Does Tolerance to Stimulants occur?

I have heard quite some about medication vacations - but am unsure how frequently one would need to take them ie 1 month on 1 month off, or 2 months on 1 month off medication; presumably one would need to take smaller and less frequent medication vacations on lower dosages?

I've been on Slow release Ritalin for three years. I have had to increase my dose several times over the years. I was on adderall for a couple on months, it didn't work out so I switched back to Ritain and went down to my original dose...

I was on Concerta for about 3 months. Then my insurance changed and I went without anything for a couple of months. Then I got a new doctor and he wanted me to try Straterra. I did Straterra for about 3 months, but just went back to Concerta about 2 weeks ago.

My doctor's plan is for me to go 6-8 months, then take about a month off. But I think that is mostly because I have a history of self-medicating back before I knew I had ADD. Since I have a bit of an addictive personality he wants to monitor it closely.

Some people take Ritalin or Concerta for years without needing to increase dosage or taking a break.

By the way, I am also inattentive and Concerta works very well for me. It does not completely eliminate my symptoms, but it does help me function.

My memory is no better, but I have the energy to make sure I write everything down. I still get sidetracked, but have the energy to not let it bring my workday to a halt. I can catch myself and get back to the task at hand.

Hi,

I'm from the UK, have ADD-Inattentive type and spend much of my 'forum posting life' on the message boards run by a British site (Adders.org).

I've learnt a great deal from this site.

In the UK, adult ADHD isn't formally recognized. Where Ritalin can be prescribed for adults if we're lucky -- Dexedrine is very difficult and Adderall is impossible to obtain. Wellbutrin isn't licensed in the UK for depression and Strattera, although licensed very recently, is virtually unheard of here.
We have very few British experts on ADD, only 2 centres within out public health system and 2 or 3 centres within the private sector. As you can imagine, the queues to be seen by a specialist in ADD are horrendously long. As a consequence of the lack of experience that the majority of our Psychiatrists have on ADD, nearly everybody that posts to our forum has been or is currently diagnosed as suffering from *depression* and *not* ADD.

The reason why I am posting the following request for information on a predominantly American forum, is because we don't have many long term (greater than 3 years) stimulant medication users within our British online ADD support community.

Regarding stimulant medication, I have tried Ritalin and Dexedrine - and found Dexedrine to work wonderfully (for the 3-4 months that I was on it), with Ritalin working, but much less well.

My question is simply, would you post the name of the stimulant medication that you're taking, time that you've been taking it, rating from 1 to 5 (relating to whether you wish you'd never started stimulant medication therapy, with 1 representing complete dissatisfaction, 5 complete satisfaction and 3 the advantages and disadvantages counterbalance one another) and comments regarding if tolerance (ie need to escalate dosage) or addiction occurred and when.

Many of the messages that I've read across many websites, seem to suggest that there's a honeymoon period that is experienced for the first couple of years on stimulant medication, and that this is bliss - but that once this period is over, that anything can happen........

The only 2 responses I've had from the UK so far have been.

From C
ritalin-5 years-5-No Tolerance/Addiction

From H
dexedrine-2 years-5-No Tolerance/Addiction

I should mention that the reason I've turned to you for help, is that there's a chance that I might soon be able to restart taking Dexedrine, but I'm ever so worried that I will only be buying myself a couple of years of improvement from ADD, and thereafter will be either back where I started (or even worse off).

Thanks in advance for your replies,

SB

My understanding is that people do eventually develop tolerances to a stimulant.

But that is not necessarily a big problem. As you build up a tolerance, you gradually increase the dosage. After a while (2-3 years?) when you start to get near the maximum dosage, you just take a month off meds. Then you can start bak at your original dose. These meds do not seem to have the withdrawal problems of unlicensed drugs.

IF you have a history of addiction or substance abuse, you need to be more careful. I have such a history, but I am still using a stimulant (Concerta). My doctor simply wants me to go off it every 6 months or so for 2-3 weeks so my dosage never has to get too high.

It is a slight risk. But without the help from my meds I will lose my marriage (maybe too late for that already), my career, my home, etc. The ADD is so debilitating for me that doing nothing is not an option.

16th World Congress of the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) in Berlin/Germany 22 - 26 August 2004.

Click on any of the titles (if underlined) for a brief abstract of their work.There's a section on Drug holidays, of particular interest to this thread.




	Does Tolerance to Stimulants occur? Hi Chazinmo, Thanks for the reply. Might I ask how long you've been using stimulants now? I have heard quite some about medication vacations - but am unsure how frequently one would need to take them ie 1 month on 1 month off, or 2 months on 1 month off medication; presumably one would need to take smaller and less frequent medication vacations on lower dosages? SB Hi, I've been on Slow release Ritalin for three years. I have had to increase my dose several times over the years. I was on adderall for a couple on months, it didn't work out so I switched back to Ritain and went down to my original dose... I was on Concerta for about 3 months. Then my insurance changed and I went without anything for a couple of months. Then I got a new doctor and he wanted me to try Straterra. I did Straterra for about 3 months, but just went back to Concerta about 2 weeks ago. My doctor's plan is for me to go 6-8 months, then take about a month off. But I think that is mostly because I have a history of self-medicating back before I knew I had ADD. Since I have a bit of an addictive personality he wants to monitor it closely. Some people take Ritalin or Concerta for years without needing to increase dosage or taking a break. By the way, I am also inattentive and Concerta works very well for me. It does not completely eliminate my symptoms, but it does help me function. My memory is no better, but I have the energy to make sure I write everything down. I still get sidetracked, but have the energy to not let it bring my workday to a halt. I can catch myself and get back to the task at hand. Hi, I'm from the UK, have ADD-Inattentive type and spend much of my 'forum posting life' on the message boards run by a British site (Adders.org). I've learnt a great deal from this site. In the UK, adult ADHD isn't formally recognized. Where Ritalin can be prescribed for adults if we're lucky -- Dexedrine is very difficult and Adderall is impossible to obtain. Wellbutrin isn't licensed in the UK for depression and Strattera, although licensed very recently, is virtually unheard of here. We have very few British experts on ADD, only 2 centres within out public health system and 2 or 3 centres within the private sector. As you can imagine, the queues to be seen by a specialist in ADD are horrendously long. As a consequence of the lack of experience that the majority of our Psychiatrists have on ADD, nearly everybody that posts to our forum has been or is currently diagnosed as suffering from depression and not ADD. The reason why I am posting the following request for information on a predominantly American forum, is because we don't have many long term (greater than 3 years) stimulant medication users within our British online ADD support community. Regarding stimulant medication, I have tried Ritalin and Dexedrine - and found Dexedrine to work wonderfully (for the 3-4 months that I was on it), with Ritalin working, but much less well. My question is simply, would you post the name of the stimulant medication that you're taking, time that you've been taking it, rating from 1 to 5 (relating to whether you wish you'd never started stimulant medication therapy, with 1 representing complete dissatisfaction, 5 complete satisfaction and 3 the advantages and disadvantages counterbalance one another) and comments regarding if tolerance (ie need to escalate dosage) or addiction occurred and when. Many of the messages that I've read across many websites, seem to suggest that there's a honeymoon period that is experienced for the first couple of years on stimulant medication, and that this is bliss - but that once this period is over, that anything can happen........ The only 2 responses I've had from the UK so far have been. From C ritalin-5 years-5-No Tolerance/Addiction From H dexedrine-2 years-5-No Tolerance/Addiction I should mention that the reason I've turned to you for help, is that there's a chance that I might soon be able to restart taking Dexedrine, but I'm ever so worried that I will only be buying myself a couple of years of improvement from ADD, and thereafter will be either back where I started (or even worse off). Thanks in advance for your replies, SB My understanding is that people do eventually develop tolerances to a stimulant. But that is not necessarily a big problem. As you build up a tolerance, you gradually increase the dosage. After a while (2-3 years?) when you start to get near the maximum dosage, you just take a month off meds. Then you can start bak at your original dose. These meds do not seem to have the withdrawal problems of unlicensed drugs. IF you have a history of addiction or substance abuse, you need to be more careful. I have such a history, but I am still using a stimulant (Concerta). My doctor simply wants me to go off it every 6 months or so for 2-3 weeks so my dosage never has to get too high. It is a slight risk. But without the help from my meds I will lose my marriage (maybe too late for that already), my career, my home, etc. The ADD is so debilitating for me that doing nothing is not an option. Hi, Lots of very current research on ADD is to be found at: http://www.iacapap-berlin.de/guest/?MIval=SciProgramSessions List&SSNTRACK=1 16th World Congress of the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) in Berlin/Germany 22 - 26 August 2004. Click on any of the titles (if underlined) for a brief abstract of their work.There's a section on Drug holidays, of particular interest to this thread. SB	Enter Your Email below to claim your Free Book