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building up an adderall tolerance


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I love Adderall...when it works for me, it really works.  Unfortunately, I am growing resistant to its effects.  I find that the benefits return if I stop the medicine for a few days, then take it again.

What I'm wondering is, are there other ADD stimulants that are less likely to poop out on me?  Has anyone ever tried alternating between two stims to keep either one from wearing out?  I'm curious about stimulants only, because Strattera threw me into a severe depression (odd, I know).  I'm also bipolar, and since I am prone more to depression, I really like how Adderall brings me out of the depths like nothing else.

Thanks!

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i def. think adderall is superior to ritalin.  but have you tried ritalin? there's also dexedrine and desoxyn.  and focalin (Velvet Elvis is a fan of this one).  then there's concerta....

what dose of adderall are you taking? xr or ir?  how long have you been on it?  taking any other meds in addition to the adderall?

~agentelle

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I love Adderall...when it works for me, it really works.  Unfortunately, I am growing resistant to its effects.  I find that the benefits return if I stop the medicine for a few days, then take it again.

i try to take drug "holidays" when ever possible.  but sometimes you get into situations where your weekends require concentrarion too... sigh.

Has anyone ever tried alternating between two stims to keep either one from wearing out? 

i've never tried it, nor heard of anyone doing it, but i found an article on how to treat ADHD when ritalin poops out and that's what they did in the article, alternated between ritalin and adderall.  it's something to talk with your doctor about at least?

Treatment of ADHD When Tolerance Develops

For patients taking methylphenidate who became tolerant, we tried other drugs, starting with dextroamphetamine, and then we used the drug that produced the best response. If the substitute was less effective than methylphenidate, the latter would be tried again after a month. In many cases, tolerance disappeared after a month, and methylphenidate's original effectiveness was restored. The newfound effectiveness would often last the same amount of time as the original.

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Treatment of ADHD When Tolerance Develops

For patients taking methylphenidate who became tolerant, we tried other drugs, starting with dextroamphetamine, and then we used the drug that produced the best response. If the substitute was less effective than methylphenidate, the latter would be tried again after a month. In many cases, tolerance disappeared after a month, and methylphenidate's original effectiveness was restored. The newfound effectiveness would often last the same amount of time as the original.

<{POST_SNAPBACK}>

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Most people need one or two dose increases to combat tolerance.  I think I had to at around one month and around six months but the effect has been steady from there on out.  Everyone gets a bit of a tolerance and it's normal to have to increase the dose.  After a while it won't have the same kick it did at first but side effects will get better at the same time.  As long as you don't go over the recommend total mgs per day you're at no risk for addiction.

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also, you may want to read this thread on L-Tyrosine and then talk to your doctor and ask him/her what he/she thinks of this idea

(sorry, i'm a stickler for talking to docs about supplements with rx meds.)

penny

<{POST_SNAPBACK}>

If you're bipolar and also on a stimulant I would be VERY careful with taking L-Tyrosine. I learned that the hard way. Straight to mania-land. After that little... ehm... mistake I'm not allowed to take ANY supplements except fish oil and a multivitamin for my doctor.

"This supplement may increase sensitivity to the effects of CNS stimulants. Caution is advised when taking tyrosine along with stimulants and dosages should be lowered accordingly."

from: http://www.bulknutrition.com/a18_L-Tyrosine_Profile.html

But that's all in that thread, so as Penny said, check it out. Also, not everyone reacts the same. So with pdoc supervision it might be worth a shot.

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  • 2 weeks later...

I find that I only develop mild tolerance to Adderall. And sometimes, what I think is tolerance muct be something else, because the stuff starts to work better again! Sometimes I've even cut back a bit.

Drinking OJ anywhere near the time I take the stuff seems to reduce its effectiveness; antacids enhance.

Some "tolerance" is probably just because we become jaded about the improvement and can't see it anymore.

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Effect of food on early drug exposure from extended-release stimulants: results from the Concerta, Adderall XR Food Evaluation (CAFE) Study

by

Auiler JF, Liu K, Lynch JM, Gelotte CK.

McNeil Consumer & Specialty Pharmaceuticals,

Fort Washington, PA 19034, USA.

Curr Med Res Opin2002;18(5):311-6

ABSTRACT

    Stimulant therapy is the mainstay of treatment for children, adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). Once-daily, extended-release oral formulations offer long acting control of symptoms by modifying drug delivery and absorption. In particular, consistency in early drug exposure is important for symptom control during school or work hours. Because these once-daily formulations are usually taken in the morning, the timing of the doses with breakfast is important. This study compared the effect of a high-fat breakfast on early drug exposure from a morning dose of two extended-release stimulant formulations: the osmotic-controlled OROS tablet of methylphenidate HCI (CONCERTA) and the capsule containing extended-release beads of mixed amphetamine salts (ADDERALL XR). The study had a single-dose, open-label, randomised, four-treatment, crossover design in which healthy subjects received either 36 mg CONCERTA or 20 mg ADDERALL XR in the morning after an overnight fast or a high-fat breakfast. Serial blood samples were collected over 28h to determine plasma concentrations of methylphenidate and amphetamine. The food effect on early drug exposure and the pharmacokinetic profiles up to 8 h after dosing of the two extended-release stimulants were directly compared using partial area (AUC(p4h), AUC(p6h) and AUC(p8h)) fed/fasted ratios. Amphetamine concentrations were markedly lower when the subjects had eaten breakfast, resulting in lower early drug exposures (p < 0.0001). By contrast, methylphenidate concentrations over the same 8 h were unaffected by breakfast, providing consistent levels of early drug exposure. Therefore, as a child's or adult's eating pattern varies, methylphenidate exposure over the first 8 h would be expected to have less day-to-day variation compared with amphetamine exposure. The osmotic-controlled OROS tablet provides a reliable and consistent delivery of methylphenidate HCI, independent of food, for patients with ADHD.

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