Jump to content
CrazyBoards.org

Ritalin- Inconsistent effects?


Recommended Posts

I'm sorry if this question is redundant....

@notloki I know you're knowledgeable here.

I've been getting very inconsistent effects from Ritalin. I recently increased my dosage, because I was experiencing more fatigue afternoons and having to nap. I take 20mg (extended in morning, before I get up), then I take 10mg (extended) after lunch. Pdoc said I could take 10mgIR no later than 3pm if needed.

I'm compliant with this routine. Dose 40 minutes before getting up, same exact breakfast every morning: oatmeal, fruit, yogurt, nuts, coffee. Yesterday, I felt pretty good and energetic in the morning (both mentally and physically). Then today, I feel focused..yet, (sort of zombie-dazed staring at screen), incredibly drowsy/tired and apathetic, like I really need to nap. I get plenty of sleep every night.

Is there a reason this is happening? Seems doses effect me differently all the time. I prefer extended because the IR (while it hits more noticeably) I feel more intense energy crash and can become moody...Note: Pdoc will not let me change until I hit the max (60mg), and other stimulants (even Adderall) are either extremely hard or impossible to get prescribed here.

Edited by Blahblah
Link to comment
Share on other sites

This sounds like a manufacturer issue. Do you switch makers often ?  If you can nail down which manufacture(s) work Your doc can write a script that specifies this.Your pharmacy has historical records, they can tell you which manufacturer's tablet you were on when it worked.

Link to comment
Share on other sites

1 hour ago, notloki said:

This sounds like a manufacturer issue. Do you switch makers often ?  If you can nail down which manufacture(s) work Your doc can write a script that specifies this.Your pharmacy has historical records, they can tell you which manufacturer's tablet you were on when it worked.

Nope, it's always the same, although Effexor I've had different ones on occasion, I've been given different manufacturers. Wonder if that could be the culprit?

Link to comment
Share on other sites

10 hours ago, Blahblah said:

Yesterday, I felt pretty good and energetic in the morning (both mentally and physically). Then today, I feel focused..yet, (sort of zombie-dazed staring at screen), incredibly drowsy/tired and apathetic, like I really need to nap. I get plenty of sleep every night.

Is there a reason this is happening? Seems doses effect me differently all the time. I prefer extended because the IR (while it hits more noticeably) I feel more intense energy crash and can become moody...

This could also be a result of either the medication stopping working too soon or stimulant "rebound," which is when the medicine clears the system too quickly and is no longer occupying receptors/inhibiting transporters.

If it's the former, perhaps a different formulation of methylphenidate could work better. Ritalin SR (or Metadate ER) works for only 2-8 hours at a time. Dosing 2-3x/day is what would normally be the solution to this, but if for some reason it's working less than 2 hours per dose, changing the formulation might give better results. Ritalin LA (which are 50% IR/50% DR) works for 6-9 hours, but it often falls short of this duration of action, and often needs to be dosed twice daily. Metadate CD is 30% iR/70% ER and works 6-9 hours as well, and tends to work the full 6-9 hours (as opposed to Ritalin LA). Concerta, the extended release mechanism of which is called "osmotic-release oral system" (or OROS for short), can work up to 12 hours. The think to be wary of is that the Concerta dosage doesn't equally correspond to the amount of methylphenidate that is in it milligram per milligram (IOW, 72 mg Concerta, the official max dose, which most pdocs and physicians think is 12 mg above the max methylphenidate dose, is actually only 48 mg of methylphenidate (divide the Concerta dose by 4.5 and multiply by 3 to get the amount of methylphenidate). The "unofficial" max dose is 108 mg, which has 72 mg methylphenidate. There are many more formulations in the US, most of which may or may not be available where you live.

If it's the latter reason, then raising or lowering the dose may help. Or it could be that the methylphenidate isn't the stimulant for you, in which case switching to either dexmethylphenidate (Focalin/Focalin XR) (if it's available where you live) or an amphetamine-based stimulant (not sure which ones are available where you live, but I bet dextroamphetamine and Vyvanse are probably among them...).

  • Thanks 1
Link to comment
Share on other sites

14 hours ago, mikl_pls said:

This could also be a result of either the medication stopping working too soon or stimulant "rebound," which is when the medicine clears the system too quickly and is no longer occupying receptors/inhibiting transporters.

If it's the former, perhaps a different formulation of methylphenidate could work better.

If it's the latter reason, then raising or lowering the dose may help. Or it could be that the methylphenidate isn't the stimulant for you, in which case switching to either dexmethylphenidate (Focalin/Focalin XR) (if it's available where you live) or an amphetamine-based stimulant (not sure which ones are available where you live, but I bet dextroamphetamine and Vyvanse are probably among them...).

Thanks @mikl_pls !! I have the feeling it's a combination of 2 things below (hoping I can mitigate):

1.) Is tolerance when med is less effective than when started? Used to be very noticeable when kicking in, increased motor activation (moving foot up/down), complex task motivation & endurance (important tasks I always avoid) and appetite suppression (now I get big hunger pangs within 2-4 hrs taking). I loved the lifting of depression/mood (main reason for taking it)

Despite increasing dose + afternoon dose, I often feel this really slow, drained, zombie-effect (obsessive laser-focus, but with super arbitrary stuff (getting stuck on reading random articles for 6 hours straight, glazed over, spending an hour re-reading/editing/re-writing an email to friend over & over (like 5 TIMES?!!) It's like OCD! Feels yucky...! Then afternoon (after 2pm dose) I feel so tired I nap...

2.) Maybe it is wearing off too soon? I COULD be a rapid metaboliser (unsure), so maybe it's leaving system too quickly?  I drink 3 coffees per day, plenty of water...sometimes take vitamin C supplement & wondering if all this causes excess excretion?

Dosage forms are complicated. I've found the extended (SR, LA) def do not last the timeframe listed...Hmm just trying to see what will give me the best stable coverage throughout the day (not effecting my sleep) and won't make me irritable, or feel that yucky "tired & tweaky" effect, with bloodshot eyes, totally zoned out..staring... (you know what I mean!!!!) Maybe I'll try a break and just stick with coffee 😞

Edited by Blahblah
Link to comment
Share on other sites

*Wanted to add: when I start struggling, drained, dragging in early afternoon, everythings very slow to complete...I lose track of all time and end up being late for everything and forgetful. etc. I've always had a problem with running behind, but it seems to be getting worse? Time awareness & ability to act quickly

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

  • Similar Content

    • By Blahblah
      Has anyone (without a clinical thyroid disorder) tried Cytomel and had benefit with depression & fatigue? It seems most docs are resistant to trying it due to the possible heart/ bone density side effects.
      Even when it comes to thyroid disorders, There are some circles that disagree with the TSH lab ranges (what is "acceptable") and that TSH may not be good indicator of thyroid function for everyone anyway...
      I know T3 is rarely prescribed (even for ppl with thyroid issues). But I also read that in a few studies, folks with treatment-resistant depression (with no thyroid issues) can also benefit from using T3 as an add-on or "booster".
       
       
    • By Blahblah
      This is more of a poll to see everyone's favorite med that augments Ritalin? Unfortunately, I don't have access to Adderall, Dex, or any other stimulants (not available/authorized here). So..... I'm debating on switching out my A/D... I'm leaning towards going back to Effexor.
      My pdoc also suggested Abilify to augment, but seems that would be counterproductive, I'm not thrilled about the side effects.
    • By Skeletor
      As far as I am informed you need stimulants for treatment of ADHD. Most commonly used are Methylphenidate and Atomoxetine. Sometimes stuff like Bupropion is applied. But what about classic antidepressants with stimulant (NRI) properties? Let's say Desipramine or Nortriptyline, Reboxetine!? Can they help to some degree?
    • By Blahblah
      Anyone been diagnosed with Chronic Fatigue syndrome? I feel like maybe my symptoms are not due to depression. I do not want to start more meds because they don't solve the root problem. My mood is stable.
      Symptoms: I lay in bed for hours, everything is draining, exhausting despite sleeping 10+ hours every night....Brain Fog....Moving Slow like I'm carrying lead.....Dry eye syndrome (I have RX for this)....Dry itchy skin (I have RX lotion for this)...Cold feet.....Low Blood pressure.....
      I want to pursue other medical tests to rule out other causes. Tests so far:
      Thyroid + antibodies (normal)
      Vitamin D & Folate (normal after supplementation)
      Iron (normal- but slightly low end)
      Nutrition (I eat protein daily, healthy diet, avoid sugar)
      I know I need to exercise again, but lately due to this lethargy I am really struggling to even shower and cook... it's totally debilitating.
       
      My GP suggested maybe a Sleep test (although I don't snore in sleep). I will be getting some Cardio function tests. I'm ordering a sun lamp. is there anything else I could get checked out?
       
       
    • By sming
      Hey,
      So about 5pm every day of late, my mood just turns black. I can't buy a neutral (forget positive) cognition or emotion, I start to feel and think very negatively no matter what I do. Of course, I'm feeling and thinking badly beforehand, but it just sinks to another level, or depth if you will. 
      So I'm wondering if it's a med (or meds) that I'm taking that's losing effect around 5pm. I take the following meds - yes, it's a crazy-looking brew I know, but it allows me to function somewhat - at 6am (in milligrams):
      200 Provigil, 2.5 Abilify, 40 Fetzima, 30 Lexapro, 15 BuSpar, 150 Lyrica, 10 Percocet and these at 2pm:
      150 Lyrica, 15 BuSpar and these 4 times a day, where the last dose is typically 2pm:
      15 Adderall 10 Percocet (for chronic pain) and these at 7pm for sleep:
      150 Trazodone, 50 Benedryl It's impossible to confidently predict a "culprit" but if anyone has any hunches, I'd love to hear them.
      For example, today I'm splitting (some of) the 6am batch into two and  taking the second half at 2pm as an experiment. I feel that empirical experimentation might be the way to go because the theory is too complex with this many psychotropic medications in play. 
      Cheers , Pete
×
×
  • Create New...