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Board Index > ADD / ADHD | 0-9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


I can't speak for Bob, but I am most definately [B][I][U]not[/U][/I][/B] a chemist! ;) Alas, I am but a layman who is generally effective at describing science to other laypeople, because I break things down until they're simple enough for me to understand, and once they're that simple, [I]anyone[/I] can understand them!

So, I'll do my best with Methylphenidate. I'll start by defining a couple of terms. At the molecular level, many drugs (and I'm not sure if this holds true for all compounds, remember, not a chemist) have multiple shapes. These shapes can be described as a right twist (it's not 100% physical from what I've read, but how they refract light, but I'm simplifying), and a left twist. The right twist is called dextro- or d- after the Latin word for 'right.' The left twist version is called levo- or l- from the Latin for left. A drug that is made up exclusively of one of these versions of the molecule will be named accordingly (thus, dextroamphetamine consists of only the right twist version of amphetamine, any levoamphetamine has been removed). A pill that contains both the d- and the l- variant is called a racemic mixture.

The difference between the right and the left twist versions of a molecule are important, because the difference in shape can lead to variations in their ability to bind to the various receptor cites in the brain and elsewhere that they are attempting to affect. If the l- version is less effective, or even unable to bind with the target receptors, it will not have the desired effect. Worse, if it binds to cites that are not intended, it can cause side effects. What we're seeing with amphetamine is that the right twist is better at binding with the [I]desired[/I] receptors, and is less likely than the l- to bind to unintended receptors.

Still with me (because I'm not certain that I am!)? ;) Ok . . .

Methyphenidate doesn't technically fit into the discussion that Bob and I were having, because although it is derived from amphetamine, it's not simply amphetamine and thus may act differently and has to be evaluated on its own. For the sake of the d- vs. l- discussion, Ritalin and its generic versions is a racemic mixture, consisting of both dextromethylphenidate and levomethylphenidate. What little reading I've done on the specifics of Methylphenidate indicates that the d- and the l- are similar in effect on the brain to their counterparts in the amphetamines, the l- being generally less effective than the d-.

Apparently, Focalin is an example of dextromethylphenidate, a med which I'm going to have to read more about, because my knowledge of it is virtually nil.

The lists of adverse effects for Methylphenidate are similar to those for amphetamine.

The most important reason for understanding the d- vs. l- question is to gain an understanding of dosing. The reason one might require a larger dose of Adderall as compared to Dexedrine is that Dexedrine doesn't have the less effective l-amphetamine in the mix, and thus you can achieve the desired effect with less overall medication. As an example, let's say you need 5mg of dextroamphetamine to get the effect you're looking for. To get the result you want, you'll need to take just 5mg of Dexedrine, while you may need 7 or 8mg of Adderall to get the same effect.

The idea that the l-amphetamine may be responsible for the lion's share of the side effects of Adderall is something I hadn't considered before. Thanks to Bob for making me think. :)
[QUOTE=Thunor;4036562]...I'm beginning to wonder if I'm expecting a panacea that will do it all for me, and thus abdicating my responsibilities to make good decisions.

I don't know. Reflection time is required. I'll get back to you.[/QUOTE]

Dexedrine CR delivers the d-amphetamine so consistently that I don't experience any drug related ups and downs during normal awake hours.

Stated another way: Dexedrine CR does not contribute to the problem with any side-effects.

It enables me to make good decisions. I remain very capable of making bad decisions. It's up to me. A significant contributor is the ADHD coaching I've gotten through my psychologist and through this board. I'm quite sure if we pull the coaching out of the mix, I'd still be looking for the "pancea."

I want to retain a balanced view. Dexedrine CR is NOT the med for everyone. No one medication is. It will not surprise me at all if many find Adderall or Ritalin or Strattera or Wellbutrin more effective their case.

Some additional info:

My ADHD symptoms are directly proportional to the demand on my brain. Persistently too little or too much load adversely affects me.

I can work well on 20mg/day. And on low-load days, 10mg works magnificently. 30mg is required on most work days. I'm unsure about how wise it is to adjust the med on the fly.

I intend to continue days off regularly. I firmly believe days off prevent tolerance. At any rate, it is my experience.

I dumped the Celexa against shrinks wishes. I hate taking the stuff. If the depression returns, I know where the vial is. Or is it "vile?" Yeah, the latter.

The equation is set in diamond. I understand that's a dang hard stone.

Medication + coaching + time = Adult ADHD management. Put the wrong values in the variables, and we are cooked.

Bob





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