taking Adderall and going back to sleep

[jordansonfleek]

Hi all,

i am prescribed 30mg Adderall XR TID and 10mg IR PRN.  I always take one of my 30mg XR in the morning, an hour before I need to wake up. Then I go back to sleep and somewhere within 45 min to 1.5 hours, the adderall gets me up. (I have a hard time getting up in the AM). Anyone else do this or am I weird? Lol

[Iceberg]

Yep! Use ir not Xr but it works great for me 

[Flash]

Didn't get that with Adderall, but Ritalin/Concerta used to put me out like a light. I had to stop taking it, because I was sleeping all the time. Unfortunately, it doesn't have that effect on me anymore. Quite a few meds have lost their effectiveness for me. 

[JustNuts]

OP, it's very very common to take meds in the morning like this. I personally don't do it as I always eat breakfast before taking all of my morning meds at once, and I don't have a long lag time before effects show up with IR Adderall anyways. However it's quite common, and in fact a drug company (Ironshore/Highland) is developing novel extended-release formulations of amphetamine/methylphenidate designed for overnight dosing - take the pill the night before, it kicks in 8 or so hours later (i.e. right when you need to get up) - so no pills to remember to take in the morning and zero lag time to effects once you wake up too.

If you're wondering about why you can fall asleep immediately after taking the pill, the answer lies in the fact that it takes time for the release mechanism to operate and for blood serum levels of the drug to reach high enough levels for therapeutic effects to become apparent. With IR meds, therapeutic effects can show up in as little as 20 minutes or so. XR is typically a little bit longer, although some formulations are faster than others, and it also depends on dosage relative to your personal sensitivity to the drug (and how you metabolize it). Vyvanse is the worst of all the meds at this with close to two hours for it to become fully effective, although people usually start noticing effects at least somewhat earlier than the two hour mark. The reason for Vyvanse's long lag time likely lies in the rate-limited conversion of lisdexamfetamine into dextroamphetamine, and potentially also in other bottlenecks for transporting lisdexamfetamine into the blood stream so that the enzymic cleavage of L-lysine can take place.

On 2/24/2017 at 1:04 AM, Flash said:

Didn't get that with Adderall, but Ritalin/Concerta used to put me out like a light. I had to stop taking it, because I was sleeping all the time. Unfortunately, it doesn't have that effect on me anymore. Quite a few meds have lost their effectiveness for me. 

I've found that both methylphenidate and amphetamine sometimes act like this to varying degrees (but very unpredictably and thankfully relatively rarely in absolute terms). I also sleep differently when I fall asleep on them (sleep shorter periods but feel better rested when waking).

Edited March 1, 2017 by JustNuts

[JustNuts]

24 minutes ago, Dphxa said:

It seems a lot of medicine is turning to this controlled release.  It isn't made for people who don't have a colon.

That depends on how little colon you have left and what controlled release mechanism is used. The use of controlled release mechanisms is popular because it drastically increases med compliance (and usefulness) by reducing the number of doses to remember to take (this is a massive advantage), and it's also a huge help in tweaking and optimizing the PK profile for many drugs. There are other benefits as well.

[jordansonfleek]

Thanks everyone! it is good to hear all the experiences with stimulants out there.

@JustNuts I haven't heard of that new drug before! so interesting!

[JustNuts]

21 hours ago, jordansonfleek said:

Thanks everyone! it is good to hear all the experiences with stimulants out there.

@JustNuts I haven't heard of that new drug before! so interesting!

If you're interested in researching it further, the full company names are Ironshore Pharmaceuticals and Highland Therapeutics. Technically Ironshore is a subsidiary of Highland. The dosage system is "DELEXIS". The drugs under development are HLD100/HLD200, for amphetamine/methylphenidate respectively. It appears that the FDA has accepted HLD200 for review, and the methylphenidate formulation (which is what HLD200 is) review should be complete by August 2017, so I'm guessing a launch could happen late this year or early next year, assuming the review goes well.

Interestingly enough they are now developing HLD900, which appears to be targeting Vyvanse's market (BED) with a potentially different molecule (it's unclear what formulation of amphetamine is used). And in terms of pipeline HLD100 (amphetamine - I think this was supposed to be identical to MAS in formulation, but it's possible that they're using a different formulation of amphetamine) is the furthest behind, with phase III trials only starting this year.

I can't say the DELEXIS system is that advanced in terms of pharmacokinetics (at least based on preliminary information on PK profiles), and the core design is pretty simple (basically the same basic bead design used in SODAS, Adderall XR, d-amp LA, etc with a very thick delayed-release coating on the beads). Still, it's the first overnight-dosed system, and overnight dosing is potentially super valuable from a marketing perspective. And there's nothing wrong with their approach - I'm just a fan of the really innovative designs for controlled release mechanisms, like the PSOP OROS used in Concerta, the (still incomprehensible to me) mechanisms used for delayed-release oral solutions, the more advanced transdermal patch designs, and the interesting triple-bead design in SHP465. In a sense DELEXIS is still a really innovative design, but it's not like an osmotic pump where you have that ultraprecise control over pharmacokinetics and the ridiculously fancy release mechanism, or the other mentioned examples (although some are a bit simplistic at their core).

In other news, SHP465 has been resubmitted yet again, this time with a planned launch in the second half of 2017 based on FDA review completion by July 2017. This is very interesting as SHP465 is triple-bead "Adderall XXR" (although who knows what name they'll use to market the drug - Maybe XR-E? SXR? EXR? XXR? Nobody knows yet. Likely not CR/SR/XL/DR though to avoid confusion, although one of those could be modified...). I guess Shire finally completed that pediatric study that the FDA wanted the last time or two that they turned down Shire's NDA submission (which IMO is still a bit nuts considering that Shire explicitly decided to apply for an indication for use in adults only, but I get that the FDA is concerned about off-label use). Anyways, SHP465 is intended to last 14-16 hours, so they're targeting the market segment that currently requires IR booster doses. I don't think there are any other "ultralong" formulations on the horizon (unless Janssen pulls a reformulated Concerta design out of nowhere, which is certainly theoretically possible since the OROS design used can easily last longer with some tweaks, and heck, ALZA already had to create both the PSOP design and the drug overcoat in the first place because of Concerta not playing well with the existing PPOP design).

Edit: However, there are a few other prodrug designs floating around for both amphetamine and methylphenidate, some of which could attain "ultralong" status if they were ever marketed (dubious for now, but I think a MPH prodrug might be under early development - haven't checked into that for a while).

Edited March 3, 2017 by JustNuts