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Old 08-14-11, 01:35 PM
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Beware the addiction potential of amphetamines

In the 1960's, approximately 3-5% of U.S. school age children were diagnosed with Attention Deficit Disorder and many were placed on Ritalin. Today, that number has increased by a factor of ten.
A recent study compared school age children in Utah vs. Massachusetts (two diametrically opposed states---politically, socially, and ideologically) and discovered a near 50% rate of ADHD diagnoses in both groups. Commonality? Both groups had well-meaning, highly-involved parent groups that merely wanted their children to perform their best in school.
Does the U.S. in 2011 have an epidemic of ADHD? Certainly not.
Caveat emptor——studies among M.D. addictionologists are clear: nearly half of all children placed on stimulant ADHD medications (amphetamines and their derivatives, like Vyvanse, Ritalin, Focalin, Adderall, and Concerta) in junior high or high school will develop problems with amphetamine addiction if the medication is continued after age 18 (i.e. when Mom and Dad are no longer around to oversee the proper administration of these powerful and potentially addictive medications). Remember that the DEA classifies these as Schedule II controlled substances, no different than Oxycontin and Dilaudid, because of their high abuse and addiction potential.
Today, these "legal" amphetamines are readily available at every fraternity and sorority house and dormitory in nearly every college in the U.S. Sharing and purchase of these medications has reached epidemic proportion on college campuses. (Remember that 90% of these amphetamines are produced in the U.S.) The penalties for sharing, purchase, or sale of these substances are no different than with distribution of heroin, LSD, or cocaine.
I speak from personal experience--as both a physician and the father. I have a child that was diagnosed in the 3rd grade with ADHD, placed on Concerta in the 6th grade, then on Vyvanse in the 10th grade by a well-meaning, board-certified, adolescent M.D. psychiatrist.
I, like every other well-meaning parent, honestly believed that my child would adjust to college and be responsible enough to take his ADHD medication as prescribed. After all, he had been a model patient for seven years.
Unfortunately, once in college (away from Mom and Dad's regulation of the Vyvanse), the abuse and the consequent addiction began. Regulation of the amphetamine ceased with his "typical" college schedule of classes that were no longer in the "packaged" 8am - 3pm schedule of high school. Soon, he was taking Vyvanse later in the day and even at night to help study for exams (remember that Vyvanse and Adderall XL have effective stimulant times from 6-12 hours) and found himself, not only unable to sleep, but also requiring greater and greater doses of the amphetamines to get the same effect. (He resorted to purchase of additional Vyvanse when his monthly allotment was out.) At high doses, these legally prescribed amphetamines are no different than crystal methamphetamine purchased on the street.
Today, he is in a 6 month wilderness detox program in the Rocky Mountains, along with 23 other college students from around the U.S. that developed the same addiction to their legally prescribed amphetamines for their ADHD.
I sincerely hope that all parents reading this will realize the abuse potential of amphetamines. We all want the best for our children. I know that I did. Unfortunately, these powerful controlled substances can easily take over the lives of our children once they are away in college.
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Old 08-14-11, 05:35 PM
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Re: Beware the addiction potential of amphetamines

First of all my heart goes out to you and your son. Its a difficult and tragic story that i know of all too well. When the degree of potential in someones life is destroyed in seemingly one fell swoop, with no reason or logic - its easy to place blame.. especially when there seems to not be 1 clear method in treating ADHD.

In the most gentle of aspects, i do feel it is my responsibility to provide you with accurate data, and resources.. As you are an M.D., i feel you deserve that respect.

One thing that your research neglects to initially address is that individuals with ADHD are (by nature) already prone to substance use disorders (refer below). While this is not new knowledge - for the purposes of accuracy in medicine, this is supported by a 10 year Longitudinal study that was completed in 2011. Individuals with Attention Deficit Hyperactivity Disorder, are already by nature prone to abuse substances in adolescence and later on in life.

To say that medicating children based on this study is increasing their risk of being substance abusers later on in life.. is inconclusive. Now that we know there is a factor which already predetermines the prevalence of SUD's it is important to consider the evidence.

When we go back through pediatric medical journals all the way back to 1998, we can find medical studies that support that stimulant medication in children, reduces the risk of SUD's later on in life. This is great news! since we have established that ADHD children will.. by and large.. grow up with a predisposition to abusive behavior. This finding is also replicated for Adolescents (Boys and Girls), in 2008. See below you will find 3 articles. The research is showing that Medicating our ADHD children (and teenagers), is in fact lowering the risk that they will abuse substances later on in life. Does this happen with every case? heartbreakingly no..

I should note however, that to blame childhood stimulant pharmacotherapy for a college students cocaine, heroin, or rx addiction is far reaching. Especially since the science, and date, proves the likelyhood of the opposite. Being on a stimulant medication (or not), as a child, does not determine if the child will or will not abuse substances or medication in the future. There are just as many other world factors that lead to substance abuse, that you as a parent cannot control, only seek to influence. And a majority of those factors are already not in you're control.

You cannot blame yourself.

It is tragic that addictions happen.. blaming stimulants for the arrival of a heinous addiction is easy.. so very easy. Especially in the heart of a hurting and fearful parent. However i hope that you (as a Medical Doctor) will consider the research that i have provided to you. In as such I wish that you would have provided more data for me to investigate, such as this substance abuse resort in the rocky mountains that your son is at. It would be a good resource to know of. Nothing in medicine is 100% sure - the most we can do is attempt to reduce the risk, and increase the chances for a healthy life, and a good prognosis.

Stimulant medication is a first line treatment method for ADHD for many reasons. Lowering the risk (not preventing.. but science proves most definitely not increasing) of SUD's, is only one of the benefits of medicating your child with Stimulants. The list is huge, all the way up to positively affecting their Self-Esteem because they can engage in peer-relationships and develop a healthy social identity. In as such, medication does not work for everybody, and its frustrating when medication either fails us, or doesnt work for us at all.

It is however important that through that frustration we stave off the emotional recoil that can damage an honest perspective. If i walk down the street of Pittsburgh, and get mugged.. it would be erroneous of me to say that Pittsburgh as a whole is dangerous. It is important for you as a doctor to not let that same ideology contaminate your Hippocratic oath. I am sorry that your son had this experience - but the simple fact is, stimulant medication saves lives.

As you have indicated you are a parent.. you will also appreciate my final report that i would direct you towards.. regarding the positive effects of Ritalin and the brain. Since you're an MD - you'll have no problem getting through that one.

You should be proud of your son, that he is not simply a statistic. That he is even alive and in a position that he can be in a program, and that you as a parent have the resources to send him to such a rehabilitation center is exemplary, and he deserves much respect, encouragement, and support.

All the best,

Any questions, feel free to ask,

We are a community of individuals with ADHD, or who support spouses, partners, parents or children with ADHD - who have made the decision to either medicate, or not to medicate - and we support eachother all the same.

I_DTour

Does ADHD Predict Substance-Use Disorders? A 10 Year Followup Study of Young Adults With ADHD
http://www.jaacap.com/article/S0890-...096-7/abstract
*this is only the abstract - i do not have access to my database at my college, but you as a doctor should*

Pharmacotherapy of Attention-deficit/Hyperactivity Disorder Reduces Risk for Substance Use Disorder
http://www.pediatricsdigest.mobi/content/104/2/e20.full

Drug Therapy Lowers Risk of Substance Abuse in Kids

http://addconsults.com/articles/full.php3?id=1012

ADHD Stimulant Treatment May Decrease Risk of Substance Abuse In Adolescent Girls; Results Mirror Findings In Boys

http://www.massgeneral.org/about/pre...e.aspx?id=1062

Methylphenidate Amplifies Long-term Plasticity in the Hippocampus via Noradrenergic Mechanisms
http://learnmem.cshlp.org/content/15/8/580.full
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Old 08-14-11, 06:28 PM
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Re: Beware the addiction potential of amphetamines

I really tried to be addicted to anything. ADHD meds are unpleasant and don't really seem addicting to me.

Some other people might think otherwise. Maybe to people that don't actually have ADHD?
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Old 08-14-11, 06:38 PM
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Re: Beware the addiction potential of amphetamines

Quote:
Originally Posted by Anesthesia MD View Post
>>
Does the U.S. in 2011 have an epidemic of ADHD? Certainly not.
Caveat emptor——studies among M.D. addictionologists are clear: nearly half of all children placed on stimulant ADHD medications (amphetamines and their derivatives, like Vyvanse, Ritalin, Focalin, Adderall, and Concerta) in junior high or high school will develop problems with amphetamine addiction if the medication is continued after age 18 (i.e. when Mom and Dad are no longer around to oversee the proper administration of these powerful and potentially addictive medications).
>>
.
I don't think I can add much to Impromptu's response. But I too would like to
see some of the research or facts on the claim that half the kids who take
stimulant meds in middle school and high school develop an addiction once
they leave home and parental supervision of meds.

If it's true, it's one more reason to delay starting school for kids who are
suspected of having or have been diagnosed with ADHD as they start out
substantially delayed in self-control compared to their peers. This would give
them more time to mature and to develop self-control with their own med taking.
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Old 08-14-11, 09:11 PM
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Re: Beware the addiction potential of amphetamines

Quote:
Originally Posted by StoicNate View Post
I really tried to be addicted to anything. ADHD meds are unpleasant and don't really seem addicting to me.

Some other people might think otherwise. Maybe to people that don't actually have ADHD?
I agree with this. People with adhd can develop dependence and tolerance to stimulants but actual addiction is rare for people who truly have adhd simply because they simply aren't that pleasurable to a lot of adhd people.

I've gotten into situations where I misused adderall to stay awake to study, but I never felt addicted. In fact, I would prefer to not have to take anything, but that's not really an option for me right now.

I think that parents should be aware, but not afraid, of the potential for addiction, abuse, and dependence with amphetamines.
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Old 08-14-11, 09:27 PM
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Re: Beware the addiction potential of amphetamines

Quote:
Originally Posted by Anesthesia MD View Post
At high doses, these legally prescribed amphetamines are no different than crystal methamphetamine purchased on the street.
Sorry if this is a double post, but I find it almost hilarious that someone who claims to be a physician can say that vyvanse is no different than street meth. Vyvanse must be metabolized into active amphetamine before it has any effects. Illegal methamphetamine is usually snorted, smoked, or injected, so it reaches the brain quicker and thus has a much higher potential for addiction. The time that it takes for vyvanse to be metabolized into dextroamphetamine also serves as a natural time release method. Methamphetamine (if snorted, smoked, or injected) reaches the brain quickly and all at once, versus vyvase which reaches the brain slowly and gradually since it is not all metabolized at once. Also methamphetamine is simply more potent than the dextroamphetamine that vyvanse is metabolized into.


Wow sorry for that rant but it annoys me when people compare adhd meds to street methamphetamine, especially when it's vyvanse since vyvanse is the adhd stimulant with the lowest potential for abuse and addiction.
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Old 08-14-11, 09:53 PM
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Re: Beware the addiction potential of amphetamines

I think we as parents-ADHD Children or not, have to hope and pray our children make the right decisions when it comes to drug use. It's not just illegal drugs but perception drugs are as scary. Many kids use stimulants in collage, it's a big problem.

It's not the well meaning dr. who prescribe the medication for actual diagnoses. It's the kids who choose to abuse them. I sure hope your son finds help, my prayers are with you and your son.
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Old 08-14-11, 10:17 PM
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Re: Beware the addiction potential of amphetamines

I second the suggestion that you check out Joseph

Biederman's work at Harvard,as well as that of Russell

Barkley's work,all documenting how the use of ANY

STIMULANT DECREASES THE RISK OF A SUD (Substance

Use Disorder).

In short, those data refute your orig. premise.

tc

mctavish23

(Robert)
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Old 08-18-11, 03:20 AM
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Re: Beware the addiction potential of amphetamines

This topic is worth discussing seriously....
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Old 08-18-11, 03:24 AM
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Re: Beware the addiction potential of amphetamines

Quote:
Originally Posted by Impromptu_DTour View Post
First of all my heart goes out to you and your son. Its a difficult and tragic story that i know of all too well. When the degree of potential in someones life is destroyed in seemingly one fell swoop, with no reason or logic - its easy to place blame.. especially when there seems to not be 1 clear method in treating ADHD.

In the most gentle of aspects, i do feel it is my responsibility to provide you with accurate data, and resources.. As you are an M.D., i feel you deserve that respect.

One thing that your research neglects to initially address is that individuals with ADHD are (by nature) already prone to substance use disorders (refer below). While this is not new knowledge - for the purposes of accuracy in medicine, this is supported by a 10 year Longitudinal study that was completed in 2011. Individuals with Attention Deficit Hyperactivity Disorder, are already by nature prone to abuse substances in adolescence and later on in life.

To say that medicating children based on this study is increasing their risk of being substance abusers later on in life.. is inconclusive. Now that we know there is a factor which already predetermines the prevalence of SUD's it is important to consider the evidence.

When we go back through pediatric medical journals all the way back to 1998, we can find medical studies that support that stimulant medication in children, reduces the risk of SUD's later on in life. This is great news! since we have established that ADHD children will.. by and large.. grow up with a predisposition to abusive behavior. This finding is also replicated for Adolescents (Boys and Girls), in 2008. See below you will find 3 articles. The research is showing that Medicating our ADHD children (and teenagers), is in fact lowering the risk that they will abuse substances later on in life. Does this happen with every case? heartbreakingly no..

I should note however, that to blame childhood stimulant pharmacotherapy for a college students cocaine, heroin, or rx addiction is far reaching. Especially since the science, and date, proves the likelyhood of the opposite. Being on a stimulant medication (or not), as a child, does not determine if the child will or will not abuse substances or medication in the future. There are just as many other world factors that lead to substance abuse, that you as a parent cannot control, only seek to influence. And a majority of those factors are already not in you're control.

You cannot blame yourself.

It is tragic that addictions happen.. blaming stimulants for the arrival of a heinous addiction is easy.. so very easy. Especially in the heart of a hurting and fearful parent. However i hope that you (as a Medical Doctor) will consider the research that i have provided to you. In as such I wish that you would have provided more data for me to investigate, such as this substance abuse resort in the rocky mountains that your son is at. It would be a good resource to know of. Nothing in medicine is 100% sure - the most we can do is attempt to reduce the risk, and increase the chances for a healthy life, and a good prognosis.

Stimulant medication is a first line treatment method for ADHD for many reasons. Lowering the risk (not preventing.. but science proves most definitely not increasing) of SUD's, is only one of the benefits of medicating your child with Stimulants. The list is huge, all the way up to positively affecting their Self-Esteem because they can engage in peer-relationships and develop a healthy social identity. In as such, medication does not work for everybody, and its frustrating when medication either fails us, or doesnt work for us at all.

It is however important that through that frustration we stave off the emotional recoil that can damage an honest perspective. If i walk down the street of Pittsburgh, and get mugged.. it would be erroneous of me to say that Pittsburgh as a whole is dangerous. It is important for you as a doctor to not let that same ideology contaminate your Hippocratic oath. I am sorry that your son had this experience - but the simple fact is, stimulant medication saves lives.

As you have indicated you are a parent.. you will also appreciate my final report that i would direct you towards.. regarding the positive effects of Ritalin and the brain. Since you're an MD - you'll have no problem getting through that one.

You should be proud of your son, that he is not simply a statistic. That he is even alive and in a position that he can be in a program, and that you as a parent have the resources to send him to such a rehabilitation center is exemplary, and he deserves much respect, encouragement, and support.

All the best,

Any questions, feel free to ask,

We are a community of individuals with ADHD, or who support spouses, partners, parents or children with ADHD - who have made the decision to either medicate, or not to medicate - and we support eachother all the same.

I_DTour

Does ADHD Predict Substance-Use Disorders? A 10 Year Followup Study of Young Adults With ADHD
http://www.jaacap.com/article/S0890-...096-7/abstract
*this is only the abstract - i do not have access to my database at my college, but you as a doctor should*

Pharmacotherapy of Attention-deficit/Hyperactivity Disorder Reduces Risk for Substance Use Disorder
http://www.pediatricsdigest.mobi/content/104/2/e20.full

Drug Therapy Lowers Risk of Substance Abuse in Kids

http://addconsults.com/articles/full.php3?id=1012

ADHD Stimulant Treatment May Decrease Risk of Substance Abuse In Adolescent Girls; Results Mirror Findings In Boys

http://www.massgeneral.org/about/pre...e.aspx?id=1062

Methylphenidate Amplifies Long-term Plasticity in the Hippocampus via Noradrenergic Mechanisms
http://learnmem.cshlp.org/content/15/8/580.full



This is a very insightful...
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Old 08-18-11, 05:33 AM
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Re: Beware the addiction potential of amphetamines

I took Dexedrine spansules from 7th grade until I finished college. My dosage had to be gradually increased as I gained tolerance, but I never abused my meds. No one ever asked me for them, either.

It probably helped that:
(1) I was at a very conservative university in the 90's, so no one around me thought anything abuse-worthy about my medication
(2) I only took one pill a day (time-release over 18 hours, and after that it was out of my system) so the idea of taking an "extra" one to keep going never occurred to me, and
(3) I was pretty naive as to what ADHD was, and how the meds helped, and that they could ever be abused.

If my son is ever diagnosed and medicated, I think he'll probably be as clueless as to what it's all about as I was. He'll take it with his vitamins.

Too bad they don't make Dexedrine like they used to...
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Old 06-19-17, 06:26 AM
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Post Re: Beware the addiction potential of amphetamines

Quote:
Originally Posted by Nifferka View Post
I took Dexedrine spansules from 7th grade until I finished college. My dosage had to be gradually increased as I gained tolerance, but I never abused my meds. No one ever asked me for them, either.

It probably helped that:
(1) I was at a very conservative university in the 90's, so no one around me thought anything abuse-worthy about my medication
(2) I only took one pill a day (time-release over 18 hours, and after that it was out of my system) so the idea of taking an "extra" one to keep going never occurred to me, and
(3) I was pretty naive as to what ADHD was, and how the meds helped, and that they could ever be abused.

If my son is ever diagnosed and medicated, I think he'll probably be as clueless as to what it's all about as I was. He'll take it with his vitamins.

Too bad they don't make Dexedrine like they used to...
As of the years 2013/2014, as a very long time user of brand SKF/later,
SKB/ eventually Glaxo Smith Kline both 1952 patented "Dexedrine Spansules" and, the 1937 patent, of brand name "Dexedrine" Instant Release
embossed Orange Hearts E-19, with a FDA rare rating of #1 in the Orange
book, both were discontinued, in Spring of 2009, Dex 5mg, and Dec 2010,
Dexedrine 10 and 15 ER Spansules, in US, Canada, UK and Australia.

My short term solution, to the high quality of Smith Kline pharma, was,
Barr Labs, of Pennsylvania, USA, a division of Teva, with their 10 or 15
mg extended release dextroamphetamine sulfate capsules, the generic for
brand discontinued Dexedrine beaded Spansules,for at least the years 2010,
2011, 2012, and 2013. Product shortages, plagued me in the SE USA the last two years, and, I had my USA psychiatrist, switch me over, to 100% generic
Adderall, again, by Barr Labs, a division of Teva, since Dec of 2008. The
Orange Book rating of Barr Labs of 17 categories, was no 2 for Barr labs,
generic or brand, as a AB code by the FDA.

Updating to then present, now the continuing IMHO poor quality generics, and or, the very expensive prices of brand ER Adderall XR, of, Focolin, of
especially Vyvanse brand name by ShireUS, the Insurance formulary
restrictions, and the VAST price increases of C-II stimulants both in brand, and generic, have caused me with product switching during the year 2012,
1013, and 2014, IMHO, to settle with just the Mallinckrodt generic version of the now discontinued ShireUS Dextrostat. It is rated by Orange Book as a AB rating out of 17 rating codes. I still prefer, brand SKF/SKB/GSK Dexedrine Spansules, but, the international firm, has sold the rights to all
worldwide production to different pharma entities, in the few countries it
is still produced, like Canada, and, I do not live in Canada, and as a controlled substance, I gave up on obtaining the new Dexedrine patented
manufacturer for Canada, or the UK or Australia.

Adderall, works great for me as brand name by Richwood, actually a
product name switch done legally from Rexal Pharma of Brooklyn NY, who
made the identical formula since the year 1965, as published in the 1966
Physicians Desk Reference. Even with the buy out by Shire US in 2002, I
was still content with Adderall brand, later, Adderall by Barr labs, as a excellent 10 mg i/R substitute, not remarkable different from the former,
Dextrostat, pure dextroamphetamine, made for decades, until 2009.

I have been very perturbed at the choices now left for those with bona fide
lifetime ADHD or ADD inattentive type, or Narcolepsy, or, Refractory
Depression. The choices on the generic market are in general poor substitutes compared to the time frame 1990 to about 2010.

I can live with generic Dextroamphetamine 10 mg I.R by Mallie as long as
they are manufactured. IMHO, I cannot tolerate any stimulants made by,
core, by ranbaxy, by, Wilshire, by, aurobindo, by Evikia, (another Wilshire
pharma product, or even now by the HTF med by what is left of Barr labs, now controlled by Teva pharma. The prices has risen out of my budget, since around 2014.

Technically, if I commit to my independent pharmacy, he will order, the
Dexedrine Spansule, patent holder is Amedra, for, a price range of from
$600.00 per month for 30 capsules, as the retail price, for 60 fifteen mg
Dexedrine Spansules, which have to be special ordered, was about one
thousand dollars in late 2014!!! My pharmacist wanted a commitment from me to be a regular customer of his "if he choose to special order this new
licensee of GSK, as, I apparently was the only customer willing to pay cash,
for the drug, out of his customer base, and, it is NOT on most USA insurance
formularies anymore.

As mentioned earlier, around the year 2012 on this forum we are back to the
1971 BNDD cutback of the (then) diet pills, being, placed under C-II, by
what became in 1973 as the DEA, with prescribing for diet suppression,
highly unethical and discouraged, as, ADD research was not released until
Russell Barkley, and Dr. Biderman of Chadd national conferences, by the
year 1990 to 1995, that ADHD was a bona fide treatable illness with either
amphetamines, or with methylphenidate.

The heyday of such national MD's as Paul Elliott MD of Texas with 25 years of treating ADHD children and adults, (now retired, years ago) have long peaked in the heyday of a progressive positive medical community promoting the use of stimulants for both adults, and children.

My aging MD told me boldly, two years ago, the high quality ADD meds are for the rich Americans, and, the rest, the DEA does not care about, and, the
remaining stimulant manufacturers are scrambling to get the left overs, in
a now declining number of total prescriptions written, especially for, the drug
Adderall Instant Release, and for Desoxyn instant Release. and Dexedrine
instant release, as the press has demonized those drugs as too addictive.unquote from my 72 year old Psychiatrist, who has stuck with me
for 18 years in a row.

Core and Wilshire pharma products either Dex brand, or Avidra, or generic
Adderall, I threw in the trash can they were so weak inconsistent, and, even gave me headaches, back in the year 2014-2015. Sandoz, Core, Ranbaxy,
and AuroBindo are D+ to a grade C for me and are unacceptable, Just my
humble opinion !!!

Last edited by namazu; 06-19-17 at 01:04 PM.. Reason: fixed quote tags for clarity
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