Is Ritalin working on me?

November 8, 2012 11:52 AM

I have recently been diagnosed with ADHD, at 22, and prescribed Ritalin. I am unsure to which extent it's supposed to be helping me, but I do notice subtle differences in my day to day life, like my place suddenly not getting messy anymore. While I notice I managed to get more done (school work) since starting it, I still have a hard time sitting down and just going ahead with projects. I study graphic design, so things are usually quite mental, and need time to develop, but I am wondering if it's really helping? Occasionally it feels like it's slowing me down too much. Should I suggest my psychiatrist to try another drug? (Adderall is not an option, I am curious about dexedrine)
posted by ahtlast93 to health & fitness (24 answers total)

Adderall is dexedrine, for all intents and purposes.

The medication sounds like it is working, but you may need to up the dose. Doctors usually start at the lowest effective dose based on your condition and increase it if needed. You're not going to magically gain the discipline necessary to do this stuff (especially after a lifetime of the shitty study habits ADHD instills in people,) but it should be helping somewhat. If there's no change at all with that specific field, you'll want to talk to your doctor about upping the dose a bit.
posted by griphus at 11:56 AM on November 8, 2012 [2 favorites]

How long has it been since you started taking it? While the effects are usually fairly quick to set in, it still takes your body and your mind some time to get used to doing things differently. Also you may have to do a lot of dosage/release rate/delivery method adjustment to figure out what works best for you.
posted by elizardbits at 11:57 AM on November 8, 2012

(our reaction times to ADHD questions is starting to creep me out, griphus)
posted by elizardbits at 11:58 AM on November 8, 2012 [1 favorite]

Oh, and you may, like many, many people who grew up with undiagnosed ADHD, have some psychological barriers with just getting your ass in the chair and starting to study because it just never panned out before. Try as hard as you fucking can to get the ball rolling, and the medication should give you the inertia you need to keep going. But that first really hard part isn't necessarily the ADHD, but the psychological mess that is the result of the ADHD.
posted by griphus at 12:00 PM on November 8, 2012 [4 favorites]

I recently upped my Adderall extended release and it made a big difference. But, sad to say, there's still a certain amount of just doing what needs to be done, which means sitting down and getting on it with it. No one is born with 100% will power. Everyone has some tasks that require determination.
posted by Ideefixe at 12:03 PM on November 8, 2012

Just realized I posed my questions kinda abstractly, is there any way I can edit my question?

Would have to check my calendar on how long precisely, but it has been 3 weeks at least. My first med check up was after two weeks, when he recommended upping the dose to from 15 mg daily, to 20 mg daily, and to try 25 mg at some point (this being spread out to three times a day).

I tried the 25 (10 first, 10 second, 5 last) and it just made me VERY drowsy and sleepy. The balance I found out now is 5 in the morning, 10 after, 5 after, but I've been doing that for only two days now.

I grew up with undiagnosed ADHD, along with the constant "you're lazy" "you're not trying" routine (seriously, did everyone get that?). On the art/design side, my skillset is all over the place, as a way to compensate over the years, which I always found aggravating, but teachers tell me it's a strength, as I can get involved with just about anything. This sounds ok, even to me, in theory, but is hard when having to apply to work practically.

I guess it's true about the willpower, the constant self-critiscism and belief that something will fail as soon as started is probably the thing keeping me from even getting started.

But how does the medication work on you? Do you literally notice the drugs' effects, or is it more something you can observe in your behavior (e.g. my place not getting messy anymore)
posted by ahtlast93 at 12:13 PM on November 8, 2012

cus I ain't getting none of that "fog lifted before my eyes" stuff :(((((
posted by ahtlast93 at 12:15 PM on November 8, 2012

It sounds like you're taking the regular one rather than the extended release. Is there a medical reason for that? Regular Ritalin craps out after maybe 4-6 hours depending on your physiology and right now it sounds like you're maintaining a 10 mg dose (as opposed to a 25mg dose) throughout the day, which isn't that much. I don't actually know anyone who on ADHD meds who isn't on an extended-release one so you may want to bring this up with your doctor.

Some people notice the drug (I mean, at the end of the day, you're taking an amphetamine analog) and some people don't. In my case its a "conspicuous absence" thing where my ability to get shit done -- whether it is at work or at home -- suffers without it. Picture a factory full of bored, lazy workers and a factory full of inspired, productive workers. That's the difference I feel.
posted by griphus at 12:22 PM on November 8, 2012

Yep it's immediate release. I've no clue why I was given that, perhaps to control it better? My first dose is at breakfast, the second 2-2,5 hours later, the third 2-2,5 hours later. This means that it usually wears off at about 4 o'clock.
posted by ahtlast93 at 12:26 PM on November 8, 2012

My husband's opinion (and a year on Adderall did extraordinary things for him) is that medication gave him the mental and emotional bandwidth to learn how to do things "like a normal person" (his words).

It's not magic. If you do not know how to sit down and study and manage your time and organize your projects, drugs are not going to download that information into your brain. My husband read books to learn how to deal with time management, he figured out that he needs lists and so built the habit of list-making. I introduced him to FlyLady (more lists). He did a lot of work learning the things he'd never been able to think through or learn from experience because of his distraction and disorganization.

Three weeks is not a lot of time, and you're still working on your dosage (and I also wonder why you're not on an extended release; it makes a big difference I think). Once you get to a dosage and then stay at it long enough to stabilize, you probably will notice less fog. But you may first have to learn to notice fog, so don't expect a switch to flip.
posted by Lyn Never at 12:27 PM on November 8, 2012 [3 favorites]

On the art/design side, my skillset is all over the place, as a way to compensate over the years, which I always found aggravating, but teachers tell me it's a strength, as I can get involved with just about anything.

I'm a network security engineer with hands-on expertise on a solid dozen security appliance types covering most of the big players, with Unix experience on all of the major vendors, plus four varieties of Linux, three varieties of BSD and most of the virtualization platforms, but I can't remember what I had for breakfast and I'm kind of worried I left the garage door open during a huge windstorm.

Kind of typical for our breed, yeah.

The medicine can give you focus and concentration... but it can sometimes get in the way of the fabled "hyperfocus." Some folks with ADD are able to sit down, and completely immerse themselves in something, and if they're used to harnessing this for power for good (instead of running down all of the online scholarly papers covering the Chaldean Empire for a Lovecraft pastiche I'll never finish, like I was doing this weekend), it can be upsetting or feel crippling when it's gone. The benefits of treatment - follow through, organization, initiative, attention to detail - outweigh the loss by a country mile.
posted by Slap*Happy at 12:28 PM on November 8, 2012 [2 favorites]

I'm not sure why your doctor is doing that, but then again I am neither an M.D. nor aware of your medical history. But I can say that 10 mg of methylphenidate (and you are on ~10mg throughout the day, regardless of the aggregate) not making much of a dent in your ADHD isn't surprising at all.
posted by griphus at 12:32 PM on November 8, 2012

Cool, guys! There is some consensus here which I kind of agree anyway. My whole thinking behind this has anyway been to see it as a tool that will help me get a more steady rhythm when it comes to creative work.

The fabled hyperfocus was my holy moment before, but I don't feel like it's been suffering. In fact, I had two in this 3 week period, but it might be the psychological incentive and I want to read your Lovecraft pastiche in any case because once I made a similar thing along with a drawing and a typeset cover and a book for good ol' Howard.

All clear, but last question; my medical history is fine, there is at this point nothing else diagnosed, physically nor otherwhise, would it be unwise and try 15, without consulting with my psychiatrist? These two week waiting times are terribly slow, and I suppose not much can happen?
posted by ahtlast93 at 12:38 PM on November 8, 2012

I also found it hard to tell if the medication was working. What helped was stepping back and looking at how much I was getting done over the span of a week or month and if it was getting easier to manage these tasks. Once I'd been on the medication for a little while it got easier to tell if it was working at any particular moment because I wasn't constantly taking the temperature of the situation.

Also medication is really only half the battle. The other half us changing your habits. I've found CBT-type therapy to be immensely helpful with this. It also helped me see what was the ADD and what was bad habits.
posted by matildatakesovertheworld at 12:42 PM on November 8, 2012

As a general rule, yes, it is unwise to take more (or less) of your medication than prescribed. Part of correcting for ADHD is developing good habits, and taking more stimulant than the medical professional said it is okay to take is a shitty habit and can get you into trouble in the future, regardless of whether 5mg will have a profound effect or not.

Give your doctor a call or an email; this might be something he can okay without having to see you in person.
posted by griphus at 12:42 PM on November 8, 2012 [1 favorite]

Also, what's is the "big difference" between IR and ER?
posted by ahtlast93 at 12:42 PM on November 8, 2012 [1 favorite]

Ugh, the regular release is awful, all ups and downs all day as it starts out and then sharply wears off as it is metabolized. The extended release gives you a consistent dosage over 8 hours or so and is, IMAO, about one billion times better.

You might want to try the Daytrana patch instead, which is a transdermal extended release instead of a tablet and is even more awesome than the Ritalin LA.
posted by elizardbits at 12:53 PM on November 8, 2012 [2 favorites]

The other good thing about the patch is that you don't have to worry about taking it at the same time every morning if you want to sleep late. The bad thing about the patch is that it can be kind of skin irritating.
posted by elizardbits at 12:54 PM on November 8, 2012

Talk to your doctor about extended release. Mine recommended against it, saying that many of his patients found it less effective. I'm on adderall though and ritalin might be different.
posted by matildatakesovertheworld at 1:17 PM on November 8, 2012

I'm just going to drop in and say that you should look at ADHD drugs as a behavioral tool. They can be useful on their own, but they are most useful when you use them to help you build yourself better behavioral tools: like good habits.

In some ways, this is already happening without you knowing it. It isn't that your place is suddenly not getting messy any more, it is that you are cleaning things up as you make them, which makes things easier for you going forward, because new projects aren't hindered by the remains of old projects.

Another thing that might help: You say your graphic design projects need time to develop. I am sure that is absolutely true. I personally find that a lot of what I do requires time to synthesize in my subconcious, but that often happens most effectively if I consciously work on it until I get stuck or burn out, and then let it percolate in the back of my mind. Also, I find that some things can sit in the back of my mind forever unless I take some time to consider them consciously. ADHD drugs can help by making it easier to check-in with myself about the things I've struggled with and had to put on the back burner for a while.
posted by Good Brain at 2:42 PM on November 8, 2012 [2 favorites]

I was on Ritalin (as an adult) and it caused memory problems for me, so be on the lookout for that. I had to switch to Concerta.
posted by 4ster at 3:01 PM on November 8, 2012

Exactly, dishes, for example, are washed immediately, probably because self control is improved. I think of consequences more.

Also true about the second part. The "long time" part is exactly like this. Before the diagnosis, it would be weeks of synthesizing stuff and gathering information, and then, in times of stress, when results really needed to be shown, sitting down for hours, completely burning out, only to come up with intuitive, out of the blue original ideas, that seemingly come from nowhere, but is rooted in all the research.

(it's funny, at the end of our school year we get a critical report by teachers, all of which basically sounded like an ADHD diagnosis, one specifically was similar to what you, Good Brain, said, that it seems like I just need time to "map out my territory" to finally end up making these rapid, sweeping decisions in the last minute)

Thank you Good Brain (and everyone else). I guess part of this condition is that you really need others to explain your behaviours and thought processes, it really makes sense.
posted by ahtlast93 at 3:03 PM on November 8, 2012

I take modafinil (Nuvigil) for idiopathic daytime sleepiness. I also take bupropion (Wellbutrin) for depression. Both are stimulants and I think that taking them has been good for me. However, no drug will make you do work if you don't want to do it.
posted by kat518 at 7:08 PM on November 8, 2012

Both Ritalin and Adderall leave your systems very quickly, so if you're curious, try Adderall for a few days...and almost any other ADD medication, for that matter! Even if Ritalin is working for you (and it sounds like it is), maybe Adderall will work even better. If nothing else, it will be educational.
posted by SampleSize at 7:27 AM on November 9, 2012