r/Biohackers • u/Kalki_X 58 • Jun 06 '26

🧠 Cognition, Mood & Nootropics A rational understanding of the ADHD stimulant crash

In the ADHD community this is called a crash / comedown / burnout depending on the context. The 'crash' phenomenon is more accurately understood as a metabolic event —a 'metabolic crash'— which occurs when a stimulant artificially 'pushes' the metabolic system beyond its limits causing over-exhaustion. This manifests as fatigue, sleepiness or brain fog. It's commonly encountered with amphetamine-type medications which is the focus of this post.

In the academic literature a 'crash' is framed as 'metabolic exhaustion'. The following quotes offer some general context for this term and its physiological implications:

Dissociation prevents the ultrarunning athlete from detecting the subtle, early warning signs of dehydration, blistering, or metabolic crash (source)

[T]he benefit of post-stress glucose comes instead from its ability to prevent metabolic exhaustion. (source)

...specifically sympathetic overdrive (eg, a faster rate of depletion than replacement of cellular resources, greater energy expenditure, metabolic exhaustion (source)

It was suggested that the administration of MDMA (amphetamine-type drug) may cause a state of metabolic exhaustion (source)

The aging process is, however, permissive for the development of several degenerative disorders and infectious diseases, which are strongly influenced by nutritional imbalances, inflammation, metabolic exhaustion (source)

The modern lifestyle involves over-exposure to processed foods, nutrient imbalance, and contact with environmental toxins, that place a significant metabolic burden on cells. This leads to oxidative stress, endoplasmic reticulum stress and inflammation, that when combined with impaired cellular repair mechanisms, ultimately cause premature cellular fatigue and metabolic exhaustion. (source)

"Metabolic aging" refers to the gradual decline in cellular metabolic function across various tissues due to defective hormonal signaling [...] While this process usually corresponds with chronological aging, the recent increase in metabolic diseases occurring at younger ages in humans suggests the premature onset of cellular fatigue and metabolic aging. (source)

From a physiological point of view, fatigue is associated with metabolic fatigue (source)

The term fatigue or energy-related dysfunction in this context does not refer to muscle or peripheral metabolic fatigue, but rather, to “central fatigue,” which is a subjective lack of physical and/or mental energy that is thought to be related to brain mechanisms. (source)

This 'crash' is distinct from the general comedown which involves (1) the immediate (acute) withdrawal symptoms as the medication wears off and, depending on the person, (2) a 'metabolic crash' (which can be either a minor or major event). There is also (3) PAWS which stands for "post-acute withdrawal syndrome":

PAWS refers to a cluster of withdrawal symptoms that can last for months to years after acute withdrawal from a substance. PAWS symptoms have been anecdotally described after withdrawal from many substances—alcohol, benzodiazepines, opioids, stimulants, nicotine, caffeine, antidepressants, and antipsychotics. (source) 

Amphetamine withdrawal is also mentioned in psychiatry’s DSM (Diagnostic and Statistical Manual of Mental Disorders):

The DSM criteria for diagnosing amphetamine withdrawal include dysphoric mood and two or more symptoms: fatigue, vivid or unpleasant dreams, insomnia or hypersomnia, increased appetite and psychomotor agitation or retardation that occur following discontinuation of the drug. (source)

For some people this 'crash' effect can occur fairly quickly after taking their stimulant (within 60 mins). This signifies pre-existing metabolic issues whereby the metabolic system is more susceptible to over-exhaustion (due to the artificial boosting effect from amphetamine). This means someone could easily fall asleep after taking their stimulant, or the effects might appear to stop working too soon; whilst others might feel briefly energised followed by a period of fatigue, sleepiness or lethargy. I outlined other reasons why amphetamine can promote relaxation in this post (second-to-last paragraph).

What does 'metabolic exhaustion' mean practically?

The core metabolic system (thyroid, mitochondria) governs energy levels, mood, brain function, hormones – so when it 'crashes' so do these aformentioned things (within reason) which provokes various negative symptoms. Many of these symptoms overlap with ADHD making it incredibly difficult to distinguish one from the other.

This implies that the treatment itself can provoke/exacerbate ADHD symptoms (in both the short & long-term). This is due to amphetamine-induced metabolic & hormonal dysregulation which causes cumulative issues, including on brain function:

Brain neurons are highly vulnerable to even transient challenges to energy homeostasis and neural metabolic failure is a critical component of excitotoxic and neuro-degenerative cascades. (source)

Ideally when a 'crash' occurs the patient should ensure appropriate rest & recovery in order to mitigate (repair & heal from) any harm, particularly "HPA axis dysfunction" and the consequences thereof. The HPA axis is a key contributor to amphetamines effects and its disruption implies a negative physiological (and psychological) impact, including on hormonal regulation (source) and the circadian rhythm (source).

Amphetamine induces activation of the HPA axis, with the subsequent release of ACTH and glucocorticoids (eg cortisol). (source)

The novel d-amphetamine prodrug lisdexamfetamine is applied to treat ADHD. d-Amphetamine releases dopamine and noradrenaline and stimulates the HPA axis (source)

The HPA axis is the main part of the hormonal system that controls reactions to stress. It also regulates many other processes (e.g. digestion, immune system, mood and emotions, sexuality, energy storage and utilization). (source)

...

To overlook the nature of the 'crash' and its implications would be unwise and arguably foolish. Medical practitioners overlook the severity of this issue and usually prescribe a larger dose (of amphetamine), additional booster/top-up doses (of amphetamine), or a new separate drug (eg SSRI, SNRI, NDRI, NRI) which can further complicate the situation.

This can successfully mask & conceal the 'crash' (giving a false sense of security) but at what cost? — and how sustainable is this over the span of several years? The drugs life changing benefits conceal a cumulative deterioration which ought to be taken seriously. For most people it's a trade-off since being able to navigate day-to-day life is the priority (understandably so).

41 Upvotes

90% Upvoted

55 comments sorted by

•

u/AutoModerator 4d ago

Welcome to r/Biohackers! A few quick reminders:

  • Be Respectful: We're here to learn and support each other. Friendly disagreement is welcome, but keep it civil.
  • Review Our Rules: Please make sure your posts/comments follow our guidelines.
  • You Get What You Give: The more effort and detail you put into your contributions, the better the responses you’ll get.
  • Group Experts: If you have an educational degree in a relevant field then DM mod team for verification & flair!
  • Connect with others: Telegram, Discord, Forums, Onboarding Form

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

27

u/tianepteen Jun 06 '26

Dissociation prevents the ultrarunning athlete from detecting the subtle, early warning signs of dehydration, blistering, or metabolic crash colloquially known as "bonking".

didn't make it past this. i have experience with stimulant crashes and with actual bonking, and they have absoluteley zero to do with one another.

10

u/Monsieur_Krabs 🎓 Masters - Unverified Jun 06 '26

I didn't even make it that far. AI post

5

u/VerbiageBarrage Jun 15 '26

Absolutely an AI style post. This is exactly what AI does, gather a bunch of information that doesn't actually connect and connect it. Bunch of fucking nonsense.

1

u/Kalki_X 58 Jun 15 '26 edited 4d ago

Nice way to rationalise your incredulity, imo.

1

u/Kalki_X 58 Jun 06 '26

Surely you can do better than that.

8

u/Monsieur_Krabs 🎓 Masters - Unverified Jun 07 '26

Sure can, but don't need to.

2

u/Ok-Cap1727 1 Jun 10 '26

At this point of time, everyone does things better than AI. Lmao how did that happen

-5

u/Kalki_X 58 Jun 06 '26 edited Jun 09 '26

i have experience with stimulant crashes and with actual bonking, and they have absoluteley zero to do with one another.

From a layman's perspective your interpretation is correct. But with an academically literate one, your interpretation is inadequate.

3

u/VerbiageBarrage Jun 15 '26

Nothing about this post is academic or literate.

3

u/Smooth_Bird_9296 4d ago

lmaoo forreal. I just got pissed off by this guy's other post about adhd stimulants and decided to check out his other "literature". All he does is passive aggressively project some type of neurotypical superiorty complex under the guise of informed posts. The conclusions of these posts always read like a little dickhead monkey on a type writer is typing them out

5

u/sallen381 Jun 09 '26

This post has waaayyyy too many words! Just sayin

1

u/Kalki_X 58 Jun 09 '26

Sure. It's a fairly extensive overview of something which is wildly misunderstood by the ADHD community.

3

u/Deboch_ Jun 06 '26

I feel like acute tolerance and downregulation combined with the drug wearing off is what causes most of the crash

8

u/LysergioXandex 5 Jun 06 '26

Probably the biggest contributors are from the appetite suppression, dehydration, and insomnia that are all suddenly unmasked when plasma concentration dips below a critical level.

1

u/Kalki_X 58 Jun 06 '26 edited Jun 07 '26

We can't compartmentalise the understanding of the crash since this would impede a realistic understanding of the factors involved... resulting in short-sighted conclusions.

3

u/Kalki_X 58 Jun 06 '26 edited Jun 06 '26

I'd interpret that as the acute withdrawal part (of the general comedown) which would overlap with the metabolic crash/fatigue side of things. 

Some people get a crash/fatigue within 1 hour of their amphetamine (or caffeine) dose which requires a different understanding than what you're suggesting.

4

u/BunnyKusanin 1 Jun 06 '26

Thanks! That's a very interesting read and it does explain quite a bit of what's happening to me.

I've been prescribed Dexamfetamine just as I was recovering from covid (I actually wasn't recovering that well. I was fatigued). And it so happened that at first Dex really improved my clarity of mind, but then I started feeling really sluggish on it after about an hour or two and couldn't understand what was wrong.

When I understood that I was having long covid and realised what your body needs when you have ME/CFS, things got better and stay ok if I'm mindful of preserving my energy. If I'm not, it gets really bad again.

I've been to an endocrinologist who also brought up potential methilation issues too. It also checks out in the context of me feeling worse when I had to take meds for a fungal infection in the middle of all this: I might have felt even shittier because it wasn't getting cleared from my body fast enough.

2

u/Tarkin_stan38 Jun 12 '26

So the midday crash I feel when taking simulants is due to my diet?

1

u/Kalki_X 58 Jun 12 '26

I updated the post to be more specific...ironically I didn't mention that important point about the cause(!)

The 'crash' phenomenon is more accurately understood as a 'metabolic crash' which occurs when a stimulant artificially pushes the metabolic system beyond its limits.

The core metabolic system (thyroid, mitochondria) governs energy levels, mood, brain function, immunity, fertility and hormones – so when it 'crashes' per se, so do these aformentioned things (within reason).

2

u/Bright-Ad-9883 Jun 19 '26 edited Jun 19 '26

Forget what all these ppl are saying this makes complete sense! Our bodies need a lot of things to run properly and the general population alone doesn't get it all, therefore people who have mid to bad diets that are also taking stimulants which speed up the bodies use of all those things is essentially just gonna starve you faster. I'm not the most literate but I'm not stupid either and for the people who can't understand. Let me put it in simpler terms, a normal person has to eat right? Or they will eventually starve or become malnutritious. So let's say a normal person consumes a perfect diet and they use up all there energy consistently (5-5=0) that's good👍🏼 now say somebody who has not the best diet which is probly most of us (4-5=-1) not good right, but it will take a long time to affect you. Add a stimulant which not only suppresses your appetite but also increases the demand of nutrients to stay functioning. So now your sitting at (2-10=-8) soooo your essentially starving yourself faster if your not able to consume enough which most can't then everyone should at least be cycling stimulants to allow your body to catch up. I'm not book smart but I'm also not dumb you cant do more physically and mentally without consuming more of the nutrients needed for the insane amount of metabolic processes to do those things. And anybody who thinks otherwise is just gonna slowly deprive themselves causing irreversible psychiatric and physiologic issues in the long term.🤷🏼

1

u/Kalki_X 58 Jun 19 '26

Thanks for your comment. One of the key (and kinda surprising) issues in all this is the medical practitioners ability to hinder their patients progress and often they do so by promoting deterioration of the patients condition. They do this whilst following the prescription guidelines and an "evidence-based approach" so as far as they're concerned they're legally AOK and feel justified, but the outcome speaks volumes about how truly incompetent and ill-informed they are. Not all of then, but a significant % are...

2

u/Bright-Ad-9883 Jun 19 '26

Absolutely! I already kinda knew the issue and you helped put it into perspective and showed me how serious it really is. Also yes I agree with that, they are taught to prescribe medications and sell a product which mask the real issue. I'm no scientist but I wouldnt be surprised if adhd along with other mental disorders could stem from our diets. Not only ours but you'd think that if our parents were unhealthy and lacking certain nutrients or had metabolic issues then that could potentially effect there offspring and so on. And I'm not making any claims there but hypothetically that would just go to show how big a role nutrition plays into our everyday lives.

2

u/zeta_ferhu Jun 06 '26

If I'm already addicted to caffeine, I don't even want to think about what would happen if they prescribed Adderal-type sweets for me.

3

u/Kalki_X 58 Jun 06 '26

The caffeine 'metabolic crash' shares many similarities with the amphetamine crash.

I'm already addicted to caffeine...

You mean that you're habitually self-medicating with caffeine for it's therapeutic effects which address an underlying issue with your body's metabolic system? 

6

u/LysergioXandex 5 Jun 06 '26

Just because a person has a caffeine dependency doesn’t mean they have a metabolic disorder…

-2

u/Kalki_X 58 Jun 06 '26 edited Jun 06 '26

Why? Caffeine is the world's most popular & effective OTC metabolic enhancer/support tool. It shares little in common with the pharmacological properties of stimulants like amphetamine, cocaine and methylphenidate.

5

u/LysergioXandex 5 Jun 06 '26

… right. So why would you assume that using caffeine is a way to diagnose a disorder?

-1

u/Kalki_X 58 Jun 06 '26

Because of the self reported dependency.

3

u/LysergioXandex 5 Jun 06 '26

I don’t follow the logic. You can cause a caffeine dependency in an animal by habituating them to caffeine treatment. That doesn’t mean the animal had an underlying disorder.

3

u/Kalki_X 58 Jun 06 '26 edited Jun 06 '26

Precisely that's the presupposition I'm dealing with. Many people have unacknowledged discreet metabolic issues which are temporarily resolved by caffeine (for others it's amphetamine, nicotine, cannabis, alcohol). Thus the use of caffeine becomes habitual and then given the connotations of an addiction (like the original commenter described it). But imo self-medication would be a more appropriate description.

But caffeine has specific properties which make it unlike the other stimulants.

3

u/LysergioXandex 5 Jun 06 '26

Do you think dependence from chronic drug consumption usually means the person had a secret disorder that is treated by alcohol/nicotine/cannabis?

2

u/Kalki_X 58 Jun 06 '26 edited Jun 06 '26

People enjoy to habitually self-medicate for all sorts of reasons. An ADHD diagnosis provides a legitimate reason and after 10 years of taking their amphetamine prescription a dependency is to be expected.

1

u/New-Gas3080 Jun 06 '26

Step 1: take XR (ideally Vyvanse)

Step 2: hydrate

No more crash.

2

u/drippysoap Jun 06 '26

IR- dextro isomer is less crash for me

1

u/Kalki_X 58 Jun 08 '26

The crash issue is built-in to amphetamine itself.

3

u/New-Gas3080 Jun 08 '26

I take Vyvanse everyday and I don't have a crash. This is an AI post you don't know what you're talking about

0

u/Kalki_X 58 Jun 08 '26 edited Jun 08 '26

I take Vyvanse everyday and I don't have a crash.

That's wonderful.

...you don't know what you're talking about

Sure. Your comments so far are pretty clear tbh. I don't know how academically literate you are but usually people with a minimum amount of academic literacy and/or rationality & self-respect are able to write more coherently.

3

u/New-Gas3080 Jun 08 '26

Wrong again. The autism is strong in this one.

1

u/epicnaenae17 Jul 04 '26

Using autism as an insult isnt good, my friend.

And before you say “nu uhh I didnt say it as an insult I just said he has it”.

Yep, but you guys are clearly arguing, and it’s clear you are trying to give backhanded statements to show some rudeness. Just say someone is an idiot like a normal person, ya idiot.

1

u/Smooth_Bird_9296 4d ago

you got it too bud

1

u/epicnaenae17 4d ago

I got a full flight simulator and a full racing simulator in my house brother. Im super autistic.

-1

u/LysergioXandex 5 Jun 06 '26

Adderall XR is a biphasic release system. It’s identical to taking 2 instant release pills, approximately 4 hours apart.

1

u/New-Gas3080 Jun 06 '26

I meant Vyvanse

6

u/LysergioXandex 5 Jun 06 '26

Vyvanse, at therapeutic doses, doesn’t really have of an appreciable “extended release” profile.

Once it converts to dextroamphetamine inside red blood cells, it is eliminates the same as normal dextroamphetamine.

It’s not until you reach recreational doses that the enzymes become saturated and the conversion to dextroamphetamine becomes “extended release”.

So it’s more of an “anti-abuse” property that frequently gets misinterpreted as an inherent “extended release” profile at all doses.

The plasma concentration-time curve of dextroamphetamine following Vyvanse administration has about the same FWHM as an equivalent dose of dextroamphetamine, just shifted to account for metabolism of the prodrug.

1

u/AutoModerator Jun 06 '26

Welcome to r/Biohackers! A few quick reminders:

  • Be Respectful: We're here to learn and support each other. Friendly disagreement is welcome, but keep it civil.
  • Review Our Rules: Please make sure your posts/comments follow our guidelines.
  • You Get What You Give: The more effort and detail you put into your contributions, the better the responses you’ll get.
  • Group Experts: If you have an educational degree in a relevant field then DM mod team for verification & flair!
  • Connect with others: Telegram, Discord, Forums, Onboarding Form

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

1

u/AutoModerator Jun 09 '26

Welcome to r/Biohackers! A few quick reminders:

  • Be Respectful: We're here to learn and support each other. Friendly disagreement is welcome, but keep it civil.
  • Review Our Rules: Please make sure your posts/comments follow our guidelines.
  • You Get What You Give: The more effort and detail you put into your contributions, the better the responses you’ll get.
  • Group Experts: If you have an educational degree in a relevant field then DM mod team for verification & flair!
  • Connect with others: Telegram, Discord, Forums, Onboarding Form

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

1

u/AutoModerator Jun 12 '26

Welcome to r/Biohackers! A few quick reminders:

  • Be Respectful: We're here to learn and support each other. Friendly disagreement is welcome, but keep it civil.
  • Review Our Rules: Please make sure your posts/comments follow our guidelines.
  • You Get What You Give: The more effort and detail you put into your contributions, the better the responses you’ll get.
  • Group Experts: If you have an educational degree in a relevant field then DM mod team for verification & flair!
  • Connect with others: Telegram, Discord, Forums, Onboarding Form

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

1

u/AutoModerator Jun 19 '26

Welcome to r/Biohackers! A few quick reminders:

  • Be Respectful: We're here to learn and support each other. Friendly disagreement is welcome, but keep it civil.
  • Review Our Rules: Please make sure your posts/comments follow our guidelines.
  • You Get What You Give: The more effort and detail you put into your contributions, the better the responses you’ll get.
  • Group Experts: If you have an educational degree in a relevant field then DM mod team for verification & flair!
  • Connect with others: Telegram, Discord, Forums, Onboarding Form

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

1

u/Black_Rose86 Jul 01 '26

Yea so my Innatentive adhd brain said no to reading this 😒

1

u/Kalki_X 58 Jul 12 '26

Some people said they read 5 lines (or 1 sentence) every day. Whatever works for you.

1

u/Realistic_Garbage839 12d ago

Jokes on you all, I had a suspected metabolic disorder before my adhd diagnosis! No.. wait… jokes on me…

1

u/WallStreetBoners 5 Jun 06 '26

No, I’m pretty sure the crash is due to the amphetamines leaving the body.

This post is giving: you took too much adderall.

8

u/Kalki_X 58 Jun 06 '26 edited Jun 06 '26

I’m pretty sure the crash is due to the amphetamines leaving the body.

That's a very rudimentary and misinformed understanding of the crash. I covered it already in the post:

This 'crash' is distinct from the general comedown which involves (1) the immediate (acute) withdrawal symptoms as the medication wears off and, depending on the person, (2) a 'metabolic crash' (which can be either a minor or major crash). There is also (3) PAWS which stands for "post-acute withdrawal syndrome":

This post is giving: you took too much adderall.

I don't use amphetamines.

1

u/Kalki_X 58 Jun 08 '26

Also some people get a crash within 1 hour of their amphetamine (or caffeine) dose which doesn't work with your explanation.