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I'm asking about relative potency of methylphenidate, dexmethylphenidate, and dextroamphetamine tablets. I don't do well on extended release adderall. Okay, I should say I haven't done well on XR Amphetamines. Maybe the  methylphenidate drugs are a better fit.  I know, I know. It's been asked before. Let me stop you right there, pal. I've got a congenital heart defect, making my case quite unique. I'm working with NYS Medicaid via independent health and I'm about to start a new job as a pharmacy technician and can't wait for a goddamn Prior Authorization. 

 

Why don't I like Adderall?  20mg IR BID was ineffective. Utterly ineffective.  30mg BID is profoundly better, but I never sleep, my teeth are severely worn, I have chest pain and general physical discomfort. Oh, and I'm on Wellbutrin. I really love being super horny and not being able to keep it up. That's fucking awesome. /sarcasm.

So I was going to ask my doctor if he might be willing to try methylphenidate or dexmethylphenidate. I don't like amphetamines. I've been on Vyvanse, and that was okay, but my insurance won't cover it. They definitely cover the IR versions of the methylphenidate drugs, and SOME ER versions but again, I don't do well on ER drugs. 

 

My concern is that, since I'm on 30mg Adderal BID (remember, 20mg BID wasn't effective) I might not get an equipotent dose from either of the methylphenidate meds. I'm not looking for a speedy high. I hate that. My heart races and my chest hurts. I just want to fucking focus. I've tried Strattera, Intuniv, Provigil, and Nuvigil, to no avail. What do you guys think? Is there any way to make it work? Is it worth asking my doctor? I really don't do well without the meds, but the Adderall seems to be a catch-22. It's either effective for ADD  and overstimulating or ineffective.  My problem is that I need to sit down, still my thoughts, and focus. My thoughts race too much with Adderall.

 

I apologize for the length of this post. Thank you guys.

 

 

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You probably wouldn't get an equivalent dose in methlyphenidate-- I too have the sleep issues on the adderall based meds. Methylphenidate doesn't do that but to me the effectiveness isn't as high. In theory ADHD meds (from what I've been told by both my pdoc and neurologist) should not cause sleep problems in people with ADHD because it's actually only speeding up a part of the brain that for folks with ADHD is too slow. So in theory stims should actually help people with ADHD sleep. Now-- I have Bipolar II on top of the ADHD so I believe that's where my sleep issues come in. Anyway, it might be a trade off. Methylphenidate is effective, but getting to that high of an equivalent dose is unlikely I believe plus like I said it's effects are milder. Good luck.

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Have you been to a cardiologist and asked him if stimulants are safe for you? Definitely do this!

I think the max dose of methylphenidate for an adult is officially 80mg. How 30mg adderall compare to 80mg MPH is something one needed to try out.

What do you take wellbutrin for?

Do you take anything else besides wellbutrin?

 

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I take wellbutrin for anhedonia. I was told it would help me concentrate. 

 

Adderall is too strong in terms of peripheral stimulation. Maybe dexedrine spansules would be a viable choice? I was once on vyvanse and that stuff was great.

 

I wanted to try ritalin or focalin expressly because it's less potent. I'm starting to think I don't need any of that, though. 

Edited by La La LOLocaust
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Yes, I know, this is a first person site, yada yada, but I have been through the wringer with my ADD daughter. She was finally put on daytrana, the methylphenidate patch. Much smoother transition, and unlike swallowing a med, if she's done for the day and doesn't need it (it lasts for 9 hours), she can remove it. She can actually eat while using it, tho not as much. 

I don't know how to translate the dosage, she went from 20mg focalin to 30mg daytrana.

If you go on their website, they have coupon offers.

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Thanks, rabbit. I'll ask my doctor. By the way, I love the African Grey in your avatar. Birds are the best. Off topic, but if you like African Greys, google Alex the parrot and prepare to be blown away.

 

I'm wondering if ritalin or focalin is even worth it if I'm on wellbutrin. Don't they both do the same thing in the brain, essentially? I could also retry Intuniv. I don't want to be speedy, I just want to focus. Maybe I don't need a stimulant at all.

Edited by La La LOLocaust

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If vyvanse was good why dont you take it anymore? too expensive?

then you could try dexedrine either instant or extended. dexedrine and vyvanse both contain dexamphetamine.

You can also try ritalin+wellbutrin. I think ritalin and wellbutrin both work through reuptake inhibition. Wellbutrin acts mainly on NE (norepinephrine)

while Ritalin acts on DA and NE. Ritalin's reuptake inhibition also has to be much stronger than that of wellbutrin cause ritalin works

instantly and doesn't have to be taken for weeks before you get an effect.

 

Can you even tell if wellbutrin helps or not? Cause if it doesn't do much then why stay on it?

Maybe you'd tolerate stuff like adderall better without wellbutrin cause adderall and wellbutrin both work on NE. If you're sensitive to too much NE

then you get side effects when you take a drug or various drugs which work on NE.

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Wow , to the OP our situations are quite similar . I don't like the speedy feeling either and my chest hurts often , but the EKG is always ok . Not sure if you're on the forum still , how did things work out ? 

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If the amphetamines aren't suiting you it seems worthwhile to me to try the methylphenidate based ones. I found both IR Ritalin good and Concerta was great.

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The first day I was on Ritalin was amazing.  So I wouldn't say Ritalin has a weaker effect. However, it raise my heart rate to 150, though it might not for you.  I can tolerate Focalin, and, if anything, it was too potent. I apparently was exhibiting very little affect (not showing any feelings), which is what I've heard happens to kids if they're taking too much Ritalin. So that might be an avenue for you. Maybe I should try it again in a lower dose. If Vyvance worked for you, why not try Dexedrine? It helps me some, without the anxiety and meltdowns I got with Adderall. Everyone reacts a bit differently. I take Dexedrine as immediate release, splittable tablets, and I tailor the dose through the day. I like it that way because I find extended release meds don't last as long as they're supposed to, though they last a little bit longer than the immediate release. 

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Lots of people report they do not like the extended release amphetamines and just take the IR. This allows you tailor the dose to your needs. I've yet to meet an extended release amphetamine last as long as it is advertised to and I have taken all of them.

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I hate Adderal. It's an unfortunate necessity at this very moment, but my_god I hate it. I've tried to go off it several times - I've been off it for 2, 3 and 6 month stretches - but without it, I can_not function. I feel 1000% better emotionally, but there's no way I can work. I'm self-employed and can take time off when I need it, but I would love to just be stable and normal enough to have a regular job again. But I don't even undesrtand my own software or basic organization and work principles enough to get ANYTHING done at this point without it.

I know there was life before Adderral. I just don't know how to get back there. I just went on a 3-month stretch of doing nothing and being off the drug, but I've recenlty had to return to working.

I've tried Ritalin, Vyvanse and Straterra and didn't have luck with any of those for different reasons. 

I feel kinda upset/angry too with my last psychiatrist (well, I guess all of them in a way), for how...EASY they make it sound to stop taking it. They all swear that therer's no long term side effects, no withdrawal, etc. -- and that very well may be true in terms of medical definitions, but I would really have appreciated someone telling me the truth about how I'd feel once I'd stopped taking it, and how to deal. Because I'm not simply in the place I was before I started taking it, I'm in a much, much worse place. And I think attributing it ALL to "well it's been years and your ADD would have gotten progressively worse anyway" is a copout. It's more than just the focus. There's energy issues. There's cognition issues.

My energy levels are actually consistently better OFF Adderal. That crash is no joke and it leaves me feeling more drained than I've ever felt in my life. I've had rounds and rounds of endrocronological testing and labwork over the years and seriously -- nothing I've ever been treated for effects my energy as much as Adderal. It just is what it is. 

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I found focalin to be milder if you've never tried that...actually too mild for me. Have u tried any of the long acting methylphenadate options? Is the adderall Xr or ir ? 

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I just started a thread -- I quit after 5 years, and it took almost six months to feel better. I started to hate Adderall, and I felt HORRIBLE on it. Aside from the mood swings, I felt like death. Drained most of the time. 

When doctors say there's no withdrawal, I feel like I don't understand that word lol. I definitely felt off my rocker for weeks. Then I still felt bad but less so and couldn't function, and it was last week I started feeling human. Feel great the last 3 days, but still don't have the concentraion to work. it's getting better though.

I honestly thought I had Cushing's disease on Adderall. Gained about 70 lns and it baffled me. I looked pregnant and still have moon face, but my stomach is getting better.

I will_never take it again.

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Welp, update - but months off it, I'm non-functional. None of the other drugs worked for my ADD, and I'm in a severe state of constant BAD confusion/disorientation. I'm thinking about seeing a neurologist -- it's not just like, I'm easily distracted -- I can't think enough to work. I haven't been working for a few months.

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