![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by benn dover on April 24, 2004, at 14:56:10
I'm 31 years old and have been taking 40mg of ir adderall for about 1 year. The last dose of20mg is taken at noon. I still have some trouble getting to sleep. I also sweat more than when I wasn't on the adderall. Would dexedrine be more manageable because of the shorter duration and lack of the levo isomer that's in the adderall? Would my doctor have a problem changing medication? Also, are the dosages of adderall and dexedrine the same? Thanks
Posted by utopizen on April 24, 2004, at 15:26:26
In reply to adderall or dexedrine for adult adhd?, posted by benn dover on April 24, 2004, at 14:56:10
> I'm 31 years old and have been taking 40mg of ir adderall for about 1 year. The last dose of20mg is taken at noon. I still have some trouble getting to sleep. I also sweat more than when I wasn't on the adderall. Would dexedrine be more manageable because of the shorter duration and lack of the levo isomer that's in the adderall? Would my doctor have a problem changing medication? Also, are the dosages of adderall and dexedrine the same? Thanks
>The dosages of Adderall and Dexedrine are not equivocal. Only your doctor can determine what the appropriate dose is for you.
For IR Dexedrine, onlyh the 5mg tablets are available, brand name from SmithKline or generic. Or you may prefer Dextrostat, but don't expect your doc to explain the difference (no one really knows, it's sort of just a brand name version of Dexedrine made by Shire).
Since when I played around with the dosing at first and took 15mg, I remember that would give me euphoria... maybe it was the Effexor I was on at the time, I wonder... I sort of wonder, in retrospect, if the changes in my stim experiences reflect changes in my med combos, now that I have been off antidepressants for a year now.
I noticed that, in cases of rather tiring/pretty bad depression, the kind of depression where you're lethargic almost, the same stimulants that once would give me a kick now barely do anything for me at any dose. I need to get a hold of that... either getting a girlfriend, or an antidepressant, or probably both.
ah, ADD. What were we talking about again? =)
Posted by Ame Sans Vie on April 25, 2004, at 12:01:02
In reply to adderall or dexedrine for adult adhd?, posted by benn dover on April 24, 2004, at 14:56:10
> I'm 31 years old and have been taking 40mg of ir adderall for about 1 year. The last dose of20mg is taken at noon. I still have some trouble getting to sleep. I also sweat more than when I wasn't on the adderall. Would dexedrine be more manageable because of the shorter duration and lack of the levo isomer that's in the adderall? Would my doctor have a problem changing medication? Also, are the dosages of adderall and dexedrine the same? Thanks
Hi there,
I'm 21 and have been on and off various stimulants since I was 13 for ADD. Tried Dexedrine, Dexedrine Spansules, DextroStat, Desoxyn, Adderall, Adderall XR, Ritalin, and Cylert (don't know if Provigil counts, but I tried it too). Currently I'm taking immediate-release Adderall, 30mg twice daily. I don't have any of the problems you mentioned; I certainly don't have insomnia from the amphetamines -- sometimes the Adderall lulls me into a nice nap! lol
A switch to pure dextroamphetamine sulfate sounds like a good move at this point. Adderall, because of the saccharate and aspartate monohydrate salts, tends to remain effective for about an hour or two longer than dexamphetamine. And you're likely correct in assuming that it's the levoratory amphetamine isomer that's causing the sweating and any other peripheral effects; the dextroratory isomer is about twice as active in the CNS.
Concerning dosage, as utopizen said, you and your doctor will of course have to work to find what works for you. But I can break it down like this:
Adderall 20mg: 5mg dextroamphetamine sulfate, 5mg dextroamphetamine saccharate, 5mg amphetamine sulfate, 5 mg d,l-amphetamine aspartate monohydrate
Dexedrine: 5mg dextroamphetamine sulfate
Dexedrine Spansule: 5, 10, or 15mg dextroamphetamine sulfate
DextroStat: 5 or 10mg dextroamphetamine sulfate
Thus, with Adderall, you have half dextroratory amphetamine and half racemic amphetamine. The racemic amphetamine is half dextroratory and half levoratory, so that leaves you with 75% (15mg) d-amphetamine salts and 25% (5mg) l-amphetamine salts. The levoamphetamine is by no means inactive in the CNS; it's just about half as potent as d-amp, as I mentioned earlier, with stronger peripheral effects. But to simplify things, you may want to discuss with your doctor starting at a dose of 15mg dextroamphetamine sulfate twice daily to see how that fares you. It may also be helpful to request permission from your doctor to toy around with the dose a bit should 15mg prove inadequate/overwhelming.
Hope this helps! :-)
Posted by katalina on April 25, 2004, at 19:49:07
In reply to adderall or dexedrine for adult adhd?, posted by benn dover on April 24, 2004, at 14:56:10
> I'm 31 years old and have been taking 40mg of ir adderall for about 1 year. The last dose of20mg is taken at noon. I still have some trouble getting to sleep. I also sweat more than when I wasn't on the adderall. Would dexedrine be more manageable because of the shorter duration and lack of the levo isomer that's in the adderall? Would my doctor have a problem changing medication? Also, are the dosages of adderall and dexedrine the same? ThanksHi there - I just went through this a few months ago. I'm 33 and have taken Adderall XR for over 2 years at a current dose of 30 mg (a.m.) and 20 (noon). I also take klonopin (1.5 per day) which kind of helps with the se's of the adderall (the higher blood pressure, insomnia and sweating, being hot all the time). A couple of months ago, I wanted to try Dexedrine instead and my neurologist said taking 50 mgs. of Adderall XR would be about the equivalent of 40 mgs of Dexedrine (4 tablets in a.m. and 4 at noon). Of course I felt ridiculous walking out of the pharmacy with 320 tablets of Dexedrine for 30 days, but that's another story.
The Dexedrine was not stimulating like the Adderall, and while I got rid of some of the bad effects (the yawning and heart racing at times) I also didn't have that "zing" that Adderall gave me in the morning 30 minutes after taking it. The energy wasn't there, but the sharpness was. So, anyway I went back to the Adderall and am feeling less and less from it. I usually only take 30 mgs in the morning even though I am prescribed 20 mgs more. I don't want to become tolerant to it, even though I have to some extent. I don't feel nearly as good as I used to, and although I expected it to fade out on me eventually, it still bites, knowing what it was like to feel good and feel positive most of the time. Of course I skip my Adderall occasionally on weekends to see if I can "restart", but although I definitely notice I feel worse not taking any at all, it doesn't come back with that newness. Aaaah, well, I can't say I didn't see it coming, but one can hope . . .
ANYWAY, the Dexedrine may be enough for you, especially if you don't need the physical boost from Adderall (I have two preschoolers who I'm home with all day and would want to sleep until noon if I could every day w/o adderall). If you just need the mental alertness, Dexedrine could be the med for you.
Good luck! Katie
Posted by chemist on April 25, 2004, at 21:46:07
In reply to Re: adderall or dexedrine for adult adhd?, posted by katalina on April 25, 2004, at 19:49:07
>
> > I'm 31 years old and have been taking 40mg of ir adderall for about 1 year. The last dose of20mg is taken at noon. I still have some trouble getting to sleep. I also sweat more than when I wasn't on the adderall. Would dexedrine be more manageable because of the shorter duration and lack of the levo isomer that's in the adderall? Would my doctor have a problem changing medication? Also, are the dosages of adderall and dexedrine the same? Thanks
>
>
>
> Hi there - I just went through this a few months ago. I'm 33 and have taken Adderall XR for over 2 years at a current dose of 30 mg (a.m.) and 20 (noon). I also take klonopin (1.5 per day) which kind of helps with the se's of the adderall (the higher blood pressure, insomnia and sweating, being hot all the time). A couple of months ago, I wanted to try Dexedrine instead and my neurologist said taking 50 mgs. of Adderall XR would be about the equivalent of 40 mgs of Dexedrine (4 tablets in a.m. and 4 at noon). Of course I felt ridiculous walking out of the pharmacy with 320 tablets of Dexedrine for 30 days, but that's another story.
>
> The Dexedrine was not stimulating like the Adderall, and while I got rid of some of the bad effects (the yawning and heart racing at times) I also didn't have that "zing" that Adderall gave me in the morning 30 minutes after taking it. The energy wasn't there, but the sharpness was. So, anyway I went back to the Adderall and am feeling less and less from it. I usually only take 30 mgs in the morning even though I am prescribed 20 mgs more. I don't want to become tolerant to it, even though I have to some extent. I don't feel nearly as good as I used to, and although I expected it to fade out on me eventually, it still bites, knowing what it was like to feel good and feel positive most of the time. Of course I skip my Adderall occasionally on weekends to see if I can "restart", but although I definitely notice I feel worse not taking any at all, it doesn't come back with that newness. Aaaah, well, I can't say I didn't see it coming, but one can hope . . .
>
> ANYWAY, the Dexedrine may be enough for you, especially if you don't need the physical boost from Adderall (I have two preschoolers who I'm home with all day and would want to sleep until noon if I could every day w/o adderall). If you just need the mental alertness, Dexedrine could be the med for you.
>
> Good luck! Katiehi there, from chemist....adderall is a racemic mixture of the L and D enantiomers of amphetamine, with the L form binding affinity 100 times less than the D form, which is what dexedrine is (all dextroamphetamine). perhaps you are one of those folks who is predisposed to the L enantiomer, although i have nothing in my literature or research experience to suggest that this is common...i disagree that the ``boost'' from adderall is greater than that of dexedrine, but again, it's up to your genetics....fyi, given the hundredfold difference in Ki for L-amphetamine, i find it unlikely that the dose equivalence of 50 mg adderall is that of 40 mg dexedrine: closer to 27 mg......all the best, chemist
Posted by katalina on April 26, 2004, at 19:45:44
In reply to Re: adderall or dexedrine for adult adhd? » katalina, posted by chemist on April 25, 2004, at 21:46:07
Chemist,
Thanks for your response. I noticed I should have stated that the dose of Dexedrine wasn't prescribed based on equivalencies between Adderall and Dexedrine and more about what would be a better fit for me. I should have been more clear with that. If you happen to read this, do you have any opinion about the long term use of amphetamines for adult add (w/o the hyper component). Sometimes I wonder if I'm causing irreparable neuronal damage and will pay for this in the long term. I try to take a lot of supplements (milk thistle, antioxidants, alpha lipoic and others) and to lead a healthy lifestyle despite taking "speed" on a daily basis.
Also, the only real concern I have with side effects from the adderall is the resting heart rate which is always high (at least 98, sometimes 115 and even escalated to 180 after being on a treadmill for 10 minutes, even though I wasn't really feeling out of breath). Should I be highly concerned about this? My blood pressure is low/normal, despite the tachyiardia symptoms?
Thanks in advance if you see this - you really make a difference to so many people on this board with your taking the time to answer so many questions - I'm sure others appreciate your generosity as well!
Thanks again, Katie
Posted by chemist on April 26, 2004, at 21:05:05
In reply to Re: adderall or dexedrine for adult adhd? » chemist, posted by katalina on April 26, 2004, at 19:45:44
> Chemist,
>
> Thanks for your response. I noticed I should have stated that the dose of Dexedrine wasn't prescribed based on equivalencies between Adderall and Dexedrine and more about what would be a better fit for me. I should have been more clear with that. If you happen to read this, do you have any opinion about the long term use of amphetamines for adult add (w/o the hyper component). Sometimes I wonder if I'm causing irreparable neuronal damage and will pay for this in the long term. I try to take a lot of supplements (milk thistle, antioxidants, alpha lipoic and others) and to lead a healthy lifestyle despite taking "speed" on a daily basis.
>
> Also, the only real concern I have with side effects from the adderall is the resting heart rate which is always high (at least 98, sometimes 115 and even escalated to 180 after being on a treadmill for 10 minutes, even though I wasn't really feeling out of breath). Should I be highly concerned about this? My blood pressure is low/normal, despite the tachyiardia symptoms?
>
> Thanks in advance if you see this - you really make a difference to so many people on this board with your taking the time to answer so many questions - I'm sure others appreciate your generosity as well!
>
> Thanks again, Katiehi katie, thanks for the compliment!...although i am out of my league on many issues, i try to help (and get help too!) if i can....as far as long-term neuronal damge from amphetamine use, the answer is (as in most cases in science): it depends. there are compelling clinical data that long-term use of stimulants leads to altered dopaminergic response, and hence drug-craving and/or inability to safely withdraw. there are also data that suggest that - if your dopamine ``circuity'' is miswired - the benefits of staying on a stimulant will set you straight. your blood pressure is nothing to worry about, and perhaps your high pulse is attributable to an interaction from whatever supplements you are taking, underlying anxiety, or the very real chance that you know you are taking ``speed,'' (you aren't: speed is methamphetamine, or desoxyn) and thus you are in a heightened state of arousal. bottom line: your dopamine receptors could very well be functioning at a sub-par level, in which case the stimulant(s) are going to be the right answer; if not, then you would be racing all over the place and not be able to sleep or even eat occasionally. from what you present, seems to be the former. you can always taper a bit and see if life gets better or worse, and adjust from there. and if you find yourself needing more and more of the stimulant, then you are looking at an abusive pattern, and then it is time to seek an alternative....hope i could shed some light, and all the best, chemist
Posted by Gumball on April 26, 2004, at 23:13:52
In reply to Re: adderall or dexedrine for adult adhd? » katalina, posted by chemist on April 26, 2004, at 21:05:05
> > Chemist,
> >
> > Thanks for your response. I noticed I should have stated that the dose of Dexedrine wasn't prescribed based on equivalencies between Adderall and Dexedrine and more about what would be a better fit for me. I should have been more clear with that. If you happen to read this, do you have any opinion about the long term use of amphetamines for adult add (w/o the hyper component). Sometimes I wonder if I'm causing irreparable neuronal damage and will pay for this in the long term. I try to take a lot of supplements (milk thistle, antioxidants, alpha lipoic and others) and to lead a healthy lifestyle despite taking "speed" on a daily basis.
> >
> > Also, the only real concern I have with side effects from the adderall is the resting heart rate which is always high (at least 98, sometimes 115 and even escalated to 180 after being on a treadmill for 10 minutes, even though I wasn't really feeling out of breath). Should I be highly concerned about this? My blood pressure is low/normal, despite the tachyiardia symptoms?
> >
> > Thanks in advance if you see this - you really make a difference to so many people on this board with your taking the time to answer so many questions - I'm sure others appreciate your generosity as well!
> >
> > Thanks again, Katie
>
> hi katie, thanks for the compliment!...although i am out of my league on many issues, i try to help (and get help too!) if i can....as far as long-term neuronal damge from amphetamine use, the answer is (as in most cases in science): it depends. there are compelling clinical data that long-term use of stimulants leads to altered dopaminergic response, and hence drug-craving and/or inability to safely withdraw. there are also data that suggest that - if your dopamine ``circuity'' is miswired - the benefits of staying on a stimulant will set you straight. your blood pressure is nothing to worry about, and perhaps your high pulse is attributable to an interaction from whatever supplements you are taking, underlying anxiety, or the very real chance that you know you are taking ``speed,'' (you aren't: speed is methamphetamine, or desoxyn) and thus you are in a heightened state of arousal. bottom line: your dopamine receptors could very well be functioning at a sub-par level, in which case the stimulant(s) are going to be the right answer; if not, then you would be racing all over the place and not be able to sleep or even eat occasionally. from what you present, seems to be the former. you can always taper a bit and see if life gets better or worse, and adjust from there. and if you find yourself needing more and more of the stimulant, then you are looking at an abusive pattern, and then it is time to seek an alternative....hope i could shed some light, and all the best, chemistHello,
I've just stumbled across this resource, and I'm glad I did. Tomorrow I'm to be 'officially' tested for ADHA. However, I've done my homework, and talked to a number of people I trust, and I'm 98% sure that it is part of me - and 100% relieved, come to that.
I would greatly appreciate some input regarding meds. As a first timer it's more than a little confusing: methylphenidate (Ritalin, Metadate, Concerta, Focalin), amphetamine (Dexedrine, Dexedrine Spansules, Adderall), methamphetamine (Desoxyn), fast acting, sustained release . . . ? Any suggestions as to initial type and dosage would be most welcome? Thanks very much.
Posted by chemist on April 26, 2004, at 23:17:14
In reply to Re: adderall or dexedrine for adult adhd?, posted by Gumball on April 26, 2004, at 23:13:52
> > > Chemist,
> > >
> > > Thanks for your response. I noticed I should have stated that the dose of Dexedrine wasn't prescribed based on equivalencies between Adderall and Dexedrine and more about what would be a better fit for me. I should have been more clear with that. If you happen to read this, do you have any opinion about the long term use of amphetamines for adult add (w/o the hyper component). Sometimes I wonder if I'm causing irreparable neuronal damage and will pay for this in the long term. I try to take a lot of supplements (milk thistle, antioxidants, alpha lipoic and others) and to lead a healthy lifestyle despite taking "speed" on a daily basis.
> > >
> > > Also, the only real concern I have with side effects from the adderall is the resting heart rate which is always high (at least 98, sometimes 115 and even escalated to 180 after being on a treadmill for 10 minutes, even though I wasn't really feeling out of breath). Should I be highly concerned about this? My blood pressure is low/normal, despite the tachyiardia symptoms?
> > >
> > > Thanks in advance if you see this - you really make a difference to so many people on this board with your taking the time to answer so many questions - I'm sure others appreciate your generosity as well!
> > >
> > > Thanks again, Katie
> >
> > hi katie, thanks for the compliment!...although i am out of my league on many issues, i try to help (and get help too!) if i can....as far as long-term neuronal damge from amphetamine use, the answer is (as in most cases in science): it depends. there are compelling clinical data that long-term use of stimulants leads to altered dopaminergic response, and hence drug-craving and/or inability to safely withdraw. there are also data that suggest that - if your dopamine ``circuity'' is miswired - the benefits of staying on a stimulant will set you straight. your blood pressure is nothing to worry about, and perhaps your high pulse is attributable to an interaction from whatever supplements you are taking, underlying anxiety, or the very real chance that you know you are taking ``speed,'' (you aren't: speed is methamphetamine, or desoxyn) and thus you are in a heightened state of arousal. bottom line: your dopamine receptors could very well be functioning at a sub-par level, in which case the stimulant(s) are going to be the right answer; if not, then you would be racing all over the place and not be able to sleep or even eat occasionally. from what you present, seems to be the former. you can always taper a bit and see if life gets better or worse, and adjust from there. and if you find yourself needing more and more of the stimulant, then you are looking at an abusive pattern, and then it is time to seek an alternative....hope i could shed some light, and all the best, chemist
>
> Hello,
> I've just stumbled across this resource, and I'm glad I did. Tomorrow I'm to be 'officially' tested for ADHA. However, I've done my homework, and talked to a number of people I trust, and I'm 98% sure that it is part of me - and 100% relieved, come to that.
> I would greatly appreciate some input regarding meds. As a first timer it's more than a little confusing: methylphenidate (Ritalin, Metadate, Concerta, Focalin), amphetamine (Dexedrine, Dexedrine Spansules, Adderall), methamphetamine (Desoxyn), fast acting, sustained release . . . ? Any suggestions as to initial type and dosage would be most welcome? Thanks very much.
>
>
gumball, see my post to your thread at bottom of page....let me know if i can be of any assistance, all the best, chemist
Posted by utopizen on April 27, 2004, at 11:26:52
In reply to Re: adderall or dexedrine for adult adhd? » chemist, posted by katalina on April 26, 2004, at 19:45:44
Neurotoxicity is used a lot to fear-monger people out of using ADD treatments.
To clarify things a bit, and provide some common sense, let me say this:
It is unknown how amphetamines of any kind cause neurotoxicity, but it is known that stress alone causes brain cell loss. And amphetamines can produce stress if you let them. (Breathing exercises, exercise in general, sleep, nutrition, and other things can and do control this, as can add-on meds)
Now, brain cell loss is always regenerative, provided your brain is in healthy conditions (you are sleeping properly, you are not 24/7 stressed to the max, you are eating regular meals that are well-balanced, and if you have any vitamin deficiencies noted from a blood work, you are taking supplments for those).
I'm not sure what neurotoxicity means exactly, but I don't think that matters, since it would be impossible to prove in a human subject that neurotoxicity has or is occuring at any point without a new generation of brain scanning technology.
So far, we can only use animals to determine things, and basically look for holes in their brain.
And if you had any idea of how acceptable sloppy research practices are the norm for animal tests, you'd take all of them with a grain of salt instead of pretending these are like tests using fuzzy humans.
If you're taking a stimulant, you need to be most concerned about your stress/anxiety--
you need to sleep properly, control any insomnia if present (I suggest using a self-hypnosis tape for several months along with some Ambien, and before you know it the self-hypnosis will let you actually sleep without resorting to a controlled substance for the rest of your life).
you also need to eat regular meals, and not skip them, whether you feel you're force-feeding yourself or not.
and if you're a student, and you're using them for all-nighters, do what you can to change your habits, and realistically, this is best done by planning a more reasonable course load the following semester.
Posted by chemist on April 27, 2004, at 22:41:32
In reply to Clarification on what neurotoxicity means, posted by utopizen on April 27, 2004, at 11:26:52
> Neurotoxicity is used a lot to fear-monger people out of using ADD treatments.
>
> To clarify things a bit, and provide some common sense, let me say this:
>
> It is unknown how amphetamines of any kind cause neurotoxicity, but it is known that stress alone causes brain cell loss. And amphetamines can produce stress if you let them. (Breathing exercises, exercise in general, sleep, nutrition, and other things can and do control this, as can add-on meds)
>
> Now, brain cell loss is always regenerative, provided your brain is in healthy conditions (you are sleeping properly, you are not 24/7 stressed to the max, you are eating regular meals that are well-balanced, and if you have any vitamin deficiencies noted from a blood work, you are taking supplments for those).
>
> I'm not sure what neurotoxicity means exactly, but I don't think that matters, since it would be impossible to prove in a human subject that neurotoxicity has or is occuring at any point without a new generation of brain scanning technology.
>
> So far, we can only use animals to determine things, and basically look for holes in their brain.
>
> And if you had any idea of how acceptable sloppy research practices are the norm for animal tests, you'd take all of them with a grain of salt instead of pretending these are like tests using fuzzy humans.
>
> If you're taking a stimulant, you need to be most concerned about your stress/anxiety--
>
> you need to sleep properly, control any insomnia if present (I suggest using a self-hypnosis tape for several months along with some Ambien, and before you know it the self-hypnosis will let you actually sleep without resorting to a controlled substance for the rest of your life).
>
> you also need to eat regular meals, and not skip them, whether you feel you're force-feeding yourself or not.
>
> and if you're a student, and you're using them for all-nighters, do what you can to change your habits, and realistically, this is best done by planning a more reasonable course load the following semester.
>
hi there, chemist here....brain cell loss is not regenerative, unless you adhere to the unsubstantiated results of a particular researcher at princeton university. the jury is not in in re: which neirons regenerate, and in the best case, they are not a homogenous crowd. ``holes in the brain'' are not what - in general - are indicative of neurodegeneration, except in schizophrenia, where there is marked decrease in volume of the corpus callusum. you can go into high-contract MRI or real-time MRI or PET, for that matter, but the issue is that your neurons are dying off at a rapid rate as life progresses. as for neurotoxicity: this is a well-established field, and the crux of the matter is that there are chemicals that can lead to pre-mature cell death (as opposed to apotosis). the drugs being discussed inthis forum are more in-line with those that condition certain receptors for enhanced/inhibited uptake of certain neurotransmitters, and the receptors themselves are an entirely different matter....all the best, chemist
Posted by utopizen on April 28, 2004, at 15:40:40
In reply to Re: Clarification on what neurotoxicity means » utopizen, posted by chemist on April 27, 2004, at 22:41:32
. as for neurotoxicity: this is a well-established field, and the crux of the matter is that there are chemicals that can lead to pre-mature cell death (as opposed to apotosis).
by "well-established field," I assume you're referring to neurology. Neurology is a well-established field? Is this what is to be inferred? Please correct me if I am over-assuming here, but we're talking about a field of doctors that pat themselves on the back if they can diagnose a patient... I would consider a "well-developed" field to go beyond giving a patient a diagnosis and providing them with medicore care if at all underdeveloped.
And if it's so well-developed, why would we stil rely on neurotoxins? A developed field of toxicology, if that's what you're instead referred to, would exist only if it actually achieved something.
Like, say, helping researhcers not make drugs neurotoxic when they develop them by exploring how to prevent a drug's mechanism of action from causing neurotoxicity.
>>
the drugs being discussed inthis forum are more in-line with those that condition certain receptors for enhanced/inhibited uptake of certain neurotransmitters, and the receptors themselves are an entirely different matter....all the best, chemist
>>condition? that suggests remission to me, IMHO. Few drugs offer remission to even fewer patients. And amphetamines certainly are discussed on this board a lot, and they are far from achieving the state of conditioning--
after one month of a drug holiday from Adderall, I received the same euphoria for a few minutes I initially experienced when I first went on it routinely a year prior.
And a lot of this is psychosomatic. The distinguishing factors are impossible to separate-- the amphetamine can cause shortness of breath, this causes the patient to feel anxious, causing an greater shortness of breath, causing lower CO2 levels in the blood, causing less CO2 flowing through the brain, causing damage to the brain.
Whether or not cells regenerate, it is clear that anxiety/stress itself, drug-induced or not, will lower IQ (Am. Textbook of Psychophamacology) and reducing anxiety or depression will alleviate much of this, especially through quality sleep and proper nutrition necessary for cellular functions to properly occur in the body.
My point was that neurotoxicity, brain cell loss, and controversies surrounding this are irrelevant, because concern should focus on the reality that much of this is managable, as it is psychosomatic action that plays the most signifigant role in degenerative effects brought on by drugs.
Posted by chemist on April 28, 2004, at 22:29:55
In reply to Re: Clarification on what neurotoxicity means » chemist, posted by utopizen on April 28, 2004, at 15:40:40
> . as for neurotoxicity: this is a well-established field, and the crux of the matter is that there are chemicals that can lead to pre-mature cell death (as opposed to apotosis).
>
> by "well-established field," I assume you're referring to neurology. Neurology is a well-established field? Is this what is to be inferred? Please correct me if I am over-assuming here, but we're talking about a field of doctors that pat themselves on the back if they can diagnose a patient... I would consider a "well-developed" field to go beyond giving a patient a diagnosis and providing them with medicore care if at all underdeveloped.
>
> And if it's so well-developed, why would we stil rely on neurotoxins? A developed field of toxicology, if that's what you're instead referred to, would exist only if it actually achieved something.
>
> Like, say, helping researhcers not make drugs neurotoxic when they develop them by exploring how to prevent a drug's mechanism of action from causing neurotoxicity.
>
> >>
> the drugs being discussed inthis forum are more in-line with those that condition certain receptors for enhanced/inhibited uptake of certain neurotransmitters, and the receptors themselves are an entirely different matter....all the best, chemist
> >>
>
> condition? that suggests remission to me, IMHO. Few drugs offer remission to even fewer patients. And amphetamines certainly are discussed on this board a lot, and they are far from achieving the state of conditioning--
>
> after one month of a drug holiday from Adderall, I received the same euphoria for a few minutes I initially experienced when I first went on it routinely a year prior.
>
> And a lot of this is psychosomatic. The distinguishing factors are impossible to separate-- the amphetamine can cause shortness of breath, this causes the patient to feel anxious, causing an greater shortness of breath, causing lower CO2 levels in the blood, causing less CO2 flowing through the brain, causing damage to the brain.
>
> Whether or not cells regenerate, it is clear that anxiety/stress itself, drug-induced or not, will lower IQ (Am. Textbook of Psychophamacology) and reducing anxiety or depression will alleviate much of this, especially through quality sleep and proper nutrition necessary for cellular functions to properly occur in the body.
>
> My point was that neurotoxicity, brain cell loss, and controversies surrounding this are irrelevant, because concern should focus on the reality that much of this is managable, as it is psychosomatic action that plays the most signifigant role in degenerative effects brought on by drugs.hi there....just wanted to point out that there are over 25,000 pubs (refereed) in print that deal with neurotoxicity. that fact that most drugs discussed in this forum are detailed for side-effects and not abrupt discontinuation of life - a euphamism - is telling that the field of neurotoxicity is (in my opinion) a steadily growing and useful field. the complexities arise, as you point out, when variations in an individual's genetic makeup arises. clearly, not all drugs are beneficial for everyone, but we are seeing more and more NDAs in the past 2 years for stereoenantiomers of what were thought to be the best drugs at the time (e.g., lexapro vs. celexa) than ever before. neurotoxicity is also a wide field, extending to topics such as how does chromium (VI) cause damage to brain cells? answer: it crosses as chromium (IV), and is oxidized to the hexavalent species that causes neurotoxic effects - *not* neurodegenerative. in environmental issues, neurotoxicity is one of many foci. haevy metals - particularly transition-state ones such as cadmium, chromium, and mercury - are very well documented in terms of levels that can induce premature cell death and inhibition. the field is not perfect, but people are not dying: if you are experiencing night sweats, tremor, and dry mouth, thank your lucky stars that you are taking meds now as opposed to 30 years ago, when side effects included much more severe consequences. when we develop a new drug, the goal is to shorten lead time (savings for consumers), decrease side effects, and maximize psycopharacological action. neurotoxicity is prevalent in *every* aspect of drug development, from pre-clinical to post-marketing. and as an aside, your receptors can indeed be `conditioned'' to respond in a certain way to certain agonists/antagonists, although the effect is quite usually diminished over time, as you noted with your experience with the mild drug amphetamine (no tongue-in-cheek: amphetamine is nothing compared to synthetic opiate derivatives, for instance, or even methamphetamine). all the best, chemist
Posted by Escher Dementian on April 30, 2004, at 7:00:45
In reply to Re: adderall or dexedrine for adult adhd? » Gumball, posted by chemist on April 26, 2004, at 23:17:14
Wow, Gumball (?) do i ever 'second' your question:
>>" methylphenidate (Ritalin, Metadate, Concerta, Focalin), amphetamine (Dexedrine, Dexedrine Spansules, Adderall), methamphetamine (Desoxyn), fast acting, sustained release . . . ? Any suggestions as to initial type and dosage would be most welcome? Thanks very much."
>>I am not exactly as "new to all this" as you are, but just when i finally found the right fit and it worked completely perfectly for some lengthy time (non-generic Adderall 60-80mgs fast acting, depending on daily need, and 1-2xweek 'holiday'), the "inactive" ingreds were changed and now any dose of Adderall leaves me with uncomfortable peripheral side-effects, just like the others.
Here's my question for the chemists & docs:
i haven't tried Desoxyn. With my sensitive comfort zone, and what i've read, it seems that it might be 'cleaner' for a med-sensitive/resistant like myself... but there is the bad association in regard to methamphetamine ("speed"), and the awkwardness i would feel asking to try it without worrying about sounding 'narcotic seeking'. <--double edged sword IMHO: the more we try to educate ourselves, the more frustrating it is when trying to discuss meds with a professional who takes the interest and self education as "drug seeking behaviour".
This has not happened to me with my pdoc, but i wouldn't want to initiate it, so i will for now take a coward's way out and ask online in this post:
--->What are the indications for desoxyn as opposed to all of the above?With advance gratitude for the info,
Escher
Posted by chemist on April 30, 2004, at 15:16:32
In reply to question re: meds for adult ADD?, posted by Escher Dementian on April 30, 2004, at 7:00:45
> Wow, Gumball (?) do i ever 'second' your question:
>
> >>" methylphenidate (Ritalin, Metadate, Concerta, Focalin), amphetamine (Dexedrine, Dexedrine Spansules, Adderall), methamphetamine (Desoxyn), fast acting, sustained release . . . ? Any suggestions as to initial type and dosage would be most welcome? Thanks very much."
> >>
>
> I am not exactly as "new to all this" as you are, but just when i finally found the right fit and it worked completely perfectly for some lengthy time (non-generic Adderall 60-80mgs fast acting, depending on daily need, and 1-2xweek 'holiday'), the "inactive" ingreds were changed and now any dose of Adderall leaves me with uncomfortable peripheral side-effects, just like the others.
>
> Here's my question for the chemists & docs:
> i haven't tried Desoxyn. With my sensitive comfort zone, and what i've read, it seems that it might be 'cleaner' for a med-sensitive/resistant like myself... but there is the bad association in regard to methamphetamine ("speed"), and the awkwardness i would feel asking to try it without worrying about sounding 'narcotic seeking'. <--double edged sword IMHO: the more we try to educate ourselves, the more frustrating it is when trying to discuss meds with a professional who takes the interest and self education as "drug seeking behaviour".
> This has not happened to me with my pdoc, but i wouldn't want to initiate it, so i will for now take a coward's way out and ask online in this post:
> --->What are the indications for desoxyn as opposed to all of the above?
>
> With advance gratitude for the info,
> Escher
>
>
> hi escher, from chemist....desoxyn will put you through the roof, methamphetamine is NOT to be messed with for ADD, ADHD, etc. and is prescribed rarely - and most deluctantly - for clinically obese people. i doubt that you could obtain a script, and if you did, it would be deleterious, as addiction potential is way high and you note your sensitivity to such meds....all the best, chemist
Posted by Escher Dementian on May 2, 2004, at 4:43:54
In reply to Re: question re: meds for adult ADD? » Escher Dementian, posted by chemist on April 30, 2004, at 15:16:32
Ah so!
Sadly, then, i shall mourn my loss of the 'old' Adderall's perfect fit for my ADD.Another question~
Care to venture a guess what the diet amphetamine(pill) could have been two decades ago that was used by students who were 'all night cramming'? This is simply a curiosity question. i remember trying it on two occasions in all night study sessions with the sorority group, and being VERY disappointed when it actually slowed me down, but made me calm, quieter, and comfortably hungry and sleepy, while all the sisters were suddenly >bright!< and >brilliant!< laughing and talking a 'zillion mph. all night long 'till after dawn. ~Then again, i was probably the only one in the room able to focus. ;-)
Since my own diagnosis of ADD and subsequent research of the brain/med mechanisms, i understand why/how it worked in reverse for me, but i've always wondered which amphetamine that might have been, two decades ago.Thanx' for the reply,
Escher
Posted by Keith Talent on May 3, 2004, at 5:39:20
In reply to Re: question re: meds for adult ADD? » chemist, posted by Escher Dementian on May 2, 2004, at 4:43:54
Chemist, is dextromethamphetamine more potent than dextroamphetamine centrally?
Posted by chemist on May 3, 2004, at 12:10:50
In reply to Re: question re: meds for adult ADD?, posted by Keith Talent on May 3, 2004, at 5:39:20
> Chemist, is dextromethamphetamine more potent than dextroamphetamine centrally?
>
yes. d-amphetamine is more potent than l-amphetamine, hence in potency desoxyn > dexedrine > adderall....all the best, chemsit
Posted by Anthony Quest on May 3, 2004, at 21:20:55
In reply to Re: question re: meds for adult ADD?, posted by Keith Talent on May 3, 2004, at 5:39:20
You mention addiction as a reason to avoid Desoxyn/methamphetamine.
Do you mean by addiction that there is data showing medical use of methamphetamine in ADHD or narcoleptic patients is correlated with addiction? Were patients with past histories of substance abuse accounted for in the study population.
Also, what definition of addiction are you using.
Any cites would be appreciated as well.
Posted by Keith Talent on May 3, 2004, at 21:57:14
In reply to Re: question re: meds for adult ADD? » Keith Talent, posted by chemist on May 3, 2004, at 12:10:50
Thanks chemist.
Posted by chemist on May 4, 2004, at 1:06:57
In reply to Re: question re: meds for adult ADD?-Q for Chemist » Keith Talent, posted by Anthony Quest on May 3, 2004, at 21:20:55
> You mention addiction as a reason to avoid Desoxyn/methamphetamine.
>
> Do you mean by addiction that there is data showing medical use of methamphetamine in ADHD or narcoleptic patients is correlated with addiction? Were patients with past histories of substance abuse accounted for in the study population.
>
> Also, what definition of addiction are you using.
>
> Any cites would be appreciated as well.
>
>
um, citations concerning methamphetamine abuse abound in both the scientific leterature and, e.g., the new york times. i cannot be more anit-meth. it is a drug of abuse (ever heard of crystal meth or ice?) and in my opinion, should be schedule I, not II. all that is all i will say about the matter...best, chemist
Posted by Anthony Quest on May 4, 2004, at 2:22:07
In reply to Re: question re: meds for adult ADD?-Q for Chemist » Anthony Quest, posted by chemist on May 4, 2004, at 1:06:57
I wasn't intending to annoy you. I don't argue that methamphetamine is abused and it the addiction of many. One of my best friends got addicted to crystal meth many years ago so I know how wicked the addiction is. I also know that the drug itself doesn't really cause the kind of withdrawal that other highly addicting drugs do - at least not physically. I was curious why if the physical withdrawal is not recognized as being so difficult that it is so hard for people to stop. It is crystal meth or is the behavior the abuse or addiction enables. Little of this applies to patients using it for narcolepsy.
If you want me to believe that large numbers of people who use the drug medically are becoming addicted to it - which as you know has a specific medical meaning - stating that lots of sources document it as a drug of abuse is irrelevant or at least falls very short of proving your point. You may well be right, but I will do further research on my own.
PArtyl why I make this point is the following:
People argue we should ban Oxycontin or various other widely abused drugs because they are "so addictive". I don't mean to imply that you argue that. I don't think you've said anything of the sort.
But anytime I hear someone make the argument that because a drug is widely abused those who might need it for medical purposes shouldn't have it, I get very worried. It's (1) not science and if we are making medical decisions on public opinion or emotions or press reports lets not pretend its science (2) unfair to those patients who need that drug.
I don't know if a single person in the entire United States need Desoxyn. I would be willing to be there are people who have tried every stimulant with little effect and get some relief from Desoxyn and only that. For that reason alone it should be kept legal. But maybe I am wrong and it's totally unnecesasry and it should be banned. It is curious if there is so much science that the drug is damaging to the brain, how can it still be permitted as a stimulant when other safer alternatives exist? No one has ever argued the FDA is rational I know.
Also, there is a snowball effect. Making Desoxyn taboo has the result of making Dexedrine the next target. "Why do we need Dexedrine, can't they take Adderall, so many other alternative, so many people abuse dexedrine".You might not make those arguments but plenty would.
Any studies of abuse or addiction in medical use of Desoxyn would very helpful to those studying crystal meth addiction. Demonizing a drug as "addictive" is hardly ever true. Addiction is principally a behavioral disorder, while the pharmocological action of a drug is a very important factor, the main one, it's not the only one.
Posted by Escher Dementian on May 4, 2004, at 3:31:39
In reply to Re: question re: meds for adult ADD?-Q for Chemist, posted by Anthony Quest on May 4, 2004, at 2:22:07
Thank you, Thank You, Thank you, Anthony Quest.
Your post is well thought out and i have to agree with the perspective and the points that you have proposed wholeheartedly.Medication is not a superficial or simple issue for me. As in most inqueries, i prefer to research and educate myself as much as possible until coming to point of decision for action.
As much as i have appreciated the many other postings of information that chemist has shared with us all, i was very disappointed in the answer i recieved from him regarding Desoxyn. It seemed to me to be "one-size-fits-all" opinion driven, and quite shallow in the information content, as well as completely missing the mark in regard to my level of inquery, experience and and intelligence.Thank You again for your challenging post.
~Escher
Posted by Escher Dementian on May 4, 2004, at 3:41:09
In reply to Re: question re: meds for adult ADD?-Q for Chemist » Anthony Quest, posted by Escher Dementian on May 4, 2004, at 3:31:39
>and and intelligence.
>
*blush and LOL*~Escher
This is the end of the thread.
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