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ADHD Insights: 9 Videos on Medication Dosage

ADHD Med Measurements MattersSolved: Problems With ADHD Medication Dosage

The confusion with ADHD meds continues daily – and remains pervasive, globally. From cookie cutter solutions with med dosing strategies based on formulaic recipes, to complete denial of pervasive ADHD diagnostic and treatment ambiguities,  it’s often an ADHD medication mess out there.  Just pop that superficial ADHD label like a glass bottle on the fence, pick your weapon, and fire away. All or none, no measurements, just hit or miss.  Shooting from the hip is the current default standard of care. Think about it.

Help Me Provide Accuracy and Measurement Protocols

I’m next suggesting here an ethical bribe. I’ve spent hours putting together these videos, years trying to understand why ADHD meds don’t work predictably at times, and even more time collating them into a free, globally available playlist at YouTube. For ADHD medications precise dosage is the absolutely essential objective, the basic imperative, for effective ADHD treatment. In these 9 Dosing Videos, lasting about 30 min played in sequence, I outline most critical ADHD medication dosage first principles.

I’m asking you to simply “Like” these on your Facebook below, a small favor in return for these useful instructions.  Join others working with me to correct the nonsense of non-science.  I teach you the details, you help spread the word. I help you help others. Sounds like a deal! ;-) – Thanks!

For far more details see my New ADHD Medication Rules – Brain Science and Common Sense book, after this convenient start. See the many testimonial comments right here at CorePsych.

9 Short Videos: The ADHD Medication Dosing Playlist

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Thanks for watching and do please leave a comment below!

cp

17 Comments
  1. Hi Dr Parker,

    Thank you for your sound advice thus far, I have upped my dosage of Vyvanse to around about 90 MG in the AM, and it is working for me absolutely fine, I am definitely hitting the zone now and even if I take another at night say a 25-35mg dose in water if I have a bunch of work to do, it doesn’t lift my heart rate or anything, obviously keeping in mind my DOE which is 6 hours for me before I consider redo sing, but this is a truly wonderful medication that has very limited downsides at all. I will be the first to say if thee is better medication for ADHD i would be very surprised, this will truly be the wonder drug for adhd sufferers now and into the future once the word gets around. Surely the sales in the USA would be increasing now of this med even over Adderall and a alike. Is this true?

    Now my only comment and I need your advice on this and hopefully a solution, that’s a concern is I have lost a little or should I say around about 40% of my libido and this is starting to concern me, I’m wondering is it because I’m feeling good anyways and the need for release say sexual release isn’t what my body/mind requires as much anymore I mean at the end of the day sexual endorphins are created by the brain anyway which creates joy, happiness, pain relief etc., if this medication is kind of like having an orgasm all day (pardon the analogy)then perhaps that’s why its down, I know this is out there as a theory but I know you think outside the square as well.

    When I was taking the short acting Dexedrine in aus this wasn’t a problem, I mean in terms of my libido but this medication does and is far better than Dexedrine by a mile….your thoughts and or opinions would be appreciated and would say taking Viagra or Cialis interact with Vyvanse and created unwanted side effects, do you suggest a medication to help with this if Viagra or Cialis does interact badly?

    Your further advice is appreciated, your a wonderful cutting edge, think outside of the box type of doctor that we need more of in the world.

    Look forward to hearing from you.

    John C

    • John,
      No drug interaction w Cialis or Viagra. Yes, I do feel the very same way about Vyvanse after miles of travel with hundreds of folks.

      I do look at all these male or female libido/orgasm issues as metabolic in origin and would chase down any 1. Immune issue, 2. Trace element imbalance 3. Metabolic challenge … and might consider further chasing down specific hormone replacements.

      The Vyvanse combo is not a prob, if used w Dex as a short term evening med prn. Yes, doing well during the day can dissipate adrenal function and if mercurial in the first place can create a significant downstream libido problems.
      cp

  2. Dr Dr Parker,

    Thank you for your quick response and vital information about dosage and DOE of this wonderful product Venvanse. I have three options going forward based on your previous reply that I would appreciate your further consideration.

    1/ Taking my second dose of 50mg at noon like you suggested rather than 3-4pm in which I’ve been doing, my only concerns/query would be is it ok to overlay the dosage that early in the day? Meaning there will be a crossover of 3 hours from the initial am dose of 9:00am to when I take my second 50mg dose at midday?? Will that take me out and give me the jitters or as you say topping me outside of the therapeutic window zone that I’m wanting to achieve, my gut feeling it wont as its slow release and haven’t had any signs of side effects thus far but obviously wanting your opinion on this. I guess you wouldn’t of suggested it if that was the case.

    2/ Or is it better to take 2x 50g straight up in the am and would that be a concern at all considering you have patients who take 90mg in the am? It’s an extra 10mg to consider here or that isn’t an issue in your opinion?

    3/ Another strategy if you agree is to cut one of the 50mg into two and split it in half so essentially I’m taking 75mg and is there a downside to DOE by taking it as a powder mixed in water rather than encapsulated as it comes in the bottle. When I did that recently it kind of felt that it did limit the effects however it could of been down to a bunch of factors like not splitting enough of the capsule etc etc.

    3 options here which one would you suggest to go with first? Brazil only seems to stock 50mg bottles at this point that’s why I cant get 70mg at the moment as you suggested.

    Thank you in advance and btw do you offer appointments in the states as I’m Australian currently living in Brazil and they have limited supply of it here as its only being introduced recently it seems, Shire need to produce more of it here, there is a bottleneck in supply of it anyways in Brazil currently, we struggle to get the medication when required here on a regular basis, its like a treasure hunt sometimes.

    Australia do not have this medication there behind the times for sure all we have there is Dexedrine quick release 5mg and the others that to me make my condition worse like Ritalin Strattera etc.. We don’t even have Adderall in Australia??? These slow release are the way to go as you can exercise without worries and even drink coffee with out the having anxiety attacks etc, be it limited amounts of it of course.

    Look forward to hearing your thoughts on my 3 options and go forward from here outlined above on Venvanse and are you able to prescribe to patients who live outside of USA pending we have the correct medical report from my physiatrist in Australia just as a back up if I cant get the medication here in brazil from time to time?

    Looking forward again to your response. And thanks again for your support and advice.

    JC

    • John,
      We follow US rules on writing meds, and only write for meds if a person travels to this office in Va Beach, VA.

      We do offer appointments internationally for consultation, not to provide specific treatment. See our Services Page Here.

      On your options:
      1. I always, under the direction of your medical Dr, start with what I call the “Compliance Edge”- taking both in the AM and watching to see if the DOE is sufficient.
      2. Don’t ‘split’ the capsule – use this water dosage strategy linked here: Vyvanse Dosage. Other Dosage Measures here.
      3. Overlay is OK if taking it around noon, no different than taking both at the same time in the AM, but will give about 4 more hrs DOE in the PM.

      Best wishes,
      cp

  3. Dear Dr Parker,

    I really love your honestly in these video’s thank you very much. I love your style. I want to ask you a question relating to Vyvanse, and I think its a wonderful medication, I really do. To me its just slow release Dexedrine and Shire has done a really good job no doubt.

    However, one thing is that you talk about D.O.E and I feel that this product in no way shape or form last the 14 hours as they promote. For me 50mg lasts 6 hours max and they recommend only one a day.

    Correct me if I’m wrong but you do advocate dosing based on whatever works for you keeping in mind your own metabolism rate and therapeutic window and tolerance, I’ve been taking the 2nd 50g now at around that 6 hour mark and it seems that it’s working much better for me, however the downside although limited is that its not as effective as the morning dose, – just inquiring as to why this is? And any tips to help promote the effectiveness of that second dose?

    Would taking a more short active Dexedrine in the afternoon be more effective than the slow release Vyvanse, or perhaps a 70g morning and 50g in late afternoon or vice versa??? Don’t get me wrong this medicine is truly amazing just looking at maximizing my D.O.E. and any tips in this regard based on my tolerance etc as specified above.

    Thank you in advance and keep up your great work in the field of ADHD diagnosis and treatment, you’re at the cutting edge.

    JC

    • JC,
      Glad that Vyvanse made it to Australia for those suffering w ADHD down under! – And thanks for your kind remarks.

      My take on your issue:
      1. Shire doesn’t advocate for 12-14 hr, or else they would spell out more effectively how to dose Vyvanse. I’ve been reporting that it does work 12-14 hr for most adults, not all, when dialed in correctly and most effectively, paying attention to the DOE.
      2. Dosage strategies such as 50 mg 2X/day do work, but are a clear second choice. Often increasing the dose in the AM to match each person’s 12-14 hr objective is the useful first choice for Vyvanse dosage at that plan decreases the challenge of taking that second dose.
      3. A 50 mg 6 hr DOE from an AM dose is less than 1/2 the DOE. It would be reasonable to go up to 70 mg through your doc and you could expect about 4-6 hr more duration in the PM. At 6 hr DOE no need to worry about only a 10mg AM increase as you likely wouldn’t experience improvement.
      4. I have some patients on even 90 in the AM to cover the day, using the DOE guidelines above, and with that careful titration process achieve max DOE w/o having to go to the second dose.
      5. If you go to the 2X/day dosage, which we often do w college students based on prolonged evening work always stay in the 11-12 noon dose for the second dose as later in the day most often will effect sleep, and can carry a person into 2-3AM – another reason to work on AM dosing.
      6. Yes, an ‘as needed,’ short acting Dexedrine or Adderall will trim up the DOE for occasional late evenings w/o the problem of insomnia if given in the 4PM time range, again avoiding later dosing near 6PM to avoid insomnia.

      Good luck!
      cp

  4. Hello,
    I am a 30 year old single mom. I feel like my ADD, depression & anxiety will never be completely under control. It is a constant daily fight against my brain. I am a really nice, positive person on the outside but on the inside I feel like I’m going nuts. It’s so draining. I have tried a lot of different medications, & it seems like they are never strong enough then the effect wears off, & I have to go back to the specialist to figure out what to do next. I have a high tolerance for medications. It is the same way when I’m sick. I sometimes have to come twice to get a higher dosage for the same Illness. I also seem to get sick more easily than most people and have a weak immune system. I also as probably a side effect am losing sexual desire (to an extent) & even more so sexual feeling (I don’t feel it as much anymore). My mom thought maybe I also have a Hormonal Imbalance. Do you have any suggestions?
    Thank You!
    Julie

    • Julie,
      I’ll bet you know what I’m going to say because you have been on these videos… in word, it’s time for testing. Most folks at 30 look good, and far too often everyone thinks they are fine because they are looking good – but metabolism is the main next direction for inquiry thru IgG, TMA or Neurotransmitters. You can spend hundreds of bucks running around with guessing, and it sounds like you have a Roving Therapeutic Window We can provide those measures long distance if you wish to consider… just check out Services for the different options here at CorePsych.
      cp

  5. What you are doing is very important, just want to thank you for those videos.
    (By the way, nice picture!)
    Kevin

    • Dr Charles Parker

      Thanks Kevin, Picture on a sail off the coast near Boston with the family – that’s a replica of a coastal freight schooner from earlier times.
      cp

  6. Dear Dr.Parker,
    I just came across your site and listened to one of your broadcasts and I’m absolutely stunned by how technical ADD medication is. My psychiatrist never even mentioned any of the things you talk about like inflammation and all that.

    I wanted to ask you something.
    I have been on various antidepressants in the past (celexa,remeron,wellbutrin) and none worked for me.
    Now I’m supposed to be treated for ADD cause I have some symptoms.
    I just found out through a stool test that I have a dysbiosis in the colon. Too little of lactobacilla and Enterococci and and too many clostridia. Now I’m supposed to take capsules which contain good bacteria.

    My question is could this dysbiosis be the reason why no antidepressant worked? Remeron made me tired but nothing more than that.

    Also my GP wasn’t able to tell me what could cause the dysbiosis and if I should do any more tests. The reason why I demanded such a stool test in the first place is because I was also thinking about stuff like Leaky Gut or Celiac because I have skin inflammations which come and go and also some of my vitamins(D,zinc,B6,selenium) in the blood are low and I have no explanation for that either.

    DO you have any thoughts on this?

    Best regards,
    Eric

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