Patient Instructions for Taking
Long-Acting Amphetamines
(Adderall XR)

It is impossible to predict the best dose of an ADD medication for a particular patient.  It may be as little as 10 milligrams per day or over 150. The dose depends on how your body absorbs, metabolizes, and uses the medication. The best approach to finding the right dose is to start with a low dose and gradually increase it until we find what’s right for you.  This medication may have unacceptable side effects or not be effective for you in which case we may need to try another medication.

Schedule for starting a short acting amphetamine medication:

Days 1, 2, 3     take 1 tablet a day in the morning.  After three days, increase the dose if you have no side effects and the dose doesn't work well

Days 4, 5, 6     take 1 tablet a day in the morning.  After three days, increase the dose if you have no side effects and the dose doesn't work well

Days 7, 8, 9     take 1 tablet a day in the morning.  After three days, increase the dose if you have no side effects and the dose doesn't work well

Days 10 until our next meeting         take 4 tablets per day.  You may require a dose higher than this.

* When you find the best once-a-day dose, take a second dose four hours later

Remember: the effect that we are looking for is an improvement in your ability to focus, concentrate, and remember. While the medication gives some people more energy and helps some people feel less depressed, do not judge your improvement on how it affects your physical or emotional state but rather on how it helps you think, plan, organize, and perform.

Try to determine when the medication is wearing off and what you feel at that time.  If you experience increased irritability or if you feel very tired, we may need to talk about your taking a second dose shortly before the first one wears off.

Side effects
Most common side effects from the medication are mild and disappear after a few days. They may include minor nervousness, irritability, mild difficulty sleeping, appetite loss, dry mouth, mild tenseness of the jaw, stomach ache, and headache.  Do not increase the dose if a side effect makes you uncomfortable.  Contact me if you have any questions about how to take the medication.

If there are no bothersome side effects, keep increasing the dose every three days.  Once you get a beneficial effect, keep increasing the dose every three days as long as the new (higher) dose gives a better effect than the previous (lower) dose.  If the effect is about the same, go back to the lower dose.  Don’t take a dose any higher than the maximum amount I suggested to you. 

If you experience uncommon symptoms such as difficulty urinating, heart related problems, diarrhea, suspiciousness, moderate tenseness of your jaw, significant difficulty sleeping, or a significant increase in your blood pressure, stop taking the medication until you have a chance to talk to me. If you have chest pain on exertion or faintness, contact me, your physician, or call 911.

If you have any questions about how to take the medication, please call me.  Leave your name, your phone number (please state the number slowly and repeat it since static may cause a digit or two to be dropped, and a message containing any question you may have.  My number is (insert your phone number).

If your call is an emergency, and you are not able to reach me at my office number, (insert instructions).