Rethinking ADHD Treatment: The Power Of Non-Stimulant Medication
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It doesn’t have to be stimulants or nothing; there are other options:
More than just a matter of dopamine
The problem is that stimulants like Adderall, Vyvanse, Ritalin, and Focalin are effective for attention and motivation (by increasing dopamine levels in the brain), but they don’t directly fix other aspects of executive dysfunction.
This is compounded by the fact that difficulties with planning, organization, emotional control, and “set shifting”—the ability to switch tasks and return smoothly. Interruptions (like a “quick call”) can derail productivity for hours in people with ADHD who struggle with this skill.
Stimulants can’t help with this, because although they improve focus and motivation, they don’t do help flexibility. They can even worsen set shifting—hyperfocus may make it harder to mentally switch gears, and interruptions can cause focus to shift to the derailment instead of the intended task.
You may have heard stories of people with ADHD who took their meds to focus on an important task, got distracted before the meds kicked in, and now they will be spending the next four hours intently focused on reorganizing their wardrobe. This kind of thing happens a lot and is a well-known problem for people on ADHD meds.
Current non-stimulant medication options include:
- Clonidine (Kapvay) and guanfacine (Intuniv): approved for children/adolescents; help with impulsivity; sometimes used alongside stimulants.
- Atomoxetine (Strattera): first non-stimulant ADHD medication (approved 2002) for both adults and children; modest results and slower onset (up to a month).
- Viloxazine (Qelbree): newest option (approved 2021); works faster—about a week in children, two weeks in adults.
How Qelbree works: like Strattera, it’s a norepinephrine reuptake inhibitor, increasing norepinephrine in the prefrontal cortex and secondarily boosting dopamine and serotonin—in other words, neurotransmitters tied to focus, motivation, and emotional regulation.
Relevant research cited in the video:
- In a 2023 study, Qelbree outperformed Strattera and worked more quickly.
- 85% of patients who used Qelbree alongside a stimulant were later able to stop the stimulant after stabilization.
- A separate study in children showed Qelbree significantly improved executive function deficits—suggesting probable benefits for adults as well, as there is no obvious reason why age should be a factor in this case.
Some practical notes:
- Qelbree must be taken daily (not as-needed like stimulants).
- It’s still brand-only and may require prior insurance authorization.
- Some insurers require trying Strattera first before approving Qelbree.
For more on all of this, plus sources for the science, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
Get Past Executive Dysfunction
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Quit Drinking – by Rebecca Dolton
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Many “quit drinking” books focus on tips you’ve heard already—cut down like this, rearrange your habits like that, make yourself accountable like so, add a reward element this way, etc.
Dolton takes a different approach.
She focuses instead on the underlying processes of addiction, so as to not merely understand them to fight them, but also to use them against the addiction itself.
This is not just a social or behavioral analysis, by the way, and goes into some detail into the physiological factors of the addiction—including such things as the little-talked about relationship between addiction and gut flora. Candida albans, found in most if not all humans to some extent, gets really out of control when given certain kinds of sugars (including those from alcohol); it grows, eventually puts roots through the intestinal walls (ouch!) and the more it grows, the more it demands the sugars it craves, so the more you feed it.
Quite a motivator to not listen to such cravings! It’s not even you that wants it, it’s the Candida!
Anyway, that’s just one example; there are many. The point here is that this is a well-researched, well-written book that sets itself apart from many of its genre.
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Fast Diet, Fast Exercise, Fast Improvements
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Diet & Exercise, Optimized
This is Dr. Michael Mosley. He originally trained in medicine with the intention of becoming a psychiatrist, but he grew disillusioned with psychiatry as it was practised, and ended up pivoting completely into being a health educator, in which field he won the British Medical Association’s Medical Journalist of the Year Award.
He also died under tragic circumstances very recently (he and his wife were vacationing in Greece, he went missing while out for a short walk on the 5th of June, appears to have got lost, and his body was found 100 yards from a restaurant on the 9th). All strength and comfort to his family; we offer our small tribute here today in his honor.
The “weekend warrior” of fasting
Dr. Mosley was an enjoyer (and proponent) of intermittent fasting, which we’ve written about before:
Fasting Without Crashing? We Sort The Science From The Hype
However, while most attention is generally given to the 16:8 method of intermittent fasting (fast for 16 hours, eat during an 8 hour window, repeat), Dr. Mosley preferred the 5:2 method (which generally means: eat at will for 5 days, then eat a reduced calorie diet for the other 2 days).
Specifically, he advocated putting that cap at 800 kcal for each of the weekend days (doesn’t have to be specifically the weekend).
He also tweaked the “eat at will for 5 days” part, to “eat as much as you like of a low-carb Mediterranean diet for 5 days”:
❝The “New 5:2” approach involves restricting calories to 800 on fasting days, then eating a healthy lower carb, Mediterranean-style diet for the rest of the week.
The beauty of intermittent fasting means that as your insulin sensitivity returns, you will feel fuller for longer on smaller portions. This is why, on non-fasting days, you do not have to count calories, just eat sensible portions. By maintaining a Mediterranean-style diet, you will consume all of the healthy fats, protein, fibre and fresh plant-based food that your body needs.❞
Read more: The Fast 800 | The New 5:2
And about that tweaked Mediterranean Diet? You might also want to check out:
Four Ways To Upgrade The Mediterranean Diet
Knowledge is power
Dr. Mosley encouraged the use of genotyping tests for personal health, not just to know about risk factors, but also to know about things such as, for example, whether you have the gene that makes you unable to gain significant improvements in aerobic fitness by following endurance training programs:
The Real Benefit Of Genetic Testing
On which note, he himself was not a fan of exercise, but recognised its importance, and instead sought to minimize the amount of exercise he needed to do, by practising High Intensity Interval Training. We reviewed a book of his (teamed up with a sports scientist) not long back; here it is:
Fast Exercise: The Simple Secret of High Intensity Training – by Dr. Michael Mosley & Peta Bee
You can also read our own article on the topic, here:
How To Do HIIT (Without Wrecking Your Body)
Just One Thing…
As well as his many educational TV shows, Dr. Mosley was also known for his radio show, “Just One Thing”, and a little while ago we reviewed his book, effectively a compilation of these:
Just One Thing: How Simple Changes Can Transform Your Life – by Dr. Michael Mosley
Enjoy!
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Delay Ageing – by Dr. Colin Rose
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Note: the title is spelled that way because it is British English. We generally write in US English here at 10almonds, but we’ll first quote directly from Dr. Rose as written:
❝I have written Delay Ageing because there is some very important recent University research on ageing and age related illness that deserves to be made accessible to a general audience.❞
What is this research? Well, there’s quite a lot over its 300-odd pages (exact number depends on the edition and whether we count end matter), and most of it is tweaks and refinements on things with which you’ll probably be at least brushingly familiar if you’re a regular 10almonds reader.
Dr. Rose addresses the nine hallmarks of aging, of which there are ten, ranging from such things as “telomeres get shorter” and “DNA accumulates damage”, to “stem cells become exhausted” and “cells fail to communicate properly”, and asks the question “what if we were to target all these things simultaneously?”.
Rather than going for drugs on drugs on drugs (half of them to deal with undesired side effects of the previous ones), Dr. Cole leaves no stone unturned to find lifestyle interventions that will improve each of these, even if just a little. Because, all those “little” improvements add up and even compound, and on the flipside, mean that factors of aging aren’t adding up and compounding so much or so quickly anymore.
The rather broad umbrella of “lifestyle interventions” obviously includes food under its auspices, and with it, nutraceuticals. So to give one example, if you’re taking a fisetin supplement (a natural senolytic agent), you’ll find science vindicating that here. And much more.
The style is… Less pop-science and more “textbook written for laypersons”, and you may be thinking “isn’t that the same?” and the difference is that the textbook has a lot less polish and finesse, but often more precise information.
Bottom line: if you’d like to combat aging on 10 different fronts with easily implementable lifestyle interventions, and know exactly what is doing what and how, then this is the book for you.
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Healthy Habits for Managing & Reversing Prediabetes – by Dr. Marie Feldman
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The book doesn’t assume prior knowledge, and does explain the science of diabetes, prediabetes, the terms and the symptoms, what’s going on inside, etc—before getting onto the main meat of the book, the tips.
The promised 100 tips are varied in their application; they range from diet and exercise, to matters of sleep, stress, and even love.
There are bonus tips too! For example, an appendix covers “tips for healthier eating out” (i.e. in restaurants etc) and a grocery list to ensure your pantry is good for defending you against prediabetes.
The writing style is very accessible pop-science; this isn’t like reading some dry academic paper—though it does cite its sources for claims, which we always love to see.
Bottom line: if you’d like to proof yourself against prediabetes, and are looking for “small things that add up” habits to get into to achieve that, this book is an excellent first choice.
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How To Avoid Slipping Into (Bad) Old Habits
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Treating Bad Habits Like Addictions
How often have you started a healthy new habit (including if it’s a “quit this previous thing” new habit), only to find that you slip back into your old ways?
We’ve written plenty on habit-forming before, so here’s a quick recap before we continue:
How To Really Pick Up (And Keep!) Those Habits
…and even how to give them a boost:
How To Keep On Keeping On… Long Term!
But how to avoid the relapses that are most likely to snowball?
Borrowing from the psychology of addiction recovery
It’s well known that someone recovering from substance addiction should not have even a small amount of the thing they were addicted to. Not one sip of champagne at a wedding, not one drag of a cigarette, and so forth.
This can go for other bad habits too; make one exception, and suddenly you have a whole string of “exceptions”, and before you know it, it’s not the exception anymore; it’s the new rule—again.
Three things that can help guard against this are:
- Absolutely refuse to romanticize the bad habit. Do not fall for its marketing! And yes, everything has marketing even if not advertising; for example, consider the Platonic ideal of a junk-food-eating couch-potato who is humble, unassuming, agreeable, the almost-holy idea of homely comfort, and why shouldn’t we be comfortable after all, haven’t we earned our chosen hedonism, and so on. It’s seductive, and we need to make the choice to not be seduced by it. In this case for example, yes pleasure is great, but being sick tired and destroying our bodies is not, in fact, pleasurable in the long run. Which brings us to…
- Absolutely refuse to forget why you dropped that behavior in the first place. Remember what it did to you, remember you at your worst. Remember what you feared might become of you if you continued like that. This is something where journaling helps, by the way; remembering our low points helps us to avoid finding ourselves in the same situation again.
- Absolutely refuse to let your guard down due to an overabundance of self-confidence in your future self. We all can easily feel that tomorrow is a mystical land in which all productivity is stored, and also where we are strong, energized, iron-willed, and totally able to avoid making the very mistakes that we are right now in the process of making. Instead, be that strong person now, for the benefit of tomorrow’s you. Because after all, if it’s going to be easy tomorrow, it’s easy now, right?
The above is a very simple, hopefully practical, set of rules to follow. If you like hard science more though, Yale’s Dr. Steven Melemis offers five rules (aimed more directly at addiction recovery, so this may be a big “heavy guns” for some milder habits):
- change your life
- be completely honest
- ask for help
- practice self-care
- don’t bend the rules
You can read his full paper and the studies it’s based on, here:
Relapse Prevention and the Five Rules of Recovery
“What if I already screwed up?”
Draw a line under it, now, and move forwards in the direction you actually want to go.
Here’s a good article, that saves us taking up more space here; it’s very well-written so we do recommend it:
The Abstinence Violation Effect and Overcoming It
this article gives specific, practical advices, including CBT tools to use
Take care!
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Cabbage vs Zucchini – Which is Healthier?
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Our Verdict
When comparing cabbage to zucchini, we picked the cabbage.
Why?
In terms of macros, cabbage has 2.5x the fiber, as well as slightly more protein and carbs, making it the more nutrient-dense option in the macronutrient category.
In the category of vitamins, cabbage has more of vitamins B1, B5, B7, B9, C, E, and K, while zucchini has more of vitamins A, B2, B3, and B6, yielding a 7:4 win to cabbage in this round.
Looking at minerals next, cabbage has more calcium and iron, while zucchini has more copper, magnesium, phosphorus, potassium, and zinc, winning a round finally.
In other considerations, cabbages also have notably more polyphenols, so that’s another round in their favor.
Adding up the sections makes for a clear overall win for cabbages, but by all means do enjoy either or both, as diversity is best!
Want to learn more?
You might like:
Super-Nutritious Shchi ← for what to do with that cabbage
Enjoy!
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