Learning the Right Dosage? Need advice

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    • #112040

      Hi all,

      I am very newly diagnosed and have some questions for others who are more experienced in managing their treatment. This will probably be long winded, I apologize.

      Two weeks ago, my doctor and I discussed medication, and I started the lowest dose of Adderall in extended release form on a 15 day trial. We are starting out slow because medication really scares me and of course, we don’t know yet what I will need. Forgive me if the following sounds ignorant, I am still learning and only repeating right now what was told to me: According to my counselor, if it turned out I didn’t need the medication (I asked), I would get nearly manic energy taking the Adderall, much like those who “take it to get things done.” And according to my PCP, I should be able to feel a positive difference fairly quickly. I am researching more holistic approaches to complement treatment as well, including continuing counseling.

      My trial prescription ends tomorrow and I am scheduled to pick up a prescription for a higher dose. Since beginning the medication, there have been times I am able to focus more, and I find myself avoiding tasks less often. But mostly the largest difference I have seen is that I am able to recognize sometimes when I am *not* focusing… sometimes I can get myself back on track, sometimes not. It still is a pretty big effort to sustain any substantial focus or motivation. I know that the pills are not a cure all, I am working slowly on behavior changes as well, and I am sure there will *always* be “good days” and days where I struggle a bit. My question is this: how do those of you who are more experienced know when your dose is or is not working, is too little, too much, etc? I would appreciate any advice given.

    • #112327
      Penny Williams

      This article covers how to determine the right medication and dosage for you:

      A Patient’s Primer on the Stimulant Medications Used to Treat ADHD

      ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism

    • #112359

      I hope this helps you.

      Here’s what I’ve noticed & I’ve taken stimulants on & off for 18yrs & many different kinds. I’m 33 now, successfully a haircolorist & enrolled in a University to finish my Bachelor’s.

      The dosage goes all the way down to 2.5mg for Adderall tablets & 5mg for XR Adderall—for adults, even though most dr’s would consider this a “child’s dosage” and I actually have to do a prior-auth to get my ins to pay.

      Low-dose can be relative, so what is the dose you started on?

      I took 20mg in High School and that worked great. I think I even took XR 2x per day, back when they allowed that for Xr’s.
      I take 10mg dextro-amphetamine (brand name Zenzedi/used to be Dexedrine) tabs.
      If I try to take more, I get too stimulated to think & I’m back to having ADHD, but WORSE.
      This is bc most people either just need a small dose or they need combination therapy. There’s so many factors involved and it depends on what your brain needs at this stage.
      Look into the SPECT scans by Dr. Amen Clinics. I got a scan there & it was well worth the $$ to see your brain.
      Seeing my brain, I know this. I have overactivity in everywhere in my brain whether resting or concentration EXCEPT in the prefrontal cortex & Left temporal lobe. This means, that a little bit of a stimulant helps me get enough stimulation & allow me to excel in school, which I currently am doing.
      If I wanted to get on a GABA or SSRI to cool off the overactive parts, I could probably increase my stimulant dosage.
      THAT is why this is a complex issue and is completely personal to you—and may even change at different stages of your life.
      I asked why I was able to tolerate a 20mg Adderall XR, but now can’t take over 10mg & the dr. suggested metabolism, that I metabolized the drug much faster in highschool, than now at 33.
      Trust your gut, if you feel like it helps you. Some dr’s will do “titration” (you go slowly up on the dose), but stick to your guns on which mg works for you. Most psych wouldn’t even consider something less than 10/20mg for an adult, but we’re all different and if you intend to take it a long time, it’s best not to increase your tolerance.

      Mine starts working after about 30m I take on an empty stomach…everyone’s different, but for me…..once it kicks in, it’s as if I’m wearing the right rx glasses after a long time of bad vision…..or like a light has been turned on in my brain that allows me to “organize/prioritize tasks, retain after reading and sustain my attention/sit still.”

      ADHD RESPONSE—-expect a long lengy reply LOL

      BUT, I hope this helps. Check out the brain gallery on Dr. Amen’s website & see which clinics offer SPECT scans. There’s no reason to “guess” with psychiatry. With SPECT scans, they actually look at your brain and treat you accordingly.
      I have found over the years, to do the research myself and I know alot…sometimes, the dr’s/nurse’s practitioners don’t really know a ton.

      Healthy VS Unhealthy

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