Hi all -

Been a while since I've been here, thought I'd check in for an update and fire out a few questions for the Adderall guru's.

Diagnosed back in Sep/Oct '06 by my primary (regular) doc. Tried Straterra and then Welbutrin w/ no success. Ended up on 10mg Adderall XR in AM, and 5mg Adderall XR in PM for about 2 months before I decided to change regular docs (not terribly pleased w/ overall experience) and also break out and see a Pysch.

Have had 2 appointments so far w/ Psych, and 1st appointment he felt like 20mg Adderall XR in the AM was the right does for me. He's made a comment that 40mg is likely the proper dosage for me. I should also note that I've been on 20mg of Lexapro for some time.

Currently at the 20mg level, I feel I have energy and focus up until about 1-2PM. I also feel it improves my mood, which I'm guessing might be the "euphoria" that I've heard referenced.

1. If this is the euphoria I'm experiencing - how long do folks typically experience this?

2. In hopes to adress the PM fall off, I'll be talking to him on my next visit on ways to address that (maybe an early PM does will be an option). Is 30 or 40 mg considered low, normal, or high dosage this early on (~6 months since diagnosis)?

3. One thing I've noticed over the last 6 months is that my mood seems to be signficantly impacted my ability (or inability) to keep 1) tasks organized, and 2) tasks completed on time. If both those are OK on any given morning, I would say 90% or better I'm in a great mood....however if not, I'm miserable. So of course I'm hoping that as my ADD treatment improves, and I'm able to better organize myself, my mood will improve.....this similar with anyone else?

Sorry in advance for bumping my own post - but wondering if rewording my questions might help solicit a little advice....

Was on 15mg Adderall XR for about 2 months, 20mg for a month, and now 30mg for almost a week.

Once I reached the 20mg, and now moreso with the 30mg, my mornings are great. I'm a perfect mood, social, and very motivated, organized and focused. I wonder how much of these benefits are due to Adderall properly treating my ADD, and how much is the "euphoria" that folks say will likely wear off.......so my question is how long to folks typically experience the euphoria effects of Adderall XR? 1 month? 2? 6?
Now with 3 trips to my new Pysch under my belt, I've told him each time that I'm real good in the morning, but I fall off by 1-2PM. His statement is that XR is supposed to be extended release over the day, so there should be no need to for a dose other than initial one in AM....and this is what led him to bump me from 20mg to 30mg. My 3rd visit I made a reference to "an internet forum" (this one, but not by name) and the feedback several folks have given reflecting XR commonly wears off after ~5-6 hours. His response was something along the line of "we rely on medical studies/trials, not internet forums, when prescribing meds." Should I challenge him on this, and if so - how?
He thought 40mg might be a good target for me. I'm 220 pounds, and typically VERY tolerant of just about any prescription med all my life. I know there's no easy formula to determine proper dosage.....but curious on opinions of an average dosage range for a male 30 year old @ 220 lbs.

He also recommended me to a counseler which I start with this Friday, so unsure how much a counseler would get involved with recommending any modifications to my Adderall/Lexapro dosage....and whether her opinion will differ from the Pysch.

Any advice would be greatly appreciated!!

Bump away!

Ok I will try to help. Keeping in mind, I am not a doctor..I just play one on TV..LOL....But I have been on Stimulants on and off for 12 years...And on Adderall XR for over a year myself...so let me see...


Once I reached the 20mg, and now moreso with the 30mg, my mornings are great. I'm a perfect mood, social, and very motivated, organized and focused. I wonder how much of these benefits are due to Adderall properly treating my ADD, and how much is the "euphoria" that folks say will likely wear off.......so my question is how long to folks typically experience the euphoria effects of Adderall XR? 1 month? 2? 6? Um sounds like it's working to me? The initial Euphoria, or for me "kicking" in of my Adderall XR has never gone away. The side-effects have lessened, and the uncomfortable jolt has left. But I always feel the "awakening" of my brain when it first kicks in. That makes my mind clearer, and focused...so hey that's euphoria to me. I don't think of it in terms of a Euphoria an addict would want? It's not long enough, it's kinda of a reminder that my meds are there? And some days, I really don't notice it at all, I just all of a sudden have the urge to get something done? So it might never go away.

Now with 3 trips to my new Pysch under my belt, I've told him each time that I'm real good in the morning, but I fall off by 1-2PM. His statement is that XR is supposed to be extended release over the day, so there should be no need to for a dose other than initial one in AM....and this is what led him to bump me from 20mg to 30mg. My 3rd visit I made a reference to "an internet forum" (this one, but not by name) and the feedback several folks have given reflecting XR commonly wears off after ~5-6 hours. His response was something along the line of "we rely on medical studies/trials, not internet forums, when prescribing meds." Should I challenge him on this, and if so - how?
Well that's a toughy. But I started on 20mg, went to 30mg and then finally 40mg and had the same issue. I needed my meds not only for work, but home??? I have 3 ADD boys and have a household to run too. Homework, cooking, cleaning and plannign for another work/school day..requires as much Adderall as work does. So my doc suggested I take 20mg in the morning normal time (about 8am) and then another 20mg about 11 or so) this enableing me to have the needed meds through the entire day. I did have a little sluggishness in the first couple of hours of the day, but this time isn't usally as important as later on, when there are meetings etc. And it wore off about 9 or so at night so I could attempt to wind down. The only unplesant effect was the "rebound" at night left me not being able to sleep like on a normal one time dose. This required me to take a "sleep aide" sometimes. I choose herbal rather than pharmacutical, with my doctor's permission. I had to watch taking it anytime after 11am or I would not be able to sleep at night. If you want to challenge him, challenge him. He WORKS FOR YOU... and where do they get those studies? Don't they do them on PEOPLE? Then why wouldn't he listen to the fact you have performed your own "study" and gathtered info from people who have had the same issues, and at least be open to hear it? If he refuses to consider it , since many of us here have done it, and several use what we call "boosters" (short acting inbetween) then perhaps it's time to find another doctor to at least get a second opinion...??? dunno? I would.

He thought 40mg might be a good target for me. I'm 220 pounds, and typically VERY tolerant of just about any prescription med all my life. I know there's no easy formula to determine proper dosage.....but curious on opinions of an average dosage range for a male 30 year old @ 220 lbs.
Stimulant's don't go by weight like regular medications. My son is only 6'1 and 115lbs...and he took 40mg, I am 5'9 175 and took the same thing. My sister is 5'6 110lbs soaking wet, and I believe takes upwards 60-80mg of short acting? So it's what stimulant make up works best for you...and dosage rather than the height/weight ratio.
He also recommended me to a counseler which I start with this Friday, so unsure how much a counseler would get involved with recommending any modifications to my Adderall/Lexapro dosage....and whether her opinion will differ from the Pysch.
I don't think counseling is ever a bad idea, esp in the beginning. There a many factors involved in bringing each of us to a diagnoses. Bad habits , bad backrounds, abuse etc, we might need to wade through some of our baggage to help "assist" with some of the things we are going through along with medication treatments. Behavior Modification and Coaching is highly recommended by my P-doc over counsling, but he says counseling is good in the beginning stages. So there you go, how could it hurt? Try it...give it a chance. If you don't see any benefits after a while of "really" trying then it's your call.

Good luck, and let us know how your are doing :)

Bah,....doctors...pharmacists....drug companies......all think these "once a day" meds truly work that long. Look at the prescribing info for Adderall XR. You will see that it hits the peak in 5-7 hours then starts the downfall. As far as the drug companies and doctors are concerned the levels of meds in the body at any given time is the indicator and they feel that if your body has x % of this drug it should still be working. That might be true for other meds but for stimulants that isn't the case, at least not for me and countless others on this forum.

For me and probably many others once you reached the peak and start the downfall is when we say "it's lost it's punch" and you start the crappy side effects. The thing with adderall is that the d-amphetamine burns out faster than the l-amphetamine. So you lose the best mental benefits earlier and the peripheral side effects still hang around (heart flutters etc.) since l-amphetamine has a longer half life.

I think the only true med that will give a constant linear dose is a patch. No ups or downs. You either remove it or leave it on until it runs out (15 hours for the Daytrana patch).

J

GO PATCH, Noven completed a succesfull phase 1 study of Amphetamine Transdermal System; the study was a randomized open-label three-way cross-over design involving about 30 adults, the study met its main objective which was to demonstrate the relative bioabilability of Amphetamine Transdermal System compared to a long acting oral amphetamine, Noven said that their partner, Shire, is now reviewing Amphetamine Transdermal System to see if they will fund the rest of the FDA trails, and if Shire rejects Amphetamien Transdermal System, Noven will either continue it on their own or find another partner. Can't wait for that amphetamine patch!

Thanks for the asound advise folks......

I'll continue pushing the issue of the drop-off effect, and maybe we can entertain a similar schedule like justhope and do a late morning dose. When I was on 20mg, I once took it late in the day (2-3'ish) and had absolutely no impact on my sleep.....so hopefully that won't be an issue.

Give this article to your doctor. It's from Mescape.com (which is totally free and an outstanding source on information)

http://www.medscape.com/viewarticle/546188

J

Hi folks, thought I'd stop by to offer up an update, and another thanks for the support from everyone in this forum....

The Pysch I was seeing continued to bump up my single dose of Adderrall XR in the morning, again with the claim that "he goes by the books" and since Adderall is supposed to last 8 hours, we must just have to keep increasing the dose. The latest bump to 40mg of XR in the morning seemed to be a bit much (caused hand shakes, etc.).....so I decided to scrap that doc in favor of someone with more ADD experience.

I was fortunate enough to find out my Primary doc is part of a network that also has an ADHD center, and had my first visit with someone there yesterday. He concurred it was probably a good move to transition to someone with more ADD experience, and immediately changed me to 30mg in AM, and 15mg at 2PM.

Even thought it's been just one visit, I'm optimistic that I've locked in now with the right doctor, and looking forward to progress. If not for the sound advise received here, I wouldn't of known any better and probably would have stuck it out with the previous doc which I don't think woulda been a good outcome.......so a big THANK YOU to all!

:D I'm so happy for you Stratdude!!!!!!!!!!!!!!!!!!!!!

When I read your posts I thought to myself, "Sheesh, wish I DID HAVE some answers for you (and me). Pretty much we're at the mercy of these doctors - many of whom are NOT informed about ADHD other than what they read or heard about it TWENTY years ago from G.Q. magazine or from their 70-year-old doctor/office mate down the hall."

I've had a HELL OF A TIME just getting ANY MEDICATION for my diagnosed-by-a-specialist-ADHD. It took YEARS to find a doctor willing to work with me to find a medication that works. Then - when I finally FOUND such a doctor - it took over a year to get an adequate dosage (20mg IR x 2 per day).

So - believe me when I say "I'M SO HAPPY FOR YOU!" Unfortunately, for many of us IT'S A FIGHT to get proper treatment!! :soapbox:

Sincerely,
Maronne