View Full Version : Just not sure about this med..

01-15-12, 02:18 PM
I've been taking Focalin XR since October, with small increases in dose from 5mg to now 15mg since November. This is the 2nd medication I have tried to help my ADD, first was Wellbutrin which didn't last long as the side effects were pretty awful and it didn't help any of my symptoms. At first, I was loving the benefits of Focalin; mind-clarity, calmer thought-process, better motivation, and the ability to read and absorb information. When I was first put on this medication, myself and my doctor agreed that we would schedule an appointment in 2 weeks to see how it was working.

I had 2 week appointments for about a month, to check up and see if it was working and she gave me the option with each appointment to decide whether I wanted to stay on it or switch to something else. The last appointment I had was in December, and we scheduled a 3-month appointment for February to follow up again. At the last appointment it was decided that I would be staying on Focalin, since I liked it and really had no side effects. I have really no experience with ADD medications and I haven't been seeing this psychiatrist for very long (5 months), but now that I've been taking this regularly for a longer period of time, I'm noticing more and more how mild it really is, and how frequent the ups and downs are during the day while I am on it. I've been struggling for a lifetime with problems in my personal life, school, and the workplace as well, and honestly I feel that I was so happy at first with this med because even small improvement can feel like miles of progress because it was much better than the unmedicated me. I am kind of confused as to where I go from here, because on one hand, I feel that I am not really at my best and although the med is helping, it's either wearing off because I am getting used to it, or it's just not effective enough. Sometimes it feels like I am fading little by little back to my old self, like regression.

I am confused because I can't really tell if that is the case or if I should be asking for a higher dose in February. I don't want to feel like I simply just settled on the first thing that worked even a little, and I also don't think it would be entirely wrong of me to ask the doctor if I could try a different medication to see if there is something that works better for me? It doesn't seem wrong to ask. She gave me the opportunity before, but we don't really have a long doctor/patient history and I don't know if she would be so willing to just up and change medications like that. Compared to many people on this forum, I have noticed that it can take years to find the right thing, or years go by and what worked before has stopped working. What I am asking basically is if I should continue to be patient and let more time pass before I ask to switch things up, or is it normal/okay to change doses or medication within a few months? That might be a hard question to answer, but all I know is that I have been feeling this way for a while and I just don't think I can ignore my frustration with this medication any more.

I honestly don't think a dose increase is the solution either, I think its the actual med. It's an XR, and for the most part the effects last me through a full work day, (8hrs), but I've noticed that if I take a dose at 8am, I am "crashing" by 12pm, and after lunchtime, I feel a "kick" around 3pm which lasts until I go home, but the effects all seem very superficial. Like I'm just drinking more coffee. It doesn't go very deep in the way of actual ADD symptoms. I don't really want that, I would like something less jumpy and more steady. I don't want to feel myself crashing and burning, and I don't want to feel myself "climbing" back up either. Sorry for typing so much, but if anyone has advice for how I should approach this subject with my doctor, or if I really am justified in wanting to go in a different direction with medication, I would sincerely appreciate the feedback :)

01-16-12, 09:49 AM
yeah I hear ya. I think I've been at this point for awhile now. I know that it helps but just as you said I'm pretty much out at lunch and it's kind of downhill from that point on. During that period the mind will wander . During the mind drift I've pondered tons of other stuff that might be wrong with me because I'm so unfocused periodically on ritalin meds. Ritalin is up and down and yeah it's speedy and then it's not speedy , you kind of never really know. Last week I tried adderall and I think I'll go back to it , I'm just not used to it. Regarding adderall it's very smooth and you feel slowed down , but after you realize it , that kind of is what you need, and it lasts seemingly alot longer.

01-16-12, 12:11 PM
Yeah I don't want to feel like that. I just don't have experience or knowledge of other medication to know if anything will really be different from the Focalin. I don't even know how to approach my doctor about this, but I think I will just be open about how I'm feeling and see what she thinks. The only problem I can tell is that she is a typical psychiatrist in the fact that even though she asks me the "required" questions such as how am I doing, how are things going, etc., she doesn't really seem to wait for my answer or even care really. She pointedly told me at my first appointment that I should continue seeing the therapist because she is not the one to spend time having lengthy discussions about life and such. She sees a lot of patients, and doesn't have the time to spare, many of the appointments since I was put on Focalin have been 10-15 minutes, with a very brief talk about how the medication is working for me. I have a feeling that even if she had the time, she just doesn't really care about anything deeper than the textbook symptoms of a disorder, and she gets straight to the point. I actually kind of like this in some ways, because she listens to what the issues are and comes to a conclusion fairly quickly without needing "proof" or "tests". I think this worked for my particular situation, and I trust her because she is smart, sharp, and very observant. She is good at what she does. I just wish I didn't feel like I'm being rushed through an appointment, like I have 5 minutes to figure out what is most important and get that out there before the time is up.

01-16-12, 12:34 PM
yeah I know exactly how you feel. Put it this way , this is how ritalin acts ( all of the formulations may differ slightly in release but they are all the same basically ) Focalin, ritalin, concerta, ritalin la , metadate. Dont get confused on the formulations just know they are all ritalin and will all act the same basically when effective.

Basically this is what happens with ritalin. Quick rise to peak and then a big valley or dip and it's not real effective from that point on. This is basically whats happening I'm guessing. Yeah , you could dose up but what happens is this pattern again and again. Basically the duration of sustained effects blows.

Adderall: Slow rise to peak and much longer sustained duration of effect, if you dose correctly is additive and will last all day.