I had great effects in the beginning, but the positive (and even the negative) effects just seemed to diminish continually after the first couple of weeks, even though the dose was increased. I started with ~3 x 10 mg methylphenidate per day, and now, 2 months later, I'm up to 4 x 20 mg (slow release).

Been kinda depressing, when the effects were so extraordinary in the beginning, to lose it completely again. For the first time in my life I started functioning like a normal person, having energy, no procrastination, concentration, ability to plan and organize, healthy eating, even good mood, and countless other severe symptoms improved significantly. But after the first couple of weeks, they slowly started to return. The last few weeks it was only the increased energy that was left, but since friday, even that improvement seems to have slipped away.

I read that tolerance doesn't built up so quickly, so I've found all this quite puzzling. Therefore it was an interesting and hope giving surprise to stumble upon this:

http://www.sciam.com/podcast/episode.cfm?id=081535BC-EB62-D649-01B40A271E2C0EDE

Neuroscientists dosed rats with Ritalin and had them perform the kind of working memory task ADHD patients have trouble with. At the same time they measured neural activity with tiny electrodes implanted in the rats’ brains. At low doses, Ritalin primarily affected the prefrontal cortex, jacking up its sensitivity to signals coming in from the hippocampus. And here’s how the drug seemed to help with attention—it strengthened choruses of neurons firing together and put a damper on scattered, uncoordinated activity.
But at high doses, the prefrontal cortex tuned out, and Ritalin’s effects were similar to those of other stimulants. The rats lost their cognitive edge and they became hyperactive, sniffing and licking repetitively. So Ritalin shows you can indeed have too much of a good thing—to the point of distraction.

I'm interested in all kinds of feedback concerning this issue:
*Advice on what I should do (should I take a week's pause from ritalin, for instance, and then start low dose again?)
*Studies about this low/high dose conundrum are most welcome (press releases and articles are also very welcome).
*Experiences and opinions most welcome

Thanks to anyone who contributes. :)

Peter :)

Hello:)
I was wondering if you could post more info about your
med history
How long have you been dx and on meds?
Have you tried any other treatments?
You will probably get more opinions and shared experiences with fellow adhders if we knew more of what you were looking for:)

keep us posted:)

That was a very interesting bit of audio. I have been taking ritalin since November, so not very long. My p-doc started me out on 10mg 3xday. I felt a bit hyper, tense and driven. I tried 5mg 3xday and feel much better. I am still ditzy and forgetful, but much less so than before. I can concentrate for much longer periods of time and can clean my house.

Hello
I was wondering if you could post more info about your
med history
How long have you been dx and on meds?
Have you tried any other treatments?
You will probably get more opinions and shared experiences with fellow adhders if we knew more of what you were looking for

keep us posted

Hi pADDyjay. :) Thanks for the interest and helpful questions. Here is my history so far:

All my symptoms are too many to mention, but the most essential are/were concentration problems, chronic fatigue, circadian rhythm problems, organisation and planning problems, procrastination, unreliable memory, social and generalized anxiety, generally low mood, low self esteem, excessive alcohol/caffeine/sugar consumption and many others.

Have had professional diagnoses of both depression (~1998), social anxiety (~2004) and ADD (2 months ago). I'm pretty sure I have depressive symtoms, and certainly social anxiety, but with ADD (primarily inattentive) I think I've finally found the root of my problems. Not only is reading about the various symptoms like reading a biography/manual of myself, but the medicine have certainly seemed to mess with the right areas of the brain.

My medical history consist of tons of SSRIs and SNRIs, which never did anything for me. I'm still taking 75 mg Efexor every day, though I'm not sure it does anything. Been through psychotherapy, individual sessions and groups, which haven't done much.

Regarding ADD treatment, ritalin is the only treatment I've so far tried. At first I got extraordinary results with just a single 10 mg pill, where all my tens, if not hundreds, of symptoms seemed to vanish, and I was "cured" from one moment to the other. But it might have been the euforia state that is sometimes mentioned on this board, and I realize that it's probably not realistic to have such dramatic effects as a goal for my treatment. The first 2-3 weeks, I had days where the medicine worked great, and others where it didn't. Since then I've tried to cut other possible drug interactions like caffeine, alcohol (stopped completely) and disulfiram (aka. antabuse), in order to be able to achieve more reliable effects. But despite of these efforts and an increasing dosage, the effects seems to have gone from dramatic to, now, none at all.

I used to feel increased anxiety and increased heart rate when I first took the pills, which went away 30-45 minutes later, and the concentration and energy level increased, and suddenly my brain seemed to function extremely well. I could do great amounts of work (~60 pages of heavy biology reading per day, compared to 10 per day as is my standard when my brain isn't functioning).

Peter :)

That was a very interesting bit of audio. I have been taking ritalin since November, so not very long. My p-doc started me out on 10mg 3xday. I felt a bit hyper, tense and driven. I tried 5mg 3xday and feel much better. I am still ditzy and forgetful, but much less so than before. I can concentrate for much longer periods of time and can clean my house.

That's interesting, thank you. :)

Peter :)

You could simply be on too high a dosage.

I recommend you try a holiday for a while and see if you notice a difference: you could be used to the feeling of Rit, even though it's still helping.

After the holiday: titrate up to a dosage you feel comfortable with.

Less is definitely more for me.

After having absolutely no luck with Stratera, my doc moved me to Ritalin (we tried the Stratera first b/c I have a mild heart condition and we wanted to stay away from stims if possible).

I started on 5mg, 3x/day and felt no change. Next was 10mg, 3x/day and the improvement was dramatic. Only side effect for me was loss of appetite.

I went up to 15mg, 3x/day, searching for stronger improvement, but that was not the case. After about 3-4 weeks of that dose, I just realized that I was over-stimulated. At 10mg, 3x/day, I'm great; at 15mg, my adhd symptoms are back in full swing.

I'm not sure it has much, if anything, to do with body composition, but if it helps, I'm a 27 yr old male, 5'11'', 175 lbs.

Oh, and if I don't need to go to be early, I'll take a fourth dose some days. I've found it best to take it 3 to 3.5 hrs apart, 4 was recommended, but just too much of a gap for me. I don't "feel" stimulated when I take the 10mg dose, but it does keep me up if I take it w/in 6 hrs of sleep.

Also, I've been at this dose for about 6 mos. now and the loss of appetite is a lot less noticeable.

Going on Ritalin was a tough choice for me, it definitely has a certain stigma to it (especially because people in my age group were children when there was such a boom of precriptions and media attention in the '80s and '90s). BUT, it has been one of the best decisions I've ever made. Taking it is like a full-body sigh - I'm relaxed and present. I'm more confident. I keep better eye contact when talking to people (and I listen more to what they are saying, rather than formula my response and wait for a chance to jump in). The best part, it makes my wife happy - when we go to out to dinner at a busy restaurant, I can be present and responsive (rather than paying attention to every conversation in the room and the movement of the waitstaff, hostess, busboys, etc.).

I just think of it as being 10mg shy of my best. Best of luck in finding what works for you.

I think the Ritalin changes effect depending on dosage, both amount of med, interval and form of medication. One part of the effect comes from when the meds are kicking in and increasing troughout the body (the brain is where the magic happens) . When going up I feel calm, alert, motivated. When coming down the motivational and activating effects disappears and I'm left with some sort of tranquilizing effect that render me unable to start projects, switch tasks and either too slow to concentrate on something or severely overfocused.

I get the tranquilizing effect starting at low doses and more activation at higher, but the higher doses also means even more tranquil brainfog when the activating effects decline.

Short acting ritalin makes the coming up more intense and shortacting and the coming down more of a crash.

Reboxetine makes me even more of a zombie than Ritalin, higher doses of tramadol makes me a zombie aswell. My guess is that too much norepinephrine release makes me a zombie.

EDIT: Oh yeah, what I'm trying to say is this. You should really try different doses, different forms of release, different intervals and evaluate what works best.