amphetamine salts dosing

[notloki]

Mixed amphetamine salts is the generic name for Adderall. I get a script for 90 mg a day (3 30 mg tabs). I had been doing 3 times a day dosing but recently I fell asleep after the first (30 mg) dose. My doc gave me broad instructions: "Take 3 every day" so I would be free to dose as needed. I tried 60 mg in the morning and kinda had a breakthrough. I got things done in the morning ! I have never done that on amphetamine. So far this has been my best experience with amphetamines and I have been taking them for decades.

[gb84]

I can't wake up and do anything unless I take my morning dose of dexedrine.  This time of year it is a lifesaver, without it I would just sleep all day.  I was switched to instant release a week ago, they work much better than the spansules.  Plus they are scored so I don't always have to take 10mg.  I can spread the dosage throughout the day. 

It feels good to be productive doesn't it?  Glad you found a solution. 

[notloki]

I also dropped the XR and only use instant release.

[Velvet Elvis]

Are you in the US?  I've been repeatedly told that more than 60/mg is out of the question for legal reasons.  My new pnurse won't rx more than 40.  

[Velvet Elvis]

I'd also like to add that I've been taking stimulants off and on for over 20 years.  It's been my experience with every single dose increase that the first couple weeks with a new dose feel amazing but it wears off after that.  Where you are at that point is still usually a hell of a lot better than nothing.  If you keep trying to get back how it worked the first couple weeks, you will eventually fuck yourself.   I can't find anything supporting this with a precursory google, but it's also been my understanding for years that the FDA max recommended dose in 60mg/day not because higher doses aren't more effective but because above that is where chemical dependency can start to enter the picture.  I'm pretty scattered myself atm so I could be wrong about this, but you probably want to do some digging and make sure what you're doing is safe.  

[Iceberg]

@Velvet Elvis Id say more "frowned upon" than totally illegal. I'm at 60 but my doc temporarily goes above that....he offered to bump me to 80ish once but we agreed to hold off for other reasons 

Although I do agree that 60 in one dose is pretty robust 

[mikl_pls]

My pdoc prescribed me 90 mg Adderall XR ONCE, but that was it. Just to get me over a hump. She did so by prescribing me 30 mg x60 and 15 mg x60 to bypass the quantity limit and not have to bother with a PA.

I've since had no one agree to prescribe me more than the max dose of any stimulant. My NP said he'd talk to my gdoc about going to 90 mg Dexedrine, but then he came back with a script of 60 mg for the next 3 months (3 scripts) so I haven't bothered him about it since. I know that they're going out on a limb to prescribe me that anyway. My pdoc just prescribed me Nuvigil 250 mg yesterday to go with the Dexedrine, but I seriously doubt the PA will go through as I don't have narcolepsy or OSA. I do have idiopathic hypersomnia, though. She could technically argue for shift work sleep disorder, maybe.

For me, Dexedrine IR works better than the ER spansules too, I've felt. I've also felt that if I don't take my 20 mg 3x/day regularly around the clock, that the next day I will suffer the consequences. I can go down to 40 mg for a few days for a "pseudo-drug holiday," but if I go down to 20 mg/day, it will be hell to pay. I'll sleep for 12-14 hours, be super foggy and unable to do anything the next day, etc.

[notloki]

There are no legal reasons to be limited to 40 mg/day. 40 mg/day is what is in the PI but even it says some may need more. There is liability in prescribing doses higher than standard if something goes wrong due to the higher dose. The same it true for all prescribed meds. I correspond with a lady who takes 120 mg/day. She sees an ADHD specialist in Texas, USA. It was discovered she rapidly metabolizes amphetamine, more than the average person.

Keep in mind I did not get to 90 mg/day overnight. My doc raised the dose slowly over about 10 years. I started with Vyvanse 70 mg (which is about 30 mg) I'm in the USA. Pdoc says he has a thick folder full of journal articles indicating some need more than the average. That is true of most meds. He sends these with the PA requests and "some are approved and some are not. The same insurance will say yes with one patient and no to another with both using the same justification".