Hello everyone,

it's been a while since I posted.

I need help/advice. Im currently taking 40 mg of generic amphetamine salts per day, but it doesn't work as well as the adderall xr which I tried. The adderall xr was just too expensive to keep taking without a prescription.

Recently I applied for the Shire patient assistance with the help of my doctor. The card should be coming any day, but it only covers 30 pills per month or one a day, which at the highest dose would on be adderall xr 30 mg.

To cover the evenings, the doctor wants to put me on effexor 37 mg. I've done a lot of research and effexors side effects and withdrawal symptoms seem to put crack to shame. When I told her this (without the crack comment), she said the withdrawals weren't any worse than amphetamine withdrawal. I don't think shes done a lot of research.

So, my question is---are there any other alternatives that I could afford without insurance in addition to the adderall xr 30 each day.

I asked her about taking dexedrine in the evenings, and she said that she didn't want to double up medication, which doesn't make a lot of sense to me. Is it doubling up medication to take adderall xr in the morning and adderall ir in the evening? (rhetorical).

I've tried the Daytrana patch which only made me tired and irritable, which I'm guessing means ritalin wont work for me?

I've tried bupropion sr in the past, and although it helped a lot with consistant focus, I was too uncomfortable and irritable all the time.

So---any advice or suggestions to talk to my doctor about would be greatly appreciated (ie any prescription alternatives to effexor).

I really , really don't want to get on the effexor, which is her first choice. One of the side effects of effexor is apathy--how can that be good for inattentive add??

My mind could be changed if anyone out their has good things to say about effexor, and the ease they had getting off of it. Anyone??? Anyone??


Lunar...

I need help/advice. Im currently taking 40 mg of generic amphetamine salts per day, but it doesn't work as well as the adderall xr which I tried. The adderall xr was just too expensive to keep taking without a prescription.

Recently I applied for the Shire patient assistance with the help of my doctor. The card should be coming any day, but it only covers 30 pills per month or one a day, which at the highest dose would on be adderall xr 30 mg.

To cover the evenings, the doctor wants to put me on effexor 37 mg. I've done a lot of research and effexors side effects and withdrawal symptoms seem to put crack to shame. When I told her this (without the crack comment), she said the withdrawals weren't any worse than amphetamine withdrawal. I don't think shes done a lot of research.

I really, really don't want to get on the effexor, which is her first choice. One of the side effects of effexor is apathy--how can that be good for inattentive add??

My mind could be changed if anyone out their has good things to say about effexor, and the ease they had getting off of it. Anyone??? Anyone?

Side effects of effexor--how about weight gain in addition to apathy. Although I have never had the side effects from withdrawal to crack, the side effects of withdrawal of effexor (for me) were HORRIBLE. Although to be fair, I was taking a much higher dose than 37 mg.

I don't think IR Adderall added to the XR could be considered doubling up (as you obviously know). In fact, I think many people do that.

Ugghhh. I was on Effexor for about 6 months. I wouldn't wish that experience on my worst enemy. Bad nausea, sweating and dizziness upon first taking it and everytime I moved up in dosage. Once 'adjusted' on a dose I was fine though unless I forgot to take it for a day then the withdrawal symptoms kicked in (same as above).
I asked my doc to switch me to prozac (which has a ridiculous long half-life) and I've been fine ever since. I guess I just had some bad side-effects from it but give it a shot I guess.
Good Luck!
J

I have heard so many bad things about effexor...
I hope you can sort someting out soon, and you and your Doc can agree on trying something different
hugs LF

Thanks for the support and responses everyone. Effexor is a strange bird--seems to be very popular among doctors and very unpopular among patients.

But, does anyone have any alternative medicine suggestions for the afternoon if she wont prescribe an amphetamine??

She did at one point talk about wellbutrin xl (she has a plentitude of samples i could use). I was on the generic bupropion sr, but maybe the namebrand xl has less side effects? Has anyone tried both?

I have taken prozac in the past, but I really didn't like the way I felt on it---kind of flat line.

Lunar.....

Thanks for the support and responses everyone. Effexor is a strange bird--seems to be very popular among doctors and very unpopular among patients.

But, does anyone have any alternative medicine suggestions for the afternoon if she wont prescribe an amphetamine??

She did at one point talk about wellbutrin xl (she has a plentitude of samples i could use). I was on the generic bupropion sr, but maybe the namebrand xl has less side effects? Has anyone tried both?

I have taken prozac in the past, but I really didn't like the way I felt on it---kind of flat line.

Lunar.....
Of all the SSRI antidepressants I took, Zoloft was better than most others for me. It took the edge off, I stopped bursting into tears w/o warning from the first day I took it, and I really helped me sleep. But I was still depressed.

Wellbutrin is doing more for my depression, but I have only been on it for 2 weeks. I have only taken the name brand. However, I do see the combination of Adderall and Wellbutrin mentioned more than once in the books I have been reading. Hallowell mentions Wellbutrin in his books Driven to Distraction and Delivered from distraction. Amen also mentions it in his book Healing ADD as a stimulating antidepressant. He especially says it works well for innatentive in combination with with Adderall. It works on dopamaine and norepinephrine. If she can give you name brand Wellbutrin, maybe you should at least give it try. (But I am no doctor, just saying that's what I would do!)

Just in the last few days, I have been reading about lamictal for depression for those who have comorbid bipolar. Crazy Feet likes it, so it must be good. :p

But I still don't know why your doc wants to go with an antidepressant instead of a stim. And I don't know if you have any depression. Ignore all of the above if you are not depressed!

And good luck!

Effexor is probably not a good choice for ADHD. The reason why she is probably prescribing it is because it has an effect on norepinephrine, although other meds have a better effect in that respect. It's most significant effect is on serotonin. It shocks me that people would prescribe this for ADHD as it is a med that requires strict compliance (especially since there are more effective antidepressants for this purpose), and people with ADHD are known for forgetting to take it. In your case, if you are taking the normal version (Effexor, not XR), it might not be that bad as you would only be taking it once a day, having time to come off of it each day. But as a full time treatment, I think it would be a horrible idea.

There are other antidepressants that would work better than effexor without the severe withdrawal problem. Already mentioned was Wellbutrin, which is very common in this context. Tricyclics (especially desipramine) can be very potent in increasing norepinephrine, but are not as effective as stimulants (but probably more than Effexor).

Really, the best solution (the most effective, anyway) would probably be to take XR and IR together as you had suggested (whether that IR is adderall or dexedrine). This is a very common practice as Adderall XR doesn't always last the duration in which you need it. It's not about how many different meds you have, but how much you take per day and per dose that matters. I would imagine that you're taking either 2 doses of 20mg or 4 doses of 10mg? 30mg XR + 10mg IR would be 40mg total, or 3 IR doses (15mg, 15mg, and 10mg).

EDIT: Something you might find interesting:

http://www.crazymeds.org/effexor.html

And the way Effexor (venlafaxine hydrochloride) works on neurotransmitters is very complicated. Your doctor may or may not explain this to you. Here's how it works: First it starts to work on your serotonin. Then somewhere around 200 mg a day it starts to work on norepinephrine. Then around 300 mg a day it starts to work on your dopamine. Mileage will vary for each individual, and there's no guarantee on getting all that much dopamine action.

That's much higher than the 37mg you have been prescribed.

I need help/advice. Im currently taking 40 mg of generic amphetamine salts per day, but it doesn't work as well as the adderall xr which I tried. The adderall xr was just too expensive to keep taking without a prescription.Hey lunarfrog, it's nice to see you posting again.

I am curious if you have ever tried any other generic versions of Adderall, or have you only tried one generic version?

I only have experience with the brand name Adderall & that was about 10 years ago, and there were no generics available for Adderall at that time. However, for the other medications I have taken for this dissorder (with the exception of Desoxyn, and Focalin) there were multiple generics available, and even what are called "brand name generics" like Methylin which is a brand name generic of Ritalin, and Dextrostat which is a brand name generic of Dexedrine. There are even generic versions of the brand name generics, for instance anyone taking a 10mg IR dextroamphetamine generic is taking a generic version of Dextrostat because Dexedrine only comes in a 5mg IR tablet, compared to Dextrostat which is available in both the 5mg IR & 10mg IR. I point this out because I have found that the generic version of Dexedrine that I prefer is more potent when I take two of the 5mg IR tablets, compared to taking one 10mg tablet from the same company. It's obvious to me that this companies 10mg IR tablet is a generic version of Dextrostat, and that their 5mg IR tablet is a generic version of Dexedrine. I've heard others report noticing this difference too.

I made it a point over the years to try as many versions of these drugs as I could in an effort to find the best fit for me. Some people claim there is no difference between the generics of certain drugs, and yet others seem to be able to detect the differences between the generics almost like a connoisseur of fine wine who can detect the differences between wines that look, smell, and taste the same to the average person.

Perhaps you should try all the generics available before assuming you have to switch to another drug, especially if the reason your switching is a matter of money. I do not have insurance either, and I have been paying out of pocket for my drugs all these years. I think me not having insurance over the years has actually forced me into becoming a more conscientious consumer of these drugs in many ways.

I guess my point here is that many people (like me) have found that not all generics have the same effect, and some people actually prefer certain generics more so than the brand name drug itself.

Perhaps some of the people here who take Adderall, and have taken more than one of the generic versions of it might be able to suggest their favorite generic.

Thanks for the advice everyone

Jeanie....

Depressed or just a cynical comedian--how would I know;)??


Lars--yeah, posting again- I seem to be a binge poster.

The problem with trying to get different generics is finding a drugstore who will work with me on this in my backwoods area. The last time I tried to request a different generic, the drugstore said they couldn't order it unless it was for over a hundred and that it would take a while to get (my dose was smaller then). I'm definitely in Barr land here. Not only that, but when I asked them about getting a different generic, the room suddenly went very quiet--like those old insurance commercials. You would have thought I asked for a tomato and arugala with my iceburg lettuce salad :)

I mentioned to my doctor something about trying different generics, and she essentially said I shouldn't split hairs like that. I don't want to criticize her too much (She has actually helps me out for almost nothing), but she seems to have unusual ideas about add medications and dosing, although shes much better than my general practitioner was.

Highfunctioning:

Thanks for the crazymed info. I'd looked it up there before, but forgot about the incremental dosing effects and that it takes around 200 mg to effect norepinephrine.

We'll I e-mailed her today, and it looks like I've avoided the effexor for a little while. She's going to send some wellbutrin xl 150 samples in the mail to try while I still have the ir (in case it doesn't work). But, strangely, she wants me to take the wellbutrin in the morning and the adderall at night. I know what the generic bupropion sr is like; it didn't give me any imsomnia, but taking the wellbutrin in the morning (less stimulating than adderall--less alertness) and then taking the adderall in the afternoon with the 24 hour wellbutrin still pumping into my system sounds like foggy mornings and sleepless nights-------but, maybe I'll be pleasantly suprised :eyebrow:.

Interesting note:

In the past two days I have taken 2 (20mg) ir spaced about 7 to 8 hours apart instead of 10 mg every 4 hours, and it seems to work much better - less ups and downs and strangely enough I'm more calm and less anxious---and this is really strange--my slight insomnia seems to be lessening even though I'm taking 20 mg instead of 10 around 4 pm (as my last dose). The side effects (slight heart palpitations, mild insomnia, etc. only seem to hit me when the medicine is wearing off. I've tried to explain this to my doctor, but she insists that its because of the direct action of the adderall, but wouldn't this mean that the side effects would be most intense when the drug was at its saturation peak--about 2 hrs after I take it???

Lunar....

It is NOT uncommon for an ADDer to be sleeping better when medicated. Very often many of us do and prefer it.

Perhaps the doctor thinks you might benefit from a small dose of antidepressant. In regards to effexor withdrawl, if you reduced the dose gradually you shouldn't have problems coming off of it. In fact, I read somewhere that if patients have a hard time withdrawing form effexor, doctors will switch their patients over to prozac. Prozac has a longer half life, so is easier to come off of. With all the antidepressants you have to wean yourself off of them slowly. Effexor is the worst because it has a short half-life.

Perhaps you could try a small dose of antidepressant, maybee it will help.

Just a suggestion.

Perhaps you could try a small dose of antidepressant, maybee it will help.

Perhaps, but in the context of the problem she's having right now, what benefit would having an evening dose of Effexor have? It's not so much that I couldn't think of any benefits, but 1.) for any benefit that it might have, there are probably better drugs to choose from to get that benefit, especially in this context, and 2.) the choice doesn't solve the fundamental stated problem (to fill in for the lapse of the ADHD medication) that she is claiming it to do (or implying it to).

If she needs an antidepressant, she can easily take one with stimulant medication at the typical dosing schedule one would for such a situation, and still take stimulant medication at night.

I'm also wondering about the cost of Effexor, considering that she can't subsidize Adderall XR. I don't think the normal release version of Effexor is that expensive, but the XR version carries a high enough price tag for those without insurance coverage. It will definitely be more expensive than generic amphetamine. Considering that she stated 37mg, that very well could be true. I'm sure there are cheaper solutions as well.

But, does anyone have any alternative medicine suggestions for the afternoon if she wont prescribe an amphetamine??

She did at one point talk about wellbutrin xl (she has a plentitude of samples i could use). I was on the generic bupropion sr, but maybe the namebrand xl has less side effects? Has anyone tried both?



Lunar.....I used to take two doses of Concerta a day. I found that if I got up and exercised in the morning and had a little caffeine, I could wait until 11 or 12 to take medication and that one dose saw me through the rest of the day. Wellbutrin might also be an option, if you're doctor is open to it. I've heard a lot of horror stories about Effexor, including those from one of my best friends.

Take care,
Scattered

HighFunctioning,

I totally agree with you. I don't understand why it has to be either or. I think maybe my doc just reads the fact sheets that come with the drugs, and bases her decisions on that instead of current info. The drug sheets would scare anyone away from mixing meds.

By the way...uh....I'm not a she. It's no problem---just FYI. Its interesting how often i've been wrong about the gender of the poster. I wonder how we come up with those assumptions? It might be an interesting topic or a very dangerous one:).

She (my doctor) was recommending effexor xr because they still give a fair amount of samples out - which she has a fair amount of. She also claimed that it worked well with her adult add patients.

Thanks for the info Scattered--exercise is something I'm trying to get into regularly. I'm sure it will help alot if I can stay consistent.

Lunar.... Lunarette?

Lunar.... Lunarette?

Oops... sorry about that... :o

She (my doctor) was recommending effexor xr because they still give a fair amount of samples out - which she has a fair amount of.

I would hope she has a lot.... from my quick research, Effexor XR goes for about $4 a pill in the United States (there is no generic form... yet).

She also claimed that it worked well with her adult add patients.

It is also quite possible that those patents were suffering from other things besides ADHD. That doesn't mean it wouldn't have any benefits (perhaps increasing the quality of your sleep?), but I doubt it would do anything for inattention.

Tricyclic antidepressants, the most common type of antidepressant used (with the exception of Wellbutrin, which is more related to stimulants than other antidepressants anyway) for the treatment of ADHD, are generally stated to improve hyperactivity and impulsiveness, but little impact on inattention (at least in comparison to the stimulants), and these meds often have more impact on norepinephrine than on serotonin (especially desipramine).

I totally agree with you. I don't understand why it has to be either or. I think maybe my doc just reads the fact sheets that come with the drugs, and bases her decisions on that instead of current info. The drug sheets would scare anyone away from mixing meds.

I'm not always that confident in the doctors' understanding of the medications... I could see not wanting to mix stimulants and tricyclics, or even stimulants with wellbutrin, but to add more adderall or dexedrine to another adderall preperation to get the originally prescribed dose doesn't make that much sense, provided that the effective dosing strategy is the same (or at least, not more in one dose).

effexor made me psychotic so I won't go there (i personally react that way to all SSRI's and that is due to my Bipolar NOS dx) but ask for dexedrine alone, the tabs are mega cheap (much cheaper than adderall)

mspen...

I've used dex in the past, but found it less motivating.

I felt great on it, but it didn't help with activation much. In the end it just made me really mellow and relaxed--a little too relaxed.

Lunar....