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Mental Health Trying to switch from AdderallXR to dexedrine or IR

chicken hoagie

chicken hoagie

Bluelighter
Joined
Jan 1, 2014
Messages
363
Location
Illinois
Okay..So a few months ago I went to a local doctor that was able to diagnose me with ADHD (whether I really have it or not is completely variable depending upon my mental deficits of the day, as we all focus and get more done some days more than others), and he prescribed me adderall XR 30mg's right away, directed at 1 per day. Adderall works awesome for my job, as it is a cubicle job requiring networking skills but is also very repetitive and..quite frankly boring. However, the pay is very good for my age(21) and seeing I have bills stacking high, I can't afford to lose the job and most likely will not find a better one at the time being, so although adderall is working really well for me as a medication, there's a few drawbacks I am having with it..


For one, I am having to pay 100+ dollars for my script with insurance, even though the XR formulation they give me is generic. I hear the instant release tablets are a LOT more affordable.

Also, since the XR's are mixed amphetamine salts, they include the l-isomer which I believe is more peripheral in its nervous system effects. Being that I am on the smaller and leaner side, I only weigh 135 lbs and have only lost weight over the past few years since I left sports in high school. The weight loss isn't all due to adderall, but I'm afraid it might make me lose more weight, as I feel most days it makes my resting pulse rate a bit high(around 100-110 it seems). So I am wondering if a pure d-amphetamine formulation will reduce my resting heart rate a bit, giving both a health advantage and money advantage.


One problem I have, however...I told my doctor I couldn't afford my prescription and asked about switching to the instant-release. he admitted that they were cheaper, but told me that even breaking a tablet into 1/4th's would be entirely too much adderall all at once and "would only get me high".

This doctor is very old and ready to retire...and quite rich. My father actually told me he is a quack and almost killed one of my Aunts a long time ago. It literally took me (and my girlfriend even) less than 5 minutes to be prescribed based upon the symptoms we described. So I ask, Do I need to find a new doctor now that I am clinically diagnosed with ADHD, and get a better opinion?
 
no way, a small dose of IR mixed amphetamine salts (75% d-/25% l-) would be just fine as long as you don't use it excessively. The extended release mechanism of Adderall XR isn't very sophisticated. Based on what I've read and experienced, brand name Adderall XR's extended release mechanism is defeated just by crushing the contents of the capsule.

dextroamphetamine is certainly better if you don't want so many peripheral side effects, be it IR, XR, or something fancy like Vyvanse. You should try getting one of those. Vyvanse also has no generic alternative which can be better for insurance reimbursement.

I switched from Adderall XR to Vyvanse since Vyvanse is dex only and Adderall raised my heart rate to the point where I didn't feel comfortable riding my bike to work and often got anxiety. Adderall also caused a few panic attacks.
 
a dream said:
no way, a small dose of IR mixed amphetamine salts (75% d-/25% l-) would be just fine as long as you don't use it excessively. The extended release mechanism of Adderall XR isn't very sophisticated. Based on what I've read and experienced, brand name Adderall XR's extended release mechanism is defeated just by crushing the contents of the capsule.

dextroamphetamine is certainly better if you don't want so many peripheral side effects, be it IR, XR, or something fancy like Vyvanse. You should try getting one of those. Vyvanse also has no generic alternative which can be better for insurance reimbursement.

I switched from Adderall XR to Vyvanse since Vyvanse is dex only and Adderall raised my heart rate to the point where I didn't feel comfortable riding my bike to work and often got anxiety. Adderall also caused a few panic attacks.
Click to expand...

Good advice..Sounds similar to my situation, although oddly I feel less anxiety from my pulse when I'm active than I do sitting at my desk or in a car...Being stationary when the side effects are kicking your ass isn't all that pleasant. So do you think I should ask my same doctor about vyvanse or find a new one? I certainly don't want to end up with a doctor trying to take me off amphetamine to try me on something completely different like garbage ritalin or strattera, but I think the doctor I have now is pretty stern and dead-set on keeping me on the adderall XR. He said it is the XR's or nothing basically.
 
It's hard to determine whether a psychiatrist is actually corrupt or not. The field has so many different philosophies, ranging from people who don't give out controlled substances to those who think they're oftentimes the only medications that work. Both ways of going about the job are "accepted". I would judge for yourself whether a doctor is fraudulent or not. People get too into what happened to their family or friends. Also, the patient has to bear some responsibility, as that's the only thing the doctor has to go off.

That said, five minutes is a really short time to get a prescription, especially if that's the first time you saw each other. However, he does have the conservative view that the IR isn't a good idea due to potential abuse.

I wouldn't take it the IR way though unless a doctor tells you to; that's setting you up for trouble. It's strange because the XR form is half IR.
 
Right..It doesn't make much sense. It's as if he is playing me a fool for the sake of my own health assuming i don't already know a fair amount about pharmacology lol. Of course most patients don't..So that is expected I suppose. He hands out adderall scripts like candy because it makes him a lot of money, and he knows a lot of people want/need it. He is a legal drug dealer who I feel is just simply trying to keep his patients in check so that he doesn't get in trouble with the law...especially since here is near retirement. The absorption of adderall is all dependent upon the stomach and GI tract's pH levels..So how does my doctor know I'm not taking my XR's with highly acidic foods and drinks, causing my medication to release faster anyways? he didn't seem concerned about my heart rate, but then again he may have not even really taken it correctly as we were talking in the midst of him doing his checkups. I know not to mix caffeine with my adderall or I will for sure be tachychardic the rest of the day..But other than that I seem to handle the medication pretty well. The XR's do string me out though, some days. Other days they don't last long enough. It's a hit or miss and definitely variable depending on your body's pH levels...So to me, the adderall XR's sounds like a pathetic attempt at trying to make amphetamines nonabusive. He should know that XR's can easily be abused..Guess I am surprised he didn't offer vyvanse. Don't doctors have a preference for what "brand" of drug they hand out? Don't some doctors get ...."deals" with certain pharmacies for writing scripts for certain drugs? This guy has ADHD posters everywhere in his office and patient rooms..
 
doctors might get gifts from pharma companies, but in the case of generics, how would the doctor know what pharmacy you go to & which generic brand is filled? Unless the prescription says "DAW" (dispense as written) and lists a specific brand name, the pharmacy will usually fill generic when available.

Note that some generic drug products DO have their own names, like Budeprion XL for as their own name for brand Wellbutrin XL/generic bupropion ER. It seems unlikely a doctor would prescribe a generic from a specific manufacturer.

Relevant: http://projects.propublica.org/docdollars/
the psychiatrist I see was paid $5k for speaking and the research institution gets millions.
 
So if I'm getting the generic brand of adderall XR, is it still mixed d and l isomer salts? On the bottle it just says D-Amphetamine salt combo, but on the capsules it does say m. amphetamine salts, assuming it means mixed salts. Seems a tad bit confusing..

If they're plain d-amphetamine salts, then my doctor really has no reason to be saying all they will do is get me high. But, if it is a mixture of salts, I could bring up physical symptoms that I am noticing along with shortened or dulled effect of actually "treating" my ADHD symptoms and perhaps he might consider a pure dextro prescription then? Any personal opinions on the different isomers' and how they personally effect any of you?
 
Bumping allowed? Still looking for suggestions on this...

And also suggestions on if I should consider finding a new doctor?

The 30mg XR's simply don't seem to mentally get the job done anymore, and if I take anymore than what is "prescribed" then I'm guaranteed to be staying up for quite awhile obviously. Taking as prescribed doesn't usually leave me with insomnia, but despite my high metabolism digesting the medication faster, I just don't feel like the XR's are giving me the mental boost or treating my "symptoms" as well as they used to when I was first prescribed them 3-4 months ago.
 
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I'm not asking what I should say to my doctor. I already know it is dead in the water asking him anything else. That is why I'm asking if seeing a new doctor would be a reasonable option. The XR's have been giving me insomnia no doubt, so I won't have any problems telling a new doctor my symptoms..I am just wondering if this would be acceptable to see another doctor since I'm clinically diagnosed now? And I'm also simply asking for a little better description on what the generic XR's contain vs. adderall-brand XR's and whatnot.
 
chicken hoagie said:
I'm not asking what I should say to my doctor. I already know it is dead in the water asking him anything else. That is why I'm asking if seeing a new doctor would be a reasonable option. The XR's have been giving me insomnia no doubt, so I won't have any problems telling a new doctor my symptoms..I am just wondering if this would be acceptable to see another doctor since I'm clinically diagnosed now? And I'm also simply asking for a little better description on what the generic XR's contain vs. adderall-brand XR's and whatnot.
Click to expand...

Generic and brand versions of the same drug are always designed to be 100% identical - the only time this isn't true is when the generic manufacturer messes something up.

Adderall itself is about 75% d-amph, 25% l-amph. For XR adderall half of the drug is formulated for slow release, the other half is still instant release. That's the only difference between IR and XR, the ratio of d/l stays the same.
 
IMO fillers profoundly affect effect. I don't think there are any psychotropic medications that commit the same "sin" as the bupropion scandal a few years ago though.
 
^^ I was actually about to ask that also..Because I see there are a lot of nasty-sounding binders and fillers specifically in the XR capsules for amphetamine. I also had my girlfriends mom complain how crappy it made her feel when she once traded me her IR's for my XR's and didn't want to trade me ever since then lol.
 
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