Adult ADHD Doctors & Meds Question: USA Only

[IAmFCA]

ENAers who know how to manage ADHD,

 

I am a recently diagnosed adult with ADHD. My meds - generic Adderall - are regulated, so that a doctor can offer me only 1 month at a time. Common practice seems to be give me one or two months of scrips, maybe three, and then one has to go back to the doctor for a check-up to get another round.

 

I don't feel like I need check ups. My psych doctor requires advance planning and $400 a pop. Ouch. Am I really obligated to see her every 2 - 3 months just to keep my scrip going? What a racket!

 

Is there a better way? Clinics?

 

My daughter is on similar regimen, but I am happy for her to have check ups, because she is growing fast and her body is constantly changing. Me, not so much.

[CatsMeeoow]

It's standard of care especially with a drug which is prone to abuse.

 

If you don't have insurance to help the psych appointments can you discuss with them a pro-rated scale? I would point out with your Dr what is holding you back. Most times they try to work with people who have hardship and no insurance but keep in mind at the same time they have to cover their professional liability.

[IAmFCA]

It's standard of care especially with a drug which is prone to abuse.

 

If you don't have insurance to help the psych appointments can you discuss with them a pro-rated scale? I would point out with your Dr what is holding you back. Most times they try to work with people who have hardship and no insurance but keep in mind at the same time they have to cover their professional liability.

 

OK thanks.

[sadchick83]

My doctor tells me to call him and he will mail the prescription to me. I don't have to pay to see him each time I need a prescription. So 3 weeks after my last appointment, I will give him a call. I am going to a regular doctor for this.

[IAmFCA]

My doctor tells me to call him and he will mail the prescription to me. I don't have to pay to see him each time I need a prescription. So 3 weeks after my last appointment, I will give him a call. I am going to a regular doctor for this.

 

Very helpful. Psych visits are often limited by insurance plans whereas GPs are not.

[trust101]

You need to give a brief history of yourself. What other symptoms do you have? Do you feel you have excess energy as well as a lack of concentration? Or more lethargic.

 

Physicians do not rashly prescribe this medication. You are 49 years old. Why are you on a psychostimulant? Talk to your Doctor about your symptoms & ask him/her about opting for atomoxetine. I use to prescribe that first.

[sadchick83]

IthinkIcan,

 

I take Vyvanse...hence why I am awake at 4:20am....I have a long history of taking the ADD meds. When I moved to NY, I just went to my boyfriend's doctor. My bf told him I needed someone in NYC to prescribe it to me. I guess he "trusted" me, because he didnt bother to ask my psychiatrist in Toronto for any info. I could not even get the meds prescribed at my university, because people abuse the drugs.

 

Anyway, the doctor told me he has to file with the state every time he prescribes me the meds just to make sure Im not filling out multiple prescriptions with other doctors around the state. This doctor was out of network and charging about $350 a visit. He just went in network and is about $200 a visit, but again, said I just had to call the office to get him to mail me a prescription to avoid an office visit charge. Im not sure how often he will want to see me since we just started this arrangement.

 

Maybe look around to find a doctor who will accommodate you like mine does. It doesn't hurt to have one of your friends ask around. My old family doctor had no problem prescribing when I told her I could not always get in with the psychiatrist. I am taking a guess here, but I think a regular doctor can be comfortable prescribing you these meds if someone else has fully assessed you. At least that has been my experience.

[Supernova1607309611]

Your medication is a highly abused substance, so that is why it is tightly controlled. But $400 a pop every 2 months is extremely high for any doctor just for a medication check visit.

 

My suggestion is you look for another doctor who has more reasonable follow up visit costs or who doesn't require such frequent visits. Then just have that doctor request your medical records from your old doctor.

 

You can call doctor's office and ask them up front before you even schedule what the cost is for a routine follow up visit and what the protocol is for how often someone with ADHD must have follow up visits... Tell them that cost is a concern and you need to find a doctor you can afford.

 

Some doctors are must more squeamish than others about staying out of trouble with the regulatory agencies who prescribe these kinds of drugs, because there is such a big business in selling them illegally. So they don't want to get on the wrong side of the law and get their license revoked for overprescribing. So this particular doctor may just be more paranoid/cautious about his prescriptions and wants to show he is following the letter of the law.

[sidehop]

Be careful with any ADHD medication. I've taken Ritalin, Adderall XR and Concerta and while Concerta worked out really well in the past, it really suppressed my hunger to the point of exhaustion. It was horrible. I only took it for eight months before I came off of it. It really messed with my sleep cycle as well. Adderall = the worst for me as I went into depression like state when it wore off at the end of the day. I've contemplated suicide & cried for no reason. Mine was month to month also but check up every three months and mandatory drug screening although my doctor wasn't worried much knowing my history. He never pushed it though and suggested seeing therapist and alternative way to combat ADHD.

 

There are ADHD Coaches aside from therapy. I was about to post a really good article from NY Times on why we ADHD'ers are the way we are and how medication may not necessarily be the solution to everything. link removed

 

It made A LOT of sense as to why; I knew all the details of how ADHD'ers act but the reason behind it really gave me some hope in changing my routine (as it cannot be the same).

[IAmFCA]

There are ADHD Coaches aside from therapy. I was about to post a really good article from NY Times on why we ADHD'ers are the way we are and how medication may not necessarily be the solution to everything. link removed

 

It made A LOT of sense as to why; I knew all the details of how ADHD'ers act but the reason behind it really gave me some hope in changing my routine (as it cannot be the same).

 

Thank you. I have some concerns re sleeping and biting my nails... both weak spots in my pre-medicated self, but I am now performing in various aspects of my life whereas keeping up previously had become a struggle. Thought about Concerta; maybe I will switch at some point, but for now, Adderall seems to be doing what I need it to do.

 

With respect to the article--- its a bit frustrating. I am the daughter of a clearly ADHD parent, GF of an ADHD adult, I am an ADHD adult who wishes I had been diagnosed years ago, and I am the mother of an ADHD child. All four of us struggle with things other people think are easy; we lose our way mid-task, or avoid admin tasks to our detriment. Halfway through working a math problem, my daughter would forget that she was adding versus multiplying, or forget which number she was working with. I didn't send in an insurance form for over a year - all I had to do was read the directions and sign it. It overwhelmed me just to think about the detail I thought it would require. My BF runs a business and habitually processes invoices for his staff at midnight the night before they are due; he just can't make himself do it sooner. My father can't clean his office. Too much detail. All four of us demonstrate similar patterns that to others appear "absent-minded".

 

With respect to our work, my father chose a profession that made use of his hyper-focus and rose to be among the best in his field. My BF has two primary jobs, both entrepreneurial and neither requires a structured environment; I have a job with a high degree of variability and drive my direct report nuts. So, yes, as the article says, we have each found our way so that we make good use of our ADHD brains.

 

OTOH, my ADHD running coach believes in med-free management and hasn't been able to implement his marketing plan for a year.

 

We still have to pay our taxes, fill out insurance forms, write thank you notes, pay bills, and pass exams. And the four of whom I speak remain energetic, frenetic, curious, and adventurous. ADHD does involve the desire for something new; it also creates real challenges for managing the responsibilities of everyday life.

 

The article dismisses this very real, day-to-day aspect of living with ADHD. If anyone has a full schedule, such as a full work day and additional responsibilities at night, then being able to process mundane tasks is essential.

[sidehop]

The article dismisses this very real, day-to-day aspect of living with ADHD. If anyone has a full schedule, such as a full work day and additional responsibilities at night, then being able to process mundane tasks is essential.

 

That's true; and in a lot of ways my focus is all over the place as well. One thing I forgot to mention when I read about your sleep issue; does sleep apnea run in your family by any chance? It's something I'm getting tested this week and only found out through my doctor recently after talking to him about my sleep habits and how I'm generally not well rested. A lot of the issues I have with my ADHD really made me curious when I read the sleep apnea symptoms and thought it was worth seeing a specialist. I'm doing an overnight study at home and will find out in few weeks. I have your typical snoring, constant vivid dreams (wake up as tired as ever), gasping for breath at times, and never feeling rested after 7-8 hours of sleep was a big indicator. I do have sleep paralysis also whenever I'm physically exhausted.

 

Starting a task is definitely hard for me as well. I don't know if I have executive functioning disorder but it's somewhat similar. My butt has to be on fire to get stuff done that's on a day to day task while I do seem to better if my wife is say in the kitchen cleaning together or there's that moral support. But I could be asking her a question, her answering and two seconds later I realized I didn't even hear the answer (and ticks her off as I'll ask the same question again!)

 

Sort of back to the sleep apnea but once in a blue moon I feel very rested and fee energetic, I seem to be able to retain better memory and have the desire and focus to get things done at work and around the house. It's such a rare thing though in my life I'm hoping there are other areas that can be addressed. Even when I was more physically in shape going to the gym on regular basis, reducing gluten, dairy and keep my system well fed, I still snored and never felt rested.

[IAmFCA]

I have never slept enough, not since childhood, but I doubt I have sleep apnea. The symptoms you describe aren't shared by me. I agree, sleep is a key component of focus, initiative, and memory. Diet and exercise and sleep. If only there were time leftover to get a life.

[sidehop]

I have never slept enough, not since childhood, but I doubt I have sleep apnea. The symptoms you describe aren't shared by me. I agree, sleep is a key component of focus, initiative, and memory. Diet and exercise and sleep. If only there were time leftover to get a life.

 

I'm still looking as to what works as well but yes it's definitely not always easy trying to get answers between all the schedules.

[Seraphim]

ADHD medication almost destroyed my son.

[IAmFCA]

ADHD medication almost destroyed my son.

 

I'm sorry. I never have followed your posts enough to understand the back story. My mom refused to let my brother take ritalin, and she was always glad for that, though I think my brother wishes he had better support managing himself.

 

My daughter and I are enjoying our meds for now. We both have more than one opinion re adhd and both opinions were delivered with a high degree of confidence.

 

Generally, I am anti-meds. I couldn't beat this on my own and neither could she.

 

I am so sorry for the impact on your son. Heartbreaking.

[sadchick83]

ADHD medication almost destroyed my son.

 

I agree, it is very hard on some children. How do they know if they are overstimulated?? I think there is a bit of a burnout issue, so Im glad I didnt start until later in life. Certainly a difficult decision for parents.

[Applewhite]

I have all of the mentioned symptoms as well, can't focus on anything, can't start a task, don't feel rested after 7-8 hrs of sleep etc. I have never been diagnosed. Who would be able to assess me?

[IAmFCA]

I agree, it is very hard on some children. How do they know if they are overstimulated?? I think there is a bit of a burnout issue, so Im glad I didnt start until later in life. Certainly a difficult decision for parents.

 

It was difficult for me. I held off on meds against everyone's advice, for a year. I am glad I did. My daughter's self-esteem skkyrocketed as she saw how much she could accomplish by implementing changes in her own life. She is a better athlete, chooses a better diet, and has overcome her frustration. She believes in herself. THEN I started her meds, so she knew they were the last 10 yards, not the first 90.

 

She is in a growth spurt. Helping her keep weight on was tough BEFORE the meds. Now, holy smokes. She has doubled up everything she orders. I think its working.

[sadchick83]

It was difficult for me. I held off on meds against everyone's advice, for a year. I am glad I did. My daughter's self-esteem skkyrocketed as she saw how much she could accomplish by implementing changes in her own life. She is a better athlete, chooses a better diet, and has overcome her frustration. She believes in herself. THEN I started her meds, so she knew they were the last 10 yards, not the first 90.

 

She is in a growth spurt. Helping her keep weight on was tough BEFORE the meds. Now, holy smokes. She has doubled up everything she orders. I think its working.

 

Ohhh...This makes me soooo happy for your daughter!! I was like her- couldn't do math and in almost every report card was "easily distracted."This was before ADD was invented.

Your daughter will succeed with a great Mama like you!! And, I can tell you I almost failed math in high school, however, recently topped my derivatives class in graduate school. Medication is a very effective alternative for some. There would be wasted talent without treatment--whichever route a person decides to go.

[sadchick83]

I have all of the mentioned symptoms as well, can't focus on anything, can't start a task, don't feel rested after 7-8 hrs of sleep etc. I have never been diagnosed. Who would be able to assess me?

 

You absolutely should be tested. People who have undiagnosed ADD are often depressed. Why? Because they have undiagnosed ADD and are depressed with the fact they cannot complete tasks, and have other ADD symptoms.

 

You could start by researching on line, on your own, but see a professional in the near future. Usually a psychologist can test you, or a psychiatrist can as well. Not always, but generally a psychiatrist will treat with medication, which a psychologist can recommend, but cannot prescribe. But sometimes a psychologist can recommend no medication solutions. They kind of work together here.

 

Word is that the medication does help those with ADD. They say people who take ADD meds without having ADD report they didnt feel anything when taking the medication.

 

Anyway, if you think you have it, compare it to thinking you have a suspicious lump. You should check it out. Too often people ignore neurological issues, since you don't appear to be "sick."

[Applewhite]

Thank you. In fact I was diagnosed for depression and adjustment disorder but never diagnosed for ADD. I'm a bit unsure of whether I should be searching for a psychiatrist or a psychologist and whether I can find one that takes my insurance. *sigh*

[Seraphim]

I'm sorry. I never have followed your posts enough to understand the back story. My mom refused to let my brother take ritalin, and she was always glad for that, though I think my brother wishes he had better support managing himself.

 

My daughter and I are enjoying our meds for now. We both have more than one opinion re adhd and both opinions were delivered with a high degree of confidence.

 

Generally, I am anti-meds. I couldn't beat this on my own and neither could she.

 

I am so sorry for the impact on your son. Heartbreaking.

 

Sadly,my son was misdiagnosed. He has autism not ADHD. So 5 years worth of 4 different ADHD medications really hurt him I feel. Concerta was especially bad. He got severely depressed and became violent and that is NOT my child.

 

Now my husband has ADHD and is not medicated for that, he is for severe anxiety but he does extremely well without ADHD meds.

[sadchick83]

Well my psychiatrist gave me a simple questionnaire...you could probably find it on line. Not sure what he did above that, but a psychologist will give you a very thorough test. It takes about 2 days...4 hours each day. some of the things are done with a stopwatch, something a psychiatrist wont do.....You really should look in to it

[IAmFCA]

Ohhh...This makes me soooo happy for your daughter!! I was like her- couldn't do math and in almost every report card was "easily distracted."This was before ADD was invented.

Your daughter will succeed with a great Mama like you!! And, I can tell you I almost failed math in high school, however, recently topped my derivatives class in graduate school. Medication is a very effective alternative for some. There would be wasted talent without treatment--whichever route a person decides to go.

 

Thank you for your kind words. It matters! Sometimes I am my own and only cheerleader. #SingleMomLife

 

I wish I had been diagnosed as a child, but like you, it was new then and Ritalin would not have been good for me anyway.

 

 

Applewhite, I have always struggled with starting a task, with details, with sitting still in a meeting; I have learned to work all night, to work with music on, to work in loud places... in short, ways of working that go against the grain of an office environment.

 

This past year, I fell into a worsening depression because I could not keep up. I was diagnosed ADHD by a second psychiatrist - confirming the first diagnosis of a couple of years ago. The first doctor had prescribed meds but it wasn't effective and I kept forgetting to take them, lol, I AM ADHD. The second doctor was much better understanding how to medicate me. And she was more informed about the impact of meds - or lack of it - on my particular physiology. She said, there is a chance your depression is caused by being overwhelmed. And she was right. Once I settled into a routine with the ADHD meds, everything else has been falling into place too, layer by layer.

 

In the US, you will need a psychiatrist to prescribe meds. Some teaching hospitals offer ADHD clinics that give a less expensive means of accessing care, and others provide psychotherapy on the cheap by doctors-in-training. You will need a doctor to get a scrip.

[IAmFCA]

Well my psychiatrist gave me a simple questionnaire...you could probably find it on line. Not sure what he did above that, but a psychologist will give you a very thorough test. It takes about 2 days...4 hours each day. some of the things are done with a stopwatch, something a psychiatrist wont do.....You really should look in to it

 

The questionnaire was funny. The two times docs gave me that checklist, they concluded, "You are definitely ADHD. No ifs ands or buts." I felt like I got an "A".