I am a Psychiatric Nurse Practitioner licensed since 2003. I started Adderall XR 20 mg in 2002 (at age 31 for ADHD, inattentive type) which was a significant factor in my ability to complete my training program. I love psychopharmacology and have a great appreciation for its complexity. I am not sure I will ever master it as I seem to learn something new constantly.

When I prescribe meds, I explain to patients that they should get a similar response with the generic that they do with the brand name but may very by the individual AND (possibly more importantly) their perception may have a significant impact on the response. I encourage patients not to decide on med choices based on what they hear from others and explain how important it is that they communicate and journal their own response. So… I tried to practice what I preach when switched to the generic Adderall XR. However, after changing from Adderall XR 30 mg brand name to gereric for the past several months, I started looking for feedback from others due to my poor response and decline in functioning. -With the brand name, within an hour of dosing, I am ready to go – focused, organized, with good energy. Taking my meds at 6:30 am, I seemed to do quite well until about 4:30. To combat the rebound, I would take a dextrostat 5mg about this time most days that got through making dinner, etc.. Since, taking the generic has been a whole different ball game. My sleep cycle is totally screwed up. I also take Wellbutrin XL 300mg and have for years but seemed to be getting more and more depressed. Within and hour of dosing, I have to go back to sleep and currently sleeping 12 + daily. It’s miserable. Usually about 4pm, I finally start waking up and have some energy but at 10pm, I am ready for bed.

I never expected such a drastic difference with the generic and thought surely something else was wrong. In November I went to see my PCP and found that my vitamin D was a little low but now normal, otherwise medically cleared. Last week, I started an extensive work up for rib pain that has been increasingly bothersome and ongoing since August. I explained that it starts during the night and terrible by the am but once I get up and move around, it’s not noticeable. Of course, he immediately started asking about my mattress. I felt like such an idiot going to him with this weird somatic complaint so I had been going through all kinds of scenarios and symptoms with my husband (a radiologist) knowing that the PCP would likely think I was a complete fruitcake. —I was floored to see the above complaints of chest, rib, and back pain. Now I am hoping to put off the KUB and chest CT I am scheduled for.

It is my understanding that manufactures of generics are only required to have 80% of the active compound (in the US). I also think that the “fillers” can effect the release of meds in the XR form. I have an appointment with my psychiatrist next week to discuss options. It doesn’t sound like increasing the generic will improve the response. I am wondering if I am getting significantly more of the active compound in the morning and being overmedicated then tapers to what I am used to in the afternoon. Also, I am wondering if the rib pain may be a rebound symptom since it starts at night and improves when I get up in the morning and move around (the same time I take my morning dose).

Sorry so lengthy but I would greatly appreciate your feedback.

When I called my insurance company, they told me that the generic version had not been approved by the FDA. A second pharmacy told me that the generic version had been approved. Searching the FDA database, I cannot find an approval for a generic version of Adderall XR for 20mg. Is there an approved version of generic Adderall XR for 20mg?