Posted by novelagent on June 7, 2012, at 9:52:49
In reply to Good idea to request dose increase for stimulants?, posted by Mistermindmasta on June 6, 2012, at 17:52:31
Don't tell me you know about the risks, I use to think I was clever and knew my sh*t. I would take my stimulant whenever I felt I needed a boost with my reading, a chore, etc.
I wound up getting schiziphreniform. A few months later, Medscape alerted doctors that the head of the National Institute of Drug Abuse was announcing research that for the first time, really, found a causal link between long-term, high-doses of amphetamines and schizophrenia.
You're at a classic point now where you are taking the medicine in what is called an "unorthodox" manner. Meaning, you lack the fear the average person has in taking a medicine without a doctor's explicit approval. The reason this is associated with addiction behavior, not to say you have addiction behavior, is because the fear of taking something without your doc's approval stops most people on stimulants from needing an early refill, and needing an early refill is a red flag.
You are also taking the mediciation with high expectstions, and this expectation is basically translating in your head to "I must have this drug 24/7 to function, it's normal to think that way, and I don't care if it means risking going without the med for a whole week if I can just have a few more hours a day of the med working." You're not weighting the risk of going without the med for a week or more against the risk of going eithout the med working at optimium capacity for just a few extra hours. That's irrational.
Let me put this another way: let's say you have acid reflux. Let's say the acid reflux med your doctor recently prescribed is only working until 9 PM, giving you acid reflux for the remaining few hours. Would you take another dose of the medicine at 8 PM, knowing you'll be out of the medicine a week early if you do, or do you wait a couple of weeks to speak to your doctor about adjusting your dose? There's a reason why your judgment is different on Ritalin. Prilosec doesn't change your ability to make decisions about taking Prilosec.
Also, you likely only need, it sounds, a very moderate, modest dose change. That's not what I'm worried about. What I'm worried about is this becoming a pattern, and the next time you have some very boring task at work, or the next time you sleep for 5 hours instead of 7, instead of grinning and bearing it, you turn to the medicine, and dose on an as-needed basis. And Gosh forbid you don't have the medicine working at its peak dose for 2 or 3 or even 4 hours.
See what I'm getting at? Don't be like me, I started off thinking I was smarter than my doc, and now I have to get an antipsychotic injection every month,
> I've been taking nuvigil for about 1.5 years for add/fatigue type issues and recently switched to generic methylphenidate bc of cost issues with the nuvigil w/o insurance. The methylphenidate is MUCH MUCH better for my add symptoms but I find that the effects tend to wear off quickly. Like a dose lasts 3 hrs or so. Btw my rx is 20mg 2x/ day. I've taken amphetamines many years ago and they lasted much longer. But anyway, to my point... So with the latter half of my day dragging a bit And not feeling as productive, I've decided to increase my dose to add a third pill per day. Now before I get ppl talking about this being the path to addiction or whatever, my decision was calculated and aware of risks. Anyway so I want to go to my doctor a week or so early for my refill and say 2x / day was a little weak on some days so I took a 3rd, and maybe suggest a dose increase. So my question is, is it a good idea (assuming my dr trusts me, which I'm pretty sure he does) to admit to taking a few extra bc I felt maybe a higher dose is needed? Or would it be better to wait until day 30 to go see him and THEN talk about a possible dose increase. So right now, I'm out of pills, which I knew was coming, and isn't that much of a big problem, but I really think 3 x / day is much better for me. However I suppose taking 1 extra per day on some days is a certain kind if misuse, I'm just hoping my doc would agree that the misuse was something that might have been justified. Thx for the tips in advance.
poster:novelagent
thread:1019342
URL: http://www.dr-bob.org/babble/20120522/msgs/1019382.html