Problems with Ritalin, HELP!

[Missy83]

Hi everyone, I was just diagnosed with ADHD a few months ago and my psychiatrist prescribed me Ritalin 10mg 2x a day. For the first couple weeks I felt like it worked great. I could focus better at work and I was getting more things done efficiently and on time. I also wasn't as forgetful. I also felt like better in my mom role because I could focus more with my kids and do more activities and projects with them without going off track. I also suffer from anxiety and after starting on Ritalin, which I was initially afraid would worsen my anxiety, I realized that a lot of my anxiety stemmed from work and being nervous about forgetting something, doing something wrong, etc (I work at a hospital so those mistakes could end up bad). So I initially felt as though my anxiety improved. Sometimes I would get slightly agitated once the Ritalin wore off, but nothing I couldn't talk myself out of ("mind over matter") or distract myself from. But after those first 2 weeks, it's like the Ritalin just stopped working. One time I even questioned whether I had actually even taken it, because I felt absolutely nothing.

So next Dr. visit, she increased the dose to 20mg. I took it at home the first time, because I like to know how it will effect me before I take it for work. Thank God I did, because I was overcome with severe anxiety, a panic attack I guess. I was having crazy palpitations, it felt hard to breathe, and I was just an absolute wreck. I actually had to go out and buy a bottle of wine (in the morning) and drink it all just to calm down.

I called the dr. and she said that it may take time to adjust. I don't understand how going from 10mg which did nothing to 20mg could make me react like that. Anyways, I tried it again the next day and same thing. So I decided to cut up the pills from then on and just take a half and a quarter (15mg) which helped, but now I am finding that I am still having a lot of anxiety. At times the anxiety gets so bad at work that I feel like it's making the ADHD worse because all I can focus on is the anxiety and nothing else. It's also bad when I come home. I feel like a bad mom because I get agitated around my kids. However, it's not always bad every time. It seems to depend on the events of the day and at what times I take it.

So anyways, in a way I kind of want to stop taking Ritalin, but in another way, I still feel as though it helps me, especially the first dose in the morning before work. I just hate the anxiety and agitation I get though. I used to drink just once every couple weeks or so, now I am drinking 2-3 times a week because I get so agitated.

Also, I've found a strong desire to smoke cigarettes. I quit smoking about 4 years ago. On very rare occasions I would smoke a cig here and there with friends while drinking but that's it. Now I am actually going out and buying packs. I only smoke when I'm taking Ritalin (mainly just when I feel the onset), and don't crave them otherwise, but I'm afraid I might end up with a habit again if something doesn't change. Plus my husband who doesn't smoke or drink is pretty upset about all of this. We have gotten into a lot of fights lately, which we hardly ever had in the past. He was very skeptical about the ADHD diagnosis at the beginning (although now he is more understanding) and has always doubted psychiatrists so his attitude about all of this was bad from the start, but now it's definitely much worse.

So I'm wondering if any of you have been on Ritalin and these side effects and if so did you switch to something else that was better? If so what? As much as I would like to stop taking Ritalin, I feel like I've gotten to the point where I'm afraid to not take something before work because I don't want to go back to being unfocused and disorganized.

I've been researching Concerta, and I'm wondering if the extended release of it would decrease the side effects? What about Adderall?

Thank you in advance for your input.

[sarahsweets]

Sometimes, the methylphenidate clas of drugs just doesnt work for some people. When I took ritalin, I couldnt find the optimal dose, it was either to much or not enough. I experienced mood swings and agitation. Once I switched to dexedrine things leveled out a bit. I am now on adderall because dex just didnt quite do it for me, but you might find the amphetamine class of drugs works better for you. Are amphetamines and option for you?

[Missy83]

I went to my pdoc yesterday and told her about all the issues I've been having. Actually, before the appointment my husband called her himself a week and a half prior to tell her that he didn't like the way I was acting on the Ritalin and we were supposed to go to an appointment together a couple days later, but it didn't work out. He also threw away the rest of my Ritalin. So anyways, yesterday after talking, the dr. decided to just increase my Prozac dose (which I recently started) from 10 to 20mg, which is still a very low and probably not effective dose, and didn't give me anything for ADHD. I'm kind of mad at my hubby now for calling her because now she's probably too scared to prescribe me anything. She did mention something about Strattera, but didn't prescribe it because it can cause liver problems and I already have liver issues. So I'm kind of upset now that I don't have anything to help me with my ADHD. I actually feel like going to another pdoc and asking about Adderall but I don't want to seem like an addict or anything. I'm just mad that the dr. wouldn't even TRY something else for me and just left me with nothing. What should I do?

P.S. I take the NCLEX (boards to get my RN license) on the 20th of this month. Since stopping Ritalin it has been a serious struggle trying to study and it's almost like my ADHD has gotten worse. I am panicking about not being able to focus while studying and taking the actual test. This is the biggest test of my life!

[gizmo1]

I'd be extremely mad if my husband threw away any of my pills!

I think you should make another appt. with your dr and explain that you'd like to try another stimulant. Strattera takes weeks to get to a theraputic level, so that's not going to help you for your exam.

If the dr doesn't want to prescribe you anything, then I'd look for a new dr.

[Missy83]

I was FUMING when he threw them away. I understand that he didn't like how agitated I was getting and I didn't either, but I think he just made my agitation worse. And I think him calling the psychiatrist is really what made her not want to prescribe me anything else. Her whole attitude seemed different at this appointment, and I'm pretty certain that if I called and set up another appointment, she wouldn't prescribe me anything. She basically just gave me some study tips and that was it. She said study for 30 min or 45 min then take a break., etc. How can I do that if I can barely read a couple sentences without my mind wandering off? I just feel so upset right now. I think I'm just going to call another dr. tomorrow. I'm also upset at the fact that my husband just doesn't understand ADHD or meds or anything psychiatric-related and looks down on all of it. He keeps saying "You're better than that... You don't need meds... You just have to try a little harder..." etc. It gets really annoying. He would rather me take 5 times as long studying (or TRYING to study) than a "normal" person would or struggle harder at work than ever go on meds.

[Targaryen]

I have been educating myself a lot lately about ADD and the most surprising thing I have learned is that when people with ADD try to concentrate on something that doesnt stimulate them there brain will start to show decreased activity when unmedicaited. This was in Dr. Amen's book and was done doing spec brain scans but there have been other studies done as well.

So when someone tells you to try harder it really just isn't that easy, which I'm sure you know all too well.

If your current doctor isn't open to YOUR feedback and trying other medication options esp. With such an important test coming up then maybe it is time to find someone who is willing to listen to you and give you options.

[Missy83]

Update:

My hubby and I had a long talk and I think he finally realized how hard it is for me to focus. I actually broke down crying because no matter how hard I tried, I could NOT study. Like I said, this was the biggest test of my life. I called up my pdoc and had to leave a message with someone on her answering service. I said that I was really scared because no matter how hard I tried, I couldn't study/focus and I was scared I wasn't going to pass my NCLEX. Well she NEVER called me back!
So I made an appointment with a new pdoc, however, I had to wait a week to see her. My hubby felt really bad about throwing my pills away so he actually was able to get a few pills from someone else he knew with ADHD who was also on Ritalin who was nice enough to share (which I'm sure is probably not "right" but it was an emergency). So I was able to get 5 days of good study time in before my appointment. The new pdoc actually seemed a lot more knowledgable and understanding. We decided that I should stick with Ritalin 15mg for now because I know how it effects me and that it helps me study better. I didn't want to try a brand new med the week before my test.
So I was able to get in some really quality study time before my test. Thank God, because I'm just about positive that I passed (I'll know for sure tomorrow).

[CheekyMonkey]

I'm glad hubby is on board now!

[Missy83]

p.s. I also wanted to add that while the Ritalin helped me TREMENDOUSLY as far as studying goes (I don't think I would have been able to pass without it) I did get agitated/anxious at times but mainly when I was around my children. I feel like Ritalin is a miracle med for me when I am alone and studying but I do get short-tempered with my family around. Luckily, I don't show it or yell at my kids but inside I kind of freak out and am really impatient with my kids, more than usual. I am still curious about Adderall, but from what I have been reading on this forum, Ritalin seems to help more with focusing (studying) while Adderall seems to help more with completing tasks. I have problems with both of these areas. I'm going back to school in September for my Bachelor's in Nursing and I know Ritalin would help me focus on my studies. However, I have extreme difficulties when it come to completing tasks/remebering things at work and it seems like Adderall has helped others with that issue. I'm just confused as to whether I should continue with Ritalin or maybe switch to Adderall. I feel as though Ritalin would help me with school but Adderall may be better when it comes to work (?). I am so confused. What do you think I should do? My new pdoc is very open to prescribing whatever I feel would help me.

[ADHDcapitalH]

First off, I know how stressful the NCLEX can be, as I'm an RN too. I hope you passed. I have been taking meds for ADHD more than 20 years and have tried many. Some work to a varying degree, and usually do not offer relief of every symptom; some do not work at all; and many cause adverse reactions, or exacerbate your ADHD symptoms. Though, with all the meds out there now, generally there's one that fits perfectly (individually, as not everyone's cells function the same with each substance).

Fortunately for me, the first script I received was Dexedrine. Within the first hour of taking it, I knew that this was what everyone else feels like (normality). Yes, I have to admit that I am able to function on a higher level than most people while taking Dexedrine, but I'm not gonna trade that for going back to being like I was before. Of course you know that people build up tolerances to meds over time, and that's what happened to me. I had to take such a high dose in order for it to be effective that my DR decided to switch meds and see how that worked. It didn't work out. After nearly 5 years of switching meds and a dozen DRs, I found one that would put me back on Dexedrine. It's horrible when you know what works for you and nobody cares.

As to Ritalin, for me, like you I became extremely agitated at everything and everyone; I felt like I needed to wear a sign saying "keep clear for your safety". I did however have some focusing ability, but not as good as when on Dexedrine. Adderall did the same thing, minus the focusing, but with added postural orthostatic hypotension symptoms (blacking out upon standing); this was not good.

Try asking your DR for a weeks trial of Dexedrine and see how that goes. It may be hard to get them to prescribe it because of the improper stigmatism that surrounds it's use.

I don't know why Adderall would not even work a little if Dexedrine was my perfect fit; all I can think of is that the salt mixture canceled out the therapeutic effectiveness of just the dextro isomer, and was causing the adverse reactions.

I have been on 20 mg tid Dexedrine only, for the last 10 years and it makes a world of difference in my life. I do however have to take vacations to keep my tolerance under control. Good luck, and don't give up on searching for that perfect fit.