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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 dazed on February 3, 2004, at 7:22:58
Is 30 mg of Adderall XR the max dose? It's either not a big enough dose, or I need to switch to another stim.
Posted by Bill LL on February 3, 2004, at 9:07:59
In reply to Adderrall XR dosage, posted by dazed on February 3, 2004, at 7:22:58
This is a response from a doctor I found on the internet (it is reliable because I have heard from other sources that the maximum is over 100mg).
"There are no good guidelines for determining what is the best dose of ADD medication for any individual. Trial and error are required. However, the maximum dose of Adderall is thought by many doctors, including the Harvard University ADD Group, to be 3/4 of a milligram per pound of body weight (120 mg per day for a 160 pound person). The maximum dose for Ritalin is thought by many doctors to be 1 milligram per pound of body weight (160 mg per day for a 160 pound person.) While these maximum doses are considerably higher than the 60 mg per day approved by the US Food and Drug Administration and more than most people need, some people do not get much benefit from doses of 60 - 80 mg per day. Please work with your doctor to find the correct dose for you."
> Is 30 mg of Adderall XR the max dose? It's either not a big enough dose, or I need to switch to another stim.
Posted by BackOfClass on February 3, 2004, at 17:27:37
In reply to Re: Adderrall XR dosage, posted by Bill LL on February 3, 2004, at 9:07:59
n/t
Posted by EscherDementian on February 3, 2004, at 19:19:08
In reply to Adderrall XR dosage, posted by dazed on February 3, 2004, at 7:22:58
> Is 30 mg of Adderall XR the max dose? It's either not a big enough dose, or I need to switch to another stim.
My total daily dose is 80mg...
Posted by utopizen on February 4, 2004, at 1:23:55
In reply to Re: Adderall XR dosage, posted by EscherDementian on February 3, 2004, at 19:19:08
> > Is 30 mg of Adderall XR the max dose? It's either not a big enough dose, or I need to switch to another stim.
>
> My total daily dose is 80mg...Okay, I take Desoxyn at 50mg, but I have narcolepsy. I'm likely to augment it with 20 or 30mg of Adderall XR.
When I had ADD w/o narcolepsy, 20mg 2x/day was fine with the IR version. And I wasn't overly talkative or anything, although my social anxiety was worsened.
Amphetamines are cute in the beginning, because they help you focus. Eventually, if you have "executive dysfunction," you realize how you focus is a nightmare, and I've submitted every paper in the past three years of college as an English major by doing an all-nighter. I have narcolepsy, so I get tired during the day the moment I try to do something boring like reading or writing a paper. My ADD+Narcolepsy coorelates to make this really terrible.
On Desoxyn, which is more potent than Adderall, say more like 100mg of Adderall at 50mg, and that's a conservative estimate, I am overly talkative unless I take a benzo, but my recent switch to Xanax XR is a dud and need to go back to Klonopin at 1mg 3x/day for social anxiety in a month when I see my doc (don't want to appear drug-seeking, waiting until my next appt., it's a new doc, need to develop trust, all that patheticness).
I am so talkative I can't control it, so anxious I feel generalized anxiety (which I do not naturally have) and I sweat excessively in my arms, waiting for my Botox to kick in over the next few days for that.
High doses of amphetamines will not make your time management skills improve. The only way I can do work for classes is if I do an all-nighter, but that may relate to my comorbid ADD+narcolepsy-- I can only work off of Adrenaline I guess, because I try to do work in the day but I just get extremely exausted even with my meds.
Anyway, my point is, I liked it when Adderall 20mg 2x/day worked, and I could combine it with 1mg of Klonopin 3x/day, it was a great combo. Then my narcolepsy developed over the past year, and I've had to up my dose of Desoxyn and will likely add Adderall XR to deal with my lulls during the day.
If you can get focused on Adderall at 10 or 20 or 30mg taken twice a day, do it. I tried to play around with 10-20mg initially, but realized 20mg 2x/day was needed.
Unless you don't have any anxiety whatsoever, high doses of amphetamines make you feel pathetic after awhile. If you're able to sleep and eat normally at these doses, you do not develop tolerance at any point (almost rare at 40mg/day, but likely at higher doses) and don't talk so excessively and uncontrollably to others around you you embarass yourself to the point of wanting to cry, continue wishing you had higher doses.
In the mean time, if you can focus at say 20mg 2x/day, or maybe need slightly more, like 30mg 2x/day, I'd try that instead.
Augment with some Aricept if you have time management issues, because increasing your amphetamines WILL NOT HELP YOUR TIME MANAGEMENT WHATSOEVER.
You'll just hyperfocus on something completely unproductive and diverting to what you should be doing.
And therapy helps you to get time management, the general issue for why many don't respond to amphetamines. I still haven't resolved this myself.
If you don't feel focused, it's because a small percentage of caucausians are poor metabolizers of Adderall. Very rare and unlikely. Try Ritalin, Dexedrine, or Desoxyn instead of increasing your dose. Or combine a long-acting dose with a short-acting dose.
But after scaring my roommates so often w/ overtalkativeness and my boss and sweating something foul, having $1650 spent on Botox a few days ago and skipping classes this week while I wait a few days for it to kick in, and feeling depressed over how I can have this much Desoxyn and still remain unproductive, it's less cute than you think it is.
I need to go to the library, but can't, because my doses are so high it makes my arms perspire right now, and I can't do work at my desk.
Posted by dazed on February 4, 2004, at 7:36:06
In reply to Re: Adderall XR dosage- not so cute, posted by utopizen on February 4, 2004, at 1:23:55
Wow! That's some amazing info.
Good luck on you Botox kicking in soon.
I have a question--how were you diagnosed as having narcolepsy? Did you just tell your pdoc that you can't stay awake during the day, or did you have to go to a sleep clini?
Posted by utopizen on February 4, 2004, at 9:55:52
In reply to Re: Adderall XR dosage- not so cute-Question, posted by dazed on February 4, 2004, at 7:36:06
> Wow! That's some amazing info.
>
> Good luck on you Botox kicking in soon.
>
> I have a question--how were you diagnosed as having narcolepsy? Did you just tell your pdoc that you can't stay awake during the day, or did you have to go to a sleep clini?
>Oh, they don't bother with that stuff, they just prescribe you 50mg of methamphetamine and 9g/night of GHB the moment you tell them you're a bit sleepy.
No, seriously, I've had 4 separate sleep tests. I've seen about 12 sleep docs. I started at 20mg Desoxyn, a few months later went up to 30mg, and several months later went up to 50mg, and will likely increase with a long-acting to augment it. And the Xyrem, that took a pulmnologist, a neurologist, all those tests, three psychopharmacologists, all consulting with one another over a 6-month period before I got it.
In other words, no. It's hell to get and you don't want it. =)
Posted by dazed on February 4, 2004, at 11:48:58
In reply to Re: Adderall XR dosage- not so cute-Question, posted by utopizen on February 4, 2004, at 9:55:52
OMG< That sounds horrific. I wouldn't have the patience or the time or $ for that kind of tests.
I get so sleepy during the day (alwys have), but I don't even want to go to a sleep clinic to find out if I have narcolepsy coz it sounds too time-consuming.
I'll stick with Adderall for ADD, and pretend I can stay awake. :)
Posted by utopizen on February 4, 2004, at 12:00:03
In reply to Re: Adderall XR dosage- not so cute-Question, posted by dazed on February 4, 2004, at 11:48:58
It's unfortunate if you don't have insurance.
I have ADD, social anxiety, narcolepsy, and borderline sleep apnea... the tests are all covered by my insurance. Most just get one, a sleep test.
But then I got a daytime nap test to objectively measure my sleepiness, and a titration study to determine how much air pressure I need blown through my nose at night for the sleep apnea.
I also got a sleep-deprived EEG, because my neurologist wanted to ensure I didn't have seizures after I mentioned I get this occassional shoulder shrug tic. She said it may relate to disturbed REM patterns.
You most likely won't have narcolepsy. Most of the time a sleep study determines that you have something that is easily treatable, like sleep apnea, or restless leg syndrome, or something like that. And you can have these without knowing it-- I'm skinny, and don't snore, and have sleep apnea. And the machine you use for it is entirely covered by insurance.
Narcolepsy is very rare.
> OMG< That sounds horrific. I wouldn't have the patience or the time or $ for that kind of tests.
>
> I get so sleepy during the day (alwys have), but I don't even want to go to a sleep clinic to find out if I have narcolepsy coz it sounds too time-consuming.
>
> I'll stick with Adderall for ADD, and pretend I can stay awake. :)
This is the end of the thread.
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