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NURSE KAREN
NURSE KAREN, Nurse (RN)
Category: Health
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Adderall doseage increase with post concussion syndrome

Resolved Question:

My 20 year old daughter has been treated for ADHD with Adderall for many years. Last year she had a concussion and because of post concussion syndrome her dose of Adderall XR needed to be increased from 25 mg pre injury to 50 mg post injury. The insurance company refuses to pay for anything over 30 mg. Is her need for 50a mg to improve her post concussion symptoms that unusual? Do you have any information such as medical research articles that I can use to appeal the insurance decision to deny payment for this dose. If no articles any other helpful information would be appreciated. She needed the increased dose because after the concussion she had poor ability to pay attention, felt brain fog, bad memory, mental fatigue, difficult with cognition that she did not have before concussion
Submitted: 1 year ago.
Category: Health
Expert:  DrThomasMd replied 1 year ago.
Hello
No there is no specific research that is going to justify this dose as a standard of care in PCS

It might help, but even the syndrome is not well established.

That is why the insurance company is not paying for the extra dosage.

Please let me know if you have further questions.
Please don’t forget a positive rating.
Customer: replied 1 year ago.
Relist: Answer quality.
I need someone who is an expert in prescribing Adderall. I am already very knowledgeable about what the PDR says about Adderall and Post Concussion Syndrome. I also know that it is not that uncommon to prescibe Adderall above 30mg. Is there a Neuropsychologist or Rehab doctor who has a vast experience in this type of patient?
Expert:  DrThomasMd replied 1 year ago.
Hello
In fact that was not your original question.

No experts have come in to take this question.

I will opt out, and this will again alert all experts to your current question.

The answer is pretty much the same, however, you are not going to find an evidence base to change the insurance companies mind.

Thus I don't really think there is enough research evidence to help you appeal their decision.
Expert:  NURSE KAREN replied 1 year ago.
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PLEASE UNDERSTAND NO ONE CAN DIAGNOSE OR TREAT A MEDICAL CONDITION ONLINE.
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HI. Sorry I am not a neurologist or expert in prescribing Adderall, but I have both personal and professional experience in dealing with insurance companies and denial of payment for meds that are needed. The ONLY things that I have ever seen make an insurance company reverse their decision is to have the prescribing doctor either call or write/fax information stating that the medication is a requirement for the condition, that lower doses have been tried and did not work and that this is the only medication and dosage that controls the symptoms. The other thing is for you to get a supervisor on the phone and explain that the insurance company is not a prescribing physician and that if you daughter was to have some detrimental effects from not getting her medication that they would be held responsible.
I know I am not the expert you asked for but hope this helps you.
NURSE KAREN, Nurse (RN)
Category: Health
Satisfied Customers: 211
Experience: REGISTERED NURSE WITH MANY AREAS OF CLINICAL EXPERTISE
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