pharmacist with adhd here that first dose is seriously bliss and i’m so happy that you got to experience it   however 20mg of adderall is way too high of a starting dose it’s what’s in the manufacturer labeling but any psychiatrist worth their salt will know to start you low and slowly titrate up   in undergrad i was diagnosed after recognizing my symptoms learning about adhd in psych101 i went to my family primary care doctor and he referenced the manufacturer labeling and started me out on adderall 20mg twice daily too   i suffered from every side effect under the sun dry mouth dry eyes and vaginal dryness made me utterly miserable i couldn’t wear contacts anymore i had several relationships end because sex was too painful i was constipated all the time i would get huge crashes as the drug wore off during the day and be debilitatingly tired my heart raced all the time and made exercising pretty frightening when my heart rate climbed to almost 200 bpm multiple times per session   the worst part of all was i couldn’t decrease my dose to reduce my side effects because of the physical tolerance i built up for the drug after taking 20mg twice daily for a couple years every attempt to decrease the dose left me struggling with uncontrolled adhd symptoms every day   i got to pharmacy school and learned how to actually treat adhd which is to start at the lowest dose of adderall possible 5 mg twice daily and titrate up every 1-2 weeks until you get to the minimum dose that controls symptoms that minimizes side effects and delays physical tolerance so you eventually can safely increase the dose in the future when you stop responding to the initial dose you were on needless to say i was pissed at my pcp  i strongly recommend you speak with your doctor or make an appointment with a psychiatrist instead of a primary care provider if that’s who initially prescribed it to you ask them about starting at a lower dose to see if it’s effective before jumping to 20mg   i am on a crusade to prevent what happened to me to anyone else many primary care providers aren’t equipped to manage adhd’s complexities and end up providing suboptimal care psychiatrists are far more likely to provide higher quality management of adhd   tldr 20mg twice daily is too high of a starting dose can result in lots of side effects and physical dependence can prevent you from decreasing the dose in the future highly recommend discussing a lower dose with your doctor also super happy for you to finally get treatment