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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by Libby on July 11, 2000, at 13:48:57
The Ritalin has made a huge difference in my life.
I can easily handle both home and work situations
now that my brain is working. However, I notice
that after taking my third dose, my facial muscles
and shoulders get very tight. For the past few
nights, I've had terrible headache from the tension.
Has this happened to anyone else? Suggestions?
Thanks,
L.
Posted by KarenB on July 11, 2000, at 14:39:40
In reply to Does Ritalin cause tension? Karen, Noa, etc., posted by Libby on July 11, 2000, at 13:48:57
> The Ritalin has made a huge difference in my life.
> I can easily handle both home and work situations
> now that my brain is working. However, I notice
> that after taking my third dose, my facial muscles
> and shoulders get very tight. For the past few
> nights, I've had terrible headache from the tension.
> Has this happened to anyone else? Suggestions?
> Thanks,
> L.Yes. You may want to 1)lower your dosage 2)maintain your dosage and add Inderal, 10mg 3x a day which will stop the headaches and ease the muscle tension 3) Ask your doc if you can try Adrafinil instead of Ritalin. If it doesn't work, you can go back to the Ritalin or try Adderall, which I believe to be superior to Ritalin in some cases. It was in mine - smoother take-offs and landings.
Karen
Posted by noa on July 11, 2000, at 15:04:04
In reply to Re: Does Ritalin cause tension? Karen, Noa, etc., posted by KarenB on July 11, 2000, at 14:39:40
Ya know, I have had increased tension in my jaw, and figured it was med related but never bothered to try to figure out if it was due to the ADs or the Ritalin. Or both, perhaps. I wonder if a different stim might work better for you. Carol Ann has had experience with Adderall.
Posted by Cass on July 11, 2000, at 17:25:37
In reply to Re: Does Ritalin cause tension? Karen, Noa, etc., posted by noa on July 11, 2000, at 15:04:04
The most tension causing AD for me was Adderall, but we all respond differently. Now that I am on Dexedrine, I do notice more tightness in the muscles of my face and shoulders, so I think this must be a common side-effect of psychostimulants. My doctor has given me Seroquel to offset some of the agitation and tension. Have you tried the other psychostimulants? Maybe another wouldn't cause the tension for you. I wish you luck.
Cass
Posted by Sara T on July 13, 2000, at 22:02:30
In reply to Does Ritalin cause tension? Karen, Noa, etc., posted by Libby on July 11, 2000, at 13:48:57
> The Ritalin has made a huge difference in my life.
> I can easily handle both home and work situations
> now that my brain is working. However, I notice
> that after taking my third dose, my facial muscles
> and shoulders get very tight. For the past few
> nights, I've had terrible headache from the tension.
> Has this happened to anyone else? Suggestions?
> Thanks,
> L.Libby-
I experience the same sort of thing, very tight facial muscles and jaw muscle tension. It gives me a headache too. I am on Zoloft and Metadate (new extended release form of methylphenidate, or ritalin). I have read that Zoloft can cause muscle tension in the jaws and bruxism. But I seem to experience the facial muscle tensions and headache if I take the Metadate too late in the day. It's supposed to be a once a day dose, and it does last longer then Ritalin SR, but my day lasts a long time, so I often do take a morning and afternoon dose. I notice that if I am tired I have tight facial muscles, I find myself grimmacing.Stimulants bring out tics, and certainly muscle spasms (tight muscles and tension in the facial muscles are a sort of spasm). That's why they can't be used with people who have Tourettes.
Are you taking the name brand or generic? it makes a difference. The name brand is alot smoother. I had alot of headaches and tension from the generic. However, I don't think I experienced the amount of facial and jaw tension that I have been lately with the Metadate.
I try various things. I take Ibupropen, because it is a muscle relaxant. I drink a cup of Linden tea, which is a relaxant, and I cut as much caffeine out as possible. And I try not to take it too late in the day. I also try relaxation and medation tapes. They take you through a series of tension reducing exercises, tighten you face and brow and then release, and so on.
And, of course, another med maybe be alot smoother. The Ritalin SR is ALOT smoother that the regular Ritalin.
Hope this helps.
Sara T.
Posted by Libby on July 14, 2000, at 10:59:47
In reply to Re: Does Ritalin cause tension? Karen, Noa, etc. » Libby, posted by Sara T on July 13, 2000, at 22:02:30
Thanks Sara! I am currently taking generic methylphenidate, 10 mg 3X/day. I'll definitely ask about the name brand.
I have some other questions... if any of you more experienced ADD-er's could help me out, I'd appreciate it.
1. What I'm taking keeps me alert well into early evening, which gives me time to take care of things around the house as well as at work. I'm worried that if I change to a longer-acting drug, it will poop out by late afternoon. That would still allow me to function at work, but would make me pretty much worthless at home. I have a huge house & lawn, a teenage daughter, and a disabled mother & sister to care for, so I often need MORE horsepower at home as at work.
2. My doc has already told me he'd like to try other stimulants. He seems to like prescribing Adderall. Can anyone tell me if the the extended release form of Ritalin and Adderall really last all day?
3. Also, I've noticed that a dose of my current med lasts for about three hours. Since my doc has instructed me to dose every four hours, with NO adjustments, I spend a couple of hours a day crashing... but I haven't complained about that because two hours of crashing is way more tolerable than the eight hours of mental fog I'm used to. Is this pretty much typical of everyone who uses short-acting Ritalin or is it a dosing issue?
4. My sleep has improved. My brain is working better. My moods are stable and good. My productivity and social activies are way up.
My only complaints are the crashing and occasional headaches. This week, I went for a massage when the tension got unbearable and that kept me relaxed for days... so I guess I could
just look for ways to relax and maybe I could learn to deal with the tension... Sara's suggestions about dosing late & being tired might help, too... I feel so much better than I ever have before that a part of me wonders if I should just keep my mouth shut and be happy... Have any of the rest of you felt this way and what did you finally do? I guess what I'm asking is whether it's likely I could do much better than I already am...Any or all suggestions are appreciated. Email is welcome if you don't want to post your answers.
Thanks again for all the help...
L.
Posted by noa on July 14, 2000, at 12:57:17
In reply to More Ritalin ?'s Am I complaining too much?, posted by Libby on July 14, 2000, at 10:59:47
> 3. Also, I've noticed that a dose of my current med lasts for about three hours. Since my doc has instructed me to dose every four hours, with NO adjustments, I spend a couple of hours a day crashing...I had that on the 10 mg 3xday of regular methylphenidate. It is better on the 20 mg 2xday of the sr version, but I find the sr a weaker version. Still, it is better than crashing. BTW, IMHO, regular never really lasts the full 4 hours. I read somewhere that it lasts from about 2.5 to 3.5 hours.
The sr doesn't last as long as you would think, either. More like 5 to 6 at most, IMHO.
I am also thinking of trying Adderall. I have been doing relatively fine with the methylphenidate, ie, not having big problems, but not perfect, either, but want to see if I do better on something else.
Posted by Lynne on July 14, 2000, at 15:14:09
In reply to Re: More Ritalin ?'s Am I complaining too much?, posted by noa on July 14, 2000, at 12:57:17
Has anyone tried Metadate ER compared to Ritalin SR? They are suppose to be the same, but sometimes I think there is a difference between brands when it comes to psch meds.I think I am going to ask for the Metadate to see how it compares.
Posted by Sara T on July 14, 2000, at 17:43:17
In reply to Re: More Ritalin ?'s What about Metadate ER?, posted by Lynne on July 14, 2000, at 15:14:09
> Has anyone tried Metadate ER compared to Ritalin SR? They are suppose to be the same, but sometimes I think there is a difference between brands when it comes to psch meds.I think I am going to ask for the Metadate to see how it compares.
Lynne-
My pdoc switched me over to Metadate so I've been using it for at least 3 weeks. I think it does indeed last longer than the Ritalin SR. I get about 7 hours out of it. Generally speaking, I get more out of the afternoon dose than I do out of the mornig one. Why? Maybe I'm more awake by the afternoon and it helps the drug work better, I don't know. Everyone has their own rythyms.Before that I had been using the Ritalin SR. I found it lasted about 4 hours, so I always needed something more at the end of the day. With the Metadate, if I take it around 11:30 am or noon, it will take me through until around 7:30 or 8:00pm.
Metadate was developed to give as a once a day dosing for kids, and my doc asked me to try it once a day for a few days. But I found that if my day starts at 7:30am and ends at 11:00pm, then I need 2 doses. If I sleep in, I only take one dose.
The thing I find is that I have more facial tension with it. And it gives me more headache when coming off it. In that regard, it seems alittle rougher than the Ritalin SR. Otherwise, no problems with it. It does what they say.
Sara T.
Posted by noa on July 14, 2000, at 18:05:21
In reply to Re: More Ritalin ?'s What about Metadate ER? » Lynne, posted by Sara T on July 14, 2000, at 17:43:17
Sara, had you tried any other stims, like dex or adderall? How do they compare with the metadate?
I definitely have facial/jaw tension, I suppose it is from the ritalin, although I thought it could also be from the effexor (and maybe even the serzone). Who knows. BUt since folks here are reporting it in association with the ritalin, that is probably it.
Posted by Lynne on July 14, 2000, at 20:07:47
In reply to Re: More Ritalin ?'s What about Metadate ER? » Lynne, posted by Sara T on July 14, 2000, at 17:43:17
Sara T,
Thank you for answering my question. Do you take the 10mg or 20mg Metadate? How about price ? Is it more or less expensive than Ritalin SR?
Thank You for your help,
Lynne
Posted by Sara T on July 15, 2000, at 11:34:14
In reply to Re: More Ritalin ?'s What about Metadate ER? » Sara T, posted by noa on July 14, 2000, at 18:05:21
> Sara, had you tried any other stims, like dex or adderall? How do they compare with the metadate?
>
> I definitely have facial/jaw tension, I suppose it is from the ritalin, although I thought it could also be from the effexor (and maybe even the serzone). Who knows. BUt since folks here are reporting it in association with the ritalin, that is probably it.Lynne-
I have never tried any thing besides ritalin. My son is on Adderall, and we tried ritalin before that with him. The Adderall is much smoother for him, and we don't see the "backlash" at the end of the day.
Sara T.
Posted by Sara T on July 15, 2000, at 11:36:53
In reply to Re: More Ritalin ?'s What about Metadate ER? » Sara T, posted by noa on July 14, 2000, at 18:05:21
OOps, Noa, I addressed my answer to Lynne when I answered your question. Sorry.
Sara T.
Posted by Sara T on July 15, 2000, at 11:50:13
In reply to Re: More Ritalin ?'s What about Metadate ER? » Sara T, posted by Lynne on July 14, 2000, at 20:07:47
> Sara T,
>
> Thank you for answering my question. Do you take the 10mg or 20mg Metadate? How about price ? Is it more or less expensive than Ritalin SR?
>
> Thank You for your help,
> LynneLynne,
I take 20 mg Metadate once or twice a day, depending on how long my day is. The cost for Metadate was around $43.00 +/- for 60 tabs. My insurance covered it and I paid a copay. The cost for Ritalin SR was $65.00+/- for 60 tabs and my insurance covered that but my copay was for some reason more. The Metadate has lasted me longer, I have 11 days more tabs @ 2/day and my prescription 30 days is up in 8 days. That's better than the Ritalin SR which barely got me through the 30 days.
Sara T.
Posted by Sara T on July 15, 2000, at 12:27:50
In reply to More Ritalin ?'s Am I complaining too much?, posted by Libby on July 14, 2000, at 10:59:47
Hi Libby,
Sorry I didn't get back to you sooner.
> I have some other questions... if any of you more experienced ADD-er's could help me out, I'd appreciate it.
>
> 1. What I'm taking keeps me alert well into early evening, which gives me time to take care of things around the house as well as at work. I'm worried that if I change to a longer-acting drug, it will poop out by late afternoon. That would still allow me to function at work, but would make me pretty much worthless at home. I have a huge house & lawn, a teenage daughter, and a disabled mother & sister to care for, so I often need MORE horsepower at home as at work.
>A longer acting Stimulant would keep you going longer, but you still might need it 2x/day. My son's neurologist said we could augment the Adderall he takes with Ritalin late in the afternoon so he can do his homework. But don't take it too late or it will interfere with sleep.
The Metadate that I take seems to keep me going into the evening (7 or 8 hours) if I take it in early afternoon.
> 2. My doc has already told me he'd like to try other stimulants. He seems to like prescribing Adderall. Can anyone tell me if the the extended release form of Ritalin and Adderall really last all day?
>No, they don't. You usually have to take them 2x/day. I got about 4 hours out of the Ritalin SR and my son gets 5 hours out of his Adderall. They are much smoother though and twice is better than 3-4x/day.
> 3. Also, I've noticed that a dose of my current med lasts for about three hours. Since my doc has instructed me to dose every four hours, with NO adjustments, I spend a couple of hours a day crashing... but I haven't complained about that because two hours of crashing is way more tolerable than the eight hours of mental fog I'm used to. Is this pretty much typical of everyone who uses short-acting Ritalin or is it a dosing issue?
>You have to overlap the doses not to crash. Typically Ritalin lasts about 2.5 -3 hours. Yes it is an issue for everyone taking Ritalin. I think the brand name lasts a little longer, IMHO. Your doc will need to write "medically necessary" on his script or the insurance co. may not pay for it.
> 4. My sleep has improved. My brain is working better. My moods are stable and good. My productivity and social activies are way up.
> My only complaints are the crashing and occasional headaches. This week, I went for a massage when the tension got unbearable and that kept me relaxed for days... so I guess I could
> just look for ways to relax and maybe I could learn to deal with the tension... Sara's suggestions about dosing late & being tired might help, too... I feel so much better than I ever have before that a part of me wonders if I should just keep my mouth shut and be happy... Have any of the rest of you felt this way and what did you finally do? I guess what I'm asking is whether it's likely I could do much better than I already am...
>Yes, you can do better and don't be afraid to tell the pdoc what you need. You should be able to adjust your dosing to target your needs, and also the longer lasting stims are really better for adults who have a longer day. And you shouldn't have to have headaches every 3 hours!
Good luck,
Sara T.
Posted by noa on July 17, 2000, at 6:06:03
In reply to Re: More Ritalin ?'s What about Metadate ER? » noa, posted by Sara T on July 15, 2000, at 11:34:14
Sara, thanks for the info on metadate.
At the moment, I feel I have been doing well, but with "room for improvement", and so, I am trying my endo's suggestion of raising my synthroid dose slightly, to see if I get any more improvement. So, I don't want to make a change in stims just yet, but I am going to give it a try at some point. I am really curious to see if metadate or adderall would be more effective for me.
Posted by Libby on July 17, 2000, at 10:20:19
In reply to Re: More Ritalin ?'s What about Metadate ER? » Sara T, posted by noa on July 14, 2000, at 18:05:21
> I definitely have facial/jaw tension, I suppose it is from the ritalin, although I thought it could also be from the effexor (and maybe even the serzone). Who knows. BUt since folks here are reporting it in association with the ritalin, that is probably it.<
Noa... I started Ritalin after being on Effexor XR, headache/tension-free for almost a year. The headaches started about a week and a half (?)after starting the Ritalin, so I'm guessing it's responsible. I'm seeing my pdoc for a med check on Wed. I'm going to discuss it with him. Meanwhile, I'm finding mentholatum patches very helpful in easing the tension between doses.
Posted by Libby on July 17, 2000, at 10:23:23
In reply to Re: More Ritalin ?'s Am I complaining too much? » Libby, posted by Sara T on July 15, 2000, at 12:27:50
Thanks Sara... Just one more question?
Does the name brand/generic thing make a difference with the other stims, or did you find that was pretty much an issue with short-acting Ritalin?L.
Posted by tdaneen on July 17, 2000, at 13:11:25
In reply to Re: More Ritalin ?'s for Sara, posted by Libby on July 17, 2000, at 10:23:23
Does anyone have any words of wisdom for suffers of TMJ who also have to take ritalin?
I am in the begining of a humdinger of a TMJ episode. Lemme tell you I don't relish the thought of taking 1800mgs of ibuprofin(MD's orders) on top of all my bipolar meds too! Geesh! How much more can my poor digestive tract take anyway?
I'm thinking of calling my Dentist to see if they would recommend a sports mouthpiece in the interium while I am waiting to get an appointment?
Does anyone have any other ideas?Thanks!
Posted by Rick on July 29, 2000, at 0:43:56
In reply to Re: More Ritalin and TMJ, posted by tdaneen on July 17, 2000, at 13:11:25
> Does anyone have any words of wisdom for suffers of TMJ who also have to take ritalin?
> I am in the begining of a humdinger of a TMJ episode. Lemme tell you I don't relish the thought of taking 1800mgs of ibuprofin(MD's orders) on top of all my bipolar meds too! Geesh! How much more can my poor digestive tract take anyway?
> I'm thinking of calling my Dentist to see if they would recommend a sports mouthpiece in the interium while I am waiting to get an appointment?
> Does anyone have any other ideas?
>
> Thanks!About 16 months ago I was getting ready to finally see a doctor about longtime jaw/facial tightness and pain. But I decided to start social phobia treatment first. (I had never taken a psychtropic before.) After a few months I tried Klonopin. It not only helped immensely with my social phobia, but to my amazement the facial/jaw pain almost entirely disappeared! It's made a slight comeback as I've tried adding some AD's to the Klonopin, but it's still SOOO much better than before...just an occasional and minor distraction.
I don't know whether this exceedingly welcome side effect was due to lessening of anxiety or a more direct impact of the Klonopin. In any event, I have since read about Klonopn's benefits in fighting chronic pain
Now I have no idea whether a Ritalin/Klonopin combo is safe or makes any theraputic sense. But I am now taking the more-gentle stimulant Provigil
along with Klonopin and Serzone, and everything's going great. (This is despite the fact that some studies have found that Provigil reduces GABA flow somwhat in certain areas of the rat brain, whereas one of Klonopin's primary anxiety-fighting benefits comes from increasing GABA availability.)
So if your doc or research from reputable sources says the combo is "O.K', you might want to try low-dose Klonopin. The effect is strongest (and the possible sedation effect goes away fairly soon) if you take it daily instead of as-needed.If by any chance you're already using Klonopin, then it's one of those YMMV situations.
Rick
Posted by Sheshe on November 28, 2001, at 20:13:55
In reply to Re: More Ritalin ?'s Am I complaining too much? » Libby, posted by Sara T on July 15, 2000, at 12:27:50
> > > I have some other questions... if any of you more experienced ADD-er's could help me out, I'd appreciate it.
> >
> Does any one know anything about the new Long Lasting Adderall? I just started Medidate 10 Mg.1xday after being on 5mg. adderall every 31/2hrs. Liked the adderrall, not the dosing...not too sure if I like the Medidate. Want to know more.
Thanks,
Sheshe
Posted by henryO on November 29, 2001, at 16:06:22
In reply to Does Ritalin cause tension? Karen, Noa, etc., posted by Libby on July 11, 2000, at 13:48:57
Concerta is Ritalin in a long lasting form. It helps with the ups and downs of dosing. I find it much smoother than regular Ritalin. Concerta comes in different doses. It is actually Ritalin in a tiny device that you swallow. It is the size of a tic-tac. It administers the drug steadily throughout the day. Good stuff. I would also say that if your muscles are tight like that then you are taking too strong of a dose all at once. The pills are easy enough to break. Cut back. See what happens.
Posted by Noa on November 29, 2001, at 17:27:00
In reply to Re: More Ritalin ?'s Am I complaining too much?, posted by Sheshe on November 28, 2001, at 20:13:55
I want to hear about the long acting adderall that just came out, too. I heard one thing--the person who started using it couldn't sleep at all, so went back to regular adderall. Actually, I also heard it is different from concerta--it doesn't deliver a steady extended dose, but releases a second big dose a number of hours after it is taken. I don't know how valid this info is, though--it is just something I was told by a friend.
This is the end of the thread.
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