Drug info - advice on prescription process

[rar2117]

Hi. SWIM is hoping to get a prescription for adderall or some other form of amphetamine, as SWIM feels that, based upon the diagnostic criteria, he suffers from ADHD. SWIM has been hesitant to this point to actually start the process because SWIM has no interest in f*ing around with SSRIs, non-pharmacological intervention, etc.. SWIM believes this is a dopamine problem!*

SWIM therefore seeks SWIYs' advice on obtaining a prescription for amphetamine on the first visit. Fortunately, SWIM has no personal or family history of 'drug abuse' nor alcohol dependence, and is well-versed in the side effects of Strattera (sexual, urological, psychological [suicidal thoughts]...), the fact that it takes a stunningly long 6-8 weeks to 'work,' and its heritage as a failed SSRI, and the paucity of its supposed advantages. SWIM wonders, though, about the following:

1) How to pick a psychiatrist. SWIM is a graduate student and lives in a wealthy suburb, so there is no shortage. SWIM has university health insurance and could either get a referall at his health center or attempt to get re-imbursed for another psychiatrist (and SWIM could pick up the tab for one visit if needs be). Which would be better, if either? And are there signs to look for in choosing? Clues that the person isn't a tight-ass about this sort of thing?

2) How to argue for amphetamine over methylphenidate without arousing suspicion. SWIM feels confident he can ward of Strattera, but is uncertain how best to go about clearing a Ritalin hurdle, if one should appear. SWIM has extensive (and wholesome) experience with pseudoephedrine, and knows of studies that imply cross-tolerance and other strong similarities between the two, which (objectively speaking) would augur well for SWIM being less likely to experience side-effects from amphetamine than from methylphenidate. But would SWIM be wise to bring this up? Are pseudoephedrine and amphetamine counterindicated, in the minds of a majority or any significant faction?

3) How to refuse suggestions for non-pharmacological intervention without arousing suspicion.

4) If there are any other substances or brandnames SWIM should be aware of going in. (SWIM wants to know what he's being prescribed while the doc is still in front of him). SWIM knows amphetamines, methylphenidates, and atomoxetine. Among Amphetamines, SWIM knows only Adderall, Vyvanse, Dexedrine, and Desoxyn (a man can dream). Among methylphenidates, SWIM knows Ritalin, Concerta, Focalin, Methylin, and Rubifen. SWIM has also heard of dumb motherf*s prescribing Wellbutrin, but hopefully he'll have better luck than this. Any others to be aware of?

5) Any other contraindications for amphetamine prescription than those mentioned above? (personal/family drug/alcohol abuse, pseudoephedrine) Or, conversely, any signs/symptoms docs look for to say that someone for sure needs amphetamine and nothing else?

And of course, SWIM would welcome and appreciate any other advice apposite to this topic. Thanks for reading.

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*SWIM also has several other reasons that amphetamine might be a fine addition to his medicine cabinet, and knows from experience that he reacts well to it and similar substances in an unusually expansive sense. SWIM suffers from a lifelong imflammatory problem with his respiratory tract that has been variously (mis)diagnosed as asthma, allergies, nothing at all, etc.. The only solution to this problem, when it presents itself in acute form, is to knock out the inflammatory response. In SWIM's experience, the most effective agent for doing this is amphetamine, followed closely by MDMA. This can also be undertaken proactively as well as reactively with pseudoephedrine (a derivative of amphetamine), antihistamines, NSAIDs, etc, and in the limit case, steroids (eg prednisone)--but none are as effective as amphetamine. SWIM was treated with steroids extensively as a child, and they have the unfortunate side-effect of substantially slowing the metabolism. Owing to this and no doubt a multiplicity of other behavioral and environmental factors, SWIM is now substantially overweight. And SWIM hears that amphetamine was also used to treat this problem, before authorities learned that it, like every other product on the planet, could be misused in harmful ways.