*Duration of Effectiveness-DOEShould Become The New Standard
Language and Precision: Maps & Changing Territories – Korzybski: M
– *DOEmarks the specific metabolic patterns for each individual, and each stimulant medication, and will announce them to both the patient and practitioner for accurate precise, individualized treatment. To not measure DOE at every med check is to passively ignore the built-in marker for effective treatment and should be the *essential evaluation toolin every med check with stimulant medications.
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The Meds Don’t Work Long Enough: The Duration of Effectiveness [DOE] is not adequate: Each stimulant drug, each family of stimulant drugs has its own expected DOE. This DOE is not discussed in the literature as a measuring tool, but it’s common knowledge with any who watches carefully for drug action and duration throughout the day.
All stimulant medications have an expected, less than 24 hr duration. Duration is an obvious point but is overlooked so often as an essential tool. If meds last less than 24 hr, then how long should each last? Dialing in the particular duration is necessary to get the best action out of each specific med. [AMP=Amphetamine Family, MPH=Methylphenidate Family]
Vyvanse [AMP] and Daytrana [MPH patch] both win the DOE race with 12-14 hr expected as optimum.
Adderall XR [AMP] is next with 8 hr DOE — sometimes can get 10, but often more DOE is too much – out the top of the Therapeutic Window: w
Concerta [MPH] and Focalin [MPH] both run 8 hr if dialed in effectively – some studies show longer, my experience: more than 10 hr with either of these is too much — see other articles on the ‘Top of the Window.’
Metadate CR [MPH] and Ritalin LA [MPH] are both right at 8 hr, rarely longer, with side effects, if pushing the dose higher
The Immediate Release Stimulants, the tablets with no extended time
expected, last only a portion of the day with Adderall IR [AMP]
[Immediate Release Tabs] lasting about max 5 hr, Ritalin IR [MPH] is 4-hour max duration.
Details on expected DOE for each stimulant: /
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