Switch from Dexedrine/dextroamphetamine due to shortages. Good alternatives?

[quark]

Originally Posted by Vito, ADDer

http://www.ashp.org/DrugShortages/Cu...in.aspx?id=853

So, it's either tough it out until sometime in May, or find an alternative.

Adderall isn't a great substitution for me...makes me feel too "medicated" and edgy and I've suddenly had some hair loss while using it. I will tough it out until May and just rely on Vyvanse as the mainstay and stretch my remaining teeny handful of Dex IR. If this happens again next year I might look into one of the methylphenidates as an IR backup to the Vyvanse. Ritalin was ok although sort of anxiety inducing, maybe I'll try Focalin IR if it comes to that.

[SnareDrumzZz]

Adderall XR seems just as mellow as Dexedrine for me. I Think any amphetamine is better than going medless or going the ritalin routexwhich if you do go with Focalin. BTW I dont think mph mixes well with amphetamines. Atleast thats to my knowledge. And regardless as to what anyone says Vvynase is also better than Nothing.

[Vito, ADDer]

By way of follow-up, this is Day 12 since I started taking Desoxyn. It does work for me, but it's nothing like dextroamphetamine. In doses larger than 5 mg., the effect of the meth tabs is very "peaky"; that is, it takes a long time to ramp up, but when it does it goes way past the point of effectiveness that I need for reasonable focus and motivation. With a 15 mg. dose, I'm definitely "speeding". That's not the effect I'm looking for.

So, I've been able to get decent results with a dosage of 5 mg. every 2 hours, but even that is not without side effects. Since I started taking meth, I've had at least three instances of headaches...and they're not little nagging headaches either; they're flat-out, raging, three-alarm headaches that I have to knock down with Fiorinal. Once that happens, I'm pretty much wiped out for the rest of the day.

These headaches have happened on three out of the 12 days I've been taking methamphetamine tablets, and they don't seem to be related to dosage. Two of them have happened on days when I was dosing at 5 mg. every two hours, and one of those on a day after I had taken only two doses.

I realize that correlation is not causation, so it's not reasonable to conclude that the meth is directly causing the headaches. I'm just reporting my experience here. I'm continuing to use the meth tabs (until dex tabs become available again), because the alternative (no meds at all) is simply unworkable. But I'll be mighty happy when the dex tabs are available.

[Sickle]

my insurance, humana, needs a prior authorization for every ADHD medication except for methamphetamine. since my summer semester is starting soon, I called to ask about 20 mg more in the afternoon since my days will be longer and the 2 tabs upon waking and 2 at noon are pointless at 5:30 in class so I checked their mail order pharmacy (and have gotten my 10 mg focalin tabs filled there once and I had the same reply each time: we have more than enough dex 10 tabs to fill your 90 day rx and I am going to be all over those prior authorization people too... humana is an odd company, you will get told one thing and then you get emails and voice messages with something totally off the wall about errors with meds and all sorts of nonsense)

the first order is on the gun but for me, I said to heck with it and found the one place in my city that had some on stock, this last refill when I asked if they could order enough regularly to keep it filled, I heard this tangent about how quotas are set on what they can order depending on demand and except for 2 different women with kids who only get 30 "like normal folks" I am the only one that fills them and rationalized it with there are modern meds that are long acting so only 1 pill is needed per day (even though I needed 2 long acting doses to hold me over for 10-11 hours) and said short acting meds make you feel super high and then crash and you should get on a long acting med...

Short acting rebound: foggy mild jittery feeling for 2-3 min. able to eat. take next dose hits almost immediately can have another small break to eat it wears off rapidly and bedtime comes.

Long acting: after an hour, you feel motivated and mentally "glued" together, you go about your day get some things done at 2 or 3 in the afternoon the rebound comes, jitteryness and anxiety, anger, irritability or depressed or so tired that you can barely stay awake... lasts for four hours... day after day...

IDK what the drug companies say, I refuse to be on a long acting med except for Daytrana but that had no rebound, wake to sleep coverage and despite the highest dose of the patch being 30 mg... it felt more like taking 4 times the 54 mg concerta dose... my insurance will not cover daytrana and I much prefer dex or focalin tabs to anything else...

vyvanse was useless when I switched from a high dexedrine dose regimen but when I tried it from a sample on a week off from focalin, all I could feel when it kicked in 4 hours later was a feeling of terror...

[Vito, ADDer]

Well, I took the Desoxyn tabs until the 'scrip ran out, and when I called to check on the availability of dex tablets, I got the same answer I've been getting since last December — namely, we don't have them, we can't order them, and we don't know when they'll be available.

Meanwhile, the Barr dextroamphetamine ER capsules have become available again. They still cost nearly 14 times what the equivalent number of dex tabs cost, but if I stretch them I can get that cost down to about 9 times the cost of the tabs. So I got the doc to write me a 'scrip for what would normally be a 20-day supply, and I'm going to see if I can stretch it to maybe 25 to 30 days. I think that's doable. Hopefully, by then the dex tabs will be available again.

The availability thing is crazy. Clearly there are some places (here in the U.S.) where the tabs are available, yet here in Southern California, no one can get them. What's up with that?

...er, I guess you should consider that a rhetorical question.

Anyhow, I've never had any problem with the Barr ER capsules, and this recent batch is no different. Coming back on them after nearly three weeks on meth tablets is like stepping out of the darkness into the light. One 5 mg. + one 10mg. cap, and it's just smooth, steady, even motivation and focus for 6 hours. No speeding, no crashing, no "come-down".

The caps take longer to ramp up than the tabs, obviously, and they ramp down more gradually as well. I actually prefer the tabs, but the ER caps are OK. At least I can function, and the effect is a great deal less "speedy" than I was getting with the meth tabs.

Even so, I sure hope this dex tab shortage goes away soon. The ER capsules are just too doggone costly.

[kolaborator]

Whoa, I never expected that it was going to be this hard to get Dexedrine spansules 15mg, when I asked for the script.

As far as scripts go, my doctor is great, and will write me the script for any ADD med, if I would like to try it. He will say why he thinks it might be a good/bad choice, but ultimately he will leave the choice up to me. The other side of the coin is that, since he prescribes a wide variety of drugs to a lot of other patients, it is that much harder for him to be aware of all the shortages.

I normally take Adderall IR 20 mg x 2/day, and while I am thankful that I can get it without the same shortage issues I encountered last year where I would have one script expire after another(never again! I currently have a backup of 130 pills of 20mg IR safely stored away, and while this growing amount is slowly starting to worry me at the same time I know it is basically my 2-month script ), at this point I feel like I know my response to this drug. I know how and when to take it in the morning for the best effect, what to avoid, exactly when to take my next dose, or when to supplement an earlier one with 5-10mg, and when to forego a dose completely and take a break. While I do think that I am in some way dependent on the med, I know that as long as I don't push it too hard, it will probably take a while before I even start thinking about really raising my dose.

However, just because I think I have found a dose of Adderall optimal for my specific case, it does not mean I am completely satisfied and the benefits do come with certain side effects. I know that as long as I keep getting generic Barr IR, I will not be able to receive any greater benefit from the drug than I already do. I have even gone as far as 80mg in one dose just as an experiment to see if there perhaps exists a whole other level of mental clarity that I have yet to experience, but there wasn't one and instead I spent 6 hours reading about the most minute subjects I could find in a euphoric-yet-emotionless state.

EON/Sandoz adderall seemed better in a lot of ways, but in order to get it these days you pretty much have to raid EON labs. Still, I will never forget getting it that one and only time (before I knew anything about different generics), trying to split one 20 into two 10s, and then going "bleh, so bitter....did they forget to coat these or something?". For about 20 minutes I was a little worried that I perhaps had received the wrong pill (especially considering the back of the bottle had the old Barr sticker that said the pill should have b-973 on it).

Since getting EON appeared too difficult, I decided to try one of the 1st-level alternatives: Ritalin, Focalin, or Dexedrine - Desoxyn seemed a bit too much without trying any of the other ones first. Given the positive reviews of Dexedrine, I was very happy when the doctor had no problems prescribing it, even going as far as saying that he has no idea who or what started this rumor that Dexedrine is in some way more damaging/more addictive than any of the other stimulants, and after thinking a little about the dose ultimately decided that 15mg Dexedrine spansules x2/day was probably a good equivalent.

Given all this, the reactions I have received from pharmacists, in Manhattan out of all places where it is rare for multiple pharmacies to be out, when showing them the prescription have ranged from disbelief to amusement. One pharmacist said, after pulling out the gigantic binder of orders, "Im pretty sure they stopped making these a few years back", another pharma - a woman - just said "No chance - it's been months since our last shipment". Other places had tried to direct me to the pharmacies I have already visited.

Ultimately, though, the most shocking thing for me is the fact that chain pharmacies cannot tell you if the med might be available at another location in the area.

[Zefira2012]

Originally Posted by tambourine-man

Something is up. I don't think everyone and their mother have started taking Dexedrine and Adderall IR.

IR meds are less profitable. Drug companies don't want us on them - so they are "dangerous" and "more addicting." We all know the truth.

Need me to UPS you some Dexies, Salleh?

That was a joke, but have you considered mail order pharmacies?

I heard across the border getting up to 50 bucks a pill--so maybe they sent a buttload down there and shorted us--ya think? Zefira