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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by geno on August 17, 2004, at 15:02:27
hello, I would like to post about a problem im running into with Adderall. THis medication was perscribed to me for ADD. I started at 10mg 2x daily, now after 6 months, im up to 30mg 2x daily. From what i read, this is a high max dose, but on occassion, i have to sometimes take a 3rd dose, because adderall wears off in 4-5 hrs. Leaving me with only 10 hrs of Psychostimulation. Another problem is that even at 30mg, my tolerance is developing , and im looking for methods to boost my tolerance. It seems for the first week, 30mg worked great. Now i can barely feel effects, but its till is working ok.
Iv read where taking antacids my help prevent the breakdown of the adderall. Also i take a few amino acids such as l-tyrosine, DL-phenylalanine to helps boost dopamine and NE naturally.
I also take .5mg of klonopin with adderall, which helps with any anxiety from such. Possibly even at a low dose ok K.P. it may be hindering adderalls effects. But on the other side, i dont wanna feel too overstiimulated or anxioius from it.
Does anyone have any imput on Adderall or psychostimulant potentiation?
thank you
geno
Posted by sanfran on August 17, 2004, at 15:18:49
In reply to Psychostimulant Tolerance and Medications, posted by geno on August 17, 2004, at 15:02:27
Strattera is longer acting from what I've heard...maybe talk to your doctor about that. Many people have experienced the issues you are with adderall...it is a very powerful stimulant. I tried Ritalin and it made my mood disorder worse...I have never taken illicit drugs, but I wondered if that was how people felt 'coming off' their drug high. Literally, my brain was punishing me for not fueling it back up with some of the stimulant ritalin.
Posted by waki on August 17, 2004, at 15:40:11
In reply to Psychostimulant Tolerance and Medications, posted by geno on August 17, 2004, at 15:02:27
I think i was in your same position. Your question is very unclear because you are asking for a stimulant and also a anxiety reducer. It appears your asking for a balance.
In my opinion you may want to start off with managing less. I then think you should change one thing at a time and set one priority at a time.
If you want to reduce anxiety and be stimulated at the same time to me it's an oxymoron. It's kind of like saying, I want to go fast but not to fast and a little slow.
Short term omit the amino acids, simply because as I said try to manage less and initiate less change.
The second thing is I would set one priority first. Either stimulation or anxiety. That klon "crap" darn near ruined me. No matter what amount I took it fatigued me for 2 days. With that being said here's what i did.
1) I did cut out my amino acids and take them now that everything has settled.I only wanted to take things my p-doc gave me, because after all he is the manager of my meds.
2) we then prioritized sleep next. More and better sleep equals better memory, more energy better concentration. 6) We tried ambien but it also made me tired for 24 hours. We then changed to a shorter half life med called Restoril / temazepam.
3) I wanted energy first, in which we got my energy "dialed in". I also changed my Lamictal to a PM dose because it had a slight sedating effect.
4) I then wanted less anxiety. We added that what I call "Klon crap". It reduced my anxiety alright, it sedated and fatigued me for two to three days everytime I took it. We stopped the klon.5) I placed anxiety as a low priority even though it is important to me, but I had to make a decision. I figured I want to solve all my "up" issues first.
6)I then wanted to work on pleasure, concentration so we tried Concerta, Strattera to now dexidrene. I heard concerta is a longer halflife of Ritlan and Dexidrene is a longer half life of adderal "I think". We are now on dexidrene trial.
7) After i get item 6 dialed in, then I'm going to hit this anxiety. To help, I work out, eliminated caffeen, sugar and alcohol. I take tranquil momentary time outs and relax. I make sure I am breathing 8 to 12 breaths per minute no more.
8) I have some xanax in my cabinet. He told me to try it because it has a shorter half life then klon. I have not yet because I am foscused to work on item 6 right now, not item 7.
Posted by zeugma on August 17, 2004, at 15:57:44
In reply to Re: Psychostimulant Tolerance and Medications, posted by waki on August 17, 2004, at 15:40:11
I don't think it's oxymoronic to take Klonopin and Ritalin or Adderall at once. I have an anxiety disorder to go with ADHD and it can be necessary to take them both, although it's hard to get either one prescribed due to FDA scrutiny of psychiatric prescriptions (politics makes bad medicine- consider how many have been disappointed by Strattera, but I think pdocs are obliged to try it first because it is not a controlled substance). I know that a lot of people become depressed on Klonopin, but as I look back, eliminating Strattera from my regimen revealed that it was probably the Strat that was responsible for the depression I suffered from recently. And tolerance to the sedating effects of Klonopin develops pretty quickly. In any case, my social anxiety is so extreme that I have no qualms about taking Klonopin, and it does not worsen my ADHD.
Posted by J. Backer on August 17, 2004, at 16:39:24
In reply to Psychostimulant Tolerance and Medications, posted by geno on August 17, 2004, at 15:02:27
there is no question in my mind why your tolerance is so high, the klonopin your taking will defently dull the stimulating aspects of the adderal.
i also want to add, i couldnt agree with waki any more, you need to focus on either your ADD or Anxiety. such as stimulant + SSRI Combo or a Benzo + Strattera/wellbutrin combo (which i think would be worse). using an upper/downer combo is not an effective long term treatment, as you have proved because of nessecary incresed doses.
peace j
Posted by zeugma on August 17, 2004, at 20:27:31
In reply to Re: Psychostimulant Tolerance and Medications, posted by J. Backer on August 17, 2004, at 16:39:24
> there is no question in my mind why your tolerance is so high, the klonopin your taking will defently dull the stimulating aspects of the adderal.
>
> i also want to add, i couldnt agree with waki any more, you need to focus on either your ADD or Anxiety. such as stimulant + SSRI Combo or a Benzo + Strattera/wellbutrin combo (which i think would be worse). using an upper/downer combo is not an effective long term treatment, as you have proved because of nessecary incresed doses.
>
> peace jI agree that one med needs to be adjusted at a time, and I am not in any way making an evaluation of the poster's situation, but where 'primary' (= not secondary to any other condition) anxiety and 'primary' ADHD are comorbid and the anxiety is resistant to standard AD's, then the stimulant/benzodiazepine combination is justified. This is a principle that may or may not be applicable to a particular case, but is in my opinion valid.
-z
Posted by chemist on August 17, 2004, at 21:02:25
In reply to Re: Psychostimulant Tolerance and Medications, posted by zeugma on August 17, 2004, at 15:57:44
hello there, chemist here....for what it's worth, i do agree most with zeugma's assessment....i take dexedrine and xanax - a much harder to come by prescription here in the u.s. than adderall and klonopin, and my doses are 30 mg/day and 4 mg/day, respectively, so by no means a lightweight combo - and it works for me. i do think that there is some room for individual biochemistry and severity/cormorbidity of disorders addressed by these meds, and should not be dismissed if the job is being done. i do modulate the dexedrine on the downside, and i would say that at a month's end, there are several 10s of mg of leftover dexedrine and a few mg of leftover xanax. this is not because i am the master of staying within my dose range, rather it turns out that on average, i require this amount of medication. period. there are times when i have had too much coffee or taken an extra 0.5 to 1.0 mg xanax, but in the end, my doctor has the final say, and i get more than enough sleep and exercise and do manage to accomlish a fair amount of work. so, unless you are roaming the bad parts of town looking for an illicit source of amphetamine or ``doctor shopping,'' why discontinue what appears to be a working combination? i do assume your doctor is apprised of your situation.....all the best, chemist
> I don't think it's oxymoronic to take Klonopin and Ritalin or Adderall at once. I have an anxiety disorder to go with ADHD and it can be necessary to take them both, although it's hard to get either one prescribed due to FDA scrutiny of psychiatric prescriptions (politics makes bad medicine- consider how many have been disappointed by Strattera, but I think pdocs are obliged to try it first because it is not a controlled substance). I know that a lot of people become depressed on Klonopin, but as I look back, eliminating Strattera from my regimen revealed that it was probably the Strat that was responsible for the depression I suffered from recently. And tolerance to the sedating effects of Klonopin develops pretty quickly. In any case, my social anxiety is so extreme that I have no qualms about taking Klonopin, and it does not worsen my ADHD.
Posted by geno on August 19, 2004, at 12:28:10
In reply to Re: Psychostimulant Tolerance and Medications » zeugma, posted by chemist on August 17, 2004, at 21:02:25
Hello there, i apprietiate all of everyones imput. Yes, i looked over my stimulant/benzo combonation. There is a reason why i take the klonopin. I do have anxiety problems, but since the add medication adderall, worked very very well for me, and if i just take it "alone", i will have some anixety. So it take a low dose of klonopin 5mg. But, now i now a few things, i may be doing wrong. Dosing Klonopin to close together, like taking .5mg every 5 hrs, is just going to overlap the first dose, so i make sure there are at least 8hrs apart.
ALso, i read baking soda ( which is an alkaline agent) INCREASES absorption of amphetamines. Acidic agents decreases such.
And i just read a threat that DXM helps tolerance to amphetamines. I believe the thread was Dextromethorphine and Dexadrine a few days back.
So i take again:
Adderall 30mg 2x daily
Klonopin 2x daily (.5mg .5gm)
Lexapro 10mgNow I must admit i took an extra dose of Adderall 30mg because the doses wear off so fast, like 4 hrs, so i had to take the 3rd dose. I may ask my doctor to up it to 3x daily. I cant , i repeat take adderall xr, because my insurance wont pay for that one.
If i lost anyone, my reason for this post is asking anyone about increasing amphetamine(adderall) potentiation and Prolong effects. So far, i got 3 alternatives:
1. lower or eliminate benzo dose. (have to take at least a small dose)
2. Take a little baking soda with amphetamines
3. Take DXM with Amphetamines.When i first started adderall 30mg, i could feel it working great, i was up doing things for 8hrs, now i barely feel it. Im starting to lay around , and i cant take more or ill short myself.
thank you
geno
Posted by geno on August 23, 2004, at 11:06:16
In reply to Re: Psychostimulant Tolerance and Medications, posted by geno on August 19, 2004, at 12:28:10
Hello again, Im reposting about Adderall(amphetamine tolerance). I must say this board, I gather and learn the most informatin that any other board. Its fabulous. I actually learn and gather 10x more information from this board, and its usually good quality info or feedback than i ever did with doctors or p-docs. Those 5-10 minute 100 dollars + and you walk out with the wrong meds.
Anyway, not to make this really long, Iv been researching alot on this topic. I came to some conclusions. I dont believe my Klonopin dose, at .5mg is effecting it, actually it eliminates the anxiety caused from Adderall. I actually failed to take make K.P. dose, and i felt a bit to anxious from adderall, because to a point i am anxiety prone.
Taking an "amphetamine Holiday" is probably the best bet. But i dont plan on just stopping adderall and taking nothing. I do have Ritalin 30mgLA, which i can take 2 daily, for 5-10 days. I have 20 caps. I was thinking of ephedrine, but after researching that, Ephedrine, which is amphetamine like, but very poor for ADD, Social Phobia, depletes too much dopamine, even after a few days of use. And it causes too much peripheral problems and hardly any Mental stimulant properties.
Caffiene, a mild Psychostimulant, though i cant be drinking 5 cups + a day, and still wont get a good effect, because its not potent enough, esp coming off 60-90 mg of adderall. And after 2-3 cups, you start to become cluttered and NOT focused or such. I dont believe caffiene effects the same dopamine receptors as adderall/dex , mostly i would say NE release, and less dopamine release.
Taking L-Tyrosine supplements, Mucuna Prurriens, both increase dopamine naturally. Another supplement, L-Theanine,may act as a NMDA receptor antagonist, which in turn lowers amphetamine tolerance. ALso, L-theanine may increase dopamine, but most research states its more of a Gaba enhancer.If anyone has imput on this topic, please post. Thank you
NM
Posted by Jake E on March 8, 2005, at 16:09:52
In reply to Re: Psychostimulant Tolerance and Medications, posted by geno on August 23, 2004, at 11:06:16
> Hello again, Im reposting about Adderall(amphetamine tolerance). I must say this board, I gather and learn the most informatin that any other board. Its fabulous. I actually learn and gather 10x more information from this board, and its usually good quality info or feedback than i ever did with doctors or p-docs. Those 5-10 minute 100 dollars + and you walk out with the wrong meds.
>
> Anyway, not to make this really long, Iv been researching alot on this topic. I came to some conclusions. I dont believe my Klonopin dose, at .5mg is effecting it, actually it eliminates the anxiety caused from Adderall. I actually failed to take make K.P. dose, and i felt a bit to anxious from adderall, because to a point i am anxiety prone.
> Taking an "amphetamine Holiday" is probably the best bet. But i dont plan on just stopping adderall and taking nothing. I do have Ritalin 30mgLA, which i can take 2 daily, for 5-10 days. I have 20 caps. I was thinking of ephedrine, but after researching that, Ephedrine, which is amphetamine like, but very poor for ADD, Social Phobia, depletes too much dopamine, even after a few days of use. And it causes too much peripheral problems and hardly any Mental stimulant properties.
> Caffiene, a mild Psychostimulant, though i cant be drinking 5 cups + a day, and still wont get a good effect, because its not potent enough, esp coming off 60-90 mg of adderall. And after 2-3 cups, you start to become cluttered and NOT focused or such. I dont believe caffiene effects the same dopamine receptors as adderall/dex , mostly i would say NE release, and less dopamine release.
> Taking L-Tyrosine supplements, Mucuna Prurriens, both increase dopamine naturally. Another supplement, L-Theanine,may act as a NMDA receptor antagonist, which in turn lowers amphetamine tolerance. ALso, L-theanine may increase dopamine, but most research states its more of a Gaba enhancer.
>
> If anyone has imput on this topic, please post. Thank you
> NM
When I'm taking adderall, I have to take as much as 1.5-2.0 mg of klonopin to relieve the adderall-induced anxiety.I've found that memantine (Namenda) prevents me from having to take more than 60 mg of adderall per day. It enhances the effect of adderall. Memantine is expensive though, and I have to take a high dose (40 mg) for it to be effective.
Posted by ed_uk on March 9, 2005, at 15:08:45
In reply to Re: Psychostimulant Tolerance and Medications, posted by Jake E on March 8, 2005, at 16:09:52
Hi,
>I've found that memantine (Namenda) prevents me from having to take more than 60 mg of adderall per day.
That's interesting. Only the other day we were saying that we only knew of a couple of people who had ever used memantine in attempt to prevent amphetamine tolerance.
Have you taken Adderall without memantine in the past? Did you develop tolerance? Do you have any side effects from the memantine?
Ed.
Posted by calamityjane on March 9, 2005, at 22:46:10
In reply to Memantine » Jake E, posted by ed_uk on March 9, 2005, at 15:08:45
What is it exactly? I would love to take it, but unresearched combinations always scare me...like I will be the one person that has a negative reaction and dies. And they will mark me in the books as the 1% that died from the interaction of Memantine and Adderall.
(J/k)
Seriously though, is it safe?
Posted by Jake E on March 14, 2005, at 22:59:31
In reply to Memantine » Jake E, posted by ed_uk on March 9, 2005, at 15:08:45
> Hi,
>
> >I've found that memantine (Namenda) prevents me from having to take more than 60 mg of adderall per day.
>
> That's interesting. Only the other day we were saying that we only knew of a couple of people who had ever used memantine in attempt to prevent amphetamine tolerance.
>
> Have you taken Adderall without memantine in the past? Did you develop tolerance? Do you have any side effects from the memantine?
>
> Ed.I have taken Adderall without memantine in the past. In fact, I abused Adderall for a while because of the tolerance problem. I usually develop a tolerance to Adderall in 2 days.
I want to take this drug combination for a month straight before I make any firm conclusions. So far I've used this combination for about 2 weeks. There might be a possibility that the Namenda slows down the tolerance, as opposed to stopping it completely. I won't be certain for a few more weeks.
I'll keep you posted.
Posted by Jake E on March 14, 2005, at 23:02:28
In reply to Re: Memantine---but is it safe?, posted by calamityjane on March 9, 2005, at 22:46:10
> What is it exactly? I would love to take it, but unresearched combinations always scare me...like I will be the one person that has a negative reaction and dies. And they will mark me in the books as the 1% that died from the interaction of Memantine and Adderall.
> (J/k)
> Seriously though, is it safe?
Honestly I don't know if it's safe. So I guess I'm taking a risk here. I scanned the internet trying to find anyone else who has given Namenda a fair trial, but I couldn't find anyone who has. I guess I'll do it if no one else will.This Adderall-tolerance is a big problem and it needs to be solved.
Posted by SLS on March 15, 2005, at 4:18:50
In reply to Re: Memantine---but is it safe?, posted by Jake E on March 14, 2005, at 23:02:28
> > Seriously though, is it safe?
> Honestly I don't know if it's safe. So I guess I'm taking a risk here.I know one person who combined the two drugs successfully. I can't think of any reason why these two drugs cannot be combined. If it makes any difference to you, I combined memantine + Parnate and suffered nothing untoward.
- Scott
Posted by ed_uk on March 15, 2005, at 5:13:34
In reply to Re: Memantine, posted by Jake E on March 14, 2005, at 22:59:31
Hi!
Sounds promising :-)
>I'll keep you posted.
Thanks, please do. I look forward to reading your posts!
Have you ever tried taking memantine without Adderall for a few weeks? I wonder whether Namenda alone would help your ADD.
Ed.
Posted by Jake E on March 24, 2005, at 14:56:23
In reply to Re: Memantine » Jake E, posted by ed_uk on March 15, 2005, at 5:13:34
> Hi!
>
> Sounds promising :-)
>
> >I'll keep you posted.
>
> Thanks, please do. I look forward to reading your posts!
>
> Have you ever tried taking memantine without Adderall for a few weeks? I wonder whether Namenda alone would help your ADD.
>
> Ed.
>
>Good question. Yes, I have tried Namenda alone, but it didn't produce any noticable improvements in my lack of energy/motivation and inability to focus and complete tasks.
I've continued taking Namenda and have made an important inspection. I don't think Namenda completely prevents Adderall tolerance, even at higher dosages (50-70 mg). Rather, it sort of slows down the development of tolerance and also slightly enhances the effects of Adderall.
I need to be on this drug combination for more time before I can give more beficial feedback.
The main problem with Adderall is that it creates artifical motivation and energy when you first start taking it, and as time progresses, this effect diminishes. When taking the Namenda, it still diminishes, but keeps the Adderall at an effectiveness of, say an 8 on a scale from 1 to 10.
This level-8 effectiveness is better than the normal ADD "fog", but doesn't eliminate the unavoidable "Adderall hunger" problem, which is the urge to take more to sustain the energy/motivation "high". This "Adderall hunger" problem is the root cause of becoming an Adderall addict.
If you have enough self-control to feel the "Adderall hunger" and resist the urge to take more, and are content with a level-8 Adderall effectiveness, then Namenda may your solution. If you lack the self-control and start abusing Adderall the moment you feel "Adderall hunger", then I suggest you either 1) find a system that makes it impossible for you to take more than, say 40 mg, per day (electronic safe, convincing a friend to give you your daily dosage, etc.), or 2) avoid Adderall completely.
Adderall can save your life and be your best friend, but it can also destroy your life and take control of you and your decision-making process; when this happens, welcome to slavery.
Heed my advice.BTW I'm going to add Strattera to the mix in the soon future. Maybe it will further optimize the effect. I'll write up a post when I do.
This is the end of the thread.
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