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Old 04-01-2010, 10:31 AM   #1
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Adderall worn off

So I have ADD and my doctor proscribed Adderall about a year ago and it worked well initially. If it wore off we bumped up the dose and I've been on the maximum dose (80mg) and it doesn't really work anymore and I'm having a lot of trouble concentrating again.

I've heard people say that Dexedrine works well in this situation. I have an appointment today and we've talked about it so we'll see what happens. The doctor hinted at Ritalin, Cymbalta and Methylphenidate-based drugs. I've heard they can have zombifying-effect which is something I'd like to avoid. I also have problems with depression and for the last 6 or 7 years I've been in sort of an Anhedonic state where I feel neither highs nor lows and I don't really want a drug that would accentuate that effect. Adderall was working well so I also have more faith in amphetamine based drugs as they're more potent (right?).

I'm currently taking Wellbutrin (150g/day) and Effexor (75g/day) for depression but SSRIs haven't really done that much for me and I'm thinking it's dopamine that's the problem neurotransmitter for me.

Anybody have any advice for me? Which drugs worked best for you?

 
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Old 04-01-2010, 03:03 PM   #2
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Re: Adderall worn off

im on 10 mg (Brand only) but on ly take 1/4 a pill every few days. I have a feeling you might just be used to this dosage. have you considered going off it for a bit THENn going back on the pill? i did this when I had the same issue as you. It was no longer working for me. I cut it back (i was on 20 mg a day). now, i am super senstive to this drug and notice a difference after a tiny amount.

 
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Old 04-01-2010, 03:46 PM   #3
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Re: Adderall worn off

I would discuss things with your doctor very honestly and see if he has any ideas. You have some misconceptions that concern me, and your Adderall dose seems somewhat high. My understanding is that recommended dosages for Adderall top out in the 40mg range for ADHD, and 60mg for narcolepsy. Obviously these dosages can be exceeded at the direction of your physician, but you seem to have a strong tolerance for the drug. I read that anhedonism is often experienced by those whose dopamine system is overtaxed by addiction to stimulants (methamphetamine and cocaine), and I wonder if maybe the rather large dose of Adderall may be a complicating factor.

Dexedrine is dextroamphetamine, which is one of the ingredients found in Adderall. While we generally recommend that you try the various meds to see which is right for you, it may be unlikely that you'll see dramatic effects from Dexedrine if Adderall isn't working for you.

Methylphenidate is a close relative to amphetamine. I may be wrong, but I suspect that any zombifying effects take place in children, and would not apply to adults, as children and adults see different effects from many drugs. Methylphenidate is a stimulant, and should affect you as such. I found Ritalin to be more effective for memory and focus in my case, rather than giving me the 'get up and go' effect that Adderall provides, but your results may vary. To my knowledge there is no clear 'better' alternative between amphetamines and methylphenidate.

Wellbutrin (bupropion) is not an SSRI, it's a norepinephrine and dopamine reuptake inhibitor, which is why it's generally considered a second line treatment for ADHD. Its action should be synergistic with the stimulant effects of Adderall and the others.

Effexor (venlafaxine) does affect the reuptake of seratonin (thus is an SSRI), but my reading indicates that it also has an effect on norepinephrine. The combination of Effexor and Wellbutrin may well be having a strong effect on norepinephrine in your system.

This is where I go from hard science to my own impressions, take them for what you will. When I was on Strattera, a norepinephrine reuptake inhibitor, I found that my level of alertness was depressed. I experienced extreme somnolence, and my ability to become excited was damatically lower. This may be seen in some cases of hyperactivity to be a good thing, and it certainly relieved my temper issues, but for me the tranquilizing effect made it almost impossible to function. This experience has made me wonder if norepinephrine is largely responsible for the hyperactive portion of ADHD, while those of us that are primarily inattentive don't require as much norepinephrine as we do dopamine.

I wonder, based on my own experience, if your anhedonism is the result of too much norepinephrine, and as such having the double norepinephrine enhancing effects of Wellbutrin and Effexor may be causing more complications than they're relieving.

What sort of doctor are you seeing? Is this a psychiatrist, or a general practitioner? I wonder if you would benefit from additional counselling, as well as a review of your medicinal regimen (both which drugs you take as well as the dosing). I don't know your situation and whether you have the insurance or funding to seek additional treatment, but I would discuss seeing specialists with your doctor if possible. Best of luck.

 
Old 04-02-2010, 04:55 AM   #4
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Re: Adderall worn off

I am on adderall xr and appears to working better than the adderall. Have you thought about trying it?

Take care,

Johna

 
Old 04-02-2010, 08:47 AM   #5
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Re: Adderall worn off

The way it was explained to me WAAAAAY back in the day (and sorry to all of you who have heard this speech before.... I'm banking on your ADD to have made you forget!), is that the purpose of getting on Adderall (or any ADD medication) is to train your brain to think properly. The longer you take it, the more your brain gets used to functioning the right way. If this is the case, you should actually be lowering your dose when you feel like you've gotten used to the adderall, not raising it!

I have been on adderall for over a decade. I started out taking 40 mgs a day (20 mgs in the morning and 20 mgs in the afternoon). When it started to feel like the adderall wasn't working anymore, and all the problems started manifesting themselves again, I lowered my dose by 5 mgs at a time. Each time I felt like I was used to the adderall (which took between 9 months and a year the first time, and then every 3-6 months after that), I lowered my dose.

One thing to keep in mind though..... brand name Adderall is a different formula now than what it used to be. I believe the stuff they give out now is equivalent to the old generic adderall (brand name adderall got sold to the makers of generic adderall awhile ago), and that stuff is crap! I read somewhere, but haven't tried it, that if you can find the generic adderall made by Eon Labs, that it's the closest to the old brand name adderall (has anyone else heard this?).

Soooo, it could be that you need to lower your dose, OR it could be that you're using a different brand of brand name adderall (in which case, you probably would do better to try something else!).

Does any of this help???

 
Old 04-02-2010, 10:31 AM   #6
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Re: Adderall worn off

fiveninefive,

You stated that you felt "anhedonic" before taking Adderall, initially felt improvement on Adderall, and now feel Adderall is no longer effective feeling anhedonic once again.

Let's use the synonymous phrase "flat lined" to indicate feeling emotionally dead. That emotionally dead state is the signature of depression, not ADHD. You are suffering from a depression that does not respond to the antidepressants you have been prescribed. Adderall is a powerful but short lived antidepressant. Dose increases seem to help but ultimately increase your depression's non-responsiveness and frankly, has put you on the fast track to amphetamine addiction.

I recommend you find another psychiatrist fast. Do not stop taking Adderall beforehand. You'll need medical help for the withdrawals. You must find the therapy that will knock out your depression, then you can treat your ADHD.

Bob

 
Old 04-02-2010, 03:55 PM   #7
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Re: Adderall worn off

marisuela;

just what i said in my post. i agree with you 100%

Last edited by mod-anon; 04-02-2010 at 11:54 PM. Reason: removed quote

 
Old 04-23-2010, 01:43 AM   #8
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Re: Adderall worn off

Quote:
Originally Posted by addprogrammer View Post
fiveninefive,

You stated that you felt "anhedonic" before taking Adderall, initially felt improvement on Adderall, and now feel Adderall is no longer effective feeling anhedonic once again.

Let's use the synonymous phrase "flat lined" to indicate feeling emotionally dead. That emotionally dead state is the signature of depression, not ADHD. You are suffering from a depression that does not respond to the antidepressants you have been prescribed. Adderall is a powerful but short lived antidepressant. Dose increases seem to help but ultimately increase your depression's non-responsiveness and frankly, has put you on the fast track to amphetamine addiction.

I recommend you find another psychiatrist fast. Do not stop taking Adderall beforehand. You'll need medical help for the withdrawals. You must find the therapy that will knock out your depression, then you can treat your ADHD.

Bob
Yes I know. I was first diagnosed with depression in high school. I was first diagnosed with ADD around 6 or 7 years old and have been constantly living with symptoms of both. I think you're under the impression that I was misdiagnosed as having ADD when I actually had depression. My psych knows I have both and I've been nothing but open with him about the meds and their effects. If I suspected addiction I would not hesitate to report it to him. He has over 20 years experience and personally I trust him.

I talked to him and he agreed to try Dexedrine at 5mg / day. For about 2 or 3 days I felt extremely fatigued but have been off Adderall for 3 weeks now and I feel no inclination to take it again even though I still have half a bottle of my previous prescription still. Dexedrine so far has been positive for me in that I no longer experience the jittering or heavy sweating that I did on Adderall. It hasn't really improved my focus or mental restlessness much but it is a low dose and adderall is 72% dextroamphetamine so I'm getting significantly less dextroamphetamine now. I feel no cravings and never once have I double dosed or taken it recreationally. I'm dead serious about getting better and I'm not doing this to get high. I'm doing this because my mental health has been a significant detriment to my quality of life for the last 10 years at the very least.

If Dexedrine doesn't work I'm fine with taking a methylphenidate based drug or whatever my doctor recommends. I research every drug before I take it and understand any risks involved with them.

 
Old 04-23-2010, 01:54 AM   #9
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Re: Adderall worn off

My anhedonism started long before I started taking any drugs for ADD. I was diagnosed with depression in high school and prescribed prozac and it took the edge off but I've never felt right since. There was a long period between when I stopped the prozac (about 5 years) and started seeing a doctor again where I wasn't taking any drugs at all and felt anhedonic and also felt perpetually sluggish. For the most part Adderall had a very positive effect on my life but I doubt it would have persisted indefinitely and my only concern is finding the drug that works for me.

I research my options for medication beforehand and I know their modes of operation and effects. I only suggested dexedrine (based on my research and symptoms) but I am always prepared to take what he prescribes and I defer to his medical experience at all time. He went to medical school and I trust his judgement. He agreed with me this time but if he prescribes me a methylphenidate based drug I will take it. He's a psychiatrist that specializes in ADD and deals with it exclusively with over 20 years of experience.

That said I value your advice. Thanks.

Last edited by hb-mod; 04-23-2010 at 02:58 AM. Reason: Removed Quote. Please use "QUICK reply" rather than "QUOTE reply". Thanks!

 
Old 09-24-2010, 04:09 AM   #10
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Re: Adderall worn off

Adderall XR (extended release) is still being made by Shire. Some people got switched to generic without realizing it and found it didn't work as well. When switching back to the Shire product, it can get expensive.

When you ask for Adderall BRAND NAME, regular, (not time released), you get pills from manufacturer Teva who is not the ORIGINAL manufacturer. It appears that Shire may have sold the branding off to Teva (or sold to Barr, which was purchased by Teva or something). Not sure about this.

Nonetheless, some are reporting a big difference in the Teva pills, as well as other generics. It seems to depend on the person. If the pills were made cheaper, perhaps the fillers and coating were made differently and the drug delivery is not as smooth. Some complain of mood swings, nausea, headaches, trouble sleeping.

It makes sense to me that if you used to get 20mg of Adderall smoothly spread out over 4 hours, you would get one result. Compare that to another pill where the coating and fillers weren't engineered as carefully. Maybe the entire 20mg would start spilling into the bloodstream 40 minutes after you swallow the pill and finish in about 20 minutes. So the level in your bloodstream might peak quickly, then drop quickly. For some that might not cause a big problem, for others a big headache. For some they may notice concentration issues being a huge problem, etc.

 
Old 09-24-2010, 06:31 AM   #11
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Re: Adderall worn off

I have been taking Adderall for over five years. The highest level was 90mg. Yes 90. I agree with the others that dropping the dose is what you need to do. I now take 10mg. and find its perfect. The adderall XR didn't work out for me as well as the 10mg does. Also stay away from all of the zombie drugs like prozac, wellbrutrin, lexapro etc... hundreds of side effects and they will fry your brain.

 
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