Stimulants Switched from MPH to dextroamphetamine-questions.

[macd610]

Hi everybody. I know that this subject has been covered liberally throughout bluelight but I have a couple of specific questions I'd like to ask.
A little background... I have been taking methylphenidate IR for about 7 years. It worked great for a long time and although I was never overweight, I got really thin for a few years, with the weight loss beginning immediately after starting it.
For the last few months I've noticed it's not been effective as normal. I also have gained a large amount of weight in the last year or so. I don't know if the 2 things have anything to do with each other, but I started using the fentanyl patch around the same time I started gaining weight.
Saw my psychiatrist today and he switched me to dextroamphetamine spansule, 30mg to be taken twice a day.
Is it possible that I may begin to lose weight again since I'm starting on a completely different stimulant? Or, is a stimulant a stimulant when it comes to weight loss properties? I feel like my body became so usedto the methylphenidate in every way that it lost all usefulness. Many of my ADHD symptoms have come back in full force as well.
It would be great if I could get some of this weight off, in addition to finding a med that will keep my symptoms at bay.
Thanks for any input!
Cat

 

[tricomb]

60mg dexedrine per day is a LOT, have you ever been RX'd amphetamines for ADHD before or did you take methylphenidate your whole life until now?

I think that you should really try to see if you can get by on less, I know that for me 60mg of dextro-amp would induce very unpleasant side effects, you should ask your psychiatrist for a different form of it so you can titrate your dose up to where you want to be instead of starting out at 60.

There is no doubt in my mind that you will lose more weight in less time on dextro-amphetamine than you ever did on methylphenidate. Tolerance to amphetamines builds much slower than MPH but still, like I said, by starting out at 60mg you are not leaving yourself much wiggle room, I mean you can't/shouldn't go any higher than that....

Honestly, I would have started you on 10mg time release taken BID (20mg daily), then given you the advice to play with the doses and find out what works best for you, you really should be experiencing most of the beneficial effects by 40mg/day, but everyone is different, I just think it's a really bad idea to start out at 60mg.

30mg time release taken BID is a lot.

 

[macd610]

60mg dexedrine per day is a LOT, have you ever been RX'd amphetamines for ADHD before or did you take methylphenidate your whole life until now?

I think that you should really try to see if you can get by on less, I know that for me 60mg of dextro-amp would induce very unpleasant side effects, you should ask your psychiatrist for a different form of it so you can titrate your dose up to where you want to be instead of starting out at 60.

There is no doubt in my mind that you will lose more weight in less time on dextro-amphetamine than you ever did on methylphenidate. Tolerance to amphetamines builds much slower than MPH but still, like I said, by starting out at 60mg you are not leaving yourself much wiggle room, I mean you can't/shouldn't go any higher than that....

Honestly, I would have started you on 10mg time release taken BID (20mg daily), then given you the advice to play with the doses and find out what works best for you, you really should be experiencing most of the beneficial effects by 40mg/day, but everyone is different, I just think it's a really bad idea to start out at 60mg.

30mg time release taken BID is a lot.

Thanks Tri. I actually asked the pharmacist what type of dose this was because I don't know much about it, but it seemed like quite a bit...and he said "medium"...???
Anyway, I took it at about 1230 and I'm feeling very jittery. It started as soon as I posted about 15-20 minutes ago. I'm not going to take anymore today but tomorrow I will do as you suggested and cut the dose in half.
Thank you so much for the quick reply
EDIT: I have always been on methylphenidate except for a trial run of adderall years ago... I hated that. My does of methylphenidate has been 20 milligrams QID

 

[tricomb]

^Yeah I really think that you should try much less than 60mg, especially since you're feeling jittery, that's not pleasant. It should not feel gross like caffeine.

I'd play with lower doses, like try taking just 1 x 30mg XR or asking your doctor for a different formulation like the 10 and 20mg tablets because that gives you more freedom with dosing lower.

 

[pbuilder]

You also probably shouldn't be relying on these for weight loss, diet and excersize is the way to go, you shouldn't be switching around your ADHD medicine if it works well for your ADHD, but no longer suppressed your appetite . That kind of weight loss is unhealthy .

 

[macd610]

You also probably shouldn't be relying on these for weight loss, diet and excersize is the way to go, you shouldn't be switching around your ADHD medicine if it works well for your ADHD, but no longer suppressed your appetite . That kind of weight loss is unhealthy .

The reason I switched was because it wasn't working well anymore. I was just hoping for the added benefit of losing a few pounds. I agree that it would be absolutely ridiculous to change any kind of medicine if it's working well just in order to lose weight.
The weight thing actually did not even occur to me until a couple hours after the switch had been made

 

[tricomb]

I'm pretty sure that the weight-loss is going to happen at all doses of amphetamines, and is likely dose dependent.

 

[pbuilder]

The reason I switched was because it wasn't working well anymore. I was just hoping for the added benefit of losing a few pounds. I agree that it would be absolutely ridiculous to change any kind of medicine if it's working well just in order to lose weight.
The weight thing actually did not even occur to me until a couple hours after the switch had been made

oh okay. I might have missed it in the OP, I don't remember you mentioning that MPH wasn't working well for your adhd anymore.

 

[tricomb]

For the last few months I've noticed it's not been effective as normal. ....


....
I feel like my body became so usedto the methylphenidate in every way that it lost all usefulness. Many of my ADHD symptoms have come back in full force as well.
Cat

@pbuilder

 

[onetwo]

Jesus christ 2x30mg Dexedrine is pretty high. I'd assume you will start losing weight again, but I'm not sure for how long.

 

[macd610]

Jesus christ 2x30mg Dexedrine is pretty high. I'd assume you will start losing weight again, but I'm not sure for how long.

Tonight has been pretty rough. If I hadn't had some alprazolam on hand I'd have been a TOTAL wreck.
I'm surprised the pharmacist described this amount as a "medium" dose based on the feedback I've gotten from you all so far. I am going to cut back to half the prescribed those tomorrow.

 

[AlphaMethylPhenyl]

You might want to think about changing psychiatrists too

 

[tricomb]

You might want to think about changing psychiatrists too

Nah I think that's a little drastic, unless he has a problem giving her instant release medication (if need be) in addition to some 10s and 20s XR and macd I would recommend that you ask for a few 10mg instant release boosters. If the XR version lasts too long for you or gives you insomnia or whatever, you can switch to a purely instant release treatment, here are a few possibilities with a purely IR form of treatment (which has pros and cons):

-taking 1-2 x 10mg IR every X hours (you'll find out how long it lasts you, everybody metabolizes it differently),
-it may be 2 x 10mg IR twice a day totaling 40mg
-it may be 1 x 10mg three times a day totaling 30mg


Keep in mind that they also make 5mg instant release tablets but IMO I much prefer the higher dose tablets with a better active ingredient / inactive ingredient ratio, because you can always cut the 10mg IR tabs in half, unlike the time released capsules which are a real bitch because they don't give you much flexibility with your dosing since you can't accurately remove a specific amount of the beads to obtain a lower dose out of a higher dose beaded capsule, which is another benefit to using the instant release formulation as they are tablets, and are much easier to deal with.

 

[macd610]

Nah I think that's a little drastic, unless he has a problem giving her instant release medication (if need be) in addition to some 10s and 20s XR and macd I would recommend that you ask for a few 10mg instant release boosters. If the XR version lasts too long for you or gives you insomnia or whatever, you can switch to a purely instant release treatment, here are a few possibilities with a purely IR form of treatment (which has pros and cons):

-taking 1-2 x 10mg IR every X hours (you'll find out how long it lasts you, everybody metabolizes it differently),
-it may be 2 x 10mg IR twice a day totaling 40mg
-it may be 1 x 10mg three times a day totaling 30mg


Keep in mind that they also make 5mg instant release tablets but IMO I much prefer the higher dose tablets with a better active ingredient / inactive ingredient ratio, because you can always cut the 10mg IR tabs in half, unlike the time released capsules which are a real bitch because they don't give you much flexibility with your dosing since you can't accurately remove a specific amount of the beads to obtain a lower dose out of a higher dose beaded capsule, which is another benefit to using the instant release formulation as they are tablets, and are much easier to deal with.

Thanks. I'm not sure why he decided to put me on ER dextroamphetamine as I had always been on the IR formulation of MPH. About an hour ago I took one capsule (15mg) and we'll see how that does. You're right though Tri...there's not much room to play around with the dose due to the way they're made and the dose they are.
I wonder if I could open the capsule and divide up the beads if I wanted to try a lower dose.
Anyway, this is a month long trial run. Dr said if this isn't the right medication for me that we'd try desoxyn (sp?). I'm hoping this 15mg will be just
the right dose, though.
I don't know if this is wishful thinking, but I think it's beginning to kick in and if so, it feels much better than when it started taking effect yesterday.