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Re: Adderall/Ritalin Tolerance Question?

Posted by Deus_Abscondis on September 8, 2007, at 11:40:07

In reply to Adderall/Ritalin Tolerance Question?, posted by Ryan2828 on November 9, 2005, at 6:46:35


good question!

I've been diagnosed with ADHD (inattentive) independently by two pdocs - one used wiz bang QEEG but I'm not sure about the validity of this technology.

Now trying to look back at ones childhood is fraught with difficulties if your as old as me ;-)

I'm not 100% convinced of the diagnosis - one pdoc says if your diagnosed you've got it.

My ADHD, in my view, could well be the consequence of years of excess cortisol, anxiety and pain degrading my hippocampus. In anycase stimulants should help. They certainly help with anergia in associated depression. While not directly helping with mood, being more effective does.

One thing to be aware is that you have to to recognise the effect and learn how to make use of it. In ADHD they don't do what they would do if you were 'normal'. Some ADHDers have the capacity to hyperfocus - at times easily distracted at others driven and stims can add to this which may result in you drilling into a task and giving it more time than you should.

I have often wondered why stims prescribed for ADHD don't create tolerance at least a large tolerance. I do notice perhaps a bigger effect if I skip a few days and resume or maybe this is just noticing the effect more.

I am using dexamphetamine sulphate 5mg three times a day since February (2x5mg from Nov 06 - Feb 07).

There are three meds allowed for ADHD in Australia - dex, Ritalin and Strattera.

One doc refused to trial me on dex and didn't give me a reason and I've had problems with SSRIs and Strattera is one so much first choice was dex - so I dumped the doc and found one who started me on dex.

The sulfate form of dex is slow to absorb. If I'm correct if it was in hydrochloride form it would be faster but more open to abuse via injection/insulfation. I find the slowness a bit of a problem. In the US I believe one can get methamphetamine hcl which acts faster and lasts longer. I find dex kicks in at about an hour and last 3-4 hours but with consecutive doses there is some cumulative effect.

I'd love to try Adderall and the meth forms but alas. Even the hydrochloride salt would be of benefit - especially as a morning dose.

If you are not paying attention to your dex use it can sneak up on you - you might not feel particularly stimulated or clear headed but notice in retrospect that you've been drilling in on a task or talking more than you might have wanted to. This has caused me some grief when playing a poker machine (US slot machine) - if you've got a compulsive streak stims can amplify it - they don't send you off looking for compulsive things to do. Stims don't help you make good choices about what you're doing they just make you go harder at it. They make the experience more enjoyable because you don't fuzz out or switch off - you get more done.

I think the reason why stims at the levels used for ADHD don't result in tolerance is because they are used at far lower doses than recreational doses - the neurotransimitter systems don't saturate.

Scripts here in Australia are tightly regulated - repeats are held by the pharmacy and you can't have them filled in less than the dose/duration prescribed by the pdoc. You could horde and throw yourself a party if you're dishonest and you don't value the daily effect.

In Australia you are allowed a maximum daily dose of 30mg (? IIRC maybe 60mg?). I could probably be on a higher dose, it's a matter of negotiation with pdoc and being responsible and self aware.
I have trailed different dosing amounts and spacings. 10mg in the morning 5mg in afternoon vs 3 x 5 mg at 4/5hr intervals. It all depends what effect you want and what you are doing as far as I'm concerned. Once your experienced you can titrate it to help yourself achieve the desired outcome.

Two paradoxical effects I've noticed - while initially it delayed sleep onset now I can chose to sleep even on 10mg and I sleep well and wake refreshed. I routinely take 5mg in the evening. I have pain and stiffness in the morning (arthritis/fibromyalgia) without dex at night.

The second paradoxical effect is that I thought dex might contribute to my anxiety but it actually calms me a bit.

One side effect is that I can get increased irritability if I'm a bit sleep deprived.

I don't perceive how one could get addicted to stims at the levels used and the way they are dispensed here in Australia.

Further, my alcohol consumption has dropped noticably - 2-4 standard drinks per week down from 10 or more. Being alert is now more rewarding than drowning sorrows.

I just wish I was diagnosed 25 years ago.



P.S I've always been long winded :-P




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