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Old 10-30-03, 08:16 PM
DeafGuy DeafGuy is offline
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I'm on Adderall, but would like to understand it better...

Hi, I'm new here, but I'm hoping to find some useful information for working with my ADD.

Background: I've ALWAYS had difficulties in school, including dropping out of high school once, and university three times. I then ended up working in Internet-related IT and did pretty well for myself for several years in a wild and fast-paced working environment, then ended up getting laid off during the dotcom bust. At that time, I figured it was a good time to go back to school and get my degree, now that I'd settled down, proven myself, etc.

I had ended up concluding that my deafness was the key factor in my school difficulties, because I was pretty much always in schools with poor accomodations and communication was a constant challenge. So this time, I'd figured out that angle, and the college I'm now attending is known for its accomodations for deaf students--they haven't disappointed, either, they've been absolutely terrific.

I started well enough there a year ago, but by the end of the semester, I was starting to flounder even after dropping one of my three classes earlier in the semester. The next semester was worse--even after going from 4 classes down to 2, I was still drowning, and this time I finally figured out that there was something more than simply being deaf in the mix.

Ironically, my wife is a teacher for special needs students, and that's when she noticed that my difficulties were similar to her ADHD student. That started the ball rolling, we started researching ADD on the web, taking the self-diagnosis tests, talking to people, etc. It was very frustrating, some people along the way pooh-poohing the whole idea, telling me I just needed to work harder (which was BS, I'd never wanted anything so badly in my life as to do well in school this past year, and I'd already proven I have no difficulty working hard), others decrying the usage of medications, etc, and then dealing with trying to find a neurologist or psychiatrist available under our insurance plan. That took the better part of the year, but I finally wrangled a psychiatrist appointment right before school started, and he did this "TOVA" test, which indicated I have both ADHD/inattentive and ADHD/hyperactive tendencies, although I would have only figured for the former.

So, a couple weeks after this semester had already started, the psychiatrist put me on a daily dose of 30mg of Adderall, 20mg in the morning, 10mg in the evening. I was disappointed that he gave me no other instructions, no explanation of what to expect, nothing. Just a, "here, take this dosage for the next 30 days, then come back" and escorted me out. But OK, after all I'd read up on everything, this was what I wanted anyhow.

I couldn't wait, so as soon as I got home that evening, I took the first 20mg pill. And WHOA!, that kept me bright-eye awake all night, such that I barely managed to sleep for two hours.

Next morning, I took the second pill, and despite the minimal sleep which should have sunk me, I still got 18 out of 20 on the Calculus quiz that day.

But the real eye-opener came a few days later, the next week. With the weekend and class schedule, I ended up attending my first class lecture 5 days after starting the prescription. And there, words utterly fail me, it was just waaaay beyond any expectation I'd had.

Now, before that time, I'd dutifully attend lecture, and although I had problems with daydreaming and not focusing and such, I COULD focus sometimes. I could understand what the teacher was saying (via ASL interpreter or real-time transcription). But when class was over, I'd have to crack the book and pore over the text to figure out how to do my homework.

But that day, it was like I'd lived in a deep, dark cave all my life, and someone finally led me out and showed me the sun. I'm not kidding, it was simply amazing. I finally actually connected to what the teacher was saying, not merely understanding the words, but grasping the meaning behind them. After that, I could home and do my homework straight off the problems, without referring to the text. Aha! Class lectures aren't merely a torture device after all! Who knew?

But wait, there's more! Homework got more easy, I could sit down and do an assignment in one sitting, or at least work up to a reasonable point. Indeed, I experienced something new, where I'd look at home many problems and think, "OK, I'll do 3 more, then take a break." And then I'd do those three, and I didn't feel like taking a break, so I'd keep going. And going. And going.

Wow.

I'd actually dropped out of this same Calculus last semester halfway through, and I was as clueless at the end as I'd started out. But this time, it's just way different, I'm not merely doing the homework and squeaking by on the tests, I'm actually learning it. Limits and derivatives make sense now. I can do them forward and backwards, and they're FUN. I'm wishing I could go back and retake trigonometry, because that was pre-medication and I don't understand it the way I'm understanding calculus now.

And housework. All these years, I'd felt like a lazy bum for bailing out and not helping my wife clean around the house (we have three young kids, so that's a LOT of cleaning). I always WANTED to, but I could never quite seem to get to it. I didn't understand then, and heck, I still don't understand now what's so "hard" about that. Just pick up things. Clean off the table. Put dishes in the dishwasher. Easy stuff. Except it wasn't. Then I started the Adderall, and ohmyheck, IT IS EASY! My wife is on cloud 9 because she doesn't have to clean the kitchen anymore, because I find it so flippin' easy to do it every night now. And I still can't figure it out...

Again, wow.

Sure, there's the side effects. The most immediate was the lack of sleep. For the first several weeks, I forgot what it was like to feel sleepy. I could feel my body running down, but I just never got mentally sleepy, which worried me enough that I skipped the pills one weekend and conked out for something like 14 hours. Occasional nausea early on, but mostly gone now. Very bad dry mouth, but I figured that for a good thing, since it reminded me to drink more water, since I tend not drink enough. And no appetite--I could forget to eat and never realize it, but then that wasn't so bad either, because I am trying to lose weight. I just need to remember to eat enough to maintain a healthy diet, and no longer have to try not to overeat.

So, mostly not bad stuff. But I still get this "jittery" feeling, something I can't really pinpoint, but makes me feel unsettled. And a couple of times, I've forgotten my morning pill, and when I do that, whoa, it really screws up my day. I accidently did that last week, day before homework was due, and I'd done enough that I'd planned to finish up that day appropriately. But I forgot my morning pill, didn't realize it until I saw my pill dispenser and noticed it was still there. Instead, I went to class, got all befuddled at why I'm sleepy and braindead, then came home and just collapsed on bed for the rest of the day, ended up not being able to finish my homework by the deadline.

I forgot again yesterday, and no urgent deadlines this time, but wow, it just really messed up my day, such that even when I tried taking the full pill after class, I still ended up being non-functional for the rest of the day.

I REALLY dislike being so utterly dependent on a pill. Yuck. But, it helps in an amazing way, so I'm willing to put up with it for at least getting through school.


And OK, that "background" got far longer than I intended, sorry! But I have some questions.

My psychiatrist is a nice enough guy, but he's doesn't tell me anything. At the first 30-day appointment to review and renew my prescription, he went through my journal notes, asked a few minor questions, then offered that if I wanted, I could take the full 30mg in the morning and not worry about taking an evening pill. And that's it. I get the impression that he simply doesn't know any more, after all, he's not like an ADD specialist or anything, just a general psychiatrist. (and I can't really switch, the insurance options are too limited)

So, I want to understand better how to do all of this. As I'm winding up my second month, I'm finding that even with the regular dose, I'm starting to slip backwards into some old behavior, starting to bounce around when doing my homework, etc.

Some of this, I find, relates to the time interval since my pill. I note the best effect starting ~2 hours after the morning pill, and gradually wearing off after that, though I haven't pinpointed the interval yet. Since the doc suggested it, I've tried taking the full 30mg in the morning a few times, and that seems to heighten the effect so I do better in class and on homework...if I do the homework soon enough.

So, I tried taking the dose at 10am instead of my regular 7am time, so the effect would be best during my noon class and immediately afterwards for my homework. And it seems to make a distinct difference. Except then my early mornings are messed up, because that's the period in which I've been without a pill for the longest period--and that's also when I started forgetting my doses and messing up my day.

I sort of hate playing guinea pig with myself, especially when it has a fairly direct impact on my school performance. There's also a bunch of other factors that muddy the waters and make it more difficult for me to pinpoint what's causing what.

I started the South Beach low-carbo diet last June and I've lost over 40 pounds, which has slowed down lately, but is still on a downward trend. I've also been trying to exercise more regularly, specifically, running, something I've tried to do off and on for a couple years, but now I'm running more regularly, often 3 or more times a week. Coincidentally, the Adderall seems to help me run a lot better, too.

But, I'm wondering what effect all of that has on the medicine's effect. I get the impression that if I run after taking my morning dose, the effect of the medicine is reduced. I still haven't figured out if taking my dose before or after meals makes a difference, although I imagine it would.

Etc.

So, can any of you help me figure out what kind of schedule I should follow? When's best to take the medicine? How much of a diference does a full morning dose make versus a split morning/evening? How does running for an hour effect it? Is it better to take it before or after the exercise? How do meals affect it, and what's the best approach there?

I don't want to get on an unending cycle of increasing dosage, but I do feel like the effect is less lately. Is it worth asking my psychiatrist next week to raise the dose from the currently daily 30mg?

What's the downside here, besides what I've already noted?

Is there anything else I should know?

Thanks!
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Old 10-31-03, 12:26 AM
Wheel1975 Wheel1975 is offline
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But I still get this "jittery" feeling, something I can't really pinpoint, but makes me feel unsettled.

That sounds like you have just a smidgin too much at a time. Spread it out a little, or instead of taking 10mg at once take 5 mg two hours apart. Check this with your doctor first.
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Old 11-01-03, 01:37 PM
Margreet Margreet is offline
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My results with Adderall, or any of the stimulants, is that they seem to make a big difference at first, and then less and less as time goes on. I'm not sure if I develop a tolerance to the meds on a physical level, or if I just forget what it's like without them.
All I have to do is go without them or take an inadequate dose: I wear out the brakes on my truck with panic stops, and I'm irritable as can be!

Your doctor is like a lot of doctors; I suspect they don't want to tell you what to expect because they don't know, and they don't want to color your results with their expectations.

I've learned to ask a few questions: can I stop this medication without tapering off, if I just can't tolerate it? Can I experiment with the doseage and the times I take it without harm? Usually, with stimulants, there's no problem, except for insomnia if I take it too late, or excessive sleepiness if I miss a dose. The shrink says that's a withdrawal effect.
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Old 11-01-03, 02:37 PM
Wheel1975 Wheel1975 is offline
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Also some people find their maximum dose, under the direction of a doctor, by grandually taking more until the stimulant make them sleepy... a paradoxical effect not uncommon for people with ADHD.
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Old 11-14-03, 12:42 AM
Mz_Desz Mz_Desz is offline
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I don't undestand why your doctor would have you splitting up your dosage. My son takes 30 mg at 8:00am and it last well after he gets home from school. Taking that 10 mg in the evening is the reason you aren't able to get to sleep. This med can cause insomia.

Edited to say I'm a fellow locarber to....I've been doing Atkins on and off for a little over a year. I'm taking it slow though...I don't want to lose to fast....25lbs so far...congrats on your weight loss!
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Old 11-14-03, 06:54 AM
Mz_Desz Mz_Desz is offline
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I forgot to mention that my son is on Adderrall XR. It last longer than 8 hrs...more like 12 hrs. You only take it once a day. My son was on plain adderrall to with no problems and he only took it once a day....just switched so he could have more time.....
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Last edited by Mz_Desz; 11-14-03 at 07:22 AM..
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Old 12-05-03, 12:29 PM
Bullitt78 Bullitt78 is offline
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Re: I'm on Adderall, but would like to understand it better...

[quote]And housework. All these years, I'd felt like a lazy bum for bailing out and not helping my wife clean around the house (we have three young kids, so that's a LOT of cleaning). I always WANTED to, but I could never quite seem to get to it. I didn't understand then, and heck, I still don't understand now what's so "hard" about that. Just pick up things. Clean off the table. Put dishes in the dishwasher. Easy stuff. Except it wasn't. Then I started the Adderall, and ohmyheck, IT IS EASY! My wife is on cloud 9 because she doesn't have to clean the kitchen anymore, because I find it so flippin' easy to do it every night now. And I still can't figure it out...[quote]

Wow somoeone that had the same thing as me. I'm new here but I read this and Started laughing. I had this same revelation at my house. My wife actually asked me to stop cleaning so that we could go somewhere. It's so cool to hear a story like this and have a big grin on my face knowing what you are feeling.
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