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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by dwlloyd810 on March 29, 2012, at 19:36:55
Yes, I have been taking 500 mg daily with 60mg of Adderall extended-release to treat excessive sleep caused by a brain injury. (A car hit me while I was bicycling for exercise.)
At 250 mg with 30 mg of Adderall, I was still sleeping 18-20 hours a day, and my actual functional hours per day were less than three hours a day. When the dose of both stimulants was doubled, I began to be able to stay awake, although not with full ability to focus as I had before. I still feel sleepy all the time. I've been experimenting with binaural waves to help me focus. I don't know whether the ELF frequencies are really helping, or if I just think they help, but they help me feel competent enough to do some work while I use them.
I checked here because with one pill left, I was turned down when I tried to refill both prescriptions. Apparently my insurance won't pay for more than a 30-250 Nuvigil tabs per month, and the pharmacy records show that my doctor prescribed a two-month supply of 30 mg Adderall last month, rather than a 30-day supply of 60 mg. I checked the bottle, and they are correct. The instructions on the bottle don't agree with how I was told to take the medicine. The only documentation that supports my understanding of the prescribed dose is the fact that he was able to prescribe 60 pills.
I'm panicking. I don't want an extended weekend of headaches, mental fog, and excessive sleep. What can I do?
My neurologist's office is only open Mondays through Thursdays (this is a Thursday night). I called and left a message, but the recording indicates the messages will be checked next Monday. I called the doctor's emergency number, but the answering service told me they don't relay messages about prescriptions.
I may be in a near-comma by this time tomorrow, and apparently there is nothing I can do about it.
Posted by Phillipa on March 29, 2012, at 23:00:18
In reply to Re: Anyone on More than 300 MG of Nuvigil?, posted by dwlloyd810 on March 29, 2012, at 19:36:55
I feel you can. This time call the answering service and tell them this is a question of medical origin. And you need to speak with your neurologist. Try this. And report back let us know what happened. Phillipa
Posted by dwlloyd810 on March 30, 2012, at 22:17:33
In reply to Re: Anyone on More than 300 MG of Nuvigil? » dwlloyd810, posted by Phillipa on March 29, 2012, at 23:00:18
Thank you for the suggestion. I think it may have worked, but I found a different work-around. I called the pharmacist back and talked about the discrepancy between the number of pills prescribed, the period of the prescription, and the daily instructions, which were to take one pill each morning. The math did not work. (Pretty good for a person who was diagnosed with dyscalculia among other things after a brain injury.) The pharmacist agreed to cover me with a partial amount of pills. i agreed to make the necessary calls to get the record corrected Monday morning. By the time I was able to pick up the prescription, I really should not have driven to pick them up. I had my daughter ride with me to insure I stayed awake for the short trip. I was having some minor difficulty walking inside the pharmacy. They were not completely ready when I got there, so I sat in a chair, and promptly fell sound asleep. I took the second pill as soon as I could, and 20 minutes later I was feeling enough better that I drove home. Then I slept the rest of the day, until a few minutes ago. Hopefully tomorrow will go much better! I'm very tired, and I'm sure I'll have no difficulty sleeping tonight.
Posted by Christ_empowered on March 31, 2012, at 17:52:48
In reply to Re: Anyone on More than 300 MG of Nuvigil? » Phillipa, posted by dwlloyd810 on March 30, 2012, at 22:17:33
I'm just glad you got this straightened out. Can you go above 60 on the adderall? I had an "ADHD" friend (read: taste for Rx speed and a friendly doctor) who was on 90. Surely, if that guy can get nearly 100mgs amphetamine for...ummm...whatever the issue was, then you should be able to go up a bit.
Posted by dwlloyd810 on March 31, 2012, at 23:38:34
In reply to Re: Anyone on More than 300 MG of Nuvigil?, posted by Christ_empowered on March 31, 2012, at 17:52:48
Perhaps you are right.
I was only able to get the problem with the Nuvigil corrected, which was my main concern. It is the Nuvigil that makes a noticeable difference in helping me to not sleep all the time. I take the Adderall because the doctor prescribed it, not because I feel I need it.
I was not as concerned when the pharmacist could not fill the Adderall, because I still had a few pills left, probably because I have forgotten to take it a few times. I just stopped taking the afternoon dose, which means I'm getting 30 mg instead of the prescribed 60 mg.
I never really understood why the neurologist prescribed the Adderall. It doesn't seem to have much of a positive effect, but it has noticeable negative effects such as making me less patient. When I take Adderall I have to constantly watch myself that I don't drive too fast or shout at the kids or generally act like a jerk. The worst part of my behavior on Adderall is that I don't perceive myself the way others perceive me. I think I'm being emphatic, and others think I sound irate (really, I'm not an angry person!).
The neurologist has a different explanation for my tendency to treat people badly. He says it is a well-known symptom of my kind of brain injury. When I asked my neurologist to cut the dose of the Adderall and to get me off of it, he doubled my dose instead.
I do what the doctor says, but I was not unhappy when the pharmacist could not refill the Adderall.
Posted by Christ_empowered on April 1, 2012, at 1:24:16
In reply to Re: Anyone on More than 300 MG of Nuvigil? » Christ_empowered, posted by dwlloyd810 on March 31, 2012, at 23:38:34
wow. OK, I know *nothin* about brain injury, but Adderall can make you an angry, on-edge person. I read a little review on the (very extensive, decades-long) literature on amphetamines. Dude, even when benzedrine and dexedrine were relatively new on the market (20s and 30s), shrinks noticed that some "normals" were more on edge. At low doses, it was observable, but the patients weren't always aware of it.
I don't know what you could use instead. Some kind of methylphenidate (Ritalin, concerta, etc.), maybe? Maybe Dexedrine or Vyvanse?
There's the meth option (Desoxyn). That stuff is very expensive and not commonly prescribed. However, in a case like yours where you need stimulation w/ fewer side effects and the doses might go high, it might be a good option if you're up for multiple doses during the day (I think 3). Lower doses are used, so there's fewer physical sides and I think there's more of an antidepressant+euphoric effect. Not sure though.
Anyway, I'm clearly not writing your prescriptions. Just thought I'd throw those little tidbits your way.
This is the end of the thread.
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