In my experience the most obvious negative and positive effects fade very quickly after day 1, e.g. anxiety, happiness, tunnel-focusing, bodily tension.
I have used methylphenidate for somewhere around a year now, maybe 80% of days in varying doses, I can't say tolerance has been problematic. I don't think it's too useful to judge the usefulness of this drug by how obvious the effects of the drug are here-and-now.
What I can say however is that regular tablets (instant release) work better in preserving the sense of "wow this drug really works, day after day". E.g. if I take 36mg concerta every day, after some time I will barely notice the onset of effects or the end of effects. Whereas when I have taken only ~20 mg Ritalin (IR) per day split up in 2-5 doses it is much more obvious that there is a beginning of effects after 30-60 minutes of intake, and this lasts for at least several weeks (I think infinitely, I haven't taken Ritalin only for more than a few weeks).
When taken for extended periods I have noted I do not feel a significant difference between 18mg or 72 mg (Concerta), using just "how I feel here and now" as metric. But there is probably some functional difference that is not immediately obvious but perhaps measurable by results ,productivity, etc.
Currently I'm prescribed 36 mg concerta and ~15 mg ritalin. I will probably move to 18mg concerta and a higher amount Ritalin if doctor will allow it. I personally like the more obvious effects regular Ritalin brings, even at e.g. 5 mg if taken infrequently, and I don't find the dips problematic in any way. I think for me Ritalin would probably allow me to use a lower daily dose. I'm considering removing concerta entirely because I find it quite annoying that I can barely feel if the drug does anything after a few weeks (even though I am quite sure it still does a lot).
Thanks for chiming in!
I am still new to Concerta but already know what you mean. The first days I felt a rock-solid focus, but the more I take it, the more that disappeared. I'm now on 27mg of Concerta until Monday with breaks now and then, and try to not use it more than 2 days in a row, but currently I barely feel anything except a slight coffee buzz.
When I start concentrating however, this seems to get stronger and stronger to a point where I feel jittery (* theory to why that happens below).
On some days I can't feel a thing, on some days I can feel it, but still loose focus easily, on some days it's great. It's a really mixed bag for me. (Although this could also just be perceived effects, and under the hood it actually helps a lot that I am not aware of.)
Sadly where I live (Japan), stimulants are still not common. The 3 only adhd meds that are available are strattera, concerta and guanfacine, concerta being the only stimulant (vyvanse is in phase 3 trials but that could still take a while).
I'll talk to my doctor about IR Ritalin but from my research it seems like that's not an option for me.
Are you splitting out dosages with breaks in between or did you notice other issues with dependency where you feel you need it?
(* I don't know much about biology and brains, but MPH is a dopamine reuptake inhibitor that blocks dopamine transporter and thus leaves more dopamine in the synaptic cleft. When doing something rewarding that would release dopamine anyway, wouldn't this mean that even more dopamine is in the synaptic cleft that can't won't get reuptaken? Thus the stronger perceived buzz and jitteriness?)
Edited by dvstr, 30 March 2018 - 03:39 AM.