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General Medication Discussion This section is to be used for general medication discussion and other medications not broken out in their own respective forums.

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Old 06-29-10, 04:22 PM
MyAchillesheel MyAchillesheel is offline
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Join Date: Jun 2010
Location: Everywhere USA
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10 years of Success, Failure, and Success again with stimulants.

10 years of Success, Failure, and Success again with Ritalin, Adderall, and back to Ritalin for Inattentive/Sluggish Cognitive Tempo )ADHD, by MyAchillesHeel


My Inattentive/SCT ADHD is and always will be My Achilles Heel….


This is a long post I felt compelled to write in order to give back to this forum and help those suffering from the Inattentive/Sluggish Cognitive Tempo ADHD. (Sleepy brain, foggy brain, fatigue, lack of drive, failure to start and complete difficult/mundane tasks.)

This data will also be of interest to the Hyperactives who may want to read about my experiences on Ritalin/Methylphenidate and my transition to Adderall, and back again to Ritalin/Methylphenidate….

***Please note: These are MY experiences and therefore this does not mean YOU will have the same reactions as I did to the various stimulants and supplements. Therefore when reading this post please recognize that there is no substitute for your own experiences when titrating dosages, trying a new stimulant, and etc. Everyone has a different metabolism and genetic code and will always react differently or opposite when trying stimulants or supplements.

*** In addition: Always consult with your physician regarding any of the ideas and experiences mentioned in this post before you try them.

Thank You:
A warm thank you goes out to all of those who have posted their comments and experiences here at the addforums.com. I would especially like to thank Josh_Kelly for the majority of his invaluable insight on various topics as well as tired_tired who posted a nice analogy regarding stimulant comparisons. One more thank you goes out to David who made a nice post about splitting the 20 mg methylphenidate tab into two 10’s and finding it to be more potent/effective than just one 10mg tab. (If you have not had a chance I would strongly recommend reading all of the posts put up by Josh_Kelly as they are very informative.)

I have summarized numerically the contents of this post so you can jump to the subjects that will interest you the most.

1) Brief summary/synopsis about me
2) My first 5 years (2000-2005) on Watson generic Methylphenidate IR 5 MG tabs
3) My Odyssey (from 2005 – 2010) the remaining five years of success, failure, and success with Stimulants
4) Experience with Watson Generic Methylphenidate HCL IR 5 MG tabs
5) Experience on Mallinckrodt Generic Methylin IR 5MG tabs
6) Experience on Mallinckrodt Generic Methylin 20MG ER tabs
7) Experience on Novartis Brand Name Methylphenidate IR 5Mg tabs
8) Experience on Novartis LA Brand Name Methylphenidate10MG (Long Acting)
9) Experience on Generic Barr Adderall IR 15 mg tabs
10) Experience on Generic Sandoz Adderall IR 20mg tabs
11) Experience on Generic Barr D-amphetamine XR 5 mg spansules
12) Experience on Novartis Brand Name Focalin XR spansules (Extended Release) at 5 mg and 10 mg
13) Ritalin/MPH Absorption on a full tummy 13A) How to take MPH and AMP
14) Various supplements
15) Diet
16) Caffeine (coffee)/Citric Acid and interactions with MPH and AMP
17) Thyroid and Adrenal glands and how they impact us
18) Things to try
19) Exercise
20) Generic Brands of MPH and AMP
21) Suggested readings
22) Sleep
23) Transition from Ritalin/Methylphenidate to Adderall/amphetamine salts and back to Ritalin/Methylphenidate


MPH = Methylphenidate/Methylin
AMP = Amphetamines/Amphetamine Salts

IR = Instant Release

Extended Release = ER, Sustained Release = SR, Long Acting = LA
(Essentially anything along these lines ER, SR, XR, LA all pertain to an extended release form of the stimulant you are taking. The point of these extended stimulants is to avoid multiple dosing and smooth out the ride (fewer ups and downs / peaks and crashes) on a daily basis.)

***GRADING SCALE: 1-10 (1 is the least effective where a 10 is the most effective)***

What I need/look for in a medication: Energy, wakefulness, drive, elimination of brain fog, and motivation to complete projects. Focus is something I already have and do not need more of. I need energy and drive to get up off my *** and get things done.

Please note: I am sensitive to any form of stimulant medication. Therefore my dosages are much lower than the norm, so please understand this is why I use low doses.


1) Brief summary/synopsis about me

I was diagnosed ten years ago in January 2000 with combined Inattentive/Sluggish Cognitive Tempo ADHD. I inherited this condition from my mother who is Limbic ADHD. My major symptoms are: low energy/daytime fatigue, brain fog, sluggish, lack of drive, failure to start and complete difficult/mundane tasks.


I am 38 years old athletic and active with weights, running, biking, and swimming. I make every effort to stay in shape. I have never used any form of recreational drugs. If I drink it is in moderation on the weekends. In short, think of me as one of the Men’s Health magazine guys who tries to stay vigilant about health and diet.

The reason for maintaining a healthy lifestyle is for one reason only: To try and help my stimulant medication work as effectively as possible!! When my stimulants don’t function properly I don’t function properly. It is that simple…


2) My first five years (2000 – 2005) on Watson Generic Methylphenidate HCL IR 5MG tabs:

After initial diagnosis, treatment began with one 5mg IR tablet daily using Watson’s generic methylphenidate every morning. This is the first medication I ever used and I was very sensitive to it. Fortunately I was able to use very small dosages which did last me ALL DAY LONG. Yes that is correct, one 5 mg tab did last all day long.

Please also note that I potentiated the effectiveness and duration by periodically supplementing my diet throughout the day (at noon and 4pm on an empty stomach with strong coffee). I must admit that for me methylphenidate worked much better with a shot of coffee at intervals throughout the day. It definitely does increase the effectiveness and duration of the stimulant for me.)

Routine: every morning one 5mg tablet with a cup of strong coffee on an empty stomach, 30 minutes later motivation, energy, drive and off to work I go! I was able to stay on this medication at this level for essentially five years. If I titrated up/increased the dosage I would lose the benefits I was after: (energy, motivation, and drive) and would become tired or overly agitated, aggressive, and mean.

Please note: When I first started MPH I would get a light headache which would last for a couple hours and then eventually permanently went away after a few days. Aside from that I had no other side effects, MPH worked immediately for me from day one.

Benefits of this medication by Watson: long duration, energy, drive, and focus. It gave me my “MOJO”!! (My “mojo” is the energy and drive to make things happen and get things done)

Side effects: aggressive, some agitation, meanness, elevated body temperature, mild sweating, mild anxiety


3) My remaining Odyssey of 5 years (2006-2010) of success, failure, and success with Stimulants

This is where the real Odyssey began… At the end of those initial five glorious years the medication became less and less effective. My energy, alertness, drive, and abilities began to wane earlier and earlier in the day. This was primarily due to developing a level of tolerance to the stimulant medication. This is what led me to trying various stimulants under the patient guidance of my doctor. He now claims I know more about the different brands of stimulants than he does… Maybe I do and maybe I don’t…


4)Experience with Watson Generic Methylphenidate HCL IR 5 MG tabs

(Doses – 1 – 4, 5 mg tabs taken throughout day as needed)
The first medication I ever used.

Pros: A soft rise with a soft crash/rebound. I liken it to the shape of a rainbow. It took off slowly but consistently towards its peak. As it reached the peak it was a slow onset for several hours and then it descended very slowly until you reached the bottom. The crash/rebound was a light general fatigue easily counteracted with coffee or another dose. For me it was a very long acting drug. The longest acting of the IR versions I have used. This brand promoted the most drive, energy, and wakefulness of the IR versions I ever encountered. (I used it for 5 years)

Cons: aggressive, some agitation, meanness, elevated body temperature, mild sweating, and it is a generic.

GRADE: 8.5


5) Experience on Mallinckrodt Generic Methylin IR 5MG tabs

(Dose 1 – 4, 5mg tablets throughout day as needed)

Pros: Promotes some energy, drive and wakefulness but in short acting duration (2 hours maximum)

Cons: Performs much like a pyramid or triangle: fast up with a short 20 minute time at the peak followed by a fast fall with a terrible crash (exhaustive fatigue, irritable, moody, very, very, irritable and mean). I find it to be a little “dirty” and not as clean as the other versions. I also found myself to sweat considerably more with this particular brand.

I used this brand for @ 2 years (which was far too long) but I was ignorant in not realizing nor caring that my pharmacy made a change. I figured all medications were the same and the side effects were simply due to the increase in dosage…. Boy was I ever wrong, the brand of drug is very important.

GRADE: 6.0


6) Experience on Mallinckrodt Generic Methylin 20MG ER (Extended Release) tabs

(Dose = one tablet in AM)

Pros: When this medication works it works well. Unfortunately based on how it was developed/manufactured (wax coating and all) it is VERY inconsistent. It is totally dependent on the PH levels in your gut and intestines for consistent stable release throughout the day to be effective. I have tried altering my diet to accommodate it but still can’t get regular benefits from this generic manufacturer’s version of the extended release methylin. When it does work it has decent drive, motivation, and focus.

(Side Notes: The brand name of this drug is produced by Novartis and is known as Ritalin SR and many folks swear the brand name version is much better. (I would imagine this to be correct) In addition please note that Ritalin LA and Metadate CD were developed as a capsule with a bead technology (little beads of MPH) to supplant the SR and ER wax based pill models. The SR and ER models all suffered from inconsistency in absorption based on the way the drug was made. The bead technology used in Ritalin LA and Metadate CD is supposed to be a much better delivery system.)

Cons: Totally hit and miss. Side effects for me were increased sweating. The crash/rebound is a little softer on this version when it works. When it doesn’t work it is as if you never took a stimulant. Sometimes the crash/rebound had some depression which for me was odd because I never experienced that with any other stimulant.

Side Note: My mother who is in her 60’s also found this ER version by Mallinckrodt to be hit and miss as well. Sometimes it worked for her where she had increased energy, drive, and focus but after 3 months of use she said on average it worked maybe 25% of the time for her.

GRADE: 6.0


7) Experience on Novartis Brand Name Methylphenidate IR 5Mg tabs

(Dose = 1 – 3, 5mg tablets throughout day as needed)

Pros: Very strong, and the strongest of the IR versions I ever tried. Very clean and pure. Rocket fuel for the brain. It functions on par with roughly a four hour plus duration. The best description is box or square like. By that I mean it takes off straight up like a rocket and then plateaus at the peak for a good 2-3 hours and then comes straight down but without a hard crash. The crash/rebound is more like a deep need to take a good nap. Great motivation, drive, and focus. It’s the benchmark all other IR’s are compared to. (Used for 8 weeks)

Cons: There are no real cons for this one. For me the con was the strength of the medication. It was much stronger than what I was used to. Also the way it took off vertically like a rocket was something I had never experienced before. I don’t like the high’s and low’s the IR release versions can give. I prefer smooth ups and downs.

GRADE: 8.9

8) Experience on Novartis LA Brand Name Methylphenidate10MG (Long Acting)

(Dose = 1, 10mg capsule in AM and titrated up to 2, 10mg capsules in AM)

Pros: Clean, smooth, and pure. No high, no low, just a smooth crystal clear brain functioning on all cylinders within an hour of taking it. Perhaps the best medication I have ever used. Amazing drive, energy, focus, essentially everything you look for in a medication. No crash/rebound to speak of. It is just a great stimulant when it releases the 2nd dose effectively… (The medication releases 50% as an IR and 50% 4 hours later)

Cons: Difficulty in getting the 2nd release to be more consistent in strength of effectiveness when it is released. The beads release a 2nd time in the intestines and that environment can be inconsistent depending on diet, bodily functions, and the person. I always have challenges when the 2nd dose is released where it is either not as strong or there is a lag in time when it is released If you are going to try a long acting or extend release or sustained release methylphenidate stimulant I would try this first.

Suggestion: I would request my doctor prescribe Ritalin LA along with an IR booster in the event the afternoon dose of the LA doesn’t kick in right away or is delayed. I imagine this would be the perfect combination to maintain consistent results.

GRADE: 8.6

Side note: In my research the Metadate CD (which I have not tried yet) releases differently and in a pattern of 30% IR and then 70% later. Perhaps this may be a better version?


9) Experience on Generic Barr Adderall IR 15 mg tabs

(Doses = started off with 7.5mg in am for 1 -2 weeks then titrated up to 15mg split into 7.5mg at 8am and 7.5mg at1pm, and then tinkered with dosages up and down and finally settled on using one single AM dose in the amount of 11.25mg a day, but the pros did not outweigh the cons enough for me to continue treatment)

Pros: Some motivation, energy, focus, wakefulness, and drive. The medication did last all day in providing energy well into the evening. (from 8am-9pm) It did promote wakefulness and completely cleared the brain fog but it does not have enough kick/mojo to get my drive in gear to accomplish tasks. I find it does help with sugar cravings and excellent for maintaining diet. It also promotes a positive attitude and sense of well being.

Cons: Inconsistent and delayed when kicking in (sometimes early AM sometimes late AM), increased pulse and heart rate, caused poor sleep, and it created muscle knots throughout my body. I figured out that if I took one day off a week from the medication the sleep issues went away, however the heart related issues persisted.

(I used this medication for 7 weeks and found the secret to the drug was to take one day off a week to catch up on sleep, only take it in the morning in a larger dose, and avoid any afternoon doses, and drink juice in evening to excrete AMP from system to get better sleep)

Side note: My girlfriend who is in her 40’s loves the generic Barr Adderall as it helps her with focus, energy, and clarity. She takes it 2 -3 times a day at 15mg per dose, and only takes it when she feels she needs it. She also likes the way it reduced her appetite.

The primary “Cons” she has with it are: interference with sleep (going to sleep and staying asleep) and muscle tension/muscle knots in her back and shoulders. Her son who is 21 loves this Adderall version as well. He is Limbic ADHD with slight depression and he gets great energy and focus from this brand. However it also interferes with his eating, sleeping, and causes muscle tension/muscle knots in his upper back.

GRADE: 7.5



10) Experience on Generic Sandoz Adderall IR 20mg tabs

(Doses = started off with 5mg in am for 1 week then titrated up to 10mg split into 5mg at 8am and 5mg at 1pm, and then tinkered with dosages up to 15-20 mg a day in the morning for the remainder of the time. I ended the trial using a single AM dose to alleviate the sleep issues but the pros did not outweigh the cons enough for me to continue treatment) (5 weeks of use with one day off a week regulate the body and get some quality sleep, drink juice in evening to help excrete AMP from system)

Pros: Very, very smooth. Produced major focus and enough energy to follow through and complete difficult projects. It also produced a general sense of well being.

Cons: no real significant energy, drive, or kick. Muscle tension/knots in legs, back, and chest persisted throughout the five weeks using this stimulant. It also triggered the same heart and sleep issues as mentioned with the Barr version.

GRADE: 7.2


11) Experience on Generic Barr D-amphetamine 5 mg XR spansules

(Dose = 1, 5mg XR spansule in AM)

Pros: laser beam hocus pocus HYPER focus!!!

Cons: zombie, no personality, sleep and heart issues. Major sleep issues as I could not get any form of restful sleep for the first 4 days. Laser beam focus caused me to become more sedentary, as in I did not move from my desk for 6 hours straight, or I would watch tv for 8 hours straight and not move… (Used for 1 week as I could not function, drive, or go to work, I discontinued treatment due to inability to function normally, it took me a solid week after discontinuance to get back to baseline normal)

GRADE: 5.0


12) Experience on Novartis Brand Name Focalin XR spansules (Extended Release)


(Dose = 1, 5 mg capsule in AM for two weeks and then 2, 5 mg capsules in AM for 1 week. Concluded trial at 1, 5mg capsule in AM)

Pros: major hyper focus for 8 solid hours regardless of dose… some energy/kick but not enough to suit my needs, well tolerated. Very clean feeling in the brain.

Cons: too much hyper focus at 5mg or 10 mg, not enough kick, and had difficulty switching from project to project. Did not provide the energy, drive, and fog clearing my brain needed. If you want focus WITHOUT a host of side effects this may be something for you to try. (Used for 4 weeks)

GRADE: 7.0


13) Ritalin/MPH absorption and a full tummy

The best and most consistent results when taking Ritalin/MPH is it must be taken on an empty stomach.

Ritalin/MPH is unaffected by acid/alkaline food/drink restrictions (unlike amphetamines) BUT, its absorption is greatly reduced when there is food in the stomach. Its extent of absorption differs radically in different people, between 30 to 70%. Therefore take it on an empty tummy and/or 30-45 minutes before your next meal. This especially goes for the IR (immediate/instant release). It is also advised for the extended versions (LA, ER, SR, and etc.) but is not normally indicated in the literature. My doctor recommends taking it on an empty stomach all the time.

13A) How to take MPH or AMP:

MPH: ALWAYS take on an empty stomach at every dosing with 12-16 ounces of water. (If you do not it will not work as well.) When you take your afternoon dose titrate up.

For example: 7AM dose = 5mg, 11am dose = 7.5 – 10mg, 3pm dose 7.5 -12.5mg. The further the day goes the more you may need to counteract the crash and potentiate the benefits. You may need more time or less in between dosings. Go by feel. You can precede or chase it with coffee if you find it helps potentiate the positives. Adjust accordingly.

AMP: Always take the largest dose in the AM, and always take it with 16 ounces of water and with something alkaline, (Tums, club soda, baking soda, etc), and always take it on an empty stomach. Be sure to eat 30-45 minutes later. Go by feel as some folks prefer to take it 30-45 minutes after a meal.


14) Various supplements (for more on this subject get the book “Healing ADD”)

DLPA (DL-Phenylalanine) – I find this amino acid to work well with MPH. It feels like it enhances my mood more positively in a gentle way. It is supposed to do just that and is purported to help with the levels and or functions of Dopamine and Norepinephrine. Anyway I have found by adding DLPA to my regimen (I take it 15-30 minutes before my MPH) that it makes me nicer and more pleasant to be around. (MPH has a tendency to make me a little mean and gruff)

L-Tyrosine – I have been using this for the past four weeks and can’t really say I have noticed any benefit yet… (This is one of many supplements recommended by Dr. Amen)

L-Theanine (Sun theanine) – no experience

I take the following supplements for brain and heart health but of course this does not mean you should. I am under the care of a physician and this is what we came up with for me.

The following dosages are a TOTAL of what I take any given day. I divide up my supplements to be taken 2 or 3 times a day.

4000-5000 mg Flax seed oil OR 3600mg Fish oil

(All the B vitamins in SEPARATE doses not a “Multi B vitamin complex”
Folic Acid and B-12 are the most important of the B vitamins to consider taking for brain function.)
800 mcg Folic acid
2500-5000 mcg B-12
100mg B-6
100mg B-2
100mg B-1
500 mg Pantothenic Acid

400 – 800 mg Magnesium Glycinate OR 325 mg magnesium Natural Calm by Natural Vitality (great stuff!) (I only take this when I feel I need it)

300 mg COQ 10

***Vitamin D – be careful with this and please note that Vitamin D can impact your wakefulness/energy during the day. I have personally found (from use over the past year, regardless of brand, in pill form or liquid) that when I take vitamin D it causes more brain fog and daytime fatigue. Therefore I no longer take it. If you are taking vitamin D because your doctor recommended it (just like I did) try and stop to see how you feel. It will take a couple of days but you may find that your daytime fatigue to improve after you stop.

500 mg Niacin (Bedtime)

D-ribose – 2-3 scoops a day

*** Vitamins are cheap BUT if you are on a budget stick with the folic acid, b-12, pantothenic acid, and fish oil. Start low, go slow, and listen to your body.

15) Diet

This is important and often overlooked by ADHD individuals. Many of us eat poorly so I am not going to preach but odds are IF YOU EAT POORLY YOUR STIMULANTS ARE GOING TO WORK POORLY.

Eat poorly = think poorly: Pizza, donuts, pastries, candy, soda, fast food and etc. (yes these are some of my favorite foods too) all interfere with your bodies function and can impact the absorption of the stimulants. Don’t believe me? Try eating clean for a month or two. You may find you can reduce your dosage…

Also be aware of the possibility of a wheat, gluten, milk or food allergy. These are things that can cause problems as well but you never knew... Investigate these foods to make sure they are not causing you any trouble.

Eat 4-6 small meals a day YOU MADE at home over the weekend. Prepare your meals and keep them in those little meal size plastic storage containers you can pick up at the grocery store. Start off slow and eat clean Monday – Friday and then eat some crap over the weekend….

Examples: chicken, fish, low fat beef, vegetables, fruit, and complex carbs like beans, brown rice, and oatmeal. For snacks eat various nuts and some rice crackers. Greek yogurt mixed with fruit and nuts. Some fruit juices such as grape and pomegranate diluted with water. (Be careful with juice when you take your AMP). For sweets try using Stevia and buy whole dates and freeze them. Dates have a high sugar content and when you eat them frozen (they are harder to eat) and with nuts they are a brilliant sweet tooth satisfying snack. (I buy most of my stuff at COSTCO)

On the weekends: eat whatever you want (I do but in moderation)

NOTE: Personally my diet is the same 5 days a week. On the weekends I change it up. The purpose in doing so is to keep the body on a regular schedule and help the stimulants function as optimally as possible. In the event my medication does not work on a particular day I know it was not related to my diet. Consistency is key.

16) Caffeine (coffee) and Citric acid interactions with MPH and AMP

MPH:
In my experience caffeine/coffee strongly potentiates Ritalin/MPH. If you are looking for more energy, kick, mojo, or whatever you want to call it… consider taking it with strong coffee. (Try taking MPH with your coffee, or drink your coffee 30 minutes before taking MPH, or drink your coffee 30 minutes after taking MPH.)

That said there are those of you who will have an adverse reaction. Therefore, be careful with your caffeine intake as it will definitely impact and potentiate the effectiveness of Ritalin/MPH. For some it will aggravate and increase side effects but for others (like me) it greatly enhances the kick and energy to get moving and make things happen.

I always take ¼ - ½ a shot of espresso (or ¼ - ½ cup of very, very strong coffee) on an empty stomach every morning. In the afternoon I mix it up where sometimes I take my MPH with or without coffee. Remember that coffee enhances the excretion of fluids from your body and consequently this can shorten the duration the MPH in your system. (Personally I have not noticed this)

Try experimenting with coffee by drinking it at different times before or after you have taken your MPH. In addition make sure prior to drinking your coffee you drink 12 ounces of water so you have fluid in your tummy aside from just the MPH and stomach acids. Water helps greatly!

STAY WELL HYDRATED!!!! Throughout the day when using MPH. It can really make a difference!!!

AMP:
I found that AMP and coffee do not play well together and only exacerbate side effects in myself and my girlfriend. In fact I cut way back on coffee consumption when using the amphetamines because it increased my heart rate and interfered with sleep. I still drink a little coffee in the afternoon as I feel it helps potentiate the AMP, but I would reconsider and cut back any caffeine or coffee intake when using AMP. However some of you may find coffee/caffeine helps so test out the theory and see what works for you.

When taking AMP take it with something alkaline like tums, a ¼ teaspoon of baking soda, or even club soda. Be careful with baking soda because it contains a lot of sodium. AMP works best in an alkaline environment so watch what you eat and drink.

***Citric Acid: Watch out for citric acid! Avoid citrus and citric acids an hour before or after taking your AMP. Citric acid greatly interferes with AMP and excretes the AMP more quickly from your body which will reduce its effectiveness. Examples are: Orange Juice, Pomegranate Juice, Cranberry Juice, and etc

***Water: Lots of water DEFINITELY helps potentiate the AMP in the body!!! I swear it works better than coffee. Drink


17) Thyroid and Adrenal glands and how they impact you

These glands are extremely important in regulating your energy levels. In the event they are low you will experience fatigue and energy loss regardless of what your stimulant dosage is. Therefore be vigilant about your health and listen to your body as it will tell you when something is wrong.

Go to the doctor annually and make sure your blood and saliva are tested regularly to make sure you and your hormones are in balance. Remember: the range of normal is very WIDE, and even if your doctor says “everything is normal” question all things that are mid range to low range normal. For example: if the range of normal for thyroid goes from 1-100 and you are a 30, you are “normal” but low normal. That indication tells you that you need to investigate your thyroid a little further… Make sure your doctor gives you copies of your records so you can review them. In the event your doctor doesn’t listen or fights you over your questions. GET A NEW DOCTOR! That’s what I did and it saved my life! (Adrenal Fatigue goes hand in hand with a Low Thyroid) This happened to me.

18) Things to try or Do

*Buy a note a date weekly/calendar to track your diet of food, juice, coffee, supplements and etc. Track how you feel each day by ranking it on a scale of 1-10. Track your “feel” at different intervals throughout the day. You have biorithms throughout the day where you will feel better and worse. Track them to pin point why and what impacted it and then make adjustments.

For example: Monday: From 8am – 12pm “I was a 9” / then from 12pm – 4pm “I was a 7” (sleepy after lunch and did not wake up until 2pm) / then from 4pm – 8pm “I was an 8 and felt great” = Average feeling today an 8, felt great but was sleepy after lunch because I had cookies and a soda. Tomorrow don’t eat cookies and soda.

*Try taking “drug holidays” to lower tolerance. It worked for me and I believe this to be very important especially if you have to spend a lifetime on these drugs. It will extend and help reduce the need to titrate up on a regular basis. I am a prime example. I try every week to either take one or two days off and give the brain a break.

(Personally I have found with MPH that it “builds up” in my system and I always take a day off per week and can sometimes can take a 2-3 day drug holiday where I almost feel as good as if I was taking my MPH. (Consult with your doctor as everyone is different)

*Try chewing up your generic or brand name IR to see if you get better absorption and better performance from your MPH or AMP

*Try buying a higher dose medication (like David mentioned) such as the 20 mg tab and cut it in half or quarters to see if it works better. Larger doses in same size pill means fewer fillers and binders. More bang for your buck. (Consult with your doctor)

*Try different brand manufacturers of medication to see if you react better to them. Sometimes your doctor can split the script and write ½ for one brand and ½ for another. (Consult with you doctor)

*Do start out (or go back to) the brand name stimulants for a point of reference in quality. Use this as a benchmark when comparing to other generic stimulants. Some people prefer the generic to the brand name.

*Try taking your medication with a 12 ounce cup of warm water. It may help with absorption.

***Try drinking more water than you normally do and see if this higher level of hydration makes you feel better throughout the day when you are on your meds. It definitely helps especially with Adderall. Hydration is critically important with the amphetamines (AMP).

*Try and improve your eating habits

19) Exercise (the book Healing ADD touches on this)

If you don’t exercise you soon will be. Why? Your brain, heart, and health all react positively to increased blood flow. The more it’s moving the better you feel.

It is all about blood circulation especially from aerobic activity such as; jogging, wind sprints, walk and jog, fast/brisk walking, swimming, and anything else that gets your heart pumping which increases blood flow to your brain. The increased blood flow to the brain really helps your feeling well being and with the performance of the MPH and AMP. It just makes you feel and function better.

Look, if you don’t exercise just start off by walking for 30 minutes every other day and then increase it from there. If you don’t believe me try it for a month and see how much better you feel. You have nothing to lose.

Like Nike says: “Just do it!”


20) Methylphenidate (MPH) & AMP Brands:

In my experience all of the brand name and generic stimulants work differently. By that I mean each brand name and generic brand will react differently on my brain. This is just the way it is for me. You may be different, but based on my past experience every manufacturer impacts my brain and

MPH:
Favorite: Novartis (Brand Name) (currently using)
2nd Favorite: Watson (generic) (I have not gone back to this brand yet but will do so in the future after tinkering with Novartis IR and LA together)
Least Favorite: Mallinckrodt (generic)

Sandoz (generic) but is owned by Novartis and purportedly is an “authorized generic”. The Sandoz generic is supposed to be identical to the brand name by Novartis. I have not tried the Sandoz methylphenidate yet to report on this.

No experience with Celltech or Danbury.


AMP:
Favorite: Barr (more energy)
2nd favorite: Sandoz (less energy)
No experience: Corepharma


21) Suggested readings

Healing ADD, by Dr. Daniel Amen:

If you don’t own this book then BUY IT. This book contains most of the answers you are looking for. It has a lot of excellent information on all forms of ADHD, diet, supplements, stimulants and other medications. Educate yourself and buy the book. You will not regret it as many of the questions I see posted in the forum are easily answered in this book.

From Fatigued to Fantastic, by Dr. Jacob Teitelbaum:

Don’t let the title fool you. It is chock full of invaluable information from supplements to hormones and pain relief. Anyone over the age of 30 should own this book as a reference and guide to maintaining a healthy brain and body.

22) Sleep

In my experience, my girlfriend’s, and her son’s we have all concluded the same thing: if we don’t get a good night sleep our medication (MPH or AMP) does not work or works ineffectively the following day. Perhaps the number one or number two reason why any of the medications are more or less effective. Try to get a good night sleep as often and as regularly as you can.

23) Transition from Ritalin/Methylphenidate to Adderall/amphetamine salts and back to Ritalin/Methylphenidate

What I have learned after 10 years of taking stimulants is you need to switch things up (try different brands of medication) and let the brain “reset”. Two month long drug holidays will only do so much and after 9 years on generic Ritalin/methylphenidate I decided to try generic adderall/amphetamine salts. I feel by doing this it helped reset my brain.

It will take you a good 2 - 4 weeks before your brain adjusts and gets used to the new medication. I will admit I almost quit several times when making the transition because I thought I was wasting my time and was a “non-responder”. However after the first 8 – 10 days things started to finally balance out and I gradually improved around day 14 – 16. I am glad I persevered because I now know I respond positively to both MPH and AMP medications.

When I transitioned back to Ritalin from Adderall it took essentially the same amount of time. The first thing I did was take a 3 - 4 day drug holiday from all stimulants before going back to Ritalin. In roughly another 7-10 days things came back around and I was well adjusted.

Although I have had positive benefits with Adderall the Ritalin is the best drug for me primarily because it gives me the most drive and motivation. If I did not need these particular benefits I would have stayed with either Barr or Sandoz Adderall because they were long acting, completely removed the brain fog, gave some energy and created a general sense of well being.

As for Ritalin/MPH I personally prefer the smoother longer acting drugs instead of the ups and downs I get from the IR version of Ritalin. The IR version is stronger but the ups and downs are annoying. I much prefer a longer acting drug with a “smooooooth up” accompanied by a “smoooooth down”.

At some point in the future I will try Metadate CD and Concerta to see how well these longer acting MPH drugs work, but until that day arrives I am going to continue to tinker with Ritalin IR and Ritalin LA.

I will post again in the future when I decide to try Metadate CD and Concerta.


Last comments to mention about success with Stimulants:

Educate yourself and buy some books on the subject.

Try several different medications before finally settling on one.

Listen to your body.

The majority of people who use stimulants to treat their ADHD are often very successful and do not have issues.

The only time people post in the forum is when they are having problems with their medication and are seeking help. I can tell you for a fact I never would have come to the forum if I had not developed a mild tolerance to Ritalin and needed to find information and answers that my doctor could not provide.

So remember that stimulants work and help the majority of folks who need them. They just don’t post their success because they don’t need to. (A prime example of this is my girlfriend and her son who have both been using stimulants for their ADHD for the past 6 years. They both have had great success and never felt a need to go online and see how others are doing nor felt a need to tell anyone how well they have been doing!)

Comments and questions welcomed as I am here to try and help!

Last edited by livinginchaos; 07-10-10 at 02:21 AM.. Reason: pasted in the most recent original post
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  #2  
Old 06-30-10, 05:11 AM
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Re: 10 years of Success, Failure, and Success again with stimulants.

Very interesting info.
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Past meds: Namenda, Focalin IR, Ritalin IR, Adderall IR, D-Amp IR, Nicotine/Swedish Snus.
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Old 06-30-10, 08:55 AM
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Re: 10 years of Success, Failure, and Success again with stimulants.

WOW! That's a marathon, man. Great info. Thanks for taking the time to put it all out there.

And welcome to the Forums!
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Old 06-30-10, 04:19 PM
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Re: 10 years of Success, Failure, and Success with Ritalin, Adderall, and back to Rit

This post warrants a special, separate "Thank You" post for the amount of information provided, and the effort made.
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Old 06-30-10, 04:56 PM
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Re: 10 years of Success, Failure, and Success with Ritalin, Adderall, and back to Rit

man that was a mini-book!!! good job and thanks, you should get this published!!
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Old 06-30-10, 06:50 PM
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Re: 10 years of Success, Failure, and Success again with Ritalin, Adderall, and back

I have a question... you say with some of the MPH brands that a side-effect was elevated body temperature. Do you mean you just felt hot, or were you running a slight fever?

I am taking the Barr generic AMP IR (20 mg 2x a day) and I sometimes run a low-grade fever in the evenings... usually between 99 and 99.5 (my normal temp. is right at 98.6). For awhile I thought I had a weird bug, but I never thought it could be my meds. Now I'm curious to experiment and take my temperature every evening, whether or not I've taken my AMP, and see if the increased temp only happens when I've taken it.
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Old 06-30-10, 08:25 PM
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Re: 10 years of Success, Failure, and Success again with Ritalin, Adderall, and back

Very interesting. I am currently taking the malinko... whatever brand. Do pharmacies have other brands or do I have to try a different pharmacy. If so, what pharmacy can I goto that has the Watson brand? I know Wallgreens carries the Watson brand hydrocodone. Does that mean they cary all the watson meds?
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Old 06-30-10, 08:59 PM
MyAchillesheel MyAchillesheel is offline
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Re: 10 years of Success, Failure, and Success again with Ritalin, Adderall, and back

Hi Kiri,
In my case the elevated body temp is me feeling "hotter" than normal. This is in direct relation to the stimulant and/or an allergic reaction to a binder or filler.

In your case the only way you will know if the medication is causing your "low-grade" fever is by not taking it for a day or two. (if that is possible)

In your case I have every reason to believe the medication is causing this reaction. If you can buy the brand name version I would strongly recommend it. Perhaps you will have a better experience.

What I have found is the brand of stimulant makes a huge difference in the elevated body temp.
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Old 06-30-10, 09:15 PM
MyAchillesheel MyAchillesheel is offline
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Re: 10 years of Success, Failure, and Success again with Ritalin, Adderall, and back

Hi DadHD,

"Very interesting. I am currently taking the malinko... whatever brand. Do pharmacies have other brands or do I have to try a different pharmacy."

Answer: Yes, every Pharmacy will use a different brand. Walgreens typically carries Watson and can also order the brand name Novartis brand for you.

Sandoz is an authorized generic made by Novartis (band name Ritalin) and COSTCO typically carries Sandoz and can also order Novartis for you.


Please note: Call in advance and find out what brand the pharmacy currently has in stock. I have found with past experience that just because Walgreens carries the 5mg version by Watson doesn't mean they also stock the 10mg version. They may normally stock Mallinckrodt in the 10mg instead.

The only way around this is twofold:
1) Call the pharmacy and see what they have in stock before dropping off the script
2) (Bullet Proof Method) Have your Dr. write up your script "Dispense as Written" and have them cite the brand you wish to try.


In addition my Dr. will "split the script" and will sign "Dispense As Written": He will write two scripts - 1/2 for one brand i want to try and 1/2 for another brand I want to try.

This way I am not stuck for one month (30 days) with a brand I am having poor results with, just two weeks. That said though every doctor is different but my doctor completely agrees with this process.
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Old 07-01-10, 11:44 AM
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Re: 10 years of Success, Failure, and Success again with stimulants.

Quote:
Originally Posted by meridian View Post
WOW! That's a marathon, man. Great info. Thanks for taking the time to put it all out there.

And welcome to the Forums!
I second this. You gave a lot of useful info.

Thank you!
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Old 07-02-10, 06:39 AM
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Re: 10 years of Success, Failure, and Success again with stimulants.

MyAchilleshell, i want to know as a long time ritalin user if you have done blood test through all this years. I read that ritalin in long term causes leucopenia (low white cells) and low plaquetes. Did you do any blood test? Were they normal? Thanks
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Old 07-02-10, 07:04 AM
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Re: 10 years of Success, Failure, and Success again with stimulants.

Very detailed and interesting. I'm surprised about not eating food. Doesn't anyone's stomach bother them? I'm sensitive to taking medication on an empty stomach.
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Old 07-02-10, 02:27 PM
MyAchillesheel MyAchillesheel is offline
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Re: 10 years of Success, Failure, and Success again with stimulants.

Hi riloal,

Blood work done every 6 - 12 months since 2001. No issues with blood or health.
In fact I pulled out my most recent blood work and looked at the white blood cell count: and it is indeed normal. Right in the middle of the range used to calculate score.

My mother has been using Ritalin since 1975 and is healthy as a horse.

Long term Ritalin use works well in my family.
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Old 07-02-10, 02:29 PM
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Re: 10 years of Success, Failure, and Success again with stimulants.

greetings,

just wanted to say that i, too, have had no adverse health affects from long-term ritalin use. no problems with blood cell production or other things and i've been taking it nearly 20 years. others on the forums have been taking it as long or longer and have not mentioned white or red blood cell problems either.

cheers
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Old 07-02-10, 03:30 PM
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Re: 10 years of Success, Failure, and Success again with stimulants.

Thank you very much for all your anwers, i feel calm now. I was anxious cause i found and article called, ritalin the silent killer, that says that there is a possibility in long term users of ritalin to develop abnormal blood tests. I want to say that i.m from Spain, excuses for my bad english, i put the article in this forum cause i was anxious i didn,t know that the article was from scientology. Here in Spain scientology is almost non existent, and my level of english it,s not so good to understand 100% the article. Excuses, i only want this forum to discuss topics about ADD, i,m not a member of scientology or any organization.

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