Simcha, you are a wealth of information on ADHD.

The data tables my PNP showed me were based on chemical half life of Vyvanse, on average. They were not based on time of effectiveness for treating specific conditions. That you would have to figure out on your own by trial and error since everyone differs in how they metabolize drugs, and also because ADHD is a heterogeneous condition--it may be caused by different things in different people. When I see my PNP again, I'll ask to see the tables/graphs again, so I can tell you what is on the Y axis. By the way, I take 30 mg Vyvanse, which my PNP calculated (with me watching) to be equivalent to about 13 mg of Adderall (not in terms of effectiveness but in terms of active ingredient). We did discuss switching me to Adderall, and she would have started me at 10-15 mg, she said, which, I believe is quite low for people with ADHD. She is conservative, however, and likes to start low and work up.

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are the drug manufacturers saying that the timeframe the drug will work on both ADHD --and Narcolepsy is still 8-10 (or however many) hours, even though they recommend different dosages for Narcolepsy and ADHD?

No, I don't believe they are saying anything about how long the drug works on the condition. It is just chemical half life they are reporting on (at least the data my PNP showed me). The effective dosages are determined during clinical trials, and remember, everyone varies, so you and your practitioner have to find out what works best for you.

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The manufacturer can't tell the doctor how much to prescribe, but they can recommend dosages---which are usually followed. This is quite a hinderance when you are an adult and taking medication that is more than likely prescribed at dosages and strengths etc. that are not really designed for you, but for a child

A good doc will use the recommendations as a starting point and make modifications after the patient reports on his/her response. So if the first trial dose isn't a good fit, you can adjust to what works for you.

On the subject of different manufacturers of the same drug, it is good to stick with the same one. For example, my PNP won't allow me to get buproprion (generic wellbutrin) from a particular manufacturer, as there are many reports of it being ineffective. She writes this into the prescription. I have been getting only bupropion made by Watson, and this works well for me. If I were to switch to a different manufacturer, I might have to start from square 1 on finding the right dose, and I don't want to hassle with that. It's not only time-consuming, but it's my health!

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Do you ever notice a return of ADHD symptoms, or are you unable to tell a difference

I notice I can get sleepy in the evenings. I don't monitor the ADHD symptoms closely. I am helped with them when I need it most, during the daytime. I take my Vyvanse in one dose at about 8 am.

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Your PNP should have prescribed something for the narcolepsy related disorder a long time ago!!

She didn't know I had it, lol. My first visit she asked about sleep but I thought that meant how do I sleep at night, not do I fall asleep during the day. I never thought to mention my trouble staying awake because it has been my way of being for so long, I didn't consider it a problem, if that makes sense. It was "normal" for me. It is just a coincidence that the drug she prescribed for ADHD happened to help with my sleep problem. But now it feels wonderful not to fall asleep during the day and I realize this is the way it is "supposed to be." I have fallen asleep briefly while driving quite a few times, actually, but I always wake up in time. It's very brief. Stop lights were great, because I could actually close my eyes and get some winks in. Of course, there are always those times I don't wake up when the light turns green, and then people honk at me. I know this sounds awful, and I am kind of ashamed/embarrassed I didn't realize this was abnormal. Now it seems really irresponsible and dangergous to me.

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Have you discussed it with your T? Self-help books about ADHD actually don't help me implement the strategies

Yes, he has ADHD himself, so he knows where I'm at. It was something he said in session once, that made me consider I might have ADHD symptoms. It was like a lightbulb went off. Quite some time later I asked him about it (had to work up the courage), we discussed it, and he referred me to the PNP. He also recommended a psychotherapist for ADHD, if I wanted to go that route. It is a guy he went to school with (same T training program) who works in the same building as him and specializes in individual and group therapy for ADHD. I looked at his website and it looked good, but I decided to see the PNP and not go the therapy route at this time. I have read some self-help books and have found some of the strategies they describe to be helpful. Even if I don't always implement them, at least I know of their existence, which is more than before. My PNP has also made some behavioral suggestions.

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It's extremely difficult to have a coherent, topic oriented discussion with us at times, and that can affect therapy

I don't really have this symptom (at least not much or enough to impair therapy). I do have some ADHD symptoms, but I don't think my symptoms are as serious as for some people. (I know, I am lucky.) For example, I am being helped by a fairly low dose of stimulants and I don't have the coherent discussion problem. My main problems I work on in therapy are not related to my ADHD-like symptoms. I am content to do meds for them with my PNP at this time. Because of my falling asleep problem, it's possible that even if I surmounted the ADHD-like symptoms with behavioral strategies, I would still stay on the stimulants.

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Fortunately, more and more T's are being trained and learning more about adults and ADHD.

Yes. It took me ages to bring my problem with this up with my T because I was very embarrassed about it and thought he would dismiss it. But he was very responsive, even though he isn't an ADHD therapist, and he had all the right names for referrals (ADHD therapist and PNP). I think it helped he has ADHD himself and so knows how it is. I believe he takes just 10 mg Adderall a day. He does the rest (behavioral) himself for optimum functioning. His office makes me feel at home because it might be considered typical of a person with ADHD (it looks just like my office!!!).