High Dose Stimulants
September 14, 2024
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Dr John Kruse Episodes Around September 14, 2024
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40:32Now PlayingHigh Dose Stimulants
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Many patients feel rebuffed by doctors who "won't prescribe a high dose" of stimulant medication. The popular media is rife with claims of how dangerous stimulants are at high doses. One study released earlier this year was widely interpreted as saying that high doses of stimulants don't offer any benefits beyond standard doses.
But we should be treating humans, not statistical averages. Stimulant dosage should be adjusted to maximize symptom reduction, while minimizing side effects. All patients should be warned about, and help monitor for the appearance of adverse effects, including agitation, insomnia, tremors, decreased appetite, anxiety, addiction, cardiac effects, and psychosis.
Research supports that for a number of reasons, not all individuals will respond to a standard range of doses - some need much less, and some considerably more. Rather than worrying about how many milligram of Adderall someone takes, we should be noting whether it helps, and whether it is causing them any problems.
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Free link to my Medium Article on High Dose Stimulants:
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References:
Treatment Outcomes With Licensed and Unlicensed Stimulant Doses for Adults With Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis (2024)
The effects of stimulant dose and dosing strategy on treatment outcomes in attention-deficit/hyperactivity disorder in children and adolescents: a meta-analysis (2022, Bloch)
Risks of High-Dose Stimulants in the Treatment of Disorders of Excessive Somnolence: A Case-Control Study (2005)
High dose methylphenidate treatment in adult attention deficit hyperactivity disorder: a case report (2012)
Full Chapter list:
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Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, well-researched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions.
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