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Making Adderall last longer- into the late evening


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#1 etkearne

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Posted 27 November 2010 - 07:31 PM

Hello. Sorry for the rather condensed title to this thread. It is a long description of the problem, and I couldn't think of a succinct way to put it.

Anyways, I am on Adderall IR 15mg BID. So, I usually get up at 8:00. I take it at 8:30. Then, like recommended, I take the second one four to five hours later, so sometime around 1:00pm. Now, I feel as though the dose is fine. I am on Adderall for two purposes- A.D.D. symptoms and treatment-resistant bipolar depression. It has been a god-send since I was bumped to the 15mg dose. I have been more stable with the cocktail I am on now than I have since 5 or 6 years ago.

The only problem is that the effects of the second Adderall dose wear off relatively quickly. I feel noticeably "uneasy" as early as 4:30pm. I think due to the other meds I am on, the half life of the Adderall is shortened or something pharmacokinetic like that. So, if I was only being treated for A.D.D., that wouldn't be a problem, as work/school/whatever is over. But, it is used for my mood, and I always get rather dull and life-less in the evening, which is a shame, since most people like to do recreational activities in the evening!

So, when I forsee being out later than usual, I wait until 10:00 am or so to start my dosing, but, then the early morning is messed up. So, my idea is that if I took 15mg Adderall XR BID, I could extend the length of effectiveness without taking more drug. Taking a 30mg XR would just behave like the 15mg IR BID, so that wouldn't help. But, doing the mental math in my head and drawing the concentration vs. time graph, it seems like the 15mg XR BID would smooth out the intensity as well as extend the effects.

My question is: Has anyone ever done this with their doctor? Does it do what I want it to do?

I see the pdoc Monday, so I want to know if it is worth even asking about. If that doesn't work, he'll probably give me a third IR pill (he hinted at that once), but I don't really like knowing I am taking that much amphetamine every day, as it is neurotoxic!

Thanks Much!
Diagnosis- Bipolar Type I - Rapid Cycling, Narcissistic Personality Disorder, Opioid Dependency (in remission)

Present Medications (in total daily dose)- Lithium Carbonate (600mg), Zyprexa (10mg), Suboxone Film (4mg), Efffexor XR (225mg), Concerta (54mg), Klonopin (1-2mg)


Attempts- Imipramine, Amitryptamine, Lexapro, Paxil, Risperdal, Trileptal, Lamictal, Cymbalta, Abilify, Wellbutrin, Seroquel, Adderall

Psychology- Weekly individual therapy, looking to change to new therapist soon!

I recently updated my "About Me" in my profile. If you want to know more about me, please read it.


#2 SashaSue

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Posted 27 November 2010 - 07:47 PM

OK, first, as a person who takes stims only for ADHD, I have to correct your mistaken notion that treatment for ADHD is only necessary during the school or work day. Whether I'm at school, work, or home, I need to be able to get places in a reasonably timely fashion, remember where I've put my keys, glasses, pens, whatever, remember deadlines and other time commitments, and attend to things I don't find implicitly interesting.

I don't really think there's any complicated interaction thing going on. Different meds remain effective in different people, for different amounts of time. It really doesn't matter what exactly the cause is, does it? You need to switch to the XR, assuming you don't want to mess around with your other meds. I took Adderall XR in a similar way to what you're talking about for years. 30mg am, 30mg pm. It provided much better control of my ADHD symptoms.

BTW, as far as I can tell, there's not really convincing evidence that stimulants used in therapeutic dosages in humans are neurotoxic.
Dx: Bipolar I, ADHD<br />
Rx: Seroquel, 800mg, Lamictal, 150mg, Effexor, 325mg, Wellbutrin, 450, Dexedrine ER, 60mg

#3 AnneMarie

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Posted 27 November 2010 - 08:07 PM

You have a few options to talk to your doc about. You could try adding a 15mg IR late afternoon. You could try 15mg XR to see if it lasted into the evening. It does a bit for me. You could try the XR with an IR late in the day. Or, you could do the XR BID as you mentioned. This would effectively increase your dose part of the day, I think.

I'd leave room for your doc to figure out how to proceed by simply telling her how your dose effects you.

Btw, I'm pretty sure that 15mg XR would be the same as your 15mg IR BID.

Edited by Stacia, 29 November 2010 - 02:06 PM.

Bipolar I and ADD


#4 etkearne

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Posted 27 November 2010 - 10:09 PM

OK, first, as a person who takes stims only for ADHD, I have to correct your mistaken notion that treatment for ADHD is only necessary during the school or work day. Whether I'm at school, work, or home, I need to be able to get places in a reasonably timely fashion, remember where I've put my keys, glasses, pens, whatever, remember deadlines and other time commitments, and attend to things I don't find implicitly interesting.

I don't really think there's any complicated interaction thing going on. Different meds remain effective in different people, for different amounts of time. It really doesn't matter what exactly the cause is, does it? You need to switch to the XR, assuming you don't want to mess around with your other meds. I took Adderall XR in a similar way to what you're talking about for years. 30mg am, 30mg pm. It provided much better control of my ADHD symptoms.

BTW, as far as I can tell, there's not really convincing evidence that stimulants used in therapeutic dosages in humans are neurotoxic.


Sorry for my rashness. I am wrapped up mainly in the world of mood disorders and only know a little about attention disorders. It makes perfect sense to me, though, that a person with ADD or ADHD would desire to be symptom free all day, but with the way they market the drugs, it seems like they only care about controlling symptoms until 5 pm!

I'm sure you'll agree with me that having the attention to read a good book in the evening, or to really get into the news on TV are desirable things that can only come from having the medication in the blood at a later hour.

I am glad to see that my "idea" of XR BID is used, and that there are even other combinations I could try, like IR in the morning, XR in the evening. I feel much more prepared for my appointment and a little more educated on a mental illness that isn't as well known to me!

EK
Diagnosis- Bipolar Type I - Rapid Cycling, Narcissistic Personality Disorder, Opioid Dependency (in remission)

Present Medications (in total daily dose)- Lithium Carbonate (600mg), Zyprexa (10mg), Suboxone Film (4mg), Efffexor XR (225mg), Concerta (54mg), Klonopin (1-2mg)


Attempts- Imipramine, Amitryptamine, Lexapro, Paxil, Risperdal, Trileptal, Lamictal, Cymbalta, Abilify, Wellbutrin, Seroquel, Adderall

Psychology- Weekly individual therapy, looking to change to new therapist soon!

I recently updated my "About Me" in my profile. If you want to know more about me, please read it.

#5 notfred

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Posted 27 November 2010 - 10:16 PM

I see the pdoc Monday, so I want to know if it is worth even asking about. If that doesn't work, he'll probably give me a third IR pill (he hinted at that once), but I don't really like knowing I am taking that much amphetamine every day, as it is neurotoxic!
Thanks Much!



Can you site studies that support amphetamines at therapeutic doses are neurotoxic ? Giving lab animals huge doses of MDMA does not count. Everything is toxic at a large enough dose.

nf

Edited by notfred, 27 November 2010 - 11:49 PM.


#6 etkearne

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Posted 29 November 2010 - 01:59 PM

So, I got back from my appointment. We decided to go with 10mg IR's t.i.d. instead of the XR, since he said if he did the XR route, he would have to give me a bottle of IR's for the late afternoons. We also discussed Vyvanse, but he told me that there would be a hangup with the insurance, and that he thinks three IR's a day would work just as well in my particular case.

As for the neurotoxic statement: I have definitely read, in reliable text, that amphetamine and methamphetamine are neurotoxic. The dose was not given. It is a fascinating subject, however, and I want to investigate it. I think amphetamine is a pretty benign drug when used orally in spaced out doses. I'm bipolar prone to psychosis and haven't had any trouble with the stuff. I count myself lucky in that regard, though.
Diagnosis- Bipolar Type I - Rapid Cycling, Narcissistic Personality Disorder, Opioid Dependency (in remission)

Present Medications (in total daily dose)- Lithium Carbonate (600mg), Zyprexa (10mg), Suboxone Film (4mg), Efffexor XR (225mg), Concerta (54mg), Klonopin (1-2mg)


Attempts- Imipramine, Amitryptamine, Lexapro, Paxil, Risperdal, Trileptal, Lamictal, Cymbalta, Abilify, Wellbutrin, Seroquel, Adderall

Psychology- Weekly individual therapy, looking to change to new therapist soon!

I recently updated my "About Me" in my profile. If you want to know more about me, please read it.





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