Transcendence
Bluelighter
- Joined
- Jul 19, 2006
- Messages
- 2,505
For about a decade I've been treated mostly for moderate general anxiety and treatment-resistant depression. I've been on most antidepressants and anxiolytics that are even prescribed anymore, including intravenous ketamine treatment. Currently my life is in a precarious position, partly because I tried to self-sabotage my job and grad degree for no explicable reason besides stress and mental illness. Long story short, people convinced me my meds aren't working and I need to TRY AGAIN.
Doc doesn't take insurance and actually spent a lot of time with me, pretty thorough compared to the other 5 or 6 pdocs I've seen. I was mostly squirming a little and rambling about how incredible unmotivated, lazy, scattered I was, and how I was a bit disillusioned with our current pharmacopeia for depression. The only thing that ever really worked for me were the $2500 IV ketamine infusions, but I can't afford to pay that much for a medicine that costs about fifty cents a dose.
She snuck in some questions about my behavior in certain situations, but I didn't know she was doing an ADHD diagnostic. She asked me to look at it and showed that I scored high in all sections of part A, and not as much in Part B (such as, "Would you walk out of a seat in a meeting where somebody is talking to you?" Well that would be rude...) We also ranted a bit about recent generic quality control issues in medicines like Wellbutrin (she brought that up).
I don't like stimulants, but she told me they might paradoxically quell my restlessness instead of increase anxiety, and give me a push to start my day on the right foot while not falling behind on menial chores. I was skeptical...she asked if I felt that adderall or ritalin would help me as there's apparently no way to tell besides trial and error like most psych meds. I replied that I had no idea, and she prescribed me a small test dose of 2x5mg adderall IR per day. She told me to experiment with dosages (e.g. take 10mg in the morning and 5mg at night and vice versa). She also told me to just call if I decide to switch to a different medication.
I think it's working. I know it's a small dose (I'm not sure I feel 5mg at all), but 10mg calms my akathesia-like restlessness and pacing more than pregabalin and benzos combined! It makes me want to prioritize and organize and I can just finish filling out a damn application without thinking about all my existential problems at once. The only real side-effects at 10mg are some jaw clenching and dehydration (possibly mild headaches, not sure if coincidence yet).
QUESTION I imagine she will want to keep me on the same medication at a reasonable dose since the trial script is working like it should on a child or adolescent with ADHD. I think ~20mg per day (2 x 10mg IR) is the usual starting dose even for kids. If she prescribes this or similar, I would agree...but am considering asking for just the d-isomer (i.e. dexedrine IR). We discussed racemic salts during the last appointment, and she admitted that she couldn't think of a convincing argument for levoamphetamine. I've tried adderall, and if anything dexedrine is probably more tolerable (maybe less vasoconstriction and jaw tension (I have TMJ)).
So really I have three questions (fuck sorry):
1)Is 2 x 10mg dexedrine so much stronger than 20mg salts? It contains 25% more d-amp, but levoamp also causes stimulation so....
2) I prefer IR because ER and XR formulations feel uneven and harsh. Is Dex IR much harder to find than the spanules?
3) Is this unreasonable and will JUNKIE be stamped across my record? My medical/criminal record is clean, I have no flags, and have a respectable job that requires federal clearance. I didn't go into this asking for ADHD meds (or any meds at all). Now that I found something that works for now, I just don't want my jaw to pop out or something. Should I ask about the dex again or just shut it?
Doc doesn't take insurance and actually spent a lot of time with me, pretty thorough compared to the other 5 or 6 pdocs I've seen. I was mostly squirming a little and rambling about how incredible unmotivated, lazy, scattered I was, and how I was a bit disillusioned with our current pharmacopeia for depression. The only thing that ever really worked for me were the $2500 IV ketamine infusions, but I can't afford to pay that much for a medicine that costs about fifty cents a dose.
She snuck in some questions about my behavior in certain situations, but I didn't know she was doing an ADHD diagnostic. She asked me to look at it and showed that I scored high in all sections of part A, and not as much in Part B (such as, "Would you walk out of a seat in a meeting where somebody is talking to you?" Well that would be rude...) We also ranted a bit about recent generic quality control issues in medicines like Wellbutrin (she brought that up).
I don't like stimulants, but she told me they might paradoxically quell my restlessness instead of increase anxiety, and give me a push to start my day on the right foot while not falling behind on menial chores. I was skeptical...she asked if I felt that adderall or ritalin would help me as there's apparently no way to tell besides trial and error like most psych meds. I replied that I had no idea, and she prescribed me a small test dose of 2x5mg adderall IR per day. She told me to experiment with dosages (e.g. take 10mg in the morning and 5mg at night and vice versa). She also told me to just call if I decide to switch to a different medication.
I think it's working. I know it's a small dose (I'm not sure I feel 5mg at all), but 10mg calms my akathesia-like restlessness and pacing more than pregabalin and benzos combined! It makes me want to prioritize and organize and I can just finish filling out a damn application without thinking about all my existential problems at once. The only real side-effects at 10mg are some jaw clenching and dehydration (possibly mild headaches, not sure if coincidence yet).
QUESTION I imagine she will want to keep me on the same medication at a reasonable dose since the trial script is working like it should on a child or adolescent with ADHD. I think ~20mg per day (2 x 10mg IR) is the usual starting dose even for kids. If she prescribes this or similar, I would agree...but am considering asking for just the d-isomer (i.e. dexedrine IR). We discussed racemic salts during the last appointment, and she admitted that she couldn't think of a convincing argument for levoamphetamine. I've tried adderall, and if anything dexedrine is probably more tolerable (maybe less vasoconstriction and jaw tension (I have TMJ)).
So really I have three questions (fuck sorry):
1)Is 2 x 10mg dexedrine so much stronger than 20mg salts? It contains 25% more d-amp, but levoamp also causes stimulation so....
2) I prefer IR because ER and XR formulations feel uneven and harsh. Is Dex IR much harder to find than the spanules?
3) Is this unreasonable and will JUNKIE be stamped across my record? My medical/criminal record is clean, I have no flags, and have a respectable job that requires federal clearance. I didn't go into this asking for ADHD meds (or any meds at all). Now that I found something that works for now, I just don't want my jaw to pop out or something. Should I ask about the dex again or just shut it?
