[jauer]

I'm normally on a very minimal dose. I have, prior to getting timer tops and forgetting that I'd already taken med, taken >100mg of dextroamphetamine without feeling high and without titrating up. Instead, I got very focused and methodical to an uncomfortable degree, but there's absolutely zero high or euphoria.

Across ~4 doctors (1 PCP, 3 pysch), none have titrated up. They've ballparked and said things like "let me know and we'll reduce if you can't sleep and increase if it doesn't work. If you want, try doubling up or cut it in half (for non-XR)".

Given the variation in dosage visible in the literature (such as this case report of megadosing: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3407707/ ) I'd suggest that there are multiple underlying physical causes for the condition described as ADHD to the extent that sweeping statements like that aren't accurate. E.g. my (very different) experience and your experience being different indicates that we probably have different underlying causes, not that one is a myth or misperception and the other is the real take.

[UniverseHacker]

Although I agree that is possible, the extreme variations in dosage between individuals could be explained simply by variations in the liver enzymes that metabolize stimulants, and don't necessarily point to different underlying causes of ADHD itself. However- I think the fact that entirely different classes of drugs, including non-stimulant medications, seem to work better for different people with ADHD does point to what you are saying.

In my case I can't tolerate even 2.5mg of adderall, and I also have hypersensitivity to several other non-psychiatric medications that happen to be metabolized by the same enzymes as adderall/amphetamine, so I am nearly certain it is a liver enzyme issue. I do tolerate a reasonably high dose of methylphenidate (ritalin) without any euphoria or insomnia.