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Old 11-05-18, 09:06 PM
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Do you think 15 - 16 hours of coverage is reasonable?

I ask this question because I'd like to hear other peoples success story, if they were able to achieve this target of mine. My concern, as it currently stands, is that my doctor will be the type who likes to go by the book. I've heard horror stories of people who had doctors refuse to prescribe stimulants once they hit their max. When I was on Concerta before switching over to Adderall, I mentioned to her how I read from one source about the possibility a patient could be prescribed more than the DRD for stimulants. She said it's not unheard of.

If by chance she doesn't agree with my goal, does anyone know of a study showing that patients can be both safely and effectively covered during that time frame? Like many, I have really bad ADHD, (inattentive.) 10 hours isn't enough time for me; I agree with the premise that ADDers should be covered by medication for 14 - 16 hours. Is it really just a matter of what kind of doctor you have and their willingness to treat you, or are doctors today no less informed than the 90's?


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Old 11-05-18, 09:34 PM
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Re: Do you think 15 - 16 hours of coverage is reasonable?

The problem is that taking this med too late in your day can prevent you from
getting enough good deep sleep.
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Old 11-05-18, 10:39 PM
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Re: Do you think 15 - 16 hours of coverage is reasonable?

If you're up by 6am and still need to function at 9pm then 14 to 16 hours is reasonable because that's just your life. I had aj increase on that basis when I uses to take meds. Talk to your doctor. If you don't need them that late every day then just don't take the last dose.
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Old 11-05-18, 11:36 PM
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Re: Do you think 15 - 16 hours of coverage is reasonable?

Reasonable, yes. Attainable without maxing out side effects? Not in my experience.
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Old 11-06-18, 12:57 AM
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Re: Do you think 15 - 16 hours of coverage is reasonable?

I am one of the people who needs a lot of coverage due to how early I wake up and what I do during the day. I also had a genetic test from my doctor that showed I am a fast metabolizer of meds. I take 20mg of xr adderall 3x a day and 1 20mg ir adderall 1 x a day for a total of 80 mg. I was at 60 for many years but that late day coverage is needed so thats why I have the instant release as a booster dose.
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Old 11-30-18, 05:59 PM
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Re: Do you think 15 - 16 hours of coverage is reasonable?

Quote:
Originally Posted by mets91428 View Post
I ask this question because I'd like to hear other peoples success story, if they were able to achieve this target of mine. My concern, as it currently stands, is that my doctor will be the type who likes to go by the book. I've heard horror stories of people who had doctors refuse to prescribe stimulants once they hit their max. When I was on Concerta before switching over to Adderall, I mentioned to her how I read from one source about the possibility a patient could be prescribed more than the DRD for stimulants. She said it's not unheard of.


Thanks for reading.

I used to be prescribed Adderall IR with a Dextrostat booster later in the day when I was working multiple jobs and in school. That seemed to work the best for me because my body didn't have to endure the physical stress of additional Adderall (and the PNS stimulation that goes with it).

Right now I have one really long day a week and to keep my brain working well for most of it, I only add 5mg more meds than regular days (under doc approval), and take it early enough that I can get to sleep at the end of the long day.

SarahSweets is smart to get the DNA test to show her high metabolism - that makes the doc's job easier to justify her treatment plan.

So many factors work against us getting adequate treatment - the insurance companies playing doctor, general hysteria about medications, people who abuse/misdirect them, and your doc has to justify her decisions. Bringing info like the DNA report to the visit definitely helps your case.
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Old 11-30-18, 06:05 PM
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Re: Do you think 15 - 16 hours of coverage is reasonable?

ANOTHER THOUGHT ON MED EXPECTATIONS TO THE OP

Sometimes our lives (both before and after treatment) haven't been as productive as we'd like due to ADHD, and for me, there's always a sense of "I've gotta catch up!"

We might find better results with our first forays into medication treatment if we first focused on merely getting a "reasonable day" from our dosage. [Pause for incredulous laughter - seriously, just expecting a "reasonable day"? Puh-leeeze! ]

Of course I didn't expect that from my first medication treatment. Oh, NO! I expected meds would make my brain perfect, and in doing so, I could also simultaneously "fix" all those years of feeling like I was "less than" due to incomplete projects, etc., and hopefully, I could get it all done before lunch and start working on building a space shuttle in my backyard (that would probably be done before dinner?).

Also, a lot of things we never tried before turn out to be more fun with a medicated, organized brain, so your world may get bigger after treatment. You have the confidence to try things that you wouldn't have when you were busy fighting the ADHD gremlins.

Medications can make our worlds so much better and bigger, but there's a tipping point on the bigger/better where it quits being that.

From someone who has been there/done that, I just want to say that yes, absolutely enjoy the newer, bigger world provided by meds/treatment, but at the same time, be aware of the possibility of undermining your impending success by taking on more than you can reasonably enjoy. I did. I failed. It sucked. No medication can add ten more hours to each day.

Of course, the caveat is that a lot of us HAVE to work a bunch of jobs to stay afloat, but that's not my point. Plus, if you're in school, you often don't have a choice as to how long your days will be, and you DO need adequate coverage on meds - you're not trying to add hours to the clock, you're just trying to get through school/work/life.

Just something to think about with your journey. Life is hard, and if I can make it easier for anyone else via sharing my experiments in ridiculous expectations and pain, I would happily do so. I do hope you can find the right treatment that makes life work well for you!
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Old 11-30-18, 10:17 PM
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Re: Do you think 15 - 16 hours of coverage is reasonable?

I think 16 hours would be absolutely great.
I wouldn't expect getting that much though. I usually get about 3-5 hours each dose. Even though I can take my adderall 3 times a day...I don't really think I reach 15 hours usually. I'd say it's much closer to about 10 hours of effective coverage.

My pill lady is by the book too...though she is SUPER awesome, non judgmental, and has been surprisingly open to my experimenting to find what works for me.

I'm on the max daily dose she'll prescribe (60 mg...20mg 3x daily), but over the last few months I've been taking 2x 20mg pills (40mg) in the morning, than later in the afternoon I take another 1 or 2 20mg pills. That means I take 20mg more than she's willing to give me...and when I told her this, I thought she'd be upset about it...and though she was maybe a tad bit annoyed with it, she was understanding too and not upset...she said her hands were a bit tied and really couldn't give me a higher dose...and she was also concerned about me running out of my meds early...which is almost never an issue for me as I always skip doses or entire days quite a bit when I just don't need the meds that day.

Sorry for the long reply.
I wish I could get a full 14-16 hours of effective coverage...but it doesn't happen for me. Also, like others have mentioned...I think it would really mess with my sleep (and I already have enough sleep issues as it is!).

I'm wishing you the best!

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Old 03-02-19, 09:49 PM
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Re: Do you think 15 - 16 hours of coverage is reasonable?

Quote:
Originally Posted by psychopathetic View Post
I think 16 hours would be absolutely great.
I wouldn't expect getting that much though. I usually get about 3-5 hours each dose. Even though I can take my adderall 3 times a day...I don't really think I reach 15 hours usually. I'd say it's much closer to about 10 hours of effective coverage.

My pill lady is by the book too...though she is SUPER awesome, non judgmental, and has been surprisingly open to my experimenting to find what works for me.

I'm on the max daily dose she'll prescribe (60 mg...20mg 3x daily), but over the last few months I've been taking 2x 20mg pills (40mg) in the morning, than later in the afternoon I take another 1 or 2 20mg pills. That means I take 20mg more than she's willing to give me...and when I told her this, I thought she'd be upset about it...and though she was maybe a tad bit annoyed with it, she was understanding too and not upset...she said her hands were a bit tied and really couldn't give me a higher dose...and she was also concerned about me running out of my meds early...which is almost never an issue for me as I always skip doses or entire days quite a bit when I just don't need the meds that day.

Sorry for the long reply.
I wish I could get a full 14-16 hours of effective coverage...but it doesn't happen for me. Also, like others have mentioned...I think it would really mess with my sleep (and I already have enough sleep issues as it is!).

I'm wishing you the best!

(((Hugs)))
I've been on ADHD psychostimulants since age 14 - I'm 34. I'm a type 1 diabetic and have been able to micromanage everything for more than 20 years. Also have celiac disease and low Testosterone: it's a trifecta of autoimmunities. In any event my psychiatrist - whom I really like - has been steadily decreasing my total daily dosage from 60mg about a year and a half ago to now just 35mg a day. I've gained weight, its harder for me to micromanage my glucose and other meds as well, my apartment is a lot less organized, which again also adds insult to injury in terms of locating and organizing my insane medication regiment. I'm really uncomfortable asking him to please reinstate a higher dose, one that did not cause me side effects and actually gave me more than a couple of hours. I wanted to support his decision to gradually reduce but now I'm not happy with the 35mg (20mg and 15mg) and its getting to the point where I just can't balance everything as well. Should I re-attempt another conversation with him or what would you propose?
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Old 03-03-19, 07:57 AM
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Re: Do you think 15 - 16 hours of coverage is reasonable?

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I've been on ADHD psychostimulants since age 14 - I'm 34. I'm a type 1 diabetic and have been able to micromanage everything for more than 20 years. Also have celiac disease and low Testosterone: it's a trifecta of autoimmunities. In any event my psychiatrist - whom I really like - has been steadily decreasing my total daily dosage from 60mg about a year and a half ago to now just 35mg a day. I've gained weight, its harder for me to micromanage my glucose and other meds as well, my apartment is a lot less organized, which again also adds insult to injury in terms of locating and organizing my insane medication regiment. I'm really uncomfortable asking him to please reinstate a higher dose, one that did not cause me side effects and actually gave me more than a couple of hours. I wanted to support his decision to gradually reduce but now I'm not happy with the 35mg (20mg and 15mg) and its getting to the point where I just can't balance everything as well. Should I re-attempt another conversation with him or what would you propose?
Yikes, that's a lot of medical stuff to deal with

That really sucks that he's been decreasing your dose. Why did he do so?

I'd absolutely bring it up to him...you don't have to be direct with him and flat out ask him to increase again...you might find a way to word it like telling him something like you just said here...that since he's lowered your dose you've been having a tough time keeping on top of everything.

I wish everyone had a doctor that was as open and trusting as mine ...I still get nervous with her, but she really has been very good to me and I'm now at a point where I don't feel afraid she's just going to think I'm a drug seeker or something. It was a real fear of mine with her at first.

I really hope things work out for you and you can be put back on a better dose that helps.
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Old 03-14-19, 08:47 AM
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Re: Do you think 15 - 16 hours of coverage is reasonable?

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Originally Posted by dprice218 View Post
I've been on ADHD psychostimulants since age 14 - I'm 34. I'm a type 1 diabetic and have been able to micromanage everything for more than 20 years. Also have celiac disease and low Testosterone: it's a trifecta of autoimmunities. In any event my psychiatrist - whom I really like - has been steadily decreasing my total daily dosage from 60mg about a year and a half ago to now just 35mg a day. I've gained weight, its harder for me to micromanage my glucose and other meds as well, my apartment is a lot less organized, which again also adds insult to injury in terms of locating and organizing my insane medication regiment. I'm really uncomfortable asking him to please reinstate a higher dose, one that did not cause me side effects and actually gave me more than a couple of hours. I wanted to support his decision to gradually reduce but now I'm not happy with the 35mg (20mg and 15mg) and its getting to the point where I just can't balance everything as well. Should I re-attempt another conversation with him or what would you propose?

There is some connection, based on what I’ve read so far, with adderall causing lower testosterone (something to do with cAMP in the testicles). I would assume it’s more of a problem with long term constant use.

I’ve had symptoms of low testosterone for some time now, creeping up ever so slowly. I tested at 330 2 years ago, which is ridiculously low for a 36 year old me. The endocrinologist ignored that and wanted to prescribe statins for cholesterol (I was fit, not over weight). After finding out about this side effect I stopped taking meds for a few days and have already started to feel better.

Testosterone affects too many things to not have it optimized. I would look into this before I asked for an increase in adderall if I were you. I’ll be talking to my doc at my next appointment to see what route to take moving forward.
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