![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Paulbwell on October 11, 2005, at 0:19:04
I am scripted this compound for medical reasons. I have read of addication potential, and troubles when stopping it.
Anyone confirm my aprenshions?
Cheers
Posted by med_empowered on October 11, 2005, at 4:25:36
In reply to Methylphenidate (Ritalin) use???, posted by Paulbwell on October 11, 2005, at 0:19:04
With the whole "addiction" thing...there seems to be an "addiction" scare in medicine today, and its pretty stupid. For a long time, particularly in the US, barbiturates and amphetamines could be easily obtained without a prescription; in fact, lots of places had amphetamines over the counter until the mid-to-late 50s. Yes, there were some addicts here and there, but it wasn't a **huge** problem. The real issue is dependence: if you were to suddenly be deprived of your Ritalin, would you go into withdrawl? Well..yeah. And it could be really, really rough. But...that's true of most psychiatric meds, even the "benign" SSRIs. Addiction isn't the same as dependence; addiction is dependence coupled with certain behaviors (increasing intake, breaking laws, theft, antisocial behavior, complete focus on drug consumption)...its basically dependence, with a strong psychosocial component in which high-risk level drug use becomes the central focus of an individual's life. Its called a "disease" these days, but that really oversimplifies the matter; there are lots of social and psychological factors to take into account, so its not a "disease" in the same sense that cancer or alzheimer's are diseases. Does this make sense? But, yes...withdrawal from ritalin can be very rough. In the US, ritalin is a schedule II substance, meaning no refills (new script for every fill), no phone ins, and lots of scrutiny. There are some who want it moved into schedule III (which would mean potentially problematic, but not too bad...refills allowed, etc. etc.). Its first-line when dealing with ADD/ADHD or treatment-resistant depression, so the overall consensus seems to be that its not quite as hardcore as, say, dexedrine, adderall, or desoxyn. Good luck!
Posted by linkadge on October 11, 2005, at 13:47:08
In reply to Methylphenidate (Ritalin) use???, posted by Paulbwell on October 11, 2005, at 0:19:04
Ritalin binds to the dopamine transporter DAT, in a similar manner to cocaine.
Tollerance will be built to the reinforcing properties of the drug.
Tollerance to the attentional effects may not occur.
Yes withdrawl will be a very difficult process.
The only way to do it is extremely slowly.
I had a hellish withdrawl from 20mg CR, so if you decide to come off, do it very slowly.
Linkadge
Posted by zeugma on October 11, 2005, at 18:00:40
In reply to Re: Methylphenidate (Ritalin) use???, posted by linkadge on October 11, 2005, at 13:47:08
> Ritalin binds to the dopamine transporter DAT, in a similar manner to cocaine.
>
> Tollerance will be built to the reinforcing properties of the drug.
>
> Tollerance to the attentional effects may not occur.
>
> Yes withdrawl will be a very difficult process.
>
> The only way to do it is extremely slowly.
>
> I had a hellish withdrawl from 20mg CR, so if you decide to come off, do it very slowly.
>
>
> Linkadge
>
> I was ordered by pdoc to come off 60 mg LA cold turkey. I wouldn't say that it was a hellish withdrawal, or even a wtihdrawal at all, except that all my symptoms returned. Sort of an exaggerated version of what I am feeling now (6:51 pm Eastern U.S. time) as 200 mg Provigil leaves my body. World becomes shrouded in fog, and don't ask me to perform complex tasks, such as putting frozen pizza in microwave. With luck, I'll be able to open the package of vegeterian ham and get some in my system before I go to sleep. Stim withdrawal is moderated by the fact that we withdraw from them daily.BTB: I totally understand what you say about needing that extra focalin to have a satisfying family life and to get through the workday in a satisfactory manner. I also have to take my stim at 5 am and have a long workday, and the Provigil starts to wear off around 4:30 pm. I become uncoordinated and not really 'there.' I really wish I could feel like a functional person after 5 pm, but such has not been the case. I am going to bring this up to pdoc at next appt.
-z
>
>
>
>
>
Posted by Phillipa on October 11, 2005, at 18:57:44
In reply to Re: Methylphenidate (Ritalin) use???, posted by zeugma on October 11, 2005, at 18:00:40
Could this be why my son-in-law has no ambition after work? And he doesn't take it on weekends. So he stays home and plays video games. But from what I understand he also smokes daily pot. Fondly, Phillipa
Posted by zeugma on October 11, 2005, at 19:09:35
In reply to Re: Methylphenidate (Ritalin) use???, posted by zeugma on October 11, 2005, at 18:00:40
It could be. I am an ambitious person, but have trouble doing anything when not on a stim. I don't smoke pot. But I can tell you that people who see me when the stim wears off tell me I look like I've been overindulging in weed, when nothing could be further from the case. And then I start walking into stationary objects. I can't even blame stim withdrawal for this- it's the condition the stims treat. On the day of my college graduation I walked at high speed into a glass wall, and lay in a heap while people laughed at me. And I won't even go into the numerous household accidents, some of which have involved major destruction of property. Of course I seemed less than ambitious to my family, when I was trying to stay alert enough not to walk into a glass wall. They're everywhere, you know.
-z
Posted by linkadge on October 11, 2005, at 19:57:15
In reply to Re: Methylphenidate (Ritalin) use??? » zeugma, posted by zeugma on October 11, 2005, at 19:09:35
Perhaps for some people it is an easier process than for others.
It depends too, on how soon you went on another drug after stopping the LA.
I experienced a significant increase in depression symptoms, as well as one hell of a case of anhedonia for just about as long as I took the drug for.
Linkadge
Posted by med_empowered on October 12, 2005, at 3:21:21
In reply to Re: Methylphenidate (Ritalin) use???, posted by linkadge on October 11, 2005, at 19:57:15
Yeah...I think it may have a lot to do with any underlying issues. When I took stims, it was first RX'd for ADHD; then the dosage was upped and some antidepressants were added to deal with treatment-resistant depression. Soo...when I withdrew, it sucked b/c I was still depressed anyway, and to add to it I was quickly withdrawn from 60mgs/Adderall daily. Not fun, not fun at all. I've read case studies where people taking stims for depression end up requiring ever increasing doses (even in the absence of abuse or misuse) and have hardcore relapses when the stim is withdrawn.
Posted by Paulbwell on October 12, 2005, at 3:33:11
In reply to Re: Methylphenidate (Ritalin) use???, posted by med_empowered on October 12, 2005, at 3:21:21
> Yeah...I think it may have a lot to do with any underlying issues. When I took stims, it was first RX'd for ADHD; then the dosage was upped and some antidepressants were added to deal with treatment-resistant depression. Soo...when I withdrew, it sucked b/c I was still depressed anyway, and to add to it I was quickly withdrawn from 60mgs/Adderall daily. Not fun, not fun at all. I've read case studies where people taking stims for depression end up requiring ever increasing doses (even in the absence of abuse or misuse) and have hardcore relapses when the stim is withdrawn.
Thanks dude for yr post,
I have an aquantaince who takes a 30mg IR Adderrall tab 4x daily=120mgs (shes 60)for add/hd issues. She reports no depression when stopping it, but a beffuled state of mind.
I also have an aquantaince who has taken Desoxyn (Medical methamphetamine)-Narcolepsy- for 40 years. I asked him if her gets depressed when not taking his meds-a strong stim-he told me he doesn't, but sleeps alot, when off his Desoxyn.
I guess we are wired differently?
Cheers
Posted by pseudoname on October 12, 2005, at 14:41:24
In reply to Methylphenidate (Ritalin) use???, posted by Paulbwell on October 11, 2005, at 0:19:04
> I am scripted this compound for medical reasons.
Paul,
Can I ask what are you being prescribed Ritalin for and at what dose(s)?
I read your comment in the Adderall thread that you "have some experience in the area," but not with amphetamines (although you strongly advised against them). Have you taken other stimulants?
In my experience with both Ritalin and Adderall XR, Adderall is smoother and results in no "crash" afterward, as Ritalin did for me. Either medicine can be helpful: judicious dosing may be the key...
Good luck. As you say, we are all wired (a little) differently.
Posted by Paulbwell on October 12, 2005, at 18:03:23
In reply to why Ritalin? » Paulbwell, posted by pseudoname on October 12, 2005, at 14:41:24
> > I am scripted this compound for medical reasons.
>
> Paul,
>
> Can I ask what are you being prescribed Ritalin for and at what dose(s)?
>
> I read your comment in the Adderall thread that you "have some experience in the area," but not with amphetamines (although you strongly advised against them). Have you taken other stimulants?
>
> In my experience with both Ritalin and Adderall XR, Adderall is smoother and results in no "crash" afterward, as Ritalin did for me. Either medicine can be helpful: judicious dosing may be the key...
>
> Good luck. As you say, we are all wired (a little) differently.Early last year, i was referred to a top Psydoc, I was having life interefing issues with a long anxiety issue . After several sessions, Xanax Valium, HE BOUGHT UP THE ISSUE OF AN ADD/HD-type problem, i had NEVER entertained the thought of this disorder-NEVER.
he told me about the treatments available in my country.
-Methylphenidate IR 10mg tabs
-Methylphenidate (Ritalin brand) 20mg SR tabs
-Dextroamphetamine USA (Dexedrine) 5mg IR tabsAND THATS IT!
I was apprehensive about taking Ritalin~(because it's a kiddys pill?)I somewhat pushed for the Dex (as i thought it to work better on adults)-at which point he asked me-judgeingly- if i had ever taken Amphetamines before- NO.
So early last year, i was started, and turned onto stimulants. First 10mg tab 2x daily,then 10mgs 4x daily, then 20mgs 3x daily, now my last script was for a 20mg Methylphenidate dose 4x daily-althought i don't follow this religiously.
Quite frankly i bloody of having to continuely take pills thru out the day. Maybe a single morning dose of medicine (AderallXR Dexedrine SR) would be ok.
All i want is to be like regular folks, and live a normal life.
Cheers
Posted by Paulbwell on October 12, 2005, at 18:05:35
In reply to why Ritalin? » Paulbwell, posted by pseudoname on October 12, 2005, at 14:41:24
> > I am scripted this compound for medical reasons.
>
> Paul,
>
> Can I ask what are you being prescribed Ritalin for and at what dose(s)?
>
> I read your comment in the Adderall thread that you "have some experience in the area," but not with amphetamines (although you strongly advised against them). Have you taken other stimulants?
>
> In my experience with both Ritalin and Adderall XR, Adderall is smoother and results in no "crash" afterward, as Ritalin did for me. Either medicine can be helpful: judicious dosing may be the key...
>
> Good luck. As you say, we are all wired (a little) differently.Early last year, i was referred to a top Psydoc, I was having life interefing issues with a long anxiety issue . After several sessions, Xanax Valium, HE BOUGHT UP THE ISSUE OF AN ADD/HD-type problem, i had NEVER entertained the thought of this disorder-NEVER.
he told me about the treatments available in my country.
-Methylphenidate IR 10mg tabs
-Methylphenidate (Ritalin brand) 20mg SR tabs
-Dextroamphetamine USA (Dexedrine) 5mg IR tabsAND THATS IT!
I was apprehensive about taking Ritalin~(because it's a kiddys pill?)I somewhat pushed for the Dex (as i thought it to work better on adults)-at which point he asked me-judgeingly- if i had ever taken Amphetamines before- NO.
So early last year, i was started, and turned onto stimulants. First 10mg tab 2x daily,then 10mgs 4x daily, then 20mgs 3x daily, now my last script was for a 20mg Methylphenidate dose 4x daily-althought i don't follow this religiously.
Quite frankly i bloody tired of having to continuely take pills thru out the day. Maybe a single morning dose of medicine (AderallXR Dexedrine SR, Whatever works) would be ok, but these Meds are not available here, althought Concerta, Bupropion is.
All i want is to be like regular folks, and live a normal life.
Cheers
Posted by linkadge on October 12, 2005, at 19:31:37
In reply to Re: why Ritalin? » pseudoname, posted by Paulbwell on October 12, 2005, at 18:05:35
I have some advice. It may not be necessarily what is best for you but..
I was in the same position. A doctor brought up ADHD with basically asking me 2 questions. No formal asessment, zip.
I didn't have ADHD, I had an anxiety disorder that led to some mild attention problems.
He started me right away on ritalin, and wanted me to take like 40mgIt was a path that started out well, and then just became nasty. I just became a junky that I didn't like. I had all of these strange feelings that made no sence, and I couldn't controll.
A few good supplements made the withdrawl easier, and long story short, I am feeling much better now.I would urge you to think through the diagnosis.
If your gut tells you that it was not accurate than you're probably right.I would taper off, and perhaps rethink the whole diagnosis.
Not to sound rude, but I just think it may bring you closer to recovery.
Linkadge
Posted by BowTie Bob on October 13, 2005, at 7:57:31
In reply to Re: Methylphenidate (Ritalin) use???, posted by zeugma on October 11, 2005, at 18:00:40
> > Ritalin binds to the dopamine transporter DAT, in a similar manner to cocaine.
> >
> > Tollerance will be built to the reinforcing properties of the drug.
> >
> > Tollerance to the attentional effects may not occur.
> >
> > Yes withdrawl will be a very difficult process.
> >
> > The only way to do it is extremely slowly.
> >
> > I had a hellish withdrawl from 20mg CR, so if you decide to come off, do it very slowly.
> >
> >
> > Linkadge
> >
> > I was ordered by pdoc to come off 60 mg LA cold turkey. I wouldn't say that it was a hellish withdrawal, or even a wtihdrawal at all, except that all my symptoms returned. Sort of an exaggerated version of what I am feeling now (6:51 pm Eastern U.S. time) as 200 mg Provigil leaves my body. World becomes shrouded in fog, and don't ask me to perform complex tasks, such as putting frozen pizza in microwave. With luck, I'll be able to open the package of vegeterian ham and get some in my system before I go to sleep. Stim withdrawal is moderated by the fact that we withdraw from them daily.
>
> BTB: I totally understand what you say about needing that extra focalin to have a satisfying family life and to get through the workday in a satisfactory manner. I also have to take my stim at 5 am and have a long workday, and the Provigil starts to wear off around 4:30 pm. I become uncoordinated and not really 'there.' I really wish I could feel like a functional person after 5 pm, but such has not been the case. I am going to bring this up to pdoc at next appt.
>
> -zHey Z,
I hear you. Everyone responds differently to the meds. I have finally figured out that if I take regular Focalin around 5AM, I take the Focalin XR 5 1/2 hours later and I am covered until about 7PM. We all just need to figure out our own timing, as it is not something any doc can tell us. Best of luck!BTB
Posted by alohashirt on October 14, 2005, at 23:18:36
In reply to Re: why Ritalin? » pseudoname, posted by Paulbwell on October 12, 2005, at 18:05:35
Paul,
I suggest flying to New York after making an appt with an ADHD specialist here and trying Focalin XR or Concerta. I can suggest a few possible people if you're interested. The big problem with the stimulants is that only a 30 day scrip is possible
Posted by theo on October 15, 2005, at 16:19:20
In reply to Re: why Ritalin?, posted by alohashirt on October 14, 2005, at 23:18:36
After being on Focalin XR for a while now, how would you compare it versus Concerta?
Posted by alohashirt on October 15, 2005, at 21:47:11
In reply to Re: why Ritalin? » alohashirt, posted by theo on October 15, 2005, at 16:19:20
> After being on Focalin XR for a while now, how would you compare it versus Concerta?
Better, shorter acting, more front-loaded. Feels "sharper" less of the tunnel vision thinking that occurs with Concerta. Focalin XR feels a little like a cross between Concerta and Dexedrine - more of dexedrine's clarity
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.