I am an ADD adult, and have been taking Ritalin (SR) for 3+ years now. It changed my life, certainly. Lately, though, I have felt the Ritalin is not as effective, and sometimes not effective at all. I have taken "holidays", and still nothing.

My doc increased my dosage, but that has not helped. I have been reading about Adderall, and it seems that people prefer it over Ritalin. My doc has not even broached the subject of Adderall, even though I have talked to him about the effectiveness problems I have been having with Ritalin.

I want to bring up trying Adderall, but (1) am not interested in being seen as some sort of drugee or, more importantly, (2) do not want to be subjected to a bunch of different new drugs like a lab rat to see if they work (I already went through the Wellbrutrin and Buspar nightmare, and Straterra did not work at all).

What do docs think when their ADD clients bring up switching to Adderall? Anyone? Anyone? Thank you.

If you have an ongoing relationship of 3+ years i dont think you'd have any problem. The choice with amphetamines is adderall or dexedrine, some doctors may be leary of prescribing dexedrine because of its reputation but the reality is that the drugs been around 80+ years and for something that was so abused back in the 60s and 70s it has a pretty stellar safety record. Adderall on the other hand is getting a bad reputation for an entirely different reason. Its been connected with some 20 or so deaths in the last 5 years from people taking it in therapeutic level doses. It was recently outright banned in canada.

From personal experiance,

Adderall = moderate to good mental stimulation but feels very physically speedy. It contains the Levo isomer which primarily works as a cardio stimulant. Lasts in general about 6 hours.

Dexedrine = very good mental stimulation but has a sort of calmness and smoothness to it that adderall doesnt. The physical effects are less pronounced. Lasts around 4 hours.

Thanks. I guess I will discuss it with him.

I was not that educated about Adderall, and assumed it was basically the same as Ritalin. I am wondering why the doc has never brought up Adderall as a possiblity. He has never even referred to it at all.

Nah ritalin is methylphenidate, its different than the amphetamine based drugs. They're both stimulants they just act differently on the brain.

Thanks. I guess I will discuss it with him.

I was not that educated about Adderall, and assumed it was basically the same as Ritalin. I am wondering why the doc has never brought up Adderall as a possiblity. He has never even referred to it at all.he probably just wanted to try upping the does of ritalin SR before going with a different drug.

ritalin SR is kind of a crappy formulation of ritalin. the delivery system generally doesn't work well for most people. ritalin SR slowly releases the methyphenidate at a constant rate. a lot of studies show that instant release 2 or 3 times a day is superior to ritalin SR style extended release. the newer drugs (concerta, adderall xr) mimick this with delivery systems that give you like 40% of the dose immediately and then the remaining 60% of the dose 4 hours later.

i started ADHD treatment on ritalin instant release, then switched to SR for a few months. And i really disliked it. it didn't work nearly as well as the instant release for me, even at a higher dose than i was taking with the instant release. next i switched to adderall instant release and have been on it since.

it's always a fine line when it comes to suggesting med changes. some docs are ok with it, some clam up and write "drug seeker" on your chart. it has a lot to do with your relationship with your doc and how much he trust you as well as how much initiative you've taken in your treatment previously. i generally think it's ok so long as you aren't demanding about it and are willing to meet him in the middle if he wants to go a different direction first.

i'm lucky because my psychiatrist and i get along famously. i've seen him forever and we trust each other. so he lets me use a variable dosing schedule (adderall IR 5-15mg three times/day, up to 40-45mg a day - usually around 20mg/day.) depending on whats going on with life/school and also lets me basically pick my other meds (lexapro qd, propranolol/xanax prn). but in return, if he wants me to give something a shot, i do it without a fuss.

so switching to adderall is definately a legit option for you. but it also would also be understandable to try one of the newer methyphenidate extended release formulations like concerta or ritalin LA. it all boils down to what works best for you.

good luck,
simbryo