I'm 42 years old and was diagnosed with ADD when I was 39. My psychiatrist started me out on generic Adderall 1o mg twice a day and 300 mg of Wellbutrin. Eventually he increased the Adderall to 20 mg twice a day, then after a while, up to 30 mg twice a day. I've been at 30 mg twice a day for about the last 3 years. I was also taking Wellbutrin 300 mg a day.

I lost my job (and my prescription health benefits) so after the samples of Wellbutrin ran out and I was unable to afford even generic Wellbutrin, I stopped taking it, but continued with the Adderall 30 mg twice a day.

I've also been having perimenopause symptoms for the last few years (hot flashes, decreased sex drive, mood swings). I could deal with the hot flashes, but the decreased sex drive was causing a major damper in my marriage and the mood swings started getting intolerable. I would literally start crying and not know why. I explained this to my psychiatrist and he put me on Prozac (generic) once a day to stabilize my moods. I had told him that I stopped the Wellbutrin because of no insurance. Prozac at least is one of Wal-Mart's $4 scripts. The Prozac did wonders for my mood swings. Evidently there doesn't seem to be anything that doctors can prescribe to help increase sex drive in women, so I've just had to deal with that aspect and often have sex when I'm not in the mood to keep hubby happy.

In 2006, I started back to school. I weighed about 140 and was in decent shape. Of course the Adderall seemed to help because it made me less hungry and probably speeded up my metabolism. I had actually lost 15-20 pounds since starting Adderall and it pretty much leveled out there, which I was happy with. I haven't made any notable changes in eating habits since then.

This past weekend I graduated with my B.A. and I feel that the medication helped out a lot with getting my degree. But I also feel that I've built up a tolerance to it because of several things I've noticed in the past year or so:



I now weigh 165 so I've put back on all the weight I had before starting Adderall plus some
It doesn't seem to necessarily be from eating way too much because even if I eat considerably less calories, I still haven't lost weight.
My metabolism seems to have slowed considerably, again making me wonder if my body has built up a tolerance to the Adderall.
I have a lot of gas and seem to feel the need to have a b.m. (bowel movement), but often will sit on the toilet and nothing happens. If it does happen, it's just a pebble or two. Then two or three days later, I will generally have a normal b.m. but may do so 3-4 times that day.
The last couple of semesters I noticed I would procrastinate more on assignments or studying for exams, sometimes even waiting until the night before to write an entire research paper and just barely making it in time.
It takes me longer to wake up now than it used to and I haven't changed my medication habit of taking my pill an hour before I need to be up.
I seem to be much more easily distracted now and waste a lot of time on things that aren't necessary (like reading the news, playing games, etc.)
I was pretty good about being on time when I first started Adderall, but now it's about 50/50. In my present job, I've already been written up for tardiness.
A lot of times, I just seem to feel tired and lethargic. Medication doesn't seem to affect it too much. I can take Adderall and still lay down for a nap or still get fairly hungry.

I know I need to exercise more because that will help some with the weight situation and possibly with the tired/lethargic bit. I have the summer off from school, but I got accepted to law school starting in the Fall. I can't be procrastinating and waiting until the last minute to do things in law school. I want to get in shape and try to lose this weight or at the very least get into a habit/routine of working out because I think I'm going to need it during law school. So while the weight gain is definitely an issue and something I'm concerned about, it's ALL of the factors I mentioned above that are making me wonder if I've built up a tolerance to the Adderall.

I'm seeing my psychiatrist for my routine appointment Monday morning and plan to mention this to him. I'm not so sure that an increase in the Adderall dosage would be a good idea. My husband thinks I should try to wean myself off of it, but I am worried that my symptoms would increase and my weight would balloon up. I've taken medication holidays and during those times I was pretty much a walking zombie. I could sleep all day and when I was up and moving, it was at a slow pace and I felt like I was in a thick fog all day. I can't imagine that I ever functioned in that condition. I don't seem to remember feeling that bad before starting on medication.

I don't know that my psychiatrist would increase the dosage anyhow. I think 30 mg twice a day (60mg) is about the limit that's allowed or something like that.

What I'm wondering is if anyone else has had this effect? Has anyone switched to a different medication from Adderall and had good results? I'm thinking if my body is used to Adderall that maybe I need to switch to a different medication to get the same benefits I was getting when I started out on Adderall. I don't want to take anything that might make me gain weight, though. It'd be a bonus if weight loss was a side effect, even.

It seems in the past my psychiatrist has been reluctant to adjust or change my medications even when I've said it doesn't seem to be working as well as it used to. This time around I plan to tell him all the reasons and symptoms I've had instead of just saying it doesn't seem to work as well as it used to. I'm hoping that way he will be more attentive to my concerns and maybe have a suggestion.

Sorry for such a long post, but what do you expect from someone with ADD...:rolleyes:

hey,
Congratulations on graduating!!!! ... That's the first thing ....

Sounds like you're asking all the right questions and all; i think as you plan you should take these up with your psychiatrist.

One thing: doesn't prozac cause weight gain for some people? ... That might be one of the problems for you .... It doesn't for all, but for some yes. ...

Prozac also zaps the sex drive of some people ...

One last thought on the weight gain and the decreasing focus: Could that be the effect of going off the Wellbutrin? .... Wellbutrin is good for weight loss and in combination with your adderall, might have been more effective than the adderall and prozac. I know you can't get it covered, but I'm just trying to think out loud to give you some feedback.

Now that you're off the wellbutrin, I wonder if you need to experiment with another drug or combo (that you can afford) that gets you back reasonably close to the place where you were.

I think others will shortly weigh in. Good luck.

Ask your doctor about dexedrine. W/O insurance it is very inexpensive and IMO an excellent medication. If they change you over the dose should be similar to what you are on now- 60mg (definitely not lower than 45mg).

To an inexperienced doctor or one that isn't up to date on treatment trends dosing these meds according to the PDR is unfortunately <O:p</O:pnot good enough for many patients.

Here is a good site for you to read. Print out some of the stuff and share it with your doctor too.

http://healthcalls.com/HighDoseMedication.htm

good luck
J

nice link there JR - thanks!

Changing to a Ritalin based drug might be a good option. Talk to your doc about it.

so here it is: it's your metabolism, imo. You really have to eat several times a day so that your metabolism doesn't go into survival mode. If your body thinks it is starving it will slow down your metabolism to compensate which actually will make you gain weight and will slow everything else down. Keeping a healthy metabolism also helps the medications work better. Also, what you eat in the morning is really important, try avoiding carbohydrates completely and just eat protein. Also, some people report success with taking a magnesium supplement with meds in the morning, but it's probably not good to try that without asking your doctor first.


I'm 42 years old and was diagnosed with ADD when I was 39. My psychiatrist started me out on generic Adderall 1o mg twice a day and 300 mg of Wellbutrin. Eventually he increased the Adderall to 20 mg twice a day, then after a while, up to 30 mg twice a day. I've been at 30 mg twice a day for about the last 3 years. I was also taking Wellbutrin 300 mg a day.

I lost my job (and my prescription health benefits) so after the samples of Wellbutrin ran out and I was unable to afford even generic Wellbutrin, I stopped taking it, but continued with the Adderall 30 mg twice a day.

I've also been having perimenopause symptoms for the last few years (hot flashes, decreased sex drive, mood swings). I could deal with the hot flashes, but the decreased sex drive was causing a major damper in my marriage and the mood swings started getting intolerable. I would literally start crying and not know why. I explained this to my psychiatrist and he put me on Prozac (generic) once a day to stabilize my moods. I had told him that I stopped the Wellbutrin because of no insurance. Prozac at least is one of Wal-Mart's $4 scripts. The Prozac did wonders for my mood swings. Evidently there doesn't seem to be anything that doctors can prescribe to help increase sex drive in women, so I've just had to deal with that aspect and often have sex when I'm not in the mood to keep hubby happy.

In 2006, I started back to school. I weighed about 140 and was in decent shape. Of course the Adderall seemed to help because it made me less hungry and probably speeded up my metabolism. I had actually lost 15-20 pounds since starting Adderall and it pretty much leveled out there, which I was happy with. I haven't made any notable changes in eating habits since then.

This past weekend I graduated with my B.A. and I feel that the medication helped out a lot with getting my degree. But I also feel that I've built up a tolerance to it because of several things I've noticed in the past year or so:



I now weigh 165 so I've put back on all the weight I had before starting Adderall plus some
It doesn't seem to necessarily be from eating way too much because even if I eat considerably less calories, I still haven't lost weight.
My metabolism seems to have slowed considerably, again making me wonder if my body has built up a tolerance to the Adderall.
I have a lot of gas and seem to feel the need to have a b.m. (bowel movement), but often will sit on the toilet and nothing happens. If it does happen, it's just a pebble or two. Then two or three days later, I will generally have a normal b.m. but may do so 3-4 times that day.
The last couple of semesters I noticed I would procrastinate more on assignments or studying for exams, sometimes even waiting until the night before to write an entire research paper and just barely making it in time.
It takes me longer to wake up now than it used to and I haven't changed my medication habit of taking my pill an hour before I need to be up.
I seem to be much more easily distracted now and waste a lot of time on things that aren't necessary (like reading the news, playing games, etc.)
I was pretty good about being on time when I first started Adderall, but now it's about 50/50. In my present job, I've already been written up for tardiness.
A lot of times, I just seem to feel tired and lethargic. Medication doesn't seem to affect it too much. I can take Adderall and still lay down for a nap or still get fairly hungry.
I know I need to exercise more because that will help some with the weight situation and possibly with the tired/lethargic bit. I have the summer off from school, but I got accepted to law school starting in the Fall. I can't be procrastinating and waiting until the last minute to do things in law school. I want to get in shape and try to lose this weight or at the very least get into a habit/routine of working out because I think I'm going to need it during law school. So while the weight gain is definitely an issue and something I'm concerned about, it's ALL of the factors I mentioned above that are making me wonder if I've built up a tolerance to the Adderall.

I'm seeing my psychiatrist for my routine appointment Monday morning and plan to mention this to him. I'm not so sure that an increase in the Adderall dosage would be a good idea. My husband thinks I should try to wean myself off of it, but I am worried that my symptoms would increase and my weight would balloon up. I've taken medication holidays and during those times I was pretty much a walking zombie. I could sleep all day and when I was up and moving, it was at a slow pace and I felt like I was in a thick fog all day. I can't imagine that I ever functioned in that condition. I don't seem to remember feeling that bad before starting on medication.

I don't know that my psychiatrist would increase the dosage anyhow. I think 30 mg twice a day (60mg) is about the limit that's allowed or something like that.

What I'm wondering is if anyone else has had this effect? Has anyone switched to a different medication from Adderall and had good results? I'm thinking if my body is used to Adderall that maybe I need to switch to a different medication to get the same benefits I was getting when I started out on Adderall. I don't want to take anything that might make me gain weight, though. It'd be a bonus if weight loss was a side effect, even.

It seems in the past my psychiatrist has been reluctant to adjust or change my medications even when I've said it doesn't seem to be working as well as it used to. This time around I plan to tell him all the reasons and symptoms I've had instead of just saying it doesn't seem to work as well as it used to. I'm hoping that way he will be more attentive to my concerns and maybe have a suggestion.

Sorry for such a long post, but what do you expect from someone with ADD...:rolleyes:

I'm in the same boat you are in some ways. I work up tolerances to my meds pretty quickly and have to have the dosages adjust often and eventually switched. It's a pain in the **** but better than the alternative of none. Most of the side effects you mentioned sound familiar so I don't think your alone there.

Hang in there!
Steve