I have been on Adderall IR for maybe 15 years at 30mg x 3/day (90mg/day total). Recently have had it start to cause me to have multiple episodes of micro-sleep at work daily and it is causing me to get into trouble. Have always had trouble staying awake during the day ever since I was a kid, slept OK at night. In adulthood night sleep great when on Adderall (have always been able to take the best nap ever right after taking one). Noticed efficacy has also significantly dropped over the past year or more. 50 y/o male professional, have MBA degree and almost done with second masters. Work 7 days 12 hr shifts 1pm-1am, then 7 days off. Primary care doctor tried adding Provigil at 100mg then 200mg coded to shift work disorder, no change.
New doctor, an actual psychiatrist, nice but very young lady for rx management, referred to her by my primary care due to the issues I've been having. She first gave me a week of Vyvanse 30mg/day, might as well have been a sugar pill. But, due to my insurance not covering Vyvanse, her office called me up two days into taking it and the nurse started telling me about this other drug my insurance would cover called Adderall (!!) and that the dr sent to my pharmacy (to the wrong pharmacy for a second time..) a new rx for 15mg/day Adderall XR. Very confused and losing confidence in this new little clinic - in a small town in very rural Deep South USA. I do not understand how if my tolerance to Adderall IR AT 90mg/day had reached the point in wasn't doing its job at all, why would 30mg Vyvanse be an appropriate substitute for one, but then even more so how on earth 15mg of Adderall XR would have any impact on my ADHD? Husband can tell quick if I've missed even one dose of my Adderall IR - legs twitch and I get so scattered and lethargic I am worthless. Told him and parents and in-laws I wanted off Adderall and all have said they can tell a major difference for the better when I am on it. I cannot allow for a doctor to play around with meds and dosages too much because I have to have a stable, clear, focused, and awake mind at work - failure would be very bad for myself and for all those who depend on me being fully alert and able to rapidly process lots of data accurately while working. Does anyone have any thoughts on what this doctor might be thinking? Or any suggestions on how to ask to proceed with alternative prescriptions maybe? Have asked for a sleep study, that is "in the works" - or so they said, but don't have a whole lot of faith in them at the moment.
