I think I may have reached a tolerance for Focalin (I take Focalin XR). Would it make sense to switch medications to adderall or something?

if you think you've peaked on focalin, then it can't hurt to discuss a new med w/ your doc.

What dosage are you currently at? How long have you been on this particular dosage?

J

What dosage are you currently at? How long have you been on this particular dosage?

J

I take 120mg of focalin xr twice a day.

Holy crap....120mg twice a day?

J

You've openly posted about abusing your meds in another thread, so I can only assume you are not prescribed 240mg a day? I doubt you have reached your 'tolerance' so to speak, at least not your therapeutic tolerance. You just need to stop chasing the high.

No, that is the amount my doctor has prescribed for me. 120mg twice a day. I don't have any clue what is a typical dose, I'm assuming by your responses that my dose is high. I knew it was high but I didn't know it was shock worthy high.

This is from the Physician's Desk Reference (PDR) for Focalin (http://www.drugs.com/pdr/focalin.html):
Recommended dosage

For people who are not currently taking Ritalin, the usual starting dose is 5 milligrams a day. For those who are switching from Ritalin, the starting Focalin dose is half the amount of the Ritalin dose. In either case, the total daily dose of Focalin should be divided into 2 doses taken at least 4 hours apart.

Depending on the response, your doctor may increase the dose by 2.5 to 5 milligrams a day, up to a maximum daily dose of 20 milligrams (10 milligrams twice a day). Increases are usually made at weekly intervals.
According to that, your dose does seem quite high. I know some doctors will prescribe dosages exceeding what is recommended by the PDR if you aren't responding to the lower dosages, but I haven't seen too many people with dosages as high as yours.

I'd definitely talk to your doctor about why he has chosen to prescribe such a high amount of the drug.

This is from the Physician's Desk Reference (PDR) for Focalin (http://www.drugs.com/pdr/focalin.html):

According to that, your dose does seem quite high. I know some doctors will prescribe dosages exceeding what is recommended by the PDR if you aren't responding to the lower dosages, but I haven't seen too many people with dosages as high as yours.

I'd definitely talk to your doctor about why he has chosen to prescribe such a high amount of the drug.

Thank you for posting this information. I will certainly speak with my doctor about the dosage I'm on. I am pretty anxious about this now. I don't know what to think about my doctor.

I know the reason for the 120mg of focalin xr is because my doc says with xr, you're actually getting 50% strength immediately and 50% several hours later. So, we agreed that 60mg of regular focalin was effective (after several trials at different doses) which is the maximum recommended dose. So with the xr, 120mg is 60mg immediately and 60 several hours later. I wake up everyday at 5:30 and take my first dose of 120, and according to my doc, 60mgs are dumped immediately, then 60 later at about 9:30/10:00. Then at 1:00pm I take my second 120mg dose which is 60mg immediately and 60mg later. I found a review of dexmethylphenidate that states the same thing (I was trying to find info about the long term effects of Focalin use when I came upon this review). It says,
"Dexmethylphenidate extended release utilizes spheroidal oral drug absorption system technology to achieve a 50% immediate medication delivery and 50% delayed release of dexmethylphenidate approximately 4 h after ingestion."

found at: http://www.expert-reviews.com/doi/abs/10.1586/14737175.5.4.437

btw, I could not find any info on the long term effects of focalin other than it may slow growth in children so if you find something, will you please post it or a link to it? Thanks!

Jackers, who says 60mg of Focalin is the maximum dose? Not trying to be confrontational here, just curious.

Hmmmm...I know I saw it somewhere. Let me see if I can find it again and I'll post a link or at least a reference. And don't worry, I did not interpret your question as confrontational. It's a very legitimate question.

BTW saw your post on exercise...could I be more jealous. Must be nice to live on one of the world's most beautiful islands. {{{ Sigh }}} Take a dip in the ocean for me! Maybe I'll get good vibes as you're doing it.

Jackers

120mg twice a day is (6) 20mg pills.

This is a high dose is that is roughly equivalent to taking 480mg of ritalin a day. Not to be judgemental but that is a bunch. Maybe this is not the proper medication if it takes that much not to mention how much money 180 pills per month costs.

i wqas just started at 10 mg a day but i my doc said we could go to 20 right away

I actually tried to up my dose past 20 a day and my doc said he didnt think my insurance would go for it

240mg of Focalin XR each day is borderline ridiculous. Unless one abused meth for decades, there is no way a proper therapeutic dose needs to be that high.

If you haven't abused drugs before, I'm surprised at why you respond to such a high dose.

That's not true at all. Some people have genetic metabolism problems that makes them only respond to very high dose stimulant therapy. Look up Ultrarapid Metabolizers for the CYP2D6 enzyme. These people have multiple alliles of the chromosome, so their body metabolized it extremely quickly.

Although... 240mg/day of focalin is unheard of. I'm not sure what doctor or pharmacist would involve themselves with that kind of treatment. Surely there are other ways to increase the effectiveness without such a high dose.

Prior to my decision a few months ago to be treated for my ADD, I had never taken any prescription or illicit drugs. I was given Vyvanse up to 80mg and Metadate CD up to 60mg, and felt absolutely nothing (including side effects). My doctor is having me try Focalin IR now, so it's not unheard of for non-addicts to not respond to stimulant therapy.