build on, which I will begin with here.
The fundamentals should always be addressed first:
- Diet – sugar is an isolated compound which is proven to be destructive to the body in various ways and more essentially here, the brain. Preferably, refined & processed foods of any kind ought to be kept out of the diet or to a minimum. These all lead to some kinds of long term health issues and the body being a symbiotic system, this ultimately affects cognitive function negatively. A simple rule of thumb is, if it’s man made, try to avoid it. Also, doing an elimination diet to identify food sensitivities or allergies can be enormously beneficial, in that, being exposed to foods that you have some kind of an immune response to can lead to consistent low level inflammation which has very definite effects on cognition and wellbeing. Eating correctly is a wide and nuanced field and often unique to each individual, so research or even a couple of sessions with a dietician is encouraged to determine what is best. Read more about the benefits of eating correctly: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5437154/
- Exercise – The body was built to move. Fullstop. A lack of exercise can lead to depression and will likely lead to general bad health. One need not run marathons or do the iron man but regular walking, hiking or just casual swimming will be of benefit. Of course, purposeful exercise will get the very best results, improved sense of well-being, more energy, more confidence, more good.. Exercise triggers the release and production of happy hormones in the brain amongst a great deal of other benefits. Need ideas for exercise? Google & YouTube have a treasure trove of resources to that end. Read more about the benefits of exercise: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5934999/
- Routine – yes, I said the word that is reviled by some but it is essential. If one doesn’t implement and practice good habits, then one automatically takes on whatever offers the lowest resistance and in most cases this is not beneficial and doesn’t lead to prefered outcomes. Very simply, examine various aspects of the day to determine what has worked best and where relevant, repeat it. In an uncertain world, routine creates some certainty and can significantly reduce anxiety and stress. Of course there’s a lot to explore here and too much routine can also be toxic but practiced in problem areas it can create much needed balance. Personal coaching can be very useful in this area. Read more about the benefits of routine here: https://www.headspace.com/blog/2016/08/22/the-secret-benefit-of-routines-it-wont-surprise-you/
- Sleep – This is perhaps among the most overlooked aspects of life that is required for overall good health. Try to get 7-8 hours of quality sleep every night. The only way to consistently get this is to go to sleep at around the same time every night to condition your body into a good pattern. If you struggle to sleep there are various ways to get relaxed. Slow deep breathing is an effective way to get relaxed enough to fall asleep. I breathe in slowly to the count of 4 and breathe out slowly to the count of 4 and repeat until I fall asleep, works every time. Lack of sufficient quality sleep can bring about serious symptoms and health issues. Consider this excerpt from Harvard Health Publishing: “Various sleep problems affect 25% to 50% of children with ADHD. Typical problems include difficulty falling asleep, shorter sleep duration, and restless slumber. The symptoms of ADHD and sleeping difficulties overlap so much it may be difficult to tease them apart.” read more here..
- Plan – Distractions can railroad one’s best intentions to get something done and particularly for people with ADHD who are already inclined to get easily distracted, the best strategy is to clear away any possibility of distraction. When you have some important work to do, firstly and most importantly get very clear on what it is you’re going to spend time on. Then set aside a 50 minute block during which no one can bother you, let everyone know you will be busy, switch off your phone and remove distractions and get to work. Take a 5 minute break to stretch and drink a glass of water and repeat as and when needed. Concentration is just like a muscle, the more purposeful you are in doing it as a matter of routine and in an intentional and structured way, the better you will get at it. If you even do this just once a day your ability to focus and concentrate will improve dramatically in just a week or two. Everything in life takes practice for one to improve at it, everything.
Gaining some level of control in the above areas is foundational to achieving increased physical and emotional well being while directly and indirectly improving cognitive function.
Now on to possible alternatives to the pharmaceuticals. Please note, I am not a medical professional and I am not suggesting you consume anything mentioned here. These are just my views based on my own experiences, what others have shared with me about their experiences and research on various platforms I believe to be credible.
In my own experience, one major barrier to focus and concentration has been anxiety, intense levels of it. This is a hallmark of ADHD. Addressing just this one issue already provided significant benefits to my ability to be more focused and think more clearly and coherently but on it’s own wasn’t enough for me to achieve the levels of motivation and energy I need to get stuff done.
What has worked incredibly well for me is now a combination of over the counter supplements and amino acids which I tried in isolation before combining them into “stacks”. Much of what I use has anecdotally and in studies been shown to be effective for many people.
- L-Theanine – I take one to two +-170mg doses per day 5-6 hours apart on the days I feel I need it. Theanine has the effect of creating calm focus by increasing brain dopamine, serotonin and GABA levels and may on its own be enough for some people with ADHD to achieve the required levels of focus. Read more at: https://examine.com/supplements/theanine/
- L-Phenylalanine – I take 1000mg of this on an empty stomach first thing in the morning every other day. This metabolizes into various things in the body but for me the main benefit is that it provides the raw materials for the body to produce dopamine and norepinephrine both of which are often deficient in people with depression and are among the hormones that ADHD brains don’t regulate very well. A dose of this stabilizes my sense of wellbeing and increases my energy levels. I have found that combined with exercise the effects are particularly notable. Read more: https://selfhacked.com/blog/phenylalanine-9-health-benefits-phenylalanine/
- Bacopa Monnieri – I take 500mg to 750mg of this once a day in the morning with breakfast or MCT oil which I’ve found to boost its effects. It’s worth reading up on this one as it has a wide range of potential benefits along with being neuroprotective. The effects for me have been significant, improving memory, mental clarity and learning and a definite reduction in stress and a deep sense of well being. On it’s own this can also work sufficiently for some ADHD people but you have to stick with it as it takes time to work, up to 4 weeks before you experience any benefits. I found the benefits to be dramatic once the effects became apparent. Read more: https://examine.com/supplements/bacopa-monnieri/
- Neuro Day – I take 1 capsule a day 2 – 3 times a week and skip weekends. This is an excellent premade nootropic stack that is designed to provide energy, focus, wellbeing and reduced stress and really works well for me as an alternative to Concerta which I have slowly phased out with my doctors guidance. This one is quite new for me and it isn’t cheap but so far it’s quite promising and I’m finding I can really get stuff done with it in a clear and focused way. On it’s own this may also be enough for some. Unfortunately this type of stack isn’t available everywhere but it can be obtained online in South Africa at https://www.neuroactive.co.za. They cite research articles for each of their products. Read more about nootropics by visiting the links provided at the end of this article.
- Sceletium – This is one I tried but for some reason didn’t work for me, I have however heard from a few others who swear by it. Also one worth reading up on and trying for a month or two as it also purportedly takes several weeks to take effect. Read more: https://examine.com/supplements/sceletium-tortuosum/
Every person is different and what works for one doesn’t always work for another so this is an area of self hacking that can take time and patience to succeed at but the reward is immeasurable once you get it right. One thing I’ve always been careful of, is mixing pharmaceuticals with natural substances that can be quite powerful in isolation and can bring about severe side effects. I do my own exhaustive research around this topic but not everyone has the time or inclination to do this and for those it’s best to consult with experts or medical professionals where applicable.
Doctors are often not aware of or sometimes not knowledgeable about non-pharmaceutical alternatives and can be wary of supplements but it is worth noting that all of the above have at least some if not fairly significant research behind them to show the potential effects. A great deal of people have derived real benefits going this route and thus avoiding the sometimes serious side effects of conventionally mandated chemicals.
I buy all the above supplements (aside from sceletium) from a local South African nootropics specialist: Neuroactive, as the quality and the prices are great. One can also buy most of these from pharmacies or health shops but the racetams (like noopept, phenylpiracetam and other racetams) can usually only be obtained from specialist nootropic suppliers. These suppliers can be quite knowledgeable in this area and can also provide good guidance on the best way forward.
Some sources of information: