Fast metabolizers – What if the usual upper dosage isn't enough?

[Anonymous]

I’m a 32 yr old male with ADD, inattentive type. Since having my ADHD diagnosed at age 26, I have never been able to convince my doctors to prescribe me as much Ritalin as I seem to need.

This past year, I had been seeing a doctor who believed that adults didn’t need any medication in the evenings. I was given 72 – 90 mg of Concerta to get through my school day, then had nothing for the evenings. Despite writing a three page letter, trying to explain why this was not enough medication to allow me to lead a functional life, referencing the CADDRA guidelines for adult dosing, my doctor insisted that I didn’t need any Ritalin for the evenings.

My system burns through the concerta in 7 hrs if I don’t exercise and eat regularily, 8 hrs if I do. That leaves me with no effective coverage for two thirds of my day. In the first four hours, just after taking the concerta, the concerta gives an IR dose equivalent to 22% of concerta dose. This is about 16 mg with a 72 mg dose. Being a fast metabolizer, that initial 16 mg, starts to fall below an effective level in about an hour after it kicks in. Therefore, the concerta gives me about 4 to 5 hrs of effective coverage.

I’ve been referred to a psychiatrist who for four weeks hasn’t acknowledged whether she has received my referral. This is just for the assessment of course. If it remains up to the system, it will be another six to nine months after that until I can get into a psychiatrist that can treat me.

Has anyone else had a similar experience? I live in Toronto, (downtown), so if anyone here knows of a way to get the expensive assessment covered, and treated by the same specialist, let me know!

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