This is the third time I'm posting this - hopefully I'll get a response this time. :o

I'm currently taking 20 mg of Ritalin LA in the morning followed by 10mg doses of Ritalin throughout the day. On top of that, I'm taking Prozac to help with irritability. The Ritalin LA does nothing, and the Ritalin sets in about 45 minutes after taking it and wears off about an hour after that, followed by a fairly intense feeling of anxiety, which I hate. Any other suggestions? I've read Dexedrine and Welbutrin can be a good combination? Any comments on that? I'm looking for something with more lasting power - I don't want to have to take 3 or 4 doses of Ritalin throughout the course of the day. The Prozac isn't really doing anything for me. Then again, I've tried Lexapro and Effexor, as well, with no luck.

Thanks!

Sorry you are having a difficult time finding the right medication. It can be quite frustrating trying to best med and ideal dosage. Stick with it and I am sure you will find it. :)

Have you tired any other stimulants? How about Adderall or Adderall XR? I have had great success with it. Maybe the non-stimulant Strattera might work for you. Please visit the the Strattera forum for more information and user experiences. It's a different kind of medication that takes 1 - 3 months to get the full effect when it works.

It's interesting that Lexapro did not work for you. It is used for the treatment of anxiety and should not make you more anxious. :eek: Wellbutrin XL is now available and a lot of people are having positive results.

Good luck and keep us posted.

Hello,


It's the Ritalin that's making me anxious. I didn't find that the Lexapro really did anything to be frank. I tried Adderall XR, but didn't notice anything. The Ritalin is certainly doing something, but I'm not really happy with what it's doing...

Thanks,
Michael

ritalin SR or LA was shown to not be longer lasting than the usual ritalin by Dr. Wender years ago. He is basically the father of ADD extending into adulthood. Metadate CD worked well for me for about 6-8 hours, but it is much more expensive. Adderall just put me to sleep. Usual dosing for adults is well accepted to be about 80 mg per day total. It usually lasts about 2-4 hours. See if your doc will up your dose to 20 mg four times a day, keep a notebook to write down how you feel, what others around you say about your activity, and any side effects. Or consider other meds as already posted. Good Luck

There could be a number of issues here. My first suspision is that you are not at the right dose of Ritalin. The fact that the Ritalin LA "does nothing" but that the regular release does - for a short time - leads me to believe this. It sounds like you are just getting to an effective dose - for your body/brain - as the regular release peaks, and then an hour later, as the level in your blood stream drops below the point where the medication has a positive effect, it stops working again. This would be my first guess. Ritalin does metabolize quite quickly and when it wears off, it makes some people very anxious and emotional. I had this same problem with Ritalin. When I switched to Dexedrine I found that it was better - for me - for several reasons. Dexedrine lasts a lot longer (but takes a bit more time to "kick in" after you take the pills) and it tends to make people less irritable than Ritalin when it does wear off. It might make you more anxious, as amphetamines have an effect on noradrenaline as well as dopamine whereas methylphenidate (the drug in Ritalin) works primarily on dopamine. This difference is significant as some people - myself included - are greatly helped by increased amounts of noradrenaline. The noradrenaline supplied by Dexedrine helps me get my butt off of the couch - without the looming deadlines that have been necessary in the past. It's pretty common for ADHDers to behave in this way - the fear and adrenaline of an approaching deadline provide the stimulation we need to get started on a project/assignment. I think the risk taking behaviour that is also common in ADHDers is related to this as well.
The down side to dexedrine is that the noradrenaline makes some more anxious, it raises BP and HR more than Ritalin, and it surpresses appetite more vigorously.
Ultimately, which stimulant medication is "better" is determined by your reaction to it. While there may be many different brands of stimulants, there are only two basic types - those based on methylphenidate (Ritalin, Concerta, Metadate, etc) and those based on amphetamine (Dexedrine and Adderall). Methlyphenidate and amphetamine work differently in the brain, doing their thing using slightly different mechanisms to increase the amount of dopamine, and it's possible that one mechanism may be more effective in your brain than the other. As a result, many people find that they prefer one type to the other or that one type works and the other does not. The only way to find out which works better for you is to try it.
Finding the medication and dosage that works best for you often takes a good deal of time, as trial and error is the only way to do it - a doctor is just guessing when they prescribe medication and dosage for ADHD, so don't assume that what they've written on the prescription pad is what will work best - you could need more, or less, or a different drug altogether.

This is the third time I'm posting this - hopefully I'll get a response this time. :o

I'm currently taking 20 mg of Ritalin LA in the morning followed by 10mg doses of Ritalin throughout the day. On top of that, I'm taking Prozac to help with irritability. The Ritalin LA does nothing, and the Ritalin sets in about 45 minutes after taking it and wears off about an hour after that, followed by a fairly intense feeling of anxiety, which I hate. Any other suggestions? I've read Dexedrine and Welbutrin can be a good combination? Any comments on that? I'm looking for something with more lasting power - I don't want to have to take 3 or 4 doses of Ritalin throughout the course of the day. The Prozac isn't really doing anything for me. Then again, I've tried Lexapro and Effexor, as well, with no luck.

Thanks!

ms244, I would try Wellbutrin. Here's why:

I have had the same responses to meds that you have. The way you describe Ritalin is almost exactly how it affects me.
I've taken Lexapro and Effexor and Paxil with absolutely NO response. I started WellButrin XL a few days ago and so far I'm having positive effects from it.

I know it takes a couple of weeks for it to build up in your system but I've already felt a little better focus, a slightly more playful mood especially around my kids, and last night I had one of the most restful sleeps in a long time.