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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Festus on September 6, 2003, at 22:50:37
I read in an article about ADHD treatment that some Dr.,s have their patients on doses of stims(in this case,it was Dexedrine)that seemed pretty high to me.I,ve seen in the drug info sites where usual dosages run around 10mgBID-20mgTID.Almost all the IR stims say this.The folks in this and in another article that I saw a few months ago,were on 30mgTID-50mgTID of IR Dex.The context of these articles had to do with difference in peoples tolerance levels.Do any of you guys know anything or have opinions on these doses or am I just ignorant(not dumb,just ignorant.Probly just set myself up for some pokes,Oh well...)Festus
Posted by EscherDementian on September 7, 2003, at 10:56:44
In reply to What IS safe maximum dose of Dexedrine???, posted by Festus on September 6, 2003, at 22:50:37
No pokes, good question.
i know ADDerall is dextro-meth-amphetamine (isn't it?) and maybe different from dexedrine, but i found the same discrepancy when i researched. i was on 45mgs Adderall and less wouldn't work.
Escher
Posted by utopizen on September 7, 2003, at 14:46:14
In reply to Re: What IS safe maximum dose of Dexedrine???, posted by EscherDementian on September 7, 2003, at 10:56:44
> No pokes, good question.
>
> i know ADDerall is dextro-meth-amphetamine (isn't it?)Guys, Google is cute, but it'll give you more misinformation that info when it comes to medicine. I'd stick to the Am. Textbook of Psychopharmacology, which I read at my hospital's library.
Adderall is 75% l and s-isomer salts of amphetamine, and 25% d-isomer salts. That's 25% dexedrine, 75% benzedrine, basically.
Desoxyn is the ONLY amphetamine with a methyl group (methamphetamine).
The PDR lists Dexedrine and Adderall as 5-60mg for average dailing dosing (the total dose over the course of the day). Few doctors will prescribe anything exceeding 60mg because it could be seen as "prescribing practices which differ from their peers," or something like that-- in the Controlled Substances Act of 1970, it makes it clear doctors can be charged simply for prescribing in doses their peers aren't.
Of course, if you have narcolepsy, and many sleep tests to prove it, you can exceed this dose if necessary. I couldn't imagine anyone with ADD requiring 60mg of Dexedrine, that would likely indicate the drug simply isn't the best for that person and a different stim should be tried.
Posted by stjames on September 8, 2003, at 1:34:56
In reply to Re: What IS safe maximum dose of Dexedrine???, posted by utopizen on September 7, 2003, at 14:46:14
There are people on 120 mgs a day of dex a day on my add list.
Posted by utopizen on September 8, 2003, at 8:00:07
In reply to Re: What IS safe maximum dose of Dexedrine???, posted by stjames on September 8, 2003, at 1:34:56
> There are people on 120 mgs a day of dex a day on my add list.
>it happens, but i wouldn't want to be on that much. most people aren't, hence why the average daily dose is 5-60mg, according to the PDR.
Posted by EscherDementian on September 8, 2003, at 11:42:38
In reply to Re: What IS safe maximum dose of Dexedrine???, posted by utopizen on September 7, 2003, at 14:46:14
))>sheesh<(( i've been finding out more and more that i can trust this board better than the ???s/ answers that were answered by my last pdoc or the "patient information" handouts.
Thanx again for the intelligent answer and information research sites/books/etc. Another thing i notice is how _educated_ most people here are about their medications. (It seems to me to be the way any intelligent person might respond to being asked to take a chemical(s)). How does anyone discuss this with their pdocs? Or DOES anyone? My last pdoc gave me the feeling when i wanted to discuss what i'd learned about any meds indepth, or asked to consider a particular alternative, that it was UNWELCOMED, and i was met with resistance or suspicion. Especially regarding Adderall. Yes, i understand the possible abuser implications, but how does one raise the level of intelligence or specifics with a pdoc beyond that? Answers being "dumbed down" or not at all was frustrating for me.
I know, I know, Dr.Bob is going to redirect me to another board for this post, but i wanted to thank you, Utopizen.
Escher
Posted by utopizen on September 8, 2003, at 18:56:52
In reply to Re:Dexedrine???/Thanx Utopizen, posted by EscherDementian on September 8, 2003, at 11:42:38
If you had a smart doc, he'd know that people who abuse Adderall aren't reading up in the American Textbook of Psychopharmacology. To say the least...
Posted by Festus on September 8, 2003, at 22:00:55
In reply to Re:Dexedrine???/Thanx Utopizen, posted by utopizen on September 8, 2003, at 18:56:52
I don,t know what "medical"reasons there would be to indicate Rxing someone a higher amount of a drug for a condition other than that person did not respond the same way someone else did at the lower dose.That is a huge problem in the Chronic Pain area,where some patients require much higher doses of certain Opiates to control pain levels than another patient might.I have CP and ADD,so therefore my Dexedrine is Rxed for both ADD and extreme drowsiness from the Methadone.When you have a double usage for 1 drug,how do they figure that into the formula?There are CP folks that take 1,200mg of Morphine a day and function NORMALLY.Without it,they could not even get out of bed.Yet,there are Dr.,s who would never think of giving any patient this kind of a dose because it "does not follow protocol".What does this kind of thinking do for those that really do need this dose of meds just to have a shot at a bit of quality in their lifestyles?I,d really like to hear some feedback on this.Festus
Posted by utopizen on September 9, 2003, at 15:07:02
In reply to Re:Dexedrine???/Thanx Utopizen, posted by Festus on September 8, 2003, at 22:00:55
If you have excessive daytime sleepiness, along with your ADD, it's common to require doses higher than those required for ADD alone.
It helps, however, to have a Multiple Sleep Latency Test, to help your doctors have an objective understanding of your fatigue. If a DEA agent came to inspect reports, it would help them to see something like that. But it could also help you to have a sleep study, who knows, you might have sleep apnea-- I suggest a PSG test as well.
And I'm aware you need more stimulant dosing to keep you awake, I have Idiopathic Hypersomnia. I just don't like the feeling I get with amphetamines, and luckily taking Xyrem helped me get off any need for Desoxyn. And my alertness during the day is higher than the normal person. That's not something I could say when I was taking 80mg/day of Adderall.
I've been in your situation, I'm just saying amphetamines aren't always the most effective solution to fatigue-- I prefer to feel totally awake from the time I wake up and go to sleep without having to take a single med in between these times (Xyrem works at night, and is gone by the time you awaken).
This is the end of the thread.
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