I was prescribed Adderall almost one month ago for ADD and Narcolepsy. Up until that point I had been taking Provigil (two months), for which I'd developed such a high tolerance it'd gotten to the point that no dose would work at all. With this in mind, my Doc prescribed 20mg of regular Adderall, three times a day. Well it didn't take long to figure out that wasn't going to cut it. I conferred again with my Doc and doubled the dose. Now it seemed like I was getting somewhere. I could focus, stay awake, and all that, which was good; however, it felt like I was just slightly out-of-reach from where I needed to be. Plus, one 40mg dose lasts just a little over four hours, which leaves a lot to be desired, especially if I don't dose back-to-back.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>
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It's frustrating. <o:p></o:p>
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Anyway, is there anyone out there that's had the same experience, and/or has some advice about what might be a good direction to go in from here?<o:p></o:p>
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(BTW - I don't have any history of hard-drug abuse. I never used amphetamines or other high-end stimulants before this.) <o:p></o:p>

I'm kinda in the same boat as you. I have sleep apnea and a very high probability of ideopathic hypersomnia or narcolepsy (just haven't taken the MSLT yet).There are many options to consider. Are you seeing a sleep specialist (usually a Neurologist)?

You could talk to your doctor about trying Xyrem. This is the legalized form of GHB (date-rape drug) that is prescribed for narcolepsy and excessive daytime sleepiness.
Maybe other options are switching to dexedrine or a methylphenidate-based medication.

Sad to say but after reading up a lot on the subject the now extinct Desoxyn Gradumet was supposed to be very good at controlling narcolepsy and ADD. You can still get Desoxyn in short acting form though. Maybe some day the extended release version will come back but it is doubtful considering the stigma attached to the drug.

What is your dose of provigil? My neurologist allows the dose to go up to 800mg a day (I've been at 400mg for about a year).

J

Keep trying different meds with your doctor. Sounds like the amphetamine based stimulants aren't for you, unfortunatly. :(

Personally, I wouldn't bother with any doses over 100mg(even less - 60mg). Health risks and side effects increase too much to be worth it (for me anyway)

Have you tried any Ritalin based meds yet? Worth trying I think. I've heard of people with Narcolepsy that have success with combos like Ritalin + Adderall, different for everyone though.

Are you seeing a sleep specialist (usually a Neurologist)?...You could talk to your doctor about trying Xyrem....Maybe other options are switching to dexedrine or a methylphenidate-based medication...Desoxyn...

What is your dose of provigil? My neurologist allows the dose to go up to 800mg a day (I've been at 400mg for about a year).

J

No, but next week I'm scheduled to see a neuro-psychiatrist, or something to that effect. My current doc is a bit out of her league on this one.

As far as Provigil goes, I started at 200 and worked my way up to 800.

Knowledge of other meds that could be used in conjunction with, or as a sustitute for Adderall (as both you and Ozchris mentioned) are something I wish I'd had going into this -- if for anything, to save time. I mean, damn, my current doc, god bless her, is really big on pushing the newest drug on the market. At first, she wanted to write me a script for Vyvanse, which I guess is the cuter, fluffier version of Adderall that, judging from what I've read about it since, wouldn't have helped me a lick. Going in I had somewhat of an idea of what I wanted. She's kinda one of those doctors that won't anything for you unless you prod the hell out of and make suggestions to -- over and over again.

I do think Adderall has potential, or at least symbolizes it. Either it needs to be tweaked, or replaced with a more narrow set of alternatives relative to my reaction to it.