[Medicated]

I just started ritalin on Wednesday for possible ADD which is causing my depression. (Or thus sayeth the shrink.)

I took 5mg Wednesday afternoon and Thursday morning, and 10mg this (Friday) morning. I'm not really feeling much (any?) effect though. I'll admit that because I'm not in school or working right now, my life is still pretty unstructured... but when I try to start a task, I'm just as averse to it as before. Mentally, my outlook and ability to focus seem essentially unchanged. I don't feel buzzed at all, my appetite is normal or increased... basically, I don't feel any different.

Part of me wonders if the pharmacy gave me placebos. I know they didn't, but 10 mg should do SOMETHING, shouldn't it? Am I not using it right? Is my lifestyle preventing me from seeing the effects? I most certainly have things to do (studying, thesis paper, bills, etc), but they're still not getting done. I feel like it's my fault... like I have this help now, and I'm still failing because I'm doing something wrong.

I have an appointment to see the shrink on wednesday, but for my information, do you think a higher dose would help me? Might a different drug (like adderall) work better for me? Are my expectations just completely unreasonable? What has your experience with ADD meds been?

Thanks for your help!

[theotterone]

When I first went on Adderall, I was on one of the lowest "starter" dosages. My brain quieted, my focus improved a little, but I wasn't anywhere near where I needed to be.

I met with my pdoc a month later, he increased my dosage 3 times what I was orginally taking! The thing about stimulants is they are not a "weight based" dosage. It really takes some tinkering to find the correct level.

I met with my pdoc today. Because of major changes at work, my hours going later (9 pm!) at my request, he added an addtional dose to my daily "schedule". Otherwise, I would be taking my last dose at 2:30, and I am not on control release!

With this, I have been lucky enough to be able to afford a life coach who specializes in ADHD and have done a lot of reseach and self examination. With the tools my coach, the research and tips/tools I have utilized from support and informational sites, I am able to concentrate much better. Know it will take time to find the right dosage, and see about behavioral therapy. Usually when used together one is much more sucessful!

[Medicated]

Thanks.

My sister used to take adderall, and my brother still takes it, so I'm kinda feeling like I want to give it a try instead of the Ritalin. As per life coaches, I'm a grad student living on loans so... it might have to wait a while! However, I just barely began DBT, and I'll discuss the ADD diagnosis/theory with the therapist when I see her next Friday. My shrink also had me order a book, 4 Weeks to an Organized Life with AD/HD, and I'm hoping that it will be helpful too.

Thanks again... I seem to want everything to be perfect immediately, so I think my problem right now is something called "impatience." Gotta learn to wait...

[phoenix47baby]

The ritalin didn't affect me except at higher doses. The Adderall was much more effective, but give the ritalin some time. Hang in there. Sending good thoughts your way. phoenix47

[Simcha]

Originally Posted by Medicated

I just started ritalin on Wednesday for possible ADD which is causing my depression. (Or thus sayeth the shrink.)

I took 5mg Wednesday afternoon and Thursday morning, and 10mg this (Friday) morning. I'm not really feeling much (any?) effect though. I'll admit that because I'm not in school or working right now, my life is still pretty unstructured... but when I try to start a task, I'm just as averse to it as before. Mentally, my outlook and ability to focus seem essentially unchanged. I don't feel buzzed at all, my appetite is normal or increased... basically, I don't feel any different.

Part of me wonders if the pharmacy gave me placebos. I know they didn't, but 10 mg should do SOMETHING, shouldn't it? Am I not using it right? Is my lifestyle preventing me from seeing the effects? I most certainly have things to do (studying, thesis paper, bills, etc), but they're still not getting done. I feel like it's my fault... like I have this help now, and I'm still failing because I'm doing something wrong.

I have an appointment to see the shrink on wednesday, but for my information, do you think a higher dose would help me? Might a different drug (like adderall) work better for me? Are my expectations just completely unreasonable? What has your experience with ADD meds been?

Thanks for your help!

5mg of Ritalin is a really low starter dose. They usually tend to start patients on the lowest possible dose and then titrate upward to the effective dose.

I have read in different scientific publications on ADHD that Ritalin (methylinphenadate) doesn't always work as well for adults as mixed amphetamine salt preparations do (such as Dexedrine, Adderall, Vyvanse, etc.).

I've never been on Ritalin, but when I started on Dexedrine, the immediate release formula didn't work well for me. They increased the dose, and still no good. We switched to Dexedrine XR (extended release spansules), which worked well, but we also upped the dose.

Now I take Vyvanse, which works much better. Takes some playing around to really get the effective medication/dose. Make sure you tell your prescriber as soon as you know that the medication isn't working and need to up the dose and/or change meds.

I recommend calling the prescriber in between appointments as soon as you realize the medication isn't working. That way, you can speed the process along instead of waiting around, frustrated. I also recommend that you call your prescriber if you experience any unpleasant side effects too.

[sunrise]

Medicated, it can take some tinkering to find the right med and dose, so don't feel like you will get no help. Report everything to your pdoc so he has all the relevant info to make adjustments. It might be an interesting question to ask--what determines whether methylphenidate (Ritalin) is prescribed rather than amphetamines (Adderall, Vyvanse)? Perhaps it is age. I do seem to hear children frequently being prescribed Ritalin. Not sure how old you are, but perhaps if you are on the young side, this is why it was prescribed. I would be interested to know what your pdoc says if you ask him that question.

I take Vyvanse (as well as Wellbutrin--frequently prescribed off label for ADHS) and recently tried Adderall also. The thing I like about the Adderall is you can get it in really small doses or cut up the pills and use when you feel things falling apart somewhat. The Vyvanse can't be cut up and the smallest dose may be more than I want to add in the middle of a day. So I like having both, although I'm not sure my PNP would agree--I am back with just a Vyvanse prescription now....

(BTW, Simcha, Vyvanse is not a mixed amphetamine salt--part of its raison d'etre is that its pro-drug form breaks down to pure dextroamphetamine rather than a mixture of amphetamine and dextroamphetamine like Adderall.)

(Also, Simcha, do you have the half price Vyvanse card right now from the manufacturer? My PNP gave me a Vyvanse swipe card that will take half off the cost of my Vyvanse prescription, even the amount paid after insurance. Usually my Vyvanse costs me $35 a month, and with this card, I pay only $17. The card is good through June 2010.)

[Medicated]

I am 25. My younger sister (21) took adderall through high school, and my younger brother (23) still takes adderall when he has a project for school. Neither of them has ever tried ritalin. When I go to my psych appointment on Wednesday, I will certainly ask why he chose the short-acting ritalin. I won't complain about the price ($8 for 60 tabs at Target), but so far, I'm not terribly impressed.

[Simcha]

Originally Posted by sunrise

Medicated, it can take some tinkering to find the right med and dose, so don't feel like you will get no help. Report everything to your pdoc so he has all the relevant info to make adjustments. It might be an interesting question to ask--what determines whether methylphenidate (Ritalin) is prescribed rather than amphetamines (Adderall, Vyvanse)? Perhaps it is age. I do seem to hear children frequently being prescribed Ritalin. Not sure how old you are, but perhaps if you are on the young side, this is why it was prescribed. I would be interested to know what your pdoc says if you ask him that question.

I take Vyvanse (as well as Wellbutrin--frequently prescribed off label for ADHS) and recently tried Adderall also. The thing I like about the Adderall is you can get it in really small doses or cut up the pills and use when you feel things falling apart somewhat. The Vyvanse can't be cut up and the smallest dose may be more than I want to add in the middle of a day. So I like having both, although I'm not sure my PNP would agree--I am back with just a Vyvanse prescription now....

(BTW, Simcha, Vyvanse is not a mixed amphetamine salt--part of its raison d'etre is that its pro-drug form breaks down to pure dextroamphetamine rather than a mixture of amphetamine and dextroamphetamine like Adderall.)

(Also, Simcha, do you have the half price Vyvanse card right now from the manufacturer? My PNP gave me a Vyvanse swipe card that will take half off the cost of my Vyvanse prescription, even the amount paid after insurance. Usually my Vyvanse costs me $35 a month, and with this card, I pay only $17. The card is good through June 2010.)

(((((((((SUNNY))))))))))))

Vyvanse is awesome! You're right about the Vyvanse being a pro-drug (dang, you know your chemistry), and not a mixed amp.

Actually, when I got my Vyvanse prescription, my ARNP-BC (Psych) gave me a card similar to the one you describe, but I can't remember what the cost was. It was only one-time use though, and I have to get another card from my NP in order to get another discount.

Now that I no longer have insurance, I'll have to go without or get creative with my prescriptions. Stinks because I'm getting awfully low on the Vyvanse now, and even with the discount, I'm not sure I can afford it. I just got a new job, and insurance kicks in after 30 days. I've gone periods without my ADHD meds., so it shouldn't be too horrible, but the timing is bad with the new job and having to perform and all.

I see my ARNP soon, so I'll definitely bring it up with her.

[sunrise]

Originally Posted by Simcha

Vyvanse is awesome!

I'm glad you like it. It does seem rather perfect to me too. I remember mentioning it to you ages ago but didn't know you had started taking it. The only thing I don't like is that it is indivisible. My PNP told me if I opened up the capsule, I could divide the contents in half and mix half with water and dissolve it, then drink that half, and save the other half for later. So I tried that once (mad home chemist!) and it was a disaster. The capsule contents are very "fly-away" little beads, and go everywhere, like they are subject to static electricity. I lost a good portion of the capsule innards when I did this. So this is not a good way to try to stretch out your Vyvanse supply.

[Medicated]

So, you ADD med veterans out there... I was planning on asking my shrink for Adderall (extended release) next because my siblings take or have taken it. Do you like Vyvanase better? If so, why?

I'm on Ritalin (short-acting) now, and I want to switch to something that, aside from working better, is easier to deal with in terms of less frequent dosing, less of this "on an empty stomach at least 30-45 min before eating" stuff, and so forth. My schedule is very inconsistent, so it's really tough for me to follow those kinds of rules.

Anyway, what makes Vyvanase so much cooler than the other ones you've tried (and what have you tried)?

[sunrise]

Vyvanse was the first stimulant I was prescribed and it worked great. So I don't have a lot to compare it to. (I took Wellbutrin for ADHD symptoms before that, but it is not a stimulant.) My PNP says her clients who have been on other stimulants before describe Vyvanse as very "smooth". You come onto it gradually and don't feel a jolt. (Because of this, it is also less prone to abuse and there is no secondary market.) I do like only taking it once a day because I am very forgetful. The downside to that is if I wait too late in the day to take it, I don't want to take it because it might interfere with sleep, so I skip it. Recently, I got a very low dose of Adderall for a month because I got really sensitive to the Vyvanse and didn't take it for a while. The Adderall was very inexpensive compared to Vyvanse so that was a big plus. It was not extended release and I could split the pills and take it multiple times a day if needed. However, I had quite low dose pills and never worked to find the "right" dose, as soon I went back onto the Vyvanse again. I think I was way underdose on Adderall and I never felt the reported "jolt". I just think it was too little. If cost is an issue for you, it might be better to not even start on Vyvanse, because then you won't know what you're missing. I have also heard that there is less problem with tolerance with Vyvanse (needing a higher dose with time). I don't know if that is true or not. I have developed no tolerance and in fact take less now (20 mg) than I used to (30 mg).

[Simcha]

Originally Posted by Medicated

So, you ADD med veterans out there... I was planning on asking my shrink for Adderall (extended release) next because my siblings take or have taken it. Do you like Vyvanase better? If so, why?

I'm on Ritalin (short-acting) now, and I want to switch to something that, aside from working better, is easier to deal with in terms of less frequent dosing, less of this "on an empty stomach at least 30-45 min before eating" stuff, and so forth. My schedule is very inconsistent, so it's really tough for me to follow those kinds of rules.

Anyway, what makes Vyvanase so much cooler than the other ones you've tried (and what have you tried)?

I just started Vyvanse about a month ago. Previously I was on Dexedrine XR Spansules. The Dexedrine XR would work really well with no side effects about half of the time. A major problem I had was that even though it was extended release, the effectiveness of it would only last for four hours at best. There was sometimes feelings of uncontrollable agitation. The immediate release Dexedrine didn't do ANYTHING for me but make me feel really agitated, so after a couple of weeks of that is when I switched to the Dexedrine XR Spansules.

When it was leaving my system and I would experience withdrawal type side effects (including the agitation). I don't care what the manufacturer says---Dexedrine XR did not last 6 to 8 or 8 to 10 hours. My experience with it is that while there were times when it would work well, it would be so variable in it's performance that it was sorta unpredictable. It didn't feel SMOOTH like the Vyvanse does.

Vyvanse not only leaves me feeling with very even and smooth moods, I can't tell when it wears off. I don't have the anxiety that I had over the Dexedrine XR, wondering if the Dexedrine was going to work that day and if so, for how long. I also don't have to do a trade off like I did with the Dex---you see, even if it did work well while it was effective (four hours for me), the symptoms when it would leave my system weren't so great. That gave me anxiety over when to take my doses, and if I should take a second dose, and if so, would I pay for it later?

I've never had Ritalin or Adderall. I've read scientific literature about Ritalin (methylinphenadate) as it compares to the other stimulants. It seems in adults, Ritalin doesn't always work that well for us as it does for children. I assume this is variable and depends on the person as well. Adderall I've only heard good things about, even though I've never tried it personally. I've also read that Ritalin can cause more stomach upset than the other stimulants, but not positive about that.

I'd say if you have insurance, give Vyvanse a try. It's the newest stimulant for ADHD, and it seems to really live up to it's reputation as smooth and dependable. I haven't had any of the side effects that I had on Dexedrine XR. Just make sure that you take the extended release stimulants early enough that it won't keep you up at night.

[sunrise]

(And yes, Simcha and I are paid by the manufacturers of Vyvanse. )

[Medicated]

Originally Posted by sunrise

(And yes, Simcha and I are paid by the manufacturers of Vyvanse. )

haha I was beginning to wonder!

[Simcha]

Originally Posted by sunrise

(And yes, Simcha and I are paid by the manufacturers of Vyvanse. )

Ha-Ha!
I can only wish. Then I wouldn't be in so much debt!

[weatherfreak]

Hi medicated, I have re-posted this from your other medication thread.

it's a shame it hasn't worked for you. I've been on so many different meds over the years and only a handful have helped. I started Ritalin about 4 weeks ago. Now, after the 1st few days I didn't notice any huge difference except it calmed me down a bit and lowered my anxiety, but when I went back to work after 4 days I noticed a huge difference. Depression and anxiety, were completely gone and my concentration has improved out of sight, memory is still crappy though. I'm taking 20mg a day now and my life has changed dramatically. It's become so good that I almost feel a bit guilty, because I haven't felt this calm and focused for years. It's taken me 17 years to find a med that works for me, what had been considered years of depression/anxiety was misdiagnosed. They now think it's adult ADD. I'm seeing a new GP and here's what I did before I went into see him.

I wrote a list of meds that I can remember taking, (it was 17 years worth) and put them into 4 groups, as to how helpful they were to me.

Terrible, Bad, Tolerable and OK.

There was only a handful of meds in the OK column, like 4.

This made things so much easier for me because I then went online and researched these 4 drugs intensively.

I hate pdoc's and my current GP at the time recommended that I see one of the other GP's in the practice that worked in the mental heath care system for years.

He took my list and notes and was very impressed with the homework I'd done. He couldn't believe I kept getting prescribed SSRI/SNRI's which are toxic to me personally, not to mention some of the other meds I'd been put on.

That's how I ended up on Ritalin, everything I had tried that had helped me was strong in norepinephrine and dopamine and anything that touched serotonin was really bad for me personally. Everyone is so different but I'm sure this is something you already know.

Now I'm scared that this won't last, but I'll just have to deal with that if it happens. I have multiple sleep disorders too. I was so lucky that most of the meds I'd tried (that worked) were also being used for ADD/ADHD. Like Provigil/Modavigil (Modafinil) and Edronax (Reboxetine, NRI anti Depressant, no serotonin) and Requip/Repreve (Ropinirole, Anti Parkinson/Restless Leg Syndrome)

I got a year and a half out of modafinil before it stopped working for me. I only got about 4 months out of Edronax, which was great to begin with but the started to make me really angry and aggressive and gave me shocking insomnia. I'm a very placid person generally, so people were going whoa!!! What's up with you? Ropinirole just made me vomit but I put up with it for about 3 months because it blew my depression out of the water, but I had to stop it in the end. It became too much.

Just a thought, I hope this was helpful to you. I'm so sick and tired of guess work so I did my own research and for now, it's paying off. Good luck with your journey! I really hope you find what works for you. Some off the reading I did was really hard going but I just kept pushing through it all. Just find the meds that have helped you in the past, find out what receptors they effect/hit in the brain, write it down and take it to your doc. Take Care. W

[Medicated]

weatherfreak - thanks for the reply. I responded to it on the other thread. I posted in two different places because I wasn't sure where should put it to get the best answers. Thanks again.