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Hello,

Could someone please honestly tell me because I can't trust myself because I'm a recovering drug addict. (Id like to put a disclaimer right here that I don't follow 12-step dogma so please don't start preaching that even though it does work for many)

anyways, new diagnosis I'm a 33-year-old male finally told that I have a little bit of aspbergers disorder which is now technically on the autism spectrum and ADHD to go together with my OCD, and GAD oh I can't forget about the clinical depression either. I was a severe opioid and benzo addict taking crazy amounts I am now medicated but I'm worried about the amount of stimulants. I have never abused stimulants other than MDMA really and I don't know much about them. 

 

I was just put on Adderall XR seven months ago now I'm a 6 foot tall 240 pound male. It was amazing to see the effects that it had. I can finally look people in the eyes and my brain was finally slow. It was like for years they tried to numb with the stupid benzo's but my brain would still race.

However, the dosing scares me because I don't know anyone else that takes this.  I take 60 mg in the morning and another 30 mg capsule at 1400. They don't last 12 hours and I work about 10 hours a day so I find the 90 mg keeps me good for the majority actually really good for thee whole day and I still sleep for 6 to 8 hours

But I didn't quit shooting up heroin to die from a heart attack..so can any of you give me some input please. Ps. By the way I also take 60 mg of Paxil and 4 mg of Xanax which sounds high but is pretty good considering before the Adderall I was taking eight and this was prescribed by my addiction Doctor. I honestly was not abusing that.

I needed that to function soon as I went on the Adderall I stopped having the stupid panic attacks and have managed to cut my dose in half. I also take an opioid called Suboxone which is used to treat addiction. So yes technically I'm on amphetamine, benzodiazepine and opioid and an SSRI

but, I'm the happiest I've ever been and I'm actually functioning and holding down a job and stuff for the first time in my life. I could really use some helpful opinions

Edited by ConfusedToronto
Spelling duh it's the ADHD room
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Yeah, when I was taking the Adderall capsules (20mgs), they didn't last 12 hours, either. I was feeling spacey by six hours. My pdoc switched me to the tablets, so I now take 20mgs in the morning and 20mgs in the afternoon, and I get through my eight-hour work day just fine (with a couple extra hours at the end, so I can remember to make dinner, lol). Adderall does help with depression, for sure. I 100% feel the difference in my mood between when I take it and when I forget. Since you're being so open (which is wonderful), I'll do the same: I've done some coke in my life, and I've taken extra Adderall to get shit done for school during midterms and finals when I was in college. I actually enjoyed it a lot more than I ever enjoyed doing coke. I'm glad you're feeling good, but to be honest, I personally think your dose sounds high, and I weigh about 100 lbs more than you, and I'm 5'10". But hey, someone else might pop up to tell you they take 120mgs twice/day, who knows. I could take 40mgs to pull all-nighters, and I'd supplement that with energy drinks (yeah, I know). Full-time work + full-time school = bad.

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I know I harp on this a lot, but do you have any signs of sleep apnea?  When I got mine treated, my dose of stimulants was suddenly WAY too high.

That's a solid question. A year ago, my aunt started feeling... cloudy? She just couldn't remember anything, figure things out on her own, etc., just out of the blue. At first, we all thought it was depression (runs in the family, among other fun things). She went to a bunch of doctors, and they eventually figured out she had sleep apnea and something going on neurologically. She started using a c-pap machine and taking 5mgs of Adderall, and BOOM! She was totally fine and back to her old self.

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Risk of heart attack on prescription stimulants is actually fairly low. They're safer than some OTC meds (mostly acetaminophen). So, no, your doctor isn't trying to kill you.

Also, there's no technically about it - Asperger's Syndrome is autism. In the US, Asperger's Syndrome was folded into a new diagnosis called autism spectrum disorder (ASD), along with autism and pervasive developmental disorder - not otherwise specified.

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I had a doctor put me on 60 mg of Dexadrine without any titration and I couldn't handle it. I started to get strange mental effects which I believe would have gone over into psychosis had I not stopped it. That was too bad because I probably needed the Dexadrine, but not at that high of a dose. Perhaps half that dose would have been ideal.

As has been said, stimulants are generally safe. They have been around since the 1930s and before, and have been tested and tested and tested again. But you don't want to be on any more than you actually need.

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Thanks guys yes I was just worried because of a new pharmacist who was like this is a crazy dose and you are going to end up with a heart attack. I went to the hospital when I had bronchitis and I was on my adderall at the time and my blood pressure was 127 over 84 but I was nervous. After I spoke to the doctor dropped and they gave me this thing where they put stickers on me I think it's called an ECG and it was completely normal so I guess that's good. 

 

I want to take the proper amount and no more it's just that some days it's the right amount and some days it isn't. I played around with the stomach acid bullshit and it's always a variable thing. Like today it was  strong. 

But the other day for example I took my 60 mg in the morning and I went back to bed to lay down and I woke up five hours later.

And yes I have been tested for sleep apnea which I do not have. Thanks guys. It sounds dumb but stimulants always scared me because when you do too much you know you kind of get panicky whereas with opioids which are more dangerous and kill more people I was never scared.

You feel good so you want to feel better and you get more relaxed and unfortunately you get so relaxed you stop breathing and die. I was on 12 oxy 80s and smoking 4 fentanyl 100ug patches a day and 8 mg of Xanax, 2 of clonazepam and 90 temazepam daily.

Mixing that amount of downers is lethal yet I was never scared. Obviously I should have been because I overdosed four times but stimulants, always scared me because when you do to much you start freaking out. With opiates you're still sedated you don't believe or even care that you can die

Edited by ConfusedToronto
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Thanks guys yes I was just worried because of a new pharmacist who was like this is a crazy dose and you are going to end up with a heart attack. I went to the hospital when I had bronchitis and I was on my adderall at the time and my blood pressure was 127 over 84 but I was nervous. After I spoke to the doctor dropped and they gave me this thing where they put stickers on me I think it's called an ECG and it was completely normal so I guess that's good. 

 

I want to take the proper amount and no more it's just that some days it's the right amount and some days it isn't. I played around with the stomach acid bullshit and it's always a variable thing. Like today it was  strong. 

But the other day for example I took my 60 mg in the morning and I went back to bed to lay down and I woke up five hours later.

And yes I have been tested for sleep apnea which I do not have. Thanks guys. It sounds dumb but stimulants always scared me because when you do too much you know you kind of get panicky whereas with opioids which are more dangerous and kill more people I was never scared.

You feel good so you want to feel better and you get more relaxed and unfortunately you get so relaxed you stop breathing and die. I was on 12 oxy 80s and smoking 4 fentanyl 100ug patches a day and 8 mg of Xanax, 2 of clonazepam and 90 temazepam daily.

Mixing that amount of downers is lethal yet I was never scared. Obviously I should have been because I overdosed four times but stimulants, always scared me because when you do to much you start freaking out. With opiates you're still sedated you don't believe or even care that you can die

Funny, I was always way too scared of downers! Aside from beer and weed, I never touched the stuff. I like to be alert- I'm a control freak, though, so I guess it makes sense, haha.

I should have mentioned earlier that it would probably be a good idea to bring your concerns to your doctor. They may have an explanation that makes sense and we don't really know about. That's why they make the big bucks. ;) And there's no rule that you can't ask another doctor about the dosage if you're concerned!

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I am diagnosed with ADHD, ASD, and Bipolar Disorder.  I also have a history of extensive drug abuse spanning over a decade, and including stimulants (pretty much only MDMA -- supposedly!  Because MDMA is so very often cut with other substances, I very likely was getting amphetamine mixed in with MDMA, MDA, MDE, etc. if not just it being flat-out amphetamine.)  Which includes illicitly obtained Dexedrine specifically.  I find that terribly amusing.  My pdoc specializes in ADHD (among other things) and has it herself, and isn't prejudiced automatically against patients with a history of drug abuse, for which I am eternally thankful.

A lot of ignorance exists even among medical professionals regarding psychostimulants.  And one very true aspect of them is the potential for increasing anxiety.  For me personally, my past experience with stimulant abuse has actually benefited me in this regard -- I'm highly aware of the physiological effects of a stimulant in my body.  I don't hyperfocus on that stuff, I don't develop the panic-attack feedback loop (then again, my anxiety/panic attacks never did go in that typical "OMG I'M HAVING A HEART ATTACK" sort of way, so.  Make of that what you will.)  So, if I experience things like a bit of an elevated heart rate, anxious thoughts, sweating, etc. I know it's my stimulant wearing off, and I'm able to counter any anxious thoughts with that.

In my experience it is extremely normal to have the "right" dose differ on even a day-to-day basis.  Previously I was on Concerta, now I take Dexedrine spansules instead.  On Concerta I technically had a 99mg/day dose, but that was broken up into 54mg AM and 45mg PM dosing, and the 45mg PM was not always required (though the 54mg AM definitely was, unless I was also manic.)  Now my prescription for Dexedrine is technically 30mg AM and 20mg PM, but sometimes I do not require the PM dose, and sometimes 20mg is just shy of being enough for my PM dose and so I take 30mg instead.  My pdoc has been an informed and active part of this process the entire time, and my current Dexedrine dosing variability still works out in the end (I do not go through it too quickly -- in fact I tend toward the opposite instead, as the official prescription is for 50mg/day.)

I really do suggest bringing your concerns up with your prescribing doctor, as others have already said.  Asking here is good too, though.  Both is best! :D My switching from Concerta was precipitated by discussions on here, and it was through both discussions with others on here and discussions with my pdoc that the switch to Dexedrine was what I felt to be right.

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I listened to that crazy pharmacist and i decided just to stop cold. Well that pharmacist I learned is in recovery and is part of the 12 step program which makes no sense to me. I think it was extremely stupid of her to give me advice not knowing my medical history. I went on a medication holiday and I can tell you it has been the closest to suicidal I have ever been. I stayed in bed for three days and cried my eyes out and all I could think about were my dead friends and my brain was racing and I felt like honestly giving up. 

I texted my doctor at midnight and today went to pick up a new prescription much better I feel like a human again I do not feel high I do not feel low I I feel like me.

I changed things up a bit. I decided that 90 mg was too much and we're now going to have a maximum of 75 mg. Instead of dealing in only 30 mg XR caps i'm going to get 1 30 mg capsule every day and I can choose to take between 1-3 15 mg XR Caps to add 

so instead of jumping in huge increments I know I can adjust myself and titrate a bit. 30 mg is the minimum that will work that's why she gave me 30 days worth.

90 capsules of the 15 mg XR will allow me based on my day to go in smaller increments but like I said to a maximum of 75 as opposed to 90.

I need to change pharmacies because not only is a pharmacist a lunatic but also I noticed when I picked up my bottle of 15 mg tablets they expired in June! This is a controlled substance they should be much more careful obviously three months is not going to be a big difference for amphetamine salts but still come on?

 

 

Edited by ConfusedToronto
Spelling ADHD duh
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WOW.  That is very, very poor behavior on the part of that pharmacist.  Both encouraging you to take a drug holiday without consulting your doctor, AND the expired medication! I strongly encourage you to find out how you could report that pharmacist and to consider doing so, if only to protect someone else after you've changed pharmacies!

I'm really glad you consulted with your doctor to find a solution that works for you.  You're the only one who can really know the effects of the medication and I'm glad your dr was able to prescribe this helpful med in such a way that you can tinker with the dosing when necessary.

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  • 6 months later...

I think you a worrying despite all signs point to 90 mg not being too much. Blood pressure is fine, ECG normal. What is your pulse rate ? I would continue to check pulse and blood pressure just to be safe.

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