9 replies to this topic

[mliw92]

I am 22 years old and 2 months ago I got diagnosed with ADD (ADHD-PI).

Over the years I developed some Social Anxiety (ADD and lack of social skills related I guess) and Depression (also ADD related), but since starting treatment (CBT) and medication I am doing fine.

 

Recently I started medication: Ritalin (methylphenidate). And this is basically what happened (excuse the shitty graph):

 

i.imgur(dot)com/dih9qe8.jpg

 

Week 1 was great, I could concentrate and focus, the fog was gone and for the first time in my life it was easy to finish things that I started. Side effects: euphoria the first 4-5 days, 1 headache, 1 rebound/badcomedown (didn't noticed the other comedowns, after the meds worn off I felt the same as always), and sometimes cold hand/feet. The effects were pretty short though (1 dose lasted about 2 hours the first days, at the end of the week maybe 1.5 hours). But after a couple of days the positive and negative effects decreased really fast, the fog came back, couldn't finish things only my concentration and focus were better than normal.

 

Week 2, a higher dose but the positive effects decreased even further. 1 dose lasted a bit longer, ~2 - 2.5 hours. At the end of the week I couldn't tell the difference between medicated and unmedicated anymore. No side effects and no bad comedowns or rebounds.

 

Week 3 The effects increased  a little bit and lasted about 2.5-3 hours, my concentration and focus were a little bit better than normal but the fog was the same as always and finishing things was also as hard as ever. Sometimes I could feel my heart beating, but other than that no side effects or bad comedowns/rebounds.

 

Week 4 - end, The next ~3 weeks I tried everything, I took breaks, tried different dosages, tried different timing, full/empty stomach, with/without supplements and nothing worked. More than 20 mg every 3 hours was pointless it didn't improve the positive effects. The only difference between 20 mg and 50 mg was my pulse, no other side effects or anything. The difference between medicated and unmedicated was so small, it was really hard to tell, when I took breaks I felt almost the same as medicated. Finally I gave up.

 

I took no other medication or drugs, and most of the time I took the following supplements: ZMA, Fish Oil, Vitamin D, Magnesium and a Multivitamin.

 

Does anybody know what happened or could have happened?

I've been searching for quit some time but it seems like no one has an aswer. I know some people don't respond well to Ritalin, but for me it worked the first couple of days. After that all the effects, positive and side effects, vanished only the (noticable) higher pulse stayed at doses higher than 20 mg.

 

After that I started Dexedrine (dextro-amphetamine), it is different but it works. I'm in my 2nd week of Dex now, the effects are still great but not as good as the first couple of days. It seems like the same is happening as with Ritalin but a much slower pace.

Besides that I'd rather take Ritalin than Dex, especially long term. Or no medication at all ofcourse but that's not an option right now. I will look into Nootropics sometime, but in the past I had not really succes with them.

 

If someone has a answer or knows (or has an idea) what is wrong (or could be) with my brain/body please tell me, Thank you!

 

 

[drg]

Nothing strange or unusual happened, you said it yourself you were initially experiencing euphoria and then that went away. Tolerance to those effects likely occurred and occurs to most people.

 

Another thing you should consider is a long acting version like concerta or adderall so the effects last more than 2.5h

[medievil]

You'd need dxm or memantine for tolerance.

[mliw92]

But tolerance after 1 week?

 

I never abused amphetamines or cocaine, if it was tolerance then a higher dose should have workerd. But like I said there was no difference between 20 mg and 50 mg.

 

To me it seems that my body decided to you use less and less Ritalin regardless of the dose it gets, but that's no logical answer I guess.

[medievil]

Tolerance can fully develop after a week yes.

[mliw92]

Tolerance can fully develop after a week yes.

 

So that means, I build up a insane tolerance in a couple of days, a immunity sort of.
But this is not normal I guess, is there a special name for this?

[medievil]

 

Tolerance can fully develop after a week yes.

 

So that means, I build up a insane tolerance in a couple of days, a immunity sort of.
But this is not normal I guess, is there a special name for this?

 

Its normal tolerance that everyone gets, except if you have classical adhd, the D4 receptors don't downregulate so its stays effective for ADHD.

[mliw92]

 

 

Tolerance can fully develop after a week yes.

 

So that means, I build up a insane tolerance in a couple of days, a immunity sort of.
But this is not normal I guess, is there a special name for this?

 

Its normal tolerance that everyone gets, except if you have classical adhd, the D4 receptors don't downregulate so its stays effective for ADHD.

 

 

Yeah, I understand but if this is a tolerance thing we can't talk about ''normal tolerance'', the therepeutical should come back at a higher dose but that was not the case.

[medievil]

That depends what therapeutic effects you mean and wheter you have classical adhd or dysfunctioning of other d receptors mimicking adhd.

[Glazing Agent]

What happened is that you increased your dose past your optimum balance point of effectiveness and now your dopamine receptor sites aren't as sensitized as they were. This is extremely common with Ritalin use and the problem is only made worse by doctors skewed perception that patients do in fact need to up their dose for it to be effective (patients have a tendency to emphatically overstate their benefits when reporting how dose increases went to insure that the doc is on board with the higher dose).

When it comes to psycho stimulants, the first week always has what I call the 'receptor site free lunch' effect. The sites are very sensitive to the new drug and produce profound effects for the patient. Then the patient is let down when the free lunch is over and the patient and doctor make the decision to up the dose in hopes of finding that sweet spot again. The problem with this is that the higher dose further compounds the receptor site sensitivity problem and the escalation continues with less and less effectiveness of the drug.

If, however, the patient goes in to the Ritalin/psychostimulant regime knowing that the first week will be a gimme in terms of effects and knows that they need to take charge to prolong the effectiveness by their own means, this perpetual loss of effectiveness isn't inevitable.

The number one means of re-sensitizing the receptor sites and boosting the effects back to those initial few days to my knowledge is physical exercise. Aim for at least 10,000 steps a day (pedometers are great) as well as some strength training.

Number two: sleep. Not just any sleep, mind you, but sleep prior to 11 o'clock or so and lasting at least 7 hours. If you can't fall asleep that early, the best means to start being able to fall asleep early, is to simply get up early on a regular basis until falling asleep isn't a challenge.

 

Number three: water. Lots of it.

So, my advice would be: drop back down to the 10mg dose, take at least 10,000 steps a day, drink more water throughout the day, and get a healthy amount of sleep.

Within two weeks, you'll most likely find that it will work very well and you'll be happier, more motivated and focused than ever.

Less is more. There are no free lunches with drugs. You need to work for them to work.