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Old 06-07-2009, 08:56 PM   #1
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I started Adderall recently.

Again . . .

And again, I'm amazed at how much difference is made in my outlook, my concentration, my motivation and my ability to make sound decisions by such a tiny amount of this med. I stand six feet tall and weigh . . . well, let's just say well in excess of 200 pounds, and 30 mg of this stuff changes me entirely.

It's a bit of a long and sorted story as to how I found myself off my meds and back into old habits, but the last 6 or 7 months have been somewhat long. Ultimately, I finally found myself a psychiatrist that has a clue, and managed to get myself back on Adderall. I started last week with 20mg, which did little for me, maybe more than the 54mg of Concerta I'd been on, maybe about the same, but 2 days on 30mg and I'm a different person. Finally I can see myself with a future again, but issues can't help but rear their ugly heads, so I need some info, if anyone has it, and perhaps a little advice.
  • It seems that Adderall XR will not be going generic in Canada anytime soon. I looked hard for info as to when the patent runs out here, and I found a link to a defunct report for which the abstract said 2019. I'm operating on the assumption that this is accurate, but as I couldn't peruse the actual report, I'm unsure. I've been unable to confirm this date (my pharmacist claims not to have a clue), does anyone have any more solid info?

  • I know that Adderall IR is illegal in Canada, and only the sustained release is available. I'm hoping to find something that has an instant release med available and try to convince my Psych to prescribe me a 'booster' for the mid to late afternoon, in hopes it will help me deal with my late evening impulsiveness. Does anyone have experience they can share regarding taking a IR type med later in the day? Does this sound reasonable, or am I starting to lose it here?

  • If indeed Adderall will continue to be name brand only in Canada, I can't take it. I'm back to University full time in the fall (I've finally got the savings to make it happen), and will lose my insurance. Two-hundred dollars a month is just not doable, no matter what, so I need a generic. I'm thinking Methylphenidate, but I'm not sure. What do you all think? I'm guessing that Ritalin and Dexedrine are my only options? I'm hoping that a relatively strong dose of generic Ritalin will do the trick, a bit frustrated about the Adderall thing.

Any comments or advice are always appreciated,

Thunor

 
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Old 06-08-2009, 04:31 AM   #2
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Re: I started Adderall recently.

Thu,

I need time to think about this one. You deserve more than one of my off-the-cuff stufftoids. I should at least try NOT to be wrong.

Shire recently bumped Adderall XR to about $215 US dollars for 30, up from ~$130. Not to worry, Vyvance, the latest and greatest dextroamphetamine solution, sells for under $150.

The pharmeceuticals claim they must charge through the gazoo to recover R&D expenses. First pill costs 3 to 4 hundred million smackers. Second pill cost a quarter. I get it. No diff than software. Adderall XR is indeed losing patent protection soon. I believe it's 15 years from release date. The patent is up well before 2019 in the US. Hasn't Shire turned a buck on Adderall XR yet? Could, perhaps, the Adderall price increase be designed to get doctors to switch their patents over to Vyvanse so Shire can milk us again for another few billion dollars? I guess I'm suffering from paranoid-schizoid-delusional-conspiree-osis.

In the meantime guess who gets screwed?

What to do?

Later.

Bob

 
Old 06-08-2009, 06:01 AM   #3
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Re: I started Adderall recently.

Thu,

Generic XR is now available in the U.S. Good news? No. Shire continues to guard the chicken coop. More horse manure for sure. Shire couldn't evergreen the stuff so had to license XR to Barr and so more BP, HP, and more BP where BP and HP are bull poop and horse poop respectively.

You had it right, man. Efficacy period is based on excrement.

Half-life for the Dexadrine component is 10 hrs. HL on the Benzadrine is 12 hours. What the hecks do the other two salts do? Beats me. If anyone knows they're not saying.

Adderall IR's real half-life period for me is 6 to 7 hours. I swear, my case, XR is too. Either beats Ritalin by a margin of 2.5. Ritalin, my case, all around sucks compared to Adderall.

Look at multiple Dexadrine doses as a possible solution. Dex is what works. The other crap only extends real-life efficacy period. Or bring up Adderall XR's time-at-work by adding 5mg of Dex around 3PM. I've never tried Dex legally. My illegal experiece is somewhat skewed by "excessive dosing." So let's extrapolate: Adderall IR in the 10mg or lower range will not keep me awake unless I take it at 9PM. 10mg of Adderall contains 2.5mg of dextroamphetamine.

Yeah, I'll talk to shrink about my conpiryosis next visit. No doubt Shire has a med for that too. For just a paltry $200/month. Or is it poultry?

Bob

 
Old 06-10-2009, 11:03 AM   #4
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Re: I started Adderall recently.

Sorry for the late response, my mood has been all over the place the last several days, generally extremely poor/depressed in the evening. I'm blaming the Adderall crash, likely complicated by my eating habits, which lately have resulted in me not eating between noon and about 9pm.

Thank you for the input, Bob. I'm thinking, right now, that I may see if my psych will give me dex instant release and just take it throughout the day . . . it seems you're right, it's the dex that helps, the rest is just superfluous. It seems, at least, that this is the conclusion Shire has come to, as Vyvanase is back to supplying just the dextroamphetamine, leaving out the levo and other salts. Fortunately, my psych doesn't see me as an addiction threat, and so I'm hoping he won't have a problem prescribing the IR stuff.

I'm thinking that for me, something along the higher edge of the dosing spectrum is required. My old doctor spent a lot of time *****-footing around on the low end, and while I saw results, I was often left wondering, 'is this it?' I'm going to have to figure out how to deal with that late day crash though, cause it's a doozy.

 
Old 06-10-2009, 02:34 PM   #5
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Re: I started Adderall recently.

Thu,

I reread your thread starter after reading your post on "Mixing Adderall and Ritalin."

I had to take Ritalin IR 6 times a day to get 12 or so hours of functional brain. I get same benefits from Adderall IR taking it twice per day.

You can survive a hard landing at an airport. Landing in mountainous terrain is DOA. If you can time your stimulant crash at the airport, say 9 to 10 PM it's doable. Earlier in the day crashes are more like hitting a rock cliff. Most of us are expected to remain functional beyond 3PM.

D-amphetamine and methylphenidate are not selective. We have a sleepy region in our heads. Those stimulants over-clock the entire system. We experience exhaustion when they wear off. The sleepy region becomes a comotose region but other systems stay on-line. That is how I spell "miserable." Please, not late in the afternoon, thank you.

I'm thinking an implant might work. Stick the dex directly into the buggy region. Get your implant implanted before you lose your insurance. You should need no more than a mg of d-amphetamine/day. Cheap.

Bob

 
Old 06-11-2009, 09:58 AM   #6
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Re: I started Adderall recently.

Thu,

I've been thinking ... that's what you've been smelling from your southeast ...

Hmn, more energy, more feel-good, less ability to concentrate than Ritalin. Has your ability to concentrate on Adderall XR increased over no med state?

The dose is too high and the XR sequencing is off. I wish I pop in a graphic. Since I can't imagine horizontilize these values.

We'll use 0 mg as relative base line, "c" = increased ability to focus and "m" = mood improvement
0mg - c0; m0;
5mg - c2; m0;
10mg - c4; m1;
15mg - c4; m4;
20mg - c3; m6;
25mg - c2; m8;
30mg - c1; m12;
>30mg - c<0; m>16;
The value 16 = stoned. More and more judgement is lost as the value of m increases above 16. The lower the value of c<0 becomes, the greater hypofocus becomes where hypofocus = focus on the meaningless on the low end to the delusional on the high end.

You simply are smart enough to recognize that higher m values are counterproductive. Whereas most of us "feel" the greater the mood enhancement, the better we are doing.

If you go with Dexadrine, keep the dose low. Experiment to get the sequencing optimized. It is very important to nail your numbers before you begin school regardless of approach you take. Perhaps Ritalin is the better choice for you. I'm thinking you have three months to find out. It's going to be close.

My situation in your place with the numbers nailed: Excel in school.

The visa-versa is flop. Reality sucks. But what is, is.

Bob

 
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Old 06-11-2009, 11:08 PM   #7
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Re: I started Adderall recently.

Thunor,

What Bob said. Mysterious stuff about the chemical workings of the various different meds. Trying different meds till you find one (or two) that work for you and that you can afford. The wonderful "graph" that isn't in graph form.

I take methylphenidat, 15 mg. It lasts for about 4 hours. No crash afterwards, the effects just taper off. If I had a job (or university studies which is basically the same thing), I'd take another dosage to keep the effects lasting through the day.

How (and whether) any med works for you is not really dependent on your body size or how much you weigh, from what I've heard. The meds work on your brain, and everyone has a different mix of brain receptors (this is where Bob and others jump in with the science of it all). So x amount of methyphenidat (similar to Ritalin IR) has a particular effect on my brain, but your mileage may vary.

At my dosage, the primary effect is to calm my panic when I am presented with multiple (more than one ) options about what to do with my time. When I panic, my brain stops functioning. With methylphenidat, I can take a deep breath, calm myself, and make some decisions, write lists, prioritize, actually get some things done. The meds don't get anything done for me. They merely calm my panic.

The meds in this dosage don't make me more alert or more intelligent, or give me more energy. They merely calm my panic, and with that peace of mind I can use whatever brain power I've got with whatever energy level is available to me for that day.

It's relatively cheap. And since it lasts for only 4 hours and doesn't build up in my system like other meds that have to be taken for several weeks before they become effective, I can decide each day if I want to take any at all, or whether taking more than one dosage is appropriate for the activities that I need to face that day.

One thing I am trying very hard to do is practice noticing what is different about my brain on meds vs my brain not on meds. On days that I don't take the meds, I try to notice when the panic is building, and practice the things that I do when I'm on the meds. This way, I have been able sometimes to stem the panic and resulting brain breakdown, and handle situations better than I would have before I started this prescription a couple of years ago. Meaning: it isn't the meds that are making a difference in my life, it's what I am doing with the meds.

I hope that you are able to find something tha works for you that you can afford. It sounds like you have a good shrink to work with.

And you've got Bob.

--Rheanna

 
Old 06-11-2009, 11:19 PM   #8
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Re: I started Adderall recently.

Bob,

Your Not-A-Graph is brilliant! It illustrates exactly why I am keeping my dosage of methylphenidat at the lowest dosage that produces a minimal effect in my brain. Once upon a time, you indicated that you thought I should be on a higher dosage. I replied that I'm doin' it myyyyy wayyyy (insert musical worm here). Your concern for me warmed the cockles of my heart (whatever heart cockles are -- well, they were warm). You care about folks.

--Rheanna

 
Old 06-11-2009, 11:21 PM   #9
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Re: I started Adderall recently.

Thunor,

You care about folks too! Thank you for being here!

--Rheanna

 
Old 06-12-2009, 09:40 AM   #10
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Re: I started Adderall recently.

Rheanna,

Thanks for your kind words. I'm in violation of the prime directive so this must be short. I hear everyone applauding. Why's that?

"Panic" is common among ADHDers. It's usually described as "feeling overwhelmed." Same diff, eh? ('eh' for Thu's sake). From where does the feeling come?.

Short path: The region of the brain that's suppose to come on-line goes off-line on load initialization. Metaphor, no simile (can't keep 'em straight): It's LIKE every time we turn on a lamp the power company reduces the juice. We end up with a brown out.

Another simile: It's like sticking a battery in backwards. Since the polarity is bass ackwards, the flash light doesn't light.

The phenomenon (love the spell checker, oh yeah, there goes phenomonom) was observed by Dr. Amen. It was later confirmed by the Harvard Medical School team. The blood flow to the buggy region is reduced when it should be increased.

My nerd brain is stimulated now. Dang it anyway. The bug probably isn't in the buggy region unless it's give-me-more out sensors are screwed up. Where ever, whatever the ADHD bug is, it is as biological in nature as can be.

Fill in the blanks. Must go back to work.

Bob

 
Old 06-13-2009, 04:21 PM   #11
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Re: I started Adderall recently.

As always, Bob, I learn from you. Keep up the good work.

It seems that the crash has evened out, it was just my body taking a few days to get used to the new dose, which is good to know. The physical and emotional side effects are much more tolerable now, and I seem to be getting relatively good efficacy during the day.

 
Old 06-14-2009, 12:18 AM   #12
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Re: I started Adderall recently.

Thunor,

I'm glad the meds are working better for you now. I hope you are able to find something affordable when you return to school in the fall.

And much praise for going back to school!

--Rheanna

 
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