heyyyyy everyone.

i have a little question. :)


so...i was diagnosed with ADD (the inattentive type) back in May...and the doctor first gave me Strattera to try out.
i took it for a week, and wanted to kill myself because it made me feel like Death. :p
so i went back to the doctor in June, told him about the nausea/sickness, and he ended up writing me a prescription for Ritalin. (the instant release kind).
i took it for a while, but i don't like it. it gives me really bad migraines, and makes me feel really uneasy...like my heart is going to explode or something. (not palpitations--just general discomfort and anxiety). so i refuse to take it anymore. it scares me.


i have another doctor's appointment on Friday, and i want to switch to Adderall-XR or the Dexedrine spanules... but my question is: what should i say to get him to switch it?!
i'm usually not assertive at all... and i don't want to go in there sounding all pretentious, like i know more about the meds than he does. and if i tell him that the Ritalin makes my chest hurt, i'm afraid that he won't let me try anything else at all. :(

has anyone else switched from Ritalin to Adderall?
if so, what did you say to your doctor to get him to do that?
what symptoms did you describe?
:confused:

Hi bliss22, and welcome to the forums.

I switched from Ritalin to Adderall many years ago, and I found it to be a bad choice for me. Turned out that Adderall was the only ADHD medication to make me feel pronounced sedation. It's important to note that we each can/do often respond differently to these drugs, and my response does not respresent the typical response to Adderall.

Anyhoot, looking back now after several years of having tried each of the stimulant drugs (except the new Vyvanse) I wish I had tried the Dexedrine before the Adderall.

There is another drug you might want to consider discussing with your Dr that is called Focalin. I found Focalin to be as good, if not better sometimes than Dexedrine. I was only on it for a month last year, so I look forward to further research with it down the road. ;) Focalin was just too expensive for me compared to the price of Dexedrine.

Hey Bliss. My guess is that Adderall would probably give you the same uneasy 'heart is going to explode' feeling as Ritalin. They're both stims and that's pretty much the nature of stims. YMMV, but that's my guess.

It could be you just started off with too high a dose. What dose of Strattera did you start with? What about Ritalin?

If the ritalin works fine in terms of clarity, there is a sustained release form of methylphenidate called Concerta. He might be fine with switching you to that :).

It could be you just started off with too high a dose. What dose of Strattera did you start with? What about Ritalin?i was taking 18 mg of Strattera... and then i upped it to 24. but i felt the same with both dosages. (and he said that these were the pills they give to little children.)

and with the Ritalin, i was only taking one 10 mg pill a day. he wanted me to take the 10 mg pills twice a day, but one of them was too much.

(i think i'm just sensitive to medication. this is the first time that i've ever tried medication in my entire life. i'm usually anti-medicine... i won't even take Tylenol.) :p




and crazy feet~ the Ritalin didn't really help with clarity, either. :rolleyes:
it didn't really help me at all. i couldn't even think because my head was hurting so bad.

but i've heard that people who don't respond well to the methylphenidate usually have better reactions to the amphetamine kinds. ? i'm not sure if that's truuue, but... i still don't know how to approach the doctor situation!

(i don't know what to say to get what i want. because you can't really argue with the doctor, ya know?):p

i'm so timid when it comes to these kinds of things. hahah.

Try to remember that you are the client...you pay them to help you! Its your treatment, right?

When I have wanted to change meds, I just told my doc what was going on. Sometimes he would suggest an option and other times I would. I made him aware that I did a lot of research on the internet and intended to be active in my choices. :)

For me, it took just over a year to finally arrive at a therapeutic dosage that seems to work as well as can be expected on a daily basis.

After Straterra put me in the hospital with hbp,methylphenidate worked fairly well for about a year.

When it started to lose efficacy, it took other people to point that out for me.

I was switched to brand name Ritalin LA, and it only lasted a month or so before I really started to "crash & burn."

At that point, I began to feel like a "zombie," which made getting through each day a struggle.

I declined Concerta because I felt the same thing would happen, in terms of it initially working and then quickly stopping.

I felt it was too hard to bounce back each time, so we finally tried Adderall.

I don't seem to respond to generic meds as well as brand name,so with the exception of Nortriptyline, that's all I use.

Adderall XR worked from the outset, however, it "kicked in" whenever it kicked in.

For example, there were times when I'd be home and the second dose finally got going.

In the meantime, my afternoon at worked was a struggle.

What I finally did to convey that message to my doc was to keep a med journal in which I plotted 39 consecutive work days .

I divided each day into morning and afternoon, and then journaled on how I felt and what happened, etc.

At the end of that time, I took 6 random clerical errors that required some type of correction, including things I temporarily misplaced, and then plugged them into to see where they fell.

Of the 39 days, 22 were "bad," and 17 were "good;" with all 6 errors falling on "bad" days.

My doc immediately seemed to "get it" and then added regular Adderall to help boost the XR in gettting started.

I hope this helps some and I wish you the best of luck, as this is truly not an exact science.

tc

mctavish23
(Robert)

Mctavish, are you still on AdderallXR + AdderallIR? How long has you used this combo?

Yes I am.

I take XR + reg Adderall and have done so for about 2 yrs now.

i was taking 18 mg of Strattera... and then i upped it to 24. but i felt the same with both dosages. (and he said that these were the pills they give to little children.)

and with the Ritalin, i was only taking one 10 mg pill a day. he wanted me to take the 10 mg pills twice a day, but one of them was too much.

(i think i'm just sensitive to medication. this is the first time that i've ever tried medication in my entire life. i'm usually anti-medicine... i won't even take Tylenol.) :p
These are both small doses for adults. I am also sensitive (but not nearly as much as you!) and had similar problems with strattera. IMHO and limited experience, being sensitive can make the process of finding the right medication a bit tricky. I wouldn't necessarily decide to switch meds right away at this point, and I don't just say this because my experience with adderall-xr was a nightmare. You definitely have other options.

First, are you going to a pdoc or a gp? It's definitely preferable to see a pdoc, particularly if you are having problems finding the right med & dose.

Second, it sounds like you're still getting used to the idea of regularly taking medication. Despite this, would you be willing to consider taking 2 smaller split doses instead of one larger dose per day? Yes, it's a pain, but it might be enough to make ritalin bearable. This might also be something to consider even if you decide to switch to adderall.

(This is why it's important to see a pdoc instead of a general practitioner. GPs won't necessarily know that split doses are possible. Pdocs will probably know, but might not suggest it unless you bring it up with them).

The decision to take a split dose really comes down to balancing effectivenss and side-effect profile. Other than the palpitations, did ritalin work for you? Or did you not notice because of the physiological side effects?

If I were you, I would consider splitting my ritalin dosage before switching over to Adderall. There are two ways you could do this, and both of them require consultation with your doctor.

One would be to switch to a 10mg dose of an extended-release form of ritalin. For example, if you took 10mg of methylin-ER (generic slow-release ritalin) at 8 am, theoretically 5mg would release shortly thereafter and the other 5mg would release around noon, & last until 4ish.

The other way is only possible if your current form of ritalin is instantaneous release. Just split it in half and take 5mg instead of 10mg at once. Can't do this with ER forms because it can destroy the release mechanism, which means it would work just like IR. This would be bad news in your case.

To put into perspective, here's my routine and side-effect profile. On workdays, I take 15mg of generic IR ritalin 2x a day, and I usually take med holidays on weekends. I have some side effects (occasional anxiety or some heart palpitations if I drink too much tea, and have to stop myself from grinding my teeth or clenching my jaw at times). I don't get headaches or anything once it wears off, thankfully.

I've only been taking IR ritalin for a couple of months and am still working toward my ultimate routine. It's a pain to remember to take that 2nd dose, but it's worth it because I'm doing so much better at work. Unfortunately I've noticed gaps in coverage, such that each dose lasts for just 3-3.5 hours (meaning a bare 6-7 hours of productive time at work). I will have to talk to my pdoc at our next appointment about adding a third IR dose or combining IRs and ERs.

Just some thoughts, and hope that they help!

what is a pdoc?

i think he's just a family physician... all i know is that he specializes in Internal Medicine.

and Kristin~ the prescription he wrote was for two 10 mg instant release pills per day, so the dosage was already split. (but i wasn't taking the second one, because the first one was already too overwhelming..)



Other than the palpitations, did ritalin work for you? Or did you not notice because of the physiological side effects?
no, not at all.
(but then again, you might be right-- i probably just couldn't tell if it was working through all the migraine pain and chest-tightening.) :b


it might actually work if i was taking Concerta or some other long-acting extended-release (whatever it's called) form... because i need something more subtle.. with less ups and downs.
but i don't know how to get him to prescribe that for me.
:confused:





my appointment is tomorrow at noon...and i'm soooo nervous!!!

i still want to try a different kind of medication to see if it works any better than the Ritalin... and i still don't know how to tell him that.
:confused:

i don't want to make it seem like i already know all the options for ADD treatment, because i'm afraid that that might signal a red flag.
there are too many girls my age who use stimulants recreationally... and i don't want him to think that i'm one of them.
so i probably just won't suggest anything, and i'll come out of there with whatever he offers.
:rolleyes:

(he doesn't know very much about ADD though..... he always has to go grab this little booklet and look through it while he's talking to me... haha)

I had the same issues with ritalin, It made me feel like crap basically. I also had this weird zapping feeling when it was wearing off, very anoying, and scared me.. Adderall is much smoother, cept it keeps me up .. which sucks. blah I take IR adderall Im kinda affraid of xr .. lol

what is a pdoc?

i think he's just a family physician... all i know is that he specializes in Internal Medicine.

...(he doesn't know very much about ADD though..... he always has to go grab this little booklet and look through it while he's talking to me... haha):soapbox: Please, get thyself to a psychiatrist (pdoc) ASAP. I cringed when I pictured that little booklet. This is not the image of good care.

GPs and internists are great when you have strep throat, an ulcer, etc. But the brain is an organ, and it requires specialized care because it IS the organ that controls the symphony that is the rest of the body. You wouldn't take your car to a bike repair shop, would you?


and Kristin~ the prescription he wrote was for two 10 mg instant release pills per day, so the dosage was already split. (but i wasn't taking the second one, because the first one was already too overwhelming..)
Maybe you need less than 10mg all at once, like 5mg 2x/day.


it might actually work if i was taking Concerta or some other long-acting extended-release (whatever it's called) form... because i need something more subtle.. with less ups and downs.
but i don't know how to get him to prescribe that for me.
:confused:

my appointment is tomorrow at noon...and i'm soooo nervous!!!

i still want to try a different kind of medication to see if it works any better than the Ritalin... and i still don't know how to tell him that.
:confused:
Have you read any books about ADD yet? Whenever I've brought up changes in my treatment plan, I've always brought a book with me so I could show how I'd reached that particular conclusion ("On page xx, Dr. so-and-so said that taking a smaller dose of strattera twice daily can be easier on the stomach...")


i don't want to make it seem like i already know all the options for ADD treatment, because i'm afraid that that might signal a red flag.
there are too many girls my age who use stimulants recreationally... and i don't want him to think that i'm one of them.
so i probably just won't suggest anything, and i'll come out of there with whatever he offers.
:rolleyes: I understand about not wanting to be seen as drug seeking. It's a problem we've all struggled with or will struggle with at some point, particularly since people who do take stimulants recreationally make our daily lives harder. However, asking to try a *smaller* dose of the medication you're already taking will probably not raise red flags.

This is why it's important to prepare for your appointments in advance. You'll get the best treatment if you are honest with your doctor, are informed about the options (read Hallowell's & Solden's books for starters!), and can present evidence to support your conclusions.

Even if this doesn't help for your appointment this week, I hope this helps in the long run. Good luck!

Dexedrine is supposed to be the 'smoothest' of the stimulants (IN THEORY), meaning you shouldn't have too bad of a 'crash', but it's still a stimulant and it will make your heart feel wierd (some people really like the stuff, others say it feels like they're tweaking on ephedrine (which is another stimuant)).

Adderall is good for me, but I do notice sometimes that if I take it without food (say if I take it in the morning and skip breakfast) that it feels a lot more intense.

Another thing - if stimulants are making you feel like you're tweaking (i.e. feel like your heart's going to explode) maybe you should try another anti-depressant/NRI besides Strattera - maybe Wellbutrin?

thanks everyone.


i went to the doctor today though, and had no luck. :(

i told him that the Ritalin was giving me severe headaches...and that it doesn't last very long...
and i was hoping that he would give me something long-lasting- like Adderall-XR or the Dexedrine spansules...or even Concerta.... but nope.:rolleyes:
he just wrote me a prescription for the same exact thing. (10 mg Ritalin twice a day).
:confused:


it's so frustrating.
and i'm surprised that he didn't even mention Adderall or Dexedrine.
he only mentioned Concerta and Ritalin LA... but he didn't give me either of those, either. :rolleyes:


ahhhhh...i hate that i have to wait another month... and even then, he probably won't switch the medication.


i was thinking about going to see a psychiatrist, because they might be better at this than a family doctor....but they're obviously more expensive, and i have no idea how many sessions that would take. and the psych would probably make me do some kind of elaborate ADD testing... which doesn't sound appealing, because i don't feel like spending thousands of dollars right now. especially when i don't even need a psychiatrist.



*sigh* :p

Well, if you're not getting the care you require from your doc, then you need a psychiatrist (not for talking... for proper med treatment).

Check into the available resources at your local psychiatric facility. If you're uninsured, they might have a low-cost clinic for you.