I don't know why I am still on Adderall. I am so tired and depressed, unexcited, and don't even feel like reading the Bible, much less have the energy or passion to make the world a better place. I have been on Adderall for 14 years and I feel a little frazzled. Does long term use of amphetamines cause brain damage?

I have many patients who do great on 60-90 mg of Adderall per day and have for up to 13 years.  Anybody like yourself who is not doing well needs to make changes.  You need to start with a re-evaluation with a physician.

One simple option may be to change to the new Vyvanse and possibly just one/day (70mg).

Many of my patients require Tenex with Adderall.  Patients on Vyvanse are much less likely to need it.

One of the most important things I learned in training in the ‘60s – if what you are doing isn’t working, do something else, even if it is wrong it gets you unstuck.

Some important lifestyle issues to consider include:   quality sleep, exercise, bright light every day, good diet, omega 3 fatty acids, and possibly Cerefolin, and personality issues.  If you need medication work with your doctor until you find “the right medication at the right dose” for you.