Well I am sorry you had to go through this ickyness with the doctor and to where you consider this an addiction. Funny though since this is an example of why I went into the mental health field to begin with.
I was one of the subjects that was first on Adderall XR so it could get approved by the FDA. So I have been on addreall either the xr or regular for almost 9 or so years. Due to this and my own research I hope I can put your fears at ease a little. First, I want you to recognize that you made the right decison to seek treatment from a psychitrist, especially if they specialize in ADHD. Primary care doctors just do not have the training, experince, or understanding of not only the disorder but also how these medications affect the body and react to long term use. I did not see that he recomended a med break of a week or more at least once a year which is a standard and effective way of reducing the tolerence effcets of having to increase your dosage as frequently.
I want to stress that tolerence to stimulant medication is not addiciton in the classical sense. As what was said before it is natural when using sitmulants over a period of time with out a break or a change in the meds to need higher doses. Adders are lacking ( per the theory of what stimulants work) enough dopamine to get their brain to funtion like "normals" and stimulants increase the level of dopamine. Like anything else may it be bublegum you have chewed way to long or (wierd reference sorry) birth contol that you have been on for a long time you body will to start to find it normal and stop producing the level of dopamine needed to sustain your attention. This is why with most medications you do not stay on the same one for long periods of time. Addiction on the other hand requires a need for "markedly" increased amounts of the substance to reach the desired effect. Ok here is my long winded point. If you were addicted you would have needed to increase a heck of alot soon than a year and a half. (Also by the way you have to have true withdrawals and several other things)
I also have to comment on the whole withdrawal thing. Wow ok yeah stimulants when used correctly are out of your system within about 6-8 hours. This is not meth guys. Your are not going to have the classic withdrawal symtoms unless you have a really bad reaction to medication becasue you are withdrawling everynight. That is why you are sleepy and probably cranky when you do not take your meds. That is also why you can feel benifits of the medication almost like the frist time you take it, if it is the correct dosage. Now when you do a true med break and taper off the meds untill you do not take it for about a week things will be rough. Not becasue you are withdrawaling so much but becasue you know how you like to act and you won't be able to do it. Hint learn from my mistakes and do not do a med break during family holidays...bad idea.
Now I will admit that I have been on some sort of stimulant or the other since I was 7 years old and I am 29 now. I am at that dreaded 40 mg a day but what also is not being discussed is your lifestyle as compared to your medication needs. I did not need as much adderall when I was doing a 9 to 5 job or less at times, but as my stress level increased (grad school will do that) so did my needs for the medication. I needed something that would last longer to get me through classess and stuff and that helped me pay attention and manage my disruptive behavior better. And after much experimanting with my shrink I found a good dosage for me, and I have been there for at least the last 5 years taking meds break to maintain where I was at.
I know this sounds like a lecture of sorts but I belive that understanding and having knowledge is what helps us adders more than anything. It is what gives us power in a world of people telling us how add is supossed to go when they have not lived with it. And well you can research on your own what I am saying if you need more information. I am just uncomfortable with you taking on this worry when it is not your issue to take on. Sorry this was so long and stuff, let me know if you need anything else.
miscbad, sounds like you know your ADD and your meds.
thanks for the valuable information.
Your welcome. Yeah it is kinda sad but ADHD is now my life and what I do. so I don't like keeping the information to myself if I can help out someone else.
Hello all. First time poster here, and desperately seeking advice.
Let's see where to begin.....
For the longest time, I thought most individuals around my age and younger (I'm 31) have some sort of ADD. I figured with all the TV and video games and what not we've grown up around our attention span is short and fleeting. I figured it was just something I had to deal with. Often while studying I would find myself reading the same paragraph over and over and over again. It could take me forever just to read a simple chapter. Then after a couple of years into my "big return to college", I decided to look into diagnostic tests. After taking the Browns ADD test, which apparently is somewhat standard, and having "many more symptoms than 'normal folk'", I sought out a doctor for some medicated help. The doctor I went in to see is an okay doctor. As a student of medical science myself, I'm not too impressed with his "skills". I first saw him for a physical before my daughter was born, then some other issues here and there over the last year and a half. My wife asked me if we should take our daughter to him, and I said "he's not that good".
Anyway, he wrote me a prescription for Adderall (20mg once daily). Having never taken any ADD medication before I looked into information on all of them during the diagnostic test period. Adderall seemed to be the one with the least amount of crazies (side effects), and luckily besides the first week or so of adjustment it has been a miracle drug. I have had zero side effects (except little crap like dry mouth and stuff). Well now after 1.5 yrs on 20mg once daily, the dosage has lost a lot of its effectiveness. It used to work for 6 hours, and now it works for a maximum of 3 hours. I've been fearful of ever seeking an increase in the dosage for mainly two reasons: 1) if I increase it to say 20mg twice daily, will that eventually become less effective as well and then I will need another increase? 2) does the lack of effectiveness mean that I am building some sort of addiction? or just a "resistance"?
As far as the addiction goes, I have had moments where I did not take it for a day or two, and I felt no withdrawal symptoms (except maybe being sleepier). And my understanding is that I would feel some sort of withdrawals. Of course the only other addiction I've ever had was to cigarettes, and I quit that pretty much flawlessly with a little help from the patch (4 or 5 yrs ago).
So anyway, I decided recently to finally come to terms with my situation and ask the doc for an increase in my dosage. I called fully expecting to have to make an appointment as I haven't been in in awhile. I explained that I don't need a refill right now and that I'm just interested in seeking an increase. They asked me for how much and I said "Oh I don't know, I guess twice a day...it doesn't last as long as it used to". They said the doctor would call me back. An hour later the doctor's assistant calls back and says that the doctor is very reluctant to increase my prescription. I didn't ask why and I didn't want to get into a whole thing with them (for fear of losing my current prescription).
Now I know that this is a narcotic. Doctors have to be careful to whom they write their prescriptions to. I'm certainly not a druggie. I don't abuse my adderall. (Honestly since the effectiveness has decreased I maybe, once or twice a month, take two tablets a day about 6 hours apart to see if it will help and it does.) My refill records may slightly reveal that, but he also only fills my prescription for 30 tablets each month, and we all know that eliminates 5 days a year. :)
So now I have made an appointment with a local psychiatrist who specializes in ADD/ADHD cases in order to ask some questions and get an increase (if they feel it will help, which I truly feel it will).
And my biggest problem is that I feel like I have to focus a certain amount of energy into "not seeming like a druggie" just so I can seek help with my disorder. I'm a very sincere and honest person, and I feel that when I sit down and explain my situation, it should be revealed as such.
After typing all this out, I suppose I just want opinions on my situation. I don't want to have to jump from doctor to doctor in order to get help. I don't want to have to feel like I'm doing something wrong by seeking help. I don't want the fact that my one doctor said no without seeing me to affect my ability to get the increase elsewhere. Any advice or comments are welcome. And if you've made it this far, thanks for reading.....
Ranglah39321.8868402778I recently got my second Rx for Adderall XR. My psych asked how it was going. GREAT! I explained that on Strattera I felt dull, boring, dull-witted, slow, even though I was able to control my thoughts/brain/actions better. On Adderall it's like the gears of my brain finally meshed and I'm in 4th gear just cruising along getting things done. It's like my actions/thoughts/thought process are finally working in tune with one another. Does that make sense? But..... I told him it's like in the afternoon early evening it all seems to unravel some. He said he was going to raise my dose to 30mg.
I voiced my concerns of raising dosage due to possibly developing a tolerence for it and having to raise the dose more to get the same level of focus, and also concerns about my past and illegal drugs (speed freak! loved those Black Mollies) and how much I do like that zoomy feeling. I definitely don't need/want to go there again. He asssured me that tolerance really doesn't happen that often especially in people who are truly ADD. I asked what things I needed to be on the lookout for if the dose is too high. High pulse/heart rate, frantic behavior, etc. I've been monitoring myself closely on 30mg. And the strange thing is I feel even calmer, more stable, and more clear-headed than on the 20mg. The only time I get any kind of racing pulse is if I've hit the caffeine more than I should in the middle of the day. Interesting, huh?!
[QUOTE=Ranglah]
An hour later the doctor's assistant calls back and says that the doctor is very reluctant to increase my prescription. I didn't ask why and I didn't want to get into a whole thing with them (for fear of losing my current prescription).
I understand your concerns. I was on Strattera because of the ease of getting refills. After talking with my sister, who was diagnosed this year and placed on Strattera and then Metadate, I decided to seek a trial of a stimulant. It is so much better than the Strattera. Like the gears in my head mesh and I start moving forward. Otherwise I would just sit and idle for hours waiting for the strattera to start working.
I have a history (teenage years) of using street amphetamines (I really liked that speedy feeling), so I was really concerned about potentially abusing them. I was also worried that maybe Adderall would give me that speedy feeling thus confirming fears that I am not truly ADD. This sounds weird to say but I am happy to say that I do indeed have ADD.
I'm on Adderall XR 20mg. It is working okay. My psychiatrist indicated that 20 mg. is a mid-point doseage and that we could go up or down from there. I don't have the appetite suppression (a side effect that I like), I don't have any jitteryness, or any of the other side effects other than dry mouth.
I think that you just need to go in to the doc and be quite honest. That you are concerned about sounding like a speed junkie but you lose focus mid-day and is it possible that the dose isn't high enough? Psychs have probably seen it all and they can tell a junkie when they see one. A speed freak isn't going to be able to sit there calmly and explain what is going on. Someone who is abusing stimulants is going to act like, well.... an unmedicated ADHD person.
Isn't it just wonderful! Here you have a doctor who writes you a script because he feels you have a legitimate affliction. And then when you NATURALLY build a tolerance to it, Doc is "reluctant" to increase the dose. Why reluctant we ask? Oh, because that is a sign of an "drug addiction!"
Notice he wouldn't get on the phone to explain it himself? (coward) Notice he didn't bring you in for further evalution? Notice this "doctor" is not a very good doctor???
The truth is, adderal is an amphetamine. And as such, you will build a tolerance. Like you, if I don't take my meds for a couple days, I see no withdrawals. It was suprising to me at first too. I couldn't BELIEVE I wasn't addicted. I mean, with all my "add symptoms" like FORGETFULNESS, I have NEVER forgotten to take my adds!!! Funny isn't it?
So anyway, it sounds like this doctor is giving you a complex. It is NATURAL for you to build a tolerance. It is unnatural for a Dr to have his assitant tell you NO! That happened to my brother once with his family doctor and he called the Attoney General and filed a report. I would do the same.
I would also have your records transferred from his office to another more qualified specialist. But I will tell you this:
The industry standard for MAX DOSAGE is 20mg 2x per day, or 40mg per day. If I were you, I WOULD NOT go that high. Doing so would ensure the drug would lose its effectiveness at some point. Here's what I have done:
I created an arbitrary "ceiling" with my doc. We aid 30mg is the highest, and if at any point the drug loses its effectiveness, I would switch over to the extended release. I have done this twice. The changeover from regular adderall to XR has enabled the dosage of 30mg to be effective.
Hope this helps.