Adderall XR—Friend or Foe?

[lorreann]

I think the idea of a drug being addictive is related to its potential for abuse. When I was on opioids for pain my doctor told me if I took it directly as prescribed and WHEN prescribed, without taking it sooner or more often then I wouldn’t have a problem. And even though I got off of them after a couple years I didn’t have a lot of trouble with withdrawal.

I have had way more problem trying to come off of antidepressants, and the withdrawal symptoms lasted for what seemed like forever. But I think with controlled drugs many people will abuse them by taking more than prescribed, and increasing tolerance. But I do think that one thing you said is incorrect. Adderall IS addictive. Adderall xl is slightly less of a problem because it is slower release but addicts will try to bypass this by snorting it. It is a controlled drug because of its high potential for addiction and abuse.

I have had good luck with Provigil which is also a federally controlled substance (C-IV) schedule 4 because it can be abused or lead to dependence, but Adderall is schedule 2 which has higher potential for abuse. I think most of these problems occur in people who don’t have a need for these drugs and take them to get high. Their focus is different than ours.

 

[lorreann]

I don’t know if anyone cares about this but I’m posting how the government schedules these drugs in potential for addiction and abuse. Like I said, the drugs I’ve had the worst problems with were antidepressants and they have the lowest schedule for problems with dependence. But I guess it’s good to be aware of what we’re taking.

Schedule I

Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Some examples of Schedule I drugs are:

heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote

Schedule II

Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples of Schedule II drugs are:

Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin

Schedule III

Schedule III drugs, substances, or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples of Schedule III drugs are:

Products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone

Schedule IV

Schedule IV drugs, substances, or chemicals are defined as drugs with a low potential for abuse and low risk of dependence. Some examples of Schedule IV drugs are:

Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien, Tramadol

Schedule V

Schedule V drugs, substances, or chemicals are defined as drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics. Schedule V drugs are generally used for antidiarrheal, antitussive, and analgesic purposes. Some examples of Schedule V drugs are:

cough preparations with less than 200 milligrams of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin

 

[Henrik]

I have had very good results with Adderall XR. I'd say it's widely regarded as the best drug in its class. The cons would be:

1. Of course it's addictive. It's not addictive in the same way as cocaine where you get a rush. It's addictive because it makes you feel normal again.

2. Taking methylphenidate will lead to serious cardiovascular problems in the long-run.

I feel it's pretty clear what the pro's and con's are. It's a very capable drug which clear risks. Basically you are accepting cardiovascular aging in return for a more normal life. My hope is that CRISPR-Cas9 or Strong AI will bail us Adderall users out before it's too late, but even if it doesn't I think it's a reasonable trade of. Or at least it doesn't get much better if you got CFS.

 

[cb2]

I have recently been trying adderall XR, I tried provigil it worked at first then made me sleepy. I am finding with the adderal XR 10mg .. it didnt seem to do much- if i have coffee with it, I can then feel a benefit. but I have noticed I am getting chest pains with the adderall xr.. even by it's self. I took one this am..and didnt have any other stimulates and notice not sure if it is palpations or just some tightness/ pain. type thing. so i guess i will be stopping the adderall xr and go back to trying the regular ritain and or adderall. kind a bummer..

 

[AngelM]

I have had very good results with Adderall XR. I'd say it's widely regarded as the best drug in its class. The cons would be:

I considered the cardiovascular risks before I began taking Adderall XR, but the difference in my quality of life while taking the drug is dramatic. However, my prescribing doctor, a psychiatrist, retired a few months ago and I transferred to the doctor who is replacing him. The new doctor questioned the reasoning behind the Adderall and, though I explained that my doctor and I arrived at the drug and the dosage after a period of several years, and though my history was clearly laid out in my chart, the new doc seemed reticent to give me the prescription. He also questioned why I get it in a 90 day supply, which I explained was not my, or my former doctor’s, idea but a suggestion made by my prescription insurance provider. I find myself always feeling only one prescription away from being without the one thing that allows me to function somewhat normally. Try explaining that to a doctor who doesn’t want his prescription history scrutinized by the DEA.

Love Adderall but hate the paper prescription.

 

[me/cfs 27931]

Anything that worsens the push-crash cycle should be avoided. Also, let's not forget that the KPAX002 methylphenidate study reported no significant statistical difference in self-reported group scores of fatigue and other measures between active treatment and a placebo.

First do no harm.

Caution is warranted in prescribing stimulants for cognitive problems. Mild stimulants may be helpful for some patients, but stronger stimulants can lead to a relapse as patients may attempt to do too much when they feel better (the so-called “push-crash cycle:” do too much, crash, rest, start to feel a little better, do too much once again, and so on). Patients need to be followed carefully to monitor for insomnia, weight loss, and other adverse effects. Many stimulants can be habit-forming, and tolerance may develop if used daily.

https://www.cdc.gov/me-cfs/healthca...-mecfs/treating-most-disruptive-symptoms.html

PS: While I would never suggest even a low-dose stimulant for regular use in ME/CFS, I personally have found that Vyvanse has fewer side-effects than Adderall-XR or Ritalin.

But I think the real question is, is it worth risking long-term health deterioration for possible short term improvement in functioning?

 

[cb2]

my dr was able to do an electronic ( i guess it was electronic) to rx coverage , and only did a 30 day supply. may i ask @AngelM how much do you take each day? I wasn't concerned about the cardiovascular risks really, i was just keeping an eye on things, bp, heart rate.. but having had really bad chest pains 3 days in a row, i am too afraid to try it. I wish that wasn't the case. I dont get the chest pains with ritalin or IR adderall. so i guess maybe that is strange? i wish i didnt need any of these, but i have to be able to function, to do even basic self care type things, is hard enough.

 

[Henrik]

Anything that worsens the push-crash cycle should be avoided. Also, let's not forget that the KPAX002 methylphenidate study reported no significant statistical difference in self-reported group scores of fatigue and other measures between active treatment and a placebo.

First do no harm.

PS: While I would never suggest even a low-dose stimulant for regular use in ME/CFS, I personally have found that Vyvanse has fewer side-effects than Adderall-XR or Ritalin.

But I think the real question is, is it worth risking long-term health deterioration for possible short term improvement in functioning?

I agree with the gist of your post. However it's pretty easy to find studies that show Concerta to be "significantly better than placebo in relieving fatigue". https://www.ncbi.nlm.nih.gov/pubmed/16443425

Nonetheless, I think you have a point. While there is a minority for CFS patients that respond positively to methylphenidate, a lot of posters on here don't seem to tolerate it well at all.

As to your long question regarding risk vs reward. I think this is a very personal decision, but for me it is. I was doing poorly and getting worse. If I risk my long term cardiovascular health, but I can get an improvement in health which allows me to live a somewhat normal life I'll take it. Of course, this only applies to the minority such as myself who responds well to it. Also, thanks for the info about Vyvanse.I will definitely check it out.

 

[cb2]

I tried the adderall xr 10mg again yesterday to see if I had the same chest pain.. no problem, so i took one today as well. again no chest pain. Yay!. it makes such a difference for me. I am thinking now the maybe the mobic i had taking for neck pain maybe was causing the strange chest pain.