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  #1  
Old 02-16-08, 09:49 PM
Hutch1ns Hutch1ns is offline
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Here's a great article on Adderall Dosing for Adults

Stumbled across this article last night. It's a great article suggesting that doses higher than the FDA approved limits on Adderall (60mg/d) are typically effective on Adolescents and Adults. The 60mg/d max dosage was for children 6-12 years old and there hasn't been any studies testing on adolescents (13-17) and adults.

"Dr. Joseph Biederman, MD, Professor of Psychiatry, Harvard Medical School, Boston, MA and Head of the Attention Deficit Disorder Program of Massachusetts General Hospital, has noted that effective stimulant doses in adolescents and adults are usually higher than those for children. If this is not taken into account by clinicians treating adults, the doses they prescribe for their patients may not reach the range needed to achieve therapeutic benefit. (Biederman, J: Practical Considerations in Stimulant Drug Selection for the Attention Deficit/Hyperactivity Disorder Patient - Efficacy, Potency, and Titration)"

"Doctors who use off-label doses have found that, as a general rule, the more a person weighs, the higher the dose of stimulants he or she will need to get a beneficial effect. Thirty milligrams twice a day might work for a 12 year old facing an eight hour school day, but twice that dose might be needed by a 180 pound adult who finishes with work at 5 PM and then has to do work at home and/or interact calmly and productively with family members in the evening. As Dr. Biederman has often said, "pediatric dosing, pediatric effects.""

http://adultadd.info/HighDoseMedication.htm

P.S You wonder why I've been pushing my doctor to give me a higher dosage than 60mg and I take 100mg/d regardless of what she gives me because it's quite simply what I know I need to be theraputic.

P.S.S the chart at the bottom is just an example, it shouldn't be used as a reference.

P.S.S.S I think this article would make a great sticky. Too many people believe that doses over 60mg/d are too high and highly dangerous. That's a complete myth and there isn't one study to back up that claim.
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Old 02-16-08, 11:41 PM
ozchris ozchris is offline
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Re: Here's a great article on Adderall Dosing for Adults

Instead of taking OVER the prescribed amount GO FIND ANOTHER DOCTOR. Stick on the 60mgs until you find a new doctor who's ok with prescribing higher doses.

If your doctor finds out about you taking more than prescribed - he/she could put 'drug seeker' on your permanent record and you'd have trouble ever being prescribed stimulants again. 60mgs is better than no medication.


Keep this in mind - You don't consider 60mgs to be therapeutic? So that means you could take no medication at all and it would not make any difference? I have a feeling 60mgs does make a difference and probably does help you more than you realize. IMO you've just gotten used to the effects.

Take a week off your medication and I think you'll find 60mgs is quite therapeutic. It's true that some people need bigger doses but I doubt Adderall suddenly starts working at 100mgs for you. Higher doses will almost always increase performance/concentration/etc. Maybe you'll try 150mg and decide 100mg isn't therapeutic anymore?

Don't take offense to my post. Just trying to get you to see it from my point of view (and probably the doctors)
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Old 02-16-08, 11:45 PM
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Re: Here's a great article on Adderall Dosing for Adults

High doses are necessary in some cases and I second the recommendation to find a new doctor.
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Old 02-17-08, 01:41 AM
Hutch1ns Hutch1ns is offline
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Re: Here's a great article on Adderall Dosing for Adults

Quote:
Originally Posted by mspen1018 View Post
High doses are necessary in some cases and I second the recommendation to find a new doctor.
I absolutely agree with you. The thing is that I've been trying to find a new doctor for atleast 6 months now. Even my Mom, who's got a master's degree in nursing and 25% of her schooling was psych and the first person to disagree with me stated that the Doctor is 'completely incompetant, uneducated and a complete baffoon.' The Doctor has never been educated in North America or Europe, getting one degree in India and one in Argentina. She's in her office once every 2 weeks, which is every other thursday and that's the only time she will see patients. She has a hard limit with all her patients, 60mg of Adderall daily, doesn't matter XR or IR and it doesn't matter who the patient is and how old they are. If you ask her for a higher dose she will try to convince you to go to detox and that you have a problem. This is why I never asked her until a month ago for a higher dose knowing this and having been through it before several years ago with her.

I run into problems finding a competant Doctor mainly because of insurance. I simply don't have the money to pay out of the pocket to see Dr.Hallowell (one of the best in the world and he's only an hour from me) or someone similar. They don't accept private insurances because it's a pain negotiating with them and they are so good at what they do that they have more than enough clients even without accepting private insurances. I have a higher tier Blue Cross HMO and I have masshealth secondary so I don't have any co-pays typically.

I even offered to have my Mother, who she knows quite well and has always gone to most of my appointments with me, hold on to the medication for me and give me a weekly pill box with my Adderall for the week. She said OK and to have my Mom call her. I went to my parents house and had my Mom call her. About 30 seconds after she returned my Mom's page, my Mom started to get really ****ed off. I heard "If you think he belongs in detox then you should not be practicing medicine." "He takes the medication and he takes it properly, and I, who is the least gullible person on this planet and know all the tricks in the book has advocated this." "He needs a higher dosage, he has been prescribed double the dosage than what he is taking now and I dispensed his pills daily to him when he was recieving that dosage." "So you know this, then what's the problem?" "Then give him enough medication until we can find him a new doctor, this is not only stressing him out beyond belief but it's also stressing me out, you have a moral and legal obligation to help him and detox is not a rational or reasonable option as he's been doing well and he's having no adverse side effects aside from getting the proper dosage prescribed."

I'm so sick of being treated like a drug dealer/addict by ignorant pharmacists and Doctors. I completely understand their concerns and that there are a few people who do abuse this medication, sell it because their welfare isn't enough, but it doesn't make it right to assume everyone is that way, not only morally but legally. I may not possess a degree, but I know myself and I know more about this medication than the people prescribing it to me. 60mg is better than nothing, no doubt about that, at the sametime, the medication wears of quickly on me, lasting no more than 3 hours at best. I need 30mg as my first dose because if I don't it really doesn't very well. Even when I only took 30mg/d when I was a kid (I'm 21 now and been on it for 8 years) I still took 30mg at once. I need the medication to last until a few hours before I go to bed because I have things to do that require me to be attentive, concentrated and not irritable (I work the graveyard shift typically.)
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Old 02-17-08, 01:56 AM
Hutch1ns Hutch1ns is offline
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Re: Here's a great article on Adderall Dosing for Adults

Quote:
Originally Posted by ozchris View Post
Instead of taking OVER the prescribed amount GO FIND ANOTHER DOCTOR. Stick on the 60mgs until you find a new doctor who's ok with prescribing higher doses.

If your doctor finds out about you taking more than prescribed - he/she could put 'drug seeker' on your permanent record and you'd have trouble ever being prescribed stimulants again. 60mgs is better than no medication.


Keep this in mind - You don't consider 60mgs to be therapeutic? So that means you could take no medication at all and it would not make any difference? I have a feeling 60mgs does make a difference and probably does help you more than you realize. IMO you've just gotten used to the effects.

Take a week off your medication and I think you'll find 60mgs is quite therapeutic. It's true that some people need bigger doses but I doubt Adderall suddenly starts working at 100mgs for you. Higher doses will almost always increase performance/concentration/etc. Maybe you'll try 150mg and decide 100mg isn't therapeutic anymore?

Don't take offense to my post. Just trying to get you to see it from my point of view (and probably the doctors)
When I was on 120mg (30mg QID) for 9 months when I was 19 from a much better Doctor. I then stopped taking it for one month and started back with the Doctor that I'm seeing now (so I saw a different Doctor for 9 months basically and then I lost my car so I couldn't travel to see him anymore.) I started back on 20mg/d of Dexedrine and then 50mg/d of Adderall for a couple weeks, then I tried 60mg/d (but even that wasn't enough but I couldn't take anymore without being left with none) when I was being prescribed 40mg/d because it simply was not enough and the Doctor wouldn't up it. Finally after a ton of convincing with my Mom present and helping me she upped it to 60mg/d but since 60mg/d wasn't working already for me I was taking 80-100mg/d. After about another month I was doing the 90-100mg/d and finished school and got a professional job. I've been doing fine with 100mg/d for a year now but I've had to go in early and get scripts from the secretaries, go to my PCP ect. every month in order to make up for it.

So I've been on 90-100mg/d for about a year now and I don't want anymore than that and it works the exact same as it did when I began it.

I understand what you're implying with the 100mg to 150mg jump ect. but I can assure you that it's not the case. When I was on 120mg a few years ago I never wanted anymore than that and never needed anymore than that.
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Old 02-17-08, 05:03 AM
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Re: Here's a great article on Adderall Dosing for Adults

Hutch1ns Writes-the Doctor has never been educated in North America or Europe, getting one degree in India and one in Argentina.

She still had to pass the USMLE, and most likely a 3 year- /80 hour a week/ residency at a hospital.
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Old 02-17-08, 12:37 PM
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Re: Here's a great article on Adderall Dosing for Adults

Correction - Hutch1ns does not currently have a doctor... according to this post of his.... and his ongoing threads that constantly change his story...

Quote:
Hey all,

Well my Psych decided to dump me on the street again after I told her I needed a higher dosage than 60mg IR/day and that I had been taking more than that for a long time. She gave me a one month supply of all my meds (only 60mg/day of Adderall) and told me to find a new doctor and that she wasn't going to prescribe me my meds after these scripts ran out. She told me to try this place called Hallowell who specializes in ADD and could likely prescribe me the correct dosage. She refuses to prescribe anyone more than 60mg a day of either the IR or XR. Well I called that Hallowell place and they are no longer in the area (they're located about 2 hours away now and don't have any open appointments for 3 months anyways.) When I went to fill my scripts, I couldn't get the full 90 20mg tablets because my secondary insurance would only pay for 60 tablets (they pay my copays but I had my yearly deductible from my primary insurance and my secondary insurance would pick that up.) So that left me with 60 20mg tablets and I take 100mg/daily. I've got 2 pills left and no Doctor still. I've called about 15 different #'s from my blue cross Massachusetts directory and only 3 of the #'s actually still worked. I talked to this place called Arbour Health which is located a couple miles down the road and the lady told me that my Doctor, by law, has to keep prescribing me my medication until I'm able to find a new doctor. She even told me that I could have my Doctor call them so they could inform her of that law. Well I called my Doc and she refused to even call them and said that she cannot prescribe me any more medication and hung up on me. Apparently they didn't teach her about Psychiatric law in Argentina where she got her rent-a-'medical degree.' Arbour Health is a no go because they require me to be in therapy with one of their therapist and have atleast 3 visits before any medication can be prescribed. The best I've been able to find is an appointment with a Psychiatrist who specializes in ADHD but has no availible appointments until March. My PCP refuses to prescribe psychiatric meds no matter what. It's now saturday so nothing is open anyways. I'm refuse to be without my medication and will get it whether it lands me in jail or not if I start to withdraw. The pain from withdrawing is unbearable and I refuse to go through it again. This is the same Doctor who did this to me before several years ago. I've got a big hole in my condo's wall still after putting my head through it from the frustration/pain of the withdrawals. I tried getting an appointment with my old Psychiatrist (although he's about an hour away) who used to prescribe me 120mg/day IR (30mg 4x daily) but he's not taking new patients. I feel like I'm all out of options to obtain it legally or even from a friend (none of my friends have any nor know anyone who does.) I just got a job that I absolutely love doing what I enjoy most (Network/Sys Admin + Tech Support) and I'm afraid I'm going to lose the job because of this neglect. I just wish I could find a Psych who actually cares about his/her patients instead of only caring about themselves.

Any suggestions would be greatly appreciated!

-Hutch
Furthermore...




According to this post that you made... your prescription was for 60mg daily. You have stated several times that your daily intake was 100mg.

If this is true... then it would also prove true before any of the occurrences , that you believe were illegal, you made another illegal decision in not taking your prescription as directed.

The dosage you claim to have taken is 40 percent more than what was legally prescribed to you. According to your statement, under your prescription one month's supply of Adderall for you would equal 1,800mg. According to the amount you claim you took daily, one month's supply of Adderall would be 3,000mg.

In conclusion, that would leave 1,200mg or 60 20mg pills of Adderall coming from another source other than your prescription and unaccounted for...

Your arguments project your notation as you are being neglected of something that rightfully belonged to you.

One, the amount you say you require was never legally given to you in the first place.
Two, when an individual independently and unlawfully chooses to increase their prescribed daily dosage they forfeit the legal rights to that prescription. By doing this; not only does one endanger the well-being of themselves, but also the careers and/of the professionals involved. I had to sign numerous documents in regards to the terms and conditions that accompany my prescription and for the protection of those who allow me to have my prescription.

This alone is enough to strip any validity or mercy for your situation.

Here is Webster's Dictionary's definition of ABUSE :
1: a corrupt practice or custom
2: improper or excessive use or treatment : misuse abuse> <abuse of tranquilizers>
3obsolete : a deceitful act : deception
4: language that condemns or vilifies usually unjustly, intemperately, and angrily
5: physical maltreatment

Four out of Five???... I feel safe to say - Merriam-Webster would define your actions as ABUSE.

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Old 02-17-08, 06:45 PM
MJwatson MJwatson is offline
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Re: Here's a great article on Adderall Dosing for Adults

I think stimulants have a negative connotation because of the abusers..it sucks for us though. I had trouble myself accepting the fact that I need to take about 90mg per day. My Dr is an ADD specialist and I do trust him. He told me that alot of ADDers have opposite reactions to meds and that stimulants don't affect us like 'regular' people. Maybe it has to do with the type of ADD you have. Adderall actually makes me sleepy.

Hutch- are there and specialists in your area? What about a psychiatrist, I am pretty sure they can prescribe medication.

Also, I have read most of your posts, and while you have helped me by providing information about Higher Doses in adults, I have seen your story change. I think that might be what makes people skeptical. Also, I know that it is frustrating not getting your meds but it really isn't the pharmacy's fault....getting escorted out of the place by the police might create a not-so-positive impression.

Do you have a co-existing condition? I only ask because I have read some very informative posts from you and some very angry ones too.
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Old 02-17-08, 07:36 PM
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Re: Here's a great article on Adderall Dosing for Adults

Quote:
Originally Posted by Amykins View Post
I think stimulants have a negative connotation because of the abusers..it sucks for us though. I had trouble myself accepting the fact that I need to take about 90mg per day. My Dr is an ADD specialist and I do trust him. He told me that alot of ADDers have opposite reactions to meds and that stimulants don't affect us like 'regular' people. Maybe it has to do with the type of ADD you have. Adderall actually makes me sleepy.

Hutch- are there and specialists in your area? What about a psychiatrist, I am pretty sure they can prescribe medication.

Also, I have read most of your posts, and while you have helped me by providing information about Higher Doses in adults, I have seen your story change. I think that might be what makes people skeptical. Also, I know that it is frustrating not getting your meds but it really isn't the pharmacy's fault....getting escorted out of the place by the police might create a not-so-positive impression.

Do you have a co-existing condition? I only ask because I have read some very informative posts from you and some very angry ones too.
That Doctor I was seeing is a psychiatrist, although a very bad at that. All the Doctors I've been looking for are psychiatrists or psychiatric nurses (I forget the name for them.) I know I was breaking the 'law' by taking more than I was prescribed, at the same time, I knew what I needed in order to be successful. I check my blood pressure daily and write it down in a journal, I get EKG's every 3-6 months, and I get my liver checked every 3 months as well. My mom does the bloodwork for me and brings it to the lab at her work. Everything has comeback as normal, blood pressure is in the normal range, EKG's have all checked out fine ect. The only one of those my Doctor even asked me to monitor was my liver enzymes but I check the others to make sure I'm safe. If any of them were not normal, I'd let my doctor know and would have to adjust my medication accordingly. I know for a fact that higher doses than 60mg are safe as long as it's not causing any problems with my health. It's recommended that one take's the highest dosage that they can handle without causing any negative physical/mental side effects. I only took more because I could not ask the Doctor for more because I knew she had a 60mg hard cap for anyone which scientifically, makes absolutely 0 sense.

I don't have a co-existing condition, hopefully, I've just been stressed out about this stuff for so long and have been treated and discriminated against on a regular basis. I also don't respond well to people attacking me when they really have no idea. My first response to it is anger, which I learned from my Dad. Although both of us have incredible self-control despite having enormous tempers, we still have trouble expressing emotions. I've been able to teach myself how show some of my emotions properly in some scenarios instead of always responding in anger, but I can't say that I've come close to perfecting it. I'm extremely enthusiastic when it comes to something that has helped me so much and I really owe so much of my success to the medication, as I was on a fast road to nowhere before I saw a Psychiatrist who started me on Adderall. The original diagnosis I recieved from him was "ADD-High Intelligence" but I'm not sure if that's a scientific diagnosis or just sugar coated. Basically I've always been too smart for my own damn good but I had so much trouble as a kid concentrating on anything at the same time. When Puberty started towards the end of 6th grade everything fell apart. Grades went from A's B's C's to C's D's F's, I started getting detentions, suspensions on a daily basis, got into fights nearly every day with other kids, was a jerk to my teachers, became disruptive in class ect. This continued until 8th grade when I started on Adderall.

I ended up dropping out of high school towards the end of my junior year, I was never able to sleep after taking the Adderall, and I would only take a single dose daily too. I must've averaged no more than 3 1/2 hours of sleep a night throughout high school, which started at 7:15am. I ended up deciding that my sanity and my health was more important than finishing high school with mediocre grades. I had several diagnosis' while I was in high school, bi-polar, depression ect. The Doctor, the same moron as I had just been seeing, started me on Zoloft and I spent a year manic and she never picked up on it despite me being completely nuts. I won't go into what I was doing but I was basically on top of the world and I thought I had no consequences for my actions. After 3 months she threw me out when I asked for a higher Adderall dose and found the Doctor who started prescribing the 120mg/d for 9 months.

Anyways, after being sent to a detox for 'stimulant dependancy' by a completely idiotic social worker when I was just asking for help (even my mom knew I was nuts but not a drug addict!) I was told that I showed no signs of being bi-polar or depression but I was a clear cut case of ADD. They released me from the hospital with no meds (I was on Zoloft + 120mg/d Adderall + Ativan before) I could vaguely function.I saw the old Doc again and she started me on the Dexedrine and then the Adderall again and I've finished college and started working as a Network/Sys Admin and doing Desktop Tech support. And that about sums it up...
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Old 02-17-08, 07:43 PM
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Re: Here's a great article on Adderall Dosing for Adults

IIRC, the max daily dose isn't just about "what works", it is about cardiovascular safety, etc.

Sometiems a doctor is tight with their Rx pad to keep a person safe.

(e.g. I know you are frustrated, but how 'happy' would you be with your Doctor if they gave you 120 mg+/day and you had a stroke? Come back and talk to us then...)
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Old 02-17-08, 11:39 PM
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Re: Here's a great article on Adderall Dosing for Adults

Quote:
Originally Posted by QueensU_girl View Post
IIRC, the max daily dose isn't just about "what works", it is about cardiovascular safety, etc.

Sometiems a doctor is tight with their Rx pad to keep a person safe.

(e.g. I know you are frustrated, but how 'happy' would you be with your Doctor if they gave you 120 mg+/day and you had a stroke? Come back and talk to us then...)
Again, show me one test that has shown dosages of over 60mg/d are hazardous to one's health. 60mg was the maximum that was tested on children ages 6-12 but they never tested more than that and they never tested on adolescents or adults. It's become a common accepted practice to prescribe more than 60mg therefor she would not be liable in a lawsuit because it's an accepted common practice. An accepted common practice is just as good as a legal defense as an FDA approved dosage is.
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Old 02-18-08, 09:03 AM
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Re: Here's a great article on Adderall Dosing for Adults

Have you ever tried any other medication besides adderall? I don't really care what the safe dosage studies are. Bottom line, taking more than prescribed is harmful and no matter how many times you repeat the same weak argument you're not going to find anyone to condone or validate it for you.
I'm asking this in all seriousness, do you think adderall might not be the right choice of meds for you? If you objectively look at your own actions, the aggression, the changing stories...maybe instead of continuing to push for higher doses you should try giving another treatment option a go and see how that works.
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Old 02-18-08, 09:57 AM
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Re: Here's a great article on Adderall Dosing for Adults

Quote:
Originally Posted by Desperate1 View Post
Have you ever tried any other medication besides adderall? I don't really care what the safe dosage studies are. Bottom line, taking more than prescribed is harmful and no matter how many times you repeat the same weak argument you're not going to find anyone to condone or validate it for you.
I'm asking this in all seriousness, do you think adderall might not be the right choice of meds for you? If you objectively look at your own actions, the aggression, the changing stories...maybe instead of continuing to push for higher doses you should try giving another treatment option a go and see how that works.
I haven't changed my story, I do not have a Doctor NOW, but I am currently taking medication that she prescribed therefor still making me HER patient so to speak. She will not prescribe me any further meds, although she legally has to until I find a new Doctor. See what I'm saying?

I have tried other medications for ADD. I've tried, lets see now, Ritalin (made me more hyper actually), strattera, concerta, wellbutrin, dexedrine and Adderall. The only other one that helped was Dexedrine, but it just didn't work as well as the Adderall.

To call my argument weak is an ignorant and completely uneducated statement. You are not in my shoes, so you are in no position to pass judgement on me. If I were to follow her scientifically illogical guidelines, I can honestly tell you that I wouldn't be as successful as I am now. I would not have the concentration throughout the day to work both jobs (which I'm on call 24/7 for one of my jobs, 4 days a week) and have such a great relationship as I do with my girlfriend. The extra 30-40mg's extends my ability to concentrate by an extra 6-10 hours a day and that's what I need. I apologize for not being able to work a regular 9-5 job like 'normal' people. Sorry for that, I should just bow down to what you tell me and suffer.
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Old 02-18-08, 10:09 AM
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Re: Here's a great article on Adderall Dosing for Adults

Quote:
Originally Posted by 50yellAD View Post
Correction - Hutch1ns does not currently have a doctor... according to this post of his.... and his ongoing threads that constantly change his story...



Furthermore...




According to this post that you made... your prescription was for 60mg daily. You have stated several times that your daily intake was 100mg.

If this is true... then it would also prove true before any of the occurrences , that you believe were illegal, you made another illegal decision in not taking your prescription as directed.

The dosage you claim to have taken is 40 percent more than what was legally prescribed to you. According to your statement, under your prescription one month's supply of Adderall for you would equal 1,800mg. According to the amount you claim you took daily, one month's supply of Adderall would be 3,000mg.

In conclusion, that would leave 1,200mg or 60 20mg pills of Adderall coming from another source other than your prescription and unaccounted for...

Your arguments project your notation as you are being neglected of something that rightfully belonged to you.

One, the amount you say you require was never legally given to you in the first place.
Two, when an individual independently and unlawfully chooses to increase their prescribed daily dosage they forfeit the legal rights to that prescription. By doing this; not only does one endanger the well-being of themselves, but also the careers and/of the professionals involved. I had to sign numerous documents in regards to the terms and conditions that accompany my prescription and for the protection of those who allow me to have my prescription.

This alone is enough to strip any validity or mercy for your situation.

Here is Webster's Dictionary's definition of ABUSE :
1: a corrupt practice or custom
2: improper or excessive use or treatment : misuse abuse> <abuse of tranquilizers>
3obsolete : a deceitful act : deception
4: language that condemns or vilifies usually unjustly, intemperately, and angrily
5: physical maltreatment

Four out of Five???... I feel safe to say - Merriam-Webster would define your actions as ABUSE.

No Way!



I stated in one of my posts that I had to either go in to get a script from the secretary or ask my PCP or go to the walk-in clinic. Obviously from the naked eye it looks like drug-seeking behavior or doctor shopping, but if you look further into it, it's a clear cut case of underprescribing due to lack of education on the particular medication.
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Old 02-18-08, 10:33 AM
MJwatson MJwatson is offline
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Re: Here's a great article on Adderall Dosing for Adults

Hutch- I don't think people disagree that sometimes adults need a higher that 60mg dose..but at the direction of your prescribing Dr.. There must be some logical reason why she won't up your dose.

Do you have any history or family history of heart conditions? Do you take anything else that might possibly interact?

Maybe you broke her trust by increasing your dose without her permission. I am not accusing you of anything, I am just saying that even if you see that getting extra from walk-in clinics looks like 'drug seeking' behavior...I am sure the dr. does. And getting angry is probably not going to help convince anyone.

In your search for a new Dr., How are you presenting yourself? Are you immediately asking if they will prescribe more thatn 60mg? Are you raging about your old Dr.?
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