ADHD Medication Question

[Penguinknees1]

Hello, I just have a couple of questions that I am hoping this awesome community can help with.

A little background: I am 22 years old and just been diagnosed today with ADHD after almost 8 months of trying to get an ADHD evaluation. My Dr. prescribed me Dextroampamphet 10 mg once a day and I started taking that today.

1.) At what point should I consider an increase in my medication. FYI I have not done nor taken anything stronger than Advil in my life and was extremely nervous about taking this. I'm feeling better in so many ways and am very happy I decided to take the meds!!! But some of the ADHD symptoms are still affecting me. If it is appropriate how should I mention a medication increase to my Dr? How long should I wait before mentioning a possible increase? Is an increase worth it?

2.) At what point should I consider switching to another type/brand of ADHD medication based on symptoms, effect, ext..

Any extra tips would be amazing, thank you, everyone.

[Birdwatcher19]

I would advise waiting a week before proposing an increase. Increasing the dosage is part of the titration process to find the correct dose for each individual and is to be expected. If you’re not experiencing side effects (or if you are, but they are tolerable) but still experiencing symptoms that you’d like to address, it makes sense to try increasing the dose. At some point increasing the dose will yield no further benefit, or will cause side effects, and then you would return to the previous dose that was working. If side effects are outweighing benefits, it may make sense to try a different medication.

Know that not all symptoms will be improved with medication, too, so you need to be realistic about what the medication can and can’t do. It’s very important to discuss all of this with your doctor (both positive results and side effects) so they can best determine if it makes sense to increase the dosage of your current medication or try something different.

[Penguinknees1 in reply to Birdwatcher19]

Thank you for responding, I just have one more concern as of this moment. I don't know if it is drug that I am taking or the fact that I am new to any medication stronger than Advil, but it feels like it takes forever for the drug to take effect. (It is extended-release.) When the medication takes effect however it is magical how much better I feel along with the increased productivity. However I have taken the drug around 6 am then I do not feel it until around 10, then at night, it seems to keep me up far too late. resulting in very little sleep. Any advice?

[Birdwatcher19 in reply to Penguinknees1]

Well, the good news is that you are noticing some positive effect, so you should be able to work with your doctor to fine-tune this. Honestly, I don’t have a lot of experience with the ER medications (I only briefly took Concerta), so I don’t know if 4 hours is an exceptionally long time for it to kick in. It seems like it would be, though I wonder if what you’re noticing is the medication at its peak, and you might notice it earlier with a higher dose. I don’t know, but I’m sure you’ll find out when you speak with your doctor. The insomnia I have lots of experience with, unfortunately. It’s very common with the stimulant medications, and it may resolve after a few more days or in a few weeks. A few things you can try, in no particular order: magnesium, melatonin (3-5mg; you can even try 1mg, but don’t go higher than 5–less is more with melatonin), and/or GABA supplements an hour before you go to bed may make you relaxed enough to fall asleep easier; Sleepytime tea before bed; citrus fruit supposedly helps stimulant medication exit your system faster, so have an orange or drink some juice when you’re ready for it to wear off; consistent bedtime/wake time and no screen time 1-2 hours before bed (read or listen to an audio book instead—preferably something boring that will make you sleepy); at least 30 minutes of exercise daily; no carbs/sugar close to bedtime. Hope the sleep issues resolve quickly for you. If not, talk to your doctor about trying something else. Maybe the immediate release version 2x/day would work better for you if you can’t find an ER medication that doesn’t keep you up.