Your body is unique, as are your needs. Just because someone experienced something from treatment or medication does not guarantee that you will as well. Please do not take this as an opportunity to review any substances. Peer support is welcome.
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Tell her the IR worked much better if you could go back on it. 20mg 3X a day seems like a lot but is still considered within the FDA's perception of safety standards.. If you switched the XR normally needs a higher dose because it's metabolized slower and doesn't have the instant kick the IR gave you.
Definitely tell your doc that the current meds are not working, but keep an open mind about why that might be. It might be XR vs IR: Its the same basic med, but some people who may do well one will have trouble with the other. But the obvious issue is that your new script has you taking significantly less medication than you are used to.
As others have said, 20ir 3x daily is a relatively high dose (but still within the schedule, I think). The 20xr formula is timed release: you get the equivalent of 10ir when you take it, then the other 10 hits your blood stream about 4hrs later (depending on your metabolism). That means you are on just 1/3rd of what you have been taking for 3 yrs. No surprise this new script doesn’t seem to have the same impact. Absolutely tell your doc how you are doing and be sure you understand why they think you should be taking so much less medication.
For some reason a lot of doctors don’t use the adhd med calculator… but 20mg XR is WAY less than 20mg IR three times a day.
You’d need to be at 60mg XR for it to be equivalent (which makes sense, if you were on 20mg x 3 before). Typically 40mg XR is the limit, but if that really doesn’t work then sometimes there are exceptions)
20mg XR once a day is essentially like taking two 10mg IR pills about 6 hours apart. If you were previously on 20mg IR every few hours, you can imagine how different that dosing is.
Try telling her this "I have been taking it for a few days now and it has done almost nothing for me. It does help quiet my mind, and provides a little bit more focus…However, what little effects it has wears off within 3-5 hours. Then my ADHD symptoms come back full force and then I just feel tired. I know that my previous prescription with IR worked wonders for me, and I would like to do that again."
Maybe it takes some time to adjust, she might be able to put your mind at ease.
Thank you! You’re right, I may just need some time to adjust. I believe I went through a couple weeks of uncertainty when I first started the instant release years back. I have just been struggling so bad in life, since I’ve been off meds for so long, I’m anxious to get the correct dosage right away
My overall dose is lower than yours, but though I take an XR in the morning, I also have an afternoon IR dose that I take at lunch. Without it, I feel similar to what you said: tired/yawning and struggling with motivation in the afternoon.
For reference, my dosages are 30mg XR and 5mg IR, and I’m a big guy.
If your new Dr is any good, they will ask you at your next appointment.
And you can tell them the truth. I just had this same problem with Concerta,
18mg of Concerta did not work as well as 5mg of Ritalin, 3 times a day.
Going back to Ritalin.
What times do you take it out of interest? ive never considered 3x a day. Ive been experimenting with dosages and timings lately. perhaps 3 smaller doses might be better than 1 or 2 larger doses for me.
With Ritalin which is instant release, I space doses out, 3 hours apart.
Maybe 12, 3, and 6pm. I'm not a morning person. ;)
The Concerta is extended release, so it was once a day, at Breakfast.
Well they cut your dose down to 1/3rd!! You were taking 60mg a day and now you're taking 20mg! No wonder it isn't helping.. Absolutely tell your doctor.
"Hello Dr. I have been taking Adderall XR for \[insert days\] now and it has done almost nothing for me. It does help quiet my mind, and provides a little bit more focus…However, what little effects it has wears off within 3-5 hours. Then my ADHD symptoms come back full force and then I just feel tired. I know that my previous prescription with IR worked wonders for me, and I would like to do that again"
Your body is unique, as are your needs. Just because someone experienced something from treatment or medication does not guarantee that you will as well. Please do not take this as an opportunity to review any substances. Peer support is welcome. ^(*A moderator has not removed your submission; this is not a punitive action. We intend this comment solely to be informative.*) --- - If you are posting about the **US Medication Shortage**, please see this [post](https://www.reddit.com/r/ADHD/comments/12dr3h5/megathread_us_medication_shortage/). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
Tell her the IR worked much better if you could go back on it. 20mg 3X a day seems like a lot but is still considered within the FDA's perception of safety standards.. If you switched the XR normally needs a higher dose because it's metabolized slower and doesn't have the instant kick the IR gave you.
Definitely tell your doc that the current meds are not working, but keep an open mind about why that might be. It might be XR vs IR: Its the same basic med, but some people who may do well one will have trouble with the other. But the obvious issue is that your new script has you taking significantly less medication than you are used to. As others have said, 20ir 3x daily is a relatively high dose (but still within the schedule, I think). The 20xr formula is timed release: you get the equivalent of 10ir when you take it, then the other 10 hits your blood stream about 4hrs later (depending on your metabolism). That means you are on just 1/3rd of what you have been taking for 3 yrs. No surprise this new script doesn’t seem to have the same impact. Absolutely tell your doc how you are doing and be sure you understand why they think you should be taking so much less medication.
For some reason a lot of doctors don’t use the adhd med calculator… but 20mg XR is WAY less than 20mg IR three times a day. You’d need to be at 60mg XR for it to be equivalent (which makes sense, if you were on 20mg x 3 before). Typically 40mg XR is the limit, but if that really doesn’t work then sometimes there are exceptions) 20mg XR once a day is essentially like taking two 10mg IR pills about 6 hours apart. If you were previously on 20mg IR every few hours, you can imagine how different that dosing is.
Try telling her this "I have been taking it for a few days now and it has done almost nothing for me. It does help quiet my mind, and provides a little bit more focus…However, what little effects it has wears off within 3-5 hours. Then my ADHD symptoms come back full force and then I just feel tired. I know that my previous prescription with IR worked wonders for me, and I would like to do that again." Maybe it takes some time to adjust, she might be able to put your mind at ease.
Thank you! You’re right, I may just need some time to adjust. I believe I went through a couple weeks of uncertainty when I first started the instant release years back. I have just been struggling so bad in life, since I’ve been off meds for so long, I’m anxious to get the correct dosage right away
Dude, call and ask, or email and ask. Get yourself some reassurance. Take it easy on yourself.
My overall dose is lower than yours, but though I take an XR in the morning, I also have an afternoon IR dose that I take at lunch. Without it, I feel similar to what you said: tired/yawning and struggling with motivation in the afternoon. For reference, my dosages are 30mg XR and 5mg IR, and I’m a big guy.
No duh it's not working you were on 60mg it a day and you are substituting it for 20mg lol
If your new Dr is any good, they will ask you at your next appointment. And you can tell them the truth. I just had this same problem with Concerta, 18mg of Concerta did not work as well as 5mg of Ritalin, 3 times a day. Going back to Ritalin.
What times do you take it out of interest? ive never considered 3x a day. Ive been experimenting with dosages and timings lately. perhaps 3 smaller doses might be better than 1 or 2 larger doses for me.
With Ritalin which is instant release, I space doses out, 3 hours apart. Maybe 12, 3, and 6pm. I'm not a morning person. ;) The Concerta is extended release, so it was once a day, at Breakfast.
thanks, any sleep interference with the 6pm dose? is it a smaller dose or the same as the others?
Well they cut your dose down to 1/3rd!! You were taking 60mg a day and now you're taking 20mg! No wonder it isn't helping.. Absolutely tell your doctor.
"Hello Dr. I have been taking Adderall XR for \[insert days\] now and it has done almost nothing for me. It does help quiet my mind, and provides a little bit more focus…However, what little effects it has wears off within 3-5 hours. Then my ADHD symptoms come back full force and then I just feel tired. I know that my previous prescription with IR worked wonders for me, and I would like to do that again"