View Full Version : Looking for a bit of guidance


ADDBill
07-28-16, 09:16 PM
I'm Bill. I always knew something was not quite right with me, that I viewed things differently. Smart but sloppy, intuitive but a procrastinator beyond belief. I'm 51 and resently retired and since then the issues have been much worse. I never could work for anyone so had my own businesses and when I was in to them I was hyper focused but when the interest faded it was always time to sell and move on as I would just completely ignore it.

Decided I needed to try to find the cause so went to my family doctor and he thought I might be depressed. I knew there was no way but he wrote a script for Welbutrin which is actually the first medication I have ever been on other than a antibiotic here and there. Took it a month, nothing so upped it to max dose and it also had no effect, was like taking sugar pills. I did some reading and came across a ADHD site which I almost ignored but then I saw a post about inattentive add and it was like reading my own biography. Took an online test for it and it was a slam dunk. Went back to my Dr who I like very much and he said there is no way you have that. Stated that he had patients with it and they are "all over the place" Knew at that point he was confusing add with adhd but hey nobody can know everything. He though did relent and wrote me a script for Stratera. We ramped the dose up to max and like the Welbutrin it did nothing except giving me the feeling of goosebumps but with no bumps. Decided I needed to seek out a specialist.

Took me a couple weeks to get the will up to call for an apt but finally did. After some testing and a chat with a nurse, a PA and then the doc himself he said you have inattentive ADD not a question in my mind. He asked me to schedule bloodwork even though I have that done yearly with my physical. He also wrote me a script for ritalin 5mg tablets. I did get the bloodwork done yesterday and was surprised they drew 6 vials, annual physical is only 3 vials. Does anyone know what they may be looking for?

On the ritalin he wanted me to start at 5mg per dose 2x a day and ramp it up myself depending on how I reacted but not to exceed 20mg 2x a day and he would see me in 2 weeks. 5mg did nothing, same with 10mg and 15mg per dose. Today I took 20mg and I felt it. The effect was not what I expected, had read, mostly on sites where people that abuse it that it gives a speed like effect. I felt no rise in energy, heart rate or motivation at ALL. What I did feel and is hard to explain but felt almost like I had been looking at the world and things through a very sheer curtain that was now gone??? For those with experience with Ritalin is that just the way it is? Does it take some time before all the effects of the Ritalin kick in or? Could it just be the 20mg is still too low? Was I just expecting too much too soon? I was looking for the kick in energy and motivation. I won't go over the 20mg dose limit he set until I talk to him again but was just wondering what others much more experienced with these medications are?

peripatetic
07-28-16, 11:14 PM
hi and welcome. i didn't read your whole post because i just can't right now :o (and i'm un-adhd medicated, so that doesn't help), but i read the paragraph about ritalin. i took that for, like, two decades.

here's the thing: you want to titrate up slowly and find the minimum effective dose. how to know what's effective? my psychiatrists have given me a chart to complete. it's like a daily log. the very fact of completion means it's doing something, ye ;)

anyway, set timers for every .75 to 1.5 hours and make a quick note of what you've done in the log. if you're reading, jot down what page or from where to where or whether you got three chores off your list...showered...whatever. and then you mention how able you feel to stay to a topic, to switch tasks... see if your doctor knows the self reporting logs i'm talking about.

and ritalin IR, which i'm assuming you have the IR? you'll want to take every four hours, but then if you find that you kinda go from a gas to a liquid, if that makes sense, for about 3 hours, then you'll want to overlap the doses so that it's as even as possible throughout the day. here's the thing about ritalin IR though: taking more doesn't make it last longer; it makes it stronger for that amount of time. you don't want it too strong...not some ossified clump. if you feel robotic at all or zoning out...then the dosage is too high or you've titrated up too quickly.

anyway, maybe take 10 however many times per day he said and keep a log for at least a few days if not a week. then maybe try 15, 10, 10 (if he said TID) for a bit and keep a log. etc

at some point it'll be like, ok, __, __, __ at these times covers me for the day, but it takes awhile to sort that. you have to figure out dosage, timing...keep hydrated, eat in regular intervals, etc. i'm always surprised when i hear a doctor has just given someone some pills and said start at five and no more than twenty at a dose and find what works :doh: soz...not to deride your doctor. i just know i would've failed miserably if i'd had to navigate that all myself. plus, i tried other meds, too.

anyway, that's my advice. how much is your total per day? and it IS instant release, right? 5mg pills? how often did he say to take it?

i would step back and start a reasonable titration process. i'm sure my psychiatrist went super slowly because i have other conditions that need to be kept under control first and foremost. but, still...go low and slow and you'll have less side effects adjusting to taking it regularly and fit it into your life more smoothly. plus, i know someone on here who's probably twice my size and he takes something like 10, 5, 5 for the day. people can vary widely in what works, so go up slowly and you could find efficacy at a low to moderate dosage. maybe more/less frequently than the standard 3.5 hours or whatever.

hope that helps!


EDIT: regarding the blood draws...no clue. i've NEVER had a blood draw for ritalin. other types of meds, yes...but never for a stimulant/adhd medication. i suggest you ask directly or at least get the results. if it were other psych meds i'd say possibly lipid panel or glucose (though you'd have to drink something or fast) or complete blood count... but you wouldn't need six vials. i have no idea...but i'm super curious what you find out they were for so please post when you find out :)

edit, part II: i just saw, on re read, you said he told you no more than BID. in that case, i would take one dose around breakfast and one dose around lunch. and keep the log. since he said start 5, 5 and you already did that...maybe try 10, 10....then 15, 10 for a week each...and go from there. let yourself adjust and keep track so you'll know what's actually working instead of feeling something...which isn't really telling you whether it's effective, just that you're having side effects from the sudden addition of the meds to your system. that's not your goal...efficacy isn't something you want to base on "feeling" but on results with tasks and focus and reduced impulsivity and keeping train of thought, sustaining concentration, etc.

sarahsweets
07-29-16, 06:44 AM
On the ritalin he wanted me to start at 5mg per dose 2x a day and ramp it up myself depending on how I reacted but not to exceed 20mg 2x a day and he would see me in 2 weeks. 5mg did nothing, same with 10mg and 15mg per dose. Today I took 20mg and I felt it. The effect was not what I expected, had read, mostly on sites where people that abuse it that it gives a speed like effect.
This is one of your problems. Trying to compare how a medication works to what tweakers look for will always be a let down.

I felt no rise in energy, heart rate or motivation at ALL. What I did feel and is hard to explain but felt almost like I had been looking at the world and things through a very sheer curtain that was now gone??? For those with experience with Ritalin is that just the way it is? Does it take some time before all the effects of the Ritalin kick in or? Could it just be the 20mg is still too low? Was I just expecting too much too soon? I was looking for the kick in energy and motivation. I won't go over the 20mg dose limit he set until I talk to him again but was just wondering what others much more experienced with these medications are?

I dont know if I would say your expectations were too high. What symptoms were controlled even if just a little?
Focus? Motivation and energy? Mood or ability to think, drive, problem solve?
If none of those were helped its worth considering another medication. If they were helped a little its probably a dosing issue
How many times a day are you supposed to take it?

ADDBill
07-29-16, 08:00 AM
Peripatetic,

Yes it is the IR version, though had to look up what IR meant, as well as TID and BID:) This taking medication thing is very new to me. He said twice a day morning and noon 4 hours apart. Just as a test to see how it worked.



Sara,

That is just the thing...I felt absolutely nothing from a 5mg, 10mg or 15mg dose. From the 20mg dose I did feel what I posted above but absolutely no change to energy or motivation, just a bit more focus. I did just start taking them on Monday though.....so the dose was Monday 5mg 2x a day, Tuesday 10mg 2x a day, Wednesday 15mg 2 x a day and Thursday (yesterday) the 20mg 2 x a day.

My mood is fine, my mood is always fine. Have had no side effects except for a bit of dry mouth yesterday on the 20mg. My biggest complaint is the lack of motivation and energy and for that I have had no help.

Sorry I was not clear, like I said I am new to all of this.

DJ Bill
07-29-16, 06:30 PM
:)I recently got put on Ritalin, my story is a mirror of yours except your other meds. I started with 10mg 2x a day, and thought the earth moved. However now I think that was just the placebo effect. Eventually I went to 10 3x a day, if I remember dose 2 and 3.

I had the same thing it felt like the fog was lifted from my eyes...My driving got better (I didn't realize it was so bad) and I started to notice things I had never noticed before. If I skip a dose I do notice some shaking of my fingers or hands......

I second the 4 hour useful time... I was looking to have the improvements from waking up to going to bed but I'd need another pill or two and my doc says 30mg is the max he will give me. (he's a GP, who works with a psychologist..) It is now more like I notice I forgot a dose,due to my losing track of things, etc, than I get a kick out of the Ritalin.

Establishing routines for things like cell phones, keys and my wallet has also helped majorly. I still need to find a belt clip for my key ring. Luckily I work for a boss who understands what I am going through and he does put up with a little absentmindedness.

Welcome and best of luck!

:)

sarahsweets
07-30-16, 04:40 AM
Peripatetic,

Yes it is the IR version, though had to look up what IR meant, as well as TID and BID:) This taking medication thing is very new to me. He said twice a day morning and noon 4 hours apart. Just as a test to see how it worked.



Sara,

That is just the thing...I felt absolutely nothing from a 5mg, 10mg or 15mg dose. From the 20mg dose I did feel what I posted above but absolutely no change to energy or motivation, just a bit more focus. I did just start taking them on Monday though.....so the dose was Monday 5mg 2x a day, Tuesday 10mg 2x a day, Wednesday 15mg 2 x a day and Thursday (yesterday) the 20mg 2 x a day.

My mood is fine, my mood is always fine. Have had no side effects except for a bit of dry mouth yesterday on the 20mg. My biggest complaint is the lack of motivation and energy and for that I have had no help.

Sorry I was not clear, like I said I am new to all of this.

I know for me, ritalin caused horrible mood issues but I also have bipolar so maybe that has something to do with it. IME ritalin either works or doesnt work. It seems like people who do well on ritalin do not do as well on amphetamines. Maybe you would do better on amphetamines?
I have no idea what they could be looking for with the blood work. I have been on adhd meds for like 15 years and never had blood work for it.

Pilgrim
07-30-16, 10:24 AM
ADDBILL,
I'm drawing a bit of a long bow here, this is just my experience. When you get that noticable dry mouth feeling not long after taking meds, I wouldn't go any higher.

That's me.

ADDBill
08-02-16, 11:06 AM
I think the odds are that Ritalin is just not for me. It has been a week now taking it and it is basically the same as the first day. Under 20mg at a time of IR I don't even notice it at all. Monday I go back to the doc and will see what he has to say. Had high hopes but I know everyone responds differently to the medications. On the positive side I have not had any side effects from it except the the dry mouth and that only happens at 20mg.

I appreciate the responses and will update when I see the doc.

ADDBill
08-08-16, 04:34 PM
Well as promised an update.

Went back to the DR this morning and he put me on Adderal 5mg and can take up to 10mg twice a day. I sure hope it works better than the Ritalan which did absolutely nothing.

They looked over the results of the blood work and the reason they wanted it was to check thyroid function and vitamin levels. My vitamin D was a little low but that was the only abnormality.

So we shall see how this works out and back to the doc in two more weeks.

Mario84
08-14-16, 04:17 AM
Your response to Ritalin (or stimulants in general) may have been impeded by your previous use of Wellbutrin, in which case I would reccomend a couple of weeks off of any meds just to reset your brain.
For a grown up I would definitely personally reccomend at least 10 mg per dose, and keep in mind that you want to be healthy in terms of not lacking minerals or vitamins, carbohydrates or proteins. Stimulants tune your brain up like a temporary turbo engine, but that in term means you need decent fuel to back up the effects it's trying to produce. You need to be a healthy eater for optimal results. I take two multivitamins a day and a Magnesium tablet before sleep (REALLY helps fallins asleep by the way). I do this anyway, but I notice how beneficial this is to Ritalin working. Another tip is to take the Ritalin (or Adderal as the case may be now) 10-15 minutes before a meal so that the body absorbs the pill easily and immediately gets supplemented with the nutrition it needs to utilize the Ritalin optimally.

It may be the doctor started you on 5mg to see how your heart handles it as a precaution since you are a 50 year old patient, but you most likely would feel the Ritalin at 10mg if you have checked off everything I've mentioned now.

You should be feeling a lifted curtain, but you should be feeling a bit more than that too. When it works, there's no doubt about it.

Let us know how the Adderal works for you. It's a stronger stimulant.

yepimonfire
08-14-16, 03:30 PM
Well as promised an update.

Went back to the DR this morning and he put me on Adderal 5mg and can take up to 10mg twice a day. I sure hope it works better than the Ritalan which did absolutely nothing.

They looked over the results of the blood work and the reason they wanted it was to check thyroid function and vitamin levels. My vitamin D was a little low but that was the only abnormality.

So we shall see how this works out and back to the doc in two more weeks.

Amphetamines tend to work better in PI patients just from what I've seen, though Ritalin works for me at 20mg 3x a day.

C15H25N3O
08-14-16, 10:05 PM
Edit: Answered to Ritalin and did not read the Adderall.