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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 28. Go back in thread:
Posted by linkadge on May 5, 2011, at 17:40:15
In reply to Re: I need doc to increase dose » SLS, posted by mtdewcmu on May 5, 2011, at 14:55:53
>My situation right now is so critical that I >absolutely have to be busy and productive for a >good part of every day.
I dunno, what are you looking for, relief of ADD or a pep pill?
Linkadge
Posted by mtdewcmu on May 5, 2011, at 17:45:29
In reply to Re: I need doc to increase dose, posted by linkadge on May 5, 2011, at 17:40:15
> >My situation right now is so critical that I >absolutely have to be busy and productive for a >good part of every day.
>
> I dunno, what are you looking for, relief of ADD or a pep pill?
>Primarily relief of ADD (but any other help is appreciated). It's such a longstanding problem that nothing is simple anymore. When I was a kid it was probably uncomplicated ADHD, inattentive type. Now my psych diagnoses are more like, all of the above. But treatment of the ADHD symptoms is an essential piece of being functional for me.
Posted by mtdewcmu on May 5, 2011, at 18:18:05
In reply to Re: I need doc to increase dose, posted by linkadge on May 5, 2011, at 17:40:15
> >My situation right now is so critical that I >absolutely have to be busy and productive for a >good part of every day.
>
> I dunno, what are you looking for, relief of ADD or a pep pill?
>I think I know where you are going with that. I'm not going to make a blanket excuse ("I know what I'm doing") and risk sounding foolish. But let's call it a calculated risk. I'm certainly plenty well informed.
Posted by Phillipa on May 5, 2011, at 18:47:55
In reply to Re: I need doc to increase dose » linkadge, posted by mtdewcmu on May 5, 2011, at 18:18:05
Hoping your doc increases it but not that familiar with this class of med so waiting on 20mg doesn't allow the med time to work? Phillipa
Posted by mtdewcmu on May 5, 2011, at 19:31:02
In reply to Re: I need doc to increase dose » mtdewcmu, posted by Phillipa on May 5, 2011, at 18:47:55
> Hoping your doc increases it but not that familiar with this class of med so waiting on 20mg doesn't allow the med time to work? Phillipa
It's not the kind that takes time to work. It either works or it doesn't.
Fortunately, my doctor called and agreed to increase to 30mg. I think that should be plenty. If I need 40 for an effect, I will take the extra from my off days. 40 is listed as the usual max, so I'm keeping that in mind.
Posted by floatingbridge on May 5, 2011, at 19:46:59
In reply to Re: I need doc to increase dose, posted by mtdewcmu on May 5, 2011, at 19:31:02
MtDew, I wrote and lost a reply, so here's the less charming, reader's digest version.
Yay! that dex works.
In my understanding, dosage 'self-sets' (if the doctor doesn't impose). If you are responding at 30, that's great. Hopefully your doc will give you some reign, and you can avoid freaking him or her out while you find your best dose.
Polish all your ad(h)d skills. Dex is only part of the treatment plan. I've never had add-l skills and life-management counseling, but those who have fare better. Never say never--I haven't gotten to it :P
How was your day? It's still day here on our coast :D
Posted by mtdewcmu on May 5, 2011, at 20:50:50
In reply to Re: I need doc to increase dose » mtdewcmu, posted by floatingbridge on May 5, 2011, at 19:46:59
> MtDew, I wrote and lost a reply, so here's the less charming, reader's digest version.
>
> Yay! that dex works.Yeah. I can't really enjoy it yet because I am so busy just with absolute necessities.
>
> In my understanding, dosage 'self-sets' (if the doctor doesn't impose). If you are responding at 30, that's great. Hopefully your doc will give you some reign, and you can avoid freaking him or her out while you find your best dose.That sounds good. The doctor has not been paternalistic about it at all. I don't find this to be the kind of med where it is always tempting to take more. Ritalin was like that, partly because it didn't enable me to focus on anything other then the drug itself. And unlike Ritalin, this takes the entire afternoon and evening to wear off enough to sleep, and I like sleep. At 40mg I am getting some unpleasant somatic side effects, so that is a limiting factor as well.
>
> Polish all your ad(h)d skills. Dex is only part of the treatment plan. I've never had add-l skills and life-management counseling, but those who have fare better. Never say never--I haven't gotten to it :PI'm not sure what that would mean, but I pretty much know what I've needed to do. It's just doing it that's been the hard part.
Posted by Phillipa on May 5, 2011, at 21:17:42
In reply to Re: I need doc to increase dose » floatingbridge, posted by mtdewcmu on May 5, 2011, at 20:50:50
That's great you have a plan. Thanks for education also. Phillipa
Posted by floatingbridge on May 5, 2011, at 21:35:08
In reply to Re: I need doc to increase dose » floatingbridge, posted by mtdewcmu on May 5, 2011, at 20:50:50
In the longer version it sounded better. No offense MtDew.
I know some folks who went through add/adhd counseling and practiced living skills. They seemed to do so much better managing things, even though they would still feel frazzled.
I've only read about it and talked about
it. I'm still reminded to keep lists and then to remember to look at the list. So my remarks were based on my
experience. I could benefit from said counseling--I didn't mean to diminish your own skills. I apologize if I underestimated your coping strategies. Actually, I have no idea, though I think of you as sharp as a tack.
Posted by mtdewcmu on May 5, 2011, at 22:37:21
In reply to Re: I need doc to increase dose » mtdewcmu, posted by floatingbridge on May 5, 2011, at 21:35:08
> In the longer version it sounded better. No offense MtDew.
>No offense taken.
Posted by mtdewcmu on May 6, 2011, at 11:28:00
In reply to Re: I need doc to increase dose » mtdewcmu, posted by floatingbridge on May 5, 2011, at 21:35:08
Reflecting on Dexedrine and dose, I think lower doses may have their place. If I was going to attend a meeting or do something social, I think the max dose of Dex would be detrimental, but a lower dose might be beneficial. 40mg puts me into a space where I am restless to do anything productive (this is the polar opposite of normal), and in social situations, although my mind and memory are super-sharp, it can tend toward impatience. Yesterday, I made a hair cut appointment (in the interest of productivity). The woman that cuts my hair is a friend, and is chatty at appointments, and usually it's a social event and a change of pace. Yesterday (she fit me in the same day), I was much too serious and it was almost stressful to sit still and try to follow the conversation. So, the right dose of Dex for that situation is probably near zero (although it helped me get there on time). For a more business-oriented interaction, like a business meeting, the right dose is probably somewhere in between. I would want the max degree of sharpness, but with less restless impatience (probably). I haven't had much chance to experiment, yet, but I will. I have two boys (6th grade and 11th) that I tutor school subjects each week, and for that, I may need a small amount of Dex, depending on the topic, but not much. But for being alone, with nobody to keep me on track, and things to do that I hate (like preparing for a move), the max dose is needed.
Posted by floatingbridge on May 6, 2011, at 12:04:01
In reply to Re: I need doc to increase dose, posted by mtdewcmu on May 6, 2011, at 11:28:00
That's the spirit, methinks. Feel it out, work it, cause if it works, you wouldn't want to lose that tool. (I speak from that lovely position of hindsight.)
Another sunny coast day. Jeez, I haven't had a haircut since August. Know about that chatty hair cutters. God bless 'em. I couldn't be one.
Posted by mtdewcmu on May 6, 2011, at 12:12:00
In reply to Re: I need doc to increase dose » mtdewcmu, posted by floatingbridge on May 6, 2011, at 12:04:01
> That's the spirit, methinks. Feel it out, work it, cause if it works, you wouldn't want to lose that tool. (I speak from that lovely position of hindsight.)
>
> Another sunny coast day. Jeez, I haven't had a haircut since August. Know about that chatty hair cutters. God bless 'em. I couldn't be one.
>
>Which coast do you live on? I live in southern California.
Posted by floatingbridge on May 6, 2011, at 13:18:07
In reply to Re: I need doc to increase dose » floatingbridge, posted by mtdewcmu on May 6, 2011, at 12:12:00
Same coast. Pacific. We have more fog up north.
Posted by Phillipa on May 6, 2011, at 19:16:50
In reply to Re: I need doc to increase dose » mtdewcmu, posted by floatingbridge on May 6, 2011, at 13:18:07
Oh my neighbors. Share a lot in common. Love Phillipa
Posted by mtdewcmu on May 7, 2011, at 8:32:22
In reply to Re: I need doc to increase dose, posted by Phillipa on May 6, 2011, at 19:16:50
The early morning awakenings have returned. I woke up around 3:30 this morning and couldn't get back to sleep. My dad used to get up excessively early every day for years and he said Zoloft cured his sleep disorder. So I think there is no getting around going up to a full 40mg of Celexa.
Posted by floatingbridge on May 7, 2011, at 16:42:24
In reply to Re: I need doc to increase dose, posted by mtdewcmu on May 7, 2011, at 8:32:22
Do you have sides at 40mg?
Posted by mtdewcmu on May 7, 2011, at 17:25:48
In reply to Re: I need doc to increase dose » mtdewcmu, posted by floatingbridge on May 7, 2011, at 16:42:24
> Do you have sides at 40mg?
You're talking about Celexa? I have some trippy startup side effects that are sort of fun. The reason I've been trying to stay low on the Celexa is that I'm worried that it might diminish the benefits of the Dex. But, otherwise, it's very easy to tolerate. I took 60mg for a year or two.
Posted by floatingbridge on May 7, 2011, at 17:31:04
In reply to Re: I need doc to increase dose » floatingbridge, posted by mtdewcmu on May 7, 2011, at 17:25:48
Ummm. Yeah. Was I talking about the wrong med by referring to celexa :(
My apologies.
Posted by floatingbridge on May 7, 2011, at 17:34:37
In reply to Re: I need doc to increase dose » mtdewcmu, posted by floatingbridge on May 7, 2011, at 17:31:04
Just reread. So, yes, celexa. 40mg? And you can tolerate it?
The early morning wake ups are one of my symptoms of having it bad.
Hows your end of the coast?
Posted by mtdewcmu on May 7, 2011, at 18:16:14
In reply to Re: I need doc to increase dose » floatingbridge, posted by floatingbridge on May 7, 2011, at 17:34:37
> Just reread. So, yes, celexa. 40mg? And you can tolerate it?
I'm not sure yet. I just took my first 40mg today.
>
> The early morning wake ups are one of my symptoms of having it bad.Yeah, me too, I guess. I feel kind of bad today, even in spite of the Dex. Being on Dex and really busy all week may have masked some depression.
>
> Hows your end of the coast?The weather has been kinda iffy today. I like the fact that it's cooler, but the sky has been intermittently kind of cloudy and gloomy. I've been trained to expect sunshine since moving here, and so it seems like my mood depends on it. When I lived back east, where I grew up, it was gray and rainy much more often, but I don't recall it ever bothering me.
Posted by mtdewcmu on May 7, 2011, at 18:18:38
In reply to Re: I need doc to increase dose » mtdewcmu, posted by floatingbridge on May 7, 2011, at 17:31:04
> Ummm. Yeah. Was I talking about the wrong med by referring to celexa :(
>
> My apologies.I guess you misread something in my response, because there's nothing to apologize for.
Posted by Phillipa on May 7, 2011, at 19:57:02
In reply to Re: I need doc to increase dose » floatingbridge, posted by mtdewcmu on May 7, 2011, at 18:16:14
What part of E Coast as born and raised in CT. Know about expecting sunny nice weather also cold and lots of storming in NC due all next week. Phillipa
Posted by mtdewcmu on May 7, 2011, at 20:49:06
In reply to Re: I need doc to increase dose » mtdewcmu, posted by Phillipa on May 7, 2011, at 19:57:02
> What part of E Coast as born and raised in CT. Know about expecting sunny nice weather also cold and lots of storming in NC due all next week. Phillipa
Pittsburgh
Posted by Phillipa on May 7, 2011, at 21:31:34
In reply to Re: I need doc to increase dose » Phillipa, posted by mtdewcmu on May 7, 2011, at 20:49:06
How did you manage to escape the cold. CA is nice and warm where you are. Phillipa
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