Mental Health What is the recommended adult dosage of instant release Adderall for extreme fatigue? (ALSO please tell me your experiences with adderall)

[ivorymoon]

I take 20mg of instant release Adderall 2x daily to help combat my already existing extreme fatigue/lethargy that my antidepressant makes worse. It's not really an option to get off of it. I've been trying to find the right "cocktail" of medications for over a decade now and tend to have bad reactions to most medications, so finding one that actually helps me and only has minor negative side effects (the fatigue) is too rare to stop taking it.

The other reason I take Adderall is to help improve my cognitive functioning (an unfortunate lingering side effect I ended up with after enduring a year-long psychosis subsequent to being prescribed Seroquel back in 2014).

I've read that the maximum adult dose of Adderall IR for ADHD is 40mg daily. For narcolepsy, I read it's 60mg daily. I'm wondering what the maximum dose would be for someone in my situation.

I don't see my doctor again until the 20th so until then, I was hoping you guys could weigh in on what you think and share your experiences about how much you're taking/used to take and what you take/used to take it for.

Thank you!

 

[Layered Onion]

This is a very much a question for a medical doctor who knows your medical history, physiology, tolerance, or a physicists who knows your diagnosis and has spent time on your case. All the answers you may get between now and the 20th are likely to be by untrained young adults who are misusing unprescribed medication, or therapeutic prescription users who are most knowledgeable about their own specific situation and who know nothing about yours. If you are concerned with using your medication as prescribed, this is probably not the best platform to get answers on such a specific question. If you just intend to use it in an off-lable manor, just start with slightly more than you usually take and don't increase often or in large increments.

 

[Layered Onion]

Oh and as far as my own experience with adderall, I would get uncomfortable if I had more than 80 mgs IR in one 24 hour period that was at a time when I weighed about 135-140 American pounds.

 

[psy997]

I'm pretty sure people get more than 40-60mg/day prescribed, regularly at that.

If that is the max, maybe try dextroamphetamine? I just read someone saying they are prescribed 30mg x2 day, and dextroamphetamine is more potent than amphetamine salts (adderall).

 

[Layered Onion]

It is my understanding that adderall is 75% dextroamphetamine.

 

[psy997]

It is my understanding that adderall is 75% dextroamphetamine.

75% dextroamphetamine and 25% levoamphetamine, yes. So d-amp is 1.33x more potent than adderall considering most of the desired CNS stimulation comes from the d isomer, not the l isomer.

 

[Layered Onion]

I don't think that necessarily translates to more potency just because it lends more of one type of stimulation over another. The effects that come from the levo are definitely felt by the user. When I have had all dextro products I always felt something was missing. You are still getting 100% of the effects (combo of effects, cocktail of effects , bouquet of effects) by wieght even with the 75/25 split.

Although I am not going on any chemical education, just the subjective experience of consumption. I would be interested to hear a sophisticated breakdown of how we perceive potency.

 

[psy997]

I don't think that necessarily translates to more potency just because it lends more of one type of stimulation over another. The effects that come from the levo are definitely felt by the user. When I have had all dextro products I always felt something was missing. You are still getting 100% of the effects (combo of effects, cocktail of effects , bouquet of effects) by wieght even with the 75/25 split.

Although I am not going on any chemical education, just the subjective experience of consumption. I would be interested to hear a sophisticated breakdown of how we perceive potency.

D-amp is responsible for most of the CNS stimulation while l-amp is responsible for the PNS stimulation. Technically, d-amp is more potent in regards to the stimulation it's prescribed for ADD/ADHD for. Albeit, there is something that the l-amp adds, a kind of fullness. Though, I really don't like the added l-amp because it makes me even more antisocial.

 

[Layered Onion]

Now that I think about it, I remeber a couple years ago, when I was dabbling in darknet markets, I manged to get some European amphetamine sulfate paste shipped to me in North America (my understanding is that it typically forms about 50/50 l-d, but maybe not even that favorable). After washing out the cut, I was left with about 10 grams of amp. It did go very fast as the thing that was missimg was the uplift in mood and a good bit of the cognitive streamlining. So I get what you mean. I ended up using it quickly trying to squeeze the proverbial blood fromna stone. Even though my sweat was copious and my sleep was thin.

 

[AlphaMethylPhenyl]

Yeah I mean that's something for your doctor to decide. I don't think it will do any good to talk about it (even if you're not exactly scheming) with others. Provigil might be better; it helps people keep awake and think clearly.

Just saying, there are antidepressants that are more on the stimulating side. Maybe so that you won't need another medication on top of it (adderall).

 

[checktest]

Agree with Onion and AlphaMethylPhenyl, sounds like a pretty complex situation with a year of psychosis, even if drug related. I'm surprised you got the dose of AMP you got. So while there certainly are people who get more than 40mg, how it matches your exact situation and your Psych's comfort with doses may vary. E.g. I know a lady on brexpiprazole, sertraline?, and 60 mg dexamp in severe depression....but she's on maintenance ECT as well so it doesn't really make it applicable as you cite fatigue. Modafinil/armodafinil augments are possible, and can be common for fatigue in MS

Lisdexamfetamine is an option for longer acting, though Shire failed in some pivotal trials for MDD (just as they did trying to get it schedule III, haha). Part of it was due to side effects and inconsistent dose response - some people in trials did worse on higher doses (70mg vyvanse) than lower doses (30mg, 20mg).

In terms of fatigue you could ask for thyroid and other bloodwork or something else along those lines, though it probably has already been tested a lot over a decade of mental health. Some supplements like methylfolate can be prescribed, that aren't like a typical drug. I can't attest for vortioxetine being special on the cognitive front, though it is trying to get that rep.

Personally, I am on adjunct methylphenidate for depression (with my antidepressant). I find it quiets my mind and I am less anxious. Sometimes makes me hungrier. I tried adderall a long time ago, and I was in a different depression, so I can't really personally recall what I had for effects. I don't remember a lot from then, accurately. Modafinil I found some what beneficial- made me more awake, but was less effective in terms of anxiety for me vs. methylphenidate (perhaps more anxious on modafinil). Stopped it due to a rash though. Urine smelled too, haha. Must be that S.

More may not be better for some people, especially with addiction issues and psychosis. Not you specifically, but others. Amphetamines can be destabilizing for some, and relying on street amphetamines can be devastating.

Not gonna cover behavioral, therapy, planning or whatever. Stuff is out there.

Best of luck!