Took a little too much Adderall. Advice on staying calm and comfortable?

October 17, 2011 10:40 AM

This morning, I accidentally took too much of my (legally prescribed) Adderall — 40mg rather than 20. This is still a fairly low dose and I'm not worried about health consequences, but I sure do feel like flaming dogshit. Suggestions?

If I'm an idiot and should be in the ER right now, I trust that y'all will cheerfully call me out on my mistake. But assuming that's not the case... well, I've got the predictable side effects: headache, tense muscles, cottonmouth and the world's worst case of nerves. Advice on staying calm and comfortable (and not acting like a total raving speed freak at work) would be much appreciated.

posted by nebulawindphone to Health & Fitness (28 answers total)

Do not speak unless spoken to. Do not send any emails; they can wait until later or tomorrow. Somewhere nearer the end of the day, tell whomever you need to tell that you are feeling under the weather and are going home early to get into bed.

Your ally here is time. And, although I have no idea if it will help, I would drink lots of water to stay hydrated.
posted by JohnnyGunn at 10:46 AM on October 17, 2011 [8 favorites]

Call your pharmacist and ask them what they would recommend you do.
posted by TheBones at 10:47 AM on October 17, 2011 [6 favorites]

I bet you already thought of this, but just in case: don't have any coffee or soda. No caffeine for you today!
posted by BlahLaLa at 10:50 AM on October 17, 2011 [3 favorites]

This happened to someone I know. Stay hydrated and have some food.
posted by infinitewindow at 10:50 AM on October 17, 2011

If you're in Austin and you took it this morning and you're cognizant enough to have not freaked out everyone at work and typed this up, you'll be fine. Don't drink any coffee, soda or anything else with caffeine (that includes many teas.) Stay away from sugar. Drink lots of cold water. Eat something. If you start getting the panics, retire to a bathroom stall (or somewhere else private) with something to distract you until you can get it together again. If you're a smoker, smoke enough to quell the urge and that's it.

I am not a doctor or a pharmacist. This is not medical advice.
posted by griphus at 10:52 AM on October 17, 2011 [2 favorites]

(Oh, and you might feel like a bag of shit tomorrow so heads up.)
posted by griphus at 10:53 AM on October 17, 2011

Drink a lot of water. Eat regularly. Take little mini-breaks where you just close your eyes, breathe slowly in and out and let your mind wander. Even if you have to go to the bathroom to do it.
posted by canine epigram at 10:54 AM on October 17, 2011

Oh man. I've done this with adderall. It's kind of a scary feeling. First, call your doctor to just give him/her a heads up and see if there is anything you should consider. Do not go to the ER unless directed. (I am not a doctor, what follows is not medical advice!)

Water. Drink lots of water. No coffee. No beer tonight. No alcohol.

Eat something. You probably don't feel like eating something. But do. Oatmeal with a banana. Something relatively substantial. Even a granola bar is better than the nothing you feel like eating.

Sit still unless you have someplace to go. Alternately, take a walk to get yourself some fresh air and expend some of this focus. Take a bottle of water on your walk.

Call someone you trust to listen to you for a minute, because that will get some of your....blerg out. Trying to keep it bottled in did no good for me, because at the end of the day I was an even bigger wreck.

If there is any place you can go to sneak a nap, do that.
posted by bilabial at 10:55 AM on October 17, 2011 [2 favorites]

Not medical advice, but try the 4-7-8 breathing exercise at regular intervals today to relieve tension.
posted by susanvance at 11:01 AM on October 17, 2011

You'll be fine in 4 hours. Drink water. You're not incapable or operating motor vehicles or writing emails. You may just write the longest, most intricately correct emails.
posted by wrok at 11:01 AM on October 17, 2011

Drink lots of water, and find something fun to focus on for a while.
posted by LZel at 11:03 AM on October 17, 2011

I would call your doctor and ask his advice. There are details about your medical history that we don't know and could potentially affect you.
posted by DoubleLune at 11:04 AM on October 17, 2011

If you can afford the sick day, just be honest with your boss and go home. I once had a bad reaction to a (legally prescribed) painkiller for a toothache and going home was the best possible choice.
posted by PhoBWanKenobi at 11:10 AM on October 17, 2011

Call your pharmacist and ask them what they would recommend you do.

Ignore most advice except for this right here.
posted by Cool Papa Bell at 11:21 AM on October 17, 2011

You're fine. 40 mg really isn't that that much adderall. if it's not time release you'll be fine in about 4-5 hours. You'll be very thirsty and get tons of work done.
posted by twoforty5am at 11:23 AM on October 17, 2011

Nthing, calling the pharmacist. I wouldn't be too concerned, I've taken that dose (illegally) and staying hydrated and eating (even if you don't feel like it) can help out manage the effects. Seeing as your body is use to adderall to some degree, it probably isn't too bad. As I've learned with adderall and its various chemical cousins is that staying away from caffeine is a good idea.

While drinking probably isn't the best idea, it isn't the worst. If you are a cannabis user, it will certainly mediate some of the extra effects.

I am not a doctor, not a pharmacist, just some guy on the internet who lives better through chemistry.
posted by handbanana at 11:32 AM on October 17, 2011

Response by poster: You'll be fine in 4 hours. Drink water.

Extended release — so more like 8, I think, but yeah.

Call your doctor/pharmacist/rabbi/whatever...

Thanks for the nudge. I called the nurse line at my insurance company, which is my usual go-to for this sort of thing. They confirmed that it's not an emergency unless I start feeling more drastically awful, and told me to stay hydrated.

While drinking probably isn't the best idea, it isn't the worst. If you are a cannabis user, it will certainly mediate some of the extra effects.

I don't smoke pot, and I've found Adderall makes my alcohol tolerance much lower, so I'm steering clear of that.

You may just write the longest, most intricately correct emails.

How about pedantic point-by-point replies on AskMe? Do those count?
posted by nebulawindphone at 12:22 PM on October 17, 2011 [4 favorites]

On the positive side - this may be your opportunity to put on some headphones and some kind of drone-y music and write whatever comes into your head.
posted by RandlePatrickMcMurphy at 12:41 PM on October 17, 2011

Thanks for the follow up, glad everything is well!
posted by handbanana at 1:29 PM on October 17, 2011

Calling the nurse was the right thing to do. Now here's some more advice to get through today.

I take Adderall, not the extended release, and I'm a woman, and my dose is 20 mg twice a day. With my normal dose, I'm not hyper; I drink caffeine all day long and I'm still not running around like a hamster in a wheel, just more focused and productive. I have a really slow metabolism, so honestly the Adderall barely affects me more than helping me get up and get moving in the morning and not crash in the afternoon (I could probably take a higher dose, but I'm very mindful of how addictive it can be, and you can always add more, so I try to keep the dose low).

BUT my doses have sometimes overlapped by mistake or poor planning. So I'm familiar with the nasty cotton mouth, and I also find myself, I'm not sure how to explain this, but having nervous tics like sucking in my cheeks, clenching my jaw, stuff like that. So, the headaches could be from clenching your jaw and tensing those muscles.

I find chewing sugar-free gum helps to get rid of that cotton mouth, and from clenching that jaw.

Now, let's talk about what happens when the Adderall wears off.

I know the docs say it only lasts 4 hours (or 8 hours for the extended release), but I have found that if I miss a does, I'll actually be fine on that initial dose for about 8 hours (and remember, I am NOT on the extended dose), and then crash. Most of the time, the crash just means feeling really, really tired, but sometimes I get super-emotional: teary and anxious. That could just be my slow metabolism, but I wanted to warn you about that.

So be aware that this evening, you may have trouble sleeping even though more than 8 hours have passed by, and THEN, when the meds wear off, you might crash.

You'll just suddenly feel like collapsing into a puddle on the floor, or falling into bed without so much as undressing, and it hits you pretty hard.

If you suddenly feel overwhelmed or panicky, talk yourself down and remind yourself it's just the crash from the Adderall messing with you, okay?
posted by misha at 1:48 PM on October 17, 2011

Draw :)
posted by lain at 1:52 PM on October 17, 2011

Take a long walk. It will help your body metabolize the extra meds.
posted by theora55 at 3:32 PM on October 17, 2011

To specify on the eating, eat protein.
This will 'slow you down a bit' (and keep glucose levels normal. No spikes! No lows!)

If you get twitchy, set a timer for a few minutes at a time, and find somewhere you can lie down, with something over your eyes, and chill out. You are *practicing* chilling out, and relaxing muscles, so you don't hype yourself up too much.
I have little relaxation tracks on my phone, to listen to. (I also know of a massage place around the corner that does 15 min massages! Probably not immediately useful to you, but good example of things to keep aware of).
Sometimes if I'm a bit hyped, I go wash my face with cool water, dry off, and re-tye hair back. It gives a slight re-boot, fresh start feeling.

Keep aware of your temperature. You might get a bit hot, and alternatively, not notice when you've taken off too many layers and are getting too cool.

An ibuprofen for headache. And chewing gum is actually a pretty good idea!

And yeah, you'll be fine.
posted by Elysum at 4:23 PM on October 17, 2011

I would personally not put any more drugs into my body while dealing with this. Eat healthy meals, plenty of water, no booze.

What I would need to do is try to remain chill today, but prepare to take tomorrow off of work. Because I will almost for sure not sleep that night, and need to sleep the next day.

I would also recommend NOT taking tomorrow's dose, and letting the excess wash out of the system.

Because even though the amphetamine "wears off" after 4 or 8 hours, that is actually the blood concentration starting to fall off its peak. The half life of amphetamine is aprox 12 hours, so only half of it is gone 12 hours after the peak.

So if you just go back to regular dosing tomorrow, you are still going to have more than normal swimming around.

But yeah, talk to a pharmacist. And stretch. Also, be mindful of your mood. Coming down might make you irritable. (And ravenous with the food. See above- eat healthfully.)
posted by gjc at 5:07 PM on October 17, 2011

Although I get where gjc is coming from, unless you can get away without having your adderall normally (ie can cope without it), I'd try to have a normal, or less-than-normal dose tomorrow.

I am seriously not saying what you should do, just saying that I would have between a half to a whole normal dose, because I would not want to be a write-off at work two days in a row. Actually, if anything, the stuff in your system will probably just mean tomorrows dose feels a bit lower than usual (It's kinda like it's the rise, rather than the relative level of drug in your system, that has the effect).

Unfortunately, I feel worse during after the wear-off (concentration-wise), than I do when I'm entirely without meds (kills my evenings sometimes). Hair of dog I guess.

Have a berocca/b-vitamins etc.

And get as much sleep as you can get tonight. Have a warm shower, wear sunglasses inside, lie in the dark and listen to music, anything to give your body and brain that recovery time. If you get that, you should be completely fine tomorrow.
posted by Elysum at 8:28 PM on October 17, 2011

I once took my regular 300 mg of Wellbutrin, 2 extra strength excedrin, and some cold medicine with a large mocha. About half an hour later, I was sure I was having either a heart or panic attack until I realized what an awful mix of stimulants I had in my system. I had a full day of work to get through too, and here's what helped:

Plenty of water and a drink with electrolytes
Chewing gum
Protein heavy food
A long walk at lunch
Yoga breathing when I felt I was going to jump out of my skin
Reminding myself that the anxiety was a chemical reaction, not a harbinger of doom

It wasn't fun, but it also wasn't emergency room worthy and hopefully the same has been true for you. Check in & let us know how you're doing?
posted by Space Kitty at 9:36 PM on October 17, 2011

Hey, it's a day after your Adderall mistake. I hope you got enough sleep to avoid feeling too horribly hung over, dopamine-depleted, and exhausted. But if not, here are Things I Learned In College, Dealing With The Day After Adderall Edition:

- Keep drinking water. Or Gatorade if you don't mind how it tastes. Electrolytes are your friend.

- You might have an upset stomach. Your stomach might utterly recoil at the very thought of food. Nevertheless, if you can ingest some calories, you will feel better. If you can't deal with the thought of solid food, try a smoothie or other forms of drinkable calories. And seconding Space Kitty -- protein is your friend. Especially lean protein. Fat is likely to be your enemy.

- Coffee, in my experience, is highly likely to lead to a gastrointestinal nightmare. Drink some tea instead, preferably herbal or otherwise decaffeinated.

- Don't expect to get a whole lot of productive work done.

Also I hope you feel better.

For what it's worth, I used to routinely misuse prescription stimulants. If you have any questions or concerns, you know where to find me.
posted by kataclysm at 7:49 AM on October 18, 2011

Honestly, if you can, have a drink.
posted by lalex at 1:44 PM on October 17 [2 favorites +] [!]

For the benefit of people coming across this in the archive, alcohol is a bad idea in this setting.

Booze can increase the risk of heart arrhythmia, especially in concert with stress, stimulants, nicotine, et cetera. There's a reason cardiologist were less than psyched about the popularity of 4Loko here in the States last year. 40 mg of adderall is not reason to visit the ED, 40 mg of adderall and a resting heart rate of 170 bpm, however, is.
posted by midmarch snowman at 10:09 AM on October 18, 2011 [2 favorites]