Adderall tolerance HELP?!

[mmm32687]

I been taking adderall since before i can remember, atleast 18 years on and off but mostly on.  Ritalin never worked...  Im 26, 5'5 and weigh post partum at 7 weeks 152 lbs and im at 30mg ir 3x a day.  I was taking this dosage before pregnancy about a yr ago when i was 122 lbs and it worked for te most part...  AS most ppl may know some docs wont allot pregnant women to have any adderall.  I was miserable without it, very depressed, couldnt concentrate or will myself to do anything let alone finish anything and i balooned upto 177 plus lbs and my baby was less than 6 lbs at birth full term.  anyways i have been put back on my normal dosage from my highadias and it doesnt seem to effect me like it use to and my new doc isnt comfortable with my high dosage.  My pharmacy told her my dosage was never that high which is a lie.  She wants to switch me to something else but doesnt really know what,  and i wouldnt mind trying other things if it would help me 16 hours a day.  Problem is im scared she dunno whats best to switch me to or if she should switch me to something and then still provide me with a single dose of adderall?  What works best for y'all if you've grown tolerant to adderall?  Also ive taken the adderall XR 30 mg and didnt really benefit from that alone.  Suggestions please?

[Sandman2]

   Yep, thats pretty much what I suspected from your doctor.  Its not unusual, unfortunately.  Frankly, its probably better that you be the expert anyway - as long as she will listen to you.  Stay nice to her (even though she is going to drive you nuts with the script).  Sounds like she is all you've got out there.   And, she could very well be stuck over at the hospital delivering babies, which tends to cut into her response time.  Its just not a good situation - but it is what it is.
   Let me know if I can funnel any more info your way.  Good Luck!  (I think you are going to need it).

[mmm32687]

thanks for your follow ups... I did scan through those sites and knowing what I know now about my doc I think she doesn't have time to really research into it because THEY had me fax over a SUMMARY of my research on dosages and that was 8 pages out of like 25... Anyways I did that 2 days ago and called again today and have not heard back..
   She said she was going to take care of it LAST week to fill some kind of script for me but hasn't, and because of last time she did that im having to miss dosages cause i cant go off cold turkey again i need to function even if its just for a few hours, but i hate the crash i get from lowering the dose!!!  my script is up and she still hasn't made her decision on what to do, or called me back herself... Im getting quiet frustrated because I don't have time to be playing doctor, that's what she gets paid for.

[Sandman2]

   OK, I definitely see why you want a long lasting med.   You've got one of the few jobs (like an airport controller :)  )  where you really don't have any "down" time.
    You might try suggesting that your doc go here - http://www.corepsych.com/  and  pick up Dr. Parkers book, "New ADHD Medication Rules".  It will help her help you.  Or you buy it for her - read it - and then give it to her?   It will take some trial and error to get the meds right for you and this book will help.
  Oh, and if you didn't read the following link you should do so.  The important part is the response to Daisy where he mentions that he will go up past 70 mgs of XR at times.    http://www.corepsych.com/2009/06/vyvanse-dosage-for-adhd-finding-the-safe-top-of-the-window/

[mmm32687]

Oh and I love my job, its Not depressing meeting new ppl daily.  LOVE entertaining customers with my personality.  Some ppl can't stand me some can't get enough, win some loose some but I don't let it bring me down long. I make extremely good money for livin in such a small town.

[mmm32687]

I live in the country farming area and waitress full time.  I don't have the luxury of relaxing.  And like I mentioned before the XR wasn't strong enough unless I boost it with a IR.  I eat eggs and meat every morning.  The psychiatrists here are a joke and my insure doesn't cover doctor hopping but thx anyways I think I have it figured out, I'm determined and usually get what I need/want.

[Sandman2]

  Interesting, read the post from heymelissawhoa. http://www.medhelp.org/personal_pages/user/7723768
    She talks about the pink and orange pills and not liking one of. Them.

[Sandman2]

   Well, the main problem is that while your doctor did deliver your baby and probably really cares - she did deliver your baby.  She is not a psychiatrist.  She really probably doesn't know much about these meds.  If you can, I would find a psychiatrist. Look for one that specializes in this area.
  If that can't happen, I would drop the adderall (or try the XR version first) and try vyvannse as it is the longest lasting med out there.  Here is a link to all ADHD meds.   http://www.leeheymd.com/charts/adhd_1.html
   Most of the other meds are listed in this chart.   But typically, a doctor is not going to give you both - well, maybe the Wellbutrin for depression.
   By the way, the reason I mentioned the high protein breakfast is because it makes the meds much more effective during the day.  Just eating fine, is not enough.  You need the protein.
   And, another thought.  I am not sure what you are expecting from the adderall for a full 16 hour day.  I mean if you are living anywhere back East or in the Midwest in this sucky weather and stuck indoors - I would be super depressed.  Adderall is not going to fix that.   Do all you can to get outside.  Take the child and walk the indoor malls.  Yoga classes, gyms, etc.  Do something to change up things.  Things are very different for you now then they once were.  You may be expecting too much from the meds?
   Hope this helps.
    

[mmm32687]

that does sound like the case, another concern I have is the fact I get migraines.  idk if they are related or not because I've had them back a few years ago on a daily bases.  I also was previously diagnosed with mild case of bi-polar disorder around 9 years ago and stopped treatment for it figuring I would grow out of it because taking 500 mgs of Seroquel a night to knock me out was ridiculous, but it did help my moods...  I been doing research and it seems like I didn't grow out of it, or its my hormones from getting older, just having a baby, ADD, the new birth control im on, so on so forth, I cant seem to figure out wtf is wrong with me and I get rather annoyed with docs not taking me seriously.  
     Right away after first meeting me my new doc knew that something was wrong with me, and said "would you like to go back on your ADD meds now?" in a funny way smirking.  She just happened to be the doc that delivered my baby, because I fired my previous doc at 38 weeks because she wasn't listening to me.  
    I do really like my new doc but she doesn't seem aware of how serious It is to get the meds right for me cause my mood is allllll over the place lately.  I am told to just wait it out its my hormones but its getting rather aggravating trying to get ahold of her to discuss my next prescription when its nearly up.  It took her a WEEK to get my last one filled after she said if there was any problem she would get it done the next day.  
im frustrated because she said 90mg was too high and the pharmacy told her I never had that dose before!  Now I think she thinks im a liar now, but honestly it was the damn pharmacy lying.  I told her I would do some research to find out  what meds could work, but helllll im not the doctor here lol  Oh and I also noticed that the generic pink ones don't seem to be as effective as the generic orange ones... (I compared them myself after I found a previous prescription I had)  I called all around town and no one seems to carry the orange ones and that became more frustrating because I don't want to be stuck with junk pills again.  
   What could I take in conjunction with my Adderall?  Heres a few drugs that I found could possibly help... Focalin XR,  Wellbutrin SR, Depakote, Quillivant XR?  SRY for the rambling lol see the Adderall isn't working that well!

[Sandman2]

  It may be you, have a" ultrarapid metabolizers [UMs] as reported in many books such as Drug Interactions in Clinical Practice leaving practitioners with a challenging few that just can’t correct their ADHD on average doses, as they burn up the effectiveness just too fast. These individuals are often unhappy and disappointed, often with long unsuccessful trials of meds. For these folks only someone completely comfortable with those higher [notice I didn't say 'highest'] doses of medications [using the predictable, careful titration strategies outlined in multiple posts here at CorePsychBlog and at http://www.squidoo.com/vyvanse is recommended.

Read more: http://www.corepsych.com/2009/06/vyvanse-dosage-for-adhd-finding-the-safe-top-of-the-window/#ixzz2uZTnIWvJ
   This if from this link - http://www.corepsych.com/2009/06/vyvanse-dosage-for-adhd-finding-the-safe-top-of-the-window/    
    I think its worth checking out.  
    And yes, your new doctor is part of the problem because the doctor is not used to working with you.   I would try what she is suggesting and slowly work upwards.  I think that unless you are like some adults who use a stim med only when it is needed, that an extended release would be helpful.
   Hope the above link helps.  And corepsych does have lots of other good information on finding the right medication.

[mmm32687]

Oh and I sleep just fine and eat well especially in the morning

[mmm32687]

I been back on adderall for 7 weeks and I do think my hormones have something to do with it cuz I don't have the "rush" or pick me up on the 30mg even when its 3 times a day.  I can take 60 at once and still go back to bed.. My doc wants to try me on something that will last longer but idt she understands the condition very well as she is my new doc.  I use to take seroquel 500mg nightly for bipolar depression and a 100 could knock out a horse... Would suggesting to her to put me on a XR med with my adderall be more effective?  She just thinks the 90 is too high but I don't agree.  I think I need something more.

[Sandman2]

   Well, you may not have grown tolerant to Adderall.  I mean you have been off it for close to 9 months?   And you had been on it for years, and didn't have those problems.  The big change is your pregnancy and afterwards.  You have had a lot of hormonal changes, which does change how your body is affected.  You might just want to give it some more time - but I don't know how long you have been on it since restarting.
    In terms of other meds Vyvansse is probably the longest acting one out there.  It is much smoother as you are not getting the initial rush 3 times a day.
   I would make sure that you are getting enough sleep and are having a high protein breakfast as those things will effect how any of these meds work for you.