View Full Version : Doctor is dead set on Adderall XR but it doesn't work long enough for me


musiclover83
07-30-17, 03:06 AM
Hi, all. Longtime lurker, first-time poster. I was diagnosed ADD as a child but my parents did not want to medicate me so I was never treated until I was in college and at that point I sought treatment (both meds and therapy) for myself.

I went off medication (Adderall) after graduate school and discontinued therapy; for some reason, I thought I wouldn't need them once I was through with school.

Fast-forward 20 years and many jobs later and I decided to be retested. I was diagnosed ADHD-PI and I asked to try Strattera and started cognitive behavioral therapy. The Strattera didn't work, so a month later I started Adderall 10 mg twice a day. The Adderall worked like a charm, and I felt calm and focused for the first time in 20 years. Since 10 mg worked, my psych wanted to switch me to Adderall XR 20 mg once a day. However, I've found the XR does not work as well as the immediate-release version did for me. I don't have quite the same sense of focus on it, and it wears off long before the 12 hours it advertises (on a good day it keeps me focused for around 6-7 hours). When I brought this up to my psych and asked if maybe I could just switch back to the IR, she just increased my dosage of the XR. So I took 25 mg XR for a month and the results weren't any different, really, except I felt a little jittery. When I went back the following month she put me back on the 20 mg XR. Needless to say, I'm still having the same issues I've had all along with it wearing off early. I work 40 hours/week plus I've taken on freelance work at night, so there are some days I need 10-12 hours' worth of focus I'm just not getting right now. When I brought this up to my doctor, I thought perhaps she'd suggest a small booster dose in the afternoon, but instead, she just told me I could take the XR later in the day. However, my day starts at 9 a.m. and I need to be focused at 9 a.m., not 3 hours later in the hopes my Adderall will last until 6 or 7 p.m. (I did not say this to her.)

Has anyone encountered a doctor who seems reluctant (or flat-out is reluctant) to prescribe regular Adderall? And if so, do you have any advice on how you approached your doctor about switching back to it or adding a booster dose occasionally? I've searched all over looking for any information I might be able to show my doctor at my next appointment that proves I'm not the only patient for whom Adderall XR lasts significantly less time than its package insert says it does. I also realize I don't advocate for myself as hard as I probably should but since Adderall is a schedule II controlled med, I'm afraid that if I press the issue she'll flag me as a drug seeker.

Any advice is appreciated and thanks in advance.

sarahsweets
07-30-17, 04:56 AM
my psych wanted to switch me to Adderall XR 20 mg once a day. However, I've found the XR does not work as well as the immediate-release version did for me. I don't have quite the same sense of focus on it, and it wears off long before the 12 hours it advertises (on a good day it keeps me focused for around 6-7 hours).
Adderall xr isnt meant to last 12 hours. It lasts 6-8 hours. In theory its like taking 10mg ir and then 4 hours later 10mg is released. The only 12 hour meds I know of are supposed to be vyvanse and concerta.

When I brought this up to my psych and asked if maybe I could just switch back to the IR, she just increased my dosage of the XR. So I took 25 mg XR for a month and the results weren't any different, really, except I felt a little jittery. When I went back the following month she put me back on the 20 mg XR. Needless to say, I'm still having the same issues I've had all along with it wearing off early. I work 40 hours/week plus I've taken on freelance work at night, so there are some days I need 10-12 hours' worth of focus I'm just not getting right now. When I brought this up to my doctor, I thought perhaps she'd suggest a small booster dose in the afternoon, but instead, she just told me I could take the XR later in the day. However, my day starts at 9 a.m. and I need to be focused at 9 a.m., not 3 hours later in the hopes my Adderall will last until 6 or 7 p.m. (I did not say this to her.)
IR meds do not last for me due to absorption issues. I take xr and I take it 5 times a day. Most people might take it 3 times a day. I take it that many times a day due to my schedule and the fact that it doesnt last more than 5 hours for me. My dosing schedule is: 20mg xr at 4a,8a,12 noon. 15mg xr at 3 and 6. This isnt typical but the xr meds just do not last for me.


Has anyone encountered a doctor who seems reluctant (or flat-out is reluctant) to prescribe regular Adderall? And if so, do you have any advice on how you approached your doctor about switching back to it or adding a booster dose occasionally? I've searched all over looking for any information I might be able to show my doctor at my next appointment that proves I'm not the only patient for whom Adderall XR lasts significantly less time than its package insert says it does. I also realize I don't advocate for myself as hard as I probably should but since Adderall is a schedule II controlled med, I'm afraid that if I press the issue she'll flag me as a drug seeker.

Any advice is appreciated and thanks in advance.

Have you asked your doctor outright why she switched you and what her reasoning is? It doesnt make sense if the IR was working. If I were your doctor based on what you told me and assuming the 20mg works, I would recommend you take 5mg ir 4 times a day. Thats just me though. Do you think the xr is working at all even if its only 4 hours?

musiclover83
07-30-17, 01:09 PM
Yes, the XR does usually work for some period of time, and I'd be happy to stay on it if my doctor would agree to a booster (if that worked, of course--I know everyone's body chemistry is different and I would need to try it out). I also have had a couple days on the XR where I didn't notice any effect at all (my mind was still racing and I wasn't able to focus like I usually am on it; I'm not sure why).

I haven't asked her why she switched me but that's good advice (like I said, I've *got* to be a better advocate for myself) but when I told her the XR wasn't working for as long as it should be working, she said, "Oh, well it stays in your system even if you notice it or not, for 12 hours. Believe me, it's still helping you" Then she pointed to that info which was in a dosing handbook she had with her (I didn't notice its title, unfortunately), and also added that if I need it to work longer into the evening, "just take it later in the day."

I suppose it can't hurt to ask to be either switched back or to mention that I know some people take booster doses--the worst she can do is say no. I forgot to mention one of her treatment specialties is addiction (opiate, I think) but I'm betting that seeps into everything else she prescribes as well. Of course that could just be me overthinking it as I am prone to do.

musiclover83
07-30-17, 01:32 PM
Thanks for the prompt reply, sarahsweets! Yes, the XR does work for me, just not as long as I need it to work. (And I've had a couple days where I don't think it worked at all--at least not that I could notice. On those days my thoughts were completely jumbled and I never got that calm focus that helps me get organized and work through tasks--instead, my brain was basically functioning the way it does without medication.)

I know I have a fast metabolism, so absorption may be an issue for me, too. I haven't asked her outright why she switched me to XR (like I said, I have *got* to be a better advocate for myself) but in hindsight I suspect it's because one of her areas of specialty is opiate addiction, and I'm thinking that might impact all her prescribing practices. I could be totally wrong about that, of course.

At our last visit, when I mentioned that even at a higher dose the XR was still only working around 6 hours on a good day, she showed me in a dosing book (I didn't notice its name unfortunately) that said Adderall XR is made to last 12 hours. That's when she said "See? You probably just don't notice it working because you're getting used to it. It's definitely still in your system" and she also added that if I need it to work later on nights I freelance after work, etc., I could just take it later in the day.

Should I have been pushier, do you think? I really don't want to get flagged as a drug seeker--I'm making good progress in therapy, and the Adderall is helping somewhat, but every time I read about people finding that sweet spot that helps make day-to-day functioning easier, that's what I would like to be able to achieve.

Swissy
07-30-17, 02:51 PM
My doctor pushed the XR once we knew the IR worked, too. He tried twice, one of those times he wrote the script without telling me he put XR down. I went back and told him I preferred the IR so I could stay in control of my dosing. My work days can be long, but the middle is relaxed so I don't mind if my first dose wears off after 3 or 4 hours. When I know I need to focus again I take my 2nd dose and that gives me the coverage I need most days. Also, sometimes I don't take 2nd dose, and some days when I work 12 hours I use a 3rd dose. (Doctor approved)

As Sarah suggested, I find halving the 10mg and taking 5mg at a time every couple hours during my busiest part of the day helps keep me consistently good.

The reason I started with IR was the cost, my insurance didn't cover the adderall and I didn't want to pay the astronomical cost of XR (or Vyvanse.). The reason I stayed with it is because it works.

Good luck!

musiclover83
07-30-17, 05:48 PM
Thanks so much for the info, Swissy, and sorry for the double post everyone. I thought my first post hadn't gone to moderation, and now I can't delete it for some reason.
[MODERATOR NOTE: All new members' posts are moderated, and we approve them as soon as we can get to them -- sorry for any delay. ADDF does not allow members to delete posts; there is an edit window of 15 or so minutes during which you can change your posts. - Namazu]

I found some more dosing info in ADHD studies and ADHD sites that appear credible, and all state that even though the XR is formulated to last 12 hours--a point my doctor keeps coming back to--it does not usually last that long and most users take a second (and sometimes third) booster dose.

Hopefully that will help my case (although I, like you, would rather just switch back to the IR altogether). If I have to live with the XR, though, I can--the cost is the same--but it would be nice to able to just get pay for one prescription instead of two.

CharlesH
07-31-17, 12:56 AM
It's very common for people to have an IR booster dose to take as needed in addition to the XR. If your doctor insists that everyone's body functions exactly the same, and that every person will get exactly 12 hours, then she's either insanely ignorant or lying to you.

sarahsweets
07-31-17, 06:52 AM
but when I told her the XR wasn't working for as long as it should be working, she said, "Oh, well it stays in your system even if you notice it or not, for 12 hours. Believe me, it's still helping you" Then she pointed to that info which was in a dosing handbook she had with her (I didn't notice its title, unfortunately), and also added that if I need it to work longer into the evening, "just take it later in the day."


The half life of Adderall is about 10 hours.

This means that every 10 hours, half of the previous amount of Adderall in the body disappears.

For example, if you took 10mg of Adderall at 12AM (midnight), at 10AM 5mg of Adderall will be left in your body. At 8PM, 2.5mg will be left, and so forth until there is 0mg left in your body.



Amphetamine is eliminated via the kidneys, with 30–40% of the drug being excreted unchanged at normal urinary pH.[6] When the urinary pH is basic, amphetamine is in its free base form, so less is excreted.[6] When urine pH is abnormal, the urinary recovery of amphetamine may range from a low of 1% to a high of 75%, depending mostly upon whether urine is too basic or acidic, respectively.[6] Amphetamine is usually eliminated within two days of the last oral dose.[136]


Something to point out is that half life and efficacy is different. All half life means is that there is still some medication left in your system. Id love to know what she showed you because adderall is not marketed to last 12hours-its just not.

musiclover83
07-31-17, 10:09 AM
Something to point out is that half life and efficacy is different. All half life means is that there is still some medication left in your system. Id love to know what she showed you because adderall is not marketed to last 12hours-its just not.

YES! Thank you--she seems to think that half-life and efficacy are the same, right? That was my assumption; I just didn't know how to argue my point since she has the MD/PsyD and I don't. I wish I knew what dosing info she was using (my next appointment is this upcoming Saturday, so maybe I can take a look at that book) but I have found several sites that say Adderall XR is meant to last 12 hours (although I also found some that say IR boosters are often used).

Here's one study I found that claims 12 hour effectiveness from Johns Hopkins:
http://education.jhu.edu/PD/newhorizons/Exceptional%20Learners/ADD%20ADHD/Articles/A%20Physicians%20Perspective/index.html

And a couple that make me wonder if she isn't coming at this largely from an addiction specialist's standpoint.
Like this blogger who clearly has a bias against Adderall: "All About Medications, Part II" by Gina Pera (https://www.printfriendly.com/print?source=homepage&url_s=uGGCF_%7E_PdN_%7E_PcS_%7E_PcSnquqEByyrEpBnFG rEmBEt_%7E_PcSGBByF-nAq-FGEnGrtvrF_%7E_PcSnyy-noBHG-zrqvpnGvBAF-sBE-nquq-CnEG-vv_%7E_PcS)
And this from a site called "Addiction Blog," that claims "up to 12-hour effectiveness" (https://www.printfriendly.com/print?source=homepage&url_s=uGGC_%7E_PdN_%7E_PcS_%7E_PcSCErFpEvCGvBA-qEHtmnqqvpGvBAoyBtmBEt_%7E_PcSJurA-qBrF-nqqrEnyy-xvpx-vA_%7E_PcS).

Anyway, I suppose I just need to be firm and convey it isn't working for me. I've been keeping a journal since my last appointment noting time of onset, time I began to lose focus, any other OTC meds taken, meals, etc., so maybe that will help. It just sucks because the XR does work well for me, just not long enough. I don't mind trying another med, either, but it seems like kind of a waste before figuring out if my dosing is just not quite right on Adderall.

One last question, if you don't mind, sarahsweets--when you talk about absorption issues, is that a metabolism thing or something else? I have a fast metabolism and my stomach is fairly acidic so I'm assuming those affect absorption?

Again, guys--thanks!

sarahsweets
08-01-17, 07:41 AM
YES! Thank you--she seems to think that half-life and efficacy are the same, right? That was my assumption; I just didn't know how to argue my point since she has the MD/PsyD and I don't. I wish I knew what dosing info she was using (my next appointment is this upcoming Saturday, so maybe I can take a look at that book) but I have found several sites that say Adderall XR is meant to last 12 hours (although I also found some that say IR boosters are often used).

Here's one study I found that claims 12 hour effectiveness from Johns Hopkins:
http://education.jhu.edu/PD/newhorizons/Exceptional%20Learners/ADD%20ADHD/Articles/A%20Physicians%20Perspective/index.html

And a couple that make me wonder if she isn't coming at this largely from an addiction specialist's standpoint.
Like this blogger who clearly has a bias against Adderall: "All About Medications, Part II" by Gina Pera (https://www.printfriendly.com/print?source=homepage&url_s=uGGCF_%7E_PdN_%7E_PcS_%7E_PcSnquqEByyrEpBnFG rEmBEt_%7E_PcSGBByF-nAq-FGEnGrtvrF_%7E_PcSnyy-noBHG-zrqvpnGvBAF-sBE-nquq-CnEG-vv_%7E_PcS)
And this from a site called "Addiction Blog," that claims "up to 12-hour effectiveness" (https://www.printfriendly.com/print?source=homepage&url_s=uGGC_%7E_PdN_%7E_PcS_%7E_PcSCErFpEvCGvBA-qEHtmnqqvpGvBAoyBtmBEt_%7E_PcSJurA-qBrF-nqqrEnyy-xvpx-vA_%7E_PcS).

Anyway, I suppose I just need to be firm and convey it isn't working for me. I've been keeping a journal since my last appointment noting time of onset, time I began to lose focus, any other OTC meds taken, meals, etc., so maybe that will help. It just sucks because the XR does work well for me, just not long enough. I don't mind trying another med, either, but it seems like kind of a waste before figuring out if my dosing is just not quite right on Adderall.

One last question, if you don't mind, sarahsweets--when you talk about absorption issues, is that a metabolism thing or something else? I have a fast metabolism and my stomach is fairly acidic so I'm assuming those affect absorption?

Again, guys--thanks!

My absorption issues have to do with the fact that I had gastric bypass surgery in 2006(kept the 120lbs off thank you! ;)) and because the type i had called for 100cm removal of small instestine, it affects how medications are absorbed for me, and also food and nutrients as well.

Many people have absorption issues that did not have this surgery and it tends to be across the board. Many people have a fast metabolism with pain meds and stimulants and blame themselves. This is why I take so many doses per day. Most people raise an eyebrow if they do not know my story. I also have Barretts esophogus which contributes to absorption issues and I have to have frequent (once a year) biopsies for that.

Now, I am the person who doesnt get sleepy and nod off when I have had pain medicine. It goes through me quickly so I have to endure a great deal of pain before I would ever think of taking any kind of pain medicine in or out of the hospital. With stimulants, if I wasnt so aware of my body I could easily start blaming tolerance when it comes to effectiveness because I do not "feel" the meds like most people do. I had to learn that not feeling them doesnt mean that they are not working. It just means that the tell tale signs of a higher than normal dose are not present for me.

I know there are some genetic markers or enzymes or something that some people can find out about that can predict what meds will work and how well they will work but I dont know anything about them.
Hope this helps!

musiclover83
08-01-17, 09:11 PM
Sarahsweets, that is awesome that you've kept off the weight I know several people who were not able to do so (even after multiple surgeries in a couple cases) so I know what a struggle it is--congrats to you.

I've gotten a lot of good info together and I'm going in to my meeting with my psych on Saturday with info for her: printouts from several amphetamine efficacy studies that say IR boosters are usually administered when an XR dose does not last the full time; and multiple Adderall XR user reviews that state the same thing. Hopefully she won't dismiss my concerns. I took my Adderall at 8:30 this morning and by 2 p.m. most if not all of its therapeutic effects were gone. I don't mind staying on the XR at all but it definitely does not last 12 hours like she insists (or even 8 for that matter).

Thanks for all the advice, guys. I'm going to approach her more assertively than I have before and hope it works. Fingers crossed!

Cinzzz
08-04-17, 09:51 AM
just because you dont feel high doesn't mean it isn't working. You shouldn't be getting a good feeling out of them. It is solely for focus and attention sustainability

aeon
08-04-17, 10:16 AM
just because you dont feel high doesn't mean it isn't working. You shouldn't be getting a good feeling out of them. It is solely for focus and attention sustainability

Who are you to say what should or should not be?


Wondering,
Ian

Little Missy
08-04-17, 11:22 AM
just because you dont feel high doesn't mean it isn't working. You shouldn't be getting a good feeling out of them. It is solely for focus and attention sustainability

I don't believe she mentioned any of what you wrote there. What exactly are you getting at.

I'm feeling pretty darn good today.

Swissy
08-04-17, 03:42 PM
just because you dont feel high doesn't mean it isn't working. You shouldn't be getting a good feeling out of them. It is solely for focus and attention sustainability

You are not well informed at all. Adderall is NOT solely for focus and attention sustainability. It is also for PI symptoms such as fatigue, and also for chronic fatigue syndrome, narcolepsy and an off label way to treat depression. I am on a very low dose and it helps stabilize my moods, makes me feel happy (which is different than euphoric, but knowing I am not a complete loser actually is a bit euphoric after living my life thinking I was lazy, forgetful and sad). I am not an addict who is chasing any dragon, and though I agree with people who are well informed that some people don't "feel" the adderall working, some of us do feel the differences in ourselves when treating ourselves with medication as prescribed.

It is offensive to refer to those of us who feel the positive effects as feeling "high," the OP said nothing about looking to feel "high" and in no way sounds as if she is looking for anything except therapeutic help with adderall.

musiclover83
08-05-17, 01:30 AM
just because you dont feel high doesn't mean it isn't working. You shouldn't be getting a good feeling out of them. It is solely for focus and attention sustainability

I'm not looking to get high. Maybe I should have explicitly stated that, but I didn't think I needed to. Maybe I should have noted that the reason my doctor lowered my XR dose from 25 mg to 20 mg was because the higher dose made me feel buzzed and speedy (which is what I assume what you mean by "high") and I asked her if I could go back on the lower dose because that feeling is actually counterproductive to my goals.

What I am looking for is eventually to find the best dosage(s) of medication or medications that will help increase my focus and boost my mental clarity. I'm hopeful that doing so, in conjunction with continuing cognitive behavioral therapy, will help me be able to manage my time more efficiently and be better organized. Right now, most days I'm clear-headed and focused from around 8:30 a.m. to 1 or 2 p.m., and then I hit a wall and my brain feels increasingly jumbled again. Some days I get incredibly sleepy as well. My husband asked me the other day if I'd stopped taking my meds because he noticed how disorganized I am in the afternoons on Adderall XR as opposed to how functional I was on regular Adderall, so I suppose it's a noticeable difference.

Thanks to everyone who offered advice; this is my first experience with an extended-release medication so I really appreciate it. Hopefully my doctor will offer an alternative solution rather than just raising my XR dose again. Cheers.

Never ends
08-05-17, 02:47 AM
I get one XR a day and it only lasts 4-6 hours and I'm back to my old self. I tried for an am or pm IR dose or even a second dose but the docs seem to think they know it all.

sarahsweets
08-05-17, 06:45 AM
No one in this thread asked about getting high, talked about misusing meds or implied that they were.

musiclover83
08-05-17, 02:17 PM
I get one XR a day and it only lasts 4-6 hours and I'm back to my old self. I tried for an am or pm IR dose or even a second dose but the docs seem to think they know it all.

Never ends--I feel you. I discussed adding a small booster dose with my doctor today, and she wanted to simply up my dosage to 25 mg XR again. I told her I didn't feel comfortable with that because it made me so jittery last time, and I asked her if a 5 mg booster dose with 20 mg (or even 15 mg) XR wouldn't work just as well (or better, since my therapeutic effects on the XR generally diminish after 1 or 2 p.m.) She told me that there's no evidence that boosters are helpful and that she doesn't prescribe them as a rule.

Then she took my blood pressure and it was very high (it's usually great--almost textbook normal). She took it twice more over the course of a half-hour to be sure (it was still high) and she told me to discontinue the 20 mg XR immediately.

She switched me back to 10 mg IR twice a day, which she said I can take as 5 mg 4X/day if necessary (that's my plan). I'm going back to see her in a week to make sure my blood pressure is down and I bought a home blood pressure monitor as well. I hope this dosage and schedule will be better in terms of actually helping my focus and clarity throughout the day without the side effects. I had no issue with this dosage last time. If my blood pressure is still up next week, she wants to put me on Intuniv and move me back to the XR next month; however, I'm scared enough that I might ask to try Strattera again instead.

I'm hoping, though, that my blood pressure normalizes on the IR since it worked well before with no crazy side effects. Fingers crossed, and good luck to you as well. I understand your frustration.

sarahsweets
08-06-17, 07:24 AM
Never ends--I feel you. I discussed adding a small booster dose with my doctor today, and she wanted to simply up my dosage to 25 mg XR again. I told her I didn't feel comfortable with that because it made me so jittery last time, and I asked her if a 5 mg booster dose with 20 mg (or even 15 mg) XR wouldn't work just as well (or better, since my therapeutic effects on the XR generally diminish after 1 or 2 p.m.) She told me that there's no evidence that boosters are helpful and that she doesn't prescribe them as a rule.
Next time dig up sources like this and show her that she is wrong. This one focuses on children but the same thing applies to adults:

What Rebound Is

Rebound is the brainís reaction when a stimulant medication drops off too quickly as itís wearing off. When the medication leaves the system too quickly, it may cause ADHD symptoms to briefly return with a vengeance.

The good news is that this intense reaction usually lasts for only about an hour or so. The even better news is that an adjustment in medication can almost always prevent the problem.

Why Rebound Occurs

Rebound is directly linked to a childís metabolism and how fast her body processes a stimulant medicine. The rate at which the medication wears off isnít the same for all kids.

For some, a long-acting (ďall dayĒ) stimulant medicine may work for 10 hours. For others, that same medication may last only for six.

Stimulant medication is fast acting. It enters the bloodstream and starts working within 30 to 90 minutes, depending on the type. As the medicine is released, it enters the bloodstream. Then, itís filtered through the kidneys or liver and gradually eliminated from the body. Usually most of itís cleared out by later in the same day.

These medications are designed to wear off evenly. But in some kids, the medication moves through the filtering process very quickly. And that causes a steep drop-off in medicine level as it wears off.

Thatís when a rebound typically happens. Instead of your childís ADHD symptoms just reappearing when the medicine is all gone, theyíll flare up suddenly as the medication is wearing off. And for a brief time, theyíll be more intense than they usually are when she isnít on the medication.

During a rebound your child might be a bit more impulsive, hyperactive or emotional than usual. Or she may be very serious or sad and withdrawn when she normally isnít.

This rebound reaction typically lasts about an hour or so until the medicine has completely worn off. Then youíre likely to see a return of your childís usual symptoms.

How to Tell If Itís Rebound

Many kids experience some side effects when they first start taking stimulant medication. They may have stomach pain or headaches, or they may have a decrease in appetite. Those side effects usually clear up within a few weeks as the body adjusts to the medicine.

Sometimes a child will show a different set of symptoms, however. She may become:

Extremely wired
Very irritable
Tired, sad and subdued
The reason for those symptoms depends on when they start and end.

In some cases, the symptoms appear during the time the medication is supposed to be active. They begin soon after a child takes a dose and last for a few hours. And they subside only as the medication wears off.

When that happens, it may be a sign that the dose is too high and needs fine-tuning. It may also be a sign that the medicine isnít right for that child.

In other cases, the exaggerated symptoms appear when the medicine is wearing off. Until then, the child is fine and the medicine is working well.

When symptoms appear toward the end like that, itís usually not because the dose is too high. Itís more often because the level of medication is dropping off too fastóa rebound effect. That also requires an adjustment in medication.

How to Stop and Prevent Medication Rebound

When you see rebound symptoms repeatedly over a number of days, itís a good idea to speak with your childís doctor. He may prescribe a ďboosterĒ to eliminate them.

A ďboosterĒ is usually a small dose of an immediate-release version of the same stimulant medicine your child takes. Kids take it shortly before their regular medication is set to wear off (which is right before the rebound typically hits.)

The addition of a small amount of medication usually makes the drop-off more gradual. And that keeps the rebound reaction from happening.



https://www.understood.org/en/learning-attention-issues/treatments-approaches/medications/adhd-medication-rebound-what-you-need-to-know

musiclover83
08-06-17, 01:14 PM
Thank you, sarahsweets! I'll read up on it and print this info off in case she thinks I'm just talking out of my a**, which it seems she usually does.

If the IR continues to work and my blood pressure stays normal, and she still doesn't listen to me about not switching back to the XR (and wants to add blood pressure meds to the mix just to be able to do so), though, I've decided it may be time to try to find a psychiatrist who lets me have an active voice in my treatment and the medications I'm putting into my body.