Adderall - First time - I have questions

[livingbeing1989]

06/22/2014 - 9:21 PM
Full caveat: I am writing this at 10:00 PM, long after my adderall has worn off so I dont think its the medication making me focus enough to write this.

Medications I'm taking:
Effexor - 75mg 1xdaily
Norco - 10-325 (1/2 pill 6xdaily)
Xanax - 5mg as needed (barely take this)

I was diagnosed with Adult Attention Disorder on June 10, 2014. The first dosage I was perscribed was 5mg twice daily. That dosage didnt do anything for me so on June 19, 2014 I was upped to 20mg twice daily. Today I last took adderall today at 5:33pm and had it kick in seamlessly but I did not feel it helping me focus, I felt the same but maybe a little bit more into the movie I was watching. It felt like I could really engulf myself into the movie and focus. However, that feeling lasted for maybe 30-35 minutes. After that I was back to normal. It didnt give me the energy that people say it does nor did it give me the focus that its typically used for.

A few hours later (4-5 hours) after I take my dose of adderall I get very unmotivated, anxious, nervous, my heart beats kind of fast (kind of irregular) and this feeling lasts for about an 1 1/2 and then goes away and I feel back to normal. This has happened after both times that I have taken adderall, it seems there is some sort of a slump or low as the medication wears off. All speculation of course.

The thought of having to out to do a simple task is overwhelming for me and if I think about it, my chest gets a funny feeling in it and I want to avoid it at all costs. I DID NOT feel this way up until after I started taking this medication. Is this normal? Is this a side effect?

I will be taking my morning dose tomorrow before going into work so lets see how I will feel. I hope it'll be different from what I felt at home, however, I wanted to try it at home first over a weekend to see how I would react to it. Just so I wouldnt go tweaking in front of my colleagues during a project meeting or something.

So I have a few questions:

I take Norco 10-325 (split in halves 6x daily) for pain. Could that drug be screwing with the way adderall is working and in turn make me feel worse?
Is the dosage too low for me?
Is adderall not the right drug for my body?
Is it not supposed to make you feel any different? Just a new normal that just becomes your subconscious so you dont even notice the shift occurring?

Thank you in advance.

 

[Alex000]

My thoughts are the following:

- The Norco, taken as you take it, would not interfere significantly so as to take away from the doses of Adderall you are taking.
- I think after being on amphetamines for two weeks, 20 mg twice daily is quite a high dose - very, very likely too high a dose, too erratic a dosing schedule, too harsh on your mind and body, on the whole.
- The Adderall very well might not be a fit for you; I cannot say that for sure, of course, because you know yourself best, but it sounds that for you, the negative effects are outweighing the positive effects. You are experiencing the typical amphetamine comedown, as you described it, with the lack of motivation, anxiety, nervousness etc. But, some pharmaceutical amphetamines are not as harsh, generally. Still, I think your dose may be much too high.
- Amphetamines do make one feel different, when the individual has little or no tolerance to a given dose, or when one takes a dose higher than his usual, if he is taking an amphetamine regularly on a daily basis. But, in time, if the dose is not increased, it can certainly become the new 'normal' feeling, as one is habituated to the drug.

Another thought, a little more liberal to share, is that if you continue with the Adderall, you might want to use it as needed, and not everyday, thus avoiding more amphetamine tolerance and possible habituation with regular use. 5 mg didn't do much anything for you, but 20 mg sounds a bit too much - I might suggest you try out 10 mg up to twice daily as needed. Amphetamines do have an unpleasant comedown, but with your situation, I wouldn't expect it to be so bad as you just started it two weeks ago. That is why I think the dose is too high, and also, the Effexor may very well be changing how the amphetamine would otherwise work and feel. It is possible, even if your dose of Effexor is relatively low, it is still possible. It could be dulling the better effects, and exacerbating the negative effects.

But, I do believe, almost always, that it is in the best interest of someone using a stimulant, especially an amphetamine, to use it as needed so it does not become the 'normal', but rather something that can allow you do be more effective and functional, despite your ADHD, when you most need to be, such as when you need to get something done and the amphetamine would be of help. That said, I will reiterate, I'd try 10 mg at once, and stop the 20 mg doses altogether. That is my opinion, but I think it would work out better. But, if your doctor is okay with it, it might be of benefit to switch to Dexedrine instead of Adderall, which is just d-amphetamine and not a mix of d-amphetamine and dl-amphetamine, as with Adderall. Dexedrine might very well be a better option, rendering less negative side-effects, being even more therapeutic, within the amphetamine family. If you do feel you need an amphetamine on a daily basis, Vyvanse, which metabolizes more gently into d-amphetamine, might be a better option. There are, also, other non-amphetamine stimulants such as methylphenidate and d-methylphenidate; these may not work as well, but if you have that much of a problem with amphetamines, it might be worth a try.

 

[fuc]

It doesn't sound to me like Adderall is right for you considering the drugs you take already and your experience with it. And that "very unmotivated" feeling you got later (surprisingly fast) never goes away, especially after taking it for a few days or years. May I ask what led to you getting this diagnosis?

 

[livingbeing1989]

@Alex000 - thank you for the great response.
- I was also thinking that the 20mg jump within 2 weeks was huge but I trusted my doctors advice and went with it. Boy was I wrong. I am 6"4' 220lbs and that kicked the hell out of my body. As im writing this I feel exhausted, my muscles are soar and to top it all off im getting a cold (yay, I have the best luck).

- I have been keeping a meticulous journal with when im taking my medicines and how they are making me feel so that I can forward it to my doctor and talk to him about it

-I have lowered my dose to 5mg/ 2xday and that has made a huge difference with the debilitating side effects I was getting. I took my last 5mg at 3:00 PM and it didnt give me many side effects, though the benefits were mediocre at best. Felt a little bit more focused but that only last about 45 minutes, if that.

@fuc - thank you for responding

-that is what I am afraid of, but im even more afraid of trying something new. I hate...wait... Loathe taking drugs because they screw up your body chemistry and I get anxiety thinking what these drugs are doing to me so I try to keep it simple (though my current state is far from it)

- I was having issues at work and at home so we talked about it with a therapist and they suggested talking to a doctor to see if Adult ADD might be the case. Took a couple tests and scored in the range of someone that shows the symptoms of ADD.


I have even more questions now:

1) I have Xanax that I get, should I not be taking this to help me sleep if I also take vicoden before going to sleep (for pain)

2) My doctor is starting to wean me off of the effexor and wants me off of that soon. Do you think that being off that medicine and then starting adderall would be best for me? Kind of like starting with a fresh slate.

 

[Alex000]

1. What is your opiate history/tolerance like? I know you take 5 mg hydrocodone six times daily, but a little more background would be helpful. I will say, though, that is a very low dose, relative to what many others might take. And, what is your benzodiazepine history/tolerance like? Do you take your Xanax as needed, how much, for how long, and how does your current dose effect you?

2. I cannot answer this question - I barely know anything about your case, where really everything about your case matters in a question/decision like that. It is one that is up to you.

But, I will say this - I don't believe so much in ADHD, at least not nearly as much as others seem to, but there are certainly ADHD criteria, and for that they use symptoms to make diagnoses. Now, your symptoms are real - I don't think a bunch of tests would do as much good as a simple oral interview in determining whether or not you have enough of those symptoms to be treated with a stimulant. And, remember you feel your symptoms; all psychiatric medications change how you feel, think, operate, etc. in some way or another, and you, as a person, need to decide what pro's outweigh what con's with different treatments and different symptoms. To determine your best course of action, it is always best to be educated about the treatments you are receiving, have received in the past, may receive in the future, etc. Knowledge is so very important for anyone who steps foot in a doctor's office, especially a psychiatrist's office. It is good you are asking questions here to gain knowledge, and journaling your experiences to gain knowledge, but you really must know all you possibly can to make the best choices for you.

But, because I am curious, just boil your whole situation with your health - all of your health and well-being - down into a simple profile, and I might be able to give a bit more insight, esp. if you have more questions like these.