Jump to content




Photo
- - - - -

Do I need to ask doctor for raise in Adderall XR dosage?


  • Please log in to reply
6 replies to this topic

#1 CDRacingZX6R

CDRacingZX6R

    Member

  • Member
  • Pip
  • 4 posts

Posted 04 April 2009 - 01:08 AM

Hey all, recently diagnosed with Adult ADD.

Started taking Adderall XR, about 3 weeks or so ago. Was given freedom to experiment with the dosage by my doctor who started me at 10 mg, and then said to increase after four days by 10 mg if it wasn't helping. He said I could go up to 40 mg, then take it from there at my next appointment.

Generally, I have a high threshold to medications so at 10 mg, and 20 mg daily I felt no difference whatsoever. When I got to 30 mg I noticed some improvements. Not night and day, but I did start focusing a bit better in class, but it was short lived (maybe 2-3 hours max).

When I started at 40 mg, it seemed to be the perfect dosage for me. I was very happy, because before this I was starting to get discourage that maybe Adderall wasn't going to help me the way it seems to help so many people. However, the first three or four days at 40 was very good. Finished all my work on time for those days (something I rarely do), instead of waiting last minute.. Had some of the most productive days at class probably ever... My girlfriend even noticed how much more attentive I was with her when on it.. Instead of day dreaming or not listening to her, I was all there mentally. Which made us both happy.

Now on my 7th day.. I notice that it seems to be less effective with each passing day. Distractible again, and my impulsive tendencies came back to about normal(by far my biggest improvement on Adderall so far was that it killed my impulsivity).. Lack of motivation... And procrastination are back the last two days in some regards almost to how they were pre-adderall.

There have been some variables to my daily routine, and I'm hoping that is the reason. For example, last night I got less sleep than I like.. About 6 hours, vs 8.. But I had done this before without any real change in how the medication was working.

Another thing I found out tonight that was bad was drinking soda. I knew about juices, etc.. I got caffeine free soda, because my doctor told me to cut out the caffeine so I could accurately gauge the right dosage without interference, what I didn't know was the acid in my coke was possibly disrupting the Adderall's effectiveness. But the only problem is I had been guzzling soda since day one, and for the first 3-4 days at 40 mg it didn't seem to hurt it. Is the soda maybe killing off the effectiveness now that my body is used to the daily dosage?

The last thing I've done somewhat different in the last two days was eating 20 minutes or so before taking the Adderall.. Before I'd eat at least an hour or two before. And nothing for a while after. Could this be enough to contribute? I'm eating things which are all low acid, etc.

Should also note: I still crash most of the time, even if the Adderall isn't helping me focus. But the crash is less intense now than it was when it was working.

**Disclaimer, not talking about the rush feeling or Euphoria, I know some people confuse that with the drug working. I barely had a rush or euphoria at any dosage I assume from a natural high tolerance to substances.

Any advice would be great, starting to feel a bit hopeless at this point.


#2 meg

meg

    Member

  • Member
  • Pip
  • 790 posts

Posted 04 April 2009 - 03:59 AM

hey,
first of all, welcome to CB, I hope you like it here ;)
secondly, it's 5am where I am and I really need to go to bed (oy.) so I'm going to try and come back to this tomorrow and be more thorough, I just wanted to say/ask a couple of things--
- have you tried any other ADD meds (stimulants, strattera..?)
- it sounds like adderall is your first, in which case you have no buisness getting hopeless yet, mister!
lol, I just mean that there are a lot of different med options for this and most people tend to have some that work better than others even though they're mostly in the same 'class' of drugs
- adderall XR isn't nearly as helpful for me as the regular IR kind-- the kicker there is remembering to take a 2nd dose, but if this form of adderall isn't for you, it doesn't rule it out completely
- check out crazymeds.us if you haven't seen it, he's got a pretty good overview of the adhd meds and that site can be really helpful in having good info all in one place
- I'd go in and tell your doctor exactly what you've said here-- you sound pretty self-aware which is great since it makes it easier to communicate with pdocs that way, you could also get a little 'report' from your GF's point of view in case she's noticing anything that you aren't. I wouldn't just ask for an increase, I'd keep trying it until I saw the doc and ask their opinion on dosage or possibly trying a different med.
- some people (moi included) take both the XR and IR, which might be a possibility (for instance, take the XR in the AM and then a smaller dose of IR midday to get you through the rest of the day and help with any crash you're having
- the crash tends to diminish for most people after taking stims for a bit-- I have none at all now

okay, so much for not covering what I wanted to, lol
whoops.
hope you can make sense of my tired babble!
m

warning: I often write novels vs. posts-- please skim if you need to, just don't get scared off by the quantity of babble!

  • me: am 22 years old (feel about 90 sometimes), am a photographer (just finished my degree!) and makeup artist
  • dx: april'07: "mdd and adhd (inattentive)," mid'08: tack on "hyper-somnolence" (ie: meg sleeps too much)
  • mdd rx: wellbutrin xl 450mg, zoloft (sertraline) 150mg, lamictal 100mg
    • dec'07: depression is IN REMISSION. I don't believe it either! I <3 you, lamictal.
    • jan'09: just finished up my first year without depression, since, uh, 4th grade? I'm proof that stability can happen- please hang in there.
  • other rx: adderall xr 20mg in the am + 20mg regular later (for unexplained fatigue)
    • atenalol 25mg (beta-blocker for hand tremors that I get from lamictal)

"And when finally the bottom fell out
I became withdrawn,
The only thing I knew how to do
Was to keep on keepin'on like a bird that flew,
Tangled up in blue."

- Bob Dylan "Tangled up in Blue"


#3 CDRacingZX6R

CDRacingZX6R

    Member

  • Member
  • Pip
  • 4 posts

Posted 04 April 2009 - 04:41 PM

hey,
first of all, welcome to CB, I hope you like it here ;)
secondly, it's 5am where I am and I really need to go to bed (oy.) so I'm going to try and come back to this tomorrow and be more thorough, I just wanted to say/ask a couple of things--
- have you tried any other ADD meds (stimulants, strattera..?)
- it sounds like adderall is your first, in which case you have no buisness getting hopeless yet, mister!
lol, I just mean that there are a lot of different med options for this and most people tend to have some that work better than others even though they're mostly in the same 'class' of drugs
- adderall XR isn't nearly as helpful for me as the regular IR kind-- the kicker there is remembering to take a 2nd dose, but if this form of adderall isn't for you, it doesn't rule it out completely
- check out crazymeds.us if you haven't seen it, he's got a pretty good overview of the adhd meds and that site can be really helpful in having good info all in one place
- I'd go in and tell your doctor exactly what you've said here-- you sound pretty self-aware which is great since it makes it easier to communicate with pdocs that way, you could also get a little 'report' from your GF's point of view in case she's noticing anything that you aren't. I wouldn't just ask for an increase, I'd keep trying it until I saw the doc and ask their opinion on dosage or possibly trying a different med.
- some people (moi included) take both the XR and IR, which might be a possibility (for instance, take the XR in the AM and then a smaller dose of IR midday to get you through the rest of the day and help with any crash you're having
- the crash tends to diminish for most people after taking stims for a bit-- I have none at all now

okay, so much for not covering what I wanted to, lol
whoops.
hope you can make sense of my tired babble!
m


Hi Meg, thanks for responding.

You are correct about Adderall being my first stimulant. Closest thing to a stimulant I've ever taken is sudafed for sinus congestion. Even though I've had ADD all my life, I was never diagnosed with it until I recently. I've also tried Provigil for a month (best I could get without seeing a Pdoc).. But it actually made me worse. Also affected my eyes for some reason with vision changes. And I tended to be just as distracted on it as I would have been without it.

I think my diet, sleep, and drinking (cokes, etc) might have been playing a larger role in the inconsistency than I expected. Today I ate a light breakfast 1 hour before my 40 MG dosage. After I ate I had two tums (the supplementation dosage, nothing extreme). Only drank water instead of my usual coke. Then had my first coke about 2 hours after taking the dosage.

Maybe just eating a big breakfast, and drinking lots of coke at the same time as taking my dosage was killing it.

Although not perfect today, it's much better today than it was the last two days. I made sure I got enough sleep as well.

As for the doctor, I think I'm still going to take your advice and talk to him about all this anyway. Just to see what he thinks. I'd like him to consider a booster for the P.M, because I hate crashing at 1-2 in the afternoon when I got 5 hours of class and work left. Cause it makes a bit cranky, and really sleepy.

#4 null0trooper

null0trooper

    Member

  • Member
  • Pip
  • 3928 posts

Posted 04 April 2009 - 10:04 PM

It probably doesn't hurt at all to take a caclium carbonate-based antacid or supplement with Adderall. It might be a good thing in the long run if you do drink a lot of phosphoric acid-based sodas.

Since it's possible to deplete your brain's dopamine/noradrenaline stores through stimulant use, increasing your phenylalanine or tyrosine intake may help your body keep up (Best choice: more good protein, less carbs; Second-best: supplements.) Or, you may actually do better at a lower dose after skipping a weekend (You won't get anything done, but stimulants are among the few meds that you can skip a day or two with no more ill effects than that.)

Proof once again that we are the only adventurers for whom the letters "AD&D" stand for "Attention Deficit Disorder" - Roy Greenhilt, Order of the Stick

Rule your own nation at Cyber Nations, A nation simulation game! Yes, I do waste spend a lot of time on it, especially the Viridian Entente's alliance boards.


#5 CDRacingZX6R

CDRacingZX6R

    Member

  • Member
  • Pip
  • 4 posts

Posted 06 April 2009 - 09:43 AM

It probably doesn't hurt at all to take a caclium carbonate-based antacid or supplement with Adderall. It might be a good thing in the long run if you do drink a lot of phosphoric acid-based sodas.

Since it's possible to deplete your brain's dopamine/noradrenaline stores through stimulant use, increasing your phenylalanine or tyrosine intake may help your body keep up (Best choice: more good protein, less carbs; Second-best: supplements.) Or, you may actually do better at a lower dose after skipping a weekend (You won't get anything done, but stimulants are among the few meds that you can skip a day or two with no more ill effects than that.)


Thanks for the advice.

Do you think it would hurt to switch to 30 mg tomorrow after I have been taking 40 mg for 8 days or so? Or should I just wait until the weekend, take a 2 day holiday then start back up on 30 mg? I'd like to keep my dosage as low as possible, but I fear 30 not being as effective now that I've been using 40 mg for 2 weeks now.

Thanks for responding.

#6 null0trooper

null0trooper

    Member

  • Member
  • Pip
  • 3928 posts

Posted 06 April 2009 - 12:37 PM

Do you think it would hurt to switch to 30 mg tomorrow after I have been taking 40 mg for 8 days or so? Or should I just wait until the weekend, take a 2 day holiday then start back up on 30 mg?


Sometimes there are pressing reasons to change meds or dosages mid-week, but too often it causes more problems than it solves. If your doctor thinks it's worth a try, in order to gage the immediate effects of a reduction, Friday might be a good choice. No one gets much done that day, so you might not be noticed.

Proof once again that we are the only adventurers for whom the letters "AD&D" stand for "Attention Deficit Disorder" - Roy Greenhilt, Order of the Stick

Rule your own nation at Cyber Nations, A nation simulation game! Yes, I do waste spend a lot of time on it, especially the Viridian Entente's alliance boards.


#7 ghost_train

ghost_train

    Member

  • Member
  • Pip
  • 46 posts

Posted 13 April 2009 - 04:09 PM

Another thing I found out tonight that was bad was drinking soda. I knew about juices, etc.. I got caffeine free soda, because my doctor told me to cut out the caffeine so I could accurately gauge the right dosage without interference, what I didn't know was the acid in my coke was possibly disrupting the Adderall's effectiveness. But the only problem is I had been guzzling soda since day one, and for the first 3-4 days at 40 mg it didn't seem to hurt it. Is the soda maybe killing off the effectiveness now that my body is used to the daily dosage?


I had thought you only have to avoid acidic food an hour before and after taking Adderall. Once it's been absorbed at the beginning of the small intestine, it's not an issue anymore. I actually find myself drinking orange juice at night. ;) Although Wikipedia mentions that the pH of urine also factors into whether it is retained or excreted. Which makes sense, I guess. I've asked my psychiatrist and one of my pharmacology professors why, so maybe I'll hear something soon. So um, maybe orange juice and soda should be consumed in moderation outside that window?

I have a similar problem. 20 mg was great, waned progressively over a week, then it was like nothing. My doctor gave me leave to go up to 40 mg a day. I felt awesome again...then at my next appointment (weeks later), I wasn't sure if I should ask for an increase. We left it. A month later, I was increased to 40 mg XR + 10 mg IR if I needed it. Well, this dose is only helping a little bit. And then, it seems that when I'm on insufficient amounts that have some effect, I have intermediate issues...hyperfocus to the point of not doing anything important. I still get flaky and stop tasks midstream, one after another after another...

I feel like some sort of...I don't know, am I dead? How am I not reacting to 50 mg of Adderall + 450 mg of Wellbutrin? Let alone my albuterol inhaler (also a sympathomimetic) - I need four sprays for it to do anything at all. I'm not THAT big of a person. 5'4", between 150 - 155. I build muscle easily...still, I'm female.

But yeah, if you ever get any clues about that, please let me know.






The content of individual posts on this site are the sole work of their authors and do not necessarily reflect the opinions and/or policies of the Administrators, Moderators, or other Members of the Crazyboards community. Health related topics should not be used for the purpose of diagnosis or substituted for medical advice. It is your responsibility to research the accuracy, completeness, and usefulness of all opinions, services, and other information found on the site, and to consult with your professional health care provider as to whether the information can benefit you.