View Full Version : Is this tolerance?


arrested_truth
08-10-09, 03:03 PM
This is pretty long, I'm looking for some insight if this would be considered tolerance build up or not, here's some overview...

For the year I spent trying out SSRI antidepressants and whatever else they decided to give me, (this included Wellbutrin, Lexapro, seroquel, paxil, Buspar, prozac and trazodone) for my 'diagnosed' depression, I was discouraged from my general doctor and previous psychiatrists that none of this helped very much. I had some success with paxil, probably the most; however the side effects were disasterous for my lifestyle (zero libido and couldn't fully sleep, ever) and I felt like I was in a fog for the past year of my life, basically.

Remembering the few times I had actually tried Adderall recreationally in my teen years, I remember the magical clearance I experienced, a clear head, REAL concentration, and what not. I decided to take matters in my own hands for the meantime, while waiting on the neuropsychological testing I was having done to see if whether or not I had ADD/ADHD. I have spent sooo many hours on the internet researching ADD and everything along with it.

I started taking Adderall XR for school, once each morning (30mg xr). I did this out of desparation, time was running out for my senior year in high school, and from all the antidepressant meds I had given a chance earlier in the school year, I had missed a total of 77 days by the time it was spring break due to severe exhaustion and lethargy from the previous meds. Now I am not a bad student, at all. Never been to the principles office or been in trouble for 'acting out' or anything. I'm pretty smart, and pretty decent in school; I just could never work up to my ability or have my work reflect my abilities. The 30mg xr each morning would last me all school day, to even around 4 or 5pm once I was already home, and this was perfect.

For about the last three months in school, and of course my grades escalated immensely; and I graduated with 'student of the quarter' and received a scholarship for $250 for writing a paper. This definitely brought up my confidence, and now I have a lot more perseverence for life after high school.

But since the conclusion of my neuropsych. testing, and seeing my psychiatrist on a regular basis, he ruled out that it would be beneficial to start me on adderall because my results showed positive for ADD/ADHD. I began with 5mg IR tabs, two in the morning when I got up, and one or two after 12pm as needed. Once I went back, I explained to him how much better adderall has worked for me, overall completely. And how it has brought some light back into my faith in being medicated accordingly and having success from doctors, unlike before.

After the second session he put me on adderall 20mg XR, once each morning. Now, this is where I am sitting, after the switched time-release of the medication, I like how the XR lasts much longer than the IR did, when I took IR, the second two of the 4 tabs wouldn't have as much impact-at all as the first two would; this was my review and why he switched to the XR. He did not increase the total mg at all, I'm still taking the same amount as when I started the IR.

I take my 20mg XR at about 10:30am to 11:00am each day, and it will practically be 2pm and I feel the dimishing affects of it wearing off, I was told it should last 6-8 hours; like it used to when I was taking 30mg XR a couple months ago. I've changed my diet, I try to eat before or after I take the pill in the morning, drink lots of water, I take a magnesium citrate supplement in the evening, and occassionally a B-Complex multi vitamin. And even sometimes ginko biloba. I've cut down caffeine completely, only having a can of pop once in the evening to help taper off the crashing comedown I get every day between 2pm and 3pm. I've tried all these remedies to see if it would help potentiate the affects of the XR as long as it's supposed to last, not just the first good boost of energy and focus I have for the first three hours it kicks in, I would love if it went past that but it doesn't seem to...

Any help is extremely appreciated... :o

arrested_truth
08-10-09, 04:08 PM
I didn't really clarify my question here, I guess I'm wondering if this is the point where I should be raising the dosage I take daily, for the full potential of the medication... because at first I was sure the XR was the best option for me, but now after trying IR and going back to XR, it seems like the XR is less affective from what the IR was

Retromancer
08-10-09, 04:30 PM
There are a number of unadvertised realities with these drugs. Near the top of the list is the fact that sustained release medications rarely last as long as described. The actual duration of effectiveness is inevitably shorter -- and then there is the small matter of rebound as the medication wears off.

A booster dose of IR tabs is common, and on occasion a second dose of XR is prescribed. (I was given the latter option -- back when I had full medical coverage...)

Both the XR and IR versions have their advantages -- and disadvantages. A mix of both is a sound medication plan...

arrested_truth
08-10-09, 04:35 PM
Thanks very much for your input, I do agree that would probably be a feasible solution. Do you think a raise in the XR initially would show better results, and then maybe a booster for the afternoon? Because I seemed to do so well for the whole duration anyway when I had a higher mg for the XR

Would it be wise at all to mention to my psychiatrist that I've done my own research for the symptoms I experience, or should I just dance around the idea of a booster and see if he just agrees with me?

Retromancer
08-10-09, 05:00 PM
I would advise you to "forget" that you ever took stimulant medications without a doctors sanction. I do think it would be okay for you to say that you have been reading respectable internet sites such as CHADD's etc. -- I'm not saying that the forums here are disrespectable ;) -- and would he consider the possibility of booster doses. I doubt he would sign off on an increase to 30mg XR but he may very well be open to a morning IR booster dose. (Another common option.)

Since you are under 30 I am afraid you are going to have to steel yourself to doctor resistance to adequate dosing. Despite that, work with them. It's in your interest.

Thanks very much for your input, I do agree that would probably be a feasible solution. Do you think a raise in the XR initially would show better results, and then maybe a booster for the afternoon? Because I seemed to do so well for the whole duration anyway when I had a higher mg for the XR

Would it be wise at all to mention to my psychiatrist that I've done my own research for the symptoms I experience, or should I just dance around the idea of a booster and see if he just agrees with me?

arrested_truth
08-10-09, 05:09 PM
That's what I figured, once again thanks for the advice