I was just recently diagnosed with ADD, and my doctor put me on Daytrana 10 mg to start out on. I've been reading these forums for the past few hours, and it seems that more people have had luck with the amphetamine route. Wonder why he started me out with Methylphenidate instead?:confused:
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More luck with amphetamine? Where I live, regular Ritalin is the prescription of choice for ADHD. It's cheap and it's been around a long time.

More luck with amphetamine? Where I live, regular Ritalin is the prescription of choice for ADHD. It's cheap and it's been around a long time.

I can't remember where I saw the post, but someone posted a link to here>http://healthcalls.com/AdderallvsRitalin.htm, and also this forum has a lot more posts than the ritalin forums.

I would be interested if most of the people on Adderall are living in the USA. I don't personally know anyone where I live who is on Adderall. People in my community take Dexedrine, Concerta or Ritalin.

i think in cndn there were too many health issues with adderall in the past.. docotrs r less trusting

MissAdhd, that could be. I've read so many posts from people who just love Adderall and I often wonder if I should ask to try it.

I believe the pharmacuetical salespeople did a really really good job on getting doctors to prescribe it. Especially the Adderall XR. I have chonic pain too from 10 operations to my arm and doctors are really big on giving "Extended Release" EVERYTHING.

MissAdhd, that could be. I've read so many posts from people who just love Adderall and I often wonder if I should ask to try it.
I got offerd it.. when i was diagnoised, but with the warning.. that it was newer and there were some some health concerns for some who used it.

I know same can be said for any drug.. but once i read up on it.. this was maybe 4 possibly less or more years ago,, i decided ritalin was safer.

Be sure to ask your doctor about absorption with Daytrana; after about 6 weeks of use, you metabolize more of it. The rate is about 1.9x oral dose, so your 10 mg will be like 19. DD used Daytrana and really liked how long it lasted. However, she was on it before the follow up studies that revealed the uptake issue.

Source: http://www.rxlist.com/cgi/generic/daytrana_cp.htm

I think most doctors shy away from Ritalin because it can cause bad side effects (rapid peak and rapid drop = rebound hell). Extended release methylphenidate meds are different though, especially Daytrana. When all is said and done both classes of meds (amphetamine and methylphenidate) work about as well when properly dosed.
Daytrana is unique in that there is ZERO rebound. The patch will continually pump out meds until you either remove it or it runs out (after about 15 hours). Shire is actually putting an amphetamine patch into preclinical trials so if all goes well we may see it on the shelves in about 3-4 years (yay....but who cares because that is a long time).

http://www.askdrjones.com/2006/11/06/how-to-use-the-daytrana-patch/

J

Some doctors are weary of prescribing amphetamine pills to 'first timers' - that would be my guess. Adderall is a very hot street drug (especially on college campuses).

Doctors are a strange bunch.

The first psychiatrist that I ever saw just wrote me an Addy prescription like it was a normal routine thing. I didn't have to go through any ADD testing or anything.

When I moved, I basically just picked a new doc out of the phone book; he wasn't a referral or anything. My first appointment with him went something like this: Went through the general health history stuff and basic first appointment stuff. I told him what I was taking and handed him the nearly empty bottle of Adderall. He quickly glanced over the bottle and wrote me a brand new 90-day supply prescription. No verification with my old doc or request of medical records or anything.

But here's the weird part: At my second or third appointment, I brought in an old migraine med script and asked if he could give me a small refill to hold me over until I could find a permanent family doc. The med was Relpax, which is a NON-narcotic and NON-scheduled abortive migraine medication. Anyway, he absolutely refused!!! :eek:

No problems getting more Adderall though. He was totally cool with giving me XR and IR versions at the same time and both in 90 day supplies. Go figure. :rolleyes:

My mom takes Ritalyn and she likes it. I take Adderall and wonder if ritalyn would be better for me...

I got offerd it.. when i was diagnoised, but with the warning.. that it was newer and there were some some health concerns for some who used it.

I know same can be said for any drug.. but once i read up on it.. this was maybe 4 possibly less or more years ago,, i decided ritalin was safer.
I disagree very strongly with this. As my doctor and I just got done proving that AdderallXD HAS been proven safe at doses from 70-90mgs. a day. That is what we had to do to get my 2 25mg. AdderallXRs a day through my insurance company. The United HealthCare Pharmacist agreed with our findings and APPROVED our appeal on Prior-Authorization. It is VERY safe.

Doctors are a strange bunch.

The first psychiatrist that I ever saw just wrote me an Addy prescription like it was a normal routine thing. I didn't have to go through any ADD testing or anything.

When I moved, I basically just picked a new doc out of the phone book; he wasn't a referral or anything. My first appointment with him went something like this: Went through the general health history stuff and basic first appointment stuff. I told him what I was taking and handed him the nearly empty bottle of Adderall. He quickly glanced over the bottle and wrote me a brand new 90-day supply prescription. No verification with my old doc or request of medical records or anything.

But here's the weird part: At my second or third appointment, I brought in an old migraine med script and asked if he could give me a small refill to hold me over until I could find a permanent family doc. The med was Relpax, which is a NON-narcotic and NON-scheduled abortive migraine medication. Anyway, he absolutely refused!!! :eek:

No problems getting more Adderall though. He was totally cool with giving me XR and IR versions at the same time and both in 90 day supplies. Go figure. :rolleyes:


my guess is psychiatrists probably don't feel as comfortable treating medical problems that are usually the domain of "regular doctors"

would you want a cardiologist treating someone for depression? some cardiologists might try to, but overall it's dangerous to treat something you haven't been formally trained to understand

I was just recently diagnosed with ADD, and my doctor put me on Daytrana 10 mg to start out on. I've been reading these forums for the past few hours, and it seems that more people have had luck with the amphetamine route. Wonder why he started me out with Methylphenidate instead?:confused:
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It simply comes down to the individual doctor and what they think will work best for you.

He may have had other patients that responded well to Ritalin.

I disagree very strongly with this. As my doctor and I just got done proving that AdderallXD HAS been proven safe at doses from 70-90mgs. a day. That is what we had to do to get my 2 25mg. AdderallXRs a day through my insurance company. The United HealthCare Pharmacist agreed with our findings and APPROVED our appeal on Prior-Authorization. It is VERY safe.

Not sure if I'd call it 'very' safe. Have you got the research that proves this? I'd be interested mainly in studies done on long-term high-dose amphetamine treatment and its effect on the heart.

With increased dose comes increased potential side effects. What's safe for someone might not be for another. For me personally 70mg of amphetamine would have me jumping out of my skin and crashing hard when it wears off.

Ritalin has a much shorter half-life than amphetamines so it leaves the body much quicker. I guess it could be considered 'safer' in a way.

We have to remember that everyone responds differently to these meds.

bump...still waiting on that information that proves high doses of stimulants are VERY safe

Bumping thread is some thing that should be done on rare occasions - or as the guidelines say (http://www.addforums.com/forums/showthread.php?t=15844)



* “Bumping” a thread is when you make a post for the purpose of making the thread appear on the “View New Posts” option, or light up as forums with new posts do. While there are some circumstances when doing this is reasonable, it should be kept to rare use. If a moderator or admin feels there is no reason for this, there is a good chance your post will be deleted and you may be warned. Repeated abusers may have their posting privileges suspended.


This thread has had it's one and only rare occasion bump.

Doctors are a strange bunch.

The first psychiatrist that I ever saw just wrote me an Addy prescription like it was a normal routine thing. I didn't have to go through any ADD testing or anything.

When I moved, I basically just picked a new doc out of the phone book; he wasn't a referral or anything. My first appointment with him went something like this: Went through the general health history stuff and basic first appointment stuff. I told him what I was taking and handed him the nearly empty bottle of Adderall. He quickly glanced over the bottle and wrote me a brand new 90-day supply prescription. No verification with my old doc or request of medical records or anything.

But here's the weird part: At my second or third appointment, I brought in an old migraine med script and asked if he could give me a small refill to hold me over until I could find a permanent family doc. The med was Relpax, which is a NON-narcotic and NON-scheduled abortive migraine medication. Anyway, he absolutely refused!!! :eek:

No problems getting more Adderall though. He was totally cool with giving me XR and IR versions at the same time and both in 90 day supplies. Go figure. :rolleyes:

Well, he is actually right to do that. He should not prescribe your GP stuff for you and he can get into trouble with that - and if you already have an addy script and you present obvious symptoms there is no big reason to suspect you are an abuser.

To ozchris, Don't get your boxers in a knot. I have a life. A little secret: when any body tries to rush me, I instantly slow down, and take my good 'ol time. I do have a life. You know things to do, places to go, people to meet, and doctor appts; just to name a few
My answer is very very positively YES!
You want your Proof that it IS very very
SAFE to take 70mgs. - 90mgs. a day?
My "proof" is at Shire' website. The people that are the makers of Adderall IR and the AdderallXL that I take.
My proof is in the article on a 2-year long test they did on giving test subjects doses that ranged from 70mgs. a day or 90mgs. of Adderall per day.
later,
Maurice

Could you please link that Maurice, I can't find it on the site... the clinical studies I've found don't relate to the dosage you're speaking of.

To ozchris, Don't get your boxers in a knot. I have a life. A little secret: when any body tries to rush me, I instantly slow down, and take my good 'ol time. I do have a life. You know things to do, places to go, people to meet, and doctor appts; just to name a few
My answer is very very positively YES!
You want your Proof that it IS very very
SAFE to take 70mgs. - 90mgs. a day?
My "proof" is at Shire' website. The people that are the makers of Adderall IR and the AdderallXL that I take.
My proof is in the article on a 2-year long test they did on giving test subjects doses that ranged from 70mgs. a day or 90mgs. of Adderall per day.
later,
Maurice


You seem to be taking this the wrong way Maurice...I didn't say anything about you not having a life, I didn't say anything about hearing yourself talk, I didn't mean to rush you.

I didn't even say you were wrong...I was just wondering where you got this information.

Thankyou for your reply. I'll check out the Shire website :rolleyes:

Did you leave me negative feedback for my previous post? it just says: 'oppositional'. Again - I'm not saying you're wrong I simply asked for the information.

Could you please link that Maurice, I can't find it on the site... the clinical studies I've found don't relate to the dosage you're speaking of.DeloresMelon, I'm glad you asked that question.
I found some interesting information about recommended dosing limits that were originally set for children, not adults, and the problems that may create for adults with AD/HD. I wonder if this is why some adults have difficulty finding a med that works well for them?

When I Googled for 90 mg Adderall per day, I found a great article on "High" Dose Stimulant Treatment for ADD. (http://adultadd.info/HighDoseMedication.htm)

"Dr. Joseph Biederman, MD, Professor of Psychiatry, Harvard Medical School, Boston, MA and Head of the Attention Deficit Disorder Program of Massachusetts General Hospital, has noted that effective stimulant doses in adolescents and adults are usually higher than those for children. If this is not taken into account by clinicians treating adults, the doses they prescribe for their patients may not reach the range needed to achieve therapeutic benefit. (Biederman, J: Practical Considerations in Stimulant Drug Selection for the Attention Deficit/Hyperactivity Disorder Patient - Efficacy, Potency, and Titration)

For a medication to be approved by the US Food and Drug Administration (FDA) for sale to the public, the pharmaceutical company producing it must submit the results of extensive research on the medication demonstrating its effectiveness and safety. Such studies can take years to complete and can be quite expensive (millions of dollars). It is easier for a drug to pass the FDA testing requirement if it is tested at the lowest dose levels at which it may be effective. This way, side effects and other problems are less likely to occur, and the medication is more likely to be approved."

According to my psychiatrist if you go over 60mg of XR a day you might as well be snorting dope. Instant release is a different story, I've seen plenty of people come to the pharmacy with a perscription to fill 90 tablets of 30mg Adderall. I've never seen a perscription though for over 60 capsules 45mg of XR (15mg Cap & 20mg Cap BID), alot of people on this high a dose also have more extreme conditions that require high dosage stimulants. Cancer patients who have reduced energy from treatment, people with severe diseases (I believe i've heard of folks with MS taking higher dosages), and of course the ever rare Narcolepsy. Shire's also supposed to test the boundries of their products for safety issues, so I can see why they tested adults giving them extremely high doses if I remember correctly according to their findings they found "no significant improvement from <INSERT here dose>to 75/80/90mg XR. Adderall XR isn't 'supposed' to be perscribed for anything except for ADHD, but Adderall is sometimes perscribed for other conditions like those listed above.

if I remember correctly according to their findings they found "no significant improvement from <insert here="" dose="">to 75/80/90mg XRMember SuzanneX would disagree with these findings. Any chances of digging up more info about what you remember?

</insert>

Adults
A double-blind, randomized, placebo-controlled, parallel-group study was
conducted in adults (N=255) who met DSM-IV® criteria for ADHD. Patients were
randomized to fixed dose treatment groups receiving final doses of 20, 40, or 60
mg of ADDERALL XR® or placebo once daily in the morning for four weeks.
Significant improvements, measured with the Attention Deficit Hyperactivity
Disorder-Rating Scale (ADHD-RS), an 18- item scale that measures the core symptoms
of ADHD, were observed at endpoint for all ADDERALL XR® doses compared
to patients who received placebo for all four weeks. There was not
adequate evidence that doses greater than 20 mg/day conferred additional benefit.

INDICATIONS
ADDERALL XR® is indicated for the treatment of Attention Deficit Hyperactivity
Disorder (ADHD).

http://www.adderallxr.com/assets/pdf/prescribing_information.pdf

Adderall -

DOSAGE AND ADMINISTRATION
Regardless of indication, amphetamines should be administered at the lowest effective dosage and dosage
should be individually adjusted according to the therapeutic needs and response of the patient. Late evening
doses should be avoided because of the resulting insomnia.
Attention Deficit Hyperactivity Disorder:
Not recommended for children under 3 years of age. In children from 3 to 5 years of age, start with 2.5 mg
daily; daily dosage may be raised in increments of 2.5 mg at weekly intervals until optimal response is obtained.
In children 6 years of age and older, start with 5 mg once or twice daily; daily dosage may be raised in
increments of 5 mg at weekly intervals until optimal response is obtained. Only in rare cases will it be necessary
to exceed a total of 40 mg per day. Give first dose on awakening; additional doses (1 or 2) at intervals of 4 to 6
hours.
Where possible, drug administration should be interrupted occasionally to determine if there is a recurrence of
behavioral symptoms sufficient to require continued therapy.
NDA 11-522/S-040
Page 13
Narcolepsy:
Usual dose 5 mg to 60 mg per day in divided doses, depending on the individual patient response.
Narcolepsy seldom occurs in children under 12 years of age; however, when it does, dextroamphetamine sulfate
may be used. The suggested initial dose for patients aged 6-12 is 5 mg daily; daily dose may be raised in
increments of 5 mg at weekly intervals until optimal response is obtained. In patients 12 years of age and older,
start with 10 mg daily; daily dosage may be raised in increments of 10 mg at weekly intervals until optimal
response is obtained. If bothersome adverse reactions appear (e.g., insomnia or anorexia), dosage should be
reduced. Give first dose on awakening; additional doses (1 or 2) at intervals of 4 to 6 hours.

http://www.fda.gov/MedWatch/SAFETY/2007/Jun_PI/Adderall_PI.pdf

I've seen countless perscriptions written for 30mg TID of this but I believe it's because the majority of ADHD drugs were originally targeted for children who typically have an 8 hour day of school and nothing else. Adults on the other hand deal with work, school, paying the bills, taking care of the house, etc. So it's only expected in an effort to help with symptoms adults could be given a 3rd dosage in the evening.

Adderall -

DOSAGE AND ADMINISTRATION
Regardless of indication, amphetamines should be administered at the lowest effective dosage and dosage
should be individually adjusted according to the therapeutic needs and response of the patient. Late evening
doses should be avoided because of the resulting insomnia.



That's some really good info. Cheers for posting it.

I think it's easy to take a larger dose than you need because you keep seeing improvements in concentration, focus, general cognitive improvements etc.

> > Flawed St. John's Wort Study on ADHD Failed to Use Active Form of Herbal
> > Extract
> > June 2008
[removed, unreliable source]

Not sure how credible this is but it's worth investigating....lots of people use his high dose stimulant webpage. Massive conflict of interest.



Found a more reliable source.

http://blogs.wsj.com/health/2008/06/09/harvard-psychiatrists-under-fire-for-drug-company-funding/
June 9, 2008, 7:01 am Harvard Psychiatrists Under Fire for Drug-Company Funding

Posted by Scott Hensley
A controversial Harvard psychiatrist whose research and recommendations have paved the way for the wide use of antipsychotic drugs in kids has received more than $1.6 million in consulting fees from drugmakers since 2000, and he failed to properly disclose much of the funding, the New York Times reports (http://www.nytimes.com/2008/06/08/us/08conflict.html?ex=1370664000&en=a8295c43acc64e60&ei=5124&partner=permalink&exprod=permalink).
http://s.wsj.net/media/biederman_art_160_20080608212032.jpg

Joseph Biederman (pictured) is a polarizing figure in psychiatry. As the Boston Globe put it in a profile last year (http://www.boston.com/yourlife/health/diseases/articles/2007/06/17/backlash_on_bipolar_diagnoses_in_children/?page=full): “No one has done more to convince Americans that even small children can suffer the dangerous mood swings of bipolar disorder than Dr. Joseph Biederman of Massachusetts General Hospital.” When asked in 2007 by the Globe about his drug company funding, he declined to provide it, but said Harvard Medical School and Mass General approved all his income.
Two colleagues of Biederman’s also earned at least $1 million in fees from drugmakers from 2000 to 2007 and may not have reported the funding properly. The discrepancies were found in documents provided to Congressional investigators. A NYT graphic here summarizes the issues (http://www.nytimes.com/imagepages/2008/06/08/us/20080608_CONFLICT_GRAPHIC.html) and provides comments from the three psychiatrists.
The disclosure gaps could violate NIH rules on conflict of interest and could lead to sanctions. Policies at Harvard Mass General forbid researchers from conducting clinical tests with a drug if they receive payments greater than $20,000 from the company that makes it, according to a letter from Sen. Charles Grassley (R-Iowa).

Ok Biederman didn't make that page but it's based on his 'research'

New York Times article -

http://www.nytimes.com/2008/06/08/us/08conflict.html?ex=1370664000&en=a8295c43acc64e60&ei=5124&partner=permalink&exprod=permalink


Hrmm a dude recommending high doses of a medication...only problem is he gets paid $1 million + from the company that sells the medication.


Maurice - I couldn't find the study you mentioned on the shire website. Can you give me a direct link if its not too much trouble?

Member SuzanneX would disagree with these findings. Any chances of digging up more info about what you remember?



People that have abused stimulants in the past will usually need a higher dose for treating ADD than most. Understandable that she needs that much though.

But yeah..it isn't the same as snorting dope..

Lots of methamphetmine addicts I met through my work experience in counseling said that they develop a permanent tolerance to stimulants. Even if they abstained from using for a year or two they'd still need quite a high dose compared to what they took at the beginning of their abuse.



New Research on Adult ADD

Note: Much of the research on ADD medications is carried out by researchers who have financial relationships with the pharmaceutical firms that produce these medications. Furthermore, the Food and Drug Administration, which oversees the acceptance and manufacture of the drugs currently accepts money from pharmaceutical firms to support its work. For these reasons, a degree of skepticism is warranted in evaluating the findings of this research.


http://adultadd.info/Research.htm

That website isn't so bad when you take into account the above disclaimer. They have some good information and tips for managing ADD. However, I don't think the high dose stimulant page is a reliable guide for treating ADD.

Hrmm a dude recommending high doses of a medication...only problem is he gets paid $1 million + from the company that sells the medication.Should people who take medication tell other people not to?

Hrmm a dude recommending high doses of a medication...only problem is he gets paid $1 million + from the company that sells the medication.Thanks for that, Chris. On the other hand, this comment from a reader of the article you linked to is worth reading too.

It’s too bad that not one mainstream media source (not to mention the internet whacko sites) has sought to balance the story by investigating what Grassley has to gain in this hit job.
His second-biggest donor is BLUE CROSS/BLUE SHIELD. And ask the parents of children with mental disorders how easy it is to get medical coverage for their children. Of course insurance companies–our biggest lobbies!–don’t want to pay for these drugs. And they use grandstanding politicians as their hit men.
Shame on all the media for missing the big picture here. Just because reporters and editors can’t understand that babies can be born with damaged brains doesn’t mean you have to share your ignorance with your readers.
You will accept birth defects as hearts holes, deformed limbs, lungs that don’t work properly, and all the rest. But the brain–the most vulnerable organ of all–you think it always comes out wholly perfect?
I am ashamed of my fellow journalists this week, especially the New York times, which gladly took up Grassley’s mission, no questions asked.
Beyond ashamed. Enraged at the biases, the ignorance, and the damned lazy reporting.

Comment by Gina Pera - June 12, 2008 at 1:50 pm (http://blogs.wsj.com/health/2008/06/09/harvard-psychiatrists-under-fire-for-drug-company-funding/#comment-183160)

Very safe is a relative term, I suppose, but it doesn't take a genius to simply look at all the warnings on medications out there and the number of people who discontinue them and figure out what's more dangerous.

Stimulants versus SSRIs is a good place to start. I don't see a black label warning on stimulants about dying suddenly, whereas there is a black label on SSRIs about suicide ideation, and studies which show untreated depression results in suicide 1/4 as often as treated depression in controlled trials where they choose who gets placebo at random. Sounds pretty dangerous to me, yet if you compare SSRIs to antipsychotics or most anticonvulsives they start to seem positively benign.

You'd really have to make a big stretch to claim stimulants are particularly dangerous when used as prescribed in people who are being properly monitored. Yet you'll find that GPs will toss around all three of those classes of drugs like candy, and that they are by and large only slightly more restrained when it comes to EXTREMELY addictive benzos, yet there is a huge stigma against stimulants even though they are really not nearly addictive as say xanax or valium, both of which I have been prescribed at the drop of a hat when there was really no need or desire for them on my part, and both of which have hellish withdrawls if you do get addicted.

70-90mg of amphetamine a day is about what someone would snort if they were to get an illicit hit, and virtually no one dies from a 'normal' hit of that size. Spread out all day long, it is an entirely different ball game. Obviously people should be monitoring their bp and making sure to eat and espeially drink enough, but if they are taking their meds as prescribed and have no heart condition and are being monitored properly it really should not be a problem, especially compared to all the crazy drugs with crazy side effects. I've been nearly killed several times, but not from any controlled substances, but from psychiatrists and GPs prescribing 'benign' drugs for problems I didn't even have. If got killed by a controlled substance it would cause an outrage, but if I die from something uncontrolled then I'd just be another statistic.

Should people who take medication tell other people not to?

Of course not.


I have no problem with people who take high doses of whatever they need.

I saw that comment but thanks for posting it. Always good to have both sides of things.

Disclaimer: Again, I've got no problem with people taking high doses of stimulants or whatever else they need.

Maurice: I apologize if you felt I put pressure on you. I didn't mean to. I have been requested to post studies or whatever in the past and I either couldn't find them or the good ol' ADD got in the way.

Very safe is a relative term, I suppose, but it doesn't take a genius to simply look at all the warnings on medications out there and the number of people who discontinue them and figure out what's more dangerous.

Stimulants versus SSRIs is a good place to start. I don't see a black label warning on stimulants about dying suddenly, whereas there is a black label on SSRIs about suicide ideation, and studies which show untreated depression results in suicide 1/4 as often as treated depression in controlled trials where they choose who gets placebo at random. Sounds pretty dangerous to me, yet if you compare SSRIs to antipsychotics or most anticonvulsives they start to seem positively benign.

You'd really have to make a big stretch to claim stimulants are particularly dangerous when used as prescribed in people who are being properly monitored. Yet you'll find that GPs will toss around all three of those classes of drugs like candy, and that they are by and large only slightly more restrained when it comes to EXTREMELY addictive benzos, yet there is a huge stigma against stimulants even though they are really not nearly addictive as say xanax or valium, both of which I have been prescribed at the drop of a hat when there was really no need or desire for them on my part, and both of which have hellish withdrawls if you do get addicted.This is true for people I know living in different provinces of Canada. Family Physicians will not prescribe stimulants while a patient waits to see a specialist for diagnosis, but they don't hesitate to prescribe Ativan, Effexor, etc. for the patient in the interim.

They are not as addictive as Xanax or Valium? I'm sorry but that's completely wrong, any doctor, pharmacist, even nurse will tell you that Amphetamine's incredible psychological and physical dependence potiential is along parr with those of Opiates and perhaps even cocaine. This is extremely dependent on the person, route of administration and how frequently this person pushes the boundry of what's considered to be 'safe' dosing and going above it.

There is a reason why Amphetamine is a Schedule II substance; It has extreme abuse potiential, especially if misused, but it has been found in studies to have a secured medicinal purpose. Xanax and Valium fall in the Catagory of Schedule IV; They have abuse potiential but are reduced greatly in comparison to Schedules III and II. You probably hear of more people abusing Xanax or Valium on the street, why is this? One reason is doctor's aren't restricted to writing 'no refills' on each perscription because of their schedule placement.

The keyword here is potential. To a certain extent, the person in command chooses to increase the dose. There are of course individuals who choose to do this, which is why it's a controlled substance. Some have a high propensity towards drug abuse in general, and of course, the more likable ones are the ones that will be abused, as well as the more useful ones.

This is somewhat different than certain drugs like benzodiazepines, where they're really not as "attractive" as the stimulants, and tolerance forms very quickly in prescribed doses (where prescribed does not include the outliers of the quarterly quackery). One can die from stopping such drugs (which is know, and not just FUD). So it's much less of a human choice here, and is thus more dangerous to start them than the "addictive" stimulants.

They are not as addictive as Xanax or Valium? I'm sorry but that's completely wrong, any doctor, pharmacist, even nurse will tell you that Amphetamine's incredible psychological and physical dependence potiential is along parr with those of Opiates and perhaps even cocaine.

none of which are nearly as addicting as chocolate, nicotine , alcohol or sex.

So we all don't confuse each other and this remains an educational experience
some tids and bits

1)The drug scheduling thig seems to cause a deal of confusion

Chapter 1 The Controlled Substances Act (http://www.usdoj.gov/dea/pubs/abuse/1-csa.htm)


2)Terminology surrounding addiction and dependence

This time I am going to use a source NOT related to ADD so maybe just maybe it will penetrate some of the bias.

ADD combined with moderate to sever bias can often prevent information from properly adhering to human brain tissue.

Definitions Related to redundant and improper use of certain terms (http://www.cpmission.com/main/addiction.html)

Clear terminology is necessary for effective communication regarding medical issues. Scientists, clinicians, regulators and the lay public use disparate definitions of terms related to addiction. These disparities contribute to a misunderstanding of the nature of addiction and the risk of addiction, especially in situations in which opioids are used, or are being considered for use, to manage pain. Confusion regarding the treatment of pain results in unnecessary suffering, economic burdens to society, and inappropriate adverse actions against patients and professionals.

Behaviors suggestive of addiction may include: inability to take medications according to an agreed upon schedule, taking multiple doses together, frequent reports of lost or stolen prescriptions, doctor shopping, isolation from family and friends and/or use of non-prescribed psychoactive drugs in addition to prescribed medications. Other behaviors which may raise concern are the use of analgesic medications for other than analgesic effects, such as sedation, an increase in energy, a decrease in anxiety, or intoxication; non-compliance with recommended non-opioid treatments or evaluations; insistence on rapid-onset formulations/routes of administration; or reports of no relief whatsoever by any non-opioid treatments.
{End Quote}

~Underling, bold, italic added by me~

Remember this is not discussing ADD medications but a class of drugs known for it's physical dependence - one can be physically dependent without being addicted - just as one can build a tolerance and not be addicted - so can we please not scare each other with propaganda driven confusion - reality is scary enough {IMHO}


3) doses of ADD medications the final subject addressed


Table 1: Medications for ADHD (http://www.medscape.com/viewarticle/531493_3)

none of which are nearly as addicting as chocolate, nicotine , alcohol or sex.

not sure if that's a joke? :)


2)Terminology surrounding addiction and dependence

This time I am going to use a source NOT related to ADD so maybe just maybe it will penetrate some of the bias.What bias do you mean? The whole addiction/dependence/withdrawal confusion?

I hate when people are biased against ADD medications, when they see only the negative things.

ADD combined with moderate to sever bias can often prevent information from properly adhering to human brain tissue.
Yep you're right. Remember you aren't exempt from this :)


Definitions Related to redundant and improper use of certain terms (http://www.cpmission.com/main/addiction.html)

Clear terminology is necessary for effective communication regarding medical issues. Scientists, clinicians, regulators and the lay public use disparate definitions of terms related to addiction. These disparities contribute to a misunderstanding of the nature of addiction and the risk of addiction, especially in situations in which opioids are used, or are being considered for use, to manage pain. Confusion regarding the treatment of pain results in unnecessary suffering, economic burdens to society, and inappropriate adverse actions against patients and professionals.Ok, so we will now use the term dependence instead of addiction. I agree that it's a much better word to use in this situation. Good article btw



~Underling, bold, italic added by me~

Remember this is not discussing ADD medications but a class of drugs known for it's physical dependence - one can be physically dependent without being addicted - just as one can build a tolerance and not be addicted - so can we please not scare each other with propaganda driven confusion - reality is scary enough {IMHO} Yeah, totally right. When I mention withdrawal I'm not trying to imply that the person is addicted.

3) doses of ADD medications the final subject addressed

Table 1: Medications for ADHD (http://www.medscape.com/viewarticle/531493_3)
The dosage range for stimulants is quite large which makes it hard to have an exact recomended dose. Someone might need 100mg to get proper treatment of their symptoms, another person might be bouncing off the walls at 60mg.

Everything is potentially addictive. With opiates it's mainly the physical dependence/addiction, with stimulants it's mostly the mental aspect with IMO a little of the physical.

The one thing I get confused about is where the line is drawn between dependence and addiction? Is it just a mind state? Is it a doctor saying that your dose is ok?

The way I look at it - Dependence is something that happens when treating a valid condition.
Where as - Addiction is when someone is looking for a high, or getting their fix so they can feel ok.

Not sure if that's right or not..

The one thing I get confused about is where the line is drawn between dependence and addiction? Is it just a mind state? Is it a doctor saying that your dose is ok?

The way I look at it - Dependence is something that happens when treating a valid condition.
Where as - Addiction is when someone is looking for a high, or getting their fix so they can feel ok.

Not sure if that's right or not..

One of the analogies I used -

I am dependent upon my corrective lenses to see - I do not wear my contacts because they make me feel good , I do not wear them to escape reality or to avoid dealing with my problems My corrective lenses are part of a solution to a physical problem = I am blind as a bat

I am subject to negative consequences if I do not wear them properly - the same can be said for my ADD medication however the same could NOT be said for my use of tobacco.

I was addicted to cigarettes - I continued to smoke even when I didn't want to - I used cigarettes for many years to avoid dealing with my problem of nicotine addiction - cigarettes were not a solution to any thing and I used them to feel better.

I continued to smoke despite the obvious negative consequences doing so was causing

The underlined portion being the key to the difference between dependence and addiction - the consequence and the reaction there of

People will come on here and talk about medications as if they were the answer to their all of problems with motivation social skills and organization


Again I will refer to the analogy of my contact lenses

Believing ADD medications will solve all the problems associated with having ADD is like believing wearing my wearing of contact lenses will solve all my problems with bad driving . . . . My corrective lenses will allow me to see how badly I drive and they will help my have the clearer vision I need to correct crappy driving habits but it is ultimately I who must make the necessary changes to improve my driving skills

No I can not improve my driving skills without the clarity of vision contact lenses provide but correcting faulty habits requires sustained effort and work . Wearing three sets of contact lenses will not replace the necessity of effort and work it will only cause my vision to become a different kind of blurry and my driving skills will still suck . . . .

Taking medication and expecting it to be the answer to all of your problems is much like wearing three sets of contact lenses to improve crap driving with much the same results . . . .

Why some one takes a medication and how the medication is used will greatly depend upon the addiction potential of ANY drug -apart from the persons personality. Addiction is a mind set as well as a habit - addiction is why some one uses a substance despite the effects even if those effects are bad


Physical dependence is not determined by the person or their reasons for using a drug - dependence is a biological result of the change in chemistry. Dependence occurs even if taking a medication produces a positive effect

Last of all but far from least - Dependence can occur with medications that do not produce a euphoric feeling where as addiction is usually the pursuit of euphoria or avoidance of feeling.

Stimulants have a low physical dependence but a moderate addiction potential where as antidepressants have a moderate physical dependence with a low addiction potential

One of the analogies I used -

I am dependent upon my corrective lenses to see - I do not wear my contacts because they make me feel good , I do not wear them to escape reality or to avoid dealing with my problems My corrective lenses are part of a solution to a physical problem = I am blind as a bat

I am subject to negative consequences if I do not wear them properly - the same can be said for my ADD medication however the same could NOT be said for my use of tobacco.

I was addicted to cigarettes - I continued to smoke even when I didn't want to - I used cigarettes for many years to avoid dealing with my problem of nicotine addiction - cigarettes were not a solution to any thing and I used them to feel better.

I continued to smoke despite the obvious negative consequences doing so was causing

The underlined portion being the key to the difference between dependence and addiction - the consequence and the reaction there of

People will come on here and talk about medications as if they were the answer to their all of problems with motivation social skills and organization


Again I will refer to the analogy of my contact lenses

Believing ADD medications will solve all the problems associated with having ADD is like believing wearing my wearing of contact lenses will solve all my problems with bad driving . . . . My corrective lenses will allow me to see how badly I drive and they will help my have the clearer vision I need to correct crappy driving habits but it is ultimately I who must make the necessary changes to improve my driving skills

No I can not improve my driving skills without the clarity of vision contact lenses provide but correcting faulty habits requires sustained effort and work . Wearing three sets of contact lenses will not replace the necessity of effort and work it will only cause my vision to become a different kind of blurry and my driving skills will still suck . . . .

Taking medication and expecting it to be the answer to all of your problems is much like wearing three sets of contact lenses to improve crap driving with much the same results . . . .

Why some one takes a medication and how the medication is used will greatly depend upon the addiction potential of ANY drug -apart from the persons personality. Addiction is a mind set as well as a habit - addiction is why some one uses a substance despite the effects even if those effects are bad


Physical dependence is not determined by the person or their reasons for using a drug - dependence is a biological result of the change in chemistry. Dependence occurs even if taking a medication produces a positive effect

Last of all but far from least - Dependence can occur with medications that do not produce a euphoric feeling where as addiction is usually the pursuit of euphoria or avoidance of feeling.

Stimulants have a low physical dependence but a moderate addiction potential where as antidepressants have a moderate physical dependence with a low addiction potential


I agree totally... well perhaps 95%. Anyway, you guys are right you just lacked the proper word before - dependence, most definatly relates to drugs such as benzodiazapines, opiates... etc. They are famous for how quickly they built a 'physical' tolerance in patients. They do include a psychological addictional potiential; however, benzo's psychological addictional potiential is mild to moderate. The psychological addictional potiential in drugs like Codeine, Morphine, Oxycodone HCl, Hydromorphone HCl, Dextroamphetamine Sulfate, AMS (Adderall/Adderall XR), Vyvanse, etc. is much stronger.

While these drugs CAN induce a strong psychological hold over individuals it is not to say that they most definitly will depending on a variety of key factors, so many that I won't list... but there is no mistake that the physical tolerance to these drugs builds MUCH slower than those of Benzodiazapines and some opiates.

(Yes I realize alot of the drugs I listed are opiates, the reason for this is that opiates according to pharmacology research have an extremely strong potiential for not only psychological but physical dependence/addiction.)

Dependence is one thing - Addiction, while similiar, is another.

And with controlled substances Dependence might be a factor of concern, it's not the same as the issues with individuals (especially those who aren't receiving the treatment for a legitament reason) with Addiction potiential. Just my 2cents.

USA scheduling is not done according to dependence or vicodin would be stricter than adderall and antidepressants, neuroleptics would be further up the line to because they have a dependence factor

The US schedules drugs according to abuse /diversion potential -

One can build a tolerance and not be addicted or dependent - depending upon how the word tolerance is defined -

"tolerance" another term that causes frequent confusion here.

They are not as addictive as Xanax or Valium? I'm sorry but that's completely wrong, any doctor, pharmacist, even nurse will tell you that Amphetamine's incredible psychological and physical dependence potiential is along parr with those of Opiates and perhaps even cocaine. This is extremely dependent on the person, route of administration and how frequently this person pushes the boundry of what's considered to be 'safe' dosing and going above it.

There is a reason why Amphetamine is a Schedule II substance; It has extreme abuse potiential, especially if misused, but it has been found in studies to have a secured medicinal purpose. Xanax and Valium fall in the Catagory of Schedule IV; They have abuse potiential but are reduced greatly in comparison to Schedules III and II. You probably hear of more people abusing Xanax or Valium on the street, why is this? One reason is doctor's aren't restricted to writing 'no refills' on each perscription because of their schedule placement.

Wrong? No, it's not.

It's virtually impossible to use benzos regularly without getting addicted. They are far more addictive than opioids, and the withdrawls are hellish beyond belief. If you don't believe me, try it some time. I used to take 10 vicodins a day for months and I quit without even noticing a twinge, and used as prescribed it's virtually impossible to get addicted to adderal. You won't hear about anyone making such claims about benzos unless they are a complete moron or lunatic.

With stimulants even if you SHOOT them the physical addiction component is GONE in a few hours. With benzos if you quit cold turkey from a high dose you could easily die.

The reason stims are so stigmatized is people LIKE them. They are only more abusable in the sense that they are more pleasurable. Sure, if you smoke or snort them you will get addicted, and to a lesser degree if you take them for years with no break. Otherwise you have nothing to worry about, and even if you do get addicted the withdrawals are going to be minor compared to benzos.

Wrong? No, it's not.

It's virtually impossible to use benzos regularly without getting addicted. They are far more addictive than opioids, and the withdrawls are hellish beyond belief. If you don't believe me, try it some time. I used to take 10 vicodins a day for months and I quit without even noticing a twinge, and used as prescribed it's virtually impossible to get addicted to adderal. You won't hear about anyone making such claims about benzos unless they are a complete moron or lunatic.

With stimulants even if you SHOOT them the physical addiction component is GONE in a few hours. With benzos if you quit cold turkey from a high dose you could easily die.

The reason stims are so stigmatized is people LIKE them. They are only more abusable in the sense that they are more pleasurable. Sure, if you smoke or snort them you will get addicted, and to a lesser degree if you take them for years with no break. Otherwise you have nothing to worry about, and even if you do get addicted the withdrawals are going to be minor compared to benzos.


I have tried it :) If you use the medication properly the major issue that comes to hand is the physical dependence. There was a time when 1.00mg of Xanax did nothing for anxiety after a ritalin crash for me. If I were to take 1.00mg of xanax today I would probably fall asleep within minutes.

"The reason stims are so stgmatized is people LIKE them. They are only more abusable in the sense that they are more pleasurable."

I think that quote pretty much sums up my point. Benzodiazapines relax you and bring a sense of calming relief, drugs listed in schedule II generally can bring a pleasurable effect, thus increasing the likelihood of them being initially abused, which in the end can lead to long-term addiction. My comments are not lashing out at ADHD drugs, for christ sake I take 40mg of Adderall XR daily, it's simply to say that yes they ARE addictive if mis-used.

I myself at the pharmacy can fill a perscription for Xanax, Valium, Lortab, etc., I cannot fill a perscription for Adderall, Dexedrine, or Ritalin though. The only person given access to schedule II substances is a licensed 'pharmacist' not a pharmacist technician, in georgia anyway. This is in an effort to prevent 'theft' of potientially 'addicting' substances.

Schedule II stuff is locked in a safe in the pharmacy here, only the pharmacist has the key.

I think several of you are confusing addiction with abuse. Abuse is purposely using a substance beyond it's intended use. For example, if I take adderall every day before I go to work per my prescription to concentrate then I'm obviously not abusing. If some guy takes an adderall so he can stay up all night partying he is abusing it.

Addiction, on the other hand, has nothing to do with abusing a substance. I could administer heroin intravenously to you while you are in a coma. Assuming you ever come out of the coma your body is going to be addicted to a substance that you have not abused and have no physical recollection of... but you're still gonna get the shakes and throw up and whatever other withdrawal symptoms.

The exact same thing goes on with stimulants, each time you take a pill it triggers a release of dopamine in your brain and it's not going to be happy if you just stop one day regardless of whether you were legitimately medicating or abusing.

The exact same thing goes on with stimulants, each time you take a pill it triggers a release of dopamine in your brain and it's not going to be happy if you just stop one day regardless of whether you were legitimately medicating or abusing.

Yep. Your dopamine receptors can't tell the difference between abuse or legitimate use.


Finding the proper terms for all this stuff gets confusing since everyone has their own ideas on the correct terms. Words are inaccurate sometimes.


I think -

Medicating can=
Dependence

Abuse can =
Addiction