View Full Version : Little effect with Ritalin - sign that I don't have ADHD?


chilly82
07-31-14, 08:56 AM
Hi all, this is my first post here. For a while now I've suspected that I might have the inattentive type ADHD. I do pretty well in school; actually starting my first year of law school in September. However, I have just about every other symptoms:

- I day endlessly daydream to the point of being unproductive at work and getting in many near-accidents on the road
- I procrastinate on everything I do. All studying is left until the last minute, all responsibilities are put off etc.
- I have terrible sense of time. I always late at work, always.
- Very forgetful; always losing my keys and phone and other assorted items
- I zone out a lot in social situations; especially with groups of three or more. I think my spaciness is a big factor in my social awkwardness and mild social anxiety. I can never find the right word to use.

So in Canada, it takes a while to see a psychiatrist. So I spoke to my GP and told him my symptoms he thought it would be fine for me to try Ritalin to see how I got on. I was prescribed 10 mg of generic methylphenidate in the morning and 10 mg in the afternoon, with permission to experiment with the dose a bit. My results:

- 10 mg at first made me almost drowsy. Mom said it seemed like I was stoned because I was so mellow. The next day it simply made me calm but not tired. The next few days it had no noticeable effect.

- The next few days I tried 20 mg. I never did notice an effect on 20 mg. Sometimes I thought I could feel a slight comedown; where about 2 hours after taking the dose I suddenly became a little jittery and very slightly anxious for half an hour. But I never noticed any benefits.

- Finally I tried 30 mg and this has been the most consistent and beneficial dose. My concentration and drive improves tremendously. I am way more productive at work. I no longer have a million negative thoughts shooting through my head and instead I focus on the external world. I am a better driver (love that). Also made me way better at socializing. However, I don't think it made me particularly euphoric like a lot of people say. I think maybe the first time I tried 30 mg I was slightly euphoric as it seemed like it made me innately confident for no real reason. But after I could tell it made it so I can listen more intently to conversations, read their body language, and be able to process thoughts quickly enough to make proper responses without being awkward.

The 30 mg feels great and in my mind I wish I was like that 24/7. However there is one main thing that bother me.

I never realized this at first but it seems like 30 mg IR at once is a high dose to start on. Especially for inattentive since it seems like inattentive usually only requires smaller doses. In my mind I thought the perfect dosing for me would be 30 mg, 3 times a day. However upon more research I realized that number is way beyond the max dosing in Canada, and I also noticed that not so many ADDers take doses that high, especially when starting off.

So my big question is this: Could my reaction to the medicine mean I don't have ADD? I feel like if I did have it 10 mg, or at least 20 would have had an effect on me. Makes me feel like that perhaps the 30 mg is not really improving my symptoms but just getting me high. Have you heard of any cases where somebody starts out on 30 mg at once or TID? Is there a possibility that I could have ADHD but I just have an unusually naturally high tolerance to stimulants? Have you heard of any cases?

Obviously I know that one cannot be diagnosed based on reaction medicine alone, and I also know that no advice on the internet can be a substitute from a doctor's medical opinion. Still, I would love to hear any insight you might have. Thanks!

someothertime
07-31-14, 09:06 AM
One must review dosages in the context of lifestyle outputs and wellbeing indicators over a medium term to get a better indication of response.

Condition plausibility is a result of behaviours over an extended period of time and medications are intended to alleviate those to some extent.

Individual dosages vary and can be influenced by external factors such as outlook, diet, environment, demands etc. and a variance of a "light" starting dose and a "medium" starting dose is more reflective of individual reaction and physiology in addition to the influences listed above.

In other words, if you find it helps and it's within guidance.... give it time and see what a professional says after a longer period. If it's helping, this is a good thing.


Peace.

Lunacie
07-31-14, 09:25 AM
Sounds like 30 mg is doing exactly what it should do. Everyone is different and
some need a very small dose because they are ultra-sensitive, others need a larger dose
because their brain chemistry is more unbalanced.

Is the XR form of Ritalin available in Canada? You might find you like the extended coverage better.
Everyone says they wish the effects of meds lasted all day, but it just doesn't,
and might make sleep more difficult if it did.

Somo also made a good point about how we may need a higher dose for awhile and then
can drop to a lower dose, depending on things like sleep, diet, exercise, and stress.

Kombatwombat
07-31-14, 06:18 PM
After reading your post i now want to go to a GP and try and get prescribed with a stimulant. People around me have long suspected i have had learning disorders but i have never been diagnosed with anything. I guess i wasnt disruptive enough as a child and in New Zealand at least, it seems pretty impossible to get diagnosed as an adult.

After doing my own research i dyspraxia seemed to be the only thing that seemed to tick the boxes, but really my main problem has always been my inability to concentrate. I always counted out adhd because i am not impulsive like my mate who was diagnosed at an early age and has been taking meds for most of that time which seemed to normalize his behavior alot. Hearing about the inattentive type that pretty much seems me and if I am to go back to school next year to try for a bachelors degree i know i am gonna need something to help me concentrate as i cant help myself from constantly daydreaming.

My fear is though that it wont be easy in New Zealand to get these meds as an adult and i am not gonna be able to just flat out ask for them as they will just think i am seeking them for recreational use/abuse, especially as i dont have a regular gp who knows me. Any thoughts on how i should put it to the GP?

chilly82
08-01-14, 07:41 PM
Well if New Zealand's health care system is anything like Canada's then I'd say you be better off finding an open-minded GP who likes giving out medication instead of waiting for 7-8 months for an appointment with a psychiatrist appointment where more often then not they will probably just tell you don't have ADHD and refuse to let you try anything for probably some stupid reason. Imagine what a waste of time that would be.

I almost made that mistake. A couple of months after I asked for a psychiatrist appointment I managed to get "lucky" and get to see some intern. She freaked out, telling me that I can't have ADHD because I did well in school, and said that I shouldn't be using Ritalin since its a controlled substance. I kid you not. She never said because it can be potentially addicting or because it could have bad side effects or any rational reason like that. She just said because it is a controlled substance. Ridiculous. Anyways she sent a letter to my GP trying to convince him to stop my prescriptions. Luckily I visited my GP and was able to reason with him. Since he is rational. I sincerely told him that I've been experiencing no severe side effects and that they've been helping me a lot and he saw no reason to stop me from taking them.

New problem now though. The Ritalin doesn't last long enough. It only lasts 1 and a half to 2 hours for me. I mentioned this to my doctor and he gave me a new script to try sustained release Ritalin for a week. And he gave the impression that he'd be open to letting me trying Adderall after that if I wanted to.

However, the pharmacist said she can't give me the Ritalin SR prescription until I'm completely done with my old prescription. I think that is a silly rule. I mean, yes, if I were just getting a refill of a usual prescription, I can see why they would want me to not refill early since it is a controlled substance that can be abused. However I think in the case of a dosage change (or even medication change really since its a different form of ritalin), I think there should be exception. Now I have to wait a full week and a half to get my new prescription (which I don't have high hopes for), with nothing to use in the mean time except some IR Ritalin that nearly completely useless to me.

Kombatwombat
08-02-14, 05:56 PM
Good to hear your experience with psychiatrists and i think yes, i think it is pretty much the same hear. I paid good money a few years back to see one hoping to get diagnosed and it was a complete waste of time. All he said i was i was showing signs of this and that, but no clear diagnosis. He did think i needed help and should see him again. Of course i would have to fork out more of my own money and probably just be lead further "down the garden path". It's funny that you say u were told u didnt need help because u did well at school. I wouldnt say i did well at school but i stuck it out and managed to scrape a university entrance result. I guess i would say i did average and i think because i maintained average results at school it wasnt felt necessary to get help for me even though most teachers suspected something was odd with me. That really ****** me off because even though i managed to scrape through school with average results i was struggling socially and basically have struggled to function at all since i left the structured environment at school into the real world. Anyway ritalin seems to have really benefited you in the very areas i was hoping it would benefit me which is encouraging, though i am not optimistic as to being able to talk a GP into prescribing me with it. I guess can only keep trying.

someothertime
08-02-14, 06:13 PM
Kombat, throw how and when in the rubbish. Problem solve around nearby support services and people then take it one step at a time...

Ring groups, community centres, govt departments and ask really clear questions about what is available, who can assist, are they experienced etc.

Just take the next step light and keep taking it... I know you can.

sarahsweets
08-03-14, 05:27 AM
Someone 's reacting to meds is not indicative of whether or not they have adhd.

Pilgrim
08-03-14, 07:14 AM
I think trying the different types of medications and then settling on the correct dosages is a challenging element.
You will know when it's correct as it makes clear and reasoned thinking possible for long periods of time.

Kombat if I could say as Someothertime did research research .

You sound like some assistance is required to get through uni.
A good Psyc is gold in this situation.

He/ she will look at social, scholastic and work performance.

Good luck

chilly82
08-06-14, 07:01 PM
Someone 's reacting to meds is not indicative of whether or not they have adhd.

You obviously didn't read the entire opening post.

namazu
08-07-14, 12:57 AM
You obviously didn't read the entire opening post.
I think Sarahsweets' point is accurate, even taking into account the entire opening post.

For some people, low doses don't do much. This could be because the diagnosis is incorrect, because the medication isn't the right one, because of differences in metabolism, etc.

You have a couple valid questions:

1. Is your ADHD diagnosis accurate?

2. Are you getting an appropriate therapeutic effect from the medication, or is it just making you high?

Regarding the diagnosis, I would suggest following through with seeing a psychiatrist or psychologist in addition to your GP, even if it takes a while. I know you have limited choice in the matter, but if you can get a referral to someone with strong experience diagnosing and treating ADHD in adults, that would be ideal.

Regarding the medication, if you are using it under the close supervision of your physician, and don't feel the need to keep increasing the dose, and have no medical complications or substance abuse history to be concerned about, then you're probably OK. It is a high dose to start on -- you're right about that -- and a high short-acting dose in general, but people do vary in their response to medications.

You're asking the right questions of yourself.

Best wishes!

sarahsweets
08-07-14, 04:43 AM
What makes you say that? How someone reacts to stimulants does not explain whether or not they have adhd meaning: a positive reaction doesn't always mean you do have adhd and a negative reaction doesnt mean you dont have it. If everyone who reacted positively to stimulants was a way to confirm adhd then entire populations of college campuses would he considered adhd because of the positive performance enhancements they experience while taking meds.

You obviously didn't read the entire opening post.

MADD As A Hatte
08-07-14, 10:09 AM
Your original post clearly indicates yes, you have ADD and yes, stimulant meds are working for you. Standard adult dose is 3 x 20mg.

You might also consider getting a prescription for a 54mg Concerta once a day; with 20mg Ritalin early evening if you need to study into the night. Works for me, I'm very high functioning on my meds, but all over the joint the split second they wear off. Like now, I must sign off, log off, and get to sleep!!

If your dose is right, you shouldn't actually "notice" anything. But a week later you realize you've been motoring along living a "normal" version of your own life.

Best

Pilgrim
08-07-14, 11:09 AM
What makes you say that? How someone reacts to stimulants does not explain whether or not they have adhd meaning: a positive reaction doesn't always mean you do have adhd and a negative reaction doesnt mean you dont have it. If everyone who reacted positively to stimulants was a way to confirm adhd then entire populations of college campuses would he considered adhd because of the positive performance enhancements they experience while taking meds.

Quote:Sarahsweets ,

I thought that was well said.
We are learning from the experts Namazu and Sarah

MADD As A Hatte
08-07-14, 11:02 PM
What makes you say that?

Good question, Pilgrim, she says, in her best John Wayne voice.

The COLLECTION OF DESCRIBED BEHAVIOURS in the full original post

causing IMPAIRMENT in MULTIPLE ARENAS

in combination with the DESCRIBED IMPROVEMENTS when on STIMULANT MEDICATION

is what makes me say that.


[The caps are not shouting; they are simply to highlight what one is looking for, as indicators.]



With regard to experts good point, Pillllllgruhm, she says again, trying to improve her John Wayne intonation.

I have enormous respect for the seasoned, reasoned and informed voices of some of the ADDForum members. I thank them relentlessly in their posts, I send respect their way in the form of "Reputation" greenies, and from to time when I need advice, or clarification or whatever, I send a private message.

I also refer regularly and often to my own external (to the forum) band of experts. Not limited to but including:

In Sydney: Dr Mark Selikowtiz, Dr Carol Margeson, Dr Anthony Slowiacek, Ross Leonard (all of them specialists in the ADD field), et al.

In Newcastle: the entire Psychology Department at the University of Newcastle (which ranks a world beating 5 for it's current, ongoing psyche research). I drive these poor people mad with my questions about psychology, human behaviour etc.

I refer to and read international sources: Dr Russell Barkley, Dr Mary Solanto, Thomas Brown, everyone on CHADD.org, psychology.about.com (Kendra Cherry is particularly good), et al.

Again, thanks, good question, Pilgrim.

chilly82
08-08-14, 02:59 PM
Ugh so frustrating. I asked my doctor to let me try adderall xr (ir is not available in canada), only because Ritalin only lasted about an hour and a half to two hours max.

I tried 10 mg of adderall xr and there was absolutely no effect. So just this morning I tried 20 mg of the xr. Again no noticeable effects. Or if there are any effects they are incredible small and subtle.

I was under the impression that whether or not you have adhd or not, stimulants should still affect you in some way.

Now I know some drugs like antidepressants are very subtle, to the point where you only realize their effectiveness in hindsight. But I always thought that effective doses of a stimulant should be very noticeable, at least when starting out before you become more used to and accustomed to the drug.

Other than taking ritalin for the last month or so I have absolutely no experience with any kind of stimulants. I shouldn't have any tolerance built up. How frustrating. The effective doses of ritalin made everything so clear. It was like my entire life I was driving around in a car with a dirty grimy windshield and taking the ritalin was like finally activating the wipers and wash so I could properly see the road ahead of me.

namazu
08-08-14, 04:59 PM
Have you discussed with your doctor the possibility of taking multiple doses of Ritalin in a day, or trying a long-acting form of methylphenidate? If Ritalin helped (even if only at a higher dose, and not all day), then it seems reasonable to use that as a starting point for adjusting dosing.

Lunacie
08-08-14, 05:05 PM
Some ADHDers find Ritalin most helpful, others find Adderall works best for them.

It's a shame you can't get the extended version of Ritalin. Maybe you could take 30 mg in the morning with two more 20 mg boosters during the day?