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  #1  
Old 05-07-12, 04:32 PM
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adderall and Physician issues

I posted a few different posts before i wanted to just revamp them and update what is going on here and maybe someone out there has had issues like such or can give advise.

I been on Adderall and suboxone for five yrs but recenty my reg doctor stopped practicing four months ago so i had to quickly seek anew doctor. Well It was a ***** because i didnt think of seeking out 2 doctors one for suboxone and the other for adderall becasuse the suboxone doctor now who has his younger doctor seeing me is trying to ******* cut my adderall. How do i know well i was on 90mg a day of adderall. NOw im down to 60mg and im complaining to him that its a ***** to get to tthis point.

What does he do this last visit he said maybe we will lower ur suboxone a bit be right back ok. I can hear the doctor outside the door going over my visit to i guess the main doctor and he said specifically my goal is to wean him off adderall. Really .well im gonna continue to see him for the suboxnoe and juyst find another docltor for adderall andf hey let him keep ******* cutting my adderall dosages i wont even fill the scripts as long as i find a new doctor for adderall. I cannot go below 60mg and he came back in and diad how about we lower ur secong 30mg dose to 15mg so that means 45mg and i freaked i said no i cant i dont know ill just do something eslse then he said well give it a month .

What is this doctors problem . why cant they keep me at this dose. I told them that adderall works great. and they wanna take me off it. No way. something is wrong. I know lowering the adderall to wean of subs maybe but its too much then . I cannot function if i dont take three doses a day of at least 20mg.

Last edited by BR549; 05-07-12 at 05:46 PM.. Reason: paragraph breaks
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Old 05-08-12, 08:46 AM
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Re: adderall and Physician issues

I may have said this before but you need a new doc. You need your old records and you deserve proper treatment.
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Old 05-09-12, 08:03 AM
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Re: adderall and Physician issues

Remember that YOU are paying the providers, who are working for YOU. if you don't like him, "fire" him, make an official complaint with the clinic, and find someone new. Do a little research and findout who has more experience. They also shouldn't charge you if you just want to meet and "interview" the provider.
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Old 05-09-12, 08:13 AM
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Re: adderall and Physician issues

Had to look up suboxone since I wasn't sure what it was. Anyway, I agree with other folks... time for a new provider! Are you seeing a GP? Mine turned out to be relatively worthless when it came to figuring out dosages let alone listening to what feedback and opinions I needed to share. She refused to take into account certain anatomical differences that were affecting absorption, but that's neither here nor there.

Like ScrambledSpunky says, you can FIRE them, or if you're not ready to do that, then you need to be polite but firm. Try not to get emotional but do make a point of getting your opinion across. (Edit: I say this because he may read your emotional response as a problem with your meds and/or resurgence of addiction.) Your description indicates he's not really listening and is being dismissive, running off before he has a chance to listen.

BTW, you can also request that the scheduler give you a longer appointment so you can corner your doctor for a better discussion. Normal appointments are 15-30 minutes for most providers in my experience, but you can request more time and point out that you're paying him and not the other way around. (Even if it's the state paying, like with me, lol.)
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Last edited by Shevey; 05-09-12 at 08:16 AM.. Reason: Adding a footnote...
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Old 05-09-12, 10:57 PM
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Re: adderall and Physician issues

Adderall has a high dependence liability. While the doctor should confront such issues with you directly, it is important to identify and treat instances in which dependence to the medication may be an issue.

It is important to note and discriminate between abuse and dependence. I am not suggesting you are abusing the drug - but rather you show symptoms of dependence. Please consider this when seeking out a new physician.

Best,
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Old 05-10-12, 05:49 AM
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Re: adderall and Physician issues

Quote:
Originally Posted by holepunch View Post
Adderall has a high dependence liability. While the doctor should confront such issues with you directly, it is important to identify and treat instances in which dependence to the medication may be an issue.

It is important to note and discriminate between abuse and dependence. I am not suggesting you are abusing the drug - but rather you show symptoms of dependence. Please consider this when seeking out a new physician.

Best,
He may think that 90mg a day is too much for anyone and you shouldn't need that much? I never knew people took such a high dose. Vyvanse for instance is only prescribed up to 70mg a day and that is generally considered less potent.

Do you have a pretty high tolerance or did you build one up? I hope you get what you need, if 90mg is what you need, I wish you the best. Have you considered (not recommending this) but trying to add some coffee to the mix? I don't know if that is safe or not but stims + caffeine seem to work well together as far as the effects go. Of course, if you have a fine tuned dose, then obviously, this won't help you. Many people sell stims, especially adderall. You may have to convince him that you aren't selling it and that your vitals on 90mg are completely fine. Not sure how you will convince him of both, hopefully your vitals are ok at 90mg.
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Old 05-10-12, 11:30 PM
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Re: adderall and Physician issues

Quote:
Originally Posted by js81pa View Post
He may think that 90mg a day is too much for anyone and you shouldn't need that much? I never knew people took such a high dose. Vyvanse for instance is only prescribed up to 70mg a day and that is generally considered less potent.

Do you have a pretty high tolerance or did you build one up? I hope you get what you need, if 90mg is what you need, I wish you the best. Have you considered (not recommending this) but trying to add some coffee to the mix? I don't know if that is safe or not but stims + caffeine seem to work well together as far as the effects go. Of course, if you have a fine tuned dose, then obviously, this won't help you. Many people sell stims, especially adderall. You may have to convince him that you aren't selling it and that your vitals on 90mg are completely fine. Not sure how you will convince him of both, hopefully your vitals are ok at 90mg.
Adderall has a maximum recommended dose of 30-40mg (depending on IR or XR release). Any dose above that is considered off-label and the prescribing doctor has an increased liability in prescribing the medication at that dose.

Further, you should know that at 90mg, Adderall (mixed amphetamine salts) is acting as a monoamine oxidase inhibitor, and reversing the DAT [dopamine active transporter] in dopaminergic neurons, causing massive down-regulation of dopamine receptors and may result in Major Depressive Disorder (MDD) if you ever decide to discontinue the medication.

Best,
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  #8  
Old 05-12-12, 05:30 AM
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Re: adderall and Physician issues

yes i was on 90mg a day with my first doctor and even my current doctor said it was way too high. BUt im down to 60mg. Now im concerned because it does work well and i dont wanna stop the adderall and i told them and they seem to not be listening trying to get me to lower the dosages more when i have to adjust to that new dose and it sucks. Im sure the doc goal is to wean me off the suboxone but i do have add and im not taking such a high dose so why wean me off adderall is what i heard him say. .
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Old 05-12-12, 08:25 AM
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Re: adderall and Physician issues

Quote:
Originally Posted by MindResearcher View Post
yes i was on 90mg a day with my first doctor and even my current doctor said it was way too high. BUt im down to 60mg. Now im concerned because it does work well and i dont wanna stop the adderall and i told them and they seem to not be listening trying to get me to lower the dosages more when i have to adjust to that new dose and it sucks. Im sure the doc goal is to wean me off the suboxone but i do have add and im not taking such a high dose so why wean me off adderall is what i heard him say. .
Some doctors have an aversion to prescribing schedule 2 narcotics. Some doctors are afraid to have patients taking amphetamines. In my opinion you need to get a new doctor, scrap your records with this doctor and get your original records and find a new doctor. Go to a doctor who specializes in Suboxone therapy and a separate doctor (psychiatrist) to treat your ADHD. I think then you will find things are a little less complicated.

Additionally the only thing your psych needs to know about your subs is that your GP is treating you with Subs for a different condition. And the only thing your GP needs to know about your Adderall is that your Psych is treating you for ADHD. If they are competent doctors they will respect the other doctors decision.
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Old 05-23-12, 01:41 AM
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Re: adderall and Physician issues

Quote:
Originally Posted by holepunch View Post
Adderall has a maximum recommended dose of 30-40mg (depending on IR or XR release). Any dose above that is considered off-label and the prescribing doctor has an increased liability in prescribing the medication at that dose.

Further, you should know that at 90mg, Adderall (mixed amphetamine salts) is acting as a monoamine oxidase inhibitor, and reversing the DAT [dopamine active transporter] in dopaminergic neurons, causing massive down-regulation of dopamine receptors and may result in Major Depressive Disorder (MDD) if you ever decide to discontinue the medication.

Best,
you should really reference your source when stating stuff like that.
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Old 05-23-12, 01:54 PM
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Re: adderall and Physician issues

Quote:
Originally Posted by holepunch View Post
Adderall has a maximum recommended dose of 30-40mg (depending on IR or XR release). Any dose above that is considered off-label and the prescribing doctor has an increased liability in prescribing the medication at that dose.
I take 80mg XR (40mg bid) and I think many people are prescribed more than 30-40mg/d. There is no more risk for docs prescribing 10mg than 100mg/d. The liability comes from not knowing what you are doing and therefore causing a bad outcome. If the doc prescribes 20 mg XR to a patient and the patient has a bad outcome the doc will they not do anything or look into the case b/c it was only 20 mg. Standard of care is determined not by what the drug companies say but by what the average doc in that specialty would have done. If all or most docs are prescribing 2000mg/d then that is the standard of care and will hold up in any court.
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Old 05-23-12, 02:19 PM
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Re: adderall and Physician issues

Quote:
Originally Posted by holepunch View Post
Adderall has a maximum recommended dose of 30-40mg (depending on IR or XR release). Any dose above that is considered off-label and the prescribing doctor has an increased liability in prescribing the medication at that dose.

Further, you should know that at 90mg, Adderall (mixed amphetamine salts) is acting as a monoamine oxidase inhibitor, and reversing the DAT [dopamine active transporter] in dopaminergic neurons, causing massive down-regulation of dopamine receptors and may result in Major Depressive Disorder (MDD) if you ever decide to discontinue the medication.

Best,
I would need sources for this. 60mg is the maximum that is approved for narcolepsy so I think that it could also be suitable for an adhd adult.
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Old 05-23-12, 05:02 PM
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Re: adderall and Physician issues

Quote:
Originally Posted by holepunch View Post
Adderall has a maximum recommended dose of 30-40mg (depending on IR or XR release). Any dose above that is considered off-label and the prescribing doctor has an increased liability in prescribing the medication at that dose.

Further, you should know that at 90mg, Adderall (mixed amphetamine salts) is acting as a monoamine oxidase inhibitor, and reversing the DAT [dopamine active transporter] in dopaminergic neurons, causing massive down-regulation of dopamine receptors and may result in Major Depressive Disorder (MDD) if you ever decide to discontinue the medication.

Best,
Actually, holepunch is correct when it comes to prescribing dose of Adderall IR.

Adderall IR is not approved for treating Adult ADHD.

http://www.shire.com/shireplc/en/inv...irenews?id=544

Quote:
Shire developed ADDERALL IR, and the FDA approved ADDERALL IR as a treatment for ADHD in children in 1996
Adderall XR was the first stimulant approved for treating adult ADHD.
www.medicalnewstoday.com/releases/12048.php

From Barr's 2007 Adderall IR prescribing guide (now archived at the FDA.gov)http://www.accessdata.fda.gov/drugsa...522s040lbl.pdf, page 12:

Quote:
Attention Deficit Hyperactivity Disorder:
Not recommended for children under 3 years of age. In children from 3 to 5 years of age, start with 2.5 mg
daily; daily dosage may be raised in increments of 2.5 mg at weekly intervals until optimal response is obtained.
In children 6 years of age and older, start with 5 mg once or twice daily; daily dosage may be raised in
increments of 5 mg at weekly intervals until optimal response is obtained. Only in rare cases will it be necessary
to exceed a total of 40 mg per day.
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Old 05-26-12, 08:59 PM
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Re: adderall and Physician issues

I always thought the maximum dose was 30mg at least thats what the dr. Said
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Old 05-26-12, 10:55 PM
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Re: adderall and Physician issues

Quote:
Originally Posted by holepunch View Post
Adderall has a high dependence liability. While the doctor should confront such issues with you directly, it is important to identify and treat instances in which dependence to the medication may be an issue.

It is important to note and discriminate between abuse and dependence. I am not suggesting you are abusing the drug - but rather you show symptoms of dependence. Please consider this when seeking out a new physician.

Best,
no **** sherlock . Buperenorphine and amphetamin cause dependence... He's dependent? Kind of the point of maintenence, eh. Or maybe it's best for opioid addicts to go relapse(possible od) with no tolerence and buy adderall off the street. No, the fact is there are way too many of these morons doing this out there. Not everyone can take med holidays like you. Some get so depressed a hit of smack and street speed? ...is that the answer? NO, YOU MIGHT KNOW REUPTAKE VPAT JARGON BUT NOT THE COMPULSIVE FEELING OF ADDICTION. His addiction is in remission, leave him be and youre just gonna have to get a new dr mindresearcher..proper dosage is an art

Last edited by AddYourAll; 05-26-12 at 11:06 PM..
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