To preface: I am 30 years old and went back to school to complete my BS in Biology last fall. I work full time, and about 4 months ago I decided I wanted some chemical enhancement. I was on Concerta when I was a teenager, so I booked a psych appointment and was honest that my ADD is mild at best but stimulants help me and I want them. Doctor was a bit disinterested/skeptical but I clearly knew my pharmacology and thus left with a scrip for 30mg Vyvanse.
Two months later we upped it to 40mg and things were okay for a month again, but the effects wear off within about 3 hours now. Obviously tolerance is forming despite my breaks on the weekends, so I requested an IR booster for the afternoons. The PA was cool with it but went to ask the doc and you would have thought I asked to switch to meth or something. Dude comes in to the office, asks me to get on the scale, says I'm losing weight (I've literally lost about 5 pounds, I'm 6'4" 210lbs, low BF%) and ultimately tells me "This office does NOT prescribe IR Adderall". He tells me he wants to switch me to a drug called Mydayis and writes me a scrip for that. Claims it will serve the same purpose. I reluctantly agree to try it.
Mydayis is a new-ish amphetamine formulation. It's 3:1 dextro to levo just like Adderall, but it is delayed release instead of extended release. It is essentially designed to work like three IR pills within one pill, the first dose at T+0, the second T+4 hours or so, the third T+7-8 hours. It's also about $20 a pill and my insurance said "no". I also could not find it at any pharmacies in town.
So at next appointment I came prepared with even more research and what I thought was a good point. I tell the PA "Honestly I understand policy, but if the doctor says he won't prescribe me an IR booster and yet wants to prescribe me Mydayis, to me that says he doesn't trust me not to abuse the medication." She expresses slight disagreement but I follow with "Mydayis is delayed release, meaning it serves the same function as three IR pills. That means he agrees with the concept of a booster but will not prescribe one by policy. He is essentially saying 'I want to put you on IR Adderall but I don't trust you to dose it properly.'" She resigns to this truth and apologizes.
I say essentially "Look, I'm not trying to appear drug-seeking or denigrate your medical expertise, but there are plenty of people who take Vyvanse with some sort of IR amphetamine booster later in the day at doses FAR higher than I am on. If this office won't treat me in keeping with the current medical consensus as to what's safe then I will just take my final 40mg Vyvanse scrip today and find a new doctor." She is a reasonable lady, apologizes again for the policy and says "Let me see what I can do."
So the PA comes back in with the doctor. He's like "Okay look, we don't prescribe IR Adderall and I am not breaking that policy for you. If you want to find another doctor I understand, but the best I can offer you as far as a booster is either of these two drugs" (slides me a pamphlet for Evekeo and Zenzedi).
I literally smirk and then cannot stop myself from laughing. I say "No offense, but do you know what the formulations of these are?" Doctor says "Yes, they are immediate release amphetamine. The Evekeo has two kinds and the Zenzedi is just dextroamphetamine." I say "I'll take the Zenzedi."
"So if you're prescribing me 100% dextro with no issue, and you offered me a racemic mix without issue, the policy against Adderall actually has nothing whatsoever to do with the contents of the pill and everything to do with the name 'Adderall', right?" PA smirks but does not respond, doctor says "We simply do not prescribe that formulation. By Policy."
I laugh, take the scrip, say thank you. I wanted dexedrine the whole time anyway. A rather hilarious example of how even medical professionals can fall victim to stigmas surrounding certain drug names.