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Re: Good idea to request dose increase for stimulants? » Mistermindmasta

Posted by novelagent on June 7, 2012, at 10:14:12

In reply to Good idea to request dose increase for stimulants?, posted by Mistermindmasta on June 6, 2012, at 17:52:31


So um I don't think your request to EVENTUaLLY get 3x/day is unreasonable-- Especially given the fact the half life for Ritalin is 4 hours or something, But you're not going to get it early.

What I would do is stop taking more than prescribed, and then you're going to have to grin and bear it while you're without the medicine. I would also take only one dose a day, to make up for using so much, and doing your better work while with that dose.

But no, your doc, is not going to be able to give you a higher dose early on the grounds of you feeling like taking more than prescribed. Doctors have these things, they're called medical records. DEA agents routinely audit medical reports, looking for cases just like these, where patterns of what are called, eithout passing judgment, abuse. You're telling the doc he has a reason to not give you Ritalin ever again, and then you're asking your doc to give you not just more Ritalin, but an early refill.

Early refill is the biggest red flag doctors are suppose to look out for for signs of abuse, and adjust their prescribing habits accordingly. And I'm just talking about patients who claim they lost the medicine-- they're still responsible for mind reading patients and spotting liars, as far as the DEA is concerned, Your doc, I'm sure, serms like a nice, friendly guy, but even if he didn't think unorthodox use of Ritalin is a red flag for future abuse, you're effectively asking him to do something that would look bad on paper, or to a jury. DEA spots early refills in their drug monitoring programs. If your state requires you to present an ID to get Ritalin, then your state has a rx drug monitoring database the DEA uses to spot suspicious behavior. Prescribing early is a red flag the database would catch. Even if it were otherwise explainable, they trigger audits for far less suspicious reasons. An audit involves reading the medical record. So you're either thinking the DEA won't read your medical record ever, or you think your doc is willing to lie in your medical record, or you aren't thinking. I'm going with door number 3, with all due respect.

> I've been taking nuvigil for about 1.5 years for add/fatigue type issues and recently switched to generic methylphenidate bc of cost issues with the nuvigil w/o insurance. The methylphenidate is MUCH MUCH better for my add symptoms but I find that the effects tend to wear off quickly. Like a dose lasts 3 hrs or so. Btw my rx is 20mg 2x/ day. I've taken amphetamines many years ago and they lasted much longer. But anyway, to my point... So with the latter half of my day dragging a bit And not feeling as productive, I've decided to increase my dose to add a third pill per day. Now before I get ppl talking about this being the path to addiction or whatever, my decision was calculated and aware of risks. Anyway so I want to go to my doctor a week or so early for my refill and say 2x / day was a little weak on some days so I took a 3rd, and maybe suggest a dose increase. So my question is, is it a good idea (assuming my dr trusts me, which I'm pretty sure he does) to admit to taking a few extra bc I felt maybe a higher dose is needed? Or would it be better to wait until day 30 to go see him and THEN talk about a possible dose increase. So right now, I'm out of pills, which I knew was coming, and isn't that much of a big problem, but I really think 3 x / day is much better for me. However I suppose taking 1 extra per day on some days is a certain kind if misuse, I'm just hoping my doc would agree that the misuse was something that might have been justified. Thx for the tips in advance.


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poster:novelagent thread:1019342
URL: http://www.dr-bob.org/babble/20120522/msgs/1019383.html