Hey all. Just needing some advice before my psychiatrist appointment on Thursday. Here is a brief overview of my situation:

I was on Adderall XR 30mg/day for a few months, but had to switch off b/c of cost/insurance reasons. I was swtiched to Dex spansules (generic) 30mg/day. They were also too expensive, so I asked for any other alternative. So, last month, the doc switched me one more time.... This time he put me on 20mg/day IR (10mg twice/day).

I don't want to go in there sounding like a druggie, but I'd really like to have him bump me up to 30mg/day with the IR. I just don't want to sound like I'm asking for too much (yeah, maybe I'm paranoid). The last time I was in there, I went on and on about how "good" Adderall XR and how I wished I could have that again, since it worked so well..... Yeah, that was probably REALLY stupid of me.

Any advice here would be greatly appreciated! :)

Let's see here: My patient is on 30mg of Dexedrine ER, but wants to switch, so I will put her on 20mg of Dexedrine IR. Yes! This makes perfect sense! I am blind as to the fact that 30-20=10, but since I don't care about my patient and ignore them, they can suffer.

Let's see here: My patient is on 30mg of Dexedrine ER, but wants to switch, so I will put her on 20mg of Dexedrine IR. Yes! This makes perfect sense! I am blind as to the fact that 30-20=10, but since I don't care about my patient and ignore them, they can suffer.Let's try this math again, shall we?

30mgs spansules==15mgs+15mgs

15mgs spansules==7.5mgs+7.5mgs

20mgs IR==10mgs+10mgs



The amount IN TOTAL is not matching up? But the amount per dose each time with the IR is actually higher than with the spansules, which release using a 50%-50% mechanism. Perhaps this is why the doc is moving more slowly with the IR form of Dexedrine.

I would ask him for the additional dose, OP. It does make sense to have 30mgs total throughout the day, as long as you are not overdoing it each time you take the 10mg tabs, can eat and sleep and so forth. Just be honest with the guy, and I doubt he will see you as a "druggie" ;).

Good luck and let us know how things go!

I'll try the math again if you try your reading comprehension skills. Assuming things and then insulting my math skills is awesome. In fact your whole post is confusing because you made a huge assumption.

Ahhh, yes CrazyFeet.... I see where you are going with that math. That makes sense and that is probably what he was thinking. If he were to give me 15 + 15 of the IR, it would release all 15mg at once, instead of gradually, like the spansules.

I'm just not sure what I should say. I'm a little on the shy side, especially when it comes to asking for the meds. I know I shouldn't be shy about that and I know it's my health and yada yada... But I guess I am still under the whole "stigma" thing. I don't know. *sigh*

VentYourPain: Your "math" was exactly what I was thinking when I walked out of the doc's office last month.

Also, maybe it's all in my head, thinking "Okay this is 10mg LESS than what I'm used to... so it's not going to work the same way!" Maybe?

Arrrrggggh.... I wish he'd give me 10mg three times per day. I don't necessarily want 15mg twice per day. I think 15mg at once would "hit" me too hard and I don't want that either. *SIGGGHHHHHH*

OMG I don't believe it. Crazy's post confused the poor original poster and now Princess is filled with silly information. I'm not helping people anymore, I quit.

OMG I don't believe it. Crazy's post confused the poor original poster and now Princess is filled with silly information. I'm not helping people anymore, I quit.CHILL....

Ahhh, yes CrazyFeet.... I see where you are going with that math. That makes sense and that is probably what he was thinking. If he were to give me 15 + 15 of the IR, it would release all 15mg at once, instead of gradually, like the spansules.

I'm just not sure what I should say. I'm a little on the shy side, especially when it comes to asking for the meds. I know I shouldn't be shy about that and I know it's my health and yada yada... But I guess I am still under the whole "stigma" thing. I don't know. *sigh*Glad I could help! And if you need a little bit of support to bolster your courage, well, that's what most of us are here for :)...you just remember what you said here today, because its very true: its your health, and you pay them to treat you. Nobody knows what is helping you as much as you do!

Moderator mode~ from our guidelines:


*Please be respectful to one another. People come from all different backgrounds and many have different ideas and views on different issues.

*Treat your fellow members with courtesy (especially if you disagree with them).

Thank you.

Thank you CrazyFeet!!! :)

I mean... do you think I should go in there suggesting an increase? Or maybe I should *confess* the fact that some days I took 3 in one day? (Yeah, I know... that's bad)

CrazyFeet, maybe you should just write out word for word exactly what I should say on Thursday.

hehe Kidding!! ;)

LOL! I would be dishonest if I denied that I had ever written a script for another person :o I have done so already. I do think rehearsal is very important for us, since even on meds we can slip up and just blurt out whatever comes to mind, then wish we had kept our mouths shut!

My own doc gives me room to experiment with my doses when I start a new stimulant, and he is pretty laid back when I come in and tell him that X works and Y does not.

I would work out a script ahead of time that felt natural, in your own words. Practice saying what you have to say: that you believe that you need 30 mgs total per day, that the current dose is insufficient to get you through the day (I mean, let's face it: an IR med is only going to last 4 hours, tops. The doc will be aware of that fact. Some people metabolize faster than others and he ought to be aware of that, too) and sort of feel out his receptiveness.

If he seems accepting you may want to mention that you have already tried the 3rd tablet and discovered that that amount was just right for you. I know I would, but like I said, my doc expects me to try different doses, and trusts my intelligence in testing my meds. If its too much, I will admit that, too.

I am psyched to find out how this works out for you, LP! You will keep us posted, won't you? :)

Why can't you just say this since it is easier and quicker, "You had me on 30mg/day and then put me on 20mg/day, you are a bad doctor, give me 30mg/day now."

Also note that telling a doctor you took more of a med than prescribed means you won't be his patient any longer.

Ok... here's a little HF math...

Adderall XR 30mg == 7.5mg D-amphetamine sulphate, 7.5mg D-amphetamine saccharate, and 2 other 7.5 D,L-amphetamine salts, which gives us about 22.5mg D-amphetamine salt-wise. It's actually a little less than that. The L-amphetamine is weak. So really, 20mg of IR isn't too far off.

By the way... if you like Adderall (for it's effectiveness), why not take Adderall IR?

(Note: I didn't miss the fact that the doctor had originally prescribed 30mg in Dexedrine Spansules... perhaps that is where he made the mistake, or perhaps maybe he thinks there's something about the absorption of that particular package...).

I do think rehearsal is very important for us, since even on meds we can slip up and just blurt out whatever comes to mind, then wish we had kept our mouths shut!
You are SO right on. Last time I went on and on about how wonderful the Adderall XR was working before. Then later I thought, "Oh crap... Now he's gonna think I'm an XR junkie." lol.

Well, my doc is really nice too... don't get me wrong. He has let me switch all over the place. He told me basically I can take whatever I was comfortable with and that he had no problem switching me back and forth.... between Adderall, Dex, IR or XR.

I've told him numerous times that I worry about becoming addicted, dependent, or whatever the term is..... So hopefully he will remember that. Also, I believe I AM going to tell him that some days I took a third tablet. If he asks what I did when I ran out, I already have that covered too. I will just tell the truth- That I used the Dex spansules left over from last month.

Wow, I'm really making too big a deal of this, aren't I? In a nutshell, here is what I am going to tell him: The IR was comparable to XR, it was very affordable (compared to XR and Dex Spansules) and that I think 30 mg (10mg x 3) per day would just right, since they wore off much faster than XR.

Alright!!!! I think I got it! :D Thanks again CrazyFeet!!!!! :D

Ok... here's a little HF math...

Adderall XR 30mg == 7.5mg D-amphetamine sulphate, 7.5mg D-amphetamine saccharate, and 2 other 7.5 D,L-amphetamine salts, which gives us about 22.5mg D-amphetamine salt-wise. It's actually a little less than that. The L-amphetamine is weak. So really, 20mg of IR isn't too far off.

By the way... if you like Adderall (for it's effectiveness), why not take Adderall IR?I'm going to talk to him on Thursday and see what he thinks. All this is really very interesting. :)

Thanks for adjusting my math, HF, you would know as well as anybody how much I dislike math :p and Adderall as well!

LP I am glad, so glad, that you feel better and more confident now! :)

(Note: I didn't miss the fact that the doctor had originally prescribed 30mg in Dexedrine Spansules... perhaps that is where he made the mistake, or perhaps maybe he thinks there's something about the absorption of that particular package...).Yeah, this whole Adderall IR vs. Dex IR has a story all on it's own, by the way. It's in another thread somewhere, but I'll give you the basics here...

I honestly don't even know what my doctor wrote this last script for (Adderall or Dex IR). I know that sounds weird.... But, I remember seeing "dextroamphetamine" on the prescription slip... and when I got my pills, the bottle said "mixed amphetamine salts" (i.e. ADDERALL). I went back to the pharmacy when I noticed this. The pharmacist called the pharmacist who filled it and they both insisited that it was filled correctly.

So, who knows???? All I know is right now I have Adderall IR. Maybe he had written "Dextroamphetamine / Amphetamine" and I just didn't see it... or maybe he really meant to give me plain ol' Dex.

It's just one more issue to worry about. So many issues with me! :rolleyes:

So, who knows???? All I know is right now I have Adderall IR. Maybe he had written "Dextroamphetamine / Amphetamine" and I just didn't see it... or maybe he really meant to give me plain ol' Dex.

My doctor writes "ADDERALL" on my IR prescription. The pharmacy will choose a generic unless directed otherwise. It's kind of a bad idea to write it as anything else as it may introduce ambiguity (mixed amphetamine salts could refer to Adderall, Adderall XR, or even SPD465 if it was on the market), though I would think most would assume generic Adderall in this case. Whereas Adderall refers explicitly to a certain composition (within tolerances).

I would tend to lean towards him intending to give a Dexedrine prescription based on your wording of his writings... or perhaps did the pharmacy lie to you because they didn't have Dexedrine in stock (to still get money out of you)? That's definitely a bit off course, but I suppose it is possible.

HF-
Thank you for your response and insight.

I also believed that my doc was meaning to give me a Dexedrine IR prescription, which is precisely why I went back to the pharmacy and asked about it!

But like I said... The pharmacist there actually dug out the prescription from my doc, checked it all over herself, CALLED the other pharmacist that filled the prescription, and then finally after about half an hour or so, they both concluded that there was no mistake made. She even praised me for questioning the med. I didn't want to be an inconvenience, but she said not to hesitate if I thought that there was a problem. So, that was nice to hear. (In other words: She wasn't being a witch about the situation.)

Yes, anything is possible but I believe that one of two things happened: Either my doc really DID mean Adderall (and wrote Dextroamphetamine/Amphetamine) OR..... BOTH of the pharmacists that I spoke with made the same error. I do not believe that the pharmacists lied to me. That would be really really bad and I'm thinking they would get in serious trouble, especially over a CII med.... right???

Perhaps he didn't write "ADDERALL" and instead wrote out the generic name for it, since I was overly concerned about getting a generic med. I dunno. I'm just throwing out ideas at this point. :)

So, I went to my doctor's appointment this afternoon. I just flat out told him that the IR wore off much more quickly compared to the XR, so I felt like I needed more to get me through the day. I also told him about taking the third tablet on some days and that it seemed to be just right. He checked his PDA (as he often does) and said that, yeah you can have a 3 times a day dosing, so that is no problem at all.

Then, he wrote me a new script for 10mg *Dextroamphetamine* 3 times per day (90 tablets) without even giving it a second thought! So, this I was pleased with.... And I was now 100% sure that he means DEXTROAMPHETAMINE.... and NOT generic Adderall. ;)

So, I decided to take the prescription to a *different* SavOn Pharmacy location to get it filled. They seemed much more professional here... They checked my ID and everything! Okay, back to the point... They filled it with 90 tablets of 10mg MALLINCKRODT DEXTROAMPHETAMINE! (white, diamond-shaped tabs :))

Oh, one more piece of good news: 90 tabs only cost me $24.15! :D

YAY!!! I am really thrilled for you, LP! I am also glad you managed to get Malinkrodt dex; I have such problems getting it myself and prefer it over the Barr.

Keep us posted and let us know how it works for you now, this new combo? :)

Yeah, that is one of the reasons why I went to the "SavOn" pharmacy... because I heard that they stock Mallinckrodt Dex. :)

I want to thank you again for all your advice, CrazyFeet! I'm just hoping the Dex IR isn't *TOO* much different than Addy IR. From what I've read on the boards, most people highly prefer one over the other. :eyebrow:

Ku ku ku, maybe you have been reading MY posts? :o In all fairness, I have only ever taken the XR form of Adderall, its the dex I took in IR and spansule forms.

I am thinking to ask my doc about IR dex for my boosters though, instead of the spansules, for that exact mathematical reason I laid out for you. 7.5 mgs now then later is not quite "doing it" compared to 10 now, and 10 later :rolleyes: you would think he would know that now wouldn't ya? LOL...

What exactly are you prescribed now (if you don't mind my asking)?

Then, he wrote me a new script for 10mg *Dextroamphetamine* 3 times per day (90 tablets) without even giving it a second thought!That's wonderful to hear. I hope that it goes well, and I hope you keep us posted on how you like it. ;)




They filled it with 90 tablets of 10mg MALLINCKRODT DEXTROAMPHETAMINE! (white, diamond-shaped tabs :))

Oh, one more piece of good news: 90 tabs only cost me $24.15! :DThat's an incredible price, in fact that's about half of what I was being charged for Mallinckrodt the last time I ordered it which was several months ago. I was charged $90-$95 for 400 of the 5mg IR tablets. Sounds like you have found a wonderful pharmacy.

BTW, if you find that the dextroamphetamine is right for you, then might I suggest that you consider trying out the 5mg Mallinckrodt IR tablets sometime. I have taken both the 10mg IR Mallinckrodt tablets, and the 5mg IR Mallinckrodt tablets, and I have noticed quite a difference between them. I am not the only member here who has experienced a difference between them.

In a nutshell, I found that taking two of the 5mg IR Mallinckrodt tablets were more potent than taking 1 of the 10mg IR tablets. My theory as to why there is a difference between these two is that the brand name Dexedrine is only available in a 5mg IR tablet (excluding its time release version), and it seems (and feels) that the generic 10mg dextroamphetamine IR tablets are more like generic versions of DextroStat which is available in both a 5mg & 10mg IR tablet. Keep in mind there is no way for me to prove this theory of mine due to the fact that the public can not gain access to the bioavailabilty information of generic drugs to compare them to the published bioavailability information of the innovator drugs that they mimic.

What I do know for sure is that the FDA has criteria which generic drugs must conform to in order for them to be approved. One of those criteria for approval is that a generic drug can not be more than 20% above, or 20% below the bioavailabilty of the innovator drug. Considering that DextroStat is a brand name generic drug, it must have been within 20% above, or 20% below the bioavailability of Dexedrine in order to be approved by the FDA. More importantly here (as far as my theory is concerned) is that about 5 years ago I happend to read in detail the fine print on the label of my bottle of 10mg IR dextroamphetamine tablets, and it stated that it was "Generic for: DextroStat."

Since DextroStat can be as much as 20% above or below the bioavailability of the brand name drug Dexedrine, I just wonder if that means that a generic version of DextroStat can then be as much as 20% above, or below the bioavailability of the DextroStat? In theory that would mean that a generic of a brand name generic drug could be as much as 40% above or below the bioavailability of the innovator drug Dexedrine. I'm not trying to imply that any of the generics I have taken are even close to being 40% above or below the bioavailability of any of the other dextroamphetamine products. However, what I am implying is that I have noticed quite a difference between some of these products. Hopefully one day the FDA will allow the public access to the bioavailability information on all the generic drugs, and people will be able to know more about the medications they are prescribed.


PS Sorry to ramble on and on about this, but it's one of my favorite subjects.:o

What exactly are you prescribed now (if you don't mind my asking)?I take 3 15mg caps spansules AM and then 1 15mg spansule later as the first wears off, and yet another later if I need it. The booster doses are not working well, IMO, and I have taken 10mg IRs in the past with great results. I am gonna (try to) call about that today, so wish me luck! The clinic does not always return calls immediately so it may be next week that I hear anything.

That's wonderful to hear. I hope that it goes well, and I hope you keep us posted on how you like it. ;) Thank you, Lars!! I'll definitely do that. :) I have taken two of the Dex 10mg tabs today (one at about 8am and another at about 2:30pm). So far, I must say that the Dex feels fairly similar to the Adderall IR.

I'll note a few subtle differences:
* Had a little more dry mouth on the Dex
*Felt much more clear-headed and "motivated" this morning. (I went to a review session for an upcoming exam... was answering questions and speaking up... usually I'll just keep my mouth shut. ;))
* Felt less "shakey" this morning (My hands can get a little shakey for the first couple hrs of the morning when on Addy IR, especially if I skip breakfast.)
*Appetite more "normal" on Dex than on Addy IR.... My tummy was actually rumbling when I skipped breakfast. After eating breakfast, my tummy was rumbling again around lunchtime. haha.
* Felt pretty drowsy around 1:30/2:00pm, but feel fine now (it's a little after 3:00pm)


That's pretty much it, so far. If I think of anything else I'll definitely let you know.

Thanks so much for all your concern! At the risk of sounding cheesy: People on this forum really do care and I like that. :)

I have similar stuff going here with dex though, hun. The dry mouth? GUM, sugarless gum and a lot of it. It gets better in time. I can eat, too. AND it does not affect the way the medication works. Dex also mildly sedates me, so the yawning happens to me too, depending on how tired I am when I take it.

Yep, sure sounds like normal dex responses to me.

:)

That's an incredible price, in fact that's about half of what I was being charged for Mallinckrodt the last time I ordered it which was several months ago. I was charged $90-$95 for 400 of the 5mg IR tablets. Sounds like you have found a wonderful pharmacy.
I may have posted this on another thread instead of this one: This wonderful website is the reason for that price!: http://www.pharmacyreward.com/needymeds/index.cfm (and a SPECIAL THANKS to Edward, here on the forums, for telling me about this!) All you do is type in your name (don't even have to give a bunch of info or join anything), then print out this little card with your name on it and then take it to one of the pharmacies listed in your area that accepts it. The card has a group number and an ID number on it, so I guess it works kinda like an insurance card would.

I believe they said the price for my Dex would have been about $45. I mean, I'm sitting here thinking... $24.15 for 10mg x 90 tabs and I have NO INSURANCE??? I am just thrilled with this! :)

BTW, if you find that the dextroamphetamine is right for you, then might I suggest that you consider trying out the 5mg Mallinckrodt IR tablets sometime. I have taken both the 10mg IR Mallinckrodt tablets, and the 5mg IR Mallinckrodt tablets, and I have noticed quite a difference between them. I am not the only member here who has experienced a difference between them.

In a nutshell, I found that taking two of the 5mg IR Mallinckrodt tablets were more potent than taking 1 of the 10mg IR tablets. My theory as to why there is a difference between these two is that the brand name Dexedrine is only available in a 5mg IR tablet (excluding its time release version), and it seems (and feels) that the generic 10mg dextroamphetamine IR tablets are more like generic versions of DextroStat which is available in both a 5mg & 10mg IR tablet. Keep in mind there is no way for me to prove this theory of mine due to the fact that the public can not gain access to the bioavailabilty information of generic drugs to compare them to the published bioavailability information of the innovator drugs that they mimic.

What I do know for sure is that the FDA has criteria which generic drugs must conform to in order for them to be approved. One of those criteria for approval is that a generic drug can not be more than 20% above, or 20% below the bioavailabilty of the innovator drug. Considering that DextroStat is a brand name generic drug, it must have been within 20% above, or 20% below the bioavailability of Dexedrine in order to be approved by the FDA. More importantly here (as far as my theory is concerned) is that about 5 years ago I happend to read in detail the fine print on the label of my bottle of 10mg IR dextroamphetamine tablets, and it stated that it was "Generic for: DextroStat."

Since DextroStat can be as much as 20% above or below the bioavailability of the brand name drug Dexedrine, I just wonder if that means that a generic version of DextroStat can then be as much as 20% above, or below the bioavailability of the DextroStat? In theory that would mean that a generic of a brand name generic drug could be as much as 40% above or below the bioavailability of the innovator drug Dexedrine. I'm not trying to imply that any of the generics I have taken are even close to being 40% above or below the bioavailability of any of the other dextroamphetamine products. However, what I am implying is that I have noticed quite a difference between some of these products. Hopefully one day the FDA will allow the public access to the bioavailability information on all the generic drugs, and people will be able to know more about the medications they are prescribed.


PS Sorry to ramble on and on about this, but it's one of my favorite subjects.:oThis is all very, very interesting, Lars. I have heard people talk about the 5mg vs. 10mg Dex before as well, stating many of the same things you are saying here. I have taken the 5mg version of Mall Dex, using it as a booster for my Adderall XR regimen at one point... but it has been a long time... was probably 3 years ago, and I don't recall any differences about it.

The only issue here would be that since my dex script is 30mg per day, this would be 6 x 5mg pills per day, which equals 180 pills per month! It sounds like such a large number, I wonder if my psychiatrist would have a problem with it. Also, I wonder if the cost would be any different?

I have similar stuff going here with dex though, hun. The dry mouth? GUM, sugarless gum and a lot of it. It gets better in time. I can eat, too. AND it does not affect the way the medication works. Dex also mildly sedates me, so the yawning happens to me too, depending on how tired I am when I take it.

Yep, sure sounds like normal dex responses to me.

:)
Whew! Glad to know I'm not alone here. I've tried the dex spansules, a couple of months ago. They were expensive and I just didn't like them, but they were BARR generics and I'm thinking that was the issue. These Mallinckrodt Dexies don't make me feel the way those BARR spansules did.

Anyway, so far the dry mouth and the drowsiness/sedation are the two potential "issues" with the dex. The dry mouth I can deal with but I'm not sure how to deal with this drowsiness. It isn't *too* bad... Maybe I waited too long in between doses? I took one dose at 8am and took the second one at about 2:30pm. PLUS: I ate a meal in between. I've heard from other users on the forum that food can affect the absorption. Hmmm. Trial and error I suppose! :rolleyes:

CF:
BTW- How did your call to your doc about the boosters go??? :)

LOL ty for asking...and of course, they have not called me back yet. I am gonna just toss it at him when Space sees him on Monday. I told them to just pull my file and send it into her appt. but ya wanna bet somebody over there forgets? :rolleyes: I swear that whole OFFICE is loaded with ADHD!!

If you need it. Ask for it. There is no shame in that

I believe she already has ;) with excellent results!

Proud of you, LP. :)

I believe she already has ;) with excellent results!

Proud of you, LP. :)
Thank you CrazyFeet!!!!! :D:D:D

I wonder if the cost would be any different?
Good question. It was quite awhile back when I used to get the 10mg Malinckrodt IR tablets, and I simply can't remember what they cost me. :o