View Full Version : Help! I'm worried I was given bad medical advice


PaulCamR
01-31-17, 06:31 PM
About 9 or 10 days ago I was prescribed concerta 36mg. It did nothing.

I went in to the same doctor today. She gave me a quick add test this time and still seemed unsure I have add, just said "well you certainly have troubles focusing." I told her about a brain injury at 5, she said well maybe it's not add then.

I was prescribed adderall xr 10mg and biphentin 10mg both to try. Not on the same days. She said to up doses how I see fit, and see if something works for me.

I told her biphentin seems like it's just another version of concerta and I'd like to try 20mg of adderall xr. She said to stathat at 10mg.

So basically I was given permission to experiment with multiple adderall xr 10mg pills... and to come back with what works for me to be re prescribed. And who knows, what if 30mg adderall xr is what works and she says that's too much?

Ugh. What am I doing?!

PaulCamR
01-31-17, 07:25 PM
I would like to add: I took 3 of the biphentin 10mg pills, since I researched and found it's just a different release mechanism of methylphenidate. If Concerta 36mg did absolutely nothing, 10mg of biphentin is a joke.

Tomorrow I will either try to fill the adderall script (it was filled as "hold"), or I'll try 5 biphentin 10mg's (if the 3 do nothing today)....

I feel like the medical advice I've been given is just steering me on a purely experimental path. The doctor didn't want me to have 20mg adderall XR pills because she was worried it was too much, but she told me I could take as many 10mg adderall XR pills as I saw fit (she knows I said I didn't want to go over 30mg, so I think she implied within reason).

Lunacie
01-31-17, 08:53 PM
Is trouble focusing your only symptom? The only problem?

You could take an online test for adhd and see if any of the other symptoms
affect you or not.

TBI (traumatic brain injury) symptoms can overlap with adhd symptoms.
And some of the adhd meds are helpful for those with TBI.

At this point, it really is experimental trying to find which meds work for each
person, and at what dosage. That's something we all deal with.

PaulCamR
01-31-17, 09:07 PM
Is trouble focusing your only symptom? The only problem?

You could take an online test for adhd and see if any of the other symptoms
affect you or not.

TBI (traumatic brain injury) symptoms can overlap with adhd symptoms.
And some of the adhd meds are helpful for those with TBI.

At this point, it really is experimental trying to find which meds work for each
person, and at what dosage. That's something we all deal with.

It just can't wrap my head around why she wanted to prescribe 10mg of biphentin to me, and not adderall XR, when 36mg of concerta didn't work. It's the same drug, methylphenidate. It makes me question if she knows that 10mg of biphentin is a way lower dose of methylphenidate than concerta.

The adderall XR was an after-thought for her. She wrote it down because I directly asked for her to prescribe it so I can figure out what works for me.

I'm just worried.

Troubles focusing is one symptom. Sustained focus. Maintaining on task and not feeling an urge to pull away due to feeling exhausted by doing the task. Disorganization, or knowing how to organize but not being able to implement planned organization. Etc, etc. I've gone through a lot of information, which got me to the doc's office to get the concerta 36mg a week and a half ago.

I'm just feeling scattered and worried at this point.

Lunacie
01-31-17, 10:05 PM
Even when two drugs have the same basic medication, the formula can make
it work differently. In this case, biphentin and concerta have different release
mechanisms, so could work differently.

So every time you try a new medicine you should start at the lowest dose to
minimize any unpleasant side effects.

PaulCamR
01-31-17, 10:10 PM
Even when two drugs have the same basic medication, the formula can make
it work differently. In this case, biphentin and concerta have different release
mechanisms, so could work differently.

So every time you try a new medicine you should start at the lowest dose to
minimize any unpleasant side effects.

Fair enough. So maybe she's just being very cautious since the first treatment (36mg Concerta) didn't work out.

I'll try to step back and take a breath and try each thing one at a time.

Without insurance, testing low doses just adds to the cost unfortunately :(

Lunacie
01-31-17, 10:27 PM
Fair enough. So maybe she's just being very cautious since the first treatment (36mg Concerta) didn't work out.

I'll try to step back and take a breath and try each thing one at a time.

Without insurance, testing low doses just adds to the cost unfortunately :(

Yep, I hear that. I just got medicare after 15 years uninsured. My daughter has
been uninsured for 18 years. Scary times.

But I learned that I can ask for only two weeks worth of pills instead of a whole
month just in case they don't work, or I'm allergic, which saved me some $$$.

PaulCamR
02-01-17, 12:13 AM
Yep, I hear that. I just got medicare after 15 years uninsured. My daughter has
been uninsured for 18 years. Scary times.

But I learned that I can ask for only two weeks worth of pills instead of a whole
month just in case they don't work, or I'm allergic, which saved me some $$$.

Wow! That's a long time to be paying full price without any insurance. Yikes. Although that $10 dispensing fee is a real dinger! But ya, good advice :)

I actually got 12 or 14 free 10mg pills of biphentin. So my trial of biphentin is free, which is wonderful. The 30mg I tried today hit me harder than Concerta, but hasn't lasted, and was more of a mood booster with no benefits for focus.

Tomorrow I will try 50mg of biphentin. If that doesn't help, I'll move to Adderall on Thursday.

Unfortunately, I think I will have to fill the full 30 days of Adderall. Basically, if 10mg doesn't work, I'll have to try 20mg. If 20mg doesn't work, I'll have to try 30mg. And if 30mg doesn't work, I won't be going any higher. If 30mg does work, I'll just have about 9 days left on the prescription of 30 10mg pills, which is just enough time to book a doctor's appointment.

Lunacie
02-01-17, 11:37 AM
Whoa! Slow down there! I understand impatience, I have adhd myself.

But you aren't giving any of this a chance. One day is hardly a fair trial.

More than doubling your dose could result in side effects that you're not
prepared for.

If Biphentin is similar to Concerta, I'm not surprised the duration wasn't
long enough. It didn't get my granddaughter through a 7 hour school day,
much less help with after school homework.

I suggested the doctor add a booster dose of IR Ritalin, but she switched to
Vyvanse instead. Which was a very bad choice for my granddaughter although
some do well on it.

If you do try Adderall, please do one week at 10 mg before doubling the dose.
And do 20 mg for one week before increasing again. And so on. Give your
body a chance to adjust as well as looking for brain benefits.

Some on this forum find that XR Adderall is great, some need a booster dose
of IR in the afternoon. Some do better taking IR Adderall spaced throughout
the day. Give yourself some time to try different doses at different times.

There are some who do well on 20 mg a day, others need 60 mg a day.
And some even need a higher dose if they are fast metabolizers. But they
didn't get there by doubling the dose every day. Slow down, okay?

PaulCamR
02-01-17, 10:28 PM
Whoa! Slow down there! I understand impatience, I have adhd myself.

But you aren't giving any of this a chance. One day is hardly a fair trial.

More than doubling your dose could result in side effects that you're not
prepared for.

If Biphentin is similar to Concerta, I'm not surprised the duration wasn't
long enough. It didn't get my granddaughter through a 7 hour school day,
much less help with after school homework.

I suggested the doctor add a booster dose of IR Ritalin, but she switched to
Vyvanse instead. Which was a very bad choice for my granddaughter although
some do well on it.

If you do try Adderall, please do one week at 10 mg before doubling the dose.
And do 20 mg for one week before increasing again. And so on. Give your
body a chance to adjust as well as looking for brain benefits.

Some on this forum find that XR Adderall is great, some need a booster dose
of IR in the afternoon. Some do better taking IR Adderall spaced throughout
the day. Give yourself some time to try different doses at different times.

There are some who do well on 20 mg a day, others need 60 mg a day.
And some even need a higher dose if they are fast metabolizers. But they
didn't get there by doubling the dose every day. Slow down, okay?

Thanks for this. You're right. I'll slow down.

I guess I was just thrown off by the fact that my doctor wanted me to go down from 36mg Concerta to 10mg Biphentin, when Concerta didn't do anything. And the fact that she called it a "different type of drug", and that she's "worried anything more than 10mg might be dangerous to start, when switching from Concerta". I was lucky that I was able to talk her into giving me the extra prescription (Adderall XR), because she originally wanted me to walk away with the Biphentin prescription.

If/when I do pick up Adderall, I'll give 10mg XR a shot and I won't rush it. You're right. I want to take that slowly. I'll give 10mg XR a few days, and I'll base its effectiveness on how my main symptoms change (maintained focus, keeping from feeling mentally fatigued from maintaining focus, making less minor mistakes, re-reading sentences over and over because I'm not really paying attention to what I'm reading, avoiding doing basic things throughout the day and relegating to playing games to let time slip away). I am employing strategies alongside the medication.

I am, however, speeding up my experience with Biphentin. Today I tried taking 40mg (because I was taking 36mg Concerta prior), and nothing. I'll try 50mg of Biphentin tomorrow, and then I'll probably give up on Methylphenidate if I can't see any benefits. Yesterday, 30mg of Biphentin gave me a mild feeling of happiness for an hour (not a high, just really stable mood, no tiredness but a feeling of calmness), but no help with focus one iota... and 40mg today didn't do anything. I may also try 10mg of Biphentin, to see what a low dose may do for me (I am doubtful but willing to see if a super low dose helps).

Postulate
02-02-17, 08:01 PM
Well, you need to research more on your type of brain injury, especially if Adderall does not work. ADHDers are carracterized by an excessive re-uptake of dopamine, so re-uptake inhibitors like Ritalin and Adderall are very successful among us. With you however, excessive re-uptake of dopamine may not be the issue. What if you just don't have enough dopamine, in AND out! Like, what if you require Parkinson medication like Levodopa to increase your dopamine count, as opposed to blocking its re-uptake? You are right when it comes to your doctor, get a better one, preferably someone with a PhD, a psychiatrist that also teaches classes in a University, who specializes in brain injuries. Don't be mad on your doctor, your issue might be very complicated to treat.

PaulCamR
02-03-17, 12:33 AM
Hmm... 50mg of Biphentin showed some promise today. I think I need a different doctor to discuss this with, as 50-70mg may be the range of biphentin that works for me. My current doctor is kind, but I just don't think she has dealt with adult ADHD as much as some other doctors may have. Granted, it has not lasted long, maybe 3 or 4 hours... but that's a lot better than what Concerta was doing.

My thought process. Any input?:

#1: I may need a new doctor, but I have to work with my current one and take things slow.

#2: I think I'll pick up the prescription for Adderall XR 10mg (30 pills). I'll take that slow.

#3: If Adderall is more promising, I'll report that to my doctor. If Adderall isn't promising, I'll report to my doctor that 50mg of Biphentin started to produce lasting benefits (but that's an isolated single day, the prescription only has 16 days left on it which would be 3 more days @ 50mg if I filled it).

#4: Is it weird to not want to settle on one thing before trying something else? I feel like Biphentin is definitely better than nothing at 50mg, I feel there's promise there (given one day @ 50mg). But if I go to my doctor and say I tried Biphentin, 50mg showed promise, but I filled the Adderall prescription you gave me, and now I've decided I would like to backtrack to Biphentin to trial 50mg for a couple weeks? (Currently I haven't filled the Adderall prescription but I intend to)

dvdnvwls
02-03-17, 01:03 AM
It is impossible (not merely tricky, impossible for real) to judge a dosage properly if you've taken it for less than five consecutive days. You can get only a general impression if you stay there less than the five days. The reason is that it takes that long for your body to get to a consistent stable day-to-day level of the medication.

A week is more reasonable.

One day is a joke, unless the dose is far too high, in which case stop immediately.

Postulate
02-03-17, 09:45 AM
Hmm... 50mg of Biphentin showed some promise today. I think I need a different doctor to discuss this with, as 50-70mg may be the range of biphentin that works for me. My current doctor is kind, but I just don't think she has dealt with adult ADHD as much as some other doctors may have. Granted, it has not lasted long, maybe 3 or 4 hours... but that's a lot better than what Concerta was doing.

My thought process. Any input?:

#1: I may need a new doctor, but I have to work with my current one and take things slow.

#2: I think I'll pick up the prescription for Adderall XR 10mg (30 pills). I'll take that slow.

#3: If Adderall is more promising, I'll report that to my doctor. If Adderall isn't promising, I'll report to my doctor that 50mg of Biphentin started to produce lasting benefits (but that's an isolated single day, the prescription only has 16 days left on it which would be 3 more days @ 50mg if I filled it).

#4: Is it weird to not want to settle on one thing before trying something else? I feel like Biphentin is definitely better than nothing at 50mg, I feel there's promise there (given one day @ 50mg). But if I go to my doctor and say I tried Biphentin, 50mg showed promise, but I filled the Adderall prescription you gave me, and now I've decided I would like to backtrack to Biphentin to trial 50mg for a couple weeks? (Currently I haven't filled the Adderall prescription but I intend to)

Let me get this straight, you were mad on your doctor for being incompetent in prescribing you biphentin, now you notice that actually biphentin works (so your doctor was right, and you were wrong), and you still want to change doctor? It appears to me that your treatment is going in the right direction so far. Like others have pointed out in this topic, it takes 5 days to a week for stimulant blood levels to reach steady-state. Otherwise, blood levels from your previous day's experiments can potentiate today's experiment. I'm not sure you know what you're doing at this point, I would ask your doctor to prescribe you a testing schedule.

By the way you write your posts, you seem a bit tense or appear stressed. Are you aware of the changes that the medication triggers in you? What's your bpm?

PaulCamR
02-03-17, 08:09 PM
Let me get this straight, you were mad on your doctor for being incompetent in prescribing you biphentin, now you notice that actually biphentin works (so your doctor was right, and you were wrong), and you still want to change doctor? It appears to me that your treatment is going in the right direction so far. Like others have pointed out in this topic, it takes 5 days to a week for stimulant blood levels to reach steady-state. Otherwise, blood levels from your previous day's experiments can potentiate today's experiment. I'm not sure you know what you're doing at this point, I would ask your doctor to prescribe you a testing schedule.

By the way you write your posts, you seem a bit tense or appear stressed. Are you aware of the changes that the medication triggers in you? What's your bpm?

I was frustrated, but not mad. I was frustrated about the 10mg Biphentin script, and how she represented it to me as a different drug. The way she presented it to me, she wanted me to try 10mg Biphentin for a couple of weeks (after 36mg of Concerta didn't have any effect). It was just through my question of "If it's not doing anything after a couple days, should I up my dose?", that she told me yes up the dose as I see fit if it's not doing anything.

I understand that she's taking a safe approach, but a few of the things she said to me indicated she was unsure of what she was doing. Particularly, when I questioned if Biphentin was another form of Methylphenidate, she pulled up Google to look that up (after she just handed me the prescription for Biphentin).

As far as sounding tense, I'm just this way on forums. I like to blurt out what I like, I say way too much. I actually wear a fitbit HR (I also sometimes cross-reference it with a manual check), no real change in BPM from before I was medicating. Resting heart rate of between 63bpm and 67bpm, hovering between 85 and 90 when walking around doing things, absolute peak of about 178 when doing intense exercise.

Since I've been given the chance to try Adderall XR, I'll take a break from Methylphenidate for a couple of days before I switch. My doctor specifically said not to bother calling in. I'll give Adderall a 15 day trial, starting at 10mg, and working up every 5-7 days by increments of 10mg (stopping @ what works, not going past 30mg dosage) while consulting with my family-friend psychologist who has ADD. If 30mg doesn't work, then I'll ask my doctor to switch me back to Biphentin 50mg with my doctor's guidance on how to proceed. I think that's a sound decision? I mean, other than finding another doctor who could provide me with better oversight, guidance, etc (as my current one is giving me a lot of leeway, and as you say, I'm winging things a bit).

Postulate
02-04-17, 06:16 PM
While there is no direct stimulant equivalency scale, Adderall appears to be on average twice stronger then biphentin in reaching therapeutic effects, so starting Adderall XR at 10mg might be wishful thinking but you can still try to see if you're lucky. You just might.

Also the fact that she's using google shows she's a smart doctor. Dr. Mailloux, a famous psychiatrist encouraged every doctor to use google before prescribing a medication. It can work wonders among doctors and it is by no means a sign that your doctor is incompetent. The information you find on google is rock solid, accurate and more up to date than any book or manual, if you know what to look for.

Your heart rate sounds healthy as a bull too.

PaulCamR
02-05-17, 01:57 AM
While there is no direct stimulant equivalency scale, Adderall appears to be on average twice stronger then biphentin in reaching therapeutic effects, so starting Adderall XR at 10mg might be wishful thinking but you can still try to see if you're lucky. You just might.

Also the fact that she's using google shows she's a smart doctor. Dr. Mailloux, a famous psychiatrist encouraged every doctor to use google before prescribing a medication. It can work wonders among doctors and it is by no means a sign that your doctor is incompetent. The information you find on google is rock solid, accurate and more up to date than any book or manual, if you know what to look for.

Your heart rate sounds healthy as a bull too.

Well then maybe I shouldn't be so quick to discount the use of Google.

I took today off of Methylphenidate. I'll be picking up my prescription tomorrow (hopefully no issues at the pharmacy, since I picked up 14 Biphentin 10mg pills on Tuesday). I'm just upfront with everyone when they ask, that I'm still in a trial period of finding what works.

I'm hoping Adderall XR works better for me than Biphentin 50mg does, but I'm happy to know at least that Biphentin 50mg is a promising fall-back to discuss with my doctor if nothing else works out.

Postulate
02-05-17, 03:51 PM
Also, the proper way to test medication is to either go to work or undergo a project, so that, at the end of the day, you can somehow measure your productivity and evaluate objectively, preferably according to certain metrics, if indeed it made you focus and stay on a task. This is more important with Adderall.

Another thing, when you're new and testing Adderall, don't make a decision to increase your dose while under the effects of Adderall. Wait until it wears off and the following day, you can increase your dose according to how you feel about it then.

Adderall modifies your decision making criteria, but it does not modify your notion of right and wrong because that's in a region of the brain it can't affect, so if you know it's wrong, you can be sure you won't do it while under the effects of Adderall, even if it temporarily sounds like a good idea to do it.

I have found that this approach leads to an increase in safety but it's up to you.

PaulCamR
02-05-17, 11:33 PM
Also, the proper way to test medication is to either go to work or undergo a project, so that, at the end of the day, you can somehow measure your productivity and evaluate objectively, preferably according to certain metrics, if indeed it made you focus and stay on a task. This is more important with Adderall.

Another thing, when you're new and testing Adderall, don't make a decision to increase your dose while under the effects of Adderall. Wait until it wears off and the following day, you can increase your dose according to how you feel about it then.

Adderall modifies your decision making criteria, but it does not modify your notion of right and wrong because that's in a region of the brain it can't affect, so if you know it's wrong, you can be sure you won't do it while under the effects of Adderall, even if it temporarily sounds like a good idea to do it.

I have found that this approach leads to an increase in safety but it's up to you.

Thanks for this :)

I may start Adderall tomorrow. I didn't pick it up today, decided I felt too lazy to go out and get it (plus another day off of stimulants is probably a good idea). I was super tired today, my sleep habits are just bad anyways (not related to meds), but today I was really tired (second day off of Methylphenidate). I figure it might have something to do with stopping after about 15 or so days.

I'm actually doing distance study courses in a graduate program, which is one of the big reasons why I need medication. Even when I get into the in-class courses next semester, this stuff is just dense, lots of reading, lots of self-discipline. While the self-discipline side is something I'm working on, it's infinitely harder to study when you're distracted at the same time. That feeling of "I'm so fatigued from focusing, I'll just take a break". And then as soon as you take a break, anxiety builds about returning to the work. Lately I've been waking up late (noon), and then starting studies around 7PM, and then studying until midnight but only 50% of the time between 7PM and 12PM, totalling 2.5 hours of study MAYBE if I'm lucky. I need to bring studies up to 6 hours a day, a tough thing to do. I needed meds to be thrown into the mix to help fix at least one cog in the study machine that is my brain, and get a bit of a leg up.

PaulCamR
02-06-17, 08:02 PM
Okay, in order to not spam the forum & just spam my own thread:

I just took 10mg Adderall XR at 3:10PM. It's 3:56PM now.

TL;DR: Seems a lot like Biphentin, but not sure.[/b]

I'm not noticing much. It might all just be placebo. It's very similar to the feeling on Biphentin 50mg though, if I am feeling anything, just less strong. Also no mood boost, just feel a slight energy boost. I haven't tried sitting down to focus yet (my end of the deal, putting in effort).

Hoping I feel more than this though. But I still have to evaluate how it works over a few days, and these things:
- How does it help me with staying on task? (Specifically, reading)
- How does it help me with mental fatigue when attempting to stay on task?
- How does it help me with keeping distracting thoughts out of my head while focusing?
- How does it help me feel balanced/good (mood)?
- How does my anxiety change while on this medication? (My anxiety is unique as is many other people's).
- How does it help me with motivation / the ability to apply myself? (that might be asking too much out of medication though, I realize that)

sarahsweets
02-07-17, 12:49 PM
I would like to understand this more. Are there sources available to explain why decision making skills are impaired or altered when taking adderall?

Another thing, when you're new and testing Adderall, don't make a decision to increase your dose while under the effects of Adderall. Wait until it wears off and the following day, you can increase your dose according to how you feel about it then.

Adderall modifies your decision making criteria, but it does not modify your notion of right and wrong because that's in a region of the brain it can't affect, so if you know it's wrong, you can be sure you won't do it while under the effects of Adderall, even if it temporarily sounds like a good idea to do it.

I would like to understand this more. Are there sources available to explain why decision making skills are impaired or altered when taking adderall?

finallyfound10
02-07-17, 03:36 PM
I would look more into the TBI to see if any brain therapy could be done. Make an appointment with a Neurologist who works with people who have a TBI.

PaulCamR
02-07-17, 07:30 PM
I'll see what I can do about getting a referral to a Neurologist. I feel like I definitely need to treat ADD, but to fully meet my goals (beyond just studying), I might need to get more insight and help.

I too would be interested to hear about how Adderall may alter decision making, while being under the effects. I think I get that while under the effects of something, it's more difficult to judge what my base-line would be.

I took 20mg Adderall XR today at 3:10PM. I know I said I'd take 10mg for 5 days, but I knew it wasn't doing a thing yesterday for any symptoms, I know I'm slim tolerant, and I know Methylphenidate just started to work for me at 50mg.

It seems 20mg is having an effect. I'm 19 minutes in. I'm planning to get to work in 11 minutes. Will see how it goes, and I certainly hope this treats symptoms effectively and lasts an absolute minimum of 5 hours (I don't have insurance to get, say, 2 pills a day).

PaulCamR
02-07-17, 09:44 PM
Eh. It's 5:37PM, just over 2 hours after taking 20mg XR. First hour was extremely promising, got some stuff organized and was productive. I could focus nicely. I didn't feel energized like people say they feel on Adderall, just nice and calm and positive. It has definitely worn off now.

I'll reassess tomorrow.

Big Question: High amounts of Adderall can cause psychosis or other bad things, as can Methylphenidate. I would never raise my dosage above 30mg (XR) without my doctor guiding me (even then I'd be uncomfortable), higher isn't even offered in Canada anyways. But if an individual has a high tolerance (requiring higher doses to respond, and higher doses even further to have lasting DoE), does that also mean higher dosages are safer for that individual? This is a very simplified question, and I know there's lots of factors, and a responsible answer may be "Ask your doctor, it differs from individual to individual", but I think you also get the gist of my question.

sarahsweets
02-08-17, 04:45 AM
While there is no direct stimulant equivalency scale, Adderall appears to be on average twice stronger then biphentin in reaching therapeutic effects, so starting Adderall XR at 10mg might be wishful thinking but you can still try to see if you're lucky. You just might.

Also the fact that she's using google shows she's a smart doctor. Dr. Mailloux, a famous psychiatrist encouraged every doctor to use google before prescribing a medication. It can work wonders among doctors and it is by no means a sign that your doctor is incompetent. The information you find on google is rock solid, accurate and more up to date than any book or manual, if you know what to look for.

Your heart rate sounds healthy as a bull too.

I am not anti-google but I fail to see how using it has anything to do with whether or not you are a good doctor.

sarahsweets
02-08-17, 04:51 AM
Big Question: High amounts of Adderall can cause psychosis or other bad things, as can Methylphenidate. I would never raise my dosage above 30mg (XR) without my doctor guiding me (even then I'd be uncomfortable), higher isn't even offered in Canada anyways.

Do you mean offered as in all in one pill? Or do you mean 30mg is the daily max?
I ask because here in the us the recommended daily max for adhd is 40mg and for narcolepsy, 60mg. I take 60mg for adhd.

PaulCamR
02-08-17, 06:55 AM
Do you mean offered as in all in one pill? Or do you mean 30mg is the daily max?
I ask because here in the us the recommended daily max for adhd is 40mg and for narcolepsy, 60mg. I take 60mg for adhd.

In one single pill. I'm afraid my initial does might have to be 30mg or even higher, which leaves me with no room afterward.

It's perplexing to me how little Methylphenidate and Adderall have done. Nil side effects, little effects. I'm not sure what that says about me. 50mg Biphentin was starting to work on the Methylphenidate side, but I felt like it was more of a fall-back option.

I'm worried Adderall XR might just start to work at 30mg, and maybe proper therapeutic effects would come in at 40mg XR in a single dose (not offered). Which begs the question, can someone's therapeutic threshold overlap with levels that are also dangerous for them?

I can definitely feel some improvements in the first hour with 20mg, but the feeling is like... a word that's on the tip of your tongue that you can't quite get out. I did get a cold cheeks feeling very momentarily, for about 10 seconds, that was accompanied with the mildest of euphoria (very, very mild); euphoria is a nice side effect, but not my goal, I'm guessing that's what some people abuse it for. It's like for the first hour I'm just almost at that treatment level I want, and I know what's happening and my difficulties are starting to be treated, and then after that hour fizzle, nothing, gone.

Lunacie
02-08-17, 01:01 PM
I take Omega 3 fish oil supplements for my ADHD. It doesn't have anything to
do with how it makes me feel.

I started taking it in a combination supplement for peri-menopause 14 years ago.

Within days I realized I could sit at the computer and write a whole paragraph
without losing my train of thought, or stopping to look up the spelling of a
word that I know how to spell but my brain-word-prosessor can't find the right
file.

I wasn't forgetting to pay my bills (as often) or forgetting other important things.
I wasn't as impaired by my ADHD as I had been my whole life.

That is the purpose of treatment for ADHD, relief of the impairments.
Not how it makes you feel.

It's often helpful to have someone who knows you well or sees you every day
keep track of whether the meds are helping. It can be hard to judge ourselves.

PaulCamR
02-08-17, 07:42 PM
Thanks for that, Lunacie. I took my fish oil (and multivitamin) today. I haven't taken those since November.

I just found a *really* cool resource. I had no idea these things existed:
http://www.attentiondeficit-info.com/pdf/quick-guide-adhd-medication-canada.pdf
http://www.caddra.ca/practice-guidelines/download

The first link is a quick reference chart for Canadians. The second link offers a PDF download (first download) which is the CADDRA guide to diagnosing and treating ADHD. There's so much information in the second link that I hadn't seen before.

A couple interesting things I saw were:
- the CADDRA suggests off-label maximum daily doses that are higher than on-label max daily doses (as a maximum, not as a suggested dose); in the dose titration maximum column in the first link, they only show the maximum on-label dose... scary thing is it stipulates that off-label max doses may not be studied for safety
- head injuries need to be ruled out when treating ADHD... but the full guide doesn't touch on head injuries other than to "rule it out"; I'm worried about that one

Lunacie
02-08-17, 07:57 PM
Dosing recommendations for stimulant meds were set based on research done
on children. It shouldn't be a surprise that adults may need a higher dose. Yet
many docs fear the government coming down on them for prescribing too much
of these meds.

PaulCamR
02-09-17, 12:11 AM
Dosing recommendations for stimulant meds were set based on research done
on children. It shouldn't be a surprise that adults may need a higher dose. Yet
many docs fear the government coming down on them for prescribing too much
of these meds.

I'm finding that to be a very difficult thing. I took your advice and took my fish oil and multivitamin today, I'll keep doing that daily as well.
TL;DR in bold, some serious questions again.

I tried 30mg Adderall XR today, and again, if you slipped it in my food I would've never known I took anything at all. I will continue at 30mg for another 4 days before I make an appointment with my doctor again (I have 8 days worth of 30mg dosage). It's just so odd that I don't notice a thing, but I'll start carefully documenting daily using the official Canadian ADHD reporting sheets. I won't go above 30mg XR in a single dose ever, just can't risk that or afford it, nor do I think many doctors would care to entertain the idea of off-label treatment.

I need to rule out head injury as the source of my ADHD symptoms (between age 3 and 4 as it turns out after clarifying). There were sudden changes in me, according to my Mom, and "Auditory Processing Disorder" designation with no follow-up on it, but assessment was just for IQ (once in elementary once in high school) which resulted in no follow-up due to high IQ. My Mom says after that head injury, I was the last to get out the door, and my memory & learning was impacted. Prior to the injury, I was positive, had a great memory, and loved to wake up early... I think loving to wake up early, getting on top of things, and my memory have all continued to be issues ever since.

Is there a good section on ADDForums.com to discuss head injuries and ADHD? It seems based on what I've Googled that the two can be indistinguishable, and a professional might not be able to with certainty diagnose correctly between the two. I can't find resources by Googling that provide in-depth information. Many qualified individuals seem to indicate that for injuries that mimic ADHD, treatment may be non-medical, and you just have to live with it; other sources indicate that ADHD medications may help someone who has ADHD symptoms as a result of head injury.

I'm left with too much uncertainty, and the doc appointments are coming slowly with no assurance that I will get a referral a psych, or a specialist. And then there's the other worry: ADHD treatment manuals state that head injury should be ruled out before medically treating ADHD. As in, I would not have access to ADHD medications if I am diagnosed with a head injury, under the diagnosis of "ADHD". I'm worried if it turns out I don't have typical ADHD, and rather ADHD symptoms caused by my brain injury as a child, that I may lose all access to ADHD medications (even if they work) due to medical policy.

PaulCamR
02-15-17, 09:22 PM
Hmmm. I think I got too wordy/out there. Question! (I promise I won't get wordy or ask stupid stuff):

I took a three day break from Adderall to see what my baseline was like. I'm back to Adderall (4 days left on prescription).

I'm noticing that Adderall 30mg XR for me is only helping focus a bit. Like, if I was a 3/10, it brings me to a 5/10 (%-wise that's very good). But it seems to be more of an energy leveller (I have low energy, it brings me up to a good baseline, without peaks or troughs, just good base-line energy); I don't feel like I'm jumping, just 'normal'. Second, it takes away most of my anxiety. Third, I feel more optimistic (not manic or unrealistic), whereas normally I have to actively try to keep from being skeptical or pessimistic in thinking. Fourth, I feel more content sitting at my laptop, but my motivation to do work is not heightened, and the anxiety that got me to do my work isn't there, so getting myself to do my work requires active discipline and self-reminders on Adderall (otherwise I might just enjoy my phone, Reddit, etc). My heart rate stays normal.

Are these all common effects of Adderall? And how does an SSRI compare? Does anyone find that Adderall treats all 3 of depression/anxiety/ADHD better than an SSRI treats depression/anxiety?