HOW DOES AN ADDER KNOW WHEN TO INCREASE MEDICATION?

[DANA]

I am interested in discovering how ADDer's know when and if they need to increase their stimulant medication? How does one come to the ideal dosage? My psychiatrist does not want to make ANY changes.....Ever!

How do I know if Adderall is at the correct dose? What are the symptoms of taking not enough and symptoms of taking too high of a dose?

[Jeremy Dyer]

well from my past experience, I would say you try a dose, and try three other doses. Its mostly just like an intuitive feeling that you will get, you want the side effects to outway the benifits. So try to go as high of a dose as you can to get rid of the add symptoms without the side effects getting to high, somewheres in there is a happy medium. does this help any? sorry if it seems some bit hard to follow, along with my adhd i have an LD and dyslexia soooo sometimes it gets a little rough :)

[brian]

Hi Dana,

I've had to play around with my dosage levels for quite awhile. Along with adhd, I also have excessive daytime sleepiness (Narcolepsy without the cataplexy) so the Adderall I am currently on helps with both conditions. At this point in time, I take 30mg total of Adderall daily. Initially I split the tablet in half and took it about 6 hours apart. That worked well for awhile but with the excessive daytime sleepiness, I could really tell when a dosage was wearing off so I started splitting the half tablets in half again and now I take one quarter tablet every 4 hours, usually starting right after I wake up. It has virtually gotten rid of the yo-yo affect of the meds wearing off and then the kick after taking another dose.

The way I try different amounts is I put aside tablets if I forget to take a dose (usually it's a quarter tablet at a time) and keep a separate bottle for these. It doesn't happen all that often that I forget but the tablets add up, enough for me to adjust the meds up a bit just to see if the extra amount is helping or not. Personally I would like to double my daily total from 30mg to 60mg, still spreading it out every four hours but my primary care doctor is not a fan of the medication so if he does not want to let me increase it, I will find a psychiatrist that will work with me to adjust the med levels.

I only start to play with the levels when I am no longer getting any benefit from the current dosage and only after it continues to downgrade for a long while. Sometimes I'll try to take a weekend off to give my body a break and if it weren't for the excessive daytime sleepiness issue, I'd rather not take medication at all but then quality of life would suffer so I guess I'm stuck. In the back of my mind I'm always concerned about long term usage and potential addiction so I always proceed with caution. If you do make any adjustments, small adjustments are always best because you may only need the smallest change to get the most out of your meds.

Good luck!

brian

[Luke]

I usually let my doctor decide when to increase the dose because I'm a bit of an over-achiever and would probably keep taking more until my work is done (which is never). I take Adderall and can tell when I've taken too much because I get really sleepy - which my doctor has told me is a good indication that ADHD is the proper diagnosis. My sister takes Adderall XR and reacts the same way. My roomate tells me that when he takes too much he sort of turns into a zombie and gets a really bad rebound when it wears off.

[DANA]

Thank you so much, Luke, Brian and Jeremy for sharing your own experiences and helpful suggestions regarding dosage of Adderall. I had no idea that Adderall could cause me to feel sleepy if I take too much. Thankfully, that has NEVER happened and I am happy about that!

The last thing that I want to feel like is a zombie or lethargic. Fortunately, when I take 20 mg Adderall one time daily, I become more energetic, motivated and focused. I was shocked on the first day that I took Adderall because I immediately felt like starting new projects, cleaning and I actually accomplished very much! What a positive difference this has had in my life!

I only take my Adderal one time per day and I never feel any rebound effect so I am guessing that this is good? I never actually can tell the exact time when Adderall wears off. It is weird, but I am not able to nail down the exact time since there is NO rebound effect, not many negative symptoms and nothing major to catch my attention.

Therefore, I can't help wondering whether I am at my perfect dose or whether I should experiment and increase the dose? The only challenge that I am experiencing is that my psychiatrist is very conservative with medication and she does not want to change my medication. I had gone to my own family physician for Adderall in the beginning, but she has not felt comfortable continuing the care for my ADHD and that is why I am now seeing a psychiatrist.

Brian, I never felt the "yo yo" affect with Adderall so I have to assume that this is very fortunate for me? What does it feel like when the Adderall begins to wear off? Is this gradual and subtle or very drastic?

Luke, how many hours does Adderall XR last compared to regular Adderall? Have you or your sister tried both to experiment and to determine which one is better?

Jeremy, I like your idea of trying three different dosages to determine which one is the best "fit" for me. I would definitely do this if my psychiatrist would be in agreement, but I highly doubt that she will be open to this idea. It is worth asking about, though, so I am going to inquire the next time I meet with her.