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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by rainbowlight on July 21, 2002, at 0:36:20
Tried the spansules, yuck! I think I will stick with the Ritalin. Question - if I am taking 5 mgs. of Ritalin 2 x day and feel good, if I raise it to 10 mgs. 2 x day I get too jumpy. Is this a med you need to get used to and then go up on the dosage or should you stay with as low of a dose as possible? Pdoc said Concerta only came in 18 mgs.? She thinks it would be too much for me (too jittery/nervous) What about Ritalin SR? What is the difference between Ritalin SR and Concerta? I am finding with the morning dose I feel great, but the afternoon dose seems to bring on the physical symptoms (tired, achy, yucky). Do you guys have any dosing tricks I can try to even this out a bit? Thanks for answering my questions. You guys are the best!!!
p.s. Fachad, you crack me up about taking the ****ing dosage every two hours all day long!!!! Ain't it the truth???!!!
Posted by Ritch on July 21, 2002, at 10:59:35
In reply to Katekite/Fachad/Mitch, posted by rainbowlight on July 21, 2002, at 0:36:20
> Tried the spansules, yuck! I think I will stick with the Ritalin. Question - if I am taking 5 mgs. of Ritalin 2 x day and feel good, if I raise it to 10 mgs. 2 x day I get too jumpy. Is this a med you need to get used to and then go up on the dosage or should you stay with as low of a dose as possible? Pdoc said Concerta only came in 18 mgs.? She thinks it would be too much for me (too jittery/nervous) What about Ritalin SR? What is the difference between Ritalin SR and Concerta? I am finding with the morning dose I feel great, but the afternoon dose seems to bring on the physical symptoms (tired, achy, yucky). Do you guys have any dosing tricks I can try to even this out a bit? Thanks for answering my questions. You guys are the best!!!
>
> p.s. Fachad, you crack me up about taking the ****ing dosage every two hours all day long!!!! Ain't it the truth???!!!RBL,
I agree with your pdoc that 18mg over the course of the day would make you too uptight. So Concerta is probably out. There isn't any difference between Ritalin and Ritalin SR except one is a sustained release formulation. It is nowhere near as smooth as Concerta's sustained release mechanism. However, it *is* much cheaper! It looks like 10mg/day is your ideal dosage of methylphenidate. If you can take 2.5mg 4x daily that might be the trick.
Mitch
Posted by katekite on July 21, 2002, at 19:04:23
In reply to Katekite/Fachad/Mitch, posted by rainbowlight on July 21, 2002, at 0:36:20
Hi RBL,
I guess I'd say since you can tolerate the 5 mg twice a day there's no reason not to at least try Concerta 18mg (supposed to be equal to 5 mg three times a day). Maybe since there's not so much of the up and down with it you wouldn't get the physical stuff as much? It's probable it'd be too much for too long, but it's worth a day before you commit to taking little pills all the time.
Ritalin SR only comes in 20 mg (as far as I know.) This is equivalent to 10mg and then another 10mg 4 hrs later. Can not be broken.
There are a couple other types, ER and metadate but they only come in even higher doses that also can not be broken.
There are not very many options for those of us who can't take more than around 5mg regular ritalin at a time.
Posted by fachad on July 21, 2002, at 19:19:34
In reply to Katekite/Fachad/Mitch, posted by rainbowlight on July 21, 2002, at 0:36:20
When I first started Ritalin, I felt a little too jittery and went from the 10 mg 3x day that was originally prescribed down to 5mg 3x day. After about a month I went back to the 10mg 3x day.
I was fine at that dose for years - but when Concerta came out, the 36mg tablet felt like much less than 30mg immediate release and I ended up on the 54mg tablet.
So I think you would be fine trying the 18mg tablet - it is so smooth that you will probably not even notice the jitteriness.
Regarding Ritalin SR, my pdoc wouldn't prescribe it. He thought it was absolute crap. He said it is a very "low tech" pill that is very unpredictable as to how it will dissolve.
About the morning vs. afternoon doses, I found the same thing. For me the Ritalin wear-off is a very sour, disphoric feeling. What I found was that the doses through the day were less effective at the same dose. So I skewed my doses in favor of the afternoon and early evening.
Instead of 10 mg 3x day, I would take 5mg in the AM, 10mg at noon, and 15mg at 4 PM. The total daily dose is the same, but the effects seemed more consistent. You could experiment along the same lines to see if you could get a more consistent effect.
One other thing: I think they have come out with a Ritalin patch. That might be the ultimate steady delivery system!
> Tried the spansules, yuck! I think I will stick with the Ritalin. Question - if I am taking 5 mgs. of Ritalin 2 x day and feel good, if I raise it to 10 mgs. 2 x day I get too jumpy. Is this a med you need to get used to and then go up on the dosage or should you stay with as low of a dose as possible? Pdoc said Concerta only came in 18 mgs.? She thinks it would be too much for me (too jittery/nervous) What about Ritalin SR? What is the difference between Ritalin SR and Concerta? I am finding with the morning dose I feel great, but the afternoon dose seems to bring on the physical symptoms (tired, achy, yucky). Do you guys have any dosing tricks I can try to even this out a bit? Thanks for answering my questions. You guys are the best!!!
>
> p.s. Fachad, you crack me up about taking the ****ing dosage every two hours all day long!!!! Ain't it the truth???!!!
Posted by katekite on July 22, 2002, at 9:33:42
In reply to Katekite/Fachad/Mitch, posted by rainbowlight on July 21, 2002, at 0:36:20
This is probably irrelevant to the current discussion, but interesting to me...
I had tried Adderall 2.5 mg once a day a few months back, maybe a week total of it. I found it seemed to make me more edgy than Ritalin did, and I decided I couldn't tolerate the increased anxiety on it. I felt physically more energetic as well, whereas on Ritalin I felt almost limp physically -- my restless feeling gone.
So now I've been on the BC pill for a week, and decided to try the Adderall again. Surprisingly, I now get more of a limp feeling with it (at least the first day). It feels more like Ritalin than it used to. Weird. Makes me wonder what Ritalin will feel like.
kate
Posted by Xevious on July 22, 2002, at 19:08:37
In reply to Re: Katekite/Fachad/Mitch » rainbowlight, posted by fachad on July 21, 2002, at 19:19:34
This is exactly how Concerta works - small morning dose, medium noon dose, larger afternoon dose. Pstims exhibit a same-day tolerance effect, so in order for each subsequent daily dose to be as effective as the last, the dosage must be increased.
The Concerta packaging is an absolutely amazing little device, but anyone taking methylphenidate (Ritalin) can approximate Concerta's effects by dividing their total daily dose in steadily increasing portions. That saves the expense of trying Concerta, at the cost of a lot more hassle!
> Instead of 10 mg 3x day, I would take 5mg in the AM, 10mg at noon, and 15mg at 4 PM. The total daily dose is the same, but the effects seemed more consistent.
Posted by rainbowlight on July 22, 2002, at 19:52:01
In reply to Re: Katekite/Fachad/Mitch, posted by Xevious on July 22, 2002, at 19:08:37
I am finding I really like the Ritalin. It's nice to feel awake for once (the Zoloft makes me soooo lethargic). By far it has been the most tolerable, I don't really get any peaks and valleys with it. I would like to try out the Concerta. Does anyone know how much I would have to take of regular Ritalin in one day and at what time of the day to get the feeling of how I would feel on Concerta? I would like to try it out before I go through the hassle of trying to get the insurance to cover it. It would be alot easier to take only 1 dose a day.
Posted by Ritch on July 22, 2002, at 21:33:22
In reply to How much Ritalin in a day to simulate Concerta?, posted by rainbowlight on July 22, 2002, at 19:52:01
> I am finding I really like the Ritalin. It's nice to feel awake for once (the Zoloft makes me soooo lethargic). By far it has been the most tolerable, I don't really get any peaks and valleys with it. I would like to try out the Concerta. Does anyone know how much I would have to take of regular Ritalin in one day and at what time of the day to get the feeling of how I would feel on Concerta? I would like to try it out before I go through the hassle of trying to get the insurance to cover it. It would be alot easier to take only 1 dose a day.
When I took Focalin (d-methylphenidate) it lasted about 1.5 hrs. that's it! It had some lingering effect for about another hour, but not much. It cracks me up that they actually call for twice daily dosing on the package insert (!) If it is true that a 5mg of immediate release methylphenidate is *too* much for you at *any* time of the day.. well you would have to probably take 2.5mg.. say 8x daily for a total daily dose of 20mg. Concerta is supposed to have a peak blood level at approx 6 hrs post dosing, with a smooth letdown. You probably could approximate it simply by taking 2.5mg first thing and then the minute you feel an energy reduction take another 2.5mg, until you are out of 20mg of medication for the day or it is within a couple of hours of bedtime. Christ! That would be far worse than trying to dose Neurontin all day! :) You can try and see. It might be easier to just get the insurance company to go for a month's supply as a trial (30x 18mg tabs). It's either going to work for you or not...Mitch
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