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How can I optimize the absorption of my Ritalin? After 4 years, effects are inconsistent and usually it's like I've taken nothing. I have tried varying dosage, changing breakfast, taking it without food, more protein or less, etc. I don't drink juice or any soda, eat very healthy diet. I've taken long med breaks. Often after lunch, i take a dose and feel very drowsy. It used to make me feel energetic, productive and allow me to get through the day without napping. Now I just zone out & feel lethargic. I know that med absorption is highly dependent on a persons PH level. (I believe my level is very acidic, because i drink coffee everyday, eat a lot of fruit, have gas). My dentist said my tooth enamel is worn down (and it's often due to high body acidity) Will taking Sodium bicarbonate (which reduces body acidity) maybe help? Or will this further reduce absorption?

I am taking stimulants for numerous reasons--primarily for ADHD and idiopathic hypersomnia, but also because I'm obese and trying to lose weight (with diet and exercise of course) and because amphetamines heretofore have been the only thing that really make me a functioning human being. I was curious though. From y'all's experience, which stimulant inhibited appetite and/or caused more weight loss, that is, between Ritalin (and all their products), Focalin, Adderall, Dexedrine, or some other stimulant. I have actually even taken Desoxyn, twice, and to be honest, it's nowhere near as potent as Adderall or Dexedrine. To my understanding, appetite inhibition can be extricable from weight loss; i.e., one can lose weight from a medicine without experiencing much appetite suppression, one can experience drug-induced anorexia without losing much weight, or both at the same time, or neither. IME, so far, this is what I've experienced... I'll list the stimulant/anorectic and max dose taken. Appetite suppression/anorexia: Dexedrine (60 mg) Adderall (60 mg) Dexedrine Spansules (30 mg) Adipex-P (37.5 mg) Adderall XR (90 mg) Wellbutrin IR/SR/XL (450-500 mg) Bontril-PDM (210 mg) Tenuate (75 mg) Desoxyn (15 mg) Vyvanse (70 mg) Adzenys XR-ODT Metadate CD (20 mg) Ritalin (30 mg) Focalin XR (25 mg) Evekeo (20 mg) Belviq XR (20 mg) Tenuate Dospan (75 mg) Contrave (32 mg/360 mg) Weight loss: Dexedrine (60 mg) Adderall (60 mg) Adipex-P (37.5 mg) Tenuate (75 mg) Dexedrine Spansules (30 mg), Adderall XR (90 mg) Wellbutrin IR/SR/XL Desoxyn (15 mg) Bontril-PDM (210 mg) Metadate CD (20 mg) Belviq XR (20 mg), Evekeo (20 mg), Focalin XR (25 mg), Ritalin (30 mg), Vyvanse (70 mg) Contrave (32 mg/360 mg), Tenuate Dospan (75 mg), Adzenys XR-ODT So I've not tried very high doses of the (dex)methylphenidate meds, and have been curious about trying a higher dose (40-60 mg, maybe higher). Focalin might be okay, but it gave me tremors, anxiety, and panic attacks at 25 mg. Vyvanse did nothing much at all except jack my resting heart rate up to 120+ BPM. This list was very hard to compile, and I don't really know if it's too accurate. I'm heavily considering trying methylphenidate again, specifically Metadate CD, because I actually felt something on it as opposed to regular Ritalin. I was considering asking my NP for a Metadate CD dose of 30-60 mg, or maybe 30 mg x2 or something like that, with some Ritalin 5-10 mg, maybe 20 mg, to take 1/2-1 up to three times per day prn. The tried and true med is Dexedrine for me, specifically the IR, but I want to give that a break for a little while. I'm curious to see how (dex)methylphenidate affects my ADHD more than it affects my weight loss/appetite suppression as well. I know this post was rather scattered and long, but if you made it through it, any input would be much appreciated!

I'm currently taking Vyvanse, and I've heard that straight amphetamine-based stimulants like Adderall and Vyvanse can be stronger stimulants than the methylphenidate class like Ritalin, Concerta (Ritalin XR), and Focalin. I'm considering talking to my doctor about something more mild, and I'm looking at the methylphenidates as an option. What I know about Adderall and Vyvanse is that there are differences. Even if Vyvanse is just the dextro- enantiomer of the amphetamine molecule. What I also know is that dextroamphetamine (along with lisdexamfetamine) has more of an effect on dopamine than levoamphetamine which is found mixed with dextroamphetamine in Adderall, and levoamphetamine has more of an effect on norepinephrine. Are there similar differences between methylphenidate and dexmethylphenidate? Where one may effect a certain neurotransmitter more than the other would? I'm curious specifically about pharmacology differences and even the slightest differences in mechanism of action. Curious as to what anyone might have to say here.

In the last four months I've moved from a Vyvanse/Adderall pairing, which was gradually making me more and more anxious, as well as leaving my heart constantly pounding, to a Concerta/Ritalin pairing. While I find the effects of Concerta and Ritalin far more smooth, I'm having almost the opposite problem with these stimulants than the prior ones. Fatigue. At first I thought I was simply sleepy, but when I'd lay down to -try- and sleep, I'd just lay there in a dozing lull. Increasing the dose helped somewhat, however this is still a symptom that annoys me. Feedback? Anyone? Bueller?

I've perused the boards for similar posts, but thought I'd throw out an arguably selfish request for evaluations of my particular mix. I know the answers are throughout the boards, but I hope to come to Cocktails for a tailored response. I know redundant posting is faux pas on message boards. In return I can only respond to threads where my input would be valuable. I'll do so. Current meds: Lamotrigine (150 mg 2x daily), Latuda (80mg 1x daily), Escitalopram (10mg 1x daily), Bupropion XL 24 hr (300mg 1x daily), Amantadine (100mg 3x daily), Clonazepam (0.5mg 3x daily), Methylphenidate (50mg distributed throughout day) History and Background: I've seen the same psychiatrist for years and he trusts and works closely with me given our history. I am diagnosed with major depression which is persistent and has been for years. Another significant diagnosis is one or another form of anxiety - primarily social. No panic problems, thankfully. I am doing as well as can be and function well consistently. I can tolerate medication changes well given experience. Current Questions: (1) Sleepiness, and Memory Problems Sleepiness has always been an issue, and I accept it to a big degree. I've learned to time dosing properly for the most part. Memory problems have grown and are very apparent in recent months. I blame 5+ years of Clonazepam at 0.5mg 3x daily. Latuda and Escitalopram do a lot for my particular anxiety. I'd like to move benzos to an as needed basis. I was actually given stimulants to combat sleepiness - nothing to do with attention disorder (1a) What can I change to minimize these, especially memory? Is tapering off Clonazepam feasible or adequate? What could be upped or added to mitigate its loss? (1b) What might be causing memory problems other than Clonazepam? Will awareness and cognition improve with its removal or is the damage done? (1c) Given the necessity and value of much of my cocktail, what can I do to mitigate sleepiness with little change? (1d) Is there any subset of drugs among those I'm taking that could be most blameworthy for cognitive problems or sleepiness? That is, is there a simple switch? (2) Akathesia, EPS, and Options Cogentin and its class are just not an option for me. Blurred vision, chemical dry mouth, and cognitive problems are just not worth it. I save it for dystonia in the emergency room. Amantadine has worked pretty well, but I cannot afford it on my upcoming insurance. This is with certainty. I don't know how Propranolol will balance with the other meds. (2a) Does anyone see implications of a switch from Amantadine to Propranolol given this cocktail? (2b) Any suggestions for akathisia given this mix? Cogentin is off the table. (2c) Are the effects of propranolol on the circulatory system, norepinephrine, and blood pressure contraindications with the rest of my meds (in your experience)? (3) Any other thoughts, experiences, advice, or criticism? Thanks! Past meds: Cymbalta (caused anxiety), Strattera (caused even more anxiety), Remeron (sleep oddities), Lithium (don't remember), Risperdal (extreme dystonia - thank goodness for Cogentin), Cogentin daily (dry mouth and very blurred vision), Xanax (very briefly - too strong), Focalin (dexmethylphenidate), Geodon (first breakthrough), other? Current meds: Lamotrigine (150 mg 2x daily), Latuda (80mg 1x daily), Escitolopram (10mg 1x daily), Bupropion XL 24 hr (300mg 1x daily), Amantadine (100mg 3x daily), Clonazepam (0.5mg 3x daily), Methylphenidate (50mg distributed throughout day)