View Full Version : Tapering off Adderall for a long-time user


ilikefrenchfrie
07-04-17, 06:32 PM
To begin this post, I would like to give my background (I'm sorry this is long, but I am really trying to find someone that can maybe relate to some of my specific circumstances) If you don't feel like reading the whole thing, I will post the final paragraph here:

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The whole point of this post: I truly despise being so dependent on Adderall. I used to only have to take Adderall when I studied, was in class, or took exams. Now I am at the point where I feel like I need it to do anything. While I believe I do indeed have ADHD (I know it is over-diagnosed), I want to know if there is any possible way to either taper off of it or limit its use for only when I have big exams. I do not want to experiment with tapering off in the middle of my first semester, but between summer and fall semester I have a one month break, and would like to start looking into it. I have expressed this concern to my psychiatrist (more than one), and they just try to make me feel okay with needing to be medicated (the classic "well if you had a physical disease, you would treat it? Right?") One thing that does help my symptoms slightly is exercise, and I am very active. I want to look into other methods to help with self-motivation and focus as well, maybe even meditation (which I don't really like because I end up getting bored, but maybe I need it).

I know adults have been able to taper off, but what about adults that are still in school? Especially adults in doctorate programs?
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I was diagnosed with ADHD at a young age, maybe in Kindergarten. However, I was not medicated until I began high school, as my mother did not want me to be on medication so young, and in middle school, I did not want to take it because it made me "not feel like myself" (and I also knew that grades in middle school did not really matter and I just had to be able to make it to high school).

I finally started taking medication in high school. I believe I took Vyvanse, and sometimes a small dose of Adderall IR (maybe 10mg) at night if needed to complete my homework. I did very well in high school, graduating with honors and around a 3.7 GPA. Following high school, I participated in an abroad gap year program and only took my medication as needed (which was not very often because there were not many academic courses during the program).

I began regularly taking my medication again in college. For some reason, the Vyvanse did not sit well with me anymore. Even being medicated during high school, I would at least be able to make myself eat despite the lack of appetite due to medication. However, in college, I could not. And the withdrawal symptoms in the evening were more terrible than I could ever remember. I remember I would often cry for no reason. That is when my prescription was changed to Adderall IR 20mg 2x/day. College is when I really started to realize how dependent I was on Adderall. I remember a time that there was an issue picking up my script (the office at one of my prior psychiatrist's office was terrible), and I panicked because I had an exam the next day and did not know what I was going to do. It ended up getting sorted out, but I had realized how depending I really was on the drug.

I managed by ADHD fairly well in college, graduating with distinction (3.9 overall GPA), departmental honors, and earning my B.S. degree in Behavioral Neuroscience. I then had plans to study for the MCAT over the summer and apply to medical school. Due to the high demands of studying and tolerance I had developed to my current Adderall dosage, my prescription was increased to 30mg IR 2x/day. Also, I should mention that I tried XR as well as Ritalin and Strattera before, but anyone that has tried multiple classes of ADHD medication knows that nothing compares to the stimulant medications.

I did not do well on my first and second attempt taking the MCAT, which are both about 4 hour long tests. They recently changed the exam and now it is 7 hours long. I planned to take it a 3rd time. Due to the increased length of the exam, my prescription once again changed, this time to 30mg 3x/day. I have always hated increasing my dosage, because as a neuroscience major with a comprehensive knowledge of psychopharmacology, I only know that my tolerance would continue to increase. But I was determined to do well on the exam. I think the beginnings of my time studying for the MCAT is when my dependency hit its peak.

Long story short, I finally realized medical school was not right for me. While trying to figure out my next step, I worked full-time, during which my prescription went back to 30mg 2x/day. It did not have as much of an effect due to my increased tolerance, but I really did not want to keep building my tolerance, and I was able to meet the demands of my job just fine with that dosing schedule.

I finally decided I wanted to earn my doctorate degree in physical therapy, and I just recently began my first semester. It is pretty intense, so I am prescribed for 30mg IR 3x/day even though I do not always need to take 3/day (this way I at least have enough). But my tolerance is back up again.

sarahsweets
07-05-17, 05:27 AM
The whole point of this post: I truly despise being so dependent on Adderall. I used to only have to take Adderall when I studied, was in class, or took exams. Now I am at the point where I feel like I need it to do anything. While I believe I do indeed have ADHD (I know it is over-diagnosed)
I think the idea of adhd being overdiagnosed is sort of like leftovers from the 90's when there were tons of boys being diagnosed. I know in women it is underdiagnosed.

I want to know if there is any possible way to either taper off of it or limit its use for only when I have big exams. I do not want to experiment with tapering off in the middle of my first semester, but between summer and fall semester I have a one month break, and would like to start looking into it. I have expressed this concern to my psychiatrist (more than one), and they just try to make me feel okay with needing to be medicated (the classic "well if you had a physical disease, you would treat it? Right?")
I think he is right for saying this because its true. If you had chronic pain would you suffer most days except for a day when you had something to do? Wouldnt you treat your pain (not only with medication), but with other things known to help pain-be it supplements, PT, accupuncture or massage?

One thing that does help my symptoms slightly is exercise, and I am very active. I want to look into other methods to help with self-motivation and focus as well, maybe even meditation (which I don't really like because I end up getting bored, but maybe I need it).

I agree with you that staying active is good for mental and physical health.

I know adults have been able to taper off, but what about adults that are still in school? Especially adults in doctorate programs?

I am not sure why you feel like you only need medication for school. You have had adhd most of your life correct? And I am sure you know that symptoms go beyond school or work. They are called impairments for a reason and when it comes to adhd diagnosis' you have to have two or more impairments in 6 or more areas of your life for it even to be considered adhd. So it makes sense that someone would want to take medication daily.
Look, I am not saying you shouldnt taper off if you want to. When it comes to stopping stimulants, you will experience some major fatigue and sleepiness and a smack-in-the-face return of your adhd symptoms. I dont know how long it would last for you but when Ive had rx issues in the past, it was a good two weeks until I felt somewhat able to stay awake during the day.

And I am not condemning you for wanting to stop medication and I am not saying you have to do cartwheels because you take it but there is NOTHING wrong with taking your medication daily and needing it for life- it is prescribed for daily use and approved for that from the FDA/DEA.

I think the guilt you may feel over it is from the external messages, spoken and unspoken, that we adhd'rs hear about stimulants. We hear they are bad for your heart, bad for your body, a cop-out, for the weak people, that you will get tolerant, that you are lazy, that you should be able to live without it, that most people do just fine without it. We hear that adhd isnt real, that its only for kids, that we should be bouncing off the walls and hyperactive, that we should only need it for work or school, that we take it to get high, that we are addicts, that everyone has our troubles and its a personal flaw to want help for it.

None of this is true. I know that if it wasnt true the powers that be would be banning and removing stimulants as a treatment option. With the exception of patent protected brands like vyvanse, big money isnt made off of generic adderall or ritalin. The pharma industry always follows the scent of money and its not in stimulants, IMO.
Good luck to you if you stop though, its ultimately up to you. I didnt want you to feel bad that you need medication, and I didnt want to feel bad that I needed medication.

someothertime
07-05-17, 08:14 AM
I know adults have been able to taper off, but what about adults that are still in school? Especially adults in doctorate programs?

I have always hated increasing my dosage, because as a neuroscience major with a comprehensive knowledge of psychopharmacology, I only know that my tolerance would continue to increase. But I was determined to do well on the exam. I think the beginnings of my time studying for the MCAT is when my dependency hit its peak.



No doubt intense study has huge pressures.... and physiologically maintaining adequate response.... energy.... and general health....... is no walk in the park.....

I think many, see dependency as either a short term necessity..... and/or akin to reliance..... thus acceptance comes easier.... from a moral and consequential point of view....

So, there is ETHICS of medication...... MAINTENANCE of EFFICACY in a general sense...... and MEDIUM/LONG term fallout management..... or negation.......

There is no simple answer..... for many of us.... these things are a minefield on the ground level..... I hope your choices work for you. :)

BlackWarrior
07-05-17, 12:06 PM
I don't really have any advice to offer to you but just know you're not alone. I don't like being dependent on adderall for completing things. I have a Biology degree with a concentration in neuroscience so I know what you're talking about when you say you're worried about being too dependent. I told my pdoc at my last visit that I want to stop using adderall as soon as I finish school.

ilikefrenchfrie
07-06-17, 12:57 AM
Thank you. It really does help to know that I am not alone.

ilikefrenchfrie
07-06-17, 01:01 AM
Because I can at least function (even with withdrawal) if I am not doing something academic and I am off Adderall. Trust me, I am no stranger to the withdrawal symptoms. I know there is nothing wrong with it. I have a psychological impairment. The problem is that I don't like how it makes me feel as a person, if that makes sense. Sure, I am able to accomplish more. But I am just not myself. I really don't feel bad that I need medication. I just feel bad that what feels like the only option for treatment is a medication that makes me feel so unlike myself.

ilikefrenchfrie
07-06-17, 01:05 AM
To give an update, I have decided that while I don't think I will be able to taper off 100% (at least right now), I would like to try some alternative treatments in conjunction with my medication (mindfulness, CBT, biofeedback, etc). I know they haven't proven to be super effective on their own, but these methods may at least help me cut back a little. I also found this book that is available at the library I go to school at, and I am going to pick it up tomorrow:

"Nonmedication Treatments for Adult ADHD: Evaluating Impact on Daily Functioning and Well-Being" - By J. Russel Ramsay, PhD

The book explores the current literature available on non-medications for adult ADHD.

someothertime
07-06-17, 07:55 AM
FWIW.... hardcore exercise helped me when i was not medicated.... definitely not on par with medication when it comes to tasks and cognition.....

but for general wellbeing...... it is very good.