View Full Version : How in the world do I convince my psychiatrist


heythere999
08-09-17, 04:45 PM
Hey guys, made a topic a few months ago about wanting not to increase my dosage, but to have it prescribed for twice a day. I currently take 30 mg, regular Adderall that is supposed to last 4-5 hours.

The thing is, that's too little for me. Aside from that little time slot throughout my day where I'm on adderall, I am not productive. The few times I've started my day with adderall, I've *gasped* cleaned my room, checked my emails, made a to-do list, etc.

When I'm not on it, I do ****ing nothing. Which is annoying.

I went to my psychiatrist and I told him exactly what I've been doing: some days I take it once, some days twice, and maybe once a week I don't take it at all because I'm scared to build tolerance.

He does this weird thing where he writes "twice a day" on the instructions, but it's really meant for once a day? He wanted to prescribe me 100 pills for 3 months, but he said "I'm worried your pharmacy/insurance will think there's something fishy about that, ask them if that's a concern" so he just prescribed me for 90 for 3 months this time. In general though my psychiatrist is very chill and understanding, I just think he doesn't want calls from insurance or what-have-you (so I'm totally gonna start taking it twice a day as a regular thing).

Should I ask my pharmacy (it's Walgreens) if they or my insurance will be concerned if I double the amount I take? Because I seriously need it :( once a day is NOT enough.

Minkyboodle86
08-09-17, 10:18 PM
You can ask him to prescribe you an extended release and if that doesn't help with it becoming ineffective through the day you can ask for an additional instant release to take as the other wears off. Walgreens doesn't give a **** about your prescription- insurance is the one calling the shots and you cannot have a 90 day supply each month. You can however have an extended and instant release as separate prescriptions. It will be for your doctor to decide if they think it would be helpful, but you may be doing a lot of re-evaluating for a correct dosage, but worth it if you're struggling now anyway.

heythere999
08-10-17, 03:47 AM
Oh no it's 90 pills for 3 months. I want that doubled :p since 4-5 hours a day is too little

CharlesH
08-10-17, 11:40 AM
I'm not a medical professional, but as I understand it, 60 mg/day is within prescribing norms. I'm assuming that you're currently prescribed IR? Your doctor is in charge of determining what's medically appropriate for you, and your insurance is in charge of deciding whether to financially cover it. Walgreens doesn't make those decisions. Generic IR Adderall is relatively cheap, so I don't think insurance should have an issue with it. Even without insurance, it's less than $1/pill.

sarahsweets
08-11-17, 06:07 AM
Does your doctor want you to take it 1,2 or 3 times a day? If its once then you have a three month rx, twice, a month and a half and three times a day, then you have a months worth. I take my xr 4 times a day due to absorption issues but I have to have a script for one xr three times a day cause 90 is the max a month, and once for once a day.

heythere999
08-12-17, 05:16 PM
The thing is on my prescription, it says "take twice a day" but he expects me to, on average, take it once a day. Doesn't this mean that if I actually want to take it twice a day that there's really nothing to worry about?

kwalk
08-12-17, 11:55 PM
The max is really three times a day. That is what I'm prescribed and half the time I only take it once a day. At work though usually it's twice. I have Medicaid, you really should have no problem...

wonderboy
08-13-17, 12:34 AM
The thing is on my prescription, it says "take twice a day" but he expects me to, on average, take it once a day. Doesn't this mean that if I actually want to take it twice a day that there's really nothing to worry about?

If this is what he actually said, it does not make any sense to me…

ToneTone
08-13-17, 09:42 PM
Just bring this to his attention.

"Hey, you say I'm to take two pills a day, but the 90-day prescription only allows me to take one pill a day."

He may have simply spaced out on this ... Just politely point out the contradiction and problem and see what he says ...

Sometimes doctors can space out.

Tone

heythere999
09-04-17, 10:53 PM
Ok, how much is "too much" Adderall?

Because I've ACTUALLY been taking it twice a day lately.

But sometimes, I have to be up at 5:30/6 AM, and I'll have to be up until 12 or 12:30 AM. That's 16 hours, but I have only enough for 8-9 hours a day.

Now with school starting, I have morning classes 4-5 days a week (sometimes my Friday class does not meet). There are some days where I have work until 11 or 12 on that same day.

I absolutely hate constantly having to plan out what time I have to take it or whatever because I only have it for 8 hours a day. This was viable over summer where I had nothing to really worry about aside from work, but now that I'm back to school and I have a billion responsibilities this isn't going to fly. I want to start going to the gym, too.

So basically, what I want is one of the extended releases, and one of the instant releases, per day. I'll take the XR when I wake up, and then take the IR at 3-5 PM.

Is that so bad? Do I sound like a crazy druggie?

Because I honestly hate how unproductive I am when I'm not on it. And it's not like this has only been the case after I started taking it. I've always been like this! I'll be a loaf, doing literally NOTHING remotely productive, and also eat like a maniac, until I am literally forced to get up and go somewhere or to do this particular thing. Until I take it, I sit and do nothing. For hours.

If it wears off in class, I'll stop paying attention. If it wears off during my breaks I'll end up just sitting on my laptop and doing nothing. I'll just be in a brain fog. If it wears off at work I'll be much slower.

When I'm not on it at home, I won't take care of my room, or my laundry, or my schedule, or anything. I'm just a loaf. And I've always been like this.

I really want this... but I don't want to sound like a druggie :(

Would it be possible for my insurance company to possibly be "suspicious" of this, too? I'll pay the full thing without insurance, IDC man. This is my life. But I don't want my psychiatrist prescribing me with little amounts because of his paranoia. But if I have to I'll stick to 30 mg IR twice a day. The dosage is fine, I just don't have it in my system enough in a day, at least in my opinion.

sarahsweets
09-05-17, 04:19 AM
I dont see why there is a problem with taking an xr/ir combo and I dont see why you would need to pay for it without insurance. Its very common. What makes you think your doc wont go for it?

wonderboy
09-05-17, 06:03 AM
Your insurance company will not be suspicious. And more than likely, they will pay for both. If they don't, always appeal.

95% of people who appeal, with the help of the doctor, will win the appeal, and insurance will pay.

Personally, I am not a big fan of mixing XR with IR, but that is, of course, just with me.

It will be up to the expertise of your psychiatrist to make the final call, but I do not think he will think you are a druggie.

I wish you only the very best!

heythere999
09-20-17, 05:13 PM
Going to him today.


This semester, I'm a full time student and I'm working around 20-25 hours a week. I have classes 5 times a week, and the drive is 50-60 minutes.

Of ALL 5 days, I have morning classes. On some days, such as Thursday and Friday, I have class in the morning (8:30 AM or 10 AM), and then I have work from 5 PM until either 11 PM or 12 AM.

So my days are long. I'm awake 18 hours a day at the very least. I have a lotttttt to catch up on, and a lot of responsibilities.

I take care of myself; I've been buying multivitamins, I signed up for the gym, I have been (kind of failing) trying to sleep more, been making sure my hygiene is up-to-snuff, that I'm not missing any responsibilities, etc.

But I also can no longer afford to have "off days." I've wasted enough time in my life and my schedule is very busy; I can hardly afford to see any friends.

So far, I like taking 1 IR 30mg at 8 AM or 9 AM (depending on if my class is at 8:30 or at 10 on that day), another one at 1 or 2 PM, and then another one at 5 or 6 PM. That way, I have little to no hours of just being a loaf, where I do absolutely nothing productive.

I just hope my request works.

CharlesH
09-21-17, 05:41 AM
You should just be open with your psychiatrist regarding your situation, and your response to the medicine. 90 mg/day is probably higher than the typical dose range, but at the end of the day, it's up to your psychiatrist's discretion.

The pharmacy isn't going to care if your dose increases, unless it's some insane dosage, in which case they have a professional obligation to contact your doctor to confirm that it's not a mistake.

Your insurance company might care, but generic IR Adderall is relatively cheap compared to other drugs (like $1/pill), so my guess is that they won't care. You can check your insurance prescription formulary to see whether they have any daily quantity limits for Adderall.

sarahsweets
09-21-17, 07:28 AM
My insurance company only cares about quantity of pills per dosage. What I mean is my doc has me on 80mg a day but my insurance only approves 3 20mg xr capsules a day. So I take those and an additional 20mg tablet.

mekaliah
09-25-17, 12:37 AM
My insurance company only cares about quantity of pills per dosage. What I mean is my doc has me on 80mg a day but my insurance only approves 3 20mg xr capsules a day. So I take those and an additional 20mg tablet.

wow youre lucky. im on tenncare and they limit the dosage to 60 mgs if youre over 21. i cant even get the 70 mg vyvanse.