Hi, everyone. I've been lurking around these forums for a while and have enjoyed reading all the posts. I have a question, and I'd like your feedback.

Background:
My psychiatrist prescribed Adderall XR for me a little over a year ago as adjunct therapy for Refractive Major Depression. I had been tried on many drug combos and the depression would not remit. Taking Adderall XR in combination with Wellbutrin SR saved me from having ECT. Several months later I received an evaluation from a psychologist who told me I had ADD. However, this was my boyfriend's psychologist (an ADD specialist - I was in his office for my bf's ADD evaluation!)...I was not a client and didn't intend to become one, so I did not get a formal report to send to my psychiatrist. I do, however, believe that the ADD diagnosis is a correct one.

I take Adderall every work day, and it has been a great help for me, but sometimes I feel "separated" from myself when it's in my system and it keeps me awake if I don't take it early enough in the morning. So on the weekends, unless I have an agenda to accomplish, I choose not to take it. I still take Wellbutrin everyday (unless I forget, which does happen!!). My psychiatrist is aware of this and has said that it's fine since the medication doesn't linger or have any "build up" effect.

But when my boyfriend mentioned to his psychologist that I only take my medication on weekdays, the dr said that was really bad for me, that I'd be better off not taking the med at all than taking it intermittently, and that only taking it on weekdays was "drug abuse".

I know there is disagreement in the medical community about "drug holidays" and the benefits/drawbacks thereof.

What is your opinion?

Do you take your medication every day, or do you occasionally take breaks?

Do you feel that a regular dosing schedule makes the drug overall more effective? In other words, do you feel that it works the same today whether or not you took it yesterday?

Do you think that drug holidays are important? unnecessary? harmful?

I have an appointment to meet with this dr b/c of what he said to my bf and I don't have any idea what I want to say to him right now, except that he'd do well to stick to the issues of the client who's paying him....

I'd appreciate anything anyone could contribute.


Moderator: This is my first post. If I've chosen the wrong forum, I apologize. Please feel free to relocate it if necessary.

I've been where you are. I've felt exactly those ways. good luck.

David

Hi, I was on adderall when I was younger. Now Im happy to say that I am on an all natural treatment plan that is working great. :D

Nice you found something that works for you. It is perfectly ok to take medication breaks from stimulants. They don't need to build up in your system to work so skipping a day or two for a med vacation will be fine. It will not have lost any of its effectiveness when you go back on it. Taking med breaks will also lower the likelyhood of the med causing addiction. It will also allow your body not to build up a tolerance to the med (when that happens the med becomes ineffective)

Actually, I'll take exception to some of the comments made here.

Most ADD meds are not flushed out of your system in 24 hours, and can take as long as several weeks to completely vacate your system.

For many ADD meds, we are told that the benefits will take from a few days to a few weeks to see the full benefits. That's because there is a build up within the body, and an adjustment to the medication.

So, depending on the medication, by taking a "holiday", you may, in fact, be doing your body less good than you think.

But, as I tell all my friends, when it comes to medicating, or in this case, self medicating, don't adjust your own meds without talking to a medical professional that understands the medication you're on.

Taking 2 days off from adderall doesnt have negative effects. Unless my doctor lied to me when I was on it.

hmmmmmmm lol

Actually I agree with you somewhat. But she is not talking about going off the med for days and days just one or two days.

Generally the effectiveness of adderall wont be changed if she takes a two day med break every week. Most likely it would just end up allowing her to have continued success with the med because her body wont build up a tolerance to it.

If a person feels not themselves on a med then they should not take it every day.

Of course, if you talk to a doctor about it maybe he could find a medication that works well for you without making you feel different in any negative way.

I started Ritalin when I was 13 years old, I took it religiously until I was 16. At 16 and 17 I took Ritalin off and on, and from 17 to my current age of 22, I take Adderall off and on...and I'm still living. ;)

I agree with LiLMissADDitude, I notice whenever I take my meds everyday, I build tolerance to it. There are times that I just want to be my ADD self, regardless of research says, I do notice a change in my personality when I'm on the meds.

The physician who prescribed the meds has said that she sees no problem with me skipping the stimulants occasionally. It's not that I "don't feel like myself" on the meds, more like "I feel too much like myself"? Sometimes, I can see my life with such starling acuity on the meds...I realize too many things that I need to do or change and it is overwhelming.

But anyway, I'm more concerned about the ethics of the situation (on the part of the therapist). This guy really had no right to be making speculations to bf about these things, especially considering he's not a medical doctor. For him to tell my bf that something my own physician approved was 'drug abuse'...it just seems wrong for him to do that...

Dana_renay: I think the bottom line answer, in my opinion, is what your physician says is the answer.....and since she said the answer is that she sees no problem in your skipping dosages well then, that's the best answer....she knows you better than anyone....

And I agree, your bf's therapist has no right to make inferences and conclusion about your meds practices to him...it's unethical and really is a violation of not only you but your bf....as it was your bf that was being treated, not you....so the focus should have stayed on your bf....

But in any event, I'm glad you have your answer and that you're happy with it:)

Originally posted by lilthingsADDup
...regardless of research says, I do notice a change in my personality when I'm on the meds.

I do too!

I do too. I notice changes in my "personality" and others do as well.

for instance, my more recent posts seem to be poking people in the eye... and I am recently "off" all my ADHD meds. A connection? (conspiracy theorists arise!) i think there could be...

It's not a great idea to take stimulants on an as-needed basis. This creates the possibility of a pattern of forgetting to take the meds over a long period of time, and then taking many times the recommended dose over a short period in order to make up all the work that wasn't done while you weren't medicated. Working for 48 continuous hours may seem like an attractive option when desperate to meet a deadline; it takes a LOT of Adderall to cover 48 continuous hours.

As long as you've set up a rigid dosing schedule and stick to it (keeping in mind that ADDers have a harder time sticking), you should be able to avoid patterns that could lead to abuse and addiction. Regular medication holidays also prevent or reduce the development of tolerance.

"Flushing" the medication from your system is not a concern with Ritalin, since methylphenidate has a half-life of only two hours. The amphetamines, however, tend to have fairly long half-lives, so it seems theoretically possible that a skipped dose of Adderall might make the next dose less effective. I haven't experienced this problem with Adderall, though.

Finally, there is a big difference between purely informational medical advice and medical treatment. You don't need to be a doctor to provide medical advice and I don't think it was wrong for your boyfriend's psychologist to inform him of the best way to take his medication. The psych is probably guilty of factual exaggeration and distortion, but he wasn't unethical.

I'm interested in exactly why he thinks skipping doses, even when done as part of a rigid medication schedule, is going to lead to abuse. If you speak with him, do let us know the conclusion!

pay attention to wht you work out with your own doctor.

tell your boyfriend to go to alanon.

tell your boy friend to mention the illegality of yuor boyfriends "doc" practicing through him, on you, unrequested.

repaet from top.

Originally posted by Wheel1975
tell your boy friend to mention the illegality of yuor boyfriends "doc" practicing through him, on you, unrequested.

How does a doctor practice medicine on someone without making any attempts to contact or converse with him?

The psych gave the boyfriend advice on how to take his meds. The boyfriend tells the girlfriend about this advice. This makes the girlfriend curious because the information contradicts the treatment program implemented by her physician. The girlfriend then proposes contacting the psychologist directly.

The psych did nothing wrong and certianly nothing illegal by giving medical advice to his patient, the boyfriend did nothing wrong by telling his girlfriend about the advice, and the girlfriend is not wrong to be interested in resolving an apparent difference of opinion between a psychiatrist and a psychologist.

The sole problem here is that we have only the boyfriend's possibly distorted or exaggerated memories of his psychologist's advice to him.

The actual original material:

But when my boyfriend mentioned to his psychologist that I only take my medication on weekdays, the dr said that was really bad for me, that I'd be better off not taking the med at all than taking it intermittently, and that only taking it on weekdays was "drug abuse".

elSenor,

I believe on inspection you might be surprised how many of the details in your post have a source other than the original message, which was quite clear, and conformed to my comments.

David

Originally posted by elSenor


How does a doctor practice medicine on someone without making any attempts to contact or converse with him?

+Just like at the top

The psych gave the boyfriend advice on how to take his meds.
+ not in the story

The boyfriend tells the girlfriend about this advice.
+different advice not "this"

This makes the girlfriend curious because the information contradicts the treatment program implemented by her physician.

+True

The girlfriend then proposes contacting the psychologist directly.
+ I don't see that.


The psych did nothing wrong and certianly nothing illegal by giving medical advice to his patient,
+That is not what happened!

the boyfriend did nothing wrong by telling his girlfriend about the advice,
+Actually it is a social and medical privacy breech.

and the girlfriend is not wrong to be interested in resolving an apparent difference of opinion between a psychiatrist and a psychologist.
+True


The sole problem here is that we have only the boyfriend's possibly distorted or exaggerated memories of his psychologist's advice to him.
+Didn't happen.


But when my boyfriend mentioned to his psychologist that I only take my medication on weekdays, the dr said that was really bad for me, that I'd be better off not taking the med at all than taking it intermittently, and that only taking it on weekdays was "drug abuse".

My bad. I read the OP incorrectly; I didn't realize that she was in the room when the comments were made.

-Mike

My bad too. I failed to realize she was in the room, live.

However, drug abuse being defined by only taking drugs when you "need" them depends entirely on whether your definition of "need" is an addict's definiton, or an non-addict's definition.

She wasn't in the room.

Sleepz

"...I was in his office for my bf's ADD evaluation!"


Yep. She was in the room, at some point.

To clarify....


How does a doctor practice medicine on someone without making any attempts to contact or converse with him?


BF was evaluated by this psychologist about 8 months ago. I was evaluated by the same guy 6 months ago, but chose to go elsewhere for treatment. The bf continued to see him.


The psych gave the boyfriend advice on how to take his meds. The boyfriend tells the girlfriend about this advice. This makes the girlfriend curious because the information contradicts the treatment program implemented by her physician. The girlfriend then proposes contacting the psychologist directly.


Recently, the bf mentioned to the psychologist that I skip Adderall on the weekends (as approved by my psychiatrist). The psychologist remarked to bf that it was 'drug abuse' for me to skip on weekends.


The psych did nothing wrong and certianly nothing illegal by giving medical advice to his patient, the boyfriend did nothing wrong by telling his girlfriend about the advice, and the girlfriend is not wrong to be interested in resolving an apparent difference of opinion between a psychiatrist and a psychologist.


In my opinion, the psychologist did do wrong because he was making speculations about my treatment to bf. I am not his patient, and he shouldn't have been discussing his opinions with bf either - it had nothing to do with him.

I was not in the office when this exchange took place between bf and psychologist. When bf told me about the exchange and saw that this had upset me, he suggested we go together and discuss it with the psychologist. However, this has never happened, even though he has seen the psychologist several times since.

Because bf asked me to, I have been taking the meds every day, even on weekends, and it doesn't seem to make any impact on the rest of the week either way.

Originally posted by dana_renay
In my opinion, the psychologist did do wrong because he was making speculations about my treatment to bf.

I agree COMPLETELY!

That is a technical breach of propriety.

you have to wonder "what was he thinking?"

I think, in retrospect, he wasn't thinking it through.

Maybe the bf's therapist has a touch of ADD himself.

Sounds like me in "blurt mode". ;o)

hi dana,
I liked your post. First off,as a psychologist myself, your bf's psych should know better than to diagnose someone else in the room,although he sounds like he was being helpful and gave you good feedback.I'm not attacking him either,We just have rigid rules and Gestapo state licensing boards to deal with.

As far as med holidays go, there are lots of different opinions. I think it depnds on the person and the reasons for the med,as well as the med itself. My understanding is that most stimulants are flushed out of your sytem fairly quickly. For me, I think kids need to stay on their meds over the weekends. You dont want to stop and start all the time. ADHD surely doesnt go away.I especially worry about the hyper kids during the summer because they are at risk for accidents. You'd be surprised how many kids have actually been hit by cars.

I'm glad Adderall works for you. As long as it does I think its a moot point as to whether or not you do , other than to learn as much as you can about adhd and depression. The theory is that whichever symptom shows up first is probably the main problem.However, you can acquire adhd at any point in your life, even tho it is primarily genetic/inherited.

I wish you much luck and hope things continue to go well for you and your boyfriend.