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Ritalin is making me lethargic after found the bottle I lost.  I had severely cut down on it.  I am not sleepy and I can focus better but I am kind of overly calm and flat.  Is it possible my dosage is too high?

Edited by Banana Smurf
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22 hours ago, Banana Smurf said:

Ritalin is making me lethargic after found the bottle I lost.  I had severely cut down on it.  I am not sleepy and I can focus better but I am kind of overly calm and flat.  Is it possible my dosage is too high?

If you don’t mind, what’s the current Dose? 

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6 hours ago, Banana Smurf said:

My current dose is 10 mg tid and it's IR.  It took me a bit to get up to that dose so I guess it might even out.  

Do you feel anything at 10mg? I've tried experimenting with my dose, 30-40mg per day. ( I don't want to be taking 3 times per day, so I divide it morning & afternoon)

At moment, I have 30mgLA (morning) and 10mg IR for afternoon....But oddly enough, I think taking 20mgLA and 20mgIR afternoon worked better...I swear it's a crapshoot sometimes! Sometimes I feel it works well, and other times I just feel numb and lethargic.

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It's weird it worked differently at different times close together for you.  I think I just have to wait for it to 'feel' like it did before since I discontinued it.  I keep worrying that I'm overmedicated or something and complaining that I want to quit my meds.  I know it would be stupid, though.  

At 10mg, I feel it pretty strongly, but it feels like calmness and flatness.  I'm not really depressed right now and tend to be spazzy when I'm at baseline and it totally wipes it out.  I guess I'd like some spazz energy as a remainder, but not all of it.  It seems really strong.  

Edited by Banana Smurf
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6 hours ago, Banana Smurf said:

It's weird it worked differently at different times close together for you.  I think I just have to wait for it to 'feel' like it did before since I discontinued it.  I keep worrying that I'm overmedicated or something and complaining that I want to quit my meds.  I know it would be stupid, though.  

At 10mg, I feel it pretty strongly, but it feels like calmness and flatness.  I'm not really depressed right now and tend to be spazzy when I'm at baseline and it totally wipes it out.  I guess I'd like some spazz energy as a remainder, but not all of it.  It seems really strong.  

It comes in 5 mg tablets that you could take once or twice a day depending, or halve them and take half twice daily.

Alternatively, you may respond differently to long-acting versions... The lowest almost any of them come in is 10 mg, except Concerta which comes in 18 mg which is equivalent to 12 mg Ritalin (not all of the methylphenidate in Concerta tablets is absorbed...). There is also a transdermal patch, Daytrana, that is mostly used in pediatric patients, but can be used in adult patients too. Whether your insurance pays for it is the question. Even though it has been out for a while, my insurance chose to stop covering it years ago.

  • Adhansia XR (25 mg, works for 16 hours, either biphasic or triphasic release mechanism)
  • Aptensio XR (10 mg, works for 12 hours, biphasic release mechanism)
  • Concerta (18 mg, works for 12 hours, continuous release mechanism)
  • Cotempla XR-ODT (8.6 mg, biphasic release mechanism, indicated only for pediatric patients)
  • Jornay PM (20 mg, taken in the evening, delayed release mechanism where it is supposed to start acting right when you wake up and then work all day)
  • Metadate CD (10 mg, works 6-9 hours, biphasic release mechanism)
  • Metadate ER (?)
  • Quillichew ER (20 mg, biphasic release mechanism)
  • Quillivant XR (extended release liquid form, the dosage of which I suppose depends on how small it can be measured, they recommend starting at 20 mg, works for 12 hours)
  • Ritalin LA (10 mg, duration 6-9 hours but often falls short of this and needs to be dosed twice daily or accompanied by an IR dose in the afternoon, biphasic release mechanism)
  • Daytrana (10 mg per 9 hours, indicated to be applied for 9 hours per day and off for 15 hours but I suppose duration can be tailored individually, it can be removed at any time during the day if needed, needs to be applied 2 hours prior to desired effect, and duration remains active 3-5 hours after removal, so it actually acts anywhere from 12-14 hours, must be titrated from 10 mg/9 hours regardless of oral methylphenidate dose, max dose is 30 mg/9 hours, I'm not sure how these dosages translate to oral dosages... there are websites that claim to offer equivalencies, but they're all different...)

There's also dexmethylphenidate (Focalin, Focalin XR) which is twice as potent milligram per milligram than methylphenidate is. Max dose of IR version is 20 mg, whereas max dose of XR version is 40 mg for some reason; minimum dose of both are 5 mg/day.

Alternatively, there are a host of other amphetamine products in the US that may work better for you if any dose/form of methylphenidate has this flattening effect on you:

  • Adzenys ER (mixed amphetamine salts ER liquid, duration 9-14 hours)
  • Adzenys XR-ODT (mixed amphetamine salts ER-ODT, duration 9-14 hours)
  • amphetamine/dextroamphetamine (Adderall)
  • amphetamine/dextroamphetamine ER (Adderall XR, 12 hours biphasic release)
  • dextroamphetamine (Dexedrine tablets, Zenzedi brand-name only tablets with a wider assortment of dosages, ProCentra instant-release liquid)
  • dextroamphetamine ER (Dexedrine Spansule, acts for 6-8 hours, may be dosed once or twice daily, IIRC is biphasic release mechanism with beads that digest with different pH's associated with different parts of the digestive tract unlike having instant- and extended release beads like Adderall XR)
  • Dyanavel XR (mixed amphetamine salts ER liquid, duration 10-15 hours)
  • Evekeo (amphetamine)
  • Evekeo ODT (amphetamine ODT, pediatric indication only)
  • methamphetamine (Desoxyn, while instant release, may be dosed once daily as duration of effects is generally longer than other amphetamines)
  • Mydayis (amphetamine/dextroamphetamine ER, duration up to 16 hours, essentially a triphasic release system with IR, ER lasting 12 hours, and another IR dose that acts 12 hours after ingestion for an extra 4-6 hours of duration)
  • Vyvanse (lisdexamfetamine, prodrug to dextroamphetamine activated by digestion, acts up to 12 hours but for some falls short or may act longer than this, comes in capsules and chewable tablets, capsules most common form)

I'd start with IR Adderall or IR Dexedrine and move to an equivalent extended-release version if you wish for once-daily dosing though twice daily dosing is possible with some forms of ER amphetamine-based stimulants (Dexedrine is limited to pretty much Dex Spansules and to some extent Vyvanse, the highest dose, 70 mg, of which metabolizes to approximately 20 mg dextroamphetamine per day, whereas the max dose of Dexedrine, Dexedrine Spansules, Zenzedi, and ProCentra is 60 mg/day; Adderall can be switched to just Adderall XR or any of the other extended release mixed amphetamine salts products, but dosage will be different and re-titration from lowest dose is recommended, however there are equivalencies for most; methamphetamine is sort of a drug of last resort for ADHD, narcolepsy, and obesity because even at therapeutic doses it is mildly to moderately neurotoxic to serotonin neurons and I believe at higher doses quite neurotoxic to dopamine neurons, especially in the nucleus accumbens). Dextroamphetamine is more potent of an appetite suppressant, more potent of a CNS stimulant, and less potent of a peripheral nervous system stimulant than racemic amphetamine is. Dextroamphetamine is relatively more dopaminergic and less noradrenergic than amphetamine, which is roughly balanced in its stimulation of dopamine and norepinephrine release, possibly more noradrenergic if anything else. Methamphetamine is actually no more dopaminergic than dextroamphetamine, less noradrenergic (stimulates the peripheral nervous system less), and way more serotonergic than any of the amphetamines on the market (which may explain its neurotoxicity to serotonin neurons). All amphetamines, like methylphenidates, are Schedule II.

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29 minutes ago, mikl_pls said:

It comes in 5 mg tablets that you could take once or twice a day depending, or halve them and take half twice daily.

Alternatively, you may respond differently to long-acting versions... The lowest almost any of them come in is 10 mg, except Concerta which comes in 18 mg which is equivalent to 12 mg Ritalin (not all of the methylphenidate in Concerta tablets is absorbed...). There is also a transdermal patch, Daytrana, that is mostly used in pediatric patients, but can be used in adult patients too. Whether your insurance pays for it is the question. Even though it has been out for a while, my insurance chose to stop covering it years ago.

  • Adhansia XR (25 mg, works for 16 hours, either biphasic or triphasic release mechanism)
  • Aptensio XR (10 mg, works for 12 hours, biphasic release mechanism)
  • Concerta (18 mg, works for 12 hours, continuous release mechanism)
  • Cotempla XR-ODT (8.6 mg, biphasic release mechanism, indicated only for pediatric patients)
  • Jornay PM (20 mg, taken in the evening, delayed release mechanism where it is supposed to start acting right when you wake up and then work all day)
  • Metadate CD (10 mg, works 6-9 hours, biphasic release mechanism)
  • Metadate ER (?)
  • Quillichew ER (20 mg, biphasic release mechanism)
  • Quillivant XR (extended release liquid form, the dosage of which I suppose depends on how small it can be measured, they recommend starting at 20 mg, works for 12 hours)
  • Ritalin LA (10 mg, duration 6-9 hours but often falls short of this and needs to be dosed twice daily or accompanied by an IR dose in the afternoon, biphasic release mechanism)
  • Daytrana (10 mg per 9 hours, indicated to be applied for 9 hours per day and off for 15 hours but I suppose duration can be tailored individually, it can be removed at any time during the day if needed, needs to be applied 2 hours prior to desired effect, and duration remains active 3-5 hours after removal, so it actually acts anywhere from 12-14 hours, must be titrated from 10 mg/9 hours regardless of oral methylphenidate dose, max dose is 30 mg/9 hours, I'm not sure how these dosages translate to oral dosages... there are websites that claim to offer equivalencies, but they're all different...)

There's also dexmethylphenidate (Focalin, Focalin XR) which is twice as potent milligram per milligram than methylphenidate is. Max dose of IR version is 20 mg, whereas max dose of XR version is 40 mg for some reason; minimum dose of both are 5 mg/day.

Alternatively, there are a host of other amphetamine products in the US that may work better for you if any dose/form of methylphenidate has this flattening effect on you:

  • Adzenys ER (mixed amphetamine salts ER liquid, duration 9-14 hours)
  • Adzenys XR-ODT (mixed amphetamine salts ER-ODT, duration 9-14 hours)
  • amphetamine/dextroamphetamine (Adderall)
  • amphetamine/dextroamphetamine ER (Adderall XR, 12 hours biphasic release)
  • dextroamphetamine (Dexedrine tablets, Zenzedi brand-name only tablets with a wider assortment of dosages, ProCentra instant-release liquid)
  • dextroamphetamine ER (Dexedrine Spansule, acts for 6-8 hours, may be dosed once or twice daily, IIRC is biphasic release mechanism with beads that digest with different pH's associated with different parts of the digestive tract unlike having instant- and extended release beads like Adderall XR)
  • Dyanavel XR (mixed amphetamine salts ER liquid, duration 10-15 hours)
  • Evekeo (amphetamine)
  • Evekeo ODT (amphetamine ODT, pediatric indication only)
  • methamphetamine (Desoxyn, while instant release, may be dosed once daily as duration of effects is generally longer than other amphetamines)
  • Mydayis (amphetamine/dextroamphetamine ER, duration up to 16 hours, essentially a triphasic release system with IR, ER lasting 12 hours, and another IR dose that acts 12 hours after ingestion for an extra 4-6 hours of duration)
  • Vyvanse (lisdexamfetamine, prodrug to dextroamphetamine activated by digestion, acts up to 12 hours but for some falls short or may act longer than this, comes in capsules and chewable tablets, capsules most common form)

I'd start with IR Adderall or IR Dexedrine and move to an equivalent extended-release version if you wish for once-daily dosing though twice daily dosing is possible with some forms of ER amphetamine-based stimulants (Dexedrine is limited to pretty much Dex Spansules and to some extent Vyvanse, the highest dose, 70 mg, of which metabolizes to approximately 20 mg dextroamphetamine per day, whereas the max dose of Dexedrine, Dexedrine Spansules, Zenzedi, and ProCentra is 60 mg/day; Adderall can be switched to just Adderall XR or any of the other extended release mixed amphetamine salts products, but dosage will be different and re-titration from lowest dose is recommended, however there are equivalencies for most; methamphetamine is sort of a drug of last resort for ADHD, narcolepsy, and obesity because even at therapeutic doses it is mildly to moderately neurotoxic to serotonin neurons and I believe at higher doses quite neurotoxic to dopamine neurons, especially in the nucleus accumbens). Dextroamphetamine is more potent of an appetite suppressant, more potent of a CNS stimulant, and less potent of a peripheral nervous system stimulant than racemic amphetamine is. Dextroamphetamine is relatively more dopaminergic and less noradrenergic than amphetamine, which is roughly balanced in its stimulation of dopamine and norepinephrine release, possibly more noradrenergic if anything else. Methamphetamine is actually no more dopaminergic than dextroamphetamine, less noradrenergic (stimulates the peripheral nervous system less), and way more serotonergic than any of the amphetamines on the market (which may explain its neurotoxicity to serotonin neurons). All amphetamines, like methylphenidates, are Schedule II.

Thank you for all that information about stimulants.  I will ask ask my sleep doctor about 5 mg tablets, and if that doesnt work, I might see how my sleep doctor feels about amphetamine.  I really like the IR dosing because it is easier to sync the stim peaks with sleepiness or a need for absolute alertness.  

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6 hours ago, Banana Smurf said:

Thank you for all that information about stimulants.  I will ask ask my sleep doctor about 5 mg tablets, and if that doesnt work, I might see how my sleep doctor feels about amphetamine.  I really like the IR dosing because it is easier to sync the stim peaks with sleepiness or a need for absolute alertness.  

I might suggest asking about the focalin too, more than one pdoc I’ve had felt that it can be a milder methylphenidate than Ritalin 

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  • 1 year later...

@Banana Smurf Were you ever able to resolve this problem? I took quite a long break & then re-instated and it doesn't effect me nearly the same way it used to... I'm  having major issues in the afternoon. (IR seems to have stronger/more noticeable effect, but I get an irritable crash after 2hours when it that wears off.)

Everyday, at around 2pm I get extremely lethargic & eyes feel heavy (not sleepy, but all I can do is lay in bed) and I start zoning out. Not thinking about anything, just spacing out for hours. (this seems to happen whether i take my afternoon dose or not). I've tried tweaking my doses a bit in afternoon, but hasn't helped. Morning, I took my usual 30mg extended....then at 1pm, I took 20mg extended + 10mg IR. By 2pm I felt drained.

Unfortunately, they do not prescribe any other stimulants here. (just getting ritalin is nearly impossible unless you are a 6-10 year old with severe ADHD & behavioral issues.) And they max out at around body weight (I'm 50kg, so they won't give me more than 60mg max). i can ask about Concerta, but not sure what dose would be best.

I've also considered changing out my A/D again..maybe back to Effexor? I like that Prozac has a long half-life and I'm still stable if I run out or miss a couple days, (Effexor isn't as kind in that way!)

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