View Full Version : Dex dose low? Feeling sedated.


ItsaRose
05-27-17, 02:33 AM
Hello All,

I have recent diagnosis of ADD-I and was started on the Barry Dextroamphetamine, 5mg once per day x 2 days, followed by 10mg tablet once per day. It is the IR tablets not the spanules. I am concerned of the side-effects that at this point are not tolerable and I've only taken three doses (5mg twice and 10mg once). I have experienced an overwhelming sedation, tiredness, brain fog and feel as if I have to force myself to think and move. The effects come on within 30 minutes to an hour of taking the dose and will most of the day. For example, I took a 5mg tab at 9am and although the sedated feeling has decreased, I still feel the effects and it is now almost midnight. When I took the 10mg tab, I was so sedated, I felt dizzy and off balance when standing and walking and I did not feel safe to drive. My psychiatrist thinks the dose is too low and if the dose were increased I would feel more of the expected results. However, at this point, I don'the want to take it anymore, since I can'tell get anything done....it'seems difficult to focus at all due to the extreme sedating effects.

I am not on any routine psych med besides clonazepam, .25 to .5MG once per day as needed which I may take at night or during high anxiety. I had been taking Parnate (social anxiety with panic) for years and stopped that about two weeks ago.

I'm discouraged now and wondering if any stimulant will help with my ADD symptoms.

Anyone with a similar experience or ideas on why I may be reacting like this?

By the way, I do have a history of being very sensitive to medications, but the MAOIs didn'the make me feel this sedated/drugged. I am 5'9", large bone structure and at least 50 pounds overweight, so I don't think my size is contributing to these effects.

Any feedback would be greatly appreciated.

emperorpenguin
05-28-17, 12:48 PM
Sounds to me like there's some sort of underlying condition that needs to be addressed before the meds can help. Remember that psych meds in general just manipulate neurotransmitters, they don't create them. Meds can't correct for upstream deficiencies which can result from diet, poor sleep, other drugs, etc. They can (at best) mask them temporarily.

Dex IR should be effective for around 5 hours; that's what you shoot for, in finding the correct dosage. The fact that you're not only getting paradoxical effects, but that kind of extreme duration, is a red flag. I share your skepticism about increasing the dose but I'm not a doctor. When titrating upwards, its more common that a too-low dose just won't be effective, or won't cover the expected duration for that drug. Taking more might well seem to work in the short term, but whatever caused this odd reaction will still be there.

Metabolic issues in particular are really important; they can prevent you from metabolizing the drug at a proper rate, such that it builds in your system and becomes toxic.

ItsaRose
05-28-17, 04:21 PM
Thank you for your reply and helpful comments. I do agree with your overall message, but still have to wonder if there are some intrinsic differences from person to person that are not yet well understood. Of course, if this type of reaction is so rare or even perhaps never identified previously, that would lend to some underlying condition specific to me. However, I did not have these types of reactions to the MAOIs, of which I've taken both Nardil and Parnate; both were very effective for social anxiety and the associated panic attacks. I've tried multiple SSRIs and anticonvulsant drugs which were all ineffective for any of my symptoms. Notably, Topamax also made me excessively sedated to the point that I could not function.

Perhaps the MAOIs are as good as it's going to get for me and I will have to learn how to optimize my functioning in spite of the other symptoms they do not treat. It's very discouraging at this time, as it is difficult to separate the failure of treatment from the feeling of one's self being the failure.

Also, just to mention, one of my sisters who has Bi-Polar disorder was never able to take Lithium. As you mentioned, the medication did not metabolize as expected, resulting in toxic blood levels...again making me wonder if there could be a genetic (intrinsic) component that causes some people to react to medications much differently than others. I will concede that sleep has been a huge issue for quite some time - but in my case I do believe it's a consequence of external stressor that have been unrelenting for years.

Thank you once again.

dvdnvwls
05-28-17, 05:29 PM
Feeling sedated is usually a clue that the dose is too high, not too low.

"Too high" can mean "too high", or it can mean "too sudden, needs to be spread over a longer time".

Normally, a too-low dose of Dexedrine has absolutely no effect, or a positive but tiny effect.

ItsaRose
05-28-17, 06:13 PM
Feeling sedated is usually a clue that the dose is too high, not too low.

"Too high" can mean "too high", or it can mean "too sudden, needs to be spread over a longer time".

Normally, a too-low dose of Dexedrine has absolutely no effect, or a positive but tiny effect.Thank you. That's the paradox....I only took three doses: 5mg once a day x 2 days and 10mg once a day x 1 day. The 10mg day was the absolute worst days that I can recall. It really did feel like I had taken too much and yet it appears the dose was sub-clinical.

ItsaRose
05-28-17, 07:09 PM
Feeling sedated is usually a clue that the dose is too high, not too low.

"Too high" can mean "too high", or it can mean "too sudden, needs to be spread over a longer time".

Normally, a too-low dose of Dexedrine has absolutely no effect, or a positive but tiny effect.

Thank you. That's the paradox....I only took three doses: 5mg once a day x 2 days and 10mg once a day x 1 day. The 10mg day was the absolute worst days that I can recall. It really did feel like I had taken too much and yet it appears the dose was sub-clinical.I should make a clarification, which may be related to the 'too sudden' theory. I took 5mg the first day and experienced the sedated type of feeling, but it wasn't excessive and in fact, did seem to wear off at about 5 hours where I then had some rebound anxiety. However, I attributed the sedated feeling to the extra magnesium I had the morning I took the dose and the anxiety to the coffee with three shots of espresso.

Nevertheless, the next day after this initial 5mg dose I did not take a dose, as I was perplexed by the sedation followed by the anxiety. I spoke with my physician that day and he encouragedid me to continue with it and suggested I just go to the 10mg dose rather than a second 5mg dose. So on the following day (day 3) is when I tried the 10mg, with no magnesium and no coffee. I had not had any food when I took the dose and at the time I would have had some food, I was no longer interested. The severe effects decreased after about 5 hours, but we're still vaguely there, but I was able to function, eat and felt safe to drive.

That night I was only able to sleep 4 hours, so I did some work and since I was then feeling better, decided to give the medication another try later in the morning. I decided again to take only 5mg instead of another 10mg dose since I didn't want the experience from the prior day. I did not take any magnesium that morning and made sure to take the dose with food. Although the sedating effects were not as severe as with the 10mg dose, it was still sedating enough that I could not focus or really get anything done - but I did feel okay driving.

So in retrospect, maybe I should have remained on 5mg for a longer period of time.

dvdnvwls
05-28-17, 07:54 PM
For many people, having caffeine causes very bad side effects when they're taking Dexedrine or other stimulants.

aeon
05-28-17, 09:50 PM
And for some, caffeine causes no problems whatsoever, or actually provides benefit in function.

I know for me, if I take too little dextroamphetamine, I get sleepy. The sleepiness is indicative of too low a dose...for me.


Cheers,
Ian

peripatetic
05-28-17, 09:57 PM
for me personally feeling sedated from stimulant medication in general is a sign it's too high a dosage for me.

you say you're usually quite sensitive to meds and that may be the case here, too. can you ask your doctor about cutting the 5 mg in half and see how that does? you might also just need to adjust to taking it...

ItsaRose
05-29-17, 06:58 AM
for me personally feeling sedated from stimulant medication in general is a sign it's too high a dosage for me.

you say you're usually quite sensitive to meds and that may be the case here, too. can you ask your doctor about cutting the 5 mg in half and see how that does? you might also just need to adjust to taking it...I am hesitant about asking to reduce the dose, but at the same time I have to at least let him know how I've responded thus far. I'm just not sure I want to try it again. This is all new to me, so it may take some adjustment time...but is a bit overwhelming.

sarahsweets
05-29-17, 08:20 AM
There is an issue with metabolizing for some people. I used to not believe it before my surgery. I am known as a fast metabolizer so I tend to burn through meds faster than the average person. In theory I would think you could be a slow metabolizer where some meds could sort of "hang out" a while in your body.

ItsaRose
05-29-17, 11:32 AM
There is an issue with metabolizing for some people. I used to not believe it before my surgery. I am known as a fast metabolizer so I tend to burn through meds faster than the average person. In theory I would think you could be a slow metabolizer where some meds could sort of "hang out" a while in your body.Thank you for your comment. I tend to agree, but it can be difficult to convince physiciansomeone of these types of reactions unless they are able to witness it themselves. I think the default is to consider the size of a person...and in my case that would appear counter-intuitive.

After reading through more Dexedrine experience posts, I wonder if the manufacturer (Barr) of the med school I received could be a factor and/or if the extended release might be better for someone like myself. It may prove to be an expensive journey.

ItsaRose
05-29-17, 11:44 AM
And for some, caffeine causes no problems whatsoever, or actually provides benefit in function.

I know for me, if I take too little dextroamphetamine, I get sleepy. The sleepiness is indicative of too low a dose...for me.


Cheers,
IanThank you for sharing your experience Ian. It is difficult for me to contemplate taking a larger dose due to how I felt on 10mg. I live alone and it was 'scary' to have such a reaction. If there was some guarantee that I would not have the same or a worse reaction, I would be happy and even eager to try a larger dose....but, I don't expect there will be such a guarantee.

I, and in fact most of my family are also very sensitive to caffeine. My sensitivity has decreased tremendously over the years, due to a need for the caffeine when working night shift and going to class during the day. My other sisters would not be able to function on an espresso and can't really drink coke without expecting to be up all night and suffer with uncomfortable jitters throughout the day.

I think I am going to try to lay off the heavily caffeinated drinks for now.

emperorpenguin
05-31-17, 07:19 PM
After reading through more Dexedrine experience posts, I wonder if the manufacturer (Barr) of the med school I received could be a factor and/or if the extended release might be better for someone like myself. It may prove to be an expensive journey.

I wouldn't expect to see a dramatic response by changing to XR, all else being equal. "Extended release" is (to me) a very misleading term as it's applied to Dexedrine and Adderall. They should be called "dual release": it's actually an IR dose now, and another IR dose that releases roughly four hours later. It's not at all like other "XR" drugs that release at a constant rate. There's nothing wrong with giving it a shot, though; everyone's different, so who knows.

The real "extended release" amphetamine option is Vyvanse. I have no experience with that drug myself but many people have great results with it; if you continue to have difficulties, you might give that a shot.

As far as Dex IR goes, I used to get Barr generic and now have a scrip for Zenzedi. They've both worked equally well for me and I don't think I could discern a difference. When I was taking spansules (extended release), I definitely felt a difference between Barr and Actavis; the latter made me feel like garbage, I only took them twice. Your mileage may vary!

ItsaRose
05-31-17, 08:17 PM
I wouldn't expect to see a dramatic response by changing to XR, all else being equal. "Extended release" is (to me) a very misleading term as it's applied to Dexedrine and Adderall. They should be called "dual release": it's actually an IR dose now, and another IR dose that releases roughly four hours later. It's not at all like other "XR" drugs that release at a constant rate. There's nothing wrong with giving it a shot, though; everyone's different, so who knows.

The real "extended release" amphetamine option is Vyvanse. I have no experience with that drug myself but many people have great results with it; if you continue to have difficulties, you might give that a shot.

As far as Dex IR goes, I used to get Barr generic and now have a scrip for Zenzedi. They've both worked equally well for me and I don't think I could discern a difference. When I was taking spansules (extended release), I definitely felt a difference between Barr and Actavis; the latter made me feel like garbage, I only took them twice. Your mileage may vary!Thank you for this added information regarding the IR formulations for Dexdrine, it was very helpful. I had thought about the possibility that I could get 'stuck' in the same type of reaction, but for double the time and I really cannot fathom going through it for a longer time period than I did.

I have not had the opportunity to speak with my physician about it yet, so at the time I'm not progressing, just kind of in limbo. Though my symptoms of depression have abated some (due to other treatments), I still get incredibly hopeless when I think of the possibility that I will not find a solution to these long-standing problems and what that means for my future.

I had genetic testing done some years ago for medications that might be most effective for me, but I have been unable to locate the report with the results. I am going to ask my physician if he might have them available to review with for other treatment options.

I am worried though, as I have a lot of the generic Dexdrine left. I will discuss with my pdoc as well on what to do with them.