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Old 08-11-14, 03:46 PM
Kimbosqueak Kimbosqueak is offline
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Should I request a dose increase now? +other questions

Hi. I was switched from Ritalin to Concerta to Adderall just last month. I am on 10 mg IR twice a day. The doctor gave me 60 pills and I don't see him until mid September. I don't take it everyday because I am on summer break, but I still take it fairly frequently when I feel I need it. I was only able to feel it kick in on the very first dose, but even on subsequent doses I could tell it was working a bit. I've noticed it doesn't last more than 3 hrs, however, and I have fallen asleep in that amount of time. Then, last week, I became tired after taking a pill and decided to take another which worked. I noticed this continue to happen when taking just one on my first dose of the day, so I recently started taking 20 mg instead of 10 and I find that it works quite well. The problem is, my fall semester starts on the 25th and I'm not sure if it will last long enough for me to wait until sept to request the increase and pick up another Rx. I was going to wait until then, but now I'm contemplating sending him an email or calling earlier instead. Would this be a little much considering the switch was just made? Also, should I admit to trying a higher dosage w/o his permission or should I leave that out? I have admitted to him before about taking more Ritalin than prescribed for stronger effect while studying and he didn't seem to care much, simply told me to be careful. He is an Rx happy doctor from my experience.

Because I do get insomnia from higher doses of this drug when taking it in the late afternoon, is it a good idea to start out with 20 mg in the morning and just 10 in the afternoon? This is what I would prefer for now rather than just jumping straight to 40/day and possibly needing sleeping pills, if those would even work. I remember taking 20 mg between 5-6 pm and the cough syrup that I've been taking didn't even make me tired when it normally would have knocked me out. I'm also concerned about the high heart rate that comes with this medication for me. If the 30/day doesn't work out though then I will still consider 40/day, but probably nothing more than that. I will just have to take the second dose as early as possible. This brings me to another question. While the Ritalin worked wonders and led me to better grades, my prescribed dose of 15 mg twice a day just wasn't very strong and lasted me all of two hrs, if that, which is why I was put on Adderall after a horrible experience with Concerta. Because of the insomnia experienced on addy, I can forget about using it for evening study/homework sessions. I don't even want to risk it with a small dose. Is it outrageous to request an Rx for rit on top of addy for late use? I know I can hope that the afternoon addy dose will last long enough for evening work, but I'm not sure that will be enough. Even with medication in my system either way, there was a huge difference between a low dose paper and a 30 mg paper on Ritalin. This option would also help me take addy breaks on weekends while still helping me get things done on weekends. I still have some rit left and alternate between that and addy to help save the addy for school use. I haven't noticed any adverse effects from taking both even on the same day. If I am going to ask for this, how would I go about explaining this in a convincing way?

Last question, if not for obtaining rx's for both simultaneously, how about alternating between rit and addy to prevent tolerance issues with the addy? Would the psych be more likely to go for this instead? I'm less enthusiastic about this one because other than to prevent tolerance and dependence to the addy, I find this unnecessary. Like I said, the rit doesn't last very long and I would need a high dosage. I have clusters of classes coming up that would make this difficult. Last semester I was constantly redosing or taking more than prescribed to last through a 5 hr pair of classes. Going back to a regular dosing of this stuff would make no sense. Should taking 3 days off addy per week be enough to make this redundant?

That's all I can think of for now. Thanks in advance. P.S. I do understand that taking more than prescribed w/o authorization is an issue, but try requesting increases when your dr is always going away on vacation. The covering dr would give me the refill, but not the increase.
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Old 08-13-14, 12:00 AM
Kimbosqueak Kimbosqueak is offline
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Re: Should I request a dose increase now? +other questions

Not sure how to edit to avoid double posting, but I wanted to add that you don't have to answer every question at once. If you have answers or opinions for either one, then please share.
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Old 08-13-14, 04:33 AM
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Re: Should I request a dose increase now? +other questions

I'm All for honesty with A doctor. There is no cross tolerance with Ritalin and adderall. I'm not even sure I believe in tolerance I'm it's typical definiton. I would make an appointment and tell the doctor that you need a higher dose and go from there.
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Old 08-13-14, 03:55 PM
Kimbosqueak Kimbosqueak is offline
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Re: Should I request a dose increase now? +other questions

Quote:
Originally Posted by sarahsweets View Post
I'm All for honesty with A doctor. There is no cross tolerance with Ritalin and adderall. I'm not even sure I believe in tolerance I'm it's typical definiton. I would make an appointment and tell the doctor that you need a higher dose and go from there.
Thanks! I'll be making a call today to ask for an increase. What exactly do you mean by cross tolerance?
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Old 08-14-14, 03:20 PM
Kimbosqueak Kimbosqueak is offline
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Re: Should I request a dose increase now? +other questions

Apparently my pdoc is still on vacation so I won't be getting the increase until next week. I still want to know if its a bad idea to request an Rx for Ritalin on top of the Adderall? I will be waiting until I see him in sept if I decide to go for it.
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