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So I've been taking an added afternoon dose of Ritalin (10mg IR) the last few days. I usually take only 20mg (extended) in morning, but was told I could add a bit in afternoon (for boost) if necessary. I literally feel more tired/drained after taking it. WTH. I don't regularly take any afternoon dose, so why would it have already pooped out? I feel like coffee gives me more of a boost that this! Grrr. I hate to take double, because my pdoc didn't prescribe it that way. I also don't want to effect my sleep (I have no sleep issues at moment) Why is it making me so tired? This afternoon dose is not apparently working at all? Does this mean I actually need more?

I have been on Ritalin LA (20mg) for about 9 months, mainly as an add-on for depression/apathy. Pretty regular in taking it everyday. I've noticed within a month, it wasn't doing nearly as much (as far as increased motivation/energy/better mood), although my focus/concentration is still very good. Also, despite eating a similar diet (taking it on same schedule), it works really inconsistently, like somedays it does nothing at all.... I just took a week-long break from it during vacation, and now that I've restarted, the effect is better again. Is this normal for everyone with stimulants? My doc doesn't want to increase my dose. Maybe I should just start taking my additional IR PRN everyday or take week-long breaks? I worry about tolerance... Is IR taken twice per day more effective? I worry that if I just switch to IR dosing, i will feel a bit of a "crash" in between, it won't be as smooth...Any thoughts??

Used to work great for me - I don't think I've developed a tolerance issue, because I've been taking this drug in the same dose range for years, and not always daily. Anyone else experience this?

I know there are some amateur pharmacologists here... a question along the topic of neuroplasticity. I've heard that chronic use of antidepressants can eventually "downregulate" your receptors (Serotonin I'm assuming) so that if you ever come off the drug, your brain will never be the same as before, it will never function the same without the med, because your brain adapted/changed due to the medication (or become dependent to function in some way)... I'm wondering if the same thing happens with Stimulant drugs? I'm aware that tolerance builds up if you use them everyday for a year or more, however, what if you use stimulants for 6-9 month periods, then take breaks? Is there a proven way to avoid both the tolerance issue and this receptor "downregulation"? I'm also wondering if ALL psych drugs cause dowregulation of receptors if used everyday for long periods (I've heard the opposite also, like some drugs are neuro-protective)? Can you ever recover (i.e. if you are someone that uses psych medications on an episodic basis)?

I am really sick right now and need some guidance. A bit of a saga... I mainly took Xanax in very low doses .125-.25 as needed for several years. I would go through periods of a constant panic feeling, take Xanax and beta blockers, feel better then wean myself off. Then just kept taking the Xanax as needed. Usually for hangovers which I know now is not the best. In Oct. 2013, I took diphenhydramine and dextromethorphan for a cold and had to go to the ER. I was messed up with a crazy reaction! After that, the constant panic feeling was back. I did the Xanax/beta-blocker thing again and by early Dec. I was feeling fine. Then I took a Xanax before Christmas and my world turned upside down. After that one, I felt worse than ever. The worst constant panic/adrenaline. I took up to 1mg once and it did nothing. I was told by a natural health Facebook group I was in "tolerance" and that I had to taper. My dr told me to keep taking more even though it wasn't really working. My usual dose at that time was .5-.6mg quite a bit more than I was used to taking. And nothing was killing the adrenaline feeling. I started the taper at .8mg and it was a nightmare for the first few months. I was so sick, like a heroin addict getting clean. Tons of adrenaline. The taper lasted 1 year and got much better 6-7 months in. After the taper, I continued to have nights with the adrenaline. Every month or 2 with no apparent trigger. I'd go to sleep, then wake up with adrenaline surges, vomiting, diarrhea, shaking, fear, panic, lasting until morning. Then I'd be tired but fine. In April, the bad nights wouldn't stop. I was diagnosed with "adrenal disfunction" from an integrative dr. It was very hard, but I finally got better (using only natural things) in July, and now I'm sick again like I was but even worse! My therapist is threatening to put me in the mental hospital because I can't eat or sleep. I'm suicidal. None of this is mental when it starts! It's just pure fight or flight adrenaline. For hours and hours. Every morning until the afternoon. Then every other night starting around 12am. It's cyclical. My therapist wants me to try a benzo again. I have Xanax still, and my mom has Valium. Probably expired but still. Just not sure what to do, what it is, what's going on. I feel fucked. If you made it this far, thank you!

I was diagnosed with ADHD five years ago. I am 28, ambitious, career driven, and have completed several years of graduate school. Now I am job hunting and having some success but I am under a lot of stress (which is my point). My dosage of Adderall was played with for about a year until we decided on one 20mg of extended release in the morning and one 20mg of short term release in the afternoon. A few times in the past I have developed a tolerance and I have always resisted the suggestion of an increased dosage. My ADHD is bad, but I felt dependent upon it. Now, however, Its getting really bad. About two months ago I gave Concetta and Ritalin a try and lasted about 6 weeks before I told the doctor that they weren't working as effectively. i have been back on Adderall for6 weeks and will be going back to the doctor on Friday, which is nine days before I am actually due for a re-fill. I tried Vyvanse in the past, and was really spaced out on it, and I don't remember my dosage. Now, I am lazy, unfocused, unproductive, and sleeping a ton! I still feel Adderall is the best drug for me, because of how I felt on it when I went back to it a few weeks ago. But I need a dosage change, or something.. Does anyone have any idea of what I can ask my doctor to go to? - would taking a 30mg of extended release in the morning and 10 in the afternoon be enough of a change to affect someone whose built up a tolerance? - would asking about the same dosage in Ritilian help? I am hesitant to ask for a dosage increase in adderall, but is that the best answer? I have been really good with my meds my whole life, and my doctor isn't going to accuse me of anything if I do. Can't necessarily say the same thing about the pharmacist though. Anyways, any advice would help!

I started Klonopin about six weeks ago after attempting to live life off benzos for quite some time and ending up in the hospital several times for panic attacks. At first, Klonopin seemed to balance me quite nicely, but as time goes on it seems like the effects are getting stronger depending on the day and dose timing, and after a few days of consistent dosing I start I feel really out of it, like I took twice the dose I did. Has anyone experienced this? Could this be an interaction with anything I'm taking? (See signature)

I need info quickly/urgently about Xanax (and to a lesser extent Klonopin) and how much I should take to be effective at combating severe anxiety without putting me into a coma or anything...I have SERIOUS obligations both tonight, tomorrow and the next day and my extreme anxiety is currently preventing me from meeting those obligations. I was just prescribed Xanax today and I'm trying to figure out how much to take, but before I go on I think it's very important to know my history with benzodiazepines...I know it's long (sorry), but I believe it definitely plays a role here: SITUATION/SUMMARY: Was prescribed Klonopin (1MG) about 4 years ago in 2010 to take *as needed* for anxiety - took it sparingly for the first 3.5 years, only when I really needed it (once or twice a month) and 1MG was enough to eliminate the anxiety every time. I once tried 3MG back then and it made me black out. Latter half of 2013 I began to take it more frequently as my anxiety was becoming slightly more severe but still only maybe once or twice a week - I actually made a Word document with a log every time I took it, how much, and how it impacted my anxiety so I know exactly how much I took. I was still taking the same dosage (1mg or 1.5mg), but maybe 3-5 times a month - this continued up until February of this year. Then comes 2014, particularly February onward, and my anxiety spikes WAY higher than ever before; my depression gets much worse as well but that's not what I'm posting about. There were no med changes, no events, nothing I know of that precipitated this...just all of a sudden, my mental/emotional health became much worse. So, with increased stress and anxiety I began taking the Klonopin more frequently. I would always purposely not eat so that I'd take it on an empty stomach so it would be more effective...and many times I wouldn't eat anything for the rest of the day in fear of food diminishing the anxiolytic effects of the Klonopin. I increased the frequency to maybe 3 times a week at first. I noticed that the 1 or 1.5mg doses weren't working against my MUCH elevated anxiety so I upped the dose to 2mg or 2.5mg. Then when even that didn't work, out of desperation I tried mixing it with alcohol...mostly hard liquor, shots of vodka etc. I am still a lightweight when it comes to alcohol and when alcohol was involved it usually did not end well and only occasionally improved things/alleviated my anxiety...maybe 15% success rate. I didn't drink with it EVERY time, but from this point on maybe like 1/3rd of the time I took Klonopin for anxiety alcohol would be involved by the end of the night. LATE FEB-MID MARCH 2014: So then at the end of February/the beginning of last month, March, my mental/emotional state deteriorated further...I stopped bothering with logs for the most part. From late February to mid March I took the Klonopin with about the same frequency, maybe 3 or 4 days a week, and took 3MG every time which was sometimes effective, sometimes not. In mid March I took 4MG, my max ever dose, and after hours with not nearly enough anxiety relief I added in alcohol to the mix and of course blacked out. It's probably worth mentioning that I live totally alone and any time I've drank anything with the Klonopin in my system (and as mentioned above, nothing else, almost always on an empty stomach) I have been alone at home. I should also mention at this point that I am a 26 year old male, 5 foot 7 and weigh 123 pounds. PAST MONTH (mid/late March to now, April 16th) After the 4mg dose with the booze and no relief I knew it was time to see a doctor about the meds (and had actually been trying for months) but my doctor had no availability until the beginning of May and every other pdoc wasn't accepting new patients or didn't take my insurance. Started taking some higher doses like 5.5MG or 6MG, although not all at once...spaced out throughout the day when I kept having anxiety so I added more. I kept brief logs of this. 4MG was what I usually took at this point, although I think I cut back on the frequency a bit (twice a week or so). Sometimes it would help, sometimes it wouldn't. When it wouldn't I would add booze to the mix, rarely with positive results. Last day of March I started out with 5MG all at once since I knew I had a majorly anxiety-provoking and stressful day ahead of me...5MG wasn't enough so I took another 1MG a few hours later, then that still wasn't enough so 2 hours later I took another 1MG, then 3 hours later the anxiety still hadn't subsided so I took another 1MG, bringing me to my grand total of 8MG Klonopin for the day...and then added booze into the mix. According to what I wrote in my diary, it was only at this point that my anxiety finally reached a manageable level. My diary is missing entries from a lot of days since March 30th, 2014 but I know I upped the frequency of the Klonopin again and 5MG was my new minimum and usually did not work. I have an entry dated 4/13/2014 (3 days ago) saying "UGH it has been 3 hours since I took 7mg kpin all at once and everything is practically the same, anxiety just as bad. 7mg kpin on no food and NOTHING in terms of anxiety relief." (END OF SITUATION/SUMMARY) So basically that's where I'm at now. First of all, I learned my lesson and have cut alcohol out of my life entirely. But 7MG of Klonopin taken all at once doesn't do anything for me and I still need immediate anxiety relief for extreme situations, and badly. I have real-world obligations, serious ones, and my anxiety is severe enough to prevent me from doing them no matter how important I know they are. I finally saw a doctor today, told her the Klonopin had stopped working for my anxiety even at high doses, and she prescribed me 0.5mg Xanax instead. I have never taken Xanax before today. I took the first 0.5mg Xanax 2 hrs and 40 minutes ago, felt no different after an hour and a half, and took another 0.5mg Xanax 1 hour and 10 minutes ago...and still feel zero anxiety relief. Questions: Xanax is not Klonopin, but they're similar. Does the fact that 7MG of Klonopin has zero effect on my anxiety mean that the Xanax will be equally ineffective? Is the same dose of Xanax equivalent in potency/efficacy to the same dose of Klonopin, keeping in mind I've never taken Xanax before? Can I mix the two together? I feel like 0.5mg is *way* too low of a dose and am more convinced of that now that 1mg has proven to do nothing but then again I don't know that much about Xanax. Can I safely take, for instance, 4mg of Xanax without major repercussions (keeping in mind my tolerance to Klonopin and the severity of my anxiety)? Or 2mg Klonopin and 3mg Xanax or something like that? How likely is it, given this info, that I am essentially screwed in terms of any benzos ever working for me again? Like I said, I have HUGELY important obligations to meet both tonight, tomorrow and the next day and my anxiety is currently ruining tonight's and I can't afford to let my anxiety ruin the others as well...so any advice would be GREATLY appreciated. Sorry for the length, but I felt including all the details was important and hopefully some kind soul will see this and be able to offer some help or information. Thank you for your time. P.S. I have been prescribed and tried almost every other medication under the sun over the last 14 years, seen 20+ different doctors for my anxiety in that time span, and absolutely none of the meds have gotten rid of my anxiety except for the Klonopin...which is now ineffective. SSRIs, SNRIs, Tricyclics, Stimulants, Anti-Psychotics and several other classes of medication I'm forgetting. Non-med routes as well...15+ different therapists, CBT, exposure therapy, aromatherapy, meditation, almost everything. Nothing else works, which is why I'm so desperate.