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  • BDD Moderators: Keif’ Richards | negrogesic

Maximum Adult dosage of Adderall?

MartyMcFly47

Greenlighter
Joined
May 27, 2016
Messages
5
First let me start off by saying that Im specifically talking about "D-Amphetamine Salt Combo" which as far as I can tell IS Generic Adderall.

I Male and am in my late 30's. I have had problems with ADD or ADHD all of my teenage-adult life. I just never had the drive to do anything about it. I always thought that it must be normal to feel like I did. But about 5-6 months ago I finally decided to go see a doctor about it. First I went to my regular doctor (female) and after describing what I was going thru decided I had depression/anxiety. She recommended I start taking Sertraline (Zoloft) right away and that I could also go see a Psychiatrist. She told me in the office that it would probably be a 3 month wait. Obviously I wasnt very happy about a 3 month wait for a 2nd opinion but she said she would put my name on the waiting list. Luckily for me, they called 2-3 days later and said I could get an appointment in 3-4 weeks. I was relieved I wouldnt have to wait an extra 2 months.

So I go see the Psychiatrist (female) and tell her all the same things I told the regular psychican. She came to a different conclusion. She said I most likely had ADHD. She asked if I could get my mother or father to come in so she could talk to them (probably to verify that I wasn't lying about my symptoms). I said that I could get my mother to come in on my next appointment. She also had me take a drug screen to make sure I wasnt on any other drugs. So after that 1st appointment with her I went down to the "Lab" and took and passed my drug screen.

2nd appointment with Psychiatrist was with my Mother. Let me say that in my late 30's having to ask my mother to come to a doctor's appointment with me was a little embarrassing. But I did it and my mother did it. She knew I wasnt making any of my symptoms up. The appointment went good/great with the doc saying that if I took one more Drug Screen and came back clean she would prescribe me a "controlled substance" for my ADHD. I asked her if thats all that can be done for someone like me, meaning if the only "Treatment" for ADHD was drugs. She said pretty much. I asked her about the kind of psychiatrist you see on T.V. The kind where you lay down on a couch and talk about your problems... She said that I was talking about a different kind of psychiatrist more of a psychoanalyst. She said that to do that kind of treatment was MUCH more expensive and implied that my insurance wouldnt cover any of it. So I took the 2nd drug screen and passed again. But I had to wait till my 3rd appointment to be prescribed anything other than the Sertraline (Zoloft). The doctor also informed me that she was quitting her practice to move to Chicago (3-4 hours away) to take care of her sick/old father and that she would be handing me off to a different Psychiatrist for my next appointment.

3rd appointment with Psychiatrist (Different Doctor). This time it was a male doctor. This appointment was over video/teleconference. Just think of Skype. I am in Central Wisconsin and the doctor was in Salt Lake City, Utah. This is the first time I have seen him. I had been on the Adderall for 1 month at this point. 20 mg's Instant Release. I am supposed to take one 20 milligram tablet and break it in half and take 10 mg's in the morning and 10 mg's later in the afternoon. He asked all the usual stuff. How was I feeling? Did I feel like it was working? Stuff like that. I told him that it seemed to be working great. I even told him about a specific problem I had been having. I like to build models. Mostly sci-fi models. Star Trek, Star Wars... all that stuff. Its something I had been attempting since I was in my teens. I told him how I had bought dozens of models over the years. Probably between 30-40. And I wasn't talking about cheap 10-20 dollar models. Most of them were more like 60-100 dollars. And that I had NEVER completed a single one of them. NEVER that is until I got on the adderall. I was amazed at how easy it was. Usually I would start, get everything all set up, and do the first 3-4 steps and then just give up. Not because I couldnt do it. But it was like there was an invisible wall stopping me. And I would never go back to finish them.
He said I should make an appointment for 3 months and if I had any problems or if I felt like the medication wasnt working to call the "Triage" number and speak to one of his nurses. So by the end of the 2nd month on the Adderall I started to feel like it wasnt working as long. It worked fine in the morning and very early afternoon but in the middle afternoon it felt like it wasn't doing anything. I started to get confused thinking and had trouble sticking with one topic or task. I asked the nurse if there was anything they could do. She said she would relay it to the Doctor and that they would call me back. They called the next day (yesterday) and said that there wasnt anything they could do, and that I was already on the highest dose for an adult. 20 Milligrams Instant Release. I said, "Oh... ok." I didnt want to argue with her. She said I could make an appointment sooner than the 2 months I was scheduled so I did. This Thursday June 2nd.

After you have read my huge post my question is... Is 20 Mg's of adderall per day really the maximum dose for a 195-200 pound adult?
 
Lol, 20 mgs./day is a baby dose. With tolerance you'll eventually feel nothing at that dosage aside from a little energy boost. And there are definitely people prescribed higher doses. I've heard the numbers 40 mg./day for kids and 70mg./ day as being the max recommended dose but don't quote me on that. Now I'm not saying it's good to up dosage, as tolerance will always come into play, but I can't see why they would say 20 mg. is the max dosage.
 
It's not the maximum dose, I have friends who are prescribed 40mg of XR. However, 20mg is what I am prescribed and have been for years. No need to go any higher for me. I'm 6'2, 225lbs. I don't take it on the weekends though, and only 2-3 days during the week when I have to train a class or present in front of a bunch of people.

This way it keeps me from developing much of a tolerance. But to get the same feeling I did when I first started taking it I do have to take 40mg of XR at once.
 
I know that it is a baby dose. And I do understand the idea of developing a tolerance. But when the nurse lady told me that 20 mg's is the maximum dose I really had to bite my tongue. I also know of people I work with who are prescribed 40-60 milligrams per day. But how can I tell that to my doctor without sounding like I have researched it? I would like to be able to print off a legitimate medical paper on Adderall and bring it in to my appointment on Thursday. But there too, I dont want to sound like Im trying to be smarter than he is. On the other hand, if he is lying to me and the legitimate medical/theraputic dose is 40-60mg's I want him to know that Im not some idiot...
 
The official labeling say Adderall IR for adult ADHD max dose is 40mg daily, with only rare instances would exceed that. For Adderall XR, it only is 20mg (officially again) as Shire did studies where 40 and 60mg were not superior to 20mg.

Of course a few clinical studies cant tell us everything and it is within the doctors right to prescribe how he feels. Ive seen people prescribed as much as 120mg of both IR and XR.
 
Well anything scripted, assuming the doctor isnt some hack who gives anything, is legal. Just because a manufacturer or some guideline says X is the max amount of drug to give, doesnt mean a doctor has to follow it or else.
 
To give a little detail, Its not that the doctor said that he didnt feel comfortable prescribing more than 20mg's or that I personally was at a maximum dosage that he would prescribe me for the severity of my condition. I was told that I was at the maximum dosage period.
Whats the consensus on me going into my doctor next week and calling him out and basically saying that 20 mg's Instant Release is NOT the maximum recommended dosage. Does anyone think thats a good idea? Or would I have the best chance if I had some legitimate literature such as the recommendation from the "Physicians Desk Reference".
 
So does anyone think it would be wise to go to my appointment and try to bring some literature in? Im not gonna say look at this, so give me more. Im thinking more along the lines of your whole 20 mg's maximum limit is bull. Then if he gets defensive or threatens to take me off the medication just switch to a different doctor.
How hard is it to switch to a different psychiatrist? If I leave the appointment pissed and with him also pissed at me is he gonna be able to write a reccommendation to my next doctor? Or do I just go and request a different doctor on my own?
 
Ive debated answering that. These days doctors, especially American ones, are inundated with patients asking about drugs. But it is less common to challenge their medical expertise and a good way to get cut off. Maybe suggesting he re-read the literature is better but it is not our place to tell you how to deal with your doctor.
 
Kittycat5, I can understand that. On the one hand doctors must realize that patients can and do look stuff up on the "Internetz". Stuff like what is the best treatment for whatever disease or condition. I just wonder either how stupid this doctor is or how stupid he thinks his patients are? Its almost like someone having a severe and late stage Cancer who is dying and the doctor saying, well we could give you something for the pain. But since you are dying and will most likely only have 3-4 weeks left to live I'm gonna prescribe you some Tylenol 3's. Now be careful. These are really strong and Im only allowed to prescribe you 2 pills per day. Thats the maximum Im allowed to give for Terminal Cancer...
 
I agree with you fully. Just I dont want you to go without anything because you questioned him. The medical field, especially locally, isnt huge and people talk. Who knows what could be put in your records but I still agree that asking him to reconsider may not be the worst thing.
 
I have been on 60mg for years which at the time was PDR but at the time that was just for children. I told the Dr. I used to take 75 mg he agreed to ad 2 10mg of Ritalin per day. Still tired, suffered daily migraines so ELAVIL at bedtime told maybe form of chronic fatigue difficult to treat. My dad is in long term hospital took 120 mg yesterday to get out the door since I had not seen him in a week. Last night my nose is running like a faucet, bad taste in throat rush into the bathroom 2x. No allergies, freaked me out.
 
Not necessarily I know the Pharmacists will call a Dr. and say, "Hey is this right, you want to go that high?" I was on 75 mg a day of adderall for 1 year, but my health insurance changed and they would only reimburse 60 mg, same as Medicare and I do not want to pay out of pocket for more or create paperwork for the Dr. so I left it alone.
 
I too am having a similar issue with Adderall 20mg irs. I just started taking them recently in the past month and at first they were great and took away most of my ADHD issues I was having... but now I don't always feel them when I take them at that dose. I have tried up to 50mg in one day and I felt perfect at around 35-40mgs in one day. I get them from my sub doc who said that after bumping me up from 10mgs a day, what I was initially prescribed to start, to 20mg a day that she doesn't feel comfortable going any higher than 20mg a day. So I don't know what to do now.. I just want to feel clear headed and have the motivation and energy to do the things that people without ADD/ADHD can do with no issues. Should I ask for a slight increase even though she said not to? maybe ask to try dexdrine or Ritalin? I haven't tried any prescription stimulants other than Adderall so I don't know how they would effect me and don't want to down grade and get something that doesn't work at all or has bad side effects.
 
Ilove2nod, if you tolerated Adderall you surely will Dexedrine. It may be a viable alternative but you need to decide if asking a doctor who prescribes you a medicine to combat addiction/dependency to switch what they are comfortable with to something they are not that can also be abused. Its not the worst thing by far, but I know dealing with Suboxone and all that goes with it can be a hassle and added complications arent needed.

Maybe see a psychiatrist/ADHD specialist if you can. They would be more up to date on the condition and treatments and willing to tinker with doses and drugs until it is correct.
 
I was just diagnosed with ADHD about four months ago. I'm currently prescribed a total of 90mg/daily (3x 30mg Adderall IR.)
 
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