Narcolepsy strattera

I've worked for the same fortune 500 employer for going on 3 years. The first two years I had a flawless employment record. This last year is when my IH symptoms got out of control after stopping some medications that were (presumably) suppressing my symptoms. I'm a software developer by trade with a background in mathematics (factory automation, c#, database admin and some data science duties). My employer was accommodating my issues with time off, but recently there have been some leadership changes at all levels. They are refusing to accommodate in any form (flexible hours, make up time, missed days, etc...). Since they refuse to allow any flexibility, my FMLA has been exhausted. They are mostly turning a blind eye to me nodding off in meetings or at my desk as long as it's not the norm. The problem is that I have severe issues with sleep inertia. It is extremely common for me to sleep in the 14-16 hour range at least 3 days a week. I can't keep living like this. I feel like the world is passing me by, and I'm watching the slow crumble of everything I've worked so hard for.
As for meds... My doctor took me off of Wellbutrin XL, Strattera, and Gabapentin about a year ago because of a hypertensive crisis I suffered that he was concerned that they were causing. (About 6 months prior to that, I was also taken off of phentermine.) Some combo of these meds seemed to mostly mask my symptoms, since I started having severe IH issues within a week of stopping them. I have had varying degrees of IH for the last two decades, since I was 15 and diagnosed with "possible narcolepsy" after a sleep study, but they have never been this debilitating. I flunked on Modafinil, and I'm about to flunk on Armodafinil since neither of these seem to keep me awake. (They do help, but not by much.) I have another sleep doc appointment for meds in a couple of days. Hopefully whatever's next helps.
Any advice on how to deal with the lack of accommodation?
Any advice on some good IH friendly employers for developers / data folks? I think it may be time to move on to greener pastures.

It's official, I've tried pretty much everything.
I tried Vyvanse -- Can't take it, gives me crazy OCD-like symptoms. Can't even look around a room of people without obsessing over them looking at me. I'll look up medical conditions for hours on end getting more and more concerned about having them. I was more productive than ever before, but I was also going insane.
I tried Adderall -- I can only take small 5mg tablets for a productivity boost, and even then I can STILL feel the hints of insanity I get from Vyvanse.
I've tried Ritalin. Same as Vyvanse. I've tried Focalin. Same as Vyvanse. So what about a non-stimulant?
Tried Strattera. Insane narcolepsy. Sleeping through classes. Sleeping for 14 hours. Go home, sleep.
Tried Wellbutrin, tried Sertaline, nope, not working. I just don't think my brain is structured to handle any sort of ADHD medication, or any psychiatric medication for that matter. I'm not the same workhorse off meds, but at least I can be a creative, funny, chill person who doesn't lose my mind.
Anyone with experience with this? How is the no medication life going for you?

Hey guys! About a year ago I was diagnosed with ADHD and now I've been referred out to Pulmonary due to narcolepsy symptoms. I've had severe sleep paralysis since I was around 10 and will find myself falling asleep where I shouldn't. When I do fall asleep I'll have auditory hallucinations (thinking I hear the TV or my name being called, etc). I never had insurance till recently so I'm just now able to afford good Healthcare (24f). Has anyone else originally started with an ADHD diagnosis? I start Strattera tomorrow as a "catch all" medication cause I haven't done the sleep study for the official diagnosis and I'm a little nervous to try stimulants. I'm curious about other people's journey and experiences. Thank yall in advance!

Hi everyone. I've struggled with Narcolepsy for as long as I can remember. I've had no luck with Nuvigl, Ritalin, and a few others. I couldn't get VyVanse or Wakix due to insurance so my doctor prescribed Strattera and wants me to give it a shot. I'm starting at 25mg - Has anyone had success?
As a side note - I struggle with Anxiety so most stimulants are a no-go.

My doctor just prescribed me this for narcolepsy after failing with Modafinil, Xyrem, Strattera and Adderall due to side effects. Isn’t this an insomnia medication? He seemed confused when he talked to me about it and now I’m really concerned he made a mistake. Has anyone else been prescribed this for narcolepsy? I did a Reddit search and couldn’t find anything linking this med to my condition.
-Anxious and exhausted

Threads on this topic tend to devolve into people giving advice and suggesting alternatives. For ADHD, usually Strattera or a different stimulant that may be magically in stock somewhere. For narcolepsy, GHB. For me, there are no such alternatives.
Besides, none of that really gets to the crux of the issue, which is that widely used and essential medications have disappeared from many communities with no indication that they'll ever be back. To me, this looks like a permanent crisis that people are just not able or willing to acknowledge.
So which is it? Is this another "new normal" we'll eventually accept, or is there a point where the shortage will have to correct itself? Because if we're still saying "Gosh I dunno" this far into the crisis, that's a good indicator that it was never really going to be fixed. Problems like this always have a prognosis.

Hello, been diagnosed with narcolepsy since april 2022 and until now I haven't found a treatment that would consistently make me being able to have a human life.
I can't say that I've a life to be honest, when I can't and don't do everything that I need to do during the day and when I can't and don't do most of things that I woud like to do but cant because not having energy.
Even the walls of my room is deteriorating because I don't have energy to do the effort of cleaning and washing the walls. Today when I woke up my body didn't want to get up from bed I had to force myself to get up after being on that situation for 15 to 20 minutes.
How can I say that I've a life of human when I'm forced to spend most of my day in my bed because of feeling sleepiness or tiredness or both and when I feel that way even watching tv is too much?
If I didn't live on disability benefits I would be living on the streets if I end up losing my family before me. Thank god I don't have to do anything more than what I do during the day (thats basically nothing) and dont have to pay for nothing. Spending almost the entire day feeling sleepy or tired when the most effortful thing that I do in a day may be writting a reddit thread/comment or cleaning my room in 30 minutes. I don't even have the energy to spend some minutes doing hobbies like: playing videogames. All I can do is to do activities that doesn't require anything from me like watching anime, youtube, tv, stream and even with that after a while I get exhausted.
Is it even possible to not be despaired, depressed and wtv if after trying and trying I still live such a life? I take max dosage of a SSRI and I still can write and say such things so obviously this mood is a thing that I'm forced to have due to my life being in such a state. It would be illogical to be satisfied or with a normal mood when Im forced to live this way.
Some people here are able to study or to work or both well for me that's impossible if I can't even endure such a effortless daily life. Doctors until now have only disappointed me.
My current medication is: 80mg strattera + 400mg modafinil + 150mg wellbutrin + 300mg fluvoxamine (and i'm taking 1 caffeine pill of 200mg). Besides modafinil here where I live we've available ritalin and vyvanse and obviously I've tried both and for big price with the lack of effectiveness over time I stopped vyvanse because for 400mg modafinil daily I already spend 120€ per month. And with ritalin I never felt anything be it supposed effects or side effects in the 3x times I tried on my life.
Sorry if I'm venting here but I've nowhere else to vent because people around me doesn't want to hear me venting maybe probably because I don't have anything to give them advantage of or to offer to them.
Thanks in advance for everyone that is able to read and read this entire text and replies to this vent.

Hello!
I’ve been taking Atomoxetine since January & slowly built up over a number of months to 100mg. I initially started taking this as I was having difficult side effects when trying Elvanse and other similar stimulants, so wanted to try the non stimulant meds.
I didn’t suffer too much with side effects, aside from the impact on my sleep, but also didn’t really feel loads of benefit from Strattera either. For a long time. One day I noticed that it actually probably was helping as I realised I did feel more able to keep on top of chores etc day-to- day and was also less impulsive. However, my main ADHD symptoms relate to starting tasks, focus, getting distracted, procrastinating etc - and I didn’t find Strattera was helping enough with this.
A friend of mine told me that he was prescribed ‘Amfexa’ for his ADHD: which he takes morning and afternoon. I spoke to my psychiatrist and he agreed to prescribe this in addition to Atomoxetine, for that little extra ‘boost’ in terms of productivity etc. He said that Amfexa isn’t generally prescribed for adults with ADHD in the UK (where I live) and is only supposed to be given to children with ADHD or adults with narcolepsy. Nonetheless, he gave it to me anyway and I’ve been taking 10mg in the morning and 5mg in the afternoon - thankfully without the adverse side effects that other stimulants gave me (presumably because this one is more of a ‘short release’?)
I’m really pleased to have found something that works for me - but am now wondering whether it’s worth me still taking Atomoxetine. This is partly because my sleep still isn’t what it used to be & I tend to sleep very lightly and wake up throughout the night. Given I now have the stimulants to help day-to- day, I don’t know how much benefit Atomoxetine is actually giving?
Having said that, I’m worried that I may have just normalised the ways in which Atomoxetine is in fact helping - and so am concerned that if I come off it, I’ll start having a load more ADHD symptoms that I’ve forgotten about because I’ve been on Atomoxetine for so long.
Hopefully the above all makes sense. I was wondering whether anyone else has had experience taking Atomoxetine/ Strattera in addition to stims? And/ or how people found coming off non-stimulants while taking stimulants?
I will of course speak to my psychiatrist before making any decisions - but just wanted any anecdotal experience too.
Thanks!

Like the title says. My narcolepsy is being treated with 75mg Sunosi in the daytime and Xyrem at night. It’s going well but my adhd is getting pretty debilitating. My sleep doc said he can’t put me on a stimulant while I’m on Sunosi, which is fine as I don’t like stimulants. I recently learned about Strattera for adhd and that it’s not a stimulant, so I’m wondering if anyone out there has been on Strattera for adhd at the same time as Sunosi or even Nuvigil (what I used to take). Would love to hear about your experience. Thanks for your time!

Hi,
This is about Armodafinil 150mg. I'm scared to take it. I took 1/4th of a 150mg (about 40mg) to test out how my body was to react. Thankfully nothing really happened, maybe I got a slight headache. What were your symptoms (if you have Narcolepsy type 2 without cataplexy)? How many hours would you sleep? How did it affect your day? Your studies? Your job? Does my story below resonate with you at all? How did you approach taking these medications that don't come without risks? Without meds, what "percentage" of awakeness and alertness do you feel? How does it manifest for you? I want to hear ALL about it!
My story:
27/F with comorbid anxiety, history of depression and CPTSD.
For the 1.5 years I have been following with a psychiatrist with my main symptoms being concentration issues, and just am yearning for more days with 100% alertness and mental clarity. I've always required at least 10 hours of sleep a day. He is incredible at what he does and I am so lucky to have him as my doctor. Over a span of 4 years, I ruled out I have tried antidepressants first. Those were Lexapro, Bupropion, Strattera, Viibryd, and small adjunct dose of Abilify. I am only on Viibryd now and it's good. I truly believe that those antidepressants helped in my success vocationally. Though I was successful at work, while others had hobbies mine was to sleep. I never really thought of my sleep being abnormal until I got married. My husband just is able to get up and go and not need one nap the whole day! He asks me to promise him that I'll go to the gym, and guys... I have yet to go. I keep waiting for energy and the focus to do that. It makes me look like I'm a lazy bum. But I'M NOT. The kitchen is a mess because I'm physically too tired to focus on putting things away.
My labwork is normal. But the symptoms persist.
He has woken me up almost every single day the last 4 years, and by that I mean by grabbing me by my legs and dragging me out of the bed while I fight it. It would be after 9-10 hours of sleep. I just feel like I need to sleep more and THEN I'll be awake. Then I would find that I don't have the time in the day that I need to manage a healthy life. Husband would say, "WELL IF YOU WOKE UP EARLIER YOU WOULD HAVE TIME". Ok so the sleeping is a problem. I have a record of sleeping 26 hours straight. Most days its at least 9-10 hours, with a probable nap and feeling about 70-80% awake, never truly FULLY awake.
A repeated thing I would do when my concentration is really poor to where I cannot function in my own kitchen, is to take a "30 minute nap". "That should help" I would think to myself. Well, it would turn into 3 hours. In the end am frustrated at myself for needing this much sleep.
Worse days are when it's 12+. I had plenty of 16-20 hour sleeps too but those are not as common. (Those days were only possible when I would travel for work and husband was not around) Moral of the story is: I sleep more than half of my life and just want to feel 100% AWAKE and ALERT and not at 70-80%. I don't believe I have full on narcolepsy and I have brought up "fatigue" to multiple providers since I was 14. My mother said I always slept very good.
In elementary school, my mom would wake me up. Once I got on the bus, I'd sleep while I can. In middle schoold, I was always be the last one entering the bus as the doors were closing each and every day at 08:00am and it was even worse at 6:57am in high school. Everyone was waiting on me all the time. Every minute of sleep was precious. I'd quickly brush teeth and put on clothes, quickly eat something in 10 minutes as I was fighting through the sleep inertia that would last all day. I ran to bus stop with the grogginess on autopilot and would run even with my eyes closed at times. I would definitely be exhausted in all my classes and for sure napped during them, but who hasn't? My friend on the other hand, would get up early, put thought into her outfit, do her hair and makeup. I just could never be one of those people. In college it became worse. I would definitely skip classes that I could to study them on my own time - but still would get that A in Chemistry. I would still be running to class at the last minute and I lived ON CAMPUS!!! It's not like I lived far away and had an excuse!!!
With the concentration that I have, it greatly affects my recall, processing speed, executive functioning, time management, memory and learning ability. So much so that I knew something was wrong with me when I studied for an extremely important exam for 3 WEEKS only to get a 52%. Guys I was DEVASTATED and cried for the first time. Normally I was an A-B student. This was when I was not on any kind of medication but I was truly always tired. I would read and reread, write and rewrite notes and they would just not stick in my brain. Have any of you experienced this?
Doc heard me out, and agreed that the recurring theme here is excessive daytime sleepiness with concentration issues with or without all the meds I've tried. He ordered Armadafinil for me to try . To take 1/2 a pill once a day to see if it works. If it doesn't, then to take the full tablet. Having never done stimulants, and reading all the possible side effects, I am terrified of it. Ofcourse Inattentive ADHD was a discussion of ours but it didn't feel right for both of us since I do have moments of full focus and clarity. Sadly it's not long-lasting and depends on the % of awakeness that I would rate my self at.
If you have come this far in my story, I applaud you for reading it all the way through. I know it was quite long and truly appreciate it.
Any feedback would be greatly appreciated in this journey and please don't judge me for not yet having done the sleep study. I will do it. I have a feeling that I am not fully narcoleptic like many of you. I will know for sure once the test is completed. This is not to say that Armodafinil may not be helpful for someone like me.
Thank you for sticking through this extremely long post and I'm excited to hear what you have to share!

The only legal ADHD medication in my country has no effect on me on the maximum dose. Not even a slightly raised heartbeat. I tracked my symptoms in terms of what I was doing and not only how I was feeling, so I know my behavior doesn't change either. Today I stopped taking them cold turkey and I have been doing exactly the same as yesterday, and as usual. My own doctor told me that I could try to get some other medications illegally on the internet if I wanted. I already take wellbutrin, strattera is not available, other narcolepsy pills cost way too much and there is no way of getting them for cheaper. I already do sports, eat proteins, sleep 8-9hours per day. I don't know. I don't want to move country and be alone just for my meds. So I just will have to cope with it. I'm struggling. I don't want to keep living like this...

Hey Dr K,
I am a medical student, who recently has been diagnosed with Adult ADHD and it is quite a severe form of ADHD, I was diagnosed with ADHD at the age of 25. Throughout my whole life I always felt something was wrong, when it came to sitting down and doing a task it was like an impossible feat, but when it came to understanding it wasn't too tricky. When I looked at my peers it felt like I would have to put in 10 times the work they did to get the same results. I grew up in a strict Indian household, where my whole family were doctors, so they demanded some form of excellence. Looking back suffering from ADHD and not knowing about it, made life far more difficult to be happy and functioning in that household. I fell in with the wrong crowd in adolescence and I experimented with a lot of drugs. Then somehow managed to get decent A-levels and make my way to med school. And I feel like an imposter, sometimes I feel like I do not deserve to be here. There is a whole lot more to the story, but I will try to give the cliff notes. I have a very strained relationship with my parents, my father has ADHD and has gone through life undiagnosed, and my mother suffers from OCD as well as my brother, home life was really difficult because my parents created competition between all of us, so we would consistently want to be better. I have been prescribed Strattera, and I have been taking it consistently, also I am taking 10mg of citalopram. I have not been prescribed this but I started taking modafinil because it would help my focus. I did feel trepidation before taking modafinil as I know what it is actually used for narcolepsy, sleep apnea etc. I do not know if I should continue taking modafinil as there has been no conclusive study to see its long-term effects. I should also mention I have been on Strattera for 1 week so it is not fully at a level within my body to see the full effect. To be honest I would like some insight on what you think I should do because I have watched your videos and they really helped me.

Always struggled with memory as I went to take a memory test with a neurologist and studied concluded that my short term memory is definitely lacking. I was diagnosed with adhd after coming up narcolepsy after a sleep study and was prescribed Strattera. Strattera was taking over my social life as I cautioned with able to have a drink and taking a med every day. So I asked for something else as needed and I was prescribed adderall starting at 5 mg to start but did mention they were going to increase the dose in the future. Since I started taking meds in general my short term memory I feel has gotten worse. I would talk to my gf and immediately forget what I wanted to say. I would go to the fridge and immediately forget. Takes me longer to remember short term items but as I can remember it was not like this for my entire life. Sure my memory wasn’t the greatest but it’s been 8 months since I started taking meds and now I can’t remember the small things. Even as I’m typing this, I did it pause to think about what I wanted to type and remembered a little while later. Has anyone else experienced something like this? Has meds worsened your symptoms of adhd when you’re off of it?

Long story short doc took me off of Adderall after my blood pressure being consistently to high even after being put on medication to lower it.
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I was on Adderall for my Narcolepsy and ADHD.
I was switched to Strattera. I am like a month an a half in. I have literally no motivation to do anything at all. And my attention span is pretty much shit too. I plan on working with my doctor but thought I'd also ask reddit also. Has anyone had any luck with being on anything non stimulating to help with their motivation/attention span?
P.s. I know everyone is different I just feel a little hopeless right now.

I’ve been mostly lurking on ADHD since my son was diagnosed last year. I now have my own diagnosis of inattentive ADHD, and I’m looking to see if anyone has any experience to share about what I hope to be doing soon.
I already have a good amount of experience with stimulants, as I also have narcolepsy. I’ve already tried Ritalin and Adderall, and they don’t work on me. I’ve also tried Wellbutrin and Modafinil, along with a number of other narcolepsy-specific meds. Stimulants/wakefulness meds just don’t work for me. Coffee doesn’t do it either. Through my search on the narcolepsy side, I came across Effexor. It didn’t help with any of my narcolepsy symptoms, but it knocked my irritability (which I’m now attributing to ADHD) completely out. I stayed on it because of that.
I’m going to ask my doctor about cross tapering from Effexor to Strattera. Since they’re both SNRIs, it sounds like this could be a pretty doable switch. My hope is that Strattera will help with many of my ADHD symptoms as well as continue to work on the irritability.
I’ve read that Effexor is a bear to get off of (been on it for nearly 2.5 years). I’m hoping that cross tapering will be easier than just weaning off of it. I’m prepared for all kinds of problems between getting off Effexor and starting Strattera, but I’m hopeful for a scenario where both the Effexor withdrawal and the Strattera ramp up complications are somewhat mitigated.
If anyone has any experiences with any kind of a similar cross taper they could share, I’d love to hear them.

Tomorrow is my birthday - I’ll be 25 tomorrow; male.
Have been treated with stimulant medication to help control my chronic fatigue and narcolepsy symptoms since 2014.. I’ve tried many different medications - Ritalin, Focalin, Vyvanse, Strattera, Modafinil, Armodafinil, Wellbutrin, Sunosi, Xyrem & most mainly - Adderall/XR.
I’ve mainly been on and off Adderall since 2017. Have had a lot of problem, including abuse with it and still somewhat struggle with it. I’m prescribed 60mg daily and I also take armodafinil with it, but will be switching the armodafinil to Wakix within the next week due to ineffectiveness.
But that’s it. I just take stimulants, stimulants, stimulants… I’ve tried Xyrem for a span of 5 or 6 months about two years ago… It caused me crippling anxiety & suicidal ideation. But that really sucks to me because sometimes when I would take Xyrem I would actually wake up and feel like refreshed for once I’m my life and I didn’t feel insane sleep inertia/disorientation.
I want Xyrem to work fine. But I don’t think it will based on previous experiences. So what are my options here?
Should I just stick with my current regimen and see how adding in the Wakix does? I am taking it with Adderall because believe it or not just taking Adderall isn’t enough as my tolerance to it is extremely high. But they won’t give me more than 60mg a day so they told me that some people with narcolepsy need to be on a combination of stimulants.
I don’t know…

I think I have ADHD, which i know is more common among people with N, so I'm hoping someone might have some experience. I take Adderall for my IH/N2 (diagnostic feedback loop) and it helps my sleepiness.
I've wondered for a while if I might have ADHD but I assumed that I couldn't because presumably taking Adderall would help it. I also thought that a lot of my symptoms that could be ADHD seems to come on in the past few years well into adulthood. But I watched a lecture today from a doctor who's an expert in ADHD and started having emotional flashbacks to getting yelled at as a kid for having so many of the symptoms he was talking about.
So I'm wondering if there's anyone here who has narcolepsy and ADHD, whose ADHD is not affected by Adderall or Ritalin, and has to take an additional medication like Strattera for ADHD.

I'm on ritalin and it works all right but I'd be more happy to be on non stimulants Tried strattera wasn't doing much for me .
Also on zyprexa and rexalti
Hoping ideally to find ADHD medication that would replace Ritalin and function as mild anti anxiety mood stabilizer? If I'm talking bull I apologize But I read somewhere that there is ADHD medication that targets anxiety as well as stabilising mood ?
My period mood swings are just over the moon now . While my partner is patient and understanding I don't want to be one of those women lol
Another medication I'm thinking of is modafinil or another narcolepsy medication I can't recall

I've been having sleep issues for a while. In preparation for an upcoming sleep study, I was weaned off my medications for depression and ADHD (Pristiq and Strattera).
Oddly enough, my sleep issues didn't get worse, but I also vegan making lifestyle changes at that time. I started working out, paying a lot more attention to my nutrition, etc. But they're still definitely there.
I've tried most treatments for narcolepsy, but for other reasons (ADHD, depression, etc). Through it all I've always had sleep issues, with the exception being Adderall which gave me insomnia, tinnitus, and no appetite.
It seems Xyrem is the only thing that may work and that I haven't already technically taken before.
However, I don't want to do this expensive sleep study of the prescription of Xyrem isn't a possibility. I'd rather just attempt at self managing. I'm still paying for the previous sleep study.
Is there a way to find out which doctors can prescribe Xyrem, what the likelihood of that happening is, and how expensive Xyrem would be?

Hi all, I started with Strattera and saw no results. After that I was put on Modafinil, which actually didn’t even help me feel less sleepy—I don’t have narcolepsy, I just noticed I was still yawning and feeling tired during the afternoon.
Finally I was put on Adderall. I started on 5, 10, then 20 mg twice per day and I’ve experienced no difference. We’re trying 20 mg XR now and I still can’t tell anything.
I feel really disappointed. Everyone talks about how much their life changes after medication and I’m still struggling as much as I was before. I’m terrified I’m going to lose my job because I’m always a few mins late, my boss complains my office is disorganized, and I struggle with paperwork—which is most of my job. Anyone else felt like this?

Hey everyone. New here. Being evaluated for idiopathic hypersomnia as they ruled out narcolepsy. Pharmacy student who’s been experiencing chronic fatigue these last 2-3 months. Graduating in less than 2 weeks and will be starting a job a few weeks after. Got my boards coming up and have been feeling insanely foggy with awful focus and concentration. Was wondering what experience, if any, you’ve had with vyvanse. Feel like something that promotes both wakefulness and concentration would be best. Doctor recommended Strattera but it has a severe interaction with my other meds. I’ve brought this up. How do I go about this without seeming like a know it all or acting like I’m drug seeking? Any help would be appreciated

I've seen a lot of concern on this sub about the effects of stimulants like Adderall and Ritalin on your heart. I like my heart, so I dedicated a few hours today to read everything I could find on PubMed about this subject. I was prepared to change my treatment plan if I learned that my meds were harming me. (Spoiler: they're not.)
I did a full write-up of this research project on my blog, but I'll post a shortened version here.
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Central nervous system stimulants such as Adderall, Ritalin, and Vyvanse are commonly used to treat ADHD and narcolepsy in children and adults. Common side effects of these drugs are increased blood pressure and heart rate. Anecdotally, many patients and doctors assume that there are negative long-term heart consequences for stimulant use, even when taken as prescribed and in approved doses. The purpose of this article is to review the available research and determine if this concern is supported by the evidence.

Disclaimers

I am not a doctor. This is not medical advice. Consult your doctor before starting any new treatment.
I acknowledge that I have a bias in favor of stimulant treatment for ADHD. I've listened to many ADHD experts speak on the subject and they have an overwhelming consensus view in favor of it. I made every effort to set this bias aside while researching the topic.

Hypothesis

My guess is that stimulant use would lead to a small increase in adverse cardiovascular events like heart attack and stroke, more frequently in adults, and especially in patients with preexisting heart conditions.

Methodology

I searched PubMed for the term "stimulant heart." I considered the first 50 results, as well as the "Similar articles" for each relevant study, and each of their "Similar articles," following the chain of related articles until no more relevant articles were found. I ignored studies that were about caffeine, cocaine, or intentional drug abuse, or did not consider heart health. I also ignored the few studies that did not have an abstract or summary publicly available on PubMed. Personal bias was not a criteria for exclusion. I reviewed and summarized the abstract, results, or conclusion of each relevant study, with a total of 37 studies found. Skip to the bottom for a general summary.

Studies

(I think I'd hit the character limit if I tried to include my summary of every study here, sorry. There really are 37 of them. There has been a lot of research done on ADHD stimulants and their effects on the heart. I can't link to my blog here per the sub rules, but I'm sure you could find it if you want to go down the rabbit hole. Or better yet, go to PubMed and do some reading on your own: https://pubmed.ncbi.nlm.nih.gov/?term=stimulant+heart.)

Conclusions

I (wrongly) expected to find that stimulants are bad for your heart. I was prepared to reassess my own stimulant use and act to minimize my long-term risk, even if it meant more difficulties with daily symptom management. However, across every study that came up, I found no compelling indications that stimulants cause heart disease, heart attacks, strokes, or other cardiovascular problems (outside of a small increased risk for new users over 65). The few studies that found an association were full of stated caveats and uncertainties. There are reported cases of unexpected heart attacks in stimulant users, but heart attacks are also reported in healthy people who don't use any drugs at all. It's not clear that there's any correlation, let alone a direct causation.
While it's abundantly proven that Adderall, Ritalin, Vyvanse, and even Strattera cause a "modest increase" in heart rate and systolic blood pressure, there is no evidence that they cause an increase in heart attacks or other adverse heart events over the long term, and studies have found no increased risk over the short and medium term. Even if there are effects at the high end of the confidence interval, the absolute risk is still very small. Whether they use stimulants are not, there's no reason the average person should be worried about getting a heart attack. Many study authors express speculative concern about possible effects all the same, so some precautions (such as increased monitoring or lower doses) may be valuable if you have a family history of cardiovascular disease. And, of course, overdosing stimulants in order to get high is extremely dangerous.
It seems that some stimulant users do not tolerate intense exercise as well as non-stimulant users. If you have trouble with prolonged cardiovascular exercise, talk with your doctor and maybe consider lower-impact forms of exercise.
The beneficial effects of stimulant medication for people with ADHD are well-known and, for most people, outweigh the negative side effects by a considerable factor. Stimulant users who take their medication as prescribed are far less likely to develop a substance abuse disorder and other mental health issues. Stimulants allow people with ADHD to enjoy a higher quality of life and greater success in school, work, and relationships. It's also worth noting that many people with ADHD find it extremely hard to exercise and eat well, and report that stimulants make it possible for them to control their impulses and make better health-related decisions.