Raise your hand if you’re watching this at 1.5x speed or higher.

By far the best explanation of these medications I could find anywhere. This was brilliant.

This is gold, we need more channels like this 🙌

Another awesome video. Thank you for this clarification.

This is amazing! Thanks for putting out this information on your channel.

For a very long time I was looking for such a comparison video

Wow! This is an incredibly detailed yet simple video that thoroughly explains the difference between both! Amazing work!

Thank you so much doctor for making this video! I was looking forward to it

Methylphenidate feels like a far more potent stimulant to me and helps me with my ADHD more than dexamphetamine. Despite being a short acting agent, correct dosage timing can result in methylphenidate being a more flexible and less intrusive (sleep, appetite) medication. But I acknowledge everyone is different.

Great info. Knowledge pouring out in an understandable way!

I’ve tried all the medications discussed, and have researched them a lot over the past few years, but this video was absolutely the most informative thing I’ve seen. Thank you so much! If you have time, I would love to see a video about Fluvoxamine (Luvox) (SSRI) in the treatment of OCD. Thank you so much ☺️

Thank you for the explanation!

You're a gifted communicator and educator. I'll be sharing your channel to others like me.

Thanks Doc! Perfectly said

Great explanation of the inverse agonism of DAT by dexamphetamine!

Dr. Rege, thank you for fulfilling my request for an MPH vs. AMP comparison!

Most informative video, saved me so much time doing tedious research! Thank you!! Please create more content!!

Thank you! This was extremely helpful! Appreciate it! Great evidence based channel 🏆

Very informative. I am about to add dexamphetamine to my antidepressant meds. It’s good to understand how this drug works. Thank you.

So concise. Thank you.

Thank you for the explanation.

Beautifully explained, concise and clear video. Thank you

Many thanks Dr Rege for such a concise but very informative approach towards explaining psychiatry. I find your videos really helpful while preparing for my exams. 👌 Keep up the good work.

This was so helpful! thank you!

LOVE this! I was diagnosed with Multiple Sclerosis in 2018, then recently an ADD/ADHD combined presentation. Still learning about ADHD and figuring out what symptoms are caused by which condition, so that I can treat them in the best way. Have been on Ritalin for a couple of weeks, not sure how affective it is, but will keep trying. This video was really helpful, thank you!

If you only knew, how grateful I am for your Video. English isn't even my native language but I still understood you very well. You have explained the effect of those two medications in an easy way but at the same time you mentioned every important aspect. I truly appreciate this well-made Video and I wish you all the best.

Ah thank you for clear and simple explanation

Great explanation, thank you

Efficient, clear presentation. Thank you

Thank u very much. My Vyvanse is a life changer. Grateful to psychiatry everyday now.

Excellent channel. Such clear explanations. Concerta XL worked to a point but Elvanse seems to suit me better. Elvanse really helps with procrastination and concentration. Videos like this should be recommended by ADHD clinics following diagnosis. Just got yourself a sub and thank you, Doctor Rege. 🙏

thank you, doctor! Very informative. Much appreciated! I have always wondered if maybe I should switch to Adderal, but I am having success with Ritalin/Concerta so I will stick to that! Note I have some Concerta I never took as I preferred a shorter acting medicaiton and also due to cost, but now that there is a nation wide Ritalin shortage, I am thankfully using the Concerta and very pleased with the results as well.

Thank you for this explanation. I have recently been diagnosed with ADHD and prescribed Concerta. My doctor explained it briefly but I have been trying to find out more about ADHD and the different treatments. This was very thorough and hit all of the points I was wondering about.

Well explained. My nephew was prescribed MPH today. I want to make sure I explained the mode of action to his mom in the most accurate, clearest way possible, and this really helped. Thank you Sir

Thank you! I have been prescribed d-amphetamine and I wanted to know what I'm dealing with. You explained the subject very clearly and I understood everything despite not having a medical background.

Beautiful explanation and differentiation between these drugs. Especially the detail about lysine cleaved in stomach for vyvanse. I have taken adderall for some time but due to drug shortage, my doctor and I decided to try vyvanse and it was NOT a good fit. Ill just say the effects were severe and extremely unpleasant. The effects of vyvanse were actually substantially worse than just quitting adderall cold turkey. I was wondering about the difference in mechanism and any reasons it would affect me so differently.

I KNEW I WASNT CRAZY!!!! Just a difference in meds that really hit me hard

Glad I found you! It’s harder than I think it should be to find information on the mechanistic actions of psychoactive drugs, and it is a useful piece of the puzzle. Pending an assessment, I am trying to understand this, because while I think I have had poor dopamine leveks all my life, I suspect my noradreline may be another story (I’m presently on Clonidine, and will check out your video on that). Assuming a positive dx, I was inclined to look at methylphenidate first, but I’ve started getting the impression that amphetamines might target dopamine a bit more than methylphenidate, and it sounds like that may be the case.

Thank you for helping me understand the medications critical to my life. This has helped me understand more than any provider has been willing to explain to me.

Great video I've got ADHD and I'm on vyvanse great tablet

Great info!

Very helpful and informative

Very good simple explanation Dr

I started medicating with Concerta and it screwed me up in all sorts of ways with no benefits so tomorrow I am starting Elvanse and hope that works better. Luckily I work at a neurophychiatric clinic so I get help instantly if needed and our patients seem to love that I can relate to them in their struggles and some like the fact that they can see that it is possible to have a career even if you do’nt have a neurotypical brain ❤ I adore most of our patients and it is so lovely to see them feel better and improve their quality of life. Might share this video with them as it is very informative yet simple ❤️🙏🏼

thank you for explaining

Something anyone new to this needs to know. Adderall is a mix of 4 compounds. Mainly 2 Isomers. Those isomers bind to different receptors sites. If you are prescribed a generic, the ratio of those compounds will be different than brand name Adderall. The issue you may run into as I did, is after a period of time adjusting to, and fine tuning dosage on the medication, your pharmacy can simply change manufacturers of the generic. Generic does not mean "same". It's pretty much a 100% forgone conclusion that the new generic will NOT have the same ratio of isomers. This is bad..Insurance companies will steer you towards generics. And it's totally true they cost less. But your brand name medications composition won't change at the whims of the pharmacy's finance department. In my case I went from a good working dose and frequency medication, to having no fingernails after a month on the new generic. Racing heart. Anxiety. All from getting a drug people would assume was the same, just from a different manufacturer. Now I'm on a non generic.

great explanation. thank you

Gonna switch tomorrow from methyl to dex, thanks for the clear explenation!

very helpful thanks so much

I have found that individuals who suffer with serious depression benefit from the extra dopamine release you get from Adderall…with the downside being that the drug burns out your dopamine receptors and you become seriously dependent on it like you would any amphetamine. Amphetamine withdrawals are no fun at all. Some people really wanna get high though.

Excellent video with truthful content. Love you sir

Excellent explanation 🤌🏿🤌🏿

Brilliantly explained. However regarding my experience with a lisdexamphetamine, Elvanse (UK version), and comparing it to my new dex (initially prescribed as a booster), it works so much better for me in that apart from it being an instant release form, it also lasted way longer and I didn’t get the crash at all that i got on Elvanse, almost like a complete opposite of what both were designed for - And this was done by taking it in it’s own at first, not as a booster, so i could guage the drug by itself and its effects. I now use that on it’s own. One question I have is, are shorter acting meds more harmful for the body than a ‘lisdex’ due to the latter being released slower? I have a overthinking worry and concern that I’m damaging my health somehow? - (taken as prescribed and not in the context of abuse etc)

Very well explained! I have an ADHD question that I will try to keep as short as possible. My daughter (19 y.o) was diagnosed with depression and anxiety 5 years ago. It has been a very long journey. She has treatment-resistant depression and nothing has really helped her - she's tried it all, including Spravato and TMS. She had genetic testing done which shows that she is not a good candidate for SSRI's as well as most other gold standard treatments. She was always an excellent student, until a few years ago. She was not tested for ADHD during high school, but now that she is struggling (badly) in college, her psychiatrist just ordered an ADHD test. I should note that my son (her older brother) was diagnosed with ADHD (inattentive) when he was 8 years old. He took Focalin and it did nothing for him. My daughter mentioned a few times through the years that she thinks she also has ADHD (inattentive), but that surprised me as she had always been a high achieving student. Anyway, we're thinking that her test will show that she does have the disorder. Included in the genetic test was an analysis of how she might respond to ADHD meds. Literally every single one says either "lower odds of response" or "moderately lower odds of response." Adderall and Vyvanse were in the "moderately lower odds of response" category. This is because she is COMT met/met. So, my question(s) after all of this is, do you genetically test your patients and if so, have any with COMT met/met had any response to Adderal, Vyvanse or any of the other amphetamine based meds? My daughter's options are so limited with everything and it's really frustrating. Thank you in advance.

Hello, I was diagnosed adhd by a Qeeg brain scan at 19 (this was in 2006 and I was never treated, I was prescribed time released Adderall took it literally one day but the dose was too high or looking back i couldn't click my executive function to activate lol. I don't even like Tylenol so I think mentally the idea of a medicine that made me feel ANYTHING was against my nature. Fast-forward, I'm now 35 with four kids ranging 3-10.. the older 3 are diagnosed combined type and suspected but not did dyslexic (specific learning disabilities in reading and writing but school won't call it dyslexic) the baby is undiagnosed but has received early intervention therapy daily since before 2 for sensory stuff, lots of stimming, probably autistic, definitely adhd but his speech and ot therapist use the word hyperlexic, he's an absolute genius - talks about parallelogram quadrilaterals trapezoidal semicircle, knows all the planets, counts by tens to 100 while my older 2 repeated kindergarten (pre diagnosis pre IEP pre mama bear knowing repeating HARMED not helped them so the boys will never repeat and both had ieps as disabled preschoolers. All 3 older have normal iq. I have extreme guilt for waiting this long and basically telling my kids "try harder and you will see that chalk board... try squinting, try moving closer, try taking longer to figure it out. I'm an obsessive researcher and I know the right thing to do is medicate the older 3 who struggle so bad. My 6 year old, number 3 lol, has the hardest time and a complete aversion to learning or trying or anything letters or speech related. My heart breaks. So I decided before medicating them I will try to treat my adhd for the first-time since 19 the one day I tried it lol. The doctor prescribed me 5mg Ritalin once a day. Two weeks went to twice a day. Two weeks later went to 10mg twice a day which I have yet to pick up from the pharmacy so I'll see if its better. Do you have a recommended medication for adults.. my biggest obstacle is the executive function / motivation to begin like where to start and completing tasks without starting 1485843182 more, and working memory is SHOT. Forget forgetting why you walk in a room, I can't remember what I was going to Google, who I was going to email etc when it can be something very important! Also do you have a recommended medication for kids who have adhd but also specific learning disabilities so like maybe more focus or problem solving ? Please help bc both my adhd and the kids neuro will listen to me and try what I ask for but I'm overwhelmed with options and stuck in analysis paralysis so my indecisiveness debilitates me and my days turn into weeks months and literally years and things that are ON THE TOP of my to-do list are still there years later. Ugh. But I have to get it under control for my kids so I can help them manage theirs. Please send me your recommendations and advice 🙏 thank you. Edit to add - my kids father is also adhd, diagnosed as a kid and overmedicated in the early 90s so he is also untreated majority of his life and explains the genetic end of it with our kids lol. Isn't it interesting how 3 struggle so so so so sooo hard learning but are socially strong while the baby is smarter than all of us combined but doesn't have input receptors to questions so he's very one sided and output output output like questions don't register right away or at all sometimes so socially I worry but academically he knows like high-school geometry lol and the other kids are social butterflies so funny and fun, make friends everywhere they go but all struggle s hard.

Thank you !

Vous êtes excellent 👍👌

Very informative! I wanna switch to a extended release. It feels more natural. Taking tentin every few hours is more ''spikey'. Not what I'm looking for.

I'm taking Adderall, Buspirone and Sertraline. They switched out the Fluoxetine for the Sertraline. ADHD depression and Anxiety supposedly but I'm super tired all the time. The Adderall works pretty good for a few hours but it makes my hair fall out too much so I stopped taking it. I took myself off Sertraline & Buspirone and just took the Adderall and it seems to make me happier to the point where it seems like the other meds aren't or weren't helping. I just need something to focus and not make my hair fall out.

I used to do loads of speed back in my day it was the only time in my life i ever read a book from couver to couver in one night jhon liveington seagel it was good book

This is a bit personal for me, but I see you you responding to comments. I currently take Ritalin SA, and my IR x2 a day. Along with Effexor and Rexulti (Abilify with less side effects.) Sometimes my anxiety is so intense that my brain will shut down, and I’ll disassociate and even I surprise myself that I’m still functioning in public while internally petrified of my surroundings (normally people.) The MPH has helped me a lot (switched from Adderall) but I’m completely lost at what I can do for my anxiety. We’ve augmented my medication heavily, and still nothing works. It’s mostly social anxiety. My question is, are there any anxiety medications that you’ve seen in your practice that maybe I could talk to my doctor about that’s out side of SSRIs/SNRIS that work well with my ADHD medication?

You mentioned Dexamphetamine is a competitive inhibitor of VMAT (which MPH isn't). This gave an explanation as to why on DEX (but not on MPH) I can't feel the "runner's high" after the gym. I'm guessing some dopamine in the synaptic vesicles might be beneficial to still feel some accomplishment after its release when completing certain tasks. Sorry to bother but I do have a question and you seem very knowledgeable about the intricate processes neurotransmitters are involved in judging by the great replies you give to comments; I always had a cold hands issue (no Reynaud's, just always cold to the touch). MPH fixed it for as long as it was working and the mental effects also seemed more "tailored" to my problem than those of DEX, which improves some things but not focus, executive function or, oddly, the cold hands. I'm guessing norepinephrine is playing a role there but I thought a higher release should make the issue worse. Do you know what process behind the MPH and cold hands could be? (I'm not seeking medical advice, just asking out of curiosity about the neurotransmitters and processes related to them)

THANKS

Great video. Personally I much prefer the short-acting medications as it gives me much, much finer control over my day and I can time precisely when the medications will wear off. I can also opt to use them in such a way that I only get a half-day effect when that's all I need. I try to use the medication as little as possible.

Why do I get tired/slow from dexamphetamine? Thank you for the clear explanation! :D

Thanks!

One question Triple or quadruple whammy, amphetamine- I count quadruple effect vs methylphenidate .NAT, DAT, competitive VMAT & Reverse DAT?

Dr. I recently got diagnosed with ADHD which I truly believe I have however I also have suffered from severe depression and anxiety most of my life. I have never "enjoyed" the feeling several SSRI's have provided for me and even the NDRI Wellbutrin wasn't good for me as it caused agitation. I knew from past experiences that Adderall was basically the cure to everything for me especially because of the euphoric effects. I have been prescribed Adderall and it was amazing just like I thought it would be but after a week of Adderall it seems that it is having a opposite effect and not only do I not have a euphoric feeling but I am considerably more depressed but the medication is holding its abilities to treat my ADHD by stimulation. I'm curious if maybe my dopamine is being depleted somehow. I'm not abusing my medication. I'm wondering if another ADHD medication would be better. I've even considered ketamine therapy for depression but it would be way too expensive. I have no intention of abusing any medication but I just feel strongly that dopamine increasing medications might be what I need in life to help, not only with ADHD symptoms but also severe depression and anxiety

Thank you. Can you please make a video regarding all three possible ways of treating adhd? Atomoxetin, mph and Amphetamine group of meds. Please, it would be great, if you can make video about comparison between amph and methamph, because I read and hear a lot” you are using medical meth, nothing else”

Great video! Thank you. You helped me to decide.

Dr. what do you think, first great Video btw!, taking ndri like bupropion or DNRI like Concerta with amphetamines first: if fe focuse on concerta as noncompetitive reuptake inhibitor and taking amphs as competitive which release additional dopamine into synaptic cleft, from that video shouldn't they work in synergy?

Hi Dr.Sanil I have Hashimotos that causes Subclinical Hypothyroidism I take Tirosint (pure levothyroxine not much added fillers) every 4 days instead of daily for maintaince of my TSH levels. Highest I've gone was a 10 TSH without levothyroxine. Is there a different approach for treating ADHD in my case ? Or are stimulants generally safe for those with Hypothyroidism? Thank you 🙏

the way I’ve always understood it. MPH makes dopamine last longer and feel more potent. While Dex more so releases extra dopamine

So would you say like SSRIs these may need some time to accomplish these effects? I know you feel improved focus and what not during your first ingestion but to inhibit these receptors

A bit of a taboo subject for many, but would you be interested in comparing & contrasting Desoxyn's active drug to dextroamphetamine & levoamphetamine? Specifically how all three differ in terms of how much they affect the norepinephrine transporter, and how Desoxyn has a greater serotonergic effect. I feel many prescribers reach for Adderall over Dexedrine simply due to its existing ubiquity despite the potentially mitigated physical & anxiety-inducing side effects of pure d-amp, and especially do not consider Desoxyn, a drug with potentially less side effects & better mood improvements that is avoided due to both stigma and neurotoxicity concerns of the serotonergic effects despite a therapeutic dose being much lower than a recreational one (as well as a blanket ban of the medication in many countries).

I take 72mg of Methylphenidate (Ritalin Long Acting) daily and it was interesting to learn about how it works to help me focus. Unfortunately I'm on quite a high dosage as my ADHD is awful but hey is what it is. But yeah thank you for the video! It's really nice we live in an era where we can learn alot about how people's disorders are treated and break it down scientifically 👍

I’ve had a love/hate relationship with Adderall the past few years. The insomnia and body crash was not worth the few hours of focus that it gave me 😅 I recently switched to Ritalin and have responded very well to it! I can actually sleep now :) I was curious how the two medications differed & this video answered all questions. Thank you!

Anoter great video, please do one specifically for PSSD (post ssri sexual dysfunction)

Could it be...Australia-based information for ADHD, so hard to find!

I used to want to smoke and get high all the time because of the dopamine release it made me feel like normal people, It felt awesome. But I quit weed recently and used methylphenidate recently it’s helping so far but I wish it would last longer

great video!

The difference in my case, is that one works and one doesn't LOL I switched from Adderall to dextroamphetamine sulfate and it is like a whole new drug. All of the jitters and nasty side effects of the Adderall are completely gone. I also found Vyvanse very ineffective the disadvantage of dextroamphetamine however is that it seems to be much more difficult to find than the other more common drugs.

Great Video. You made it easy to follow. How does dexmethylphenidate compare between the two compounds you mentioned? Is it kind of like a middle ground?

Dr. I take vyvanse. It helps with more attention type deficit but has helped tremendously with my depression and anxiety more than anything. I would welcome a comment from you about this.

I started methylphenidate today. Misdiagnosed with anxiety and depression, and had years of a quite severe anorexia nervosa. Doing much better with that these days but its seems like ADHD has been the underlying issue my whole life. I am hopeful addressing it is going to help me. So far, going okay.

Is there any feasible way to measure current DA and NA activity in relevant areas? if so, wouldn't that be a superior method of finding correct dosage for each person?

Hello. I’ve been on methylphenidate for a month now - used it 5-years back as a youngster and it worked like a charm, or so i remember. However now that i got it again, my heart is pounding, my jaw keeps clenching and i’ve been experiencing severe arrhytmia from it. What’s your opinion, do you think dexamphetamine would suit me better? Methylphenidate works for 4-6 hours after taking it but after the effect is gone, life becomes even harder. Barely lasts through the work day.

what happens if they are combined? say a long acting methylphenidate with a short acting dex? really appreciated the biological explanation here - one of the clearest i’ve heard - thank you

Can you do one about how thc interacts withn them

I have questions. 1) neurotransmitter is released into the synaptic cleft when the presynaptic neuron fired as a way to pass the signal on. In the normal brain the synaptic cleft gets cleaned again, neurotransmitter gets recycled. The synaptic cleft has to be freed of neurotransmitter or else the next signal (aka release of neurotransmitter) can't get through. Like a reset. Correct so far? Well, what happens when you inhibit reuptake and the reset doesn't happen as normally? Are the meds effectively slowing down the frequency of signaling because the neurotransmitter lingers longer in the synaptic cleft? Aka, is all the dopamine that stays in the synaptic cleft inhibiting new signals coming through? 2)how does reuptake eventually happen? I mean, the cleft does have to get cleaned before a new signal can pass through, no? Or does it mean that as long as the meds last there just lingers a constant amount of dopamine in the synaptic clefts where ever dopamine is the neurotransmitter and the clean up only happens after the meds wear off? And wouldn't that effectively block neuronal pathways? 3)are you depleting all dopamine all at once because you empty the vesicles completely and inhibit reuptake and will that dopamine linger so long on the synaptic cleft that it diffuses somewhere into the extracellular space away from the synapse and away from recycling? 3) Is the rebound effect such a drag because you depleted all dopamine for a while so you function even less well than if you hadn't taken meds to begin with? 4) a) what kind of long-term architectural changes are known to happen in the Synapses once you have taken your meds for years? b) I read that people have to increase dosage because there is some tolerance. Is tolerance related to architectural changes, like maybe the body builds more reuptake mechanisms to counter the effect?

Question. Is methylphenidate not considered an snri? And if so, why not? Something I’ve been wondering. Great video. Thank you so much!

I am under the impression that the other two actions that amphetamine enacts on vmat and dat might trigger the odd tension migraine from time to time for me. I am wondering if that might be the case? Perhaps I can get methylphenidate a shot and see. Side question, what might be the reasons as to why some people don't do well on ex. release methylphenidate and later switch to vyvanse and have a better time on it?

"The Prefrontal Cortex. They are known as *The Seat of Good Manners*". - Lector H. (M.D.). 😋

Thanks for the explanation! I have a question. I had short form 5mg dex it worked, but i wanted a longer working one. But then i got 27 mg methylfenidate xiromed long release, but it doesnt seem to work. It seems because the tablet is so hard it just doesnt fall apart. Is this even possible? I am trying for a week but it doenst do anything..so weird. It does work when i break it, but it says on the instructions you shouldnt do that. (And i needed a hammer to even break it since it is so hard)

Thank you! I have one question: my psychiatrist prescribes Dexamphetamine as an alternative treatment for depression. I have severe sleeping problems since I started using Dexamfetamine. My psychiatrist says the same as you about this stimulant: it works about 4-5 hours. I disagree. Half life of Dexamphetamine (not XR) is about 10-12 hours. In the Netherlands it is forbidden to drive for 30-40 hours after using Dexamfetamine or speed due to its long half life. After 2 x the half life (about 20h-24h) there’s still a too high blood level of amphetamine (1/4 of the initial dose). 30%+ of Dutch patients experience sleeping problems. My psychiatrist says this is not possible because it works just short (4 hours). So my question: are you both wrong? Given the half life of Dexamphetamine, I think you both are. Methylphenidate IR has a half life of about 2-3 hours. Much, much shorter. I know that. Thank you for reading and hopefully answering my question! ❤

Interesting that you mention methylphenidate binding to the *transport* for reuptake. What makes it different from Atomoxetine, if one is a stimulant and one is an antidepressant?

HI Dr, I'm 39(m) turning 40 this year. Got diagnosed with ADHD in my early to mid 20s. tried various drugs in the past for ADHD, but currently on Ritalin it has calmed me down but it's affecting my memory, focus and motivation. I'm Seeing my psychiatrist next month after my cardiologist appointment, that way based on results of my heart checkup, to determine what medication my Dr can prescribe me that works better than methylphenidate

Very informative… a question which one is more easy to the heart, I took vyvanse for the first time today 35mg it was good, clear focus good feeling little bit anxious by the middle of a day probably because it was a first time removed my fatigue but I noticed my rhr went up from 57 to 78, especially my hr while walking on vyvanse can go up to 130 usually without it stays 101-115 is it something dangerous that i should be worried, is ritalin better for the heart?

Could you do a video on Modafinil and now it compared?

Hi doctor. I've been taken ritalin for 4 months now with no successful results. Everytime I see my doctor he increases the dosis which makes the side efects worse but I don't feel the therapeutic effects. Tbh I feel like my adhd symtomps have gotten worse. Now I also feel anxious and depressed as well, specially since every person with adhd I've talked to say the saw an improvement from day one but that isn't my case at all. Do you think changing to another medication could help?