Adderall Dose Increase

Currently on 45 mg a day ... Isn't working well! Don't think my dr will up my rx. Any advice?

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Hello, Elaine! How are you? I'm sorry about the problem that you're having.

It might be time for you to try a different medication. Not all of them work for everyone that tries them.

There are several others available that treat the same conditions, such as Concerta, Dexedrine, Focalin and Ritalin. Some are available as time released formulations, so that may also be of better benefit to you. You may want to discuss the issue with your doctor to discover what they consider to be your other treatment options.

The FDA lists these medications as carrying the risk of being habit forming and they may cause side effects, such as nausea, dizziness, headache, irritability, insomnia and weight loss.

Is there anything else I can help with?

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Have you heard anything about Vyvanse?

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I know this is a very late reply and may not longer have any relevance. But, just in case you suffered like me trying to manage tolerance and ineffective dose excavation issues....

1. Primary way amphetamine causes long term tolerance is excitotoxic overstimulation of NMDA / glutamate pathways (can look online for more details as NMDA/glutamate overstimulation is well studied due to so many diseases also affected by it.)
2. Need to get a full night of quality sleep to help manage tolerance.
3. Best way to fix tolerance issue, is to take a weak NMDA antagonist. It protects from excitotoxic overstimulation allowing pathways to heal and regain function over time. AMPA and NMDA receptors when activated increase brain activity and signalling efficiency. (i.e. stimulating) And causes an increased release of glutamate (primary stimulating/modulating neurotransmitter). Overstimulation can cause oxidative stress and damage cells. Excessive extracellular glutamate levels, short story, kills brain cells when too high.

A. Best option is memantine, uncompetitive NMDA antagonist designed for the job. Normal function works and only blocks overstimulation. Some evidence based practices prescribe it with amphetamine meds to prevent and even reverse long term tolerance. Long half life so builds steady state and maintains protection. Is technically an alzheimer's drug, but don't let that spook you. Except when thinking about what amphetamine meds can do the the brain if not on stable dose.

B. Strattera, non-stimulant ADHD drug with secondary acute weak noncompetitive NMDA antagonism. Which like memantine, can also reverse and protect from long term amphetamine tolerance. But blocks regular NMDA function to a degree, not just overstimulation. It may also increase norepinephrine levels if Adderall isn't blocking reuptake 100% already. Stratton NMDA antagonism has been studied at the clinical trial level so, not just theory or test tube results.

Strattera method worked for me 3 times in 11 years. 60mg prescribed IR Adderall not fully working. Took 80 a few times for job interviews that even then, wasn't fully working. Using not fully functional 80mg as baseline. 9 months on strattera and 40mg Adderall was fully working. 3rd time I stayed on longer till 15 months and 40 mg Adderall was intolerably too strong. So, greater than 50% tolerance reduction 3 times, and did not a single therapist could tell me why it worked. If I found out how it worked back then and why, I never would have stopped it. As, NMDA/glutamate pathways heal, the dynamic changes. At 12 months strat didn't stim balanced NMDA antagonism. So didn't think it was going anything any more and stopped. 3rd time, at 15 months, strat was taken at breakfast when Adderall taken on waking was fully working. Felt drop in stim when strat kicked in. Pathways were healed enough and regained a lot of function and was being overexcited. Which the strat dose would then block enough activity to help protect. Which felt like it started to block Adderall.

Skipping long explanation but ended up with extreme tolerance due to drug interaction issue in which strat was no longer strong enough for the dose. Damaged the heck out of my brain ending up disabled and out of work. Then learned all this stuff :( So, I take memantine which does protect NMDA/glutamate from my level of tolerance on combined Stims. And take strat for added protection just in case, but also for the positive side effects that counter the negative Adderall ones to a degree for me.
You don't want strong NMDA antagonists, as those are known as dissassociatives, psychedelics, and the strongest acts as a general anesthetic used for general surgery.

Also, 4 grams fish oil, best when mostly made of EPA/DHA. increased my effective Adderall dose by maybe up to 50%. From 2007 on. So 40 mg worked about closer to 60 mg, if I didn't forget my fish oil. Research from the early 2000s explained why. It's not just fish oil but a fats thing in general. But, pounding fats to improve amphetamines is not healthy long term. So, stick to what works, and has brain and heart health benefits. As my fish oil was lovazza prescription fish oil. I take OTC ones with 3rd party testing when I don't have lovaza.

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Re: EKAINE (# 2)

On high dose Adderall or other amphetamine, makes vyvanse useless as it will not be able to reach a high enough blood concentration level of that active ingredient (amphetamines).

Vyvanse is great, flattened ithe blood concentration curve over time so it does not spike it like other IR or XR AMP based drugs. Which avoids triggering acute tolerance / receptor downregulation, reduces side effects, reduces potential for long term tolerance issues, and can actually last longer on the same base dextroamphetamine amount in equivalent other AMP drugs because of it.
i.e. Vyvanse 70 mg converts to the same base of dextroamp as about 30 mg zenzedi. Proper spit zenzedi equal dose 4 hours apart, won't last as long due to the BAC spikes that trigger the acute tolerance downregulation.

When originally posted in 2015, Vyvanse was great, no generics. Now, you'll end up on a generic and most generic ADHD stims suck, or at best are mediocre. And don't know if there is a current good generic for vyvanse or not. Amphetamines are especially susceptible to the excipients profile (inactive ingredients) in regards to the ability of the active pharmaceutical ingredient (API) crossing and/or staying across the blood brain barrier ( BBB). Which is required for therapeutic benefit, and is 100% ignored by bioequivalence that only compares absorption / elimination rates to blood, outside the brain.

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