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Tips for tapering off Adderall

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Altostrata

AKA dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, amphetamine sulfate

 

As with other psychiatric drugs, regular use of Adderall -- of a month or more (but even less) -- can incur physiological dependence. It is also well-known as a drug that is truly addictive. In the US, it is a Schedule II controlled substance.

 

Whether you are taking any dosage of Adderall under the guidance of a doctor or not, abrupt discontinuation can result in withdrawal symptoms, some of them very serious see http://www.healthline.com/health/adhd/adderall-crash#Overview1 Do not suddenly stop taking Adderall.

 

To minimize the risk of withdrawal symptoms, we recommend a conservative taper of 10% from the previous dosage every few weeks. The amount of the decrease keeps getting smaller. Some people find they can go faster and some people find they have to go slower -- they can only tolerate decreases of a fraction of a milligram at a time. See Why taper by 10% of my dosage?

 

Adderall comes in immediate-release tablets and Adderall XR extended-release capsules. According to the FDA (pdf)

Quote

 

Both ADDERALL (immediate-release) tablets and ADDERALL XR capsules contain d-amphetamine and l-amphetamine salts in the ratio of 3:1. Following administration of ADDERALL (immediate-release), the peak plasma concentrations occurred in about 3 hours for both d-amphetamine and l-amphetamine. The time to reach maximum plasma concentration (Tmax) for ADDERALL XR is about 7 hours, which is about 4 hours longer compared to ADDERALL (immediate-release).


 

 

Using regular Adderal tablets to taper

According to http://www.drugs.com/pro/adderall.html, regular Adderall (brand or generic), taken once or twice daily, is available in scored tablets of

  • 5 mg
  • 7.5 mg
  • 10 mg
  • 12.5 mg
  • 15 mg
  • 20 mg
  • 30 mg

The scoring indicates the tablets can be split, which can aid tapering. For example, depending on your total daily dosage, you might get part of your prescription as 5mg or 7.5mg tablets and cut them in quarters to taper by 1.25mg or 1.875mg, respectively.

 

Use a digital scale to weigh tablet fragments
To control your dosage more exactly, you may wish to weigh tablet fragments, see Using a digital scale to measure doses

 

Using a liquid to taper: Pharmacy compounding

At a very low dose of Adderall, if you are sensitive to dosage reductions, you may wish to request a prescription for a liquid from a compounding pharmacy. This will enable tapering by a fraction of a milligram.
 

Using a liquid to taper: Make your own liquid

It is possible to make a liquid with Adderal tablets (not Adderal XR capsules), see

 

http://www.medscape.com/viewarticle/406993

Quote

Am J Health Syst Pharm. 2001;58(15)

Stability of Adderall in Extemporaneously Compounded Oral Liquids
Jack Justice, Thomas C. Kupiec, Parrish Matthews, and Pat Cardona

 

The short-term stability of Adderall in three extemporaneously compounded oral liquids was studied.

Three suspensions of Adderall 1 mg/Mc were prepared from commercially available 10-mg Adderall tablets with Ora-Sweet,Ora-Plus, and a 1:1 mixture of Ora-Sweet and Ora-Plus. Each suspension was stored in the dark in a stability chamber at 25 °C and 60% relative humidity for 30 days. The stability of the active drug (a mixture of levoamphetamine and dextroamphetamine salts) in each of the three vehicles was determined immediately after preparation and at 10, 20, and 30 days by using gas chromatography-mass spectrometry(GCMS).

 

No significant changes in concentrations of either amphetamine isomer occurred during the 30-day study period. Visual inspection of samples revealed no changes in color or odor.

 

Extemporaneously compounded liquid oral formulations of Adderall 1 mg/Mc in Ora-Sweet, Ora-Plus, or a 1:1 mixture of Ora-Sweet and Ora-Plus were stable for at least 30 days at 25 °C and 60% relative humidity....No detectable changes in color or odor were observed, nor was microbial growth observed in any samples....

 

[Compounding method used]

  1. Count out 10 10-mg Adderall tablets.

  2. Levigate the 10 tablets in a glass or ceramic mortar to produce a fine powder.

  3. Add approximately 20 Ml of Ora-Sweet to the powder, triturate well, and transfer the contents to a 4-oz, child-resistant, glass prescription bottle.

  4. Rinse the mortar with about 20 Ml of the mixture and transfer the contents to the amber glass bottle.

  5. Repeat step 4 as necessary with enough syrup mixture to bring the final volume to 100 Ml.

  6. Label the bottle "Shake Well Before Using."

  7. Label the bottle with an expiration date of 30 days.

 

 

Rather than making 100mL of liquid, you may wish to make less, for example 30mL liquid with 3 10mg tablets. Make calculations based on your present dosage and how much you would use in 30 days while tapering.

 

Also see

Pharmaceutical liquids to make suspensions

 

Anecdotal reports on the Web indicate you could make your own suspension with water rather than the pharmaceutical liquid. See http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

Tapering Adderal XR capsules

According to http://www.drugs.com/pro/adderall-xr.html, Adderall XR (brand or generic), taken once daily in the morning (to avoid insomnia), is available in capsules of

  • 5 mg
  • 10 mg
  • 15 mg
  • 20 mg
  • 25 mg
  • 30 mg
Quote
Adderall XR capsules may be taken whole, or the capsule may be opened and the entire contents sprinkled on applesauce. If the patient is using the sprinkle administration method, the sprinkled applesauce should be consumed immediately; it should not be stored. Patients should take the applesauce with sprinkled beads in its entirety without chewing. The dose of a single capsule should not be divided.

 

Among other inactive ingredients, the capsules contain "sugar spheres", indicating that not all the beads in a capsule contain an active ingredient.

 

One possibility is opening the capsules and weighing the contents to taper -- put the beads in applesauce or in an empty gelatin capsule to take the reduced dosage. See Using a digital scale to measure doses

 

Otherwise, convert your daily dosage in part or in whole to regular Adderall and taper with the tablets. If you are replacing your entire daily dosage of Adderall XR with regular Adderall, you probably will need to take regular Adderall twice a day.

 

Using a combination of tablets or capsules and liquid

Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.

 

If your doctor prescribes compounded liquid and tablets or capsules at the same time, most likely he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.

Edited by Altostrata
updated

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