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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by bleauberry on January 15, 2014, at 7:31:02
My NP prescribed for me Ritalin. I've got both the time released and the regular to work with.
She says I have ADHD. I do not believe in that diagnosis....however I do believe in its symptoms....and when I took the ADHD diagnostic questionnaire almost all of my answers were strongly consistent with what is called ADHD.
To me it simply means....NE and DA are weak. No surprise there. Anhedonia for more than 2 decades. Much improved with antibiotics but still lingers at a lower level. Anhedonia is pretty much in the NE and DA circuits. In my condition, or actually any of our conditions, stress on the adrenal glands is I believe a major factor is all the physical and mental breakdown we suffer. I've had cortisol tested three times to monitor my adrenal gland function and every time it was on the low side.
Ritalin happens to be a good med in lyme or any condition where these symptoms are concerns: Brain fog, fatigue, anhedonia, motivation, focus, depression, sleep (paradoxical response). My NP says it is a favorite med. I asked why. The answer was that it helps so many people with so many different issues.
Anyway, here is my problem. My questions. I need some advice, suggestions, mentoring, on how to dose it.
The regular stuff has some pretty significant peaks and valleys as it kicks in and wears off. A 5mg dose will last me maybe 2 hours, a 10mg maybe 2 1/2 to 3 hours. It feels "drug-ish". But it works. I get stuff done. Motivation to do chores, interest to get that project I've been proscrastinating done, talkative, energy, improved mood. It is all so short-lived though.
The time release version is smoother on the peaks and valleys, but does not seem as effective overall.
Both tend to worsen my short term memory, yet ironically improve cloudy thinking and brain fog.
My major problem with Ritalin: It makes me feel worse the following day....lyme worse....physical stuff. Aches, pains, exhausted, no zest, no motivation. My NP said for me to try it for at least a week, two weeks better, on a daily basis. Because at this point we don't know if those side effects or after-effects will mellow out with regular usage or whether they will get worse.
Theories. Maybe since I feel better on Ritalin and do a lot more activity I exhaust the already weak adrenal glands? I mean, on one hand Ritalin is assisting the adrenals by supplementing extra NE and DA. On the other hand, the adrenals are being taxed by the extra energy and calories being spent.
I know from studying stuff that most meds have other mechanisms we do not yet understand. For example, zyprexa turns up/on the volume level of about 30 different genes (including the gain weight genes! :-) ), and at the same time turns down/off about 30 other genes. I wonder what genes Ritalin might interact with? I wonder how it plays into the immune system?
All silly questions because answers are probably not going to be available. But questions I have nevertheless. Even if we knew in detail exactly what Ritalin is doing on all fronts, there is still no way to predict how that will play out in any person's unique physiology.
Anyway. I like Ritalin but I do have some issues with it. For now it looks like the best thing to do is give it daily dosing for a week or two and see what happens.
Advice, suggestions, mentoring, information, personal experiences, science....all welcome. Thank you!
Posted by rjlockhart37 on January 15, 2014, at 20:11:08
In reply to Ritalin?, posted by bleauberry on January 15, 2014, at 7:31:02
ritilin is methyphenidate.....its a toned down version of adderall.....its not as strong in stimulation terms....it doesnt cause rapid activation as amphetamine....but i have taken Ritilin in the past but not long enough to post my experience on it. The thing is the dopamine increase with Ritilin, thats why you feel motivated to do chores because the raised dopamine levels. diffrence between ritilin and adderall...is ritilin is dopamine reptake inhibitor....it blocks the uptake, it doesnt stimulate the release like amphetamine does, thats why it doenst have that "sting" activation as adderall....
a vary vary good option for you is Concerta....its a 12 hour release formula....regular ritilim by itself only lasts for about 2-3 hours and requires redosing, and the rebound irrtibility period when it wears off is a main concern. That's why concerta is good for your case.....also Focalin XR which is a dextrometyphenidate, its stronger than regular ritilin
check it out....but while your on regular rit, take of every 3 hours to avoid the wear off irritiblity periuod
r
Posted by bleauberry on January 16, 2014, at 15:21:34
In reply to Re: Ritalin? » bleauberry, posted by rjlockhart37 on January 15, 2014, at 20:11:08
Thanks!
I have tried adderall and is was horrible. Wow, that drug sends me into a very deep dark place really fast. Scary.
Ritalin doesn't do that at all to me. So even though they are both stimulants, they are wildly different. One makes tears and the other makes smiles.
> ritilin is methyphenidate.....its a toned down version of adderall.....its not as strong in stimulation terms....it doesnt cause rapid activation as amphetamine....but i have taken Ritilin in the past but not long enough to post my experience on it. The thing is the dopamine increase with Ritilin, thats why you feel motivated to do chores because the raised dopamine levels. diffrence between ritilin and adderall...is ritilin is dopamine reptake inhibitor....it blocks the uptake, it doesnt stimulate the release like amphetamine does, thats why it doenst have that "sting" activation as adderall....
>
> a vary vary good option for you is Concerta....its a 12 hour release formula....regular ritilim by itself only lasts for about 2-3 hours and requires redosing, and the rebound irrtibility period when it wears off is a main concern. That's why concerta is good for your case.....also Focalin XR which is a dextrometyphenidate, its stronger than regular ritilin
>
> check it out....but while your on regular rit, take of every 3 hours to avoid the wear off irritiblity periuod
>
> r
Posted by alchemy on January 17, 2014, at 11:33:55
In reply to Ritalin?, posted by bleauberry on January 15, 2014, at 7:31:02
ahh ritalin, my friend and foe.
that and dexedrine have been the only thing that have touched my depression and motivation problems. (adderall gave me an extreme wild ride)
if only the initial effects would last and not make you pay later. i have not taken it in a year, but actually today i am giving up and took a small dose. i have to at least get some sh*t done. even when it doesn't touch my mood or may make it worse, it has at least given a slight bit of ability to do what takes no effort of "normal" people. and i have to admit, the weight i have gained since being off of it is also tempting me to figure out a way to take it without screwing me up too much.
i don't have add, but i do get restless easily & time moves so painfully slow. that was another benefit for me when it's working.
i find it strange that for me it lasts longer and stronger in the mornings. i got to the point that even taking the long acting kind might only work for an hour in the afternoon.
i am currently unemployed (fired in may for the 3rd time). if i get a job, i am going to have to use it with care. balancing it's ability to make me productive for a couple of hours and then deal with it's crash time is still not fun.
what was your experience with pricey provigil? it didn't help my mood but it may have on occasion helped me open my bills :) i would try it again if it weren't so pricey. i'm in the states and my dr doesn't understand why that it is still so expensive even though it is generic now.
how many do you end up taking a day? they also seemed to work for shorter time periods the longer I took them. because i am completely treatment resistant my dr even said to try just taking more. that just made my head and body more screwy (damn it!)
Posted by PaulM78704 on January 17, 2014, at 16:12:30
In reply to Re: Ritalin?, posted by alchemy on January 17, 2014, at 11:33:55
> what was your experience with pricey provigil? it didn't help my mood but it may have on occasion helped me open my bills :) i would try it again if it weren't so pricey. i'm in the states and my dr doesn't understand why that it is still so expensive even though it is generic now.
>
Well what happened was that when the patent ended and two companies announced that they would make a generic version, Cephalon, the maker of Provigil sued them, filing what was essentially a frivolous delaying law suit for some supposed patent violation. Eventually, having delayed the generic as long as they could, Cephalon then entered into an out-of-court settlement with the generic makers, that they would pay them money, so long as they did NOT market their generic version in the USA!Having blocked the generics, Cephalon then introduced a new version, called Nuvigil, and doubled the price of Provigil, to encourage users to switch to the patent protected version.
The FTC filed suit against Cephalon back in 2008 and that case is still on-going, though now other generic versions of Modafinil have appeared in the US. Now Teva, who were going to make the generic version, have taken over Cephalon.
Even the generic Modafinil still costs around $10 to $20 a pill here! (see http://www.goodrx.com/modafinil/price) However you can buy Modafinil (manufactured by a major Indian company) over the internet for about $1.20 a pill.
Seems to be a popular designer drug among students in Europe and Wall Street traders (see http://nymag.com/news/intelligencer/modafinil-2013-4/) I had a prescription for it but could not afford the silly US prices, so I used to buy it from a pharmacy in Vanuatu.
The same pharmacy also sold me genuine Cymbalta (manufactured by Eli Lily in Turkey and labelled in German) for about $1.20 a pill (when it was $9 a pill here). Of course a generic Cymbalta is now available, but even that still costs $3 to $6 a pill here.
US drug companies are robbers! The rest of the world pay far less for the same drugs!
Posted by PaulM78704 on January 17, 2014, at 18:33:11
In reply to Re: Provigil - drug price manipulated! » alchemy, posted by PaulM78704 on January 17, 2014, at 16:12:30
I should add that this was before Provigil was Schedule IV. At the time if you had a prescription it was legal to purchase overseas for personal use.
Now I would look at Adrafinil discussed here http://onlinelibrary.wiley.com/doi/10.1111/j.1527-3458.1999.tb00100.x/pdf. It is not FDA approved but also is not scheduled/regulated and so can be purchased abroad for your personal use. Clinical studies show similar benefits to Modafinil but perhaps greater benefit for depression and some other disorders.
Posted by linkadge on January 18, 2014, at 9:20:18
In reply to Ritalin?, posted by bleauberry on January 15, 2014, at 7:31:02
>I do not believe in that diagnosis....however I do believe in its symptoms..
What does that mean? At this stage, a psychiatric doses *is* just the symptoms.Linkadge
Posted by bleauberry on January 21, 2014, at 13:16:59
In reply to Re: Ritalin?, posted by alchemy on January 17, 2014, at 11:33:55
You sure said it well. So helpful, but with a price.
Provigil actually made me very depressed. Deeply. Same as Adderall. Ritain does not do that.
Years ago I was on Adrafinil for quite a while....it is the parent drug of Provigil, similar but with more antidepressant action to it....from overseas mailorder....and it was good. It took a couple years to eventually poop out. Adrafinil good, but modify it just slightly to get Modafinil instead, bad. Funny how that works.
> ahh ritalin, my friend and foe.
>
> that and dexedrine have been the only thing that have touched my depression and motivation problems. (adderall gave me an extreme wild ride)
>
> if only the initial effects would last and not make you pay later. i have not taken it in a year, but actually today i am giving up and took a small dose. i have to at least get some sh*t done. even when it doesn't touch my mood or may make it worse, it has at least given a slight bit of ability to do what takes no effort of "normal" people. and i have to admit, the weight i have gained since being off of it is also tempting me to figure out a way to take it without screwing me up too much.
>
> i don't have add, but i do get restless easily & time moves so painfully slow. that was another benefit for me when it's working.
>
> i find it strange that for me it lasts longer and stronger in the mornings. i got to the point that even taking the long acting kind might only work for an hour in the afternoon.
>
> i am currently unemployed (fired in may for the 3rd time). if i get a job, i am going to have to use it with care. balancing it's ability to make me productive for a couple of hours and then deal with it's crash time is still not fun.
>
> what was your experience with pricey provigil? it didn't help my mood but it may have on occasion helped me open my bills :) i would try it again if it weren't so pricey. i'm in the states and my dr doesn't understand why that it is still so expensive even though it is generic now.
>
> how many do you end up taking a day? they also seemed to work for shorter time periods the longer I took them. because i am completely treatment resistant my dr even said to try just taking more. that just made my head and body more screwy (damn it!)
Posted by bleauberry on January 21, 2014, at 13:22:54
In reply to Re: Ritalin?, posted by linkadge on January 18, 2014, at 9:20:18
Link I think there is too much crossover between different diagnosis, too many gray shaded areas, and way too much subjective interpretation/opinion, all displayed against a back drop that basically says "We don't really know, more research is needed."
I don't like being boxed in because I just don't think things are that simplified. A label sort of boxes me in to a defined confined way of thinking and choosing.
But that's just me. We all have our own journeys.
> >I do not believe in that diagnosis....however I do believe in its symptoms..
>
>
> What does that mean? At this stage, a psychiatric doses *is* just the symptoms.
>
> Linkadge
Posted by alchemy on January 21, 2014, at 15:45:21
In reply to Re: Ritalin? » alchemy, posted by bleauberry on January 21, 2014, at 13:16:59
bleauberry,
have you tried concerta or focalin? i haven't yet, but i'm curious about the supposed longer half-life of concerta.
This is the end of the thread.
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