Unusually High Adderall Prescription?

[Garnet2]

I recently posted that I was diagnosed with ADD and prescribed 40 mg of Adderall XR daily to be taken all in one morning dose. I followed-up with my doc (as he requested) after being on the med for five days and told him (the truth) that it was working wonderfully, but when taken at 8:30 am (time to go to work), they would last until about 3:00 and then taper-off completely by 3:30. I work typically until 7:00 or 8:00...with an intense job requiring much concentration.

I didn't expect this, but he said he expected to have to up my dosage and to go ahead and immediaely begin taking another 40 mg dose at 2:30 or 3:00 (but not later so as not to affect sleep). Isn't that a pretty high-dosage precription? Especially to begin with?

Here's the kicker: I've never been on Adderall before so I had no previous tolerance, but it takes ALL 80 mg per day to do the trick for me. I'm thinking that's a bit unusual too. I'm a big guy and it ALWAYS takes more of any drug (Prescription / OTC / illegal / etc) to do it's job...but 80 mg of XR seems like that would have me flying -- but I can only slightly tell that it's even there.

Any thoughts from those more educated on this med than me?

ONE MORE THING: I used to take Valium regularly - 10 mg twice daily (not with prescription) and pretty much could tell if I was even late on a dose. Since beginning Adderall, my need for Valium has decreased dramatically! That makes no sense to me at all...I'm not getting the jitters or anything from the Adderall and my desire for Valium is decreasing so rapidly that I think I'm soon going to be able to stop taking it all together. WEIRD!?

 

[yaesutom]

(Just a note, most of this is my experiences with doctors and adderall, and my switch to generic dextro-amphetamine, and it was written under the influence of my prescription, so warning, it just may be a "tad" too long, and possibly bore you.. )

Yeah that does sound unusual to get to 80mg that quickly, but <in my experience> most doctors don't seem to know a whole lot, especially psychiatrists.

I went to a doctor over a year ago, basically to try to get on Adderall. I played it "safe", i acted like i knew nothing about drugs, and I said my insurance isn't too great so I would like to stick to generic/cheap, and he put me on Concerta first. I said it was too expensive, and I wasn't really feeling it working good, and i said i would like to give the old generic ritalin a try since its a lot cheaper. I was on 20mg 2x day (which, doesn't hardly do anything). After i've been in there enough times, i started to tell him "i've been reading up on ADHD" which was true, and I complained that the ritalin makes me jittery, and that i've read up on Adderall and would like to give that a try. Shit, out the door with a script immediately (he always wants to get people in and out, to make his money), for 10mg twice a day of Adderall. I probably could have gone in and said I WANT ADDERALL instead of playing it safe acting stupid about drugs hehe.

This at the time, worked great! I was thinking, wow, a wonder drug, not only could i actually focus at work/school, but it did have a calming effect sorta (I have anxiety/jitteryness sometimes). One 10mg pill was sorta weak, but, it did do the job. Only for so long though. Next time i saw the doc, I said it worked great at first but seems real weak now, after the 5 minute appointment, now i have a script for 20mg 2x/day. Took this for a good while, actually i'd use less than 40mg/day, because sometimes a 20mg pill would "speed me up" too much, but slowly...tolerance is building up..slowly.. Got to the point where I would have to take two pills in the morning, just to wake the fuck up and get going, and then I would take some to work, and I felt it start wearing off sooner (4 hours MAX, sometimes less), so i'd be poppin' those things more than my bottle allows.

Next appt. I tell him that i'm getting a tolerance, that its slowly not working as good as it first did, and then I told him i'd like to try plain old generic "dextrostat", and I was just starting to talk about d and l-amphetamine, and why I think I should try dex instead from what i've read. This day he was real busy, and had pissed off "customers" waiting for a long time, so he was in a hurry. So he sorta interrupted me and said something like "well we have kids on the same dose for years and they seem fine, I think you just need a higher dose" - so now i'm at a total of 60mg/day. Tolerance crept up again.. I'd be setting my alarm in the morning for at least a half hour early, so I would reach over and take "a pill or two", and go back to sleep, so I could get my ass up when it kicked in.

Well, since this is getting a little long, i'll try to shorten this story. Tolerance is a bitch with Adderall! If you barely feel the 80mg/day right now, and you just started recently, if you take it every day..tolerance will slowly creep up, and then you'll need like 120mg JUST to get out of bed (although everyone IS different). I finally got my dumb doctor to give me "dextrostat" instead (he only knew of the brand name dexedrine, but, i had to instruct him on why he had to put "dextrostat" on the script - because the pharmacy will have 10mg pills available generic or not, and if he writes "dexedrine" it is only 5mg pills, i'm talking about instant release). This guy is so typical of a doctor, when he prescribes something, he gets on the computer in the room and has to look up all the dosages and shit. "Well Tom, I see that there are only 5mg pills available for dexedrine" - "Yes thats because your looking up dexedrine, you have to type in DEXTROSTAT" - "Oh, your right, there they are. Ok thats fine with me, hmmm, i'll give you 30mg a day and see how that goes"

30mg a day of just plain d-amphetamine, is working a lot better than 60mg/day of Adderall (which has the "mix" of amp. salts including the levo-amphetamine) for me, so maybe you would want to try that... When I take just ONE 10mg pill, it feels like i took a 30mg Adderall (not XR), although it doesn't last as long, kinda.. Its like i'm getting the "good" part of the adderall, the first few hours, and i'm not getting the "bad" part anymore (there was a long ass comedown that made me unmotivated/tired/cravings of taking more adderall but i could not sleep still). It is way stronger mg to mg, and its cheaper if your insurance doesn't cover it all. Also I don't have nearly as much of a problem with tolerance.. its still there, but goes away faster.
I prefer the instant release "dextrostat" pills, because I want to be able to take it at work, and when it wears off, feel more normal, and i can actually nap. But if you prefer a longer duration, they have "dexedrine spanules" but I have no experience with these. Hmm, so I guess the moral of my huge rant is, be careful with the adderall tolerance thing..and i'd say see if you can try dexedrine/dextrostat/plain d-amphetamine instead, because you won't need such a high dose. (Can you tell I took one and it kicked in while i started to reply? LOL, sorry) - I think i better get going on that other thing i intended to do haha.

Good luck

 

[inthegame]

^ Very informative.

 

[Shockwaveal]

Garnet, that does seem high for a starter dose, but from what you say it looks like it's the correct amount. None of us can really tell you what caused your doc to start you off at that dose, but it does appear he gave you the right amount and that's all that really matters.

Man, yaesutom, that doc sounds pretty lame! That was a psychiatrist, right? Seriously, if they're going to choose to treat you they had better be up to date on your disorder, especially the different medications.

 

[Garnet2]

Thanks for the info guys (esp the huge amount of info from Yaesutom!!). I was afraid that the post would be so long that no one owuld take the time to read it...but I had to inculude all of the details to fill-in the whole picture.

I think the dosage is perfect for me...I'm not looking for recreational use (although I ahve checwed a few)...but mainly just drastically improved concentration at work (and that is certainly the case). I just hope that my tolerance doesn't build too quickly.

I'm certainly more happy and productive...if you discover that you have ADD (esp at 28 yrs old) like I did and get it treated, it's like a new world opens up...