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Not enough stimulation!


foley

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Hi all- (SORRY SO LONG, REQUIRES BACKGROUND)

I have a question I'd like as much feedback on as possible. I have been using stimulants since about 5-6 years ago when I needed to study for the GRE and realized I could not concentrate for 10 min let alone 2-4 hours daily needed.

I was prescribed Ritalin, began at a low dose (I forget mg) and climbed up gradually as needed, to be taken just when I needed to study. It worked great until I got as high as 20mg, at which point I was jittery and a little irritated.

I was switched to Adderall. Much better. I have continued to take Adderall, throughout my 4 yrs of grad school, and I still use it now for my work. My work is almost all at my desk and requires long stretches of concentration and attention to detail. Murder when I am not medicated or when, for some reason, the Adderall is not effective.

My last pdoc (a psychiatry resident) prescribed me 20mg of Adderall XR, which was great because it could last even 8 hours sometimes. Then I had to switch to a new pdoc, and for the past 16 mos. have been seeing a Psychiatric Nurse Practitioner (she can prescribe).

About a year ago, during a routine physical, my GP heard a 'bounding heart' on me, and sent me for a consult with a cardiologist to make sure the Adderall wasn't causing ill effects. He did an EKG, and pronounced me totally normal, said the amount of Adderall I was taking was perfectly safe and that the slightly elevated heart rate was normal of those on this medication, but not to worry.

Well, my pdoc has remained extremely wary, despite the dismissal from the cardiologist. She doesn't want me taking more than 10mg a day now! And she won't let me take the XR, only the short-acting. Well, as many of you know, that only lasts, if I'm lucky, 3 hours. Not enough to get me through the work day.

When I don't take it, or it wears off, I am a vegetable. I decided to split the dose into two, taking 5mg around 10am and another 5mg around 1pm. Lasts longer now, but it's just not enough medication to be really effective. My pdoc is hung up on the fact that I am also on Wellbutrin (300mg) which has a mildly stimulating effect (although I can take it and go right to sleep!)

How do I convince her that I need more medication??? I see many of you, esp. women my age (I'm 110lbs., if that matters) are on the same drugs, but more. Am I right to think she is being overly cautious?

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Did you get a letter from your cardiologist clearing you? Or is pdoc working on your word alone?

A letter was supposed to be sent to my pdoc from the cardio - I did manage to bring her the actual EKG - but she hasn't mentioned that she never got a letter from the cardio...perhaps I should ask her?

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A letter was supposed to be sent to my pdoc from the cardio - I did manage to bring her the actual EKG - but she hasn't mentioned that she never got a letter from the cardio...perhaps I should ask her?

Definitely. You would be surprised to find out often records manage to NOT get sent where they are needed.

Meanwhile, black coffee can help, and to some extent can be good for you. Also - minimize distraction exposure! Break out the headphones if you're in a work environment that allows it (The earplugs can cut back on noise and chatter even when you can't think of anything you want to hear)

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A letter was supposed to be sent to my pdoc from the cardio - I did manage to bring her the actual EKG - but she hasn't mentioned that she never got a letter from the cardio...perhaps I should ask her?

Definitely. You would be surprised to find out often records manage to NOT get sent where they are needed.

Meanwhile, black coffee can help, and to some extent can be good for you. Also - minimize distraction exposure! Break out the headphones if you're in a work environment that allows it (The earplugs can cut back on noise and chatter even when you can't think of anything you want to hear)

Thanks. I do drink caffeine in moderation during the day, but not late into the afternoon. Trouble is, while I crave it in the morning, it doesn't really change my energy or alertness. I have had coffee just before bed at times, with no ill effects! I wish coffee were more effective for me. I will try the headphones idea though.

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Foley,

What Null says is so true. In fact, I was schlepping around just yesterday, AGAIN, filling out authorizations for release of medical records. Which is besides the point. But yeah, you should call your cardiologist's office, have them send you a MRA form and send it back to them.

If your pdoc won't oblige AFTER your cardio records have been received by him or her, I would start looking for a new pdoc. But that's just me.

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