![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Keith Talent on May 27, 2004, at 19:13:13
The reason that I ask is that I'm currently on 40 mg per day total of dextroamphetamine, and it seems like I haven't come close to reaching an optimal dose. I'm a big guy (1.93 m tall, a lean 109 kg mass (and rising through natural bodybuilding)), and the idea that psychiatrists prescribe 80 mg per day to kids who weigh a half or a third of my mass seems to support my view. I recall reading a post from one of the "experts" here (maybe chemist) that street speed abusers typically take 200 to 300 mg a day for days or weeks on end (benders) with no food and no sleep. Clearly, as someone who takes preventive health very seriously, and aims for longevity, I have nothing in common with such unfortunate persons.
Do any of you take 120 mg per day? In my case, it wasn't until my psychiatrist increased the dose from 20 to 30 mg per day that I felt ANYTHING, and even then it was barely noticeable.
I'm especially aware of the need to maintain excellent sleep hygiene when taking stimulants. So far, there has been no change in my total nightly sleep time (nine hours). I in no way feel jittery, speedy, nervous, unable to sleep or aggressive.
Since beginning the clon and dex, my level of global functioning has dramatically improved, but I feel that it still has a long way to go. To increase the dose above 40 mg per day, my psychiatrist would have to, yet again, get state health department approval because the drug is being prescribed for a non-ADHD, non-narcolepsy indication. I sense that he is wary and uncertain of this, and perhaps inexperienced in using stimulants for anything other than ADHD. Thankfully, I believe that he trusts that I'm not a drug abuser (I exercise about six days per week with weights and fairly intensive cardiovascular work, and eat well and am successfully completing a Bachelor's degree).
My diagnoses are:
Major Depressive Disorder
Obsessive Compulsive Disorder
Social PhobiaMy current medications are:
clonazepam 2 mg twice daily
dextroamphetamine 20 mg upon waking, 10 mg six hours later and 10 mg six hours later still
irbesartan 300 mg in the morning (for hypertension, which was present long before commencing the dex)
sertraline 100 mg in the morning
In short, I would be most grateful if any of you with experience of amphetamine use at greater than 40 mg per day would describe it - what drug, what dose, what indication(s), other drugs at the same time, side effects, dose-response effects, psychiatrist attitudes, effect on overall social and occupational functioning - and anything else that you consider relevant. I, and I daresay many others here at Psychobabble, would really appreciate it.
Posted by jodeye on May 27, 2004, at 20:05:14
In reply to What's the highest dose of dex/meth anyone's on?, posted by Keith Talent on May 27, 2004, at 19:13:13
>To increase the dose above 40 mg per day, my psychiatrist would have to, yet again, get state health department approval because the drug is being prescribed for a non-ADHD, non-narcolepsy indication.
May I ask which state?
Where might I look for similar regulations
in my state of Oregon?--Jay
Posted by katalina on May 27, 2004, at 21:17:41
In reply to What's the highest dose of dex/meth anyone's on?, posted by Keith Talent on May 27, 2004, at 19:13:13
Keith,
Are you taking 4 mgs. total of klonopin per day, or 2 mgs. total? I think if you were taking 4 mgs., it would almost offset 40 mgs. of Adderall (at least for me it would).
I take 50 mgs. of Adderall XR per day (30 in am, 20 at noon) and take .5 mgs. of klonopin with the second dose of Adderall and another 1 mg. at bedtime. I weigh about 100 at 5'4" and have been taking this amount for about 2.5 years. I don't always take the second dose, but there have been days when I've taken 70 mgs. total.
I don't know how long you've been taking Adderall, but I've definitely developed somewhat of a tolerance to it, as do most people over a course of a time. I have it prescribed for ADD, although I self diagnosed myself to my neurologist, and am basically taking it for dysthymia and low motivation, don't want to deal with social situations (not phobic, just think everything/everyone sucks when I'm med free). As I recall, body size/mass has little to do with the amount of Adderall needed for a response, and more to do with symptoms of ADD or whatever. If I were you, I would try adding the amino Tyrosine to your Adderall doses (2 500 mgs. per dose twice a day) and see if that doesn't boost the Adderall. I am currently taking only Tyrosine for a couple weeks to try to restore Adderall's effectiveness. You also may want to cut back on the klonopin, although I'm unsure as to whether you have panic issues and need a higher dose. You could also try adding Effexor. I took that for six months when I started the Adderall and it was more pronounced, although I did feel more jittery on both of them together and lost a lot of weight.
You could also try taking more at one time to see if that makes a difference, especially if you're taking the XR version. That seems to make a difference for a lot of people.
Hope that helps some. Let us know what you end up doing.
Katie
> The reason that I ask is that I'm currently on 40 mg per day total of dextroamphetamine, and it seems like I haven't come close to reaching an optimal dose. I'm a big guy (1.93 m tall, a lean 109 kg mass (and rising through natural bodybuilding)), and the idea that psychiatrists prescribe 80 mg per day to kids who weigh a half or a third of my mass seems to support my view. I recall reading a post from one of the "experts" here (maybe chemist) that street speed abusers typically take 200 to 300 mg a day for days or weeks on end (benders) with no food and no sleep. Clearly, as someone who takes preventive health very seriously, and aims for longevity, I have nothing in common with such unfortunate persons.
>
> Do any of you take 120 mg per day? In my case, it wasn't until my psychiatrist increased the dose from 20 to 30 mg per day that I felt ANYTHING, and even then it was barely noticeable.
>
> I'm especially aware of the need to maintain excellent sleep hygiene when taking stimulants. So far, there has been no change in my total nightly sleep time (nine hours). I in no way feel jittery, speedy, nervous, unable to sleep or aggressive.
>
> Since beginning the clon and dex, my level of global functioning has dramatically improved, but I feel that it still has a long way to go. To increase the dose above 40 mg per day, my psychiatrist would have to, yet again, get state health department approval because the drug is being prescribed for a non-ADHD, non-narcolepsy indication. I sense that he is wary and uncertain of this, and perhaps inexperienced in using stimulants for anything other than ADHD. Thankfully, I believe that he trusts that I'm not a drug abuser (I exercise about six days per week with weights and fairly intensive cardiovascular work, and eat well and am successfully completing a Bachelor's degree).
>
> My diagnoses are:
>
> Major Depressive Disorder
> Obsessive Compulsive Disorder
> Social Phobia
>
> My current medications are:
>
> clonazepam 2 mg twice daily
>
> dextroamphetamine 20 mg upon waking, 10 mg six hours later and 10 mg six hours later still
>
> irbesartan 300 mg in the morning (for hypertension, which was present long before commencing the dex)
>
> sertraline 100 mg in the morning
>
> In short, I would be most grateful if any of you with experience of amphetamine use at greater than 40 mg per day would describe it - what drug, what dose, what indication(s), other drugs at the same time, side effects, dose-response effects, psychiatrist attitudes, effect on overall social and occupational functioning - and anything else that you consider relevant. I, and I daresay many others here at Psychobabble, would really appreciate it.
>
Posted by appadoo on May 28, 2004, at 6:29:03
In reply to What's the highest dose of dex/meth anyone's on?, posted by Keith Talent on May 27, 2004, at 19:13:13
I have been diagnosed with ADHD and I am on 30mg of dexemphatamines.With my experience if I take more i slow down in regards to congnative behaviour ie slower speech,my thought process slows down and the like.I guess I am a classic case of someone with adhd.
The problem you will encounter if you start with a high dosage and keep increasing it is that you will develop a tolerance pretty quickly and for it to keep having an effect the dosage will keep getting higher and higher.You would have damaged too much of the receptors.
My guess as to why you might not be getting too much impact from dex is that since you are bodybuilding you might not be carrying much fat,since dex is a lipid drug it binds to fat and is reabsorb throught its duration which is somthing like 5hours.Another reason that you might not be getting the effect is that by drinking and eating too much protein you might have a low ph level.If that is the case most of the drug is not absorbed.My suggestion is to check you ph level and if lower than 6 take some sodium one hour before taking your dexedrine hopefully that will increase the absorption.
I suggest you try ritalin becuase it doesn't rely on ph levels to determine absorbability.
Also look at drug interactions you have a sedative there that I think it reduces the potency of the amphatamine.
Before I go you do not want to up your amphatamines too high because Big Brother will
think your becoming addicted and they might cease your dex medication,its good to have some
than none at all.
One last point I want to make, young kids metabolise the drug faster than adults if anything adults should be takin less than kids.
Hard to believe but true.
Hope I helped you out
Posted by Keith Talent on May 28, 2004, at 23:37:32
In reply to Re: What's the highest dose of dex/meth anyone's on? » Keith Talent, posted by jodeye on May 27, 2004, at 20:05:14
> May I ask which state?
> Where might I look for similar regulations
> in my state of Oregon?Jay, I'm in Queensland, Australia.
Posted by Keith Talent on May 28, 2004, at 23:47:16
In reply to Re: What's the highest dose of dex/meth anyone's on?, posted by katalina on May 27, 2004, at 21:17:41
> Are you taking 4 mgs. total of klonopin per day, or 2 mgs. total?
Katie, I'm taking 4 mg total per day at the moment, and it may soon be raised to 8 mg total per day.
> I think if you were taking 4 mgs., it would almost offset 40 mgs. of Adderall (at least for me it would).
The two classes of drugs here, benzodiazepines and amphetamines, are not opposites. The clonazepam reduces anxiety, while the dextroamphetamine both makes one more sociable AND helps treat the component of the depressive disorder that involves low motivation, lack of energy and apathy. Together, they are fantastic for Social Phobia. To correct a misconception of yours, dextroamphetamine is the generic name for Dexedrine, while mixed amphetamine salts goes by the brand Adderall. I feel absolutely no sedation from the clonazepam, by the way.
> You could also try adding Effexor.
Effexor for me was like a very weak SSRI, even at very high doses.
Posted by Keith Talent on May 28, 2004, at 23:56:54
In reply to Re: What's the highest dose of dex/meth anyone's on?, posted by appadoo on May 28, 2004, at 6:29:03
> I have been diagnosed with ADHD
I definitely do not have ADHD.
> if I take more i slow down in regards to congnative behaviour ie slower speech,my thought process slows down and the like.I guess I am a classic case of someone with adhd.
I couldn't feel any effect until I got to 30 mg per day. From 30 to 40 just seems like I have slightly more motivation and desire to talk to people - no speeding up of thoughts/actions, and no slowing down.
> The problem you will encounter if you start with a high dosage and keep increasing it is that you will develop a tolerance pretty quickly
There are people who post here who are trialling memantine (an NMDA antagonist) for amphetamine tolerance. I will wait at least until there is scientific evidence supporting this, and until the price comes down. Anyway, I hope I never develop tolerance.
> I suggest you try ritalin becuase it doesn't rely on ph levels to determine absorbability.One of the problems with methylphenidate (Ritalin) is that it only last for about 2 hours. Also, it causes greater peripheral side effects like fast heartbeat, tremors and high blood pressure.
> Before I go you do not want to up your amphatamines too high because Big Brother will
> think your becoming addicted and they might cease your dex medication,its good to have some
> than none at all.Big brother better remember who pays his salary! Here's to democracy.
> Hope I helped you out
Thanks heaps.
Posted by Sad Panda on May 29, 2004, at 22:50:47
In reply to Re: What's the highest dose of dex/meth anyone's on?, posted by Keith Talent on May 28, 2004, at 23:37:32
> I'm in Queensland, Australia.
>Me too, how much effort did it take for your pdoc to get you Dex?
Have you tried Reboxetine?
Cheers,
Panda.
Posted by chemist on May 30, 2004, at 0:30:47
In reply to Re: What's the highest dose of dex/meth anyone's on?, posted by Keith Talent on May 28, 2004, at 23:56:54
hello, chemist here... cannot say that i ever quoted a 200-300 mg qd amphetamine regimen, but could be wrong. you apparently tolerate d-amphetamine at high doses, so it appears to me that you hurdle is to get you doctor to up the dose. and i do not like desoxyn, there are too many addicts and dead people lying in the wake of methamphetamine. all the best, chemist
> > I have been diagnosed with ADHD
>
> I definitely do not have ADHD.
>
> > if I take more i slow down in regards to congnative behaviour ie slower speech,my thought process slows down and the like.I guess I am a classic case of someone with adhd.
>
> I couldn't feel any effect until I got to 30 mg per day. From 30 to 40 just seems like I have slightly more motivation and desire to talk to people - no speeding up of thoughts/actions, and no slowing down.
>
> > The problem you will encounter if you start with a high dosage and keep increasing it is that you will develop a tolerance pretty quickly
>
> There are people who post here who are trialling memantine (an NMDA antagonist) for amphetamine tolerance. I will wait at least until there is scientific evidence supporting this, and until the price comes down. Anyway, I hope I never develop tolerance.
>
>
> > I suggest you try ritalin becuase it doesn't rely on ph levels to determine absorbability.
>
> One of the problems with methylphenidate (Ritalin) is that it only last for about 2 hours. Also, it causes greater peripheral side effects like fast heartbeat, tremors and high blood pressure.
>
> > Before I go you do not want to up your amphatamines too high because Big Brother will
> > think your becoming addicted and they might cease your dex medication,its good to have some
> > than none at all.
>
> Big brother better remember who pays his salary! Here's to democracy.
>
> > Hope I helped you out
>
> Thanks heaps.
>
>
Posted by appadoo on May 30, 2004, at 4:38:55
In reply to Re: What's the highest dose of dex/meth anyone's on?, posted by appadoo on May 28, 2004, at 6:29:03
g'day mate I am from Victoria Australia.
I just to like to make a comment if I may
my pdoc was worried when he upped my dex dosage to 30mg and is hesidant to switch my medication to ritalin because the fed authorities
in canberra have to be seen to be controlling the usage of amphatamines even if legitamate adhd/depressed people require it at a theurapetic level and not a token level.
if they really wanted to control illegal amphatamine usages they should monitor the ravers and there parties.I am sure they do not get their excstacy from pdoc.
Enough of my preaching I was wondering if any of you guys have tried modafinil with dexemphatamines and if so has it complemented helped with adhd.i have asked many pharmacists about it and they have never heard of it, CSL the company that make and distribute it here in OZ have done a lousy job promoting it.
Even my GP and pdoc have never heard of the drug.
I went to two pharmacists and after looking it up one quoted me 30 100mg for aud340 and another aud 121.
Posted by Keith Talent on May 30, 2004, at 8:29:00
In reply to Re: What's the highest dose of dex/meth anyone's on? » Keith Talent, posted by Sad Panda on May 29, 2004, at 22:50:47
> how much effort did it take for your pdoc to get you Dex?
Not much - just a phone call and a faxed case summary.
> Have you tried Reboxetine?Yeah, it did absolutely nothing. My mood began to decline when I started taking it (took it for about two months).
Posted by Keith Talent on May 30, 2004, at 8:32:12
In reply to to keith.... » Keith Talent, posted by chemist on May 30, 2004, at 0:30:47
> cannot say that i ever quoted a 200-300 mg qd amphetamine regimen
That was how much you or someone else said street abusers took when they went on binges.
Posted by katalina on May 31, 2004, at 19:24:10
In reply to Re: What's the highest dose of dex/meth anyone's on?, posted by Keith Talent on May 28, 2004, at 23:47:16
Keith,
Sorry about misinterpreting the dextroamphetamine for adderall. I guess I just assummed it was Adderall because my bottle of Adderall says Dextroamphetamine/amphetamine. I forgot that Dexedrine is just the d-isomer portion, hence the name dextroamphetamine. This is when it is apparent I am on a stimulant vacation.
Anyway, I just wanted to add that I substituted Adderall for Dexedrine for a couple of months and took 40 mgs. per day (8 5 mg pills, spread out in 2-3 dosages) with the 1.5 mgs of klonopin. I didn't like dexedrine as much, although it was a little "friendlier" physically (didn't cause my heart rate to rise at all or feel amped up at all). Unfortunately, I found that I need the l-isomer portion of the amphetamine salts which does give me more energy than the dexedrine alone. Have you ever tried Adderall (amphetamines) instead to see if they give you more of that get up and go feeling? I know I liked taking a dexedrine in between Adderall doses once in a while, when I didn't want to take an XR dose and liked the alertness it gave me. I believe at the time I was on dex, I also took xanax prn and the two seemed to work nicely.
I'm also aware that benzos and stimulants work synergysticlly (sp?) and that they don't cancel each other out. It's just that if the doses aren't tweaked just right, one can feel less of the stimulant and more sedated than if the doses are fine tuned. I think 4 mgs. of clonazepam isn't considered low and could possibly be negating some of the dexedrine's more positive effects. Don't know if you ever tried lowering it to see, but just wanted to offer the suggestion. Also, did you take Effexor with the Dex? I noticed it potentiated the stimulant effect, and on it's own it was weak for me as well.
Best of luck, sorry to not respond sooner - went away for the long weekend.
Katie
Posted by Keith Talent on June 1, 2004, at 2:59:20
In reply to Re: What's the highest dose of dex/meth anyone's on?, posted by katalina on May 31, 2004, at 19:24:10
> dexedrine as much, although it was a little "friendlier" physically (didn't cause my heart rate to rise at all or feel amped up at all). Unfortunately, I found that I need the l-isomer portion of the amphetamine salts which does give me more energy than the dexedrine alone. Have you ever tried Adderall (amphetamines) instead to see if they give you more of that get up and go feeling?
Adderall is not, to my knowledge, on the market in Australia (neither is Dexedrine Spansules or Focalin). Since I like to exercise a lot (both weight-training and cardiovascular), the worse peripheral side effects of the levo enantiomer of amphetamine (present in Adderall but not Dexedrine) would most likely be unacceptable to me. I also have hypertension (controlled), which, again, would be more likely to be worsened by Adderall than by Dexedrine.
> I'm also aware that benzos and stimulants work synergysticlly (sp?) and that they don't cancel each other out. It's just that if the doses aren't tweaked just right, one can feel less of the stimulant and more sedated than if the doses are fine tuned. I think 4 mgs. of clonazepam isn't considered low and could possibly be negating some of the dexedrine's more positive effects. Don't know if you ever tried lowering it to see, but just wanted to offer the suggestion.
Essentially, I don't feel any more sedated taking 4 mg a day of clon than I did taking 0.5 mg a day. It's just much better at relieving anxiety at higher doses. So I wouldn't want to lower it "to see", even if it was negating some of the dex's beneficial effects. To tell you the truth, I've only been taking these two meds for about two months. They are already improving my life drastically, but I can feel that I'm not close to optimal doses of either yet.
> Also, did you take Effexor with the Dex? I noticed it potentiated the stimulant effect, and on it's own it was weak for me as well.
I was on the Effexor years ago (I found it to be neither sedating nor activating); back then I tended to regard the use of any potentially addictive drugs in a very narrow, judgmental way, unfortunately.
All the best,
Keith
Posted by Anthony Quest on June 4, 2004, at 1:58:42
In reply to Re: What's the highest dose of dex/meth anyone's on?, posted by Keith Talent on June 1, 2004, at 2:59:20
I have heard doses of 80 mg a day used for narcolespy as the max before fears of psychosis. I am no expert though.
Why don't you take holidays and alternate with Ritalin - maybe a long acting formulation. Two weeks on and one week of dexedrine. That way you keep your tolerance from getting too high. In the end, you'll never get aware just increasing your dose to as high as you can get away with.
Wouldn't you rather be plateaud at 60 mg a day and not getting additional effects rather than taking 200 mg a day -becoming tolerant - and needing that much not to go into withdrawal.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.