I understand from my adhd coach that she has been working in the business and with her own adhd for a long time. She explained that her drug regime involves using normal Ritalin when she needs it , implying a start-stop process. My intuition was that it was pretty normal to do so in that way.

The other day I heard from my new GP (not responsible for the diagnosis) that there was a danger in updosing on Adderall XR one week; downdosing the next; stopping it the next; and then jumping back up to the updose again (just for example, let's say). He implied that the danger resided in the drug becoming ineffective.

I've been on Adderall XR for almost a year and I don't see it. I stay on a pretty low dose of 15mg/daily plus 300mg of Buproprion daily, but sometimes I'll jump up to 25mg/d of the Adderall XR or stop it for a week. I do that because I suffer dysthymic side-effects from the stuff and therefore would only prefer to take it when I need it, and then only at the most effective amount.

If the GP's right, I should be getting used to the stuff and needing more to achieve my needs. I don't notice that at all; 25 does what it does and 15 does what it does. I'm sure 35 does what it does. Am I just lucky?

Other experiences would be welcomed.

Personally I take mine everyday and more or less get the same results everyday. My belief is that since this is a biological disorder and the medication helps on the chemicals that are otherwise off balance, by only taking it on some days I am not getting the full benefit.

Keep in mind there is a wide range on the ADHD spectrum. If you are able to use the meds only when needed than by all means do what works as long as you doctor is ok with it. However, if you are having problems when you don't take your meds than IMO it's probably better to take then everyday.

Your body will naturally build tolerance/down regulate to the high dose. And when you take the low dose(or no dose) it will not be as effective as the high dose. So you might feel some withdrawal effects (tired,headaches, etc)till you get back on the high dose. Assuming you never take more than the maximum prescribed amount I do not see how inter-mitten dosing would cause the normal dose to loose effectiveness. In theory its more likely to do the opposite.
But again on days you do not take the meds or less you will pay the price on those days.

Myself I'm not to crazy about stimulants and use them no more than a day or two at a time before I take a break.

I can tell you that my psych put me on adderall xr initially and actually recommended that I take regular "vacations". His feeling is that you should use it when you need it and not when you don't so that you don't build up a tolerance as quickly. Personally, and I'm not a dr, nor have I been dealing with this very long, I think if you aren't experiencing withdrawal symptoms, and your regimine is working for you, I would continue, but I'd also make an appointment with a Psych who specializes in ADD to discuss the pros and cons of such a treatment. Then you can take that information and decide ultimately what is best for you.

I've been on Adderall XR for almost a year and I don't see it. I stay on a pretty low dose of 15mg/daily plus 300mg of Buproprion daily, but sometimes I'll jump up to 25mg/d of the Adderall XR or stop it for a week. I do that because I suffer dysthymic side-effects from the stuff and therefore would only prefer to take it when I need it, and then only at the most effective amount.

Could the dysthymic side-effects be due to regular discontinuation of Adderall, or perhaps a daily effect when it wears off? I know that I feel mildly down for a while after I stop Adderall. It's nothing major, but it's definitely a discontinuation effect.

If the GP's right, I should be getting used to the stuff and needing more to achieve my needs. I don't notice that at all; 25 does what it does and 15 does what it does. I'm sure 35 does what it does. Am I just lucky?

Your "luck" probably comes from the intermittent dosing, which probably does a lot to prevent tolerance and resulting requirement for dose increases.

That being said, the dose increases that people see (personal experiences, 2nd & 3rd hand stories, and reading on this board) after the first month or two on Adderall and related drugs often occur very gradually over a period of years.

The dysthymia was definitely because of taking it, rather than withdrawing from it. Another six weeks of close monitoring clearly identified the phenomenon. Further consultations with the neuro-psychiatrist reveal, in fact, that I am nowhere near a sufficient dose at 25mg Adderall XR daily, in addition to 300mg Wellbutrin SR daily.

What does seem to work is 450mg Wellbutrin XL daily plus 25mg Adderall XR as necessary. However, he's not too keen on the high dose of Wellbutrin - despite the lack of seizures thus far. I'm with him. So what now?

He suggested a tricylic, but I'm not interested in gaining weight (it took a lot to get under 25 BMI (from about 29) and it takes a lot to stay in the 24's).

I've suggested lowering the Wellbutrin and taking out some Modafinil for a spin. He's going to research the interactions and get back to me. The newer stimulant formulations aren't available in Canada yet, so they're not an option.

I take it only when I need it - for one I don't want to become tolerant, and two the effects of stimulants are pretty intense (I don't want to burn out my dopamine receptors taking 20mg of Adderall day after day after day - so I don't take when I don't need it).