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Dosing Dilemma

Hi! I’m new to this board and to the ADHD diagnosis. My therapist put me on 10 mg of Adderall XR and told me to change up my dosing in the 2 weeks til I see her next. This has given me great anxiety! She gave me some info on how to proceed (which I don’t really remember haha), and I’ve been looking around online. Basically I’ve read lots of stuff from adults can change dosing everyday as needed to every 3-5 days until you find what works for you.
Basically, I am totally bad at this and have major worries. What’s too much, too little, over dosing, etc.
I’d love some advise on how others found their correct med and dosage. Just reading other people’s experiences will make me feel like I’m not in this alone.
Thanks smile

Replies

its down to you, everyone responds diferantly to diferant doses.dose 10mg. enhance your abilitys for half the day? all day? and what do you want? half or whole? for example i want to get a whole days work done so i take enough to be able to acomplish what i want… there are many factors involved in personal correct dosage. thats the main one for me…good luck   Tomkat

Posted by tomkat24 on Jun 16, 2014 at 11:45pm

its down to you, everyone responds diferantly to diferant doses.dose 10mg. enhance your abilitys for half the day? all day? and what do you want? half or whole? for example i want to get a whole days work done so i take enough to be able to acomplish what i want… there are many factors involved in personal correct dosage. thats the main one for me…good luck   Tomkat

Posted by tomkat24 on Jun 16, 2014 at 11:45pm

Myself, I only started recently. Both my doc and I thought short term IR a better way to start than XR until I had some idea how the meds would affect me.
see if you can switch to an IR as if it is unpleasant it will wear off faster.
check your heart rate and blood pressure, an inexpensive wrist monitor, I’ve had 3 omron units in the past 10 years, with good accuracy crosschecked with my doc’s BP unit, you want to be sure your dose isn’t getting your BP too high or making your pulse too fast either.
But the main thing is how do you feel and what do you get done? do you have anyone to give you feedback? can you get through simple chores like dishes, laundry, more easily? is work any easier? there are online games from places like luminosity or cambridge that will test your cognitive abilities and track them so you have some way to see if things are getting any better.
general rule of thumb, go up in dose and wait a few days to see if any good effects or bad effects. if not enough good effects, and no bad effects, go up again. repeat until you find the maximum dose that gives good benefit and little side effects or side effects that are worth the benefit.
try making some notes. I found that keeping a note pad in the bathroom so that when I needed to have a fluid exchange break, after washing my hands, I’d make a note on the pad about how I felt and what I got done.
also think about what time of day you need the most brain power, with my IR dosing, lasts about 4 hours, I take my dose about an hour before needing the best focus and not so late in the day I have trouble sleeping.

Posted by Gadfly on Jun 17, 2014 at 12:42am

Thanks, guys. I work 10 hours a day and it’s pretty intense. I like your advise, Gadfly, about the benefits of IR when it comes to controlling my dosage more. As a newbie, I’d appreciate that. The XR really isn’t doing what it claims if it’s wearing off after about 5 hrs. That’s been my experience anyway. Thanks again!

Posted by purplecat on Jun 17, 2014 at 4:37am

I have to say I think it’s not fair and possible inappropriate for a provider to give out a scrip to a “new” med user and leave the client to their own devices.

People with ADD (I am pontificating and making broad general statements here - my bias…) are by nature all over the place. How in the world are we supposed to keep track of what we did when we’ve been told to change things up? No.

Not a good idea. We may be able to notice some side effects, but unless we have a system for noting them, logging them and reporting them to our provider it will be tough for the provider to know whether we are allergic, were taking too much or too little or at the wrong time.

If that is hard, how much harder is it to be able to notice “how we’re doing”? I thought nothing was happening and was very frustrated until my provider tole me that for the first time (after many visits) I was not late for the appointment. My planner wasn’t dropping papers in a trail from her office door to my chair and I was making eye contact. Subjective assessments is a risk of changing things on our own when we’re new to this.

Your provider should be suggesting a dose and giving you some objective things to look for. What are your problems? Lose track of time? Maybe your measure is whether you remembered to feed your kids dinner before 9:30 pm, maybe being late is your deal. Proviider could have you report on how many times you were late to work compared to before meds.

Provider should be asking you to notice how you are sleeping and whether you are getting any feedback from your family or coworkers. Sometimes they will notice things and mention it - like say “Man, you never call me back, but this week you called me back right away” Or, your family will say “Woah, did you ever get up on the wrong side of the bed, you’ve been snapping at me all afternoon”.

If you are uncomfortable winging it on you own, you can call the provider back and ask for a starting minimum recommendation and ask how long it might take for you to notice at that dose if it’s wrong for you.  It took four days for my Adderall allergy to appear.  Then ask if there are some things you might think about so you can tell if it’s helping. Ask when you should increase the dose and by how much (this all might be a short period of time - a few days.

Posted by Juggler on Jun 17, 2014 at 4:42am

No, you should not be changing your dose all the time!  You need to stay at a dose for at least a week, preferably two, noticing each day how things go. 

But since you’ve already noted that at your current dose it only lasts 5 hours, that means you are metabolizing it quickly enough that you’ll need a higher dose.

Increase it but then stay at 20 for at least a week if not two.  Changing over to IR and figuring out your optimum dose then converting back to the XR is also an option.

Posted by BC on Jun 17, 2014 at 1:12pm

I would ask for anxiety meds such as Klonopin.

Posted by focusconnection on Jun 21, 2014 at 4:41am

Klonopin can be a good anti-anxiety; but it seems the anxiety is because of the lack of guidance on the ADD drugs; not stand-alone anxiety. I have been told to take anxiety meds when really what had to happen was for my doc to address my concerns. Sometimes anxiety is just that and should be treated, but sometimes it is a legitimate response to not being treated as we should - if our concerns are dismissed we have anxiety, but the solution is that our concerns should be addressed - not that we should treat our upsetted-ness (my new made up word of the day).

Posted by Juggler on Jun 29, 2014 at 2:04am

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