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Hi everybody! I am new here, obviously, and wanted to thank you for being a support for me for quite some time now. I've been convinced for some time that I am ADD and because of a tendency I have to be really impulsive with things, I've been too afraid to start a stimulant medication. Anyway, I finally went and spoke with a psychiatrist after 7 years of trying different antidepressants. Out of the 7 I've tried, including lexapro, prozac, wellbutrin, trileptal, cymbalta...wellbutrin worked the best and I would've stayed on it but I had to switch to the generic for financial reasons and it was awful. Anyway, because of a family history of depression, I've been told for years that my lack of motivation, boredom, procrastination, short attention span, etc. was due to depression. Well, finally someone said that it wasn't and boy, was I glad to finally hear that (especially after being shot down at my pcp because according to him/her, 95% of all adults would meet add requirements and the DEA is too scary, so no adults are treated for add at his office). So, here are my questions:
1. I have a pretty high tolerance for everything medicinal. In college, I could drink grown men under the table, versed for conscious sedation is a joke, I've woken up during surgery under general anesthesia and scared the surgeon to death...you get the picture.) Is there any way other than just soul searching or something to know if this is really physically true rather than just in my head? What I mean I suppose is do you think this is in my head or is there an actual test of some sort that would show you metabolize things fast or whatever?
2. The reason I ask this is because I quickly titrate up on ALL medicines, but I don't feel the need to do this so much on things that don't make a big difference in my mood. The doc put me on 10 mg adderall ir in the a.m. and 10 at 1 or 2. He asked me to wait three days then let him know if the dose wasn't right. I took my first dose, felt a little calmer and more focused for about 45 minutes after it kicked in, and then nothing. So, I took more. He agreed today to go up to 20mg a.m. and 20 mg p.m. He's hoping that will last longer. What do you think? Should I ask to try the xr? Is this a real possibility that I need more or could it be that I'm not sleeping well and still drinking caffeine? Or worse....it's just in my head?
3. How many of you have to take two days off the medicine a week? I'm really dreading this weekend....I wish I could just take it every day but he wants to do this to keep tolerance at bay.
I'm sorry this was so long....I promise I won't be so long winded every time. Thanks for your advice!
ComingAround,

Attack the "not sleeping well" problem like a wolverine on steroids. Lack of sleep can easily kill off Adderall's ADHD symptom control properties.

Is Adderall causing or worsening your insomnia? Your system needs time to adjust. The insomnia side-effect will go away but not if you take days off. Your system will be on roller coaster ride. My layman's opinion, take Adderall consistently every day year around.

I suspect tolerance is rarely developed to Adderall's ADHD symptom control properties unless it is abused. Tolerance is rapidly developed for its euphoria side effect, just two or three days. Appetite suppression and insomnia side effects can hang on for a month, maybe two, most cases, generally speaking. Some people are very sensitive to its appetite and insomnia side effects and they can be Adderall show stoppers for that small percentage.

Differential tolerance development for different effects of the same drug is commonly encountered with psychotropic meds. If consistent daily use can speed up tolerance for Adderall's insomnia side effect, why can't it speed up tolerance for its ADHD symptom control properties? My own experience and anecdotal accounts I've read on the Internet suggest that consistent use does not speed up tolerance for ADHD symptom control. Paradoxical effects are also commonly encountered with the psychotropics. I really don't have enough information to be dogmatic about tolerance rarely developing to Adderall's ADHD symptom control properties. So I'll leave it at that.

Your shrink's two day off solution, if one is needed, shows a cavalier attitude toward your well being. He certainly doesn't think ADHD causes you any real problems. Would he suggest two days off from a antipsychotic medication if you suffered with schizophrenia? Schizophrenia is more debilitating than most cases of ADHD. Think I care? ADHD devastated my life. Myself, I'd fire the bozo. He is a danger to you. His attitude seems too much like your PCP's. 95% of everyone has ADHD, not a real disorder. Your shrink can write more speed prescriptions before getting busted by the DEA. I may be getting too old and too cynical. I'd fire him for sure anyway. What if takes nothing less than 80mg/day Adderall to control your ADHD symptoms?

If I was still a boozer, I'd take you up on the challenge. You ain't drinking this grown man under no table. I learned to appear not drunk when drunk by controlling drunk behavior. Kindof, Sortof, anyway. I could manage a semi straight line with a contorted gait. Only those who knew me well knew when the gait was contorted. A buzz took more than a few cold ones. A couple, four, five, was more like it. I developed a psychological tolerance to alcohol.

But if you wake up under general anesthesia and scare surgeons to death, I'd say you got super woman physiological tolerance to everything "medicinal" and all other poisons as well. You need no further tests to prove your super woman status. Have your (new) shrink call your anesthesiologist. Too bad the surgeon is dead. He could confirm test results. :D

Bob





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