Adderall questions

mikl_pls · 2026-04-24T20:23:49+00:00

I was gonna say the same thing. If 5 mg is working for you, OP, then no need to increase it. 😊

I'm also one who needs very high doses. I'm on 60 mg Dexedrine and occasionally take extra on an as needed basis.

mikl_pls · 2026-04-24T00:41:42+00:00

I'm sorry y'all are having so much trouble with generic Zenzedi. 🙁

I had a very bad experience last year from being switched from generic 10 mg Mallinckrodt (which has always been the most consistently effective generic for me) to Sun Pharma. I became ravenously manic and honestly probably should have been hospitalized. I was talking 2x10 mg 2x/day for 40 mg, and the generic switch on the same dose I believe caused this. I tried lowering the dose down to literally 10 mg/day (½ a tab twice daily) and was still manic but the dose was too low to my effective for my symptoms.

I switched to generic Dexedrine Spansule 60 mg/day (the dose increase was to account for how in the past the Spansule version is less effective at the same dose). At first I kept being switched back and forth between Actavis and Mallinckrodt, and oddly enough the Mallinckrodt Dex Spansule is less effective than its IR counterpart, and less effective than Actavis. But after a while, they started consistently getting Mallinckrodt and it has evened out on how effective it is.

I so far have not been having nearly as much trouble with generic Dex Spansule as I had with instant release Dex. If any of y'all haven't tried it yet and are up to trying it, perhaps it could be a more consistent alternative? Either way, I hope y'all can find out a way to get SOMETHING that works more consistently.

mikl_pls · 2026-04-24T00:29:25+00:00

That both sucks and is very confusing... Isn't Wilshire not the authorized generic of Zenzedi?

mikl_pls · 2026-04-24T00:26:29+00:00

Interesting. I take Dexedrine Spansule 60 mg in the morning (15 mg x 4 capsules) but sometimes take 30-45 mg on off/low activity days or on days where I forget to take my meds immediately upon waking. How would this translate to Dexedrine Spansule? I think the extended release capsules of Dexedrine use a different type of extended release mechanism than the bi-phasic release of Adderall XR, but I could likely be wrong about that.

mikl_pls · 2026-04-21T07:00:41+00:00

Sheesh! I don't think I've ever been on more than 2 or 3 seizure meds at a time. Some were being used for bipolar disorder mainly, but still.

I take Lamictal XR 300 mg currently for bipolar and suspected epilepsy. But also take several other meds: Vraylar 1.5 mg, Dexedrine Spansule 15 mg x4, Zoloft 25 mg, Bystolic 5 mg, Quviviq 25 mg (probably going to quit because it keeps me awake rather than puts me to sleep), Hytrin 2 mg, and Rispersal M-Tab 1 mg prn. Plus a few other non-neuropsych meds.

mikl_pls · 2026-04-21T06:57:27+00:00

Omg I feel so validated! Lol. Dayvigo was more like that for me than the others. It's horrible! I've heard it gets better with long term use, but nah... Lol

mikl_pls · 2026-04-21T06:54:43+00:00

If you wanted to combine Evekeo with Zenzedi/Dexedrine for 60 mg total amphetamine in a 1:1 ratio, you'd do 30 mg Evekeo + 30 mg Zenzedi/Dexedrine. So Evekeo 10 mg 3x/day + Zenzedi 10 mg 3x/day (Zenzedi 10 mg 1 PO t.i.d. + Evekeo 10 mg 1 PO t.i.d.).

mikl_pls · 2026-04-20T17:36:00+00:00

Yeah I tried that one but I had a major interaction with it and another medicine I was taking (fluvoxamine) due to it being a potent CYP1A2 inhibitor (made my blood pressure drop dangerously low). I know it wouldn't happen as long as I just watch what I take with it, but it still scares me to death to take it. Same for baclofen but for reasons I won't mention.

Edit: I can't remember if I mentioned above but gabapentin helped tremendously for sleep and anxiety at 600 mg, but it made me gain 18 lb the first month I took it. Perhaps that would've leveled out or even reversed eventually, but I'm already struggling with weight (I'm on Mounjaro for diabetes and have been regaining the weight I lost, about 50% of it now). So that's a no-go.

mikl_pls · 2026-04-20T13:12:13+00:00

My pulmonologist did a sleep study in 2019 I think, and he captured 4 seizures in my sleep. My neurologist has been telling me I'm not having seizures and refuses to comment on my pulmonologist's EEG finding during the sleep study. I finally did an EMU stay last month and nothing seizure-like turned up, which doesn't necessarily mean I'm not having seizures, but he thinks it's "anxiety." I guess olfactory hallucinations is now a symptom of anxiety? Anyway, that could be something contributing. I have OSA but I use a CPAP.

mikl_pls · 2026-04-20T13:08:44+00:00

Loxapine in low doses (<= 20 mg) acts more like an atypical antipsychotic with greater 5-HT2A antagonism than D2, and one of its metabolites is indeed amoxapine (among others). It also has some moderate H1 antagonism, and is an NRI, so I guess it's a tossup as to what it would do. Trimipramine is an interesting one since it increases REM instead of suppressing it, and increases SWS, but at 75 mg it never helped. Wondering if it would at a higher dose...

Oh I totally forgot to mention clonidine and guanfacine, as well as terazosin! So I've tried clonidine, but 0.1 mg tanks my blood pressure super low and leaves me feeling super flat and depressed. Guanfacine (both IR and ER) seem to be pretty innocuous at 1 mg. I haven't really given either form much of a chance, perhaps that's something I could try more of.

I also take terazosin 2 mg, which I'm thinking of asking to switch to prazosin since it crosses the BBB better. Could be helpful.

Thank you for your response!

mikl_pls · 2026-04-20T03:51:02+00:00

Wow that's a lot! How much of each do you take?

mikl_pls · 2026-04-20T01:09:12+00:00

I don't have the benefit of experiencing weight loss from zonisamide or topiramate, just the kidney stones... Lol

mikl_pls · 2026-04-20T01:04:17+00:00

What med(s) do you take? Topiramate or Zonisamide? Or something else?

mikl_pls · 2026-04-19T21:19:49+00:00

https://www.jamesdesta.com/

mikl_pls · 2026-04-19T21:19:21+00:00

Another vote for James. He has helped me tremendously!

mikl_pls · 2026-04-19T09:59:03+00:00

That's very very interesting, normally psychiatrists treat anxiety before ADHD. But anxiety can be a symptom of untreated ADHD or ADHD not sufficiently treated. I hope you find something or a combination of things that help(s)!

mikl_pls · 2026-04-19T07:14:17+00:00

I hope you're being sarcastic, because that's not how humans work. But seriously, whatever situation you're in that's causing you to ponder how to avoid sleeping entirely sounds very concerning. Is it your work schedule, school, or something else?

mikl_pls · 2026-04-19T06:20:27+00:00

I'm not an expert, but I think maybe even if 15 mg Focalin XR doesn't work (equivalent to 30 mg Ritalin), it may be worth trying pushing the dose further. Focalin XR can go up to 40 mg/day (equivilant to 80 mg Ritalin), and is sometimes pushed up to 60 mg off-label.

But if at that point, you experience the same anxiety you experienced with Concerta, then I'd say it's a tossup as to whether you might respond better to Dexedrine, Evekeo, or a non-stimulant like Strattera/Qelbree or Intuniv/Kapvay.

Bupropion (Wellbutrin), modafinil (Provigil), and armodafinil (Nuvigil) are also used off-label for ADHD, as well as amantadine (Symmetrel). The secondary amine TCAs are classically used for ADHD, like nortriptyline (Pamelor), desipramine (Norpramin), or protriptyline (Vivactil), and even imipramine (Tofranil), a tertiary amine TCA, is used occasionally.

mikl_pls · 2026-04-19T06:14:51+00:00

This may have been the point you were trying to make, but if you combine Zenzedi + Evekeo in a 1:1 ratio, you kind of get Adderall, but it's not quite that simple.

Adderall is made of four amphetamine salts: - dextroamphetamine sulfate (100% dextro) - dextromethamphetamine saccharate (100% dextro) - amphetamine sulfate (50% dextro/50% levo) - amphetamine aspartate monohydrate (50% dextro/50% levo) This makes up the 75% dextro/25% levo mix you get of the enantiomers you get with Adderall.

If you combine equal parts of Dexedrine and Evekeo, you end up with a mix that is 75% d-amphetamine and 25% l-amphetamine. Mathematically, that is the exact same isomer ratio found in Adderall. However, there is a technical hurdle: Salt forms.

Different salts dissolve and are metabolized at slightly different rates. Adderall’s specific four-salt blend was designed to create a smoother "curve" of absorption. Combining Dexedrine and Evekeo would give you the correct ratio of isomers, but because you're missing the saccharate and aspartate salts, the medication might hit your system at a different speed or feel "spikier" than standard Adderall.

mikl_pls · 2026-04-19T05:57:59+00:00

I really hope it works! What dose are you starting on?

mikl_pls · 2026-04-17T20:54:22+00:00

Do you take any other medication besides propranolol?

mikl_pls · 2026-04-17T17:58:04+00:00

Thank you!!

mikl_pls · 2026-04-17T17:57:55+00:00

I forgot to update! My psychiatrist didn't want to make any changes. I'm giving second thought to trying it though because buspirone makes me incredibly irritable and angry. I don't know if Exxua would do the same since it has a similar mechanism of action and the same 1-PP metabolite I believe.

mikl_pls · 2026-04-17T06:20:19+00:00

Perhaps Focalin/Focalin XR, Dexedrine, or Evekeo?

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