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The Medical Thread: We're experts on everything else; why not?

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  • dxmnkd316
    replied
    Originally posted by tyrone View Post
    I can relate to the struggle of finding the right dosage and formulation that works for you. It’s great that your PCP is looking for a better option with the Vyvanse. The OROS mechanism is interesting; I agree it’s a solid approach for extended release.
    Of course you struggle. Methylphenidate is metabolized in the liver. You don't have one.

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  • tyrone
    replied
    I can relate to the struggle of finding the right dosage and formulation that works for you. It’s great that your PCP is looking for a better option with the Vyvanse. The OROS mechanism is interesting; I agree it’s a solid approach for extended release. If you're considering alternatives or supplements to support your focus, Canadian Pharmacy has a range of options that might help you manage your symptoms more effectively.
    Last edited by tyrone; 10-30-2024, 07:40 AM.

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  • dxmnkd316
    replied
    Originally posted by St. Clown View Post
    I was just switched over to the 40mg Vyvanse after my last visit with my PCP. The 25mg extended release Adderall was metabolizing too quickly, so he’s changing up the method of extending the release. Playing the guessing games with meds is fun…
    The OROS and OROS-like mechanisms are the gold standard in my book for any kind of ER med. It's the only one that doesn't entirely rely on how fast a tablet dissolves.

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  • Deutsche Gopher Fan
    replied
    Originally posted by psych View Post

    A common occurrence for psych meds.
    My list so far is all opiates, muscle relaxers, Xanax, Valium, adderall and apparently now spironalactone as I had to be bumped up to the maximum daily dosage

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  • psych
    replied
    Originally posted by St. Clown View Post
    I was just switched over to the 40mg Vyvanse after my last visit with my PCP. The 25mg extended release Adderall was metabolizing too quickly, so he’s changing up the method of extending the release. Playing the guessing games with meds is fun…
    A common occurrence for psych meds.

    Leave a comment:


  • St. Clown
    replied
    I was just switched over to the 40mg Vyvanse after my last visit with my PCP. The 25mg extended release Adderall was metabolizing too quickly, so he’s changing up the method of extending the release. Playing the guessing games with meds is fun…

    Leave a comment:


  • Deutsche Gopher Fan
    replied
    60mg of adderall didn’t do a thing so now we’re trying a high dose of Ritalin

    doc thinks enzyme tests can be inaccurate but the pharmacist today said she has same issue and got a test done at her pcp and found out which enzyme she’s missing, and can proactively avoid drugs that will be an issue

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  • dxmnkd316
    replied
    I think my favorite example of people needing different levels of a drug is the (relatively) recent discovery that redheads need more anesthetic than people with other hair colors.

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  • Deutsche Gopher Fan
    replied
    Cool, thanks! Good to know this may not be that uncommon.

    my worry has always been telling a doctor that I need a stronger dose or different med and sounding like a junkie who has built up a tolerance. But I really don’t even drink so I think this Dr in particular will understand

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  • WisconsinWildcard
    replied
    Originally posted by Deutsche Gopher Fan View Post
    Question for a doc

    is there a name for a metabolizing issue, where certain drugs are metabolized too quickly in the liver and therefore ineffective?

    I’ve had the following pills prescribed to me over my life for brief ailments and none of them worked. I mean- felt like a sugar pill.

    codeine
    OxyContin (wasn’t prescribed this but my other half had surgery so I popped one for fun)
    muscle relaxers
    Valium
    Vicodin
    adderall

    so my doc told me to up adderal dosage to 20mg twice a day. A cousin tells me he has same issue and needed way more

    I don’t take pills for fun, I have no tolerance built to anything. I’m wondering if this issue is why my alcoholic grandfather was able to live until mid 80s despite starting screwdrivers at 530am for 50 years
    I am not sure there is an all encompassing name, however it is well known that people metabolize drugs at different rates. It likely explains why some people have severe side effects from the same medications that do not touch other people. The field is pharmacogenomics and there is some testing available. I think the most validated medications are psychiatric (antidepressants) but it is expanding and I expect it will be fairly routine testing in the future, especially with multiple failed drug trials.

    For now, most of the medicine we practice is in the stone age, where we try a drug, that doesn't work, and we then try another. It is frustrating for patient and doctor but unfortunately that is where the state of the field is a lot of the time. I do not utilize pharmacogenomics often as it is not covered by insurance and I only have a few medications to treat the things I see, but I am hopeful that changes in the future.

    I am not a PCP, but when I do start an antidepressant, I ask if family members have taken any and had good/bad responses as a quick/dirty way to try to increase my rate of success with the first med.

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  • Deutsche Gopher Fan
    replied
    Question for a doc

    is there a name for a metabolizing issue, where certain drugs are metabolized too quickly in the liver and therefore ineffective?

    I’ve had the following pills prescribed to me over my life for brief ailments and none of them worked. I mean- felt like a sugar pill.

    codeine
    OxyContin (wasn’t prescribed this but my other half had surgery so I popped one for fun)
    muscle relaxers
    Valium
    Vicodin
    adderall

    so my doc told me to up adderal dosage to 20mg twice a day. A cousin tells me he has same issue and needed way more

    I don’t take pills for fun, I have no tolerance built to anything. I’m wondering if this issue is why my alcoholic grandfather was able to live until mid 80s despite starting screwdrivers at 530am for 50 years

    Leave a comment:


  • dxmnkd316
    replied
    Well it was just a cold. Pretty minor too.

    Leave a comment:


  • alicestevens
    replied
    Originally posted by dxmnkd316 View Post
    Well, I hope to stay out of the other thread but I'm getting sick and I hate it. This is either my first or second cold (plus one Covid like 1.5 years ago) since November 2019 and I'm reminded how much I hate it.
    Are you vaccinated? Two times in five years sounds pretty reasonable, actually. Staying on top of vaccinations is important for maintaining good health. If you're looking for more tips on how to stay fit and healthy, you can always send ro email for some expert advice. They often have great resources and recommendations to help you with your wellness journey. P.S. I hope you feel better soon! Taking care of yourself is key, and I’m rooting for your speedy recovery!
    Last edited by alicestevens; 10-19-2024, 03:29 PM.

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  • joecct
    replied
    Originally posted by Swansong View Post
    In addition to the potassium suggestion, are you drinking enough water? You old folks simply refuse to, for some absurd reason, so that's my first thought.



    Remember, though, that I am a highly untrained non-clinical person and my advice isn't ever good.
    But you stay at a Holiday Inn Express, right?

    Leave a comment:


  • dxmnkd316
    replied
    Well, I hope to stay out of the other thread but I'm getting sick and I hate it. This is either my first or second cold (plus one Covid like 1.5 years ago) since November 2019 and I'm reminded how much I hate it.

    Leave a comment:

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