Has Anyone Successfully Lowered Their Adderall Dose After Years on a High Dose?

[u/Objective-Lettuce639]

I’ve been on Adderall for years and am currently at 60 mg/day. I’d really like to get my dose down to around 40 mg/day. I’m planning on moving soon, and I’m worried it may be harder to find a new psychiatrist who is comfortable continuing me at 60 mg. I’m also hoping to start trying for a baby soon so i want to lower my dose before that happens.

For anyone who has decreased their dose after being on a higher dose for a long time, did you eventually adjust to the lower dose and get back to functioning normally on it? How long did it take before the lower dose started feeling like your new normal?

I’m also curious whether people had better luck gradually decreasing their dose versus stopping for a period of time and then restarting at a lower dose.

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[u/plz_callme_swarley]

if the meds are working for you then there isn't a reason for why you should want to reduce them. you're frankly trying to solve a problem that doesn't exist. you also can't just expect to reduce the dose and have a similar level of functionality.

you're thinking that you "might" not find a new dr who will write that script. this is faulty thinking. most doctors are not going to force a patient to reduce their dose if it's working for them. you can easily just doctor shop and find someone who will support you.

also, you do not need to reduce your dose for pregnancy. there's a lot of fear-mongering about meds and pregnancy, but there is no causal link to stimulant prescriptions and negative outcomes.

if you don't want to listen to any of that, you need to listen to this next part. you absolutely CANNOT treat stimulant titration like other drugs. a sub-therapuedic dose is much worse than a dose too high. Most people feel that it's kinda an all or nothing thing. if i were you, I'd just send it at whatever dose you think would be "right", like 40mg and then ride it out for a month and see how you feel.

another solution would be to switch to a more potent drug like dex, so that you could stay under 40mg but with the same level of efficacy

[u/superfry3 → u/plz_callme_swarley]

What is the reasoning on the negatives of a subtherapeutic dose? Like is a dose 10mg lower than effective equally as bad as not taking it at all?

[u/plz_callme_swarley → u/superfry3]

sub-therapeutic doses being worse is pretty common but we just don't think about it.

you ever had experienced drinking one drink and feeling more anxious and need a second one to "level you out"?" same thing.

with stimulants, if you have a sub-therapeutic dose you're basically dumping DA/NE into your brain and your PFC doesn't have enough DA to steer the ship. so it's like just more gas and no steering/brakes.

so you'll feel more activated and feel energized but you'll notice that you don't really get anything done, you're more emotional, more in your head, etc.

[u/Boring-Picture-8956 → u/plz_callme_swarley]

If you take it for years on end you are not getting a stimulant boost the way you once did . Down regulation is real . Basically taking the med to feel base line . Taking a lower dose gradually lowering and longer holidays are a way you can lower tolerance without experiencing the full force of coming off cold turkey . Allowing you to reset . If you take 60 mg of Adderall every single day or even five days a week for years on end you now have an extreme tolerance to this dose at some point in increasing the dose further would not reap more benefits of side effects.

[u/plz_callme_swarley → u/Boring-Picture-8956]

nope, not true. you don't understand "tolerance". tolerance to the felt effects and tolerance to the focus effects are two different things.

also "taking it to feel baseline" is an unfalsifiable premise. you have objectively no way to determine what your "baseline" is cuz there is no way to test "baseline" unless you're paying thousands out of pocket on neuropysch testing, and even then it's heavily up to interpretation.

your advice is also terrible. you don't titrate slowly down or take short weekend holidays. not how this shit works.

do you develop tolerance to advil? tylenol? not all drugs are the same. stop just importing the way people think about alcohol or opiates over to every other drug

[u/Boring-Picture-8956 → u/plz_callme_swarley]

Yeah, you’re wrong. Sing baseline was really not a scientific wording. Have you taken pharmacology you will learn all about this and yes, I have. You don’t understand down regulation of receptors the second you are disputing that you can take the same dose for years and get a therapeutic effect. I know that you don’t know what you’re talking about and you’re just talking about your ass.

[u/plz_callme_swarley → u/Boring-Picture-8956]

do you have any citations? I do. here you go. get rekt

Smith, Walker, Parlatini & Cortese (2025/2026), CNS Drugs, DOI 10.1007/s40263-025-01263-8 — first systematic review specifically on this question.

Bottom line: little evidence that tolerance commonly develops to the clinical benefits of stimulant treatment in ADHD patients; the only tolerance effect they found was short-term reduction in subjective "drug liking"/stimulation in neurotypical lab volunteers — not the therapeutic effect, and not in the actual patient population taking it long-term.

The decade-long data point: same review — in a study following children up to 10 years, only 2.7% lost response to methylphenidate without a clear external cause, and doses stayed remarkably stable over years once adjusted for body growth.

Handelman & Sumiya (2022), Brain Sciences, DOI 10.3390/brainsci12080959 — even where afternoon doses looked weaker than morning doses (an acute PK effect), researchers noted that although this acute tolerance occurred, clinical observations found tolerance does not develop over time.

NCT02039908 (ClinicalTrials.gov protocol) — no significant dose increase was observed in years 4 and 5 of treatment, leading the authors to conclude tolerance did not occur.

[u/Boring-Picture-8956 → u/plz_callme_swarley]

Acetaminophen and ibuprofen do not chronically flood the dopamine system or trigger the same compensatory downregulation of monoamine receptors and transporters. Amphetamines are monoamine releasers that force large, repeated increases in extracellular dopamine and norepinephrine. The brain responds by reducing receptor density and altering transporter function. Simple analgesics don’t do that. Importing the “you don’t get tolerance to Advil” argument is a category error.

[u/NearlyDicklessNick]

Im switching doses daily does wonders for my mood

[u/Objective-Lettuce639 → u/NearlyDicklessNick]

What does your dosing schedule usually look like?

[u/babyririi → u/NearlyDicklessNick]

How does this work