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Re: How to Work With Psychiatrist on Dosage » jazzaholic

Posted by fachad on July 7, 2002, at 9:56:18

In reply to How to Work With Psychiatrist on Dosage, posted by jazzaholic on July 5, 2002, at 18:49:27

Hi again jazzaholic,

I just wanted to add another suggestion about your situation and your asking for a dosage adjustment.

If you were to switch to Adderall XR, or Dex, or Ritalin, you would once again be in the "initial period" when dosage adjustments are considered standard practice.

You could then see (or phone conference with) your pdoc every month and adjust the doseage up or down as needed until you and your pdoc decide on a "final" effective and optimal dose.

Thinking back on my med history, I was taking 30 mg Ritalin immediate release for years, but when I changed to Concerta (a long acting form), my doc and I changed to dose to 54 mg Concerta. It seemed like the 34 mg Concerta was not as effective as 30 mg of Ritalin, and the next incriment in Concerta pill was 54 mg.

> Hi,
>
> I have been treated many years for depression and ended up doing pretty well with Prozac 20 mg and 10 mg of Klonopin. So well I quit smoking and drinking! When I recently started to feel some depression again, I described a lack of concentration, weariness, and also asked about something my daughter had responded well to - Adderall.
>
> He gave it to me for a month, 20 mg and when I went back I told him how I was focused at work again, getting things done, feeling confident and how it seemed to offer a renewed outlook with vigor and determination. He therfore prescribed 5 months worth and I see him again later this month.
>
> The problem was the good effect did not last. I began taking the Adderall a bit later in the day as I was starting to feel like i was falling asleep again after lunch and driving home.
>
> Bottom line is, i think the dose is not working anymore. I tried 2 one day and the benefits returned.
> Since I was prescribed a certain amount, I knew that wouldn't work however. I then experimented with medicines similar. Namely Didrex and Phentermine which were available online. This helped allot, but there was no question the Adderall felt healthy and right while these misxtures could make me nervous. I also knew self medicating was bad for me.
>
> Well, I want to work with my doctor. When i see him, i am afraid of mentioning the experiments as he may give me nothing. What I want is advice as to how to get the benefits of Adderall without it becoming less effective. I think a greater dose might help, but if that just happens again, then what?
>
> In other words I had a glimpse of productivity and being able to focus again, and now I don't know what to tell him. I was going to just say it helped for awhile and the benfits became less.
>
> Any thoughts on getting the right help from your doctor without being branded as an addict and left with nothing? Why did the Adderall have to start failing? Would an increase dose help? IS there a group of medicines you rotate through.
>
> By the Way, he diagnosed ADD when giving it to me in the first place. he cautioned about addictiveness.
>
> Any insight is most welcom.
>
> J


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