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I've heard it argued that ADHD diagnoses should come with a social worker. Every time I realize it's Friday and I'm gonna run out of medication because I forgo

I've heard it argued that ADHD diagnoses should come with a social worker. Every time I realize it's Friday and I'm gonna run out of medication because I forgot to call in the refill I think about that. Three day weekends are the worst. One workaround I've heard is that you order every 30 days even if you forgot to take your pills one or two times. Any surplus pills go into an old bottle you hide in the back of a drawer. You only ever withdraw when you've fucked up your re-order.

pesus 1y ago
I'm of course not recommending or condoning this, but with instant release it's definitely possible to also get a higher dosage than you actually need and cut the pills up to take the lower dosage you need, and stash the rest to build up a surplus. Or so I've heard.
- lazide 1y ago
  And yet, the exact same song and dance is required for extended release and prodrugs like Vyvanse.
- hinkley 1y ago
  The extended release means you only have to remember to take the medication once a day instead of twice. What we need is for these pills to be compounded the way they do opioids: the wax granules are arranged to attempt to keep you from getting a burst dose by crushing the pills. The same process that makes crushing work makes splitting not work. So if you make split pills still time release, no problem. But not for saving pills. Some people are exquisitely sensitive to these medications and you need 25mg per day but it only comes in multiples of 10 up to 50. So you’d like to split a 50 and take 1/2 pill per day. Also the 40mg often costs only 30-40% more than the 20.
  - impure-aqua 1y ago
    Vyvanse is biochemically rate-limited rather than mechanically, so it is ideal for this; there is not really an alteration to the absorption properties no matter what you do.
  - xlii 1y ago
    One thing to keep in mind that methylphenidate is contextual and metabolic related. Hard focus work could make it work shorter, but also some have metabolism so quick that they burn through medication. That's controlled by doctors so no worries, but I know people who take IR forms every 2 hours, and for those XR forms don't work at all (as it's like 2 complete cycles with all side effects).
- hsod 1y ago
  When I was taking ADHD stimulants I had my core dose (long release) and then a “top-up” dose (5mg instant release) every month. The guy who prescribed me initially may have been a bit of a quack (I had to leave him because my insurance dropped him) but when I switched to a super mainstream doctor she had no problem continuing it.
- pas 1y ago
  you can open the XR/LR capsules too, there's just a bunch of small "grains" inside, with different coatings, and thus they get digested at different rates, and basically it's like eating one instant release and one ~4 hour release capsule. (though there are fancy ones that have ~3 peaks, etc.) you can simply measure the grains with a scale and separate some fraction.
baby_souffle 1y ago
> I've heard it argued that ADHD diagnoses should come with a social worker. I know a few people with crippling ADHD that have managed to hire a "life coach" of sorts to help. Takes a bit of screening to find somebody that knows ADHD and how to help with it versus the more generic/useless skills you probably first thought of when you read 'life coach' :). > Every time I realize it's Friday and I'm gonna run out of medication because I forgot to call in the refill I think about that. We all have to develop our own coping / survival tools and I'm sure you've heard "put it in your calendar" before. I've had really good luck with an electronic pill dispenser. They can get pricey but for ~ $100 you can get a device that'll keep track of 30 doses and even push alerts to your phone if you've missed a scheduled dose or are down to your last few. You can also DIY; micro controllers and eInk display panels are _cheap_ now. My current iteration is wired into my Home Automation system and that affords me several opportunities to nudge me towards medication when i'd have otherwise forgotten. > One workaround I've heard is that you order every 30 days even if you forgot to take your pills one or two times. Any surplus pills go into an old bottle you hide in the back of a drawer. You only ever withdraw when you've fucked up your re-order. Yep. +1 for this. The first prescribing psych that I had clued me into this. They explicitly asked me if I wanted a bump to my Rx for the month so I could start building a buffer. I was clueless but it was explained to me that there's a bunch of timers and rules around how/when you can re-fill and you might not always have a continuous supply unless you take matters into your own hands. Years later, I now live in an area where fire season is almost year-round and you can bet that I have ~ 2 weeks supply stashed away in my "go bag".
- saaaaaam 1y ago
  Can you share a link to that pill dispenser that pushes alerts to your phone please?
  - bookofjoe 1y ago
    https://www.amazon.com/Organizer-Bluetooth-Portable-Medicines-Supplements/dp/B0C8J16LW4/ref=sr_1_9?crid=3J7K3GLPNTL5T&dib=eyJ2IjoiMSJ9.2SlaFJzNrX4gTvq-fJawyS91V_-O_JaxFd2IJG8ltDoMSeXbyOKW4g6-Fh0_jshbO4r0x73mLQcItKc9nWC8KJ_mAOFZTsMlpmJ2o12X9BGUhyF-Yt0AhtVQiMNFMIx0Ad1augMjC2HcIivptURyn5hEtasjQb4Dpb_Dn2xj02M-FAmogZzCpHXmcWaSDG7xkiHFZk7gg2LQFrTqQ1c_piP4IZuAMxpSbB20WnaPe8P4gyQGvJLSIiayfFbISXja1szMbEGENaqegNcMbpYv1ilzPy2U9Za1vuc6FqpeJq0.bxFfc2WTbXAeMhDyRwo7F0VZfyYZ0nNrXKn6Jo9qeHw&dib_tag=se&keywords=pill%2Bdispenser%2Bwifi&qid=1755517977&s=hpc&sprefix=pill%2Bdispenser%2Bwifi%2Chpc%2C113&sr=1-9&th=1 https://www.amazon.com/Organizer-Bluetooth-Portable-Medicine... https://www.amazon.com/EziMedPil-Bluetooth-Dispenser-Medication-Prescriptions/dp/B099DM645J/ref=sr_1_13?crid=3J7K3GLPNTL5T&dib=eyJ2IjoiMSJ9.2SlaFJzNrX4gTvq-fJawyS91V_-O_JaxFd2IJG8ltDoMSeXbyOKW4g6-Fh0_jshbO4r0x73mLQcItKc9nWC8KJ_mAOFZTsMlpmJ2o12X9BGUhyF-Yt0AhtVQiMNFMIx0Ad1augMjC2HcIivptURyn5hEtasjQb4Dpb_Dn2xj02M-FAmogZzCpHXmcWaSDG7xkiHFZk7gg2LQFrTqQ1c_piP4IZuAMxpSbB20WnaPe8P4gyQGvJLSIiayfFbISXja1szMbEGENaqegNcMbpYv1ilzPy2U9Za1vuc6FqpeJq0.bxFfc2WTbXAeMhDyRwo7F0VZfyYZ0nNrXKn6Jo9qeHw&dib_tag=se&keywords=pill+dispenser+wifi&qid=1755518043&s=hpc&sprefix=pill+dispenser+wifi%2Chpc%2C113&sr=1-13 https://www.amazon.com/EziMedPil-Bluetooth-Dispenser-Medicat...
eep_social 1y ago
this is also standard practice with insulin for diabetics. though the regulations are less onerous the risk of running out is a bit worse so the incentives end up about the same.

pesus 1y ago

I'm of course not recommending or condoning this, but with instant release it's definitely possible to also get a higher dosage than you actually need and cut the pills up to take the lower dosage you need, and stash the rest to build up a surplus. Or so I've heard.

lazide 1y ago
And yet, the exact same song and dance is required for extended release and prodrugs like Vyvanse.
hinkley 1y ago
The extended release means you only have to remember to take the medication once a day instead of twice. What we need is for these pills to be compounded the way they do opioids: the wax granules are arranged to attempt to keep you from getting a burst dose by crushing the pills. The same process that makes crushing work makes splitting not work. So if you make split pills still time release, no problem. But not for saving pills. Some people are exquisitely sensitive to these medications and you need 25mg per day but it only comes in multiples of 10 up to 50. So you’d like to split a 50 and take 1/2 pill per day. Also the 40mg often costs only 30-40% more than the 20.
- impure-aqua 1y ago
  Vyvanse is biochemically rate-limited rather than mechanically, so it is ideal for this; there is not really an alteration to the absorption properties no matter what you do.
- xlii 1y ago
  One thing to keep in mind that methylphenidate is contextual and metabolic related. Hard focus work could make it work shorter, but also some have metabolism so quick that they burn through medication. That's controlled by doctors so no worries, but I know people who take IR forms every 2 hours, and for those XR forms don't work at all (as it's like 2 complete cycles with all side effects).
hsod 1y ago
When I was taking ADHD stimulants I had my core dose (long release) and then a “top-up” dose (5mg instant release) every month. The guy who prescribed me initially may have been a bit of a quack (I had to leave him because my insurance dropped him) but when I switched to a super mainstream doctor she had no problem continuing it.
pas 1y ago
you can open the XR/LR capsules too, there's just a bunch of small "grains" inside, with different coatings, and thus they get digested at different rates, and basically it's like eating one instant release and one ~4 hour release capsule. (though there are fancy ones that have ~3 peaks, etc.) you can simply measure the grains with a scale and separate some fraction.

baby_souffle 1y ago

> I've heard it argued that ADHD diagnoses should come with a social worker. I know a few people with crippling ADHD that have managed to hire a "life coach" of sorts to help. Takes a bit of screening to find somebody that knows ADHD and how to help with it versus the more generic/useless skills you probably first thought of when you read 'life coach' :). > Every time I realize it's Friday and I'm gonna run out of medication because I forgot to call in the refill I think about that. We all have to develop our own coping / survival tools and I'm sure you've heard "put it in your calendar" before. I've had really good luck with an electronic pill dispenser. They can get pricey but for ~ $100 you can get a device that'll keep track of 30 doses and even push alerts to your phone if you've missed a scheduled dose or are down to your last few. You can also DIY; micro controllers and eInk display panels are _cheap_ now. My current iteration is wired into my Home Automation system and that affords me several opportunities to nudge me towards medication when i'd have otherwise forgotten. > One workaround I've heard is that you order every 30 days even if you forgot to take your pills one or two times. Any surplus pills go into an old bottle you hide in the back of a drawer. You only ever withdraw when you've fucked up your re-order. Yep. +1 for this. The first prescribing psych that I had clued me into this. They explicitly asked me if I wanted a bump to my Rx for the month so I could start building a buffer. I was clueless but it was explained to me that there's a bunch of timers and rules around how/when you can re-fill and you might not always have a continuous supply unless you take matters into your own hands. Years later, I now live in an area where fire season is almost year-round and you can bet that I have ~ 2 weeks supply stashed away in my "go bag".

saaaaaam 1y ago
Can you share a link to that pill dispenser that pushes alerts to your phone please?
- bookofjoe 1y ago
  https://www.amazon.com/Organizer-Bluetooth-Portable-Medicines-Supplements/dp/B0C8J16LW4/ref=sr_1_9?crid=3J7K3GLPNTL5T&dib=eyJ2IjoiMSJ9.2SlaFJzNrX4gTvq-fJawyS91V_-O_JaxFd2IJG8ltDoMSeXbyOKW4g6-Fh0_jshbO4r0x73mLQcItKc9nWC8KJ_mAOFZTsMlpmJ2o12X9BGUhyF-Yt0AhtVQiMNFMIx0Ad1augMjC2HcIivptURyn5hEtasjQb4Dpb_Dn2xj02M-FAmogZzCpHXmcWaSDG7xkiHFZk7gg2LQFrTqQ1c_piP4IZuAMxpSbB20WnaPe8P4gyQGvJLSIiayfFbISXja1szMbEGENaqegNcMbpYv1ilzPy2U9Za1vuc6FqpeJq0.bxFfc2WTbXAeMhDyRwo7F0VZfyYZ0nNrXKn6Jo9qeHw&dib_tag=se&keywords=pill%2Bdispenser%2Bwifi&qid=1755517977&s=hpc&sprefix=pill%2Bdispenser%2Bwifi%2Chpc%2C113&sr=1-9&th=1 https://www.amazon.com/Organizer-Bluetooth-Portable-Medicine... https://www.amazon.com/EziMedPil-Bluetooth-Dispenser-Medication-Prescriptions/dp/B099DM645J/ref=sr_1_13?crid=3J7K3GLPNTL5T&dib=eyJ2IjoiMSJ9.2SlaFJzNrX4gTvq-fJawyS91V_-O_JaxFd2IJG8ltDoMSeXbyOKW4g6-Fh0_jshbO4r0x73mLQcItKc9nWC8KJ_mAOFZTsMlpmJ2o12X9BGUhyF-Yt0AhtVQiMNFMIx0Ad1augMjC2HcIivptURyn5hEtasjQb4Dpb_Dn2xj02M-FAmogZzCpHXmcWaSDG7xkiHFZk7gg2LQFrTqQ1c_piP4IZuAMxpSbB20WnaPe8P4gyQGvJLSIiayfFbISXja1szMbEGENaqegNcMbpYv1ilzPy2U9Za1vuc6FqpeJq0.bxFfc2WTbXAeMhDyRwo7F0VZfyYZ0nNrXKn6Jo9qeHw&dib_tag=se&keywords=pill+dispenser+wifi&qid=1755518043&s=hpc&sprefix=pill+dispenser+wifi%2Chpc%2C113&sr=1-13 https://www.amazon.com/EziMedPil-Bluetooth-Dispenser-Medicat...

eep_social 1y ago

this is also standard practice with insulin for diabetics. though the regulations are less onerous the risk of running out is a bit worse so the incentives end up about the same.