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I have ADHD primarily inattentive, and until recently it was pretty much decently controlled. However, in the last 4-6 months, I have been suffering greatly from the inattentive symptoms so much so that they are practically debilitating. Also, my motivation to do anything, recreational or not, has just gone completely out the window. My room has been an absolute mess—an embarrassingly barely traversable sea of clothes and trash that I just cannot bring myself to pick one single thing up. I'm sure depression is a factor, but just... FUCK! I ran off the road the other day because I was flapping my gums talking to my friend and not paying attention to the road. I got a flat tire on my brand new set of 4 tires and bent the fucking rim of the wheel! That's going to cost a lot to fix... Going to have to probably leave my car at the dealership while they order the part to replace it with... My pdoc just simply doesn't prescribe me stims anymore. Won't get into that. We got into an argument and now she's all vindictive about it. She barely prescribed 10 mg Adderall before that anyway as the death of her husband left her very conservative with prescribing, especially stims. So my gdoc does my stims. He didn't know what to do. I asked about adding a little oral selegiline (Eldepryl) for the levoamphetamine metabolites (more noradrenergic = better for inattention) + MAO-B inhibition for more dopamine (better for motivation symptoms), but he said "that sent shivers down [his] spine just thinking about prescribing that" and preferred to stay away from it. So I asked about protriptyline (Vivactil), which I've taken before with some success, and he agreed. Problem is, it's so uncommon and hard to find that I'm going to have to use a mail-order pharmacy to get it, very likely. Any self-proclaimed ADHD experts out there? Should I be searching for a second pdoc to see specifically for my ADHD? Someone who will go above the 60 mg max of Dexedrine for my ADHD? A second amphetamine stimulant? (Adding methylphenidate to amphetamine will cancel each others' mechanisms of action out...) I have tried all the amphetamine stimulants and so far Dexedrine is the most potent, even more potent than Desoxyn (methamphetamine), which I hated... I don't want to go back to Adderall because of the shortage... Evekeo my insurance doesn't pay for, but would actually probably be best for me because of my inattentive symptoms. (shrugs) Anyone have any ideas on other augmenting options? Add something like phentermine? I don't think protriptyline (an NRI) is going to cut it. Atomoxetine 80 mg hasn't, desipramine 200 mg hasn't, and nortriptyline 150 mg hasn't either. I've tried amoxapine up to 150 mg I think, but it doesn't feel too potent, and has dopamine blocking, and maprotiline I'm afraid of the seizures and the sedation/weight gain... Kinda thinking about giving an MAOI another try, but my pdoc is so so so stingy with those...