ADD Forums - Attention Deficit Hyperactivity Disorder Support and Information Resources Community  

Go Back   ADD Forums - Attention Deficit Hyperactivity Disorder Support and Information Resources Community > TREATMENT & MANAGEMENT > Medications > Adderall
Register Blogs FAQ Chat Members List Calendar Donate Gallery Arcade Mark Forums Read

Adderall (four amphetamine salts)

Reply
 
Thread Tools Display Modes
  #1  
Old 07-25-10, 08:17 AM
Anonymity Anonymity is offline
Newbie
 

Join Date: Jul 2010
Location: USA
Posts: 4
Thanks: 0
Thanked 11 Times in 2 Posts
Anonymity is on a distinguished road
Post Adderall Dosing Guidelines and FAQ

In searching for my own answers I have noticed an abundance of questions regarding dosing. How much should I take? What is the maximum dose? How will I know?

Your first and best source is your doctor, however if your doctor is light on information or you just want to see it in writing, here is what I have found.

** Disclaimer: My entire medical training has consisted of watching House reruns, however a little research yielded some good guidelines that helped answer my questions. So, be sure to confirm anything you may glean from this post with your doctor before taking it to heart.


How Much Should I Take?:

The following dosing guidelines were published by Dr. Joseph Biederman, Chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at the Massachusetts General Hospital, and Professor of Psychiatry at the Harvard Medical School



Typically, the dosage for Adderall is shown as 10mg-60mg, however this guideline fails to take into account the effects of body weight. The same dosage does not necessarily make sense for persons weighing 100lbs and 280lbs.

Therefore, your dosage should range from 0.3-1.5 x your body weight in kg (1kg = 2.2lbs)

For example, if you weigh 175lbs (75.5kg) your dosage should start around 20-25mgs (0.3mg x 75.5kg = 23.5 mg/kg) to a maximum of 115mg (1.5mg x 75.5kg = 113.25 mg/kg)


How Will I Know When It’s Right?

The ideal dosage is the minimum necessary to be effective. The best way to find the proper amount is to start low (10mg for adults, 5mg for children) and increase by 10mg every 1-4 days until symptoms are under control. If you have found a dose that seems to work, but you are unsure that it is the best amount you can continue to increase the dose. Increasing the dose over the proper amount will increase the occurrence and intensity of side effects and in most cases will not increase the effectiveness of the drug. If nervousness or over-stimulation occurs, always REDUCE the dose.

It is important to note that in the first days of taking Adderall you will experience a euphoria which is much closer to a “high” than what you should be looking for when finding the proper dose. Therefore, it may make sense to disregard the first few days to avoid disappointment when the drug no longer seems to work.

Side Effects:

There are a number of possible side effects when using amphetamine based stimulants, some of which can be quite dangerous. Be sure to tell your doctor if you have a history of seizures or heart problems as amphetamines have shown increased danger of tachycardia, increased blood pressure and seizures. That being said, for most healthy people these should not be an issue and occurrence is statistically low.

The most common side effects include:

Decreased Appetite
Insomnia
Emotional Lability
Abdominal Pain
Weight Loss
Dry Mouth
Headache

*Side effects that peak around 6 hours from dose are most likely due to the medication. Dose needs to be reduced.

*Irritability and tiredness/fatigue that occurs more than 6 hours after last dose are more likely due to medication wearing off (rebound effect). Dosing may need to be adjusted by adding an extra dose or by increasing the dose.

Rebound Effect
The “come down” or “crash” from amphetamines will often be strongest in the first two weeks and decrease with time. The effects can include psychosis, depression and a return of ADHD symptoms but in a temporarily exaggerated form. If you find that you are experiencing rebound effect without any of the positive effects (greater focus and concentration) your dose may be too low.


Effectiveness

Urinary and stomach pH levels can have a strong effect on amphetamine excretion and absorption. An acidic stomach and GI pH will decrease the absorption of Adderall, and acidic urine levels will decrease the reabsorption of the drug through the renal system. Acidic substances (e.g. citric acid) cause decreased renal reabsorption of amphetamine, while alkaline agents (e.g. antacids) may cause a marked increase in renal tubular reabsorption. The increased reabsorption can increase the retention of amphetamines, potentially resulting in dangerously high serum levels.

Therefore, it is best to avoid taking multivitamins containing certain vitamins (Vitamin C - Ascorbic Acid) and eating or drinking acid foods immediate before or after taking amphetamines. E.g. Soda, Citrus Juice

It is also important to note that antacids will have a magnifying effect on amphetamines, increasing absorptions and retention. Take caution when using any acid neutralizing medication.

Studies have also shown that high fat diets may have a significant impact on the absorption of Adderall XR. A report published in Current Medical Research and Opinion showed that subjects who took Adderall after a high fat meal had a 55% decrease in their blood levels of amphetamine during the first four hours following dosing, compared with those who took Adderall after fasting.


Common Interaction Cautions

Decongestants: may increase the risk of cardiovascular and CNS stimulatory effects
Caffeine: may increase the risk of cardiovascular and CNS stimulatory effects
Bupropion (Wellbutrin, Zyban): may increase risk of seizures
Cannabinoids: may increase risk of tachycardia, hypertension, cardiotoxicity

Safety and Monitoring

Pregnancy: C
(Animal Studies show adverse fetal effects but no controlled human studies or no animal studies. Weigh possible fetal risk vs. maternal benefit)

Lactation: Possibly Unsafe
(Available animal/or human data demonstrates potential or actual adverse effects to infant/breast mile production; consider alternatives or weigh risk/benefits)

Monitoring Parameters:
For patients with risk factors, your doctor will perform a baseline cardiac evaluation; Blood Pressure, Heart Rate at baseline, after dose increase, then periodically

For Children: height, weight at baseline, then periodically


And just incase you thought I was making any of this up, here are some sources:
http://pn.psychiatryonline.org/content/37/15/19.2.full
http://ajp.psychiatryonline.org/cgi/reprint/136/2/226
https://online.epocrates.com/noFrame...veSectionId=10
http://en.wikipedia.org/wiki/Adderall
http://en.wikipedia.org/wiki/Amphetamine

Last edited by namazu; 10-06-16 at 02:22 PM.. Reason: retroactively removed 2 links that went to websites with viruses
Reply With Quote
The Following 5 Users Say Thank You to Anonymity For This Useful Post:
Kackle (10-06-16), oopssiddaisy (10-16-16), postictal_pete (10-18-16), puzzled (03-29-11), randomguy1235 (09-28-16)
  #2  
Old 04-22-16, 08:09 AM
Smashachu Smashachu is offline
Member
 

Join Date: Feb 2015
Location: Fort pierce, FL
Posts: 46
Thanks: 4
Thanked 24 Times in 14 Posts
Smashachu is on a distinguished road
Re: Adderall Dosing Guidelines and FAQ

I know it's a really old bump, but it's very useful information. Kinda looks copy pasta'd but it's very good information assuming it's accurate.
Reply With Quote
  #3  
Old 04-22-16, 08:59 AM
sarahsweets's Avatar
sarahsweets sarahsweets is offline
ADDvanced Forum ADDvocate
 

Join Date: Mar 2011
Location: nj, usa
Posts: 21,299
Thanks: 5,305
Thanked 25,320 Times in 11,192 Posts
sarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond repute
Re: Adderall Dosing Guidelines and FAQ

Quote:
Originally Posted by Smashachu View Post
I know it's a really old bump, but it's very useful information. Kinda looks copy pasta'd but it's very good information assuming it's accurate.
Useful except for the parts that are incorrect.
__________________
President of the No F's given society.

I carried a watermelon?
Reply With Quote
Sponsored Links
  #4  
Old 04-22-16, 11:14 AM
AED1955 AED1955 is offline
Member
 

Join Date: Mar 2014
Location: Dayton,Oh USA
Posts: 40
Thanks: 5
Thanked 16 Times in 13 Posts
AED1955 is on a distinguished road
Re: Adderall Dosing Guidelines and FAQ

Quote:
Originally Posted by sarahsweets View Post
Useful except for the parts that are incorrect.
What parts are incorrect?
Reply With Quote
  #5  
Old 04-22-16, 01:59 PM
sarahsweets's Avatar
sarahsweets sarahsweets is offline
ADDvanced Forum ADDvocate
 

Join Date: Mar 2011
Location: nj, usa
Posts: 21,299
Thanks: 5,305
Thanked 25,320 Times in 11,192 Posts
sarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond repute
Re: Adderall Dosing Guidelines and FAQ

Quote:
Originally Posted by AED1955 View Post
What parts are incorrect?



Quote:
Typically, the dosage for Adderall is shown as 10mg-60mg, however this guideline fails to take into account the effects of body weight. The same dosage does not necessarily make sense for persons weighing 100lbs and 280lbs.

Therefore, your dosage should range from 0.3-1.5 x your body weight in kg (1kg = 2.2lbs)

For example, if you weigh 175lbs (75.5kg) your dosage should start around 20-25mgs (0.3mg x 75.5kg = 23.5 mg/kg) to a maximum of 115mg (1.5mg x 75.5kg = 113.25 mg/kg)
Wrong. Meds are not dosed on weight, mass, height, age or girth.

Quote:
*Side effects that peak around 6 hours from dose are most likely due to the medication. Dose needs to be reduced.

*Irritability and tiredness/fatigue that occurs more than 6 hours after last dose are more likely due to medication wearing off (rebound effect). Dosing may need to be adjusted by adding an extra dose or by increasing the dose.
There are no time frames for side effects, if anything side effects are noticiable alot sooner than 6 hours. Irritability and stuff can and does happend well before the meds wear off due to the levoamphetamine in the adderall which can cause excess stimulation.

Quote:
The “come down” or “crash” from amphetamines will often be strongest in the first two weeks and decrease with time. The effects can include psychosis, depression and a return of ADHD symptoms but in a temporarily exaggerated form. If you find that you are experiencing rebound effect without any of the positive effects (greater focus and concentration) your dose may be too low.
Ridiculous. Properly dosed meds rarely if ever have any sort of 'comedown' and incidentally that term is very popular on sites that encourage recreational drug use. A 'come down' that include psychosis...thats not the meds wearing off. Thats the meds having a serious reaction with you or a mental health emergency or abuse or too high of a dose. Amphetamine psychosis is a real thing and its not because regularly taken meds wear off.

Quote:
Urinary and stomach pH levels can have a strong effect on amphetamine excretion and absorption. An acidic stomach and GI pH will decrease the absorption of Adderall, and acidic urine levels will decrease the reabsorption of the drug through the renal system. Acidic substances (e.g. citric acid) cause decreased renal reabsorption of amphetamine, while alkaline agents (e.g. antacids) may cause a marked increase in renal tubular reabsorption. The increased reabsorption can increase the retention of amphetamines, potentially resulting in dangerously high serum levels.

Therefore, it is best to avoid taking multivitamins containing certain vitamins (Vitamin C - Ascorbic Acid) and eating or drinking acid foods immediate before or after taking amphetamines. E.g. Soda, Citrus Juice
People get all bent on the whole vitamin c, ph thing and its truly very minor. And as far as any of this being absorbed through the renal system? I have never heard of that- thats kidneys right?>
Do not avoid taking vitamins if thats your thing.
Before I had the internet 10 or so years ago I had all kinds of stuff that is supposed to mess with your meds including the scary OJ. Never had an issue and had no Google to check it.


Quote:
Studies have also shown that high fat diets may have a significant impact on the absorption of Adderall XR. A report published in Current Medical Research and Opinion showed that subjects who took Adderall after a high fat meal had a 55% decrease in their blood levels of amphetamine during the first four hours following dosing, compared with those who took Adderall after fasting.
I want to see this study.

The thing that irks me is this is read by so many people. It looks and sounds good, is well thought out and organized so they think the info is correct and that this person is an expert. Then it gets dragged out after laying low and I realize that no one chimed in when it was written AND that one of our members bumped it thinking it was accurate info.
__________________
President of the No F's given society.

I carried a watermelon?
Reply With Quote
The Following 2 Users Say Thank You to sarahsweets For This Useful Post:
karenparker (09-29-16), salleh (09-28-16)
  #6  
Old 09-27-16, 02:55 PM
postictal_pete postictal_pete is offline
Newbie
 

Join Date: Sep 2016
Location: Kansas
Posts: 4
Thanks: 3
Thanked 4 Times in 2 Posts
postictal_pete is on a distinguished road
Re: Adderall Dosing Guidelines and FAQ

I realize this is old an old reply, but I literally created an account here just to point out that every single one of sarahsweet's "counter-points" is incorrect and show a deep ignorance on the subject of medicine and biology. The fact that sarahsweets was willing initially to just say "There are parts that are wrong" and nothing else, was enough of a giveaway that sarahsweets doesn't bother researching things properly or backing up any of sarahsweets statements with facts or research, or even details and anecdotal evidence.

Quote:
Wrong. Meds are not dosed on weight, mass, height, age or girth.
No details, no cited research, no real counterpoint besides "No". So first off, many (not all) medications are absolutely weight based and 1 minute of research will tell you this, so I'm not gonna do that for you. Would you give a small child and an adult the same dose of, say, Acetaminophen? Why not if age and weight aren't factors in dosing? Age is also obviously a factor, as young children and the elderly metabolize meds differently because of changes in biology you should have learned about in HS. I am a paramedic and absolutely take into consideration weight, age, musculature, gender (different fat/muscle ratios between genders lead to differences in absorption and metabolism of certain drugs) along with other factors when administering medications, because I know that these things matter to a great degree and I don't like murdering people with ignorance.

Quote:
There are no time frames for side effects, if anything side effects are noticiable alot sooner than 6 hours. Irritability and stuff can and does happend well before the meds wear off due to the levoamphetamine in the adderall which can cause excess stimulation.
More misleading than wrong. All OP said was that based on the timeframe in which specific side effects occur, the likelihood of it being a direct side-effect of this medication can be deduced based on what we know about serum levels after "x" time. So yes, there are time frames for side effects. You'll need to clarify why you think L-amphetamine would cause "excess stimulation"- and by that I mean: Why that ingredient specifically (as opposed to the dextroamphetamine, which is, in fact, more potent than L-amphetamine and makes up 2/3s of the Adderall mix), What is meant when you say "excess stimulation"? etc.

Quote:
Ridiculous. Properly dosed meds rarely if ever have any sort of 'comedown' and incidentally that term is very popular on sites that encourage recreational drug use. A 'come down' that include psychosis...thats not the meds wearing off. Thats the meds having a serious reaction with you or a mental health emergency or abuse or too high of a dose. Amphetamine psychosis is a real thing and its not because regularly taken meds wear off.
I don't see anything wrong with what OP stated there, it remained responsible. It doesn't seem like he's saying anything like "psychosis is normal as the meds wear off, don't bother talking to your doctor about it".

What is a "properly dosed med"? If you require a higher dose than someone else of the same age and weight as you, you may have a "comedown". The dose you are both taking IS each of your therapeutic dose (proper dose?) and yet IF you have a have a "comedown", it WILL be greater than that other individual will experience because you are on a higher dose out of necessity.

Quote:
People get all bent on the whole vitamin c, ph thing and its truly very minor. And as far as any of this being absorbed through the renal system? I have never heard of that- thats kidneys right?>
Do not avoid taking vitamins if thats your thing.
Before I had the internet 10 or so years ago I had all kinds of stuff that is supposed to mess with your meds including the scary OJ. Never had an issue and had no Google to check it.
Well, OP provided some known biological mechanisms and a brief and simplified theory on how pH would obviously have an effect. And you provided anecdotal evidence on how you believe your meds are probably still effective when you do certain things.. So that's cool that you at least did that.. THEN you go on to deny that a persons renal system is involved in metabolizing Adderall? I think that's what you're saying.. You back this up and establish yourself as a biology expert by then saying, "that's kidney's, right?" Yes..that's kidneys.. As my source for how wrong you are about this I will cite: "The nearest human Biology book you can find" or, A current HS or college student taking Human Biology or A&P. Nephrology (study of kidneys) is insanely complicated. Nephrologists are some of the most intelligent people you'll meet, so I would take their word for gold when you come across it in any research.

As for your last "point", You want to see that study? Well OP told you the publisher. Took me 15 seconds to type it and find the published study and a nice summarization of it's methods and findings which state indeed that amphetamine levels were found to be markedly decreased at certain intervals when taken with certain meals, while methylphenidate (Concerta) levels seemed to remain relatively unchanged by. This study also mentions how pH levels cause variability, but you have anectdotal evidence that that is maybe no true to a significant degree, so you're probably not interesting in the general consensus of trained scientists..

It "irks" you when people post unresearched and innaccurate info? How would you know if it's unresearched and innaccurate? You didn't bother to check it yourself before coming to a conclusion and posting your opinion to be read by many users. The info OP gave is accurate enough not to be dangerous and to actually be useful to people. He also states that people should talk to real experts to confirm what he says and for more detailed information.

Seriously though, research some A&P. There are so many neat things about how our body systems function and interact. (Did you know blood cells are made by your bones?!)

Sorry for the Novel.. The ignorance was too much for me to let go.

Last edited by midnightstar; 10-16-16 at 03:59 PM.. Reason: removing insult as per etiquette guidelines
Reply With Quote
The Following 3 Users Say Thank You to postictal_pete For This Useful Post:
Kackle (10-06-16), oopssiddaisy (10-16-16), randomguy1235 (09-28-16)
  #7  
Old 09-28-16, 04:33 AM
sarahsweets's Avatar
sarahsweets sarahsweets is offline
ADDvanced Forum ADDvocate
 

Join Date: Mar 2011
Location: nj, usa
Posts: 21,299
Thanks: 5,305
Thanked 25,320 Times in 11,192 Posts
sarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond repute
Re: Adderall Dosing Guidelines and FAQ

Quote:
Originally Posted by postictal_pete View Post
No details, no cited research, no real counterpoint besides "No". So first off, many (not all) medications are absolutely weight based and 1 minute of research will tell you this, so I'm not gonna do that for you. Would you give a small child and an adult the same dose of, say, Acetaminophen? Why not if age and weight aren't factors in dosing? Age is also obviously a factor, as young children and the elderly metabolize meds differently because of changes in biology you should have learned about in HS. I am a paramedic and absolutely take into consideration weight, age, musculature, gender (different fat/muscle ratios between genders lead to differences in absorption and metabolism of certain drugs) along with other factors when administering medications, because I know that these things matter to a great degree and I don't like murdering people with ignorance.
I definitely could have been a lot less harsh and a lot more understanding or tolerant but stimulants are not weight based. Of course you wouldnt give a child the same amount of tylenol as an adult but its a completely different medication. Stimulants given to adults and children can often be the same dose. My daughter was taking 20 mg x 2 when my son was taking 25mg of amphetamine. My son at the time was 13 and my daughter was 7.
Like I said, looking back I can realized at the time that I was in and out of the hospital with 2 tumors, I am guessing that had a lot to do with my attitude.





Quote:
More misleading than wrong. All OP said was that based on the timeframe in which specific side effects occur, the likelihood of it being a direct side-effect of this medication can be deduced based on what we know about serum levels after "x" time. So yes, there are time frames for side effects. You'll need to clarify why you think L-amphetamine would cause "excess stimulation"- and by that I mean: Why that ingredient specifically (as opposed to the dextroamphetamine, which is, in fact, more potent than L-amphetamine and makes up 2/3s of the Adderall mix), What is meant when you say "excess stimulation"? etc.
Levoamphetamine is responsible for Excess PNS stimulation compared to just amphetamine that is in adderall or dxex.

Quote:
What is a "properly dosed med"? If you require a higher dose than someone else of the same age and weight as you, you may have a "comedown". The dose you are both taking IS each of your therapeutic dose (proper dose?) and yet IF you have a have a "comedown", it WILL be greater than that other individual will experience because you are on a higher dose out of necessity.
I think it is the term 'come-down' that gets me. It sounds so recreational. I guess this is the same thing as crash? Either way, its something I always associated with recreational doses but obviously thats not the same for everyone.




Quote:
It "irks" you when people post unresearched and innaccurate info? How would you know if it's unresearched and innaccurate? You didn't bother to check it yourself before coming to a conclusion and posting your opinion to be read by many users. The info OP gave is accurate enough not to be dangerous and to actually be useful to people. He also states that people should talk to real experts to confirm what he says and for more detailed information.
I guess I would look at this differently if it wasnt labeled a guide.

Quote:
Sorry for the Novel.. The ignorance was too much for me to let go.
I am not someone who cant admit when they've gone off the rails or done wrong. I could have approached it a whole different way rather than pound anyone into the ground.
__________________
President of the No F's given society.

I carried a watermelon?

Last edited by Greyhound1; 10-17-16 at 12:54 AM.. Reason: Edited quote for consistency
Reply With Quote
The Following 2 Users Say Thank You to sarahsweets For This Useful Post:
karenparker (09-29-16), Lunacie (09-28-16)
  #8  
Old 09-29-16, 04:39 AM
foreverwarrior foreverwarrior is offline
Member
 

Join Date: Aug 2015
Location: St. Louis
Posts: 56
Thanks: 3
Thanked 24 Times in 20 Posts
foreverwarrior will become famous soon enough
Re: Adderall Dosing Guidelines and FAQ

She's right. More or less. I won't go into biological process since it's early and I'm working, but she is mostly right (about as right as anyone needs to be, and more right than you). A doctor does not calculate dosage based on body weight. That'd be.....stupid.
Reply With Quote
The Following 2 Users Say Thank You to foreverwarrior For This Useful Post:
Little Missy (09-29-16), sarahsweets (09-29-16)
  #9  
Old 09-29-16, 05:57 AM
sarahsweets's Avatar
sarahsweets sarahsweets is offline
ADDvanced Forum ADDvocate
 

Join Date: Mar 2011
Location: nj, usa
Posts: 21,299
Thanks: 5,305
Thanked 25,320 Times in 11,192 Posts
sarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond repute
Re: Adderall Dosing Guidelines and FAQ

Quote:
Originally Posted by postictal_pete View Post
Would you give a small child and an adult the same dose of, say, Acetaminophen? Why not if age and weight aren't factors in dosing? If you would, please don't have children. Age is also obviously a factor, as young children and the elderly metabolize meds differently because of changes in biology you should have learned about in HS. I am a paramedic and absolutely take into consideration weight, age, musculature, gender (different fat/muscle ratios between genders lead to differences in absorption and metabolism of certain drugs) along with other factors when administering medications, because I know that these things matter to a great degree and I don't like murdering people with ignorance.
A word on Tylenol..the reason it is based on weight and age is because of the Liver. The way the liver processes certain drugs has to do with how "mature" or grown the liver is. A young child will have a less developed liver than an adult and too much tyelenol will stress and damage the liver. It is NOT the same with stimulants. Its not that much about weight with tylenol but age.


Quote:
Originally Posted by postictal_pete
More misleading than wrong. All OP said was that based on the timeframe in which specific side effects occur, the likelihood of it being a direct side-effect of this medication can be deduced based on what we know about serum levels after "x" time. So yes, there are time frames for side effects. You'll need to clarify why you think L-amphetamine would cause "excess stimulation"- and by that I mean: Why that ingredient specifically (as opposed to the dextroamphetamine, which is, in fact, more potent than L-amphetamine and makes up 2/3s of the Adderall mix), What is meant when you say "excess stimulation"? etc.

I don't see anything wrong with what OP stated there, it remained responsible. It doesn't seem like he's saying anything like "psychosis is normal as the meds wear off, don't bother talking to your doctor about it".

What is a "properly dosed med"? If you require a higher dose than someone else of the same age and weight as you, you may have a "comedown". The dose you are both taking IS each of your therapeutic dose (proper dose?) and yet IF you have a have a "comedown", it WILL be greater than that other individual will experience because you are on a higher dose out of necessity.



Well, OP provided some known biological mechanisms and a brief and simplified theory on how pH would obviously have an effect. And you provided anecdotal evidence on how you believe your meds are probably still effective when you do certain things.. So that's cool that you at least did that.. THEN you go on to deny that a persons renal system is involved in metabolizing Adderall? I think that's what you're saying.. You back this up and establish yourself as a biology expert by then saying, "that's kidney's, right?" Yes..that's kidneys.. As my source for how wrong you are about this I will cite: "The nearest human Biology book you can find" or, A current HS or college student taking Human Biology or A&P. Nephrology (study of kidneys) is insanely complicated. Nephrologists are some of the most intelligent people you'll meet, so I would take their word for gold when you come across it in any research.

As for your last "point", You want to see that study? Well OP told you the publisher. Took me 15 seconds to type it and find the published study and a nice summarization of it's methods and findings which state indeed that amphetamine levels were found to be markedly decreased at certain intervals when taken with certain meals, while methylphenidate (Concerta) levels seemed to remain relatively unchanged by. This study also mentions how pH levels cause variability, but you have anectdotal evidence that that is maybe no true to a significant degree, so you're probably not interesting in the general consensus of trained scientists..

It "irks" you when people post unresearched and innaccurate info? How would you know if it's unresearched and innaccurate? You didn't bother to check it yourself before coming to a conclusion and posting your opinion to be read by many users. The info OP gave is accurate enough not to be dangerous and to actually be useful to people. He also states that people should talk to real experts to confirm what he says and for more detailed information.

Seriously though, research some A&P. There are so many neat things about how our body systems function and interact. (Did you know blood cells are made by your bones?!)

Sorry for the Novel.. The ignorance was too much for me to let go.
__________________
President of the No F's given society.

I carried a watermelon?

Last edited by namazu; 10-06-16 at 02:35 PM.. Reason: fixing quote tags
Reply With Quote
  #10  
Old 10-05-16, 12:58 PM
postictal_pete postictal_pete is offline
Newbie
 

Join Date: Sep 2016
Location: Kansas
Posts: 4
Thanks: 3
Thanked 4 Times in 2 Posts
postictal_pete is on a distinguished road
Re: Adderall Dosing Guidelines and FAQ

Quote:
A word on Tylenol..the reason it is based on weight and age is because of the Liver. The way the liver processes certain drugs has to do with how "mature" or grown the liver is. A young child will have a less developed liver than an adult and too much tyelenol will stress and damage the liver. It is NOT the same with stimulants. Its not that much about weight with tylenol but age.
I appreciate these facts and I said as much in my original reply when I referred to the differences in biology that are associated with different age groups.

Quote:
Originally Posted by foreverwarrior View Post
She's right. More or less. I won't go into biological process since it's early and I'm working, but she is mostly right (about as right as anyone needs to be, and more right than you). A doctor does not calculate dosage based on body weight. That'd be.....stupid.
No, she's not right when she says "Meds are not weight based". No, I am not less right when I point out that many meds are, in fact, weight based.

You did the same thing I objected to when sarasweets did it, which is that you and sarasweets said something that you believe to be true to an adequate extent, but in such a vague way to leave it ambiguous and possibly confusing for the general population. You do this when you say "Meds are not dosed on weight, mass, height, age or girth.", or "A doctor does not calculate dosage based on body weight" because those words by themselves are wrong. The context you say them in doesn't necessarily make them clear in this particular case (especially since even in context the statement is refutable) and too many readers would benefit if you clearly referred to the specific med (Adderall) that you are speaking about when you say these things. At least, I hope you are specifically referring to Adderall because, if not, I'm wasting time with this conversation.

I didn't comment directly on whether or not Adderall should be weight based... But you think guidelines
Quote:
...published by Dr. Joseph Biederman, Chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at the Massachusetts General Hospital, and Professor of Psychiatry at the Harvard Medical School
are "...stupid"? You're entitled to whatever opinion you want to defend, I suppose, but it would be nice to hear said defence of your argument against Dr. Biederman providing guidelines for weight based dosing. The calculations OP provided from those guidelines do coincide well with findings during clinical trials for adults. This also points to the fact that the manufacturers of these drugs "play it safe" in their dosing recommendations to a degree that leaves a "normal" dose comfortably prescribed by a physician, out of, or too close to, the bottom of the therapeutic dose range...But I suppose that's neither here nor there. In my Adderall dosing example, it was intended to be clear that I believe the therapeutic dose of Adderall is dependent on symptoms firstly. I do not know the pharmacokinetics of Adderall or other ADD/ADHD drugs well enough to say that weight doesn't affect it at all, or to what degree or in what aspects it does if it does. But again, to argue with the source of the published guidelines OP provided is...bold.

Lastly! I apologize to readers, and to sarasweets in particular, for my apparent irritation in my previous post. I should have let it sit for a while and edited it before posting. So just to be clear: All I want to object to is significantly ambiguous language and what I perceived to be a dismissiveness of OPs well-intended, and well researched post. I think OP did a good job of saying "Hey, I'm nobody, ask your doctor, but think about these things I found that may not be 100% accurate, but have good sources". I think posts like this do well at getting people to do their own research and ask their doctors questions. I think it's equally dangerous to believe blindly whether its OP here or your doctor. We can't assume that some person on the internet never knows anything and can't be right if his information doesn't match our current beliefs, just as we can't assume our medical professionals DO know everything ALL the time and can't be wrong. So if this well disclaimered (IMHO) guide gets people to think about questions they want asked or answers they want tested then it is a decidedly good thing OP has done.

I hope you are both having good days today.
Reply With Quote
The Following User Says Thank You to postictal_pete For This Useful Post:
oopssiddaisy (10-16-16)
  #11  
Old 10-05-16, 08:21 PM
foreverwarrior foreverwarrior is offline
Member
 

Join Date: Aug 2015
Location: St. Louis
Posts: 56
Thanks: 3
Thanked 24 Times in 20 Posts
foreverwarrior will become famous soon enough
Re: Adderall Dosing Guidelines and FAQ

Well - If you understood the pharmacokinetics - It would make sense to you why basing dosage on body weight is stupid. Maybe this Dr. doesn't.
Reply With Quote
  #12  
Old 10-06-16, 12:00 PM
sarahsweets's Avatar
sarahsweets sarahsweets is offline
ADDvanced Forum ADDvocate
 

Join Date: Mar 2011
Location: nj, usa
Posts: 21,299
Thanks: 5,305
Thanked 25,320 Times in 11,192 Posts
sarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond reputesarahsweets has a reputation beyond repute
Re: Adderall Dosing Guidelines and FAQ

Quote:
Originally Posted by postictal_pete View Post
Side Note: You really railed me before in a snarky attacky kind of way. Im sensitive so writing a long reply to highlight my ignorance makes it really hard to look beyond that to discuss your points.


Quote:
No, she's not right when she says "Meds are not weight based". No, I am not less right when I point out that many meds are, in fact, weight based.
Yes many meds are weight based- stimulants are not. This is why a child and adult could be the same dosage of say, adderall and even then, the child may have better symptom control on a higher dose than an adult.

Quote:
You did the same thing I objected to when sarasweets did it, which is that you and sarasweets said something that you believe to be true to an adequate extent, but in such a vague way to leave it ambiguous and possibly confusing for the general population.
Its no more confusing or ambiguous then someone posting a guide and saying that stimulants are weight based.

Quote:
You do this when you say "Meds are not dosed on weight, mass, height, age or girth.", or "A doctor does not calculate dosage based on body weight" because those words by themselves are wrong. The context you say them in doesn't necessarily make them clear in this particular case (especially since even in context the statement is refutable)
http://www.additudemag.com/adhd/article/8942.html
Quote:
2. “For an adult of your height and weight, we start with this dosage.”
An optimal dosage is not related to a person’s height or weight.
Quote:
and too many readers would benefit if you clearly referred to the specific med (Adderall) that you are speaking about when you say these things. At least, I hope you are specifically referring to Adderall because, if not, I'm wasting time with this conversation.
I hope you can see how abrasive this sounds.


Quote:
I didn't comment directly on whether or not Adderall should be weight based... But you think guidelines are "...stupid"? You're entitled to whatever opinion you want to defend, I suppose, but it would be nice to hear said defence of your argument against Dr. Biederman providing guidelines for weight based dosing.
The link I shared has a lot of information about common medication myths.

Quote:
I do not know the pharmacokinetics of Adderall or other ADD/ADHD drugs well enough to say that weight doesn't affect it at all, or to what degree or in what aspects it does if it does. But again, to argue with the source of the published guidelines OP provided is...bold.
If you say you do not know the pharmacokinetics of adderall or other stimulants why would you say anyone is wrong ?

Quote:
Lastly! I apologize to readers, and to sarasweets in particular, for my apparent irritation in my previous post. I should have let it sit for a while and edited it before posting. So just to be clear: All I want to object to is significantly ambiguous language and what I perceived to be a dismissiveness of OPs well-intended, and well researched post. I think OP did a good job of saying "Hey, I'm nobody, ask your doctor, but think about these things I found that may not be 100% accurate, but have good sources". I think posts like this do well at getting people to do their own research and ask their doctors questions. I think it's equally dangerous to believe blindly whether its OP here or your doctor. We can't assume that some person on the internet never knows anything and can't be right if his information doesn't match our current beliefs, just as we can't assume our medical professionals DO know everything ALL the time and can't be wrong. So if this well disclaimered (IMHO) guide gets people to think about questions they want asked or answers they want tested then it is a decidedly good thing OP has done.
I am sorry you think its ambiguous but in the specifics about weight, it is not as researched as you say it is.
Quote:
I hope you are both having good days today.
Back atcha friend.
__________________
President of the No F's given society.

I carried a watermelon?
Reply With Quote
The Following User Says Thank You to sarahsweets For This Useful Post:
Little Missy (10-06-16)
  #13  
Old 10-13-16, 02:48 PM
postictal_pete postictal_pete is offline
Newbie
 

Join Date: Sep 2016
Location: Kansas
Posts: 4
Thanks: 3
Thanked 4 Times in 2 Posts
postictal_pete is on a distinguished road
Re: Adderall Dosing Guidelines and FAQ

Quote:
Originally Posted by foreverwarrior View Post
Well - If you understood the pharmacokinetics [of adderall] - It would make sense to you why basing [adderall] dosage on body weight is stupid. Maybe this Dr. doesn't [understand the pharmacokinetics of adderall].
Hey, that's a well thought out and informative response. Thank you.

I will counter with this study of the pharmacokinetics of Adderall though, which states:

"Comparison of the pharmacokinetics of d- and l-amphetamine after oral administration of ADDERALL XR in children
(6-12 years) and adolescent (13-17 years) ADHD patients and healthy adult volunteers indicates that body weight is the primary determinant of apparent differences in the pharmacokinetics of d- and l-amphetamine across the age range. Systemic exposure measured by area under the curve to infinity (AUC∞) and maximum plasma concentration (Cmax) decreased with increases in body weight, while oral volume of distribution (V/F), oral clearance (CL/F), and elimination half-life (t1/2) increased with increases in body weight." -- Shire US Inc. Adderall XR (mixed salts of a single-entity amphetamine product) prescribing information. Wayne, PA; 2007 Mar

If you have something informative to say, I'd love to hear it instead of your vague and pointless repetition of your original "point", which I find insulting. I'm confident that I am capable of understanding whatever you throw my way if you want to enlighten me on the pharmacokinetics. <--I do NOT mean this sarcastically, I would really be interested in something other than "Nah it's stupid, you don't understand, but it's stupid and that doctor is probably ignorant too.".

Quote:
The link I shared has a lot of information about common medication myths.


The article in link you provided simply states:
"2. “For an adult of your height and weight, we start with this dosage.”

An optimal dosage is not related to a person’s height or weight."

The article offers no sources, no explanations, and besides that does not appear to be saying what I believe you believe it is saying. What it says is that the optimal dosage is not related to weight.. and I agree with that statement, it fits with my dosing example a few replies ago.. What it is NOT saying is, "weight does not affect the pharmacokinetics of adderall at all." Also, it is simply written by a journalist with no stated credentials that I could find, so it absolutely NEEDS cited sources for the arguments provided to be considered credible and for someone to have any confidence in her word.

I realize that optimal dose is determined primarily by each individual deficit. I am saying though, that if you took two genetically IDENTICAL humans...as in, for all intents and purposes they ARE the same person, same deficits, same EVERYTHING.. then you made one of those individuals 100lbs. heavier THEN you would surely see an appreciable difference in the effectiveness of a particular dose of Adderall given to both of these humans. Maybe it would be in the absorption, or the distribution, half-life, peak serum levels, excretion of, etc.


Quote:
Quote:
and too many readers would benefit if you clearly referred to the specific med (Adderall) that you are speaking about when you say these things. At least, I hope you are specifically referring to Adderall because, if not, I'm wasting time with this conversation.

I hope you can see how abrasive this sounds.
I did not intend it to be abrasive. I merely meant it as a matter of fact that if the argument is "weight affects the pharmacokinetics of no drug, ever" then my time is wasted in arguing against that, as it's simply a fact that therapeutic range of many drugs is affected by the weight of the organism receiving it. If the argument is strictly about dosing of Adderall received orally, then I'm happy to continue this.
Reply With Quote
  #14  
Old 10-14-16, 03:18 PM
postictal_pete postictal_pete is offline
Newbie
 

Join Date: Sep 2016
Location: Kansas
Posts: 4
Thanks: 3
Thanked 4 Times in 2 Posts
postictal_pete is on a distinguished road
Re: Adderall Dosing Guidelines and FAQ

Quote:
Quote:
I do not know the pharmacokinetics of Adderall or other ADD/ADHD drugs well enough to say that weight doesn't affect it at all, or to what degree or in what aspects it does if it does. But again, to argue with the source of the published guidelines OP provided is...bold.

If you say you do not know the pharmacokinetics of adderall or other stimulants why would you say anyone is wrong ?
Sorry, I forgot to answer this part. Although the answer IS in the original quote, here is that answer: I say what I say because I know generally how these things work. I have a working knowledge (I believe) that is adequate enough to say what I have said with confidence. And I have found very credible sources that support me. Secondly, the source of OP's information on the dosage suggestion is very credible, therefore I am very happy to take that sources side of this argument.

To turn the question around, though, Why would you say you are right? Or do you agree with what I've argued so far?

Furthermore, I am happy (as I have proven) to back up what I say with appropriate research sources. I am also happy to say when I am wrong and am open to correcting my thoughts and beliefs as I sincerely wish to have as accurate and updated a knowledge base as possible...on all applicable subjects. I hope to prove that repeatedly if I continue to post in these forums.

Lastly, I'd like to express again how frustrating and disheartening it is that the OP was treated the way it was with such dismissiveness. The lackadaisical approach with which OP's post was "torn apart" is insulting to OP and to everyone reading it who comprehended it fully and knows better than the arguments used against it. I sincerely ask that you and the other person responding so far to me really LOOK into your responses objectively. I think what you'll find is that your responses are inadequate, erroneous, unsupported. Look at evidence such as that article on common medical myths you posted and ask yourself if that is truly a credible source..and if so, how? After seeing and using the sources I've provided, do you truly believe things such as "weight doesn't affect Adderall" and "It doesn't matter what you eat with it"? Sources such as information directly from a manufacturer, studies by various qualified and credible members of the health and science community. And if you dismiss those sources, then why? Please do not take this last bit harshly, I really do mean this sincerely and with an appropriate "softness".
Reply With Quote
  #15  
Old 10-16-16, 01:15 PM
oopssiddaisy oopssiddaisy is offline
Newbie
 

Join Date: Oct 2016
Location: Houston
Posts: 1
Thanks: 4
Thanked 1 Time in 1 Post
oopssiddaisy is on a distinguished road
Re: Adderall Dosing Guidelines and FAQ

I find it incredibly helpful and refreshing when posters are able to civilly disagree (especially when using FACT-based arguments and not sweeping generalizations). Well done!
Reply With Quote
The Following User Says Thank You to oopssiddaisy For This Useful Post:
postictal_pete (10-20-16)
Reply

Bookmarks

Tags
adderall, dosage, dosing, feel like, how much


Currently Active Users Viewing This Thread: 3 (0 members and 3 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is On
Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
Question: Why aren't the guidelines outlined in the Terms of Service when I sign up? DevinRoxMyWorld Forums Help, Q&A 5 02-24-09 09:39 PM


All times are GMT -4. The time now is 08:26 AM.


Powered by vBulletin® Version 3.7.4
Copyright ©2000 - 2016, Jelsoft Enterprises Ltd.
(c) 2003 - 2015 ADD Forums