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by gazby 1495 days ago
Thank you mate!

To clarify, my current dose is 20mg XR daily. I have raised with my doctor that this dose is completely spent (I have other [diagnosed] issues that lead to an overly acidic stomach) long before the end of the work day, and thus I don't have medicinal help when I turn to my personal life.

As yet she seems quite unwilling to adjust the dose or add an IR (anecdotally adding an IR seems very common), and I was wondering what the timeline was between starting medication and landing on a sufficient dose of XR+IR between you and your doctor.

2 comments

Personally, I found the promise of XR's delayed-duration to be massively overstated. I like the IR's better, because you can figure out when to re-dose through experimentation (which my doc encouraged.)

I was also motivated to change to IRs, and mentioned to my doc, that the generic IRs can be had for less than half what generic XRs cost, with GoodRx. I have insurance, but GoodRx is cheaper, and insurance gives me runarounds with 'prior auth' nonsense.

My timeline was a month before switching meds/doses. Obviously, you want to give it an honest shot of a few weeks, but if something isn't working after a month, your doc should be willing to change it up. If they're giving you a hard time, I'd explore other options. There seem to be a number of providers that have a prejudiced view of stimulants. If you needed to switch/increase the dose of say, an antidepressant, no doctor would think twice.

Ah, I see. Sorry for rambling. I can understand why you would not be happy with this schedule.

Timeline-wise, when I started medication, I was given only IR. As methylphenidate is shorter acting than Adderall, this resulted in me taking 3 doses per day and active levels fluctuating a lot throughout the day, so about a week later I decided to set up another appointment and was given additional XR to be taken once per day, and the IR only when needed.

Your doctor does not sound very competent. I would not recommend increasing dosage if the problem is a too short duration, as a higher dosage will not prolong duration, but adding IR to XR is indeed a common course of action to accomplish that.

Also, I should note, try making sure to always keep your stomach full during the day. I'm not sure if the same applies to Adderall, but I've observed diminished duration and bioavailability of XR without food.