I’ve been using dexedrine to treat my ADD for about 4 or 5 years now but suddenly I’ve become very tolerant to it and I fear this tolerance won’t go away easily.
I’m prescribed 10mg 2X a day but I actually break the 10mg tablets into quarters and typically take 2.5 2X a day which has worked fine for the passed few years.
About a month or 2 ago, this amount seemed to quickly become ineffective and being that it was the end of the school semester and being able to concentrate was very important to me, I began taking half tablets at a time. They got me through the semester but they also were becoming noticeably ineffective within a month or so.
I really don’t want to go up to whole pills (even though my prescription allows it) so I’ve been taking some short holidays from the drug and generally using it as little as possible. Specifically, I’m taking summer classes now on 2 days a week and I abstained completely during the week between sessions. Now I typically only take it on those school days Mon & Wed. but it still doesn’t seem to be doing what it should.
How does dexedrine tolerance work? Will I ever be able to fully achieve the sensitivity to it that I once have? Is this tolerance to any degree permanent? Approx. how long would I need to abstain from it? weeks? months? years?
Since you said pills and tablets I assume that you have dextostat, the immidiate release form of dextroamphetamine. Perhaps you could have your doc switch you to Dexadrine, which would allow you to take one or two pills and have them slowly release over the day. Or, you could go the route that I went and switch over to adderall. Which has a time release element to it. (ie it has four different salts in it, all of which absorb into your body at different rates, giving you a time release feel).
I agree with Joey P. My little bro had to change his medication a couple of times when it became ineffective. Perhaps your Serotonin reuptake transporters are adapting to the specific chemical and are no longer as responsive to it.
If I drink coffee (caffeine) for a week, a cup of coffee just doesn’t do what it used to. But a good dose of ephedrine does the job. Same effect, different chemical.
BTW, my son has ADD and took various drugs, including Ritalin, Dexedrine, etc. but I never did notice that he became tolerant of Dexedrine. Now he’s taking Concerta (a long-term release form of Ritalin), he only needs to take it once per day and it works very well, better than taking separate tablets (for him, anyway.)
Dextrostat is just the generic form of Dexedrine, they are both dextroamphetamine sulfate. “Dexedrine” comes in both an immediate-release form and an extended-release form, but the “extended” form lasts only a few hours AFAIK.
Tolerance to this won’t be permanent. Your best bet would be to talk to your doctor (of course), but I believe the general rule is to take about a two-week “vacation” from the drug. Some switch back and forth between Ritalin and Dexedrine; this might be worth a try, though I’ve never found Ritalin to be as effective.
What’s Adderall like? I’ve heard of it but know nothing about it. Is it an amphetamine or amphetamine-like? Are the effects noticeable the way they are with dexadrine and ritalin?
Is there a negative comedown? Are the side effects similar (loss of appetite, insomnia, etc.)?
occ I also have found dex to be more effective than ritalin. But ritalin still has had some benefit for me in the past. Can I assume from what you said that there is no cross-tolerance between the 2 drugs? Because Dex has just been a life saver in my life and if I could take ritalin for a few weeks and go back on Dex it would be ideal. (Personally I think the comedown is much worse with Ritalin, but nothing I can’t handle).
Would my sensitivity to it be restored to 100% do you think?
I’d talk to whoever’s prescribing you, really, as far as cross-tolerance goes between Dex and Rit. Ritalin’s somewhat of a reuptake inhibitor (like cocaine), while Dexedrine causes more dopamine release at the synapse. Tolerance is probably caused by downregulation of dopamine receptors; essentially, the brain likes to remain at a “baseline”, and if it sees too much action somewhere, it tries to reduce it by disabling receptors. Tolerance goes away as the brain reenables the receptors, after seeing “too little” action in the dopamine system. The concept of “sensitivity” to the drug is subjective, and you’ll get different answers from different people. I’d definitely say you’ll start “feeling” it again, much as you did before. It’s not due to a permanent brain change, but a perfectly normal cycle of up and down-regulation.
Adderall is pretty similar to Dexedrine, subjectively, to me and most people. It’s a mixture of four amphetamine salts – it’s more-or-less 75% dexedrine and 25% other amphetamines. It’s somewhat “smoother”, I’d say, in that it doesn’t cut in and out as sharply as Dexedrine. During the period when its fully active, I’d say its pretty similar. Might be worth talking to your doc about trying it, although if you’re tolerant to Dex, you’ll be tolerant to Adderall. As far as comedown, both Dexedrine and Adderall can cause one. I’ve never noticed much of a pattern, though; it just seems to happen sometimes and not happen others. Kind of like drinking alcohol and having hangovers, I guess.
Oh, and IANAD (I am not a doctor), but any psych will tell you the same thing.
I’ve been on ritalin, adderall, and dex and I definately became tolerant. I eventually went off all of it because of the stress/hypomania I felt from it. I was on it for years. This stuff is speed, pure and simple (and not even particularly weak speed at that) . People who say that dex, rit, or add can’t make permanent changes in your brain chemistry are the same one’s that make the “Speed Kills” posters and show PET scans of how speed use (abuse) creates areas in the brain with reduced glucose uptake. I have seen people that really need to be on ritalin et al, and they are in the 99nth percentile of those currently on ritalin. The medical establishment is built on a hierarchy of generally unquestioned authority. BTW these stimulants work primarily on dopamine, not serotonin.
See how the last three sentences were virtually complete non sequitors? That’s ADD, but still not necessarily indicative of the type that needs to be on ritalin. Almost anyone will feel a better sense of focus and motivation while on ritalin; just because it works doesn’t mean it’s indicated.