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  • BDD Moderators: Keif’ Richards | negrogesic

Just started on Adderall, need advice please

R

Renegade87

Greenlighter
Joined
May 15, 2016
Messages
7
So basically after struggling for most of the last 20 years, (just turned 29 last month) beginning in elementary school, getting much worse in high school, and things continued to go downhill into my early adult life I decided to look into ADD and realized I suffered severely from the inattention symptoms associated with ADD.

I started seeing a Nurse Practitioner 5 years ago and she started me on treatment for depression and anxiety, which I realized stemmed from the root of my problem being having ADD and being untreated for it all my life, for that I'm on Celexa (40mg / day) and Klonopin (1mg x 3 / day, which has elevated my mood and kept my anxiety under control but my overall quality of life never improved, I ended up dropping out of high school my senior year and still haven't been able to start a career.

Anyways long story short I started seeing a Psych last week and he confirmed what I realized myself, I have ADD. For which he's wrote me a prescribed for x30 generic 10mg Adderall IR pills. He wants to let me know how I'm doing with the new medication, and discussed the possibly of increasing my dosage when I see him again in 3 weeks.

I saw minor progress at 10mg, decided to try 15mg which resulted in much better results, and at x1 IR dose a day it lasts around 5 hours, so I just feel better for half of the day.

(XR isn't an option for me, they cost twice as much as IR and my insurance doesn't cover it, x30 10mg generic IR's cost me $60, which is a lot for me not having a job)

Anyways what would be the appropriate way to go about my findings next time I see him?

Should I just tell him I felt a little better with 10mg and think I would benefit from a higher dose?

Should I tell him I tried 15mg and felt much better?

Should I ask for an additional dose a day as x1 pill lasts 5 hours? If so should I ask him if he'll write me x1 30mg IR / daily to split into 2 dosages as x30 30mg IR's would be cheaper than x60 15mg IR's since money is an issue for me?

Any advice would be greatly appreciated, Thank you.
 
Just be completely straight and express all your concerns and you'll get to that right dose sooner or later. ADD meds have to be experimental like many meds. Sometimes you get it right first try... often times you must try different doses and meds to see what works best for yiu.
 
I don't know if I'm just overly paranoid, but if it were me I would not, after securing a prescription for amphetamines, say that I used more then I was prescribed. Believe me OP, I'm not suggesting that you're abusing your medications, it sounds like you really just want relief from you ADD. If it was me though, I would say instead that the 10mg helped a bit but that it wore off too fast, or maybe suggest outright that you think you need the dose to be a bit higher.

Anyway Im moving this over to Basic Drug Discussion.
 
cripkeeper said:
Just be completely straight and express all your concerns and you'll get to that right dose sooner or later. ADD meds have to be experimental like many meds. Sometimes you get it right first try... often times you must try different doses and meds to see what works best for yiu.
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I second this. Don't be hesitant just because of the nature of the med. I know a lot of doctors tend to be suspicious about controlled substances, but if it's not working for you just be straightforward and honest like you would with any other med. All medications have to be titrated to dose that provides therapeutic effects, otherwise what's the point in putting someone on something and keeping it low just because it's controlled? That's just bad practicing.

You mentioned your insurance doesn't cover XR. Adderall is an XR version of dextroamphetamine which is sold as Dexedrine. I was going to ask about Vyvanse, is that the XR you're talking about not being covered?
 
theGirlWithBlueHair said:
I second this. Don't be hesitant just because of the nature of the med. I know a lot of doctors tend to be suspicious about controlled substances, but if it's not working for you just be straightforward and honest like you would with any other med. All medications have to be titrated to dose that provides therapeutic effects, otherwise what's the point in putting someone on something and keeping it low just because it's controlled? That's just bad practicing.

You mentioned your insurance doesn't cover XR. Adderall is an XR version of dextroamphetamine which is sold as Dexedrine. I was going to ask about Vyvanse, is that the XR you're talking about not being covered?
Click to expand...

Uh, you have that wrong-- Adderall was originally a combination product containing four salts of amphetamine. Amphetamine aspartate and amphetamine sulfate are present but as we know amphetamine is racemic, so for instance, the 10mg Adderall tablets contain 2.50mg Amphetamine aspartate (monohydrate) of which ~1.25mg is the dextro, and 1.25mg is the levo. Same with amphetamine sulfate which would be present in a mass of 2.50mg (for a 10mg tablet), ~1.25mg would be dextro, and ~1.25mg would be levo. They then added the dextro only form as the sulfate (2.50mg) and the dextro only form as the saccharate (2.50mg).

Adderall was originally NOT an XR product. The vast majority of scripts I write are for the XR, but sometimes I am asked to write for the IR (to be clear, Adderall with no other notation refers to what you would understand to be an immediate release form, and Adderall XR uses a controlled release technology).
 
I'm familiar with the formulation Adderall, I was just referring to it' active ingredient - the d amphetamine. l amphetamine does NOT cross the blood brain barrier and pretty much just waters down the product. and the different salts do not alter the chemistry of d amphetamine: d amphetamine is d amphetamine, regardless of what it is bonded to. Which is why I mentioned Vyvanse, which provides the same ACTIVE ingredient as Adderall and Dexedrine, albeit in different guises.

Sorry, about that. I was unaware that Adderall was both an IR and XR product. My bad.
 
theGirlWithBlueHair said:
I second this. Don't be hesitant just because of the nature of the med. I know a lot of doctors tend to be suspicious about controlled substances, but if it's not working for you just be straightforward and honest like you would with any other med. All medications have to be titrated to dose that provides therapeutic effects, otherwise what's the point in putting someone on something and keeping it low just because it's controlled? That's just bad practicing.

You mentioned your insurance doesn't cover XR. Adderall is an XR version of dextroamphetamine which is sold as Dexedrine. I was going to ask about Vyvanse, is that the XR you're talking about not being covered?
Click to expand...

Sorry I think you misunderstood me, my doctor said my insurance doesn't cover any form of the two medications he recommended for me in adults, which were Adderall and Vyvanse, so I'm paying completely out of pocket, and he said Vyvanse was x4 more expensive like $200/monthly, so Adderall was the obvious choice due to my financial situation. I also read online that Adderall XR pills cost than Adderall IR pillls when paying completely out of pocket, is that true? I actually think XR pills would be perfect with the way they work for me, a higher dose instantly and a lower dose that kicks in later in the day. But if the cost thing is accurate perhaps 15mg IR in the morning and 10mg IR or 5mg IR in the afternoon would be ideal.
 
you said adderall xr cost than adderall Ir pills. did you mean less or more? Have you tried methylphenidate? the extended release forms of that are ridiculously cheap, like ritalin la or metadate. I think concerta is the only expensive one. it's not an amphetamine but an NDRI, so it's a little different but the end result is the same. but yeah, ask about that dosing. Your reasoning is perfecting legit. I don't see why he'd have a problem. He's probably familiar with the problem you are having. Dexedrine 4x a day is an option too, that would be equal to a vyvanse dose.
 
Check online at the manufacturers site. Sometimes they have patient help programs and there may be one for the XR. There are contact numbers on the site, so you can also call and find out if there are any help programs for uninsured persons.
 
theGirlWithBlueHair said:
I'm familiar with the formulation Adderall, I was just referring to it' active ingredient - the d amphetamine. l amphetamine does NOT cross the blood brain barrier and pretty much just waters down the product. and the different salts do not alter the chemistry of d amphetamine: d amphetamine is d amphetamine, regardless of what it is bonded to. Which is why I mentioned Vyvanse, which provides the same ACTIVE ingredient as Adderall and Dexedrine, albeit in different guises.

Sorry, about that. I was unaware that Adderall was both an IR and XR product. My bad.
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L-amphetamine is still active. Maybe moreso in the peripherary but its not like its inert.
 
I doubt so at the doses in the adderall, though. l methamphetamine is otc and incredibly high doses need to be used to be CNS active. I know it's a different drug, but it's likely the same principle applies.
 
Oh. You meant it being active at all? lol. My bad. I didn't mean it being without effect entirely. I meant it just contributing to adderall's intended therapeutic benefit.
 
Yeah. Some of us enjoy a heart rate of 170 for 4 hours. Makes us know its working. :)
 
@TheGirlWithBlueHair, et. al.

My apology for not focusing more on the target question of affordability, but pharmacologists see the chemistry being potentially misunderstood and have our own little fits. I believe I sufficiently covered the breakdown of levo- and dextro isomers present which is available from the PI/monograph as well, but completely ignored the Vyvanse issue. Given you don't seem to looking for a more readily abused form of drug and are asking cost, well it generally goes Vyvanse > Adderall XR > Adderall. To the extent that each may be as much, and frequently more than double the least expensive, "Adderall." If pill burden is an issue, Adderall XR and Vyvanse would be equivocal, but if you are also looking for an abuse...say deterrent, then Vyvanse is the one to put money on. Not to say one couldn't misuse it, but the requisite erythrocyte action on the molecule (to remove the aa lysine) results in a more limited abuse scope (in my professional experience; no assumptions or presumptions upon this forum or its user base is implied).

Not sure that clears much up, but I didn't mean my post to come off like I was being a snob or even less desirable, a prick about the matter...and certainly not a "Dr. Zee" or Shulgin of substituted PEA chemistry...hah ;)
 
Are you saying that Vyvanse is more abused? I wou.d say that Adderall is, because of the ability to crush them up and insufflate them.

Vyvanse would be the most exepensive.
 
No (s)he said Vyvanse is the one that is hardest to abuse, most abuse-deterrent
 
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