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Old 01-02-16, 04:49 AM
blke22 blke22 is offline

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Re: Adderall - first thread post since registration - anxious/nervous, dousy of a thr

So, update (and yes, blke33 vs blke22 because of an issue with password reset email not making it to my email address, actually it doesn't work with any of my email addresses I tried).

Still anxious about progress. But got to see the doc as planned/schedule/appointment. Increased ER/XR dose for the AM/Day by one bump. Which is good, at the dose I was at during those times at work it was just beginning to be noticeable and I felt it was enough some days and not the the others.

However, the small second ER/XR dose I had been taking to try to deal with the first not lasting beyond 5-6 hours before I started feel very down (some days, for a couple hours, but not all) or start noticing myself being impatient with people at least... Although it seemed to help some days, I was hoping the doc would have tried increasing the dose of that ER/XR. Doc kinda did. Before any changes I noted I was concerned about how badly the couple hours (or evening/night) had been on some days (again, not all, not even many as long as I could get home and basically keep myself going on things I found interesting enough to keep the mind moving/distracted-almost). Best description I have seen from other here is a toss up between two words of "come down" or "rebound". What I can associate to days when this happens is when either the AM/day started out badly. As in, something happens early before taking first dose or getting to work and maybe it isn't quite up to right level in me yet due to timing. That, or the days I seem fine, but as I think back they are days of what should have been boredom by my definition any other day. Days that were not exciting, and I was OK (not irritated, or short with people, not other emotional break outs like tears as I think about family and my issue with being bored with them at times). But then, later in the day.. It's like I am aware of how boring the day felt anyway. Not trapped on thinking about it, but all of a sudden a feeling of something missing. Days with something a bit more in line with "interesting", or where I already have something lined up like that to do outside of work once I get home, I can still be OK. When not, though, the worst couple/few days over the last weeks are like a new level of OK being reached, and then having the worst days of past 7+ months come back in a rush. All the negative thoughts return and shoot further down then the bad days before. Or maybe not lower, but more like the rate is faster. This happens just like other times when this gets to me, one of the many thoughts I am jumping through normally that are not really bad/negative/sad (just OK or fine or even exciting/interesting) gets replaced with the first thought of the past actions or lack of action or failure to contain emotion(s). A few days, those have popped into my mind for a moment, and then I can go onto one of the others that are still there and OK and just let the first negative memory or thought fade into the background. But like before, when one takes focus and I just ruminate. It is the best word here I can think of , as it is one thought to another but all much more negative/dark either in frustration, agitation, anger or sadness, I spin into attacking myself for things. Of all things, not a big Star Wars fan but a bit into Science Fiction at times, one memory comes to mind that I oddly have just felt in the past at times similar to this:

Fear, uncertainty, doubt; the dark side of the force are they. - Yoda

Fear, uncertainty, doubt... Much like the last couple posts in this thread... I start to doubt this is going anywhere.. Medical care/treatment, and then pondering if the diagnosis is right/wrong, complete (maybe co-morbid depression vs as I have been seeing it depression as a result of feeling badly about my lack of interest in spending time with family or doing my job even though they care for me so much and I honestly get paid "enough" to live by my employer to a do a job that is interesting/stimulating at times but then I can't be "OK" with doing boring tasks even though from a knowledge/physical effort level the tasks are "easy". Why should I have an issue with that?)....

Anyway, sometimes unpredictable timing of the ER/XR stuff in the morning, I am OK with. I note this to the doc as I have flexibility from my employer right now on start of each day in the AM and I don't want it to be there any faster then needed as the first 1-2 days after each increase of dose the first dose has been a bit undesirable for an hour or two. I really liked the simple tingling/numb fingers on those day as a mark of when medication might be kicking in, but nothing more.. But far worse then having to wait an extra hour or more to feel comfortable with going to work and starting this grand experiment of if the medication is helping/enough on my employer and co-workers, the end of the day when wearing off (I think as, it is 5-6 hours in) and hitting this much more rapid drop has me a bit fearful of myself. Doc was bit concerned as long after that comment, and talking medication etc, as I we were ready to end the appointment she asked about my concern for myself in a way some in this forum may be familiar with. I noted those thoughts are there every so often, as they are memories that don't seem to ever go away now that they have been there once. But I am fine still, part of the concern is long term future fro this if needed. As long as it is working and covering the hours of the day, great. But, even if right now it is a uncommon feeling/occurrence, what happens when/if I forget medication? (I have never done so in the past, but I could see it). Or, some other medical condition necessitates me no longer taking this medication or some stimulant at all (like heart condition)? Or I can't afford it at all do to something bad like loss of job and financial issues (not present now)? This even as I read threads on here from long ago about "Adderall" shortages in 2012.. Or even in last weeks people that run into timing issues with holidays and doctors schedules or a pharmacy or insurer problem? These questions (or scenarios in my mind) about inability to take the medication and concern about not doing so were not all mentioned to the doctor. At least not in this appointment. And they have been there since day one, and before, when the doc first wanted to prescribe the first medication to me since my first visit with her. It is why when the doc started by mentioning stimulants (no specific name), I stopped the conversation midway through and said why not non-stimulant like Straterra and ended up trying it first. Next round of thoughts later in the day as I realize I was able to keep those loops of "what if" scenarios in my head during the appointment, "If I talk with the doctor about those thoughts with that much concern, do I sound like I am addicted? When really I am quite aware of my own concerns about the medication or any medication becoming something I could become trapped on not because I am dependent on it to be "OK" in a good way, but dependent as in "addicted" so that other negatives come of me trying to stop taking it or having to stop taking it. Beyond my it's lack of positive effect in dealing with an issue there in me since before taking any medication for anything.

Anyway, she (doc) suggest an increase in dosage of second period of time (5-6 hours after first when first was appearing to loose effect as we had spoken about in prior appointment and thus the second dose being added then). At first, just increase the ER/XR form. Which I felt OK with, as it was a small bump in level at or less than the existing 15mg I was taking in the morning, and I thought I had a feeling for how timing of ER/XR was working. But then she suggested a change to IR form, single larger dose and trying it either whole or splitting and diving into two 4 hour doses. She mentioned, like others here have, that it may work better then ER/XR. This as I am thinking yes, but when I first was prescribed ER/XR the duration and having to repeated take this through the day was already a concern. But I then mentioned to her my concerns about my own reading online/etc about the other marketed/noted purpose of ER/XR and even things like Vyvance was the slower onset and offset of the medication to make it more gradual. And how I really did not like the few days in past month when it seemed like the timing of the offset of medication lined up with the rapid downward spiral of negativity was my focus and worse then days of the past when I hit extremes (even with caffeine being a big helper back then in soda or over the counter caffeine pills).

She said it is worth a try, and start with part of first dose if neded. First being 10mg only, so that would 5mg if I split it. Which I know some say is nothing to them, but I really am concerned more about onset/offset rate of medication than the total dosage. Anyone have comments about concerns of trying a instant release of Adderal (or generic of course) or of any other stimulant medication only after having tried just extended release versions that are designed for slower/more-gradual onset/offset? I know for me the IR tablets will be much cheaper, but to a certain extent I was already prepared to be paying a certain amount per month for medication beyond the ER/XR as the try at Straterra was far more expensive for 2 months given no generic available fro it.

I have a couple days of medication from this last month left to take (as month was not fully over yet when I got to see the doc) and am taking those before starting this new "increased ER/XR dose + change IR" prescription. Would love any thoughts/insights or (again) even just "don't worry so much, this will likely go fine and you are starting low/slow" or "I have been through the ER/XR change to some instant release, versus instant release change to ER/XR, and had same concerns but it went OK".
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