[Rose76]

I got referred to a pdoc who I waited months to see. I have a crazy, chaotic sleep pattern. Also I feel lethargic and apathetic in the morning. Often I am depressed in the morning, but feel okay by 4 p.m. First half of the day, I have a hard time keeping awake. My plan was to ask for a prescription for a stimulant to take in the morning. I was on Ritalin once I the past. It seemed helpful, so I asked.

First the pdoc wanted to give me a lecture on the benefits of aerobic exercise. I did leave the office with a presciption - for Ritalin. It was for 5mg tablets, 30 of them. Instructions were to take one tablet per day.

From what I've read on-line, thats less than is typically prescribed for 6 year old kids with ADHD. I feel like the doctor basically gave me what amounts to a placebo. It does nothing for me. I believe the pdoc knew full well that it wouldn't have any effect . . . beyond a placebo effect, if I were dumb enough to believe it would make a difference.

I feel angry and hurt. Maybe he didn't believe my problem is real or that I deserve any help. I don't believe he took me seriously. He could have been honest and said he didn't want to prescribe anything. Instead he prescribed such an insignificant dose that, even if I had taken all 30 tablets at once, there wouldn't have been much impact.

I'm wondering about what doses other members have been given. How much Ritalin is needed to make an impact?

[unaluna]

My dr gave me 10 mg, and i had to cut them in half. I could not take them every day, just 5 mg lasted for like 3 days with me, until i felt normal again. I stopped taking them after just a couple, i dont like that "pulled" feeling. I feel better delaying my breakfast, starting off with just sweetened coffee, and eating lighter the rest of the day. Light enough to where i dont need tums.

[WildcatVet]

My doctor started me on 5mg to be sure I could tolerate the drug/possible side effects then raised me over a few weeks to 10mg twice daily. Worked out well that way.

[still_crazy]

hi. 5mgs/day is a -very- low dose. i don't know what that's about. maybe the shrink will ramp up the dose, based on how well you tolerate it? Maybe...its a control issue? a lot of shrinks are controlling and ridiculous.

its only "serious" because ritalin is a Schedule II controlled substance. Not a big deal...they give it to kids and adults, all the time...but some shrinks are weird about controlled substances, others aren't.

sorry about this. its..odd...if you have a label of "ADD," some shrinks don't care about giving out the uppers, but if you don't have that label, they'll be ridiculously over-cautious.

again, sorry about your situation. maybe a family doctor? they're sometimes more practical, common-sense about things.

[unaluna]

I think you have to consider our age and what other meds we take. These old tickers aint what they used to be. Not that i was ever fond of speeding up to begin with. I was always more of a quaaluude girl.

[Deejay14]

I am 57. Because I am getting on in years my doc says it would be wise to lower some of my meds as oft times a person could develop kidney or liver issues and oft times don't need as much medication for the same effect. Falling is also a very big concern for me. Four of my meds, psychiatric a d otherwise I have decided to come off. Gone are the narcotics, the muscle relaxers, most of the ambien( which I am hoping to totally get rid of), the daily use of benzodiazepines, and the gabapentin which did not help with pain and made me unsteady on my feet and tired. So if you are getting on in years it's another reason to start small.

My pharmacy bill is much more manageable

[unaluna]

Yeah when i turned 62 blue cross wrote me i was too old for ambien.

[Rose76]

Thanks to all for the feedback above. The only other meds I take are amitriptyline 50 mg/day and hydrocodone 10 mg/day. Interestingly, I read that stimulants actually improve balance and gait in older patients. Surprised me to read that. The source said that stimulants are probably under-utilized for older patients with treatment-resistant depression. I have heard of stimulants being given to elderly folks who were terminally ill with cancer.

I think it is probably easier, as an adult, to get them for attention deficit disorder than for depression.

[Rose76]

Originally Posted by still_crazy

hi. 5mgs/day is a -very- low dose. i don't know what that's about. maybe the shrink will ramp up the dose, based on how well you tolerate it? Maybe...its a control issue? a lot of shrinks are controlling and ridiculous.

its only "serious" because ritalin is a Schedule II controlled substance. Not a big deal...they give it to kids and adults, all the time...but some shrinks are weird about controlled substances, others aren't.

sorry about this. its..odd...if you have a label of "ADD," some shrinks don't care about giving out the uppers, but if you don't have that label, they'll be ridiculously over-cautious.

again, sorry about your situation. maybe a family doctor? they're sometimes more practical, common-sense about things.

Thanks for the validation. You seem to see this somewhat as I do. When I let him know I was uninterested in his little speech about the benefits of aerobic exercize, I think he kind of retaliated by being less interested in anything I had to say. It felt to me like we were caught up in a headgame for control

Maybe I was unfair and seemed too resentful. But I do think he was blowing off my problem.

[still_crazy]

hi. me again.

some shrinks power trip. for me, the men have been worse than the women, but they're all tricksy rabbits. if you have the $$$, sometimes the shrinks who don't take insurance are a little more accomodating, at least that's how it is around here. not for me, but...they're usually easier to get into see, they're not as surly, and they're not as conservative.

but...for the rest of us....ugh. maybe a family doctor? stimulants were once fairly standard for depression, and there have been more recent studies in older people, people with health problems, etc. that were promising, but...

they'll pump kids full of uppers, but suffering adults often have a harder time. its not right, but...it is what it is, I guess.

some people do well on provigil or nuvigil. they're both -very- expensive, but one can get refills on them and some doctors are more comfortable with those than with traditional stimulants.

again, sorry about all this.