Hey, everyone...
I'm newly diagnosed with ADHD and my current therapist put me on a trial of Dexamphetamine (the short-lasting tablets) to see how my body and behaviour would react to it due to bad past experiences with other medications such as anti-depressants. I started the medication last Thursday and he told me to begin with a 2.5 Mg dose once in the morning for a couple of days, and then increase it to 5 Mgs once per day until I saw him next.
When I had another appointment with him yesterday, I told him that the medication went down well, and I had noticed a lot of vast improvements with behaviour for the hours in which it was effective.

But at the moment, I have a few concerns about the Dexamphetamine tablets. Because I haven't really lived a normal life and felt like a 'normal' person should for as far back as I can remember, I don't know what 'normal' really is, if that makes sense. I mean, I feel all right when I'm on it; I'm not irritated or angry, and I feel that my concentration and motivation for personal work and chores is a lot better than what it used to be. But I'm twenty-four and my ADHD symptoms have affected the way I've lived my life. While this disorder hadn't come to my attention until now, I've been unfit for study and work ever since I completed home-school.

For about the first four days after I took the two 2.5 Mg doses and two 5 Mg doses, I felt like I've never felt before; what I'd consider to be 'normal'. I was so pleased that I could do things immediately, remember instructions, multitask without becoming frustrated by doing too many things at once, and being able to answer the phone without feeling anxious or forgetting what was said in the conversation if I had to take a message for someone. Even my motivation for actually wanting to start work was there when it has never been around before (lack of self-confidence)! I've been without that feeling for so long that it made me thrilled that something finally works for me.

The problem is now that I've been on it for that week's trial, I wonder how I'll detect if the dose I'm on is correct for me? I noticed a big difference to start off with, and now I'm not noticing it as much as I used to. I don't know if it's because I've become accustomed to the effects of the Dexamphetamine after that week so I wouldn't notice it, or whether or not I need to trial a higher dose of medication? It's hard to base it on because I can't work right now, and that's where you need most of your concentration and motivation.

I saw the therapist yesterday, and now that the 'reaction' trial is over, he's increased my dose to 5 Mg in the morning (8:00 AM) and another 2.5 Mg dose in the afternoon (12:00 PM). He said that if I find that doesn't work as well, to take a 5 Mg tablet in the morning and in the afternoon as well, but I cannot exceed a dose of two 5 Mg Dexamphetamine tablets per day. I'm short and thin, and he said that I may suffer bad side-effects if I exceed that dose because of how I'm built.

The real thing that bothers me the most about the Dexamphetamine and this dose limit is when I come down off of it. I find the ADHD symptoms come back (which I knew would happen), and then I feel really negative about the treatment. Because the medication works while I'm on it, I feel it doubly-so when I'm not on it. I seem worse, but I know it'll be because these symptoms will be magnified against how the medication makes me function.

Also when it wears off, it can make me really tired and irritable, and because the tablets are the short-acting ones and I'm now on a 'dose' trial, I'm stuck with it for the rest of the day.

So let's see, I wake up at 8:00 AM, have breakfast, and then take my medication straight after. I need another dose at lunchtime which can only be 2.5 Mgs (or a 5 Mg tablet if I skip the late afternoon one), and then I can take another 2.5 Mg dose at around 4:00 PM. What happens if I want to be out late on weekends, though, and I need more? I hate this limit, and I'm worried about what will happen if I do need to increase it eventually or even now. I know that for me, 2.5 Mgs isn't as effective now as 5 Mgs of Dexamphetamine.

I know it's a matter of trialling different doses, except as I said, he's given me a limit to work with which makes that a bit hard. I really need some advice about the questions I've asked because I don't know what else to do. He won't be available for another appointment next week, so I'm stuck with these concerns until around the 20th of April.

Help. :(

i guess you shouldn't panic and worry about things that haven't happened. hm? just go along with what your therapist wants you to do and accept the fact that when the dexedrine wears off you get your usual symptoms back again. no big deal. happens to me as well. sometimes i feel really wiped. at least i know why. i guess the difference between us is that i've had major health issues and i'm a lot older than you are so i've learned to accept the fact that the body doesn't always do what the mind wants it to do or vice versa. also i've been doing yoga for a couple of years and that changes the way a person views things as well. don't panic. breathe. :)

I know how you feel, I have no idea what normal is. Remember that normal is different for each person. Try thinking about normal for you, as when you related to others the way you want to and begin meeting your goals successfully. Think of the symptoms of ADHD you experience and how much they decrease..

I just started Dexedrine, a little before you, in February. The only way you can find out what the right dose for you is for you to keep moving the dose up incrementally. I started out where you are, and at the present I'm taking 47.5 mg per day in 4 doses per day. I have stuck with this current dose for 7 days now, today i will ask to increase it and we will discuss how that is to be done.


The problem is now that I've been on it for that week's trial, I wonder how I'll detect if the dose I'm on is correct for me? I noticed a big difference to start off with, and now I'm not noticing it as much as I used to. I don't know if it's because I've become accustomed to the effects of the Dexamphetamine after that week so I wouldn't notice it, or whether or not I need to trial a higher dose of medication? It's hard to base it on because I can't work right now, and that's where you need most of your concentration and motivation.

Originally my appointments were two weeks apart. I found this exceedingly frustrating because i knew within a day of taking a new dose how it was going to affect my thinking. I discussed this with him, and also that the standard titration method (the way medication is increased incrementally) for Dexedrine and Ritalin was in one week periods, mainly to allow your body to physically adjust to the new dose. My appointments are now one week apart, and the weekly visits are very short, 15 minutes, just long enough for a progress report and if an increase is needed or not. So far its been increased each time by about 5 mg.


I saw the therapist yesterday, and now that the 'reaction' trial is over, he's increased my dose to 5 Mg in the morning (8:00 AM) and another 2.5 Mg dose in the afternoon (12:00 PM). He said that if I find that doesn't work as well, to take a 5 Mg tablet in the morning and in the afternoon as well, but I cannot exceed a dose of two 5 Mg Dexamphetamine tablets per day. I'm short and thin, and he said that I may suffer bad side-effects if I exceed that dose because of how I'm built.
The real thing that bothers me the most about the Dexamphetamine and this dose limit is when I come down off of it. I find the ADHD symptoms come back (which I knew would happen), and then I feel really negative about the treatment. Because the medication works while I'm on it, I feel it doubly-so when I'm not on it. I seem worse, but I know it'll be because these symptoms will be magnified against how the medication makes me function.


I also discussed with my doctor how my waking day worked. When he understood how many hours I was active during the day, he agreed to 4 doses instead of three. This affects the way he writes the prescription. Dexedrine is said to be effective for 4 hours. This is different for some people. Now my doctor has a idea of how long during he day i need to be covered. He has to think about your needs as well as any prescribing regulations for this drug. In Canada it is less strictly regulated than in the US, I don't know how carefully regulated it is in Australia


I take 4 doses per day, because my day is that long. Sometimes I take the first dose at 6 AM and go back to sleep for a few more hours. Other times I sleep right thru to almost time for the second dose at 10 AM. That means I've missed the first dose and will only take 3 doses that day. My doctor has never treated ADHD before so, in some ways he's playing it by ear. The reason for at least trying to make the 6 AM dose is that i am sometimes up at that time and even when i am not, it helps to keep to one schedule. I also do some volunteer work at night which requires me to be on the ball, so I have mentioned that to him and have agreed on some exceptions to the medication schedule. I have found that it is important to keep the amount of Dexedrine steady during the hours you are awake. I feel much better than if the dose changes during the day or I don't have enough leeway to make small adjustment. The medication should fit your schedule, not the other way around.

One thing that matters a lot (of course) is how you react physically as well as mentally . How others react to you and how you relate at work and at home is just as important. Some people I work with have made mention of some good changes. I've been mentioning those to my doctor as well. One friend I spend quite a bit of time with online (He's in Australia to!) typed up a one page report on how the had seen me change. I gave that do my doctor as well.

Your doctor can only respond to the information he has on hand, so the more information you bring him the more easilly he will be able to tailor your treatment to your needs.

Hope this helps!
katatak

The problem is now that I've been on it for that week's trial, I wonder how I'll detect if the dose I'm on is correct for me? I noticed a big difference to start off with, and now I'm not noticing it as much as I used to. I don't know if it's because I've become accustomed to the effects of the Dexamphetamine after that week so I wouldn't notice it, or whether or not I need to trial a higher dose of medication? It's hard to base it on because I can't work right now, and that's where you need most
of your concentration and motivation..

I think the answer is yes. The will find out by learning as much as you can about ADHD and how it's symptoms affect you. You will be taking enough when you control your own impluses and can act appropriately. Don't forget about the organizational things. That's the biggie for me! I can't organize large on going projects at all!



I saw the therapist yesterday, and now that the 'reaction' trial is over, he's increased my dose to 5 Mg in the morning (8:00 AM) and another 2.5 Mg dose in the afternoon (12:00 PM). He said that if I find that doesn't work as well, to take a 5 Mg tablet in the morning and in the afternoon as well, but I cannot exceed a dose of two 5 Mg Dexamphetamine tablets per day. I'm short and thin, and he said that I may suffer bad side-effects if I exceed that dose because of how I'm built.

You probably aren't at a dose where it will affect your appetite. Just make sure you keep eating!



The real thing that bothers me the most about the Dexamphetamine and this dose limit is when I come down off of it. I find the ADHD symptoms come back (which I knew would happen), and then I feel really negative about the treatment. Because the medication works while I'm on it, I feel it doubly-so when I'm not on it. I seem worse, but I know it'll be because these symptoms will be magnified against how the medication makes me function.

I know it's a matter of trialling different doses, except as I said, he's given me a limit to work with which makes that a bit hard. I really need some advice about the questions I've asked because I don't know what else to do. He won't be available for another appointment next week, so I'm stuck with these concerns until around the 20th of April.

The amount of Dexedrine you are trying is the total daily amount, not any of the speed bumps in the road. Those distract from the main goal. Right now, your body has to get used to increasing amounts of Dexedrine. It takes time. Make it easy on yourself and make your experiene as even as possible. When you go back to your therapist you can say simply, that you had this result when you took a certain amount evenly during the day. The 10 days will pass, and you can document clearly what your experiences have been and what you're afriad will happen. As I said in my earlier post, ask to see your therapist weekly for a while.

This is a difficult time! My experience is that steady coverage during the day is much easier to deal with than doeses that jump up and down. Those humps and bumps where you get lots more medication then suddenly much lower or none at all is extremely emotionally wearinig. You don't need the roller coaster ride!

As the doses get higher, the coverage gets more even. In my earlier post I said I was seeing my doctor today. The result of taht visit is that he raised the dose to 55 mg. That is a bigger jump than he would have liked, but in the interests of keeping my mood steady he opted for 15 mg three times, starting at 6AM, at 4-5 hour intervals. The last dose is 10 mg. which will make sleeping easier at night.

Hang in there, It looks like you already have some good results and you don't want to loose that.

Cheers,
Katatak

I'm twice your age and have just recently admitted to what I've always called zipzap (ADD/etc) and clinically diagnosed. I currently set small goals to achive each day and once they are done so is my self judgment! ! ! I will never be 20 again nor can I expect absolution in medication. I plan to use medication to meet reasonable daily goals that with pratice can evolve into routine. Beyond that I'm just gonna allow myself to be off duty. So long as I do not undo what good I may do in a day I'm gonna let my zip keep zapping. A college psychology teacher once told me that medication is not the yellow brick road. I've since added that if it is,...It will not be traveled upon without effort, belief, and acceptence.
Peace

I like that, set small goals each day and once they're done allow yourself to be off duty.

Hi - I actually finally got around to registering to reply to your post....when I first started dex I was nursing was limited to 5mg once a day. I found the same frustration - now I know what I'm missing out on, can't I have it all the time. I got up to 7.5 at that one dose 9 (at 10mg I start to get side effects), and am now 7.5 3x day. I will sometimes take an additional dose, if for example I wake up early and need to work until late. It's taken about 3 months and I'm still straightneing it out...The first dose STARTS to wear off around 3 hours, but I don't want to take too much so it tends to be 5 hours, when it's washed out to the point of no effect that I remember to take the next dose, sometimes more. So I'm still working on it...try to be patient, ask at your next appt if you can have a 10 min phone consult between appointments?