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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by DiscoPuppy on May 13, 2002, at 15:22:09
About a year ago, I have been diagnosed with an anxiety disorder and panic attacks, at which point, my doctor prescribed me Effexor. I took it for a few months to no avail. Not only did it not help, but it caused additional problems like weight gain and sexual side effects.
I am an otherwise healthy 28yo male in an intimate relationship, so naturally the sexual side effects are completely unacceptable - so I decided to quit the Effexor cold turkey. I never saw that doctor again.
I have, since then, been living with the fact that I'm going to have to live with the anxiety/panic/depression until I couldn't handle it anymore. This is when I changed doctors and talked to her about my situation. She felt that Zoloft was a better drug for me. I reluctantly tried it. While it did help my anxitey to a certain extent, those side effects I experienced on Effexor a year ago came back (weight gain/sexual side effects). She then augmented my treatment with Wellbutrin. This made matters worse - I am now *INCREDIBLY* unattentive and unable to concentrate. Didn't do anything to help the sexual side effects or my constant hungriness (my appetite has become enormous).
Reading through the post on the babble thing here, I became quite interested in Adderall. I understand that it is a stimulant used for ADD. It poses no threat to someone who is concerned about sexual side effects and has been shown to curb one's appetite.
Before I march into my doctor's office to discuss getting rid of my Zoloft/Wellbutrin combo, I'd like to know what you all think of Adderall (perhaps used in conjunction with some other medication). Also, why does depression always have to be treated by an antidepressant and not a stimulant?
Regardless, the following are my concerns for medication to treat my anxiety/panic/depression:
1. Does not inhibit sexual functioning
2. Does not promote weight gain
3. Does not inhibit concentration/unattentiveness
4. Is not sedatingAm I asking for too much? I think Adderall satisfies all the above conditions.
If anyone has input, I will be forever grateful for any advice I can get.
Thanks!
~Puppy~
Posted by MomO3 on May 13, 2002, at 15:38:50
In reply to Antidepressant or Stimulant?!?! Need your advice!, posted by DiscoPuppy on May 13, 2002, at 15:22:09
Stimulants are great for weight loss, I have heard of adderall and dexadrine both being prescribed for weight loss. But for most people on this board they seem to be prescribed for ADD/ADHD - the decreased appetite is just a nice side-effect for me.
However, my pdoc said that they are not good for anxiety, if anything they will increase your anxiety level. I have to have a script for xanax to go with my 'stimulant of the month'. They are also controlled substances and you will have to visit with your pdoc monthly to keep up with it.
Posted by DiscoPuppy on May 13, 2002, at 15:43:36
In reply to Re: Antidepressant or Stimulant?!?! Need your advice!, posted by MomO3 on May 13, 2002, at 15:38:50
Thanks for your reply. Just outta curiousity, however, what does one need to tell the doctor to get him/her to prescribe me Adderall? Are there any buzz words that one should use when visiting the doctor?
What were you prescribed Adderall for? Are there any indications other than ADD that Adderall is used for?
> Stimulants are great for weight loss, I have heard of adderall and dexadrine both being prescribed for weight loss. But for most people on this board they seem to be prescribed for ADD/ADHD - the decreased appetite is just a nice side-effect for me.
>
> However, my pdoc said that they are not good for anxiety, if anything they will increase your anxiety level. I have to have a script for xanax to go with my 'stimulant of the month'. They are also controlled substances and you will have to visit with your pdoc monthly to keep up with it.
Posted by geno on May 13, 2002, at 17:14:26
In reply to Antidepressant or Stimulant?!?! Need your advice!, posted by DiscoPuppy on May 13, 2002, at 15:22:09
you may wanna try this.
remeron 45mg, less sedating, less weight gain, no sexual side effects.
Or
100mg of zoloft. At this dose, less sexual side effects and sedation due to slight reuptake of dopamine and norepinephrinexanax .5mg 2-3 times a day
adderal or dexadrine as perscribed.(3 beers is very knowlegeable on this)
good luck
geno
Posted by DiscoPuppy on May 13, 2002, at 17:23:53
In reply to Antidepressant or Stimulant?!?! Need your advice!, posted by DiscoPuppy on May 13, 2002, at 15:22:09
> About a year ago, I have been diagnosed with an anxiety disorder and panic attacks, at which point, my doctor prescribed me Effexor. I took it for a few months to no avail. Not only did it not help, but it caused additional problems like weight gain and sexual side effects.
>
> I am an otherwise healthy 28yo male in an intimate relationship, so naturally the sexual side effects are completely unacceptable - so I decided to quit the Effexor cold turkey. I never saw that doctor again.
>
> I have, since then, been living with the fact that I'm going to have to live with the anxiety/panic/depression until I couldn't handle it anymore. This is when I changed doctors and talked to her about my situation. She felt that Zoloft was a better drug for me. I reluctantly tried it. While it did help my anxitey to a certain extent, those side effects I experienced on Effexor a year ago came back (weight gain/sexual side effects). She then augmented my treatment with Wellbutrin. This made matters worse - I am now *INCREDIBLY* unattentive and unable to concentrate. Didn't do anything to help the sexual side effects or my constant hungriness (my appetite has become enormous).
>
> Reading through the post on the babble thing here, I became quite interested in Adderall. I understand that it is a stimulant used for ADD. It poses no threat to someone who is concerned about sexual side effects and has been shown to curb one's appetite.
>
> Before I march into my doctor's office to discuss getting rid of my Zoloft/Wellbutrin combo, I'd like to know what you all think of Adderall (perhaps used in conjunction with some other medication). Also, why does depression always have to be treated by an antidepressant and not a stimulant?
>
> Regardless, the following are my concerns for medication to treat my anxiety/panic/depression:
>
> 1. Does not inhibit sexual functioning
> 2. Does not promote weight gain
> 3. Does not inhibit concentration/unattentiveness
> 4. Is not sedating
>
> Am I asking for too much? I think Adderall satisfies all the above conditions.
>
> If anyone has input, I will be forever grateful for any advice I can get.
>
> Thanks!
>
> ~Puppy~
Posted by 3 Beer Effect on May 14, 2002, at 2:00:33
In reply to 3 beers - any thoughts?, posted by DiscoPuppy on May 13, 2002, at 17:23:53
Basically, any drug that meets your 4 criteria is going to cause anxiety/panic attacks.
I would not discount the Wellbutrin SR. Wellbutrin SR does not cause weight gain or sexual side effects. Wellbutrin SR usually causes weight LOSS (one of its main side effects) & is often pro-sexual. Wellbutrin also is effective at increasing concentration & alleviating symptoms of Adult ADD although it is not as effective as Adderall or Dexedrine in doing this.
Anything your are experiencing to the contrary is probably an interaction between the Zoloft & the Wellbutrin, but Wellbutrin SR by itself will not cause weight gain, sexual side effects, attention problems.I took Zoloft 100 mg for over six months & the sexual side effects were pretty ridiculous- that is probably the problem, the Wellbutrin wasn't able to overcome the Zoloft induced anorgasmia/delayed ejaculation. I also noticed that when I resumed taking Ritalin 20 mg 2x per day which I had taken a year before with much pyschostimulant success that the Zoloft somehow interacted/interfered with the Ritalin making my brain numb & basically making the Ritalin useless.
So the Zoloft could be interfering with Wellbutrin's known psychostimulant properties.Instead of taking Adderall, I think you should ask your doctor about eliminating the Zoloft & instead take Wellbutrin SR by itself at an effective dose, which is 300 to 400 mg/day in 2 divided doses & give it a month to start working. Wellbutrin SR doesn't generally work well at doses below 300 mg/day.
The reason I would recommend Wellbutrin SR is that Wellbutrin decreases anxiety over time (see the Wellbutrin SR website- they have a chart about its positive effect anxiety on there), & is also an effective anti-depressant with hardly any side effects compared to the SSRIs except weight loss & insomnia.
Amphetamines like Adderall & Dexedrine are anti-depressants, but only during the 4 or 6 hours that they are working. After that your original depression returns with a vengence, & this is pretty bad because it happens every day- unlike anti-depressants, stimulants are unsustainable- you can't pop them 24 hours a day & tolerance is always a problem. My only anti-depressant right now is Dexedrine & I feel wonderful for the 4-5 hours after my 2 daily doses, but the other 4-6 hours i'm awake per 24 hour period I feel terrible & severly depressed.
If you do end up taking an amphetamine, i've found Dexedrine usually causes less anxiety & nervousness than Adderall & low-dose Dexedrine makes you quite sociable especially if combined with an adequate dose of the benzodiazepine Klonopin (1 mg breakfast, 1 mg lunch). But, after reading your history of anxiety, if you take over 5 mg of Dexedrine at one time, you will probably become nervous & may even have a panic attack. I would keep the dose low, say 5 mg 2 or 3 times a day. Doses of 10 mg or more at a time are usually reserved/effective for ADD & are less effective for (social) anxiety.
Anyways, I think your best bet is
Wellbutrin SR 300-400 mg/day in two divided doses at breakfast & lunch (any later causes insomnia). Even better would be to also take Klonopin 1 mg breakfast & 1 mg lunch and Ambien (10 mg at night if the Wellbutrin SR causes any insomnia). The Klonopin basically eliminates any anxiety/panic attacks & ironically is one of the most potent but at the same time least addictive benzodiazepines. Klonopin does make you a bit dumber at first & tired (not me, but i've heard that from others), but those & any other side effects are gone by 2 weeks, but the anti-anxiety/anti-panic attack effect lasts atleast 3 months, & some researchers believe the anti-anxiety effect never goes away. For me, Klonopin makes me a nicer person, more confident, & more sociable.3 Beers.......
Posted by Krazy Kat on May 14, 2002, at 9:33:45
In reply to Antidepressant or Stimulant?!?! Need your advice!, posted by DiscoPuppy on May 13, 2002, at 15:22:09
puppy:
you seem ad-intolerant to me. i can't imagine why a stim couldn't be tried. i think depression is almost always treated with an ad first, just like manic depression "should" be treated with a stabilizer first (mine was not).
your side effects mimic mine on ad's, even though you're not bipolar. i don't think a different ad is going to do it.
i am trying ritalin now - it's helping. not spectacular, but it's helping. my appetite is waning instead of growing. no anxiety (provigil caused anxiety in me like welbutrin did).
good luck.
- kk
Posted by Krazy Kat on May 14, 2002, at 9:39:36
In reply to 3 beers - any thoughts?, posted by DiscoPuppy on May 13, 2002, at 17:23:53
i agree with 3beers and he has great advice (as you know since you sought him out :)).
keep in mind, though, that some people do tolerate stims better than ad's. but perhaps it's just bipolars, and that's the difference.
i still think it's worth a try, esp. if you go for the welbutrin sr and it continues to cause anxiety.
adding a benzo - i forgot that many folks do that. good idea.
key words to get a stim -- the things you posted are fine - unable to focus/concetrate. lack of energy and motivation. and stims do provide a small ad effect. these are all legit reasons and if your pdoc disagrees, you might try another. you can't get ahold of any more stims that he/she wants you to anyway. don't know why there's so much controversy over stims when one can commit suicide with otc sleeping pills...
bizarre to me.
good luck.
- kat
Posted by DiscoPuppy on May 14, 2002, at 10:10:37
In reply to Re: 3 beers - any thoughts?, posted by 3 Beer Effect on May 14, 2002, at 2:00:33
Thanks everyone for your information and advice. I really REALLY appreciate it.
3beers: Are you experiencing any sexual side effects on your Dexedrine? Just outta curiousity, what are you taking meds for? I'm sure you have mentioned it in other threads but I am still kind of new here.
Also, everything you guys have told me leads me to believe that stimulants like Dexedrine and Adderall might be in a Schedule II or III category. And if so, what does it mean to me if I get prescribed such a drug?
> Basically, any drug that meets your 4 criteria is going to cause anxiety/panic attacks.
>
> I would not discount the Wellbutrin SR. Wellbutrin SR does not cause weight gain or sexual side effects. Wellbutrin SR usually causes weight LOSS (one of its main side effects) & is often pro-sexual. Wellbutrin also is effective at increasing concentration & alleviating symptoms of Adult ADD although it is not as effective as Adderall or Dexedrine in doing this.
> Anything your are experiencing to the contrary is probably an interaction between the Zoloft & the Wellbutrin, but Wellbutrin SR by itself will not cause weight gain, sexual side effects, attention problems.
>
> I took Zoloft 100 mg for over six months & the sexual side effects were pretty ridiculous- that is probably the problem, the Wellbutrin wasn't able to overcome the Zoloft induced anorgasmia/delayed ejaculation. I also noticed that when I resumed taking Ritalin 20 mg 2x per day which I had taken a year before with much pyschostimulant success that the Zoloft somehow interacted/interfered with the Ritalin making my brain numb & basically making the Ritalin useless.
> So the Zoloft could be interfering with Wellbutrin's known psychostimulant properties.
>
> Instead of taking Adderall, I think you should ask your doctor about eliminating the Zoloft & instead take Wellbutrin SR by itself at an effective dose, which is 300 to 400 mg/day in 2 divided doses & give it a month to start working. Wellbutrin SR doesn't generally work well at doses below 300 mg/day.
>
> The reason I would recommend Wellbutrin SR is that Wellbutrin decreases anxiety over time (see the Wellbutrin SR website- they have a chart about its positive effect anxiety on there), & is also an effective anti-depressant with hardly any side effects compared to the SSRIs except weight loss & insomnia.
>
> Amphetamines like Adderall & Dexedrine are anti-depressants, but only during the 4 or 6 hours that they are working. After that your original depression returns with a vengence, & this is pretty bad because it happens every day- unlike anti-depressants, stimulants are unsustainable- you can't pop them 24 hours a day & tolerance is always a problem. My only anti-depressant right now is Dexedrine & I feel wonderful for the 4-5 hours after my 2 daily doses, but the other 4-6 hours i'm awake per 24 hour period I feel terrible & severly depressed.
>
> If you do end up taking an amphetamine, i've found Dexedrine usually causes less anxiety & nervousness than Adderall & low-dose Dexedrine makes you quite sociable especially if combined with an adequate dose of the benzodiazepine Klonopin (1 mg breakfast, 1 mg lunch). But, after reading your history of anxiety, if you take over 5 mg of Dexedrine at one time, you will probably become nervous & may even have a panic attack. I would keep the dose low, say 5 mg 2 or 3 times a day. Doses of 10 mg or more at a time are usually reserved/effective for ADD & are less effective for (social) anxiety.
>
> Anyways, I think your best bet is
> Wellbutrin SR 300-400 mg/day in two divided doses at breakfast & lunch (any later causes insomnia). Even better would be to also take Klonopin 1 mg breakfast & 1 mg lunch and Ambien (10 mg at night if the Wellbutrin SR causes any insomnia). The Klonopin basically eliminates any anxiety/panic attacks & ironically is one of the most potent but at the same time least addictive benzodiazepines. Klonopin does make you a bit dumber at first & tired (not me, but i've heard that from others), but those & any other side effects are gone by 2 weeks, but the anti-anxiety/anti-panic attack effect lasts atleast 3 months, & some researchers believe the anti-anxiety effect never goes away. For me, Klonopin makes me a nicer person, more confident, & more sociable.
>
> 3 Beers.......
Posted by Krazy Kat on May 14, 2002, at 10:18:44
In reply to Re: 3 beers - any thoughts? » 3 Beer Effect, posted by DiscoPuppy on May 14, 2002, at 10:10:37
i'm not certain about schedule 3, but schedule 2, ritalin i.e., means you must have a specific type of script in hand every 30 days. no refills. this SUCKS for me b/c my pdoc is 2 hours away.
Posted by DiscoPuppy on May 14, 2002, at 10:34:43
In reply to Re: 3 beers - any thoughts?, posted by 3 Beer Effect on May 14, 2002, at 2:00:33
Just to clarify, I've always had concentration/attention issues (main reason why I dropped out of college). I think the medication combination just perpetuated it.
*Puppy*
Posted by 3 Beer Effect on May 14, 2002, at 12:14:00
In reply to Re: 3 beers - any thoughts?, posted by DiscoPuppy on May 14, 2002, at 10:34:43
Keep in mind that doctors are very wary about prescribing the ADD psychostimulants ESPECIALLY TO ADULTS because they are in the DEA schedule II class, the same class as cocaine, morphine, oxycontin. Your doctor must write you a DEA triplicate prescription & can only write/dispense for one month at a time (so you have to see your doctor once/month), no refills allowed. In other words it is a major hassle.
Schedule II amphetamines:
Dexedrine, Dextrostat,
Dextroamphetamine Sulfate (generic Dexedrine), Adderall, Adderall XR, generic Adderall, Desoxyn;Schedule II Ritalin/Methylphenidate drugs:
Ritalin, Focalin, Concerta, Generic Ritalins: (Methylphenidate, Metadate, Methylin).
Ritalin SR (sustained-release) is erratic, & ineffective- don't waste your time with that. The brand name Ritalin & Focalin last a half hour longer & are noticeably more effective than the Ritalin Generics.I would study up on Adult ADD symptoms if this is the route you plan to take. Adderall XR, Dexedrine, Adderall, or Concerta would be the best choices as a stimulant anti-depressant because Ritalin only lasts 3.5 hrs and has a terrible irritable rebound feeling when it wears off. But keep in mind getting & keeping a prescription for these ADD drugs is a major hassle- Wellbutrin SR on the other hand is not controlled & refills are allowed & doctors don't mind writing prescriptions for it.
I take Dextrostat 20 mg 2x per day & also Klonopin 1mg 2x per day for ADD/Depression/Social Phobia. As far as sexual side effects, I haven't noticed any myself on Dexedrine except that time to ejaculation is increased a few minutes but nowhere near as much as with Zoloft.
In the late 1960s/early 1970s alot of people abused amphetamines so they could last longer with their girlfriend(s) & have a more intense orgasm. So I guess (lasting longer) is a good thing for most males. I don't think there is any trouble with anorgasmia, & ability to get aroused is not affected.3 Beers.........
Posted by DiscoPuppy on May 14, 2002, at 12:48:50
In reply to pyschostims DEA schedule II hassle, posted by 3 Beer Effect on May 14, 2002, at 12:14:00
Thanks! You've given me a lot of good information! How much longer does the doctor intend on keeping you on Dextrostat? Going to the doctors once a month is not a hassle for me. I had no idea these meds were in the same category as cocaine and morphine.
^puppy^
> Keep in mind that doctors are very wary about prescribing the ADD psychostimulants ESPECIALLY TO ADULTS because they are in the DEA schedule II class, the same class as cocaine, morphine, oxycontin. Your doctor must write you a DEA triplicate prescription & can only write/dispense for one month at a time (so you have to see your doctor once/month), no refills allowed. In other words it is a major hassle.
>
> Schedule II amphetamines:
> Dexedrine, Dextrostat,
> Dextroamphetamine Sulfate (generic Dexedrine), Adderall, Adderall XR, generic Adderall, Desoxyn;
>
> Schedule II Ritalin/Methylphenidate drugs:
> Ritalin, Focalin, Concerta, Generic Ritalins: (Methylphenidate, Metadate, Methylin).
> Ritalin SR (sustained-release) is erratic, & ineffective- don't waste your time with that. The brand name Ritalin & Focalin last a half hour longer & are noticeably more effective than the Ritalin Generics.
>
> I would study up on Adult ADD symptoms if this is the route you plan to take. Adderall XR, Dexedrine, Adderall, or Concerta would be the best choices as a stimulant anti-depressant because Ritalin only lasts 3.5 hrs and has a terrible irritable rebound feeling when it wears off. But keep in mind getting & keeping a prescription for these ADD drugs is a major hassle- Wellbutrin SR on the other hand is not controlled & refills are allowed & doctors don't mind writing prescriptions for it.
>
> I take Dextrostat 20 mg 2x per day & also Klonopin 1mg 2x per day for ADD/Depression/Social Phobia. As far as sexual side effects, I haven't noticed any myself on Dexedrine except that time to ejaculation is increased a few minutes but nowhere near as much as with Zoloft.
> In the late 1960s/early 1970s alot of people abused amphetamines so they could last longer with their girlfriend(s) & have a more intense orgasm. So I guess (lasting longer) is a good thing for most males. I don't think there is any trouble with anorgasmia, & ability to get aroused is not affected.
>
> 3 Beers.........
Posted by 3 Beer Effect on May 16, 2002, at 1:11:29
In reply to Re: pyschostims DEA schedule II hassle » 3 Beer Effect, posted by DiscoPuppy on May 14, 2002, at 12:48:50
Thanks! You've given me a lot of good information! How much longer does the doctor intend on keeping you on Dextrostat? Going to the doctors once a month is not a hassle for me. I had no idea these meds were in the same category as cocaine and morphine.
^puppy^
I guess i'll been on an ADD stim until I graduate college next spring. I plan to move out of state then, so i'll have a new psychiatrist & another hassle trying to get an adequate dose of an ADD medicine.
I going to try Concerta 56 mg next month, Focalin the month after that, & Adderall the month after that so then I can decide which one is best & will take that one during the school year.
If you decide to use a stimulant as an anti-depressant I would recommend the long acting Adderall XR or Concerta above anything else because they last 12 hours, almost as long as Wellbutrin SR. The immediate release stimulants are too up & down (especially Ritalin & Focalin) to work well for depression. When they wear off 3, 4 or 6 hours later you have a horrible irritable rebound characterized by fatigue, depression, & crankiness.
3 Beers......
Posted by medlib on May 16, 2002, at 11:53:00
In reply to Re: , posted by 3 Beer Effect on May 16, 2002, at 1:11:29
Hi 3beers--
I'm impressed by the amt. of info you've collected re stims. May I contribute a little factoid or two about dispensing Sched II meds to your library?
While every rx of a Sched. II med requires a separate triplicate for no more than 1 month's supply, it is *not* illegal for a pdoc to give the pt. more than 1 triplicate script for the same med on the same visit--as long as each one is post-dated appropriately. My pdoc has provided both a 1 week and a 3 week scrip each time I've tried a different stim so I won't end up with an entire bottle of an rx I can't take. He also has given me 2 full month scrips for the same med (he was going to be on vacation when I was due to run out). I always bring back scrips I haven't used (for his DEA records).
Also, it is *not* illegal to mail triplicate scrips. My pdoc's practice has done it for a number of pts. It helps to build trust if you're an established pt. whose stim dosage is stable. It helps, also, if you use the same pharmacy consistently, and for other meds as well.
My state requires that Sched II scrips be filled no later than 7 days after the scrip date, and that they be filled in-state only. It's helpful to call ahead to see if they have sufficient stock to fill your rx. Although you may purchase less than the scrip was written for, the pharmacy can not legally give you the balance later (even if "later" is within the 7 day period). They must have a separate piece of paper each time a Sched II med is dispensed (because the coming-on and the going-off pharmacists must count the narc safe together, have paperwork to account for each dose "missing" from the previous count and each must sign for the count). These are 1 state's regs; they may differ in other states and countries.
Sorry for the length of this; just wanted you to know that there *are* work-arounds for the 1 triplicate scrip/month/pdoc visit rule--at least here. (No one should have to drive 2 hours for a single month's rx!) Good luck on your upcoming stim trials.
Carefully tiptoeing around the dozing dragon "Paranoia"---medlib
Posted by Ritch on May 16, 2002, at 12:43:35
In reply to Re: Dispensing Schedule II meds, posted by medlib on May 16, 2002, at 11:53:00
Posted by 3 Beer Effect on May 17, 2002, at 10:59:29
In reply to Re: Dispensing Schedule II meds, posted by medlib on May 16, 2002, at 11:53:00
Medlib, thank you for that info. It will probably be very useful to me within the next few months so I printed it out & will put it in my "psychopharmacology" binder for future reference.
Also, please read my new post dated 5/17 "? Sched II ADD rules HMO Blue 3 Month supply allowed?"
Thanks,
3 Beers
Posted by BLPBart on May 19, 2002, at 5:03:41
In reply to Re: Dispensing Schedule II meds, posted by medlib on May 16, 2002, at 11:53:00
> Hi 3beers--
>
> I'm impressed by the amt. of info you've collected re stims. May I contribute a little factoid or two about dispensing Sched II meds to your library?
>
> While every rx of a Sched. II med requires a separate triplicate for no more than 1 month's supply, it is *not* illegal for a pdoc to give the pt. more than 1 triplicate script for the same med on the same visit--as long as each one is post-dated appropriately. My pdoc has provided both a 1 week and a 3 week scrip each time I've tried a different stim so I won't end up with an entire bottle of an rx I can't take. He also has given me 2 full month scrips for the same med (he was going to be on vacation when I was due to run out). I always bring back scrips I haven't used (for his DEA records).
>
> Also, it is *not* illegal to mail triplicate scrips. My pdoc's practice has done it for a number of pts. It helps to build trust if you're an established pt. whose stim dosage is stable. It helps, also, if you use the same pharmacy consistently, and for other meds as well.
>
> My state requires that Sched II scrips be filled no later than 7 days after the scrip date, and that they be filled in-state only. It's helpful to call ahead to see if they have sufficient stock to fill your rx. Although you may purchase less than the scrip was written for, the pharmacy can not legally give you the balance later (even if "later" is within the 7 day period). They must have a separate piece of paper each time a Sched II med is dispensed (because the coming-on and the going-off pharmacists must count the narc safe together, have paperwork to account for each dose "missing" from the previous count and each must sign for the count). These are 1 state's regs; they may differ in other states and countries.
>
> Sorry for the length of this; just wanted you to know that there *are* work-arounds for the 1 triplicate scrip/month/pdoc visit rule--at least here. (No one should have to drive 2 hours for a single month's rx!) Good luck on your upcoming stim trials.
>
> Carefully tiptoeing around the dozing dragon "Paranoia"---medlibI'm really lucky in that I have a pretty cool pdoc who was willing to give me scrips for three months worth of dexedrine SR so I don't have to go back to see him every month. He just dated one 5/20, the next one 6/20, etc.
This is the end of the thread.
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