High dose stimulant treatment for ADHD - CHADD's Adult ADH...

CHADD's Adult ADHD Support

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High dose stimulant treatment for ADHD

fitness7 profile image

I was diagnosed with Adult ADHD in 2009, and getting treated with Adderall XR 30mg x3 per day. By 2014, I found my optimum dosage of Adderall XR 30mg, 6 capsules per day (Brand Medically Necessary) after trying out Concerta, Strattera, generic Adderall XR, and discussing "High dose stimulant treatment for ADHD" with my Psychiatrist. Dr. Joseph Biederman, MD, Professor of Psychiatry, Harvard Medical School wrote his articles and explained his professional justification in "High dose stimulant treatment for ADHD" and I have been doing well by keeping the same dose for 7 years. Adult ADHD patients have more bodyweight than children with ADHD. Also, each patient has a different degree of stimulant needs. Since 2015, different Psychiatrist continued the same dosage until November 2020. But he changed his mind, he only prescribe FDA limits 2 capsules per day. It is not possible to reduce the dosage from 6 to 2 per day. So, we had an argument, and the doctor told me to find a new doctor. Later, he apologized to me that he gave me such emotional distress, and he resume writing the 6 capsules per day. But he told me that he would not do anything to get me insurance coverage. As I could not find another doctor right away, I didn't tell him that it was his responsibility, and I prepared all documentation for an insurance company. I had a previous doctor's patient notes, but the current doctor has no documents to explain his justification for prior authorization and quantity limit exception. Therefore, insurance denied coverage without the current doctor's justification and I had to pay over $15000 since last November 2020. It is not easy to find a different doctor and I have been distressed psycologically and financially. Since I had to change my health insurance in November 2021, again I prepared all prior authorization requests with supporting documents from my previous doctor. I took all documents for the doctor ask for his medical records and his signature. He has no satisfactory records to justify Adderall XR Brand necessity nor any quantity limits exception request. Then, he started complaining that he only continued to prescribe a high dosage of Adderall XR, but FDR limits were 2 per day. Then he again started telling me he only prescribe 2 per day. It is impossible, so I was upset and asked him why he was requesting quantity limits exception to insurance and why he continued writing a high dosage of Adderall XR if he didn't agree with it. I also told him that his conduct was unethical and unprofessional. Then he told me to get out of his office and he was cutting professional relationships. I had to leave his office with prior authorization with doctor's signature. I was shocked and seriously started wondering what to do next. Without the service provider, what prior authorization? If I could find a different doctor, I have no problem, but I can't find one easily. What do I do now? Most physicians and pharmacists have a bias against the high dose of stimulants. But I need medication for strictly medical necessity. I am an adult ADHD patient but not a stimulant abuser at all. I have been doing much better than before by taking a high dose of Adderall XR and I know how to monitor safety issues. I had no safety problems. As an adult ADHD patient who needs medication, I don't have to go through struggles surrounded by biased professionals.

4 Replies

Hi, I understand your need for medicine. We all want to live a healthy life. Are you in counseling or solely relying on stimulants? I think it would be good to talk with a professional about how to manage ADHD in different ways. It's not up to us to tell the Psychiatrist what to write on the prescription. They are licensed professionals, and have been trained to identify signs of addiction. The fact that you got thrown out of your ducts office because he didn't give you a prescription that's outside of FDA guidelines says a lot. I think you should consider finding a therapist for support.

fitness7 profile image
fitness7 in reply to BayBae

I don't think that you read my post carefully.

fitness7 profile image
fitness7 in reply to BayBae

I am talking about unethical and unprofessional conduct by MD.

I have never heard of 6 x 30mg of adderall a day ... Wow, that's way beyond--like miles and miles beyond even what I consider high dose.

Doctors do get pressure from insurance companies and from the DEA about prescribing certain medications ... I think he had a responsibility to gradually wean you to a lower dose.

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