Ask MetaFilter questions tagged with ritalin

Travelling with Ritalin

Zé Pequeno — Sat, 21 Nov 2009 09:57:02 -0800

I currently live in Brazil but shall be returning to my country of origin, the UK, for a month or so in December. I recently managed to get a prescription for Ritalin from a psychiatrist here in Brazil and was wondering whether I'd have any complications in bringing this back into the UK. I will most likely be travelling with two 10mg boxes containing twenty tablets each. Perhaps even less. I only use it when I have a really important project to do and, as I'm in the middle of my Masters dissertation, I'm going to need it big time.

Any tips would be appreciated. Luckily, I photocopied the prescription before handing it to the pharmacist because she kept it and I'd have had no supporting documentation. The matter is somewhat complicated by the fact that I was prescribed by a psychiatrist friend without a proper diagnosis, though I have known for a long time that I have a pretty severe case of ADD Inattentive-type for which Ritalin helps me tremendously (i.e. on Ritalin, I can behave like a normal human being).

St. John's wort + ADHD medications?

Anonymous — Sun, 13 Sep 2009 18:36:45 -0800

What are your experiences with St. John's wort? In particular, have you ever taken it at the same time as ADHD medications like Ritalin/Focalin (methylphenidate), Adderall (amphetamine) etc? Some sources seem to warn against taking then together, some say only that one will might decrease the effectiveness of the other, and many don't say anything at all, so I'd like to know if there's anything to worry about. Even if you have never taken the two together, I'd still be curious to hear what you thought of St. John's wort in general.

Throwaway email: sjwquestion@yahoo.com

(Please don't tell me to ask a doctor; I'm asking because the doctors that wrote all the information I've read seem to disagree.)

Bringing legally prescribed controlled substances through customs in Asia?

Anonymous — Wed, 12 Aug 2009 06:01:33 -0800

Advice on bringing a small quantity of legally prescribed Ritalin (methylphenidate) and other prescriptions for personal use into Japan, Thailand, Singapore, Hong Kong, China, South Korea, and the Philippines? I'm traveling to a number of Asian countries in the next three weeks, and I would like to bring my prescriptions with me. The drugs are 30x20mg Ritalin (methylphenidate), 6x200mg Provigil (modafinil), and 30x10mg Ambien (zolpidem). These are legally prescribed by a U.S. doctor, and I will carry the pills in the original, labeled bottle and will have an official-looking letter from the doctor.

But Japan, Singapore, and Hong Kong, according to their customs Web sites, either ban these drugs outright or require preapproval through a bureaucratic process. I wasn't able to find info on the other countries, but it's those three places that I'm most concerned about anyway (Japan and Singapore especially).

In those countries, since they require preapproval, if I indicate on my customs forms that I have controlled substances, then I'll almost certainly have them confiscated and could face other penalties (right?). If I play stupid and just state I have no items to declare, I'd most likely get through OK. But if they pull me aside and search my bags, then I'd be in big trouble, right? I will have entered and exited different countries ~13 times by the end of this trip, so at least on that I'd look suspicious.

So: what actually happens if Japan/Singapore/Hong Kong customs finds undeclared, un-preapproved but legally prescribed controlled substances in your bags? Is it something I can plead ignorance on and just get a warning, or are there serious consequences? I'm not sure if these laws are actually enforced in the case of small quantities and legal personal use. Should I just not bring the drugs?

Willpower or Ritalin?

Anonymous — Sun, 14 Jun 2009 11:34:24 -0800

ADD Filter (YANMD): Willpower or Ritalin? Your anecdotes, advice, opinions, options, and facts are all welcome here. As a child, I was diagnosed with ADD. They had me on Ritalin during 4th and 5th grade. In retrospect, it worked. I remember being able to go upstairs, sit down, and do all my math homework. I loved that.

We moved, my parents got different insurance, and they no longer insisted that I take the Ritalin before school, so I stopped taking it.

Last year, a good friend of mine sat me down and had a conversation about ADD with me, and suggested that I should consider medication. He explained ADD as a chemical imbalance that should be rectified. "Do you have ADD" is something that I've heard many times over the years, and I've pretty dismissively just acknowledged that I was diagnosed with it as a child. Since that conversation, however, I have done some reading, and acknowledge that yes, I do, in fact, as an adult, have ADD.

So now, here I am. I am 26, healthy, happy. I have a regular sleeping schedule, I get from A to B by foot or bike.

I think of it as a personality trait. I feel like there are traits that are associated with ADD that folks associate with me. For instance, my short attention span: like the way I skip a conversation from one topic to the next. I feel like, if I'm bored with the conversation, or if the topics relate in my head, why not? When folks say I'm "unique", I feel like this is one of my traits that they are referring to. ("but we're all unique." "no, no. You're unique differently.")

School.
I took some years off before I went to college, for traveling and adventures and such, and now I'm in school. I did fine at my community college, it was pretty much just like high school, and I got my A.A. with an honorable mention. Now I've spent a year at a quality university on a quarter system, and my grades have dropped dramatically. This trouble I have with focusing, it has been called out.

My usual tactics aren't enough. I give myself enough time to get things done, I keep my days free enough. So mostly I spend a lot of time saying "I'm going to do homework" and failing to get it done. I've got the organization part down. I keep everything in one notebook so that nothing gets lost (papers that accumulate throughout the quarter are admittedly everywhere by the end, but I can usually find what I need, and the notes stay in one place), and Google Calendar has been incredibly useful for sending me email reminders to let me know when my homework is coming up due.

It's not enough, though. There comes a point where one must sit down and focus. Everyone else that I know, when they devote long chunks of time to sitting down and studying, they sit down and they study. Me? I sit down, and I doodle. Or I write, but not about homework. Or I voraciously browse MetaFilter, at least until I turn the Internet off. Then I work on it for ten minutes, feel victorious after accomplishing a sentence or a paragraph or an idea, and wander off to feed myself or find some other distraction. And I hate a completely sterile environment. There has to be, at a minimum, food, and room to sprawl. I work really really well when there are people with me who are concentrating on their own work, and who I can chat with briefly, and then we both go back to our own thing, but even in those instances, they manage to accomplish thrice as much, for my thoughts, they wander. That sort of study buddy is hard to come by, and not a practical solution.

I really want to keep doing it my way. I want to struggle through school on my own. It's really hard for me to be getting these grades, but I try not to let it get me down, and mostly I'm successful in that.

Here's the thing. I want to be able to go to grad school. In order to get into one of the two grad school programs I am interested in, I need a 3.0 GPA for my last two years of school. Right now I'm struggling to stay above a 2.0. I plan to stay an extra year so that I can bring my grades up, but I need to be changing my habits right now. And I'm practically at my wit's end. (P.S. I enjoy going to school.)

I'm pretty biased against 'fixing' problems with medication. It doesn't seem like a long-term solution. Especially since, according to Wikipedia, Ritalin is pretty similar to Cocaine, and has a list of side-effects a mile long.

What am I missing? The Internet (and my friend last year) say it isn't a matter of willpower, it's a matter of chemistry. Am I wrong in trying to willpower my way through this? If Ritalin, why is that your opinion? If willpower, what new tactics do you suggest I take?

I plan to go talk to a school doctor, but I would like to have sorted out my own ideas and opinions better before I go. Thanks for your help!

Longterm affects of amphetamines?

decoherence — Tue, 22 Jul 2008 08:07:02 -0800

What are the potential longterm effects of regular amphetamine (i.e., adderall, ritalin) use? Does anyone really know? As more and more of my friends have begun daily regimens of amphetamines, I've begun wondering how much is known about the longterm effects of these drugs. It's not unreasonable to suspect that running any bodily organ on overdrive for years on end might have some negative consequences, but I haven't seen much research on the subject. This psychiatrist's blog post, however, suggests the suspicion could be well-founded.

Does anyone have any information -- anecdotes are fine, but research would be better -- that says one way or another whether amphetamine usage over the long run is anything to worry about?

Uninsured and unfocused

zoomorphic — Thu, 03 Jul 2008 10:02:42 -0800

I'm a typical ADD adult, and I don't have health insurance until at least September. I'm down to my last few Ritalin tablets, and I need a new Rx. How much does Ritalin (or Concerta, Adderall, etc) typically cost without insurance, and can I minimize these costs without having to sign up for an interim insurance plan? What are the best generic varieties of the big name psychostimulants? Will getting an Rx while uninsured just kick up my fees when I am finally covered by a health plan because my condition is pre-existing? I've been on Ritalin since I was in fifth grade, where I escalated from a back-of-the-class, disorganized goof-off into a straight-A, ambitious student. Maybe that's a red flag for dependency, but I don't care--Ritalin does right by me.

When I graduated college and no longer had insurance I went off of the pills for two years and floundered, had a string of bad jobs, and I kept a filled bottle around Just In Case. Finally I started using the pills again, and my career is on track. Now I'm down to the last few tablets. I'm now a writer/editor, so in addition to keeping me focused and on task throughout the day (I'm naturally hardwired to work at night, 7pm-3am), Ritalin gives me a sustained sense of well-being that vastly improves my vocabulary and mental acrobatics. I don't want to give it up and see what happens.

I'm currently uninsured, though by September I'll officially be on staff and thusly on a plan. I have medical records stating a pre-existing history with Ritalin.

Then I came across this question that puzzled me. Can my new insurance plan opt to not cover my ADD meds because I have a pre-existing condition? I managed to last without Ritalin for over two years, so will I be shooting myself in the foot if I get another Rx two months before my health insurance kicks in?

Am I overthinking or misinterpreting this? Obviously I don't understand the health insurance maze at all, but I do understand that I can't afford $270/bottle of Ritalin every month (I assume generics are my best bet), nor do I want to face the repercussions of being the scatterbrained, where-did-I-put-that-manuscript trainwreck I can be when left to my own unmedicated devices.

I'm in NYC/Brooklyn, a 25 year old woman, and survive on the minimal bounties of a writer's salary.

How do I maintain my sanity when my partner has ADHD?

Anonymous — Tue, 11 Mar 2008 12:40:03 -0800

My partner has ADHD and I need ways of understanding/coping with his behavior so I can maintain my sanity. We live together, are in our mid 30s, no kids, and have been together for four years. My boyfriend was diagnosed with ADHD about a year later. He was on meds (Ritalin) for about a year, but stopped taking them because he felt like he was weak for needing drugs, and because he didn't like the side effects. We had a major confrontation where I insisted he go back on them or go back to the doctor to get a different prescription. He occasionally takes them now, but mostly "forgets," and he's "forgotten" to make an appointment with the doctor despite many reminders. He's also "forgotten" to make an appointment for couples counseling (I don't have insurance and I don't know which doctors are on his plan, so I can't make the appointment.). I suspect that some of this forgetfulness is passive-aggressiveness. I've been as supportive as I know how to be; I've read up on ADHD, I've assured him that I don't think less of him and I have tried to be patient with his distractedness, forgetfulness, and irresponsibility.

But sometimes I just reach my limit and I don't know how to handle this any better than I have been. He pays the rent, because his income is much more than mine (I pay the utilities and many other incidentals). He is late with the rent EVERY SINGLE MONTH despite my reminders. Our landlord is pretty passive and hasn't insisted on late fees, but we're planning to move at the end of our lease and I'm afraid he won't give us a good reference. He's late with other bills and has completely destroyed his credit, so that any major purchases must be made by me. He's tried various organizational tools such as financial software, but doesn't stick with it. He has most of his bills set up on auto-pay, but they frequently bounce.

Then there's the housework. I won't say he doesn't do anything, because he can be extremely helpful in short bursts, but if we've planned to clean the house on a given day, it's like pulling teeth. I accept that he'll always be naturally messier than I am (and I am far from a neat freak), but I don't know how to deal with the constant promises of "Oh, I'll clean that up tomorrow" only to have the mess sit there for weeks. He plays video games and watches TV instead of doing his laundry, and then has no clean clothes to wear. This kind of stuff bothers me the most because he fails to plan or procrastinates and ends up stressed out, and doesn't seem to learn any lesson at all from this. He loses his stuff constantly (phone, keys, wallet) and can't learn to put it in the same place every day.

I'm sensitive to the fact that people with ADHD have been called lazy and stupid much of their lives, and he is a pretty classic case, having dropped out of college numerous times, bounced around different jobs, etc. His mother is a rescuer, and probably would still do his laundry if I wasn't in the picture. I refuse to be a parent to him and refuse to clean up his messes (literally and figuratively). He is extremely sensitive to what he perceives as nagging or accusation. 95% of our fights begin with me saying something like "Hey, did you get a chance to do task X yet?" and him spiraling into "I can't ever do anything right, can I?"

His ADHD seems to affect his work and he's frequently very stressed out because he's behind due to his inability to focus (his boss is also certifiably insane, but that's another issue). I've tried to get him to exercise, to meditate, to do anything to relieve the stress, but it seems like all he wants to do is watch TV and play videogames, which don't seem to do anything as far as stress relief because he's still up half the night fretting.

Despite all this, I really do love him. He's sweet, generous, intelligent, funny and he absolutely adores me. I do believe he tries his best to make me happy. I really want to stay with him - this is not a "should I leave" question. However, I won't stay "no matter what" - I've already threatened to leave because of his temper (verbal, not physical), and he's completely changed in that regard, so I know he can control at least that much. I just want to know if there is any better way to approach a partner with ADHD.

It should be said that I am not the most easygoing person in the world. I have an anxiety disorder as well as issues with abandonment. I know the ADHD feeds into these things, as I often feel like I'm not exciting enough for him. Because of the distractibility, sometimes I don't even feel like I'm there. (Example: if we go to a restaurant with a TV in the dining area, he becomes fixated on the TV to the exclusion of our conversation.) I have worked on these issues in therapy on my own (and I'm on medication), but I haven't figured out a way to reconcile them with the ADHD.

martial arts for kids in San Diego

diode — Fri, 14 Dec 2007 10:42:53 -0800

I've got a friend with an adopted son. The kid has some adjustment problems from his early treatment and adjustment here. She's looking at using meds to change his behavior. I think that's not a great idea and she should look to enrolling him in martial arts classes. They are in San Diego. Can anyone recommend a program in that area? My friend is a single mother. With single-track determination, she adopted a child from Russia a few years ago. He's eight now. This kid is headstrong, willful, perhaps has a wild mathematics talent, and also has problems being moody and depressive. He also likes to challenge adults around him physically at times (aka being rowdy and physical). He's also a great kid too.

The mother is coping with this but the mix is not quite right. They get into tussles and the kid is challenging to handle. She's been looking for psych help, and of course they pull out the pharmacopia and their book of terminology which will end up with the kid on Ritalin and other mood changers. I think he needs some good discipline, focus, and self-esteem building which succeeding at a martial arts can provide. Maybe he needs both. But I would try the arts before the drugs IMHO. In any event, a program that has a strong spiritual component where the sensei are teaching people to be strong beings as well as fighters is called for I think.
Any programs you know of that you like?

There's also a factor of adult-child power struggles. Perhaps a primer in how to be the top dog with children would also be a good thing to have.
Thanks in advance.

Overzealous recommendation of ADD meds?

Anonymous — Thu, 02 Aug 2007 05:57:13 -0800

My partner just went to the doctor for a urinary tract infection and came out with a referral to a psychiatrist and a recommendation to be put on dexamphetamine! This doctor also insists it is important she meets me as well. Is this normal? Background hist:

My partner is 32 years old. In his early twenties he had been diagnosed with depression and trialed on every drug imaginable (none of which worked). Eventually he self-diagnosed as ADD, and spoke about this with a psychiatrist, who agreed and put him on dexamphetamine. I don't think he took it as directed.

I met him when he was 28. From the ages of about 26-30 he was moderately using street drugs and so he stopped going to the psychiatrist for dexamphetamine. Speed was generally his drug of choice and he eventually injected it for around one year, stopping when he was 30. That was when we moved interstate. So one year of extreme, almost daily drug use. Context: he was in the music industry.

Since moving, life is completely different. We're clean living, we dont smoke, we study and work full-time, we do normal people things, and we're happy and functional. We've been this way for 2 years. Neither of us can imagine going back. And it is for this reason, that I am a little iffy about this doctor's recommendation for stimulant drugs to treat his ADD.

I am open to having my opinion changed, if his psychiatrist truly believes he is a "textbook case", just as this doctor seems to. But to my mind, he is functional, calm, perhaps a little vague sometimes, but that is just his personality. In short, there is nothing wrong with him. I concede that he has no concentration for reading, I don't think he has ever read a full book, even though he wishes he could. But I had always put that down to him not developing a love of reading in childhood.

He is doing well at his job, he eats well, sleeps well; it is just baffling me how a doctor could take one look at him and go, YOU NEED MEDICATION! Especially when he was just requesting antibiotics for a UTI.

My partner says she asked for his medical history, which could account for this mystery, because he has always felt extremely comfortable with doctors and is very candid with them. He comes across as very thoughtful and trustworthy but I still have doubts about a doctor who doesn't see his past drug use as a red flag? Am I wrong?

2 years isn't that long ago, is it? Is this woman just some sort of over-prescriber? Even that makes no sense though, because she has to refer him to a shrink. By the way, I asked him if he felt he was "edging" the conversation towards wanting treatment for ADD, and he swears he was not.

I would appreciate any opinion on what is going on here. To what extent should we trust the doctor? I am happy for my partner to try the medication and see if it improves his lifestyle, but I am very concerned that I don't want someone tweaked out in my household! But am I correct in my understanding that if he truly does have ADD, it should just calm him down?

FWIW, he also shares my concerns and he said that he will probably try the medication but discontinue use in the case of adverse changes in personality.

Sorry so long. Any questions, direct them to this throwaway account: dexamWHYaphine@gmail.com

Will Adderall kill me, and can I take it on occasion?

Anonymous — Thu, 26 Apr 2007 21:13:43 -0800

Two questions about ADD medication, especially Adderall: 1) How dangerous is it (for me)? 2) Can it be taken "as needed"? Since I was young child I've had problems concentrating; I started school early but was held back a year for failing to pay attention, and then switched back and forth between "gifted" and "troubled" programs, etc. I'm still constantly forgetting and losing stuff and often unable to focus on tasks until after the last minute. I've nevertheless managed to cope, more or less, and should soon manage to complete a doctoral degree at a major university (they've been remarkably kind, letting me finish my degree in almost twice the time it usually takes--I'm now 35).

I'm tempted to ask about medication for ADD. This summer I have to finish and defend my dissertation, and while I'm quite close to completion, I'm nevertheless afraid that I might fail to do this, which I'm not sure I could bear.

Getting to my first question, then: the reason I've never really pursued the possibility of using ADD medication is that I think I may on occasions have benign heart palpitations. When I started to notice these, perhaps a decade ago, an EKG reveled a partial right bundle branch blockage which, they say, is supposed to be a pretty insignificant and common condition.

Here's the thing however: I don't even know that I *have* had palpitations. If I do on occasion have these, they never involve more that a few skipped beats, and have never produced faintness or other symptoms (I've never had a holter test). Additionally, these events seem to have become less frequent than in the past (or perhaps I don't notice them so much any more). All the same, the possibility of "sudden cardiac death" as a result of using stimulants has been a powerful deterrent to my asking about using Ritalin, Adderall, Strattera, etc.

Now however (as more and more of my students attest to the effectiveness of Adderall) I'm wondering whether an excessive paranoia about sudden cardiac death or etc. has kept me from trying medication that could make a major difference in my life, and I wonder: how dangerous *is* ADD medication (especially Adderall) for someone in my state? How much worse is it, for example, than caffeine, which I drink all the time? Mightn't I try it, in a controlled setting at first, and discontinue use if anything worrying occurs?

Also, I wonder whether it's possible to get a prescription that allows one to take ADD medication "as needed"? I hate the idea of long-term use of stimulants, which I suspect can't be good for one's cardiac system. I've (almost) managed to cope for a long time without medication, and on days when I'm just running errands or etc., I can manage fine. I'd like to take a medicine that doesn't give me the heart-damage of long term use of stimulants, or flatten my creativity, or my usual spacey digressiveness, except when it's necessary to do so. I think that people with real ADD can *sorta* get by without medication---I'm pretty sure that many can, and that I'm one of those people. Therefore, if it's not inadvisable, I'd like to try taking a low dose of Adderall on occasions when I need to fix my concentration on something and it just won't happen.

So, how likely is stimulant-type ADD medicine to kill me, and is it possible to legally take these medicines only "as needed"? Any advice or comments would be greatly appreciated.

Withdrawal Symptoms

kaytrem — Thu, 27 Jul 2006 19:58:55 -0800

What is the name of the condition caused by abrupt discontinuance of anti-depressent medications like Xanax... said condition is described as a feeling of immense internal physical pressure/stress/twisting... and could you have the same symptoms from stopping taking 20mg of ritalin a day?

I saw a wikipedia artical on withdrawal that mentions rebound "An unsupervised acute withdrawal from the use of an antidepressant can deepen the feel of depression significantly (see "rebound" below), and some specific antidepressants can cause a unique set of other symptoms as well when stopped abruptly. A combination of these factors has been reported by many patients to be quite horrible to endure." but what I am thinking of had a specific name and its symptoms were closer to what I tried to describe.

Is it possible that taking 10mg of Ritalin a day could cause my tendons/ligaments to tighten up and be sore?

kaytrem — Thu, 29 Jun 2006 18:23:47 -0800

Is it possible that taking 10mg of Ritalin a day could cause my tendons/ligaments to tighten up and be sore? I am noticing a correlation between starting taking it again and tendon pain in my wrists and ankles (achilles) and the top of my foot