keks and other pasttimes

the following events ensued:

1. predictable lively discussion on the preparation of Wienerschnitzel, in which natives and wurstaboos are pro-puff and everybody else is like *confused dog head tilt* why wouldn’t you want the crust to stay ~attached to the thing you put it on? as with other fried foods?

2. thirty “Bad Schnitzel is my band name” jokes

3. thirty “Bad Schnitzel is my stripper name” jokes

4. one “ah yes, Bad Schnitzel! a lovely spa town” joke

5. this absolute masterpiece:

if you get a new adderall prescription i am medically advising you to start your first dose at 5mg or below, same for ritalin. the entire idea of medication of this type is to titrate up slowly until you hit the homeostasis of your own tolerance, genetic metabolic factors, and use case. titrating DOWN from a dose thats too high is wasteful and unpleasant and puts you at higher risk of psychosis

i posted on here a few days ago the idle thought that i wondered if prescribing physicians are all on long term adderall tolerance anyway (based on the adderall usage stats in med schools) so they think their patients should be started at higher doses and one of my pharmacy industry mutuals replied to me privately and just said “yep” so keep in mind the entire field of western medicine as it exists today is practiced by functional speed freaks and adjust your expectations

yes, you are reporting what the doctors have been advised to do and which i am telling them not to do, which you can see the results of in the notes of this post from all the people who were started on either of these doses/formulation combos and had horrific side effects/psychosis. also a few people who did completely fine! 20mg XR and 5mg 2-3x/day is STILL too high a starting dose for many adults to be prescribed safely. i am one of the patients who would have been injured by taking my full prescribed 20mg/day IR dose and has been instead taking a much lower one, with zero tolerance, for over ten years. my case is not unusual. my OP was based on like the fourth or fifth personal friend of mine, just the most recent one, to have been prescribed 30mg as a starting dose of XR and, despite being twice my body mass and not psychotropic-naive, had a mood episode bad enough to interrupt their participation in a pleasant social event. this KEEPS happening to people i know. one friend had a full on psychotic episode, many others have had to learn through attrition to take fractions of their doses, sometimes through water solutes at home which is crazy

its not an antibiotic, there is no reason not to start patients on lower doses and titrate up except some sort of broad medical ignorance about it, or possibly it's a "if they cant tolerate big doses they dont actually 'need' it" punitive approach to prescribing. low starting doses and gradual titration (which can be fast if the patient is confident in increasing quickly) is in fact the only logical way to prescribe this medication, as there are no benefits to prescribing high doses first, it does not create a better clinical outcome and vastly opens the field for additional issues.