Newly diagnosed and put on 60 mg adderall -- too high?

[necromancer]

I was recently diagnosed by a psychiatrist as having adult ADD (or i suppose ADHD-inattentive's the right term now?) and told to take 3 x 20 mg dose of adderall xr to start out with, three times a day for the first month. this seems like an inordinately high beginning dose. i am a 27-year-old, 5'11, 116-pound woman. the doctor didn't consult my previous chart in any way and seemed to make this evaluation on the basis of my conversational style, which is somewhat erratic, and a prevalent pattern of ADHD in my family. my life has a disorganized and chaotic pattern that might reflect ADD, and i have thought this for some time: on the other hand, despite having struggled and possibly achieved below my capabilities in life, i also managed to be high school valedictorian and experienced some level of academic success. so i don't know. adderall, after 2-3 days of doing this, tends to calm me down although i feel as if i'm crashing within 6 hours or so into a slight state of depression - i don't feel inspired to clean my house, etc., more just like sitting around, and my motivation at work hasn't improved. in short i can see how there would be benefits to this, but i'm a little concerned about whether i should be concerned about possible addiction/dependence issues, excessive weight loss given my current weight, etc. given that i haven't received the most thorough evaluation. My inclination has been to just take the meds as prescribed - I was told it would "change my life". And I do feel better, no trouble with sleep etc. really, but it seems that people generally start adderall at a much lower dose and I'm concerned about developing some kind of immediate tolerance to it. My boyfriend's been severely ADHD since he was a child and is just prescribed 2 x 20 mg adderall a day, which he uses primarily when studying and attending classes and with holidays on the weekends. Any advice about what I should do with the meds? I just want to be prudent (and maybe wash some of the dishes this weekend) and I'm wondering if you guys could help me. i've read elsewhere that if one really doesn't have ADD, addiction can become a problem...but the advice on the internet is sort of contradictory. i've read that if you don't really have the condition, adderall will affect your brain differently and have a calming effect...however, reading and hearing other people's descriptions of what the prescribed vs. non-prescribed meds actually do for them, the effects don't seem to vary all that much. Is there anything I can gauge in my own reaction to the drug that might let me know if I'm misusing it? I didn't mean to do this irresponsibly, and of course these are prescribed through a doctor, but I just want to make sure.

Thanks very much, and I would love to hear anything you'd have to say - I'm a little worried. Sorry for the epic length of this post but I've been freaking out reading stuff on the web for a few days.

nicole

[Crazy~Feet]

Dosage is based on severity of symptoms, not on body weight or height. I took 30 mgs for 4 days then 60 mgs thereafter.

[speedo]

The street wisdom is that if you do not have ADHD, adderall will speed you up, and that if you DO have adhd hyperactive type, it will slow you down. In real terms , everyone is a little different. If you take 60 mg adderall 3 times a day and can still sleep , it is similar to experiences that others with adhd have reported on this forum. The street wisdom would suggest that this is typical for people with adhd. In contrast, one would expect a non-adder to be very, very speedy on that much adderall.

The reality is, if you take enough of it, you will speed up. ADHD or not.

The trouble is, everyone is a little different. Some people are very good metabolizers of medication and it takes lots of it to work at all for them. Other people are not good metabolizers and will only need tiny amounts ofstimulants to be effective for their adhd. It really does vary a lot. I have read accounts of people who can't tolerate more than 5 mg of adderall. At the same time, there are people who take as much as you do, and more in order to get to teraputic levels.

From what I've seen on the forums there are people taking more adderall than you have been prescribed. There are also people who are taking a lot less. As long as you take the meds as prescribed you will be okay.

The internet is loaded with misinformation, work with your doctor, let him prescribe your meds, and don't let some netloon you don't even know sell you on some snake oil version of how medications are supposed to work.

Me

[QueensU_girl]

I think your Doctor is confused and giving you too high a dose.

I'd say that is a large dose for a loading dose, YES.


Even the "CLUE" that the units of ADDERALL XR start at 5 mg (FIVE), etc, seems like that must be some sort of hint about dosing, no?

If the lowest dose is 5 mg, then you are taking 12x the dosage.

Do you think your Doctor is confusing the ADDERALL XR with the ADDERALL IR?

Talk to your PHARMACIST about it, or ask the PHARMACIST about getting a PHOTOCOPY of the Adderall product "MONOGRAPH".


SIDE EFFECTS: (They are often dose-dependent.)

(EG headaches, muscle tension (head, neck, shoulders, back), stomach pains, abdominal activity (frequent BMs; diarrhea), peeing too frequently, dry mouth, insomnia, no appetite, sweating, short of breath, rapid heartbeat; in very high doses you'll see breathing problems (short of breath), exercise intolerance, chest pain,increased body temp).

SHIRE makes ADDERALL, and i believe they have information online.

[mochakk]

Hi Nicole,

I was only diagnosed in the past month (with the inattentive variant), so don't have tons of experience to offer you, but I can tell you how medication has been prescribed and worked for me so far.

I initially started off on Ritalin, at the low dose of 10 mg a day, for a week's trial. It was to be a kind of experiment as the dr. suspected ADD but didn't know. It didn't seem to affect my concentration much, but it did improve my mood (also am being treated for clinical depression). It also threw off my sleep patterns a lot, causing me to wake up in the night, wide awake. The psychiatrist then had me go on Concerta, at a low dose of 18 mg taken in the morning. I immediately felt that this med improved my mood even further, making me feel more motivated and alert, but not really affecting concentration. I continued to get feedback at work about "spacing out" incidents and failures to follow directions. So after about 3 weeks, I went up to 27 mg, and the effect does feel phenomenal. The first two days I felt a little overagitated, and at work I noticed that I was now actually aware of the number of times my attention was leaving the task at hand (I'm an editor and could just feel my mind drifting from the graphs numerous times). But by the end of the week, I suddenly felt "in the zone," and was concentrating well, feeling absorbed in the editing despite lots of noise going on in the department around me.

Like you, I had a lot of doubts in the beginning about whether I could actually have ADD. It had never occurred to me because I associated it with hyperactivity and I'd also managed to do well in school and go on to grad school. But I realize that it took a huge effort on my part to do well, and I pretty much did it at the expense of most extracurricular activites and social life.

Anyway, from what I've read, it seems like getting the right dosage does take a trial and error, and that the kind and dosage of med that one person takes won't work for someone else. Since you're following the dr. prescription, you aren't misusing the drug. I feel I lucked out with finding a dosage and med that worked pretty quickly. When I was in the midst of the worst of my depression, I tried at least 3 antidepressants in various combinations before I found what seemed to work well (the old tried and true Prozac).

Take care, and let us know how you do.
Kyla

[necromancer]

thanks for answering so fast..i haven't been on this forum before and it's great to hear from you.

and kyla, that's good to hear somebody has sort of similar experience..i'm also a humanities person who managed to limp through grad school and have had problems with depression and major, major spaciness at work.

thanks for the advice, y'all...hilariously i don't even know whether i HAVE IR or XR (i thought it was the same thing, but that XR just allowed you to double up on the IR dose, and i didn't keep a copy of the prescription). just good old generic "amphetamine salt combo 20 mg" substituted by pharmacy, no questions asked. jeepers. i think my boyfriend takes XR and his pills are orange too, so i was just assuming.

[Crazy~Feet]

Orange Adderall XR is a 30 mg capsule I take 2 per day. Apparently things are very different in the US and Canada. I would not worry about this dose you are on very much unless its causing you too many "sped up" symptoms after a few weeks on it. As long as your concentration and attendence to tasks is improved then you probably have the correct dose.

[Crazy~Feet]

Even the "CLUE" that the units of ADDERALL XR start at 5 mg (FIVE), etc, seems like that must be some sort of hint about dosing, no?

If the lowest dose is 5 mg, then you are taking 12x the dosage.

Not necessarily. There are chidren who take Adderall who need smaller doses and its finally becoming common knowledge that average dosing for adults is typically not too high? Its too LOW.

[Inmate 839221]

I dont take adderall XR. I take adderall regular and take 20 mg a day max. I'm 145 lbs and I've been on adderall for 12 years.

Thats way too high a dosage for you I think, but I could be wrong. When I took 20mg of adderall XR, it didn't help me at all.

Dosage is based on severity of symptoms, not on body weight or height.

IF you think bodyweight has nothing to do with the dosage they give you, you're on a different planet.

[necromancer]

I keep reading about people who are starting on low doses at work and then crashing midday to early afternoon...I think that's probably making it worse for them.

Do you think tolerance correlates more with body weight or particularities of somebody's metabolism? My doctor did say, "oh, how tall are you?" and i was wearing a michelin-man overcoat and baggy pants at the time, so i mean one could assume anything.

[sloppitty-sue]

WOW!! THAT DOSEAGE - at the INDUCTION PHASE no less - would be considered CRIMINAL at the mental health agencies I've been to. I've been treated with stimulant medication for the past FIVE years, and my shrink will STILL say to me that 20mg AdderallXR is a "HUGE DOSE"! I'm not saying that I believe that opinion, but that I've had to enlist my therapist to ACTIVELY advocate for me to get my dose increased to 30mgs. And this after FIVE YEARS!!!

Just sharing. Wow!
(What part of the country did you say you're you from?)

[necromancer]

ouch. the South, of course.

why do you say it'd be considered "criminal" in terms of consequences etc. for the patient? thanks for your concern.

[Crazy~Feet]

Originally Posted by necromancer

ouch. the South, of course.

why do you say it'd be considered "criminal" in terms of consequences etc. for the patient? thanks for your concern.

I am in the South too!

IF you think bodyweight has nothing to do with the dosage they give you, you're on a different planet.

Nonsense...I just checked and I am right here body weight does not determine dosage, the cessation/improvement of symptoms does. You are mistaken. Please research this better, I do not have time to mess with research right now

[sloppitty-sue]

why do you say it'd be considered "criminal" in terms of consequences etc. for the patient?

What I meant by "criminal" is that at the various mental health offices that I'VE been to (and it may just be my area of the world??) - you'd think that I were asking the practitioner for one of his/her KIDNEYS!! I remember (after seeing a couple of prescribers that wouldn't prescribe me any type of the stimulant meds) asking about Provigil and my shrink looking at me as if I were asking her for a couple of her prescribing pads and say, "I CAN'T give you THAT!!"

So when I hear posters state that they've just been diagnosed, and that the 60 mgs (or more) of Adderall XR they've been given to try is _____________ - well, I'M SURPRISED that people are prescribed that much after all of the grumbling and fuss that I've experienced just trying to try ANY amt of this medication. Ya dig?

Sorry for choosing YOUR post to vent about. It's nothing personal!

Sue

[Inmate 839221]

Originally Posted by Crazy~Feet

I am in the South too!

Nonsense...I just checked and I am right here body weight does not determine dosage, the cessation/improvement of symptoms does. You are mistaken. Please research this better, I do not have time to mess with research right now

Adderall isn't different than other drugs! Can a big person drink more alchol than a little person? YES. Can a big person handle more adderall than a little peson? YES.

I'm not saying its the only factor in determining dosage.