How quickly did your Dr. titrate dose? | ADHD Information

Teresa

I started at one dose for two weeks to see if a strong side-effect would occur. After that I was increased 5mg every 3-4 days until I reached a theraputic dose.

MaxDad
I take Ritalin now, but when I was taking Adderall XR, I started at 10mg and then increased 5mg every 2 weeks until I was at a therapuetic level with 45mg. I think it depends on who you see for your medication. Having moved several times since I was diagnosed years ago, and changing health care plans and providers, I have noticed that HMOs are always very conservative with how they handle stimulants. That is why I finally decided to go to a doctor in private practice. Also, the dosage does not depend on body weight but on how each individual's body metabolizes the drug. So a large man could actually be taking a much smaller dose than a small woman. But I still think that 2 months is a long time to have to wait to change your dose. Is there another doctor that you could see? i started at 10mgs(xr)and i went up 5mgs a month till i reached 40. thats when my tolerance caught up with the build up of adderall in my blood stream.I started on 20 mg, and was increased by 5mg per month for 2 months.  I stayed at 30 mg for a couple of months (my choice), but asked the doctor to increase my dose last month.  I now take 35 mg.

I just started Adderall XR 3 weeks ago at 10mg every morning.  I can feel a little change in attention and ability to redirect at work and after 2 weeks was having none of the awful side effects of Strattera, so I called my Dr. and asked if we could increase, anticipating that I am having a recheck visit 2 mos from initial visit.  The nurse said that the doctor really wanted to wait 4 weeks between increasing meds but that they would increase it 5mg this time, but to wait 4 weeks before calling back.  This is after she insisted that I trial Strattera for 3 weeks before she would consider stimulant treatment, because there is less potential for abuse. 

My question is... am I overreacting in being ticked?  The reading I am doing shows that meds are typically increased every 1-2 weeks based on effect and side effect tolerance.  Also, at 137#, I am pretty sure that 15mg per day is not even close to the average dosage.  I know the meds effect everyone differently, but my 105# babysitter takes 25mg per day.  What intervals did your docs use in increasing meds?

I am trying to be patient because I have seen this doctor for 6 years and in every other way like her and feel she has made good care decisions for me.  But, patience is NOT my personal virtue.  I could ask for psych referral and may end up doing that, but I am not sure I want to damage our relationship.  As my husband said, my symptoms will probably improve with each increase, so though I may not be therapeutic, I will still be improving hopefully.  I will run out of Adderall 10mg in about 1 week -- two weeks from last increase-- so, I will have to call and ask for another rx then and I may ask for an increase then.  Also, I can't tell if it is my doc who is being grumpy or her nurse.   I know ultimately that she wants to help me.  I am also printing off some dosage/titration guidelines for kids to take to my appt if I am still feeling like she is not listening to me.

I really appreciate the input.  Even since I wrote my initial post, I have calmed down a bit... this always helps.  It is nice to have a place to spout off where it is safe, instead of blurting it out to my doctor's voicemail.  I will keep you posted.