Psycho-Babble Medication Thread 1108715

Shown: posts 1 to 17 of 17. This is the beginning of the thread.

 

Restarting Methylphenidate

Posted by linkadge on February 29, 2020, at 7:12:02

Hi all,

I have been taking:

lithium 300mg
venlafaxine 37.5mg
mirtazapine 7.5mg

I connected with a new doctor who agreed to restart methylphenidate. I am a bit uncomfortable taking 4 meds (especially cost), but am not sure what to cut.

Anyhow, I am noticing that I am feeling quite a bit better. I am taking it for ADHD, but am noticing my motivation, interest and mood are improved as well.


Linkadge

 

Re: Restarting Methylphenidate linkadge

Posted by Jadde on February 29, 2020, at 8:20:36

In reply to Restarting Methylphenidate, posted by linkadge on February 29, 2020, at 7:12:02

> Hi all,
>
> I have been taking:
>
> lithium 300mg
> venlafaxine 37.5mg
> mirtazapine 7.5mg
>
> I connected with a new doctor who agreed to restart methylphenidate. I am a bit uncomfortable taking 4 meds (especially cost), but am not sure what to cut.
>
> Anyhow, I am noticing that I am feeling quite a bit better. I am taking it for ADHD, but am noticing my motivation, interest and mood are improved as well.
>
>
> Linkadge

Hello,

Glad you are feeling better. I took Ritalin for many years and it rarely failed to increase my motivation and mood. In finding an A/D that worked i had to drop it. Earlier this week I asked my pdoc if I could add Ritalin to my Nardil or Marplan and he said no. If the MAOIs fail me this time around I wont hesitate to go back to Ritalin plus Zyprexa. I do miss it and the energy it gave me.

Jade

 

Re: Restarting Methylphenidate

Posted by undopaminergic on February 29, 2020, at 11:17:14

In reply to Restarting Methylphenidate, posted by linkadge on February 29, 2020, at 7:12:02

> Hi all,
>

Hi, welcome back.

> I have been taking:
>
> lithium 300mg
> venlafaxine 37.5mg
> mirtazapine 7.5mg
>
> I connected with a new doctor who agreed to restart methylphenidate. I am a bit uncomfortable taking 4 meds (especially cost), but am not sure what to cut.
>

My vote's on mirtazapine. See below for a comment.

> Anyhow, I am noticing that I am feeling quite a bit better. I am taking it for ADHD, but am noticing my motivation, interest and mood are improved as well.
>

It used to have those effects for me too, in addition to wiping away all suicidal ideation.

Since you're taking medications for ADHD, you should consider mirtazapine in that light. I mean, guanfacine (Intuniv) is an alpha2-adrenoceptor agonist used for ADHD, and mirtazapine is an antagonist. (Guanfacine is also an antihypertensive, and as you would expect from a drug that does the opposite, mirtazapine increases heart rate and maybe blood pressure.)

Well, that said, since you're taking mirtazapine in the first place, I assume there must be something good about it. If it's good enough, you can always quit one of the others instead. Keep lithium if you need an anti-suicidal effect.

-undopaminergic

 

Re: Restarting Methylphenidate

Posted by linkadge on February 29, 2020, at 13:02:10

In reply to Re: Restarting Methylphenidate, posted by undopaminergic on February 29, 2020, at 11:17:14

Thanks for the response.

You're right, in theory mirtazapine should worsen ADHD, but a few studies have shown a positive effect. Also, it has a bit higher activity at 5-ht2a/c than alpha-2. Sleep has been a major issue in the past, so I'd like to keep it on board.

I might try to drop the Effexor, but some SSRI action seems to balance out the Ritalin. I could try dropping the lithium, but it does seem to help me with overall wellbeing.

Argg

Linkadge

 

Re: Restarting Methylphenidate

Posted by Stargazer2 on March 2, 2020, at 23:39:24

In reply to Re: Restarting Methylphenidate linkadge, posted by Jadde on February 29, 2020, at 8:20:36

I am currently on Nardil and Ritalin but of course it is
Countraindicated and will be flagged by the pharmacy.
I am careful and only take 5 TID, never more. I do need it for alertness and motivation. In a previous life I took Adderall with Wellbutrin and Celexa, I think. That was an awesome combo and I felt normal for a few years.
Just wanted to mention taking Ritalin + MAO but I doubt most docs would agree to it. My doc who just retired was awesome in his ability to blur the lines of restrictions occasionally.

 

Re: Restarting Methylphenidate

Posted by beckett2 on March 3, 2020, at 14:24:48

In reply to Re: Restarting Methylphenidate, posted by Stargazer2 on March 2, 2020, at 23:39:24

Good luck w this, and glad to hear it's helping. Adderall is a lifesaver for me. An AD wasn't quite enough. A stimulant dots the I's and crosses the t's.

 

Re: Restarting Methylphenidate

Posted by linkadge on March 3, 2020, at 14:53:37

In reply to Re: Restarting Methylphenidate, posted by beckett2 on March 3, 2020, at 14:24:48

Day 4 and I'm still doing well.

I took methylpenidate in the past but (foolishly) stopped because I thought I didn't need it.

With 20mg SR, I'm not getting any increased anxiety (almost the opposite). Also my appetite seems to be improved.

Overall I just feel more engaged in life. Effexor helped somewhat but seemed to leave me progressively more detached (socially and interest wise). I actually want to do things (read, watch a movie, talk to friends etc).

Linkadge

 

Re: Restarting Methylphenidate

Posted by beckett2 on March 3, 2020, at 15:48:12

In reply to Re: Restarting Methylphenidate, posted by linkadge on March 3, 2020, at 14:53:37

>Overall I just feel more engaged in life. Effexor helped somewhat but seemed to leave me progressively more detached (socially and interest wise). I actually want to do things (read, watch a movie, talk to friends etc).

This ^^^

After years of AD's, I have chronic apathy.

 

Re: Restarting Methylphenidate

Posted by undopaminergic on March 4, 2020, at 7:28:03

In reply to Re: Restarting Methylphenidate, posted by linkadge on March 3, 2020, at 14:53:37

> Day 4 and I'm still doing well.
>
> I took methylpenidate in the past but (foolishly) stopped because I thought I didn't need it.
>
> With 20mg SR, I'm not getting any increased anxiety (almost the opposite). Also my appetite seems to be improved.
>

I'm am pretty sure it's the confidence and positivity that the drug elicits. The anxiety itself may not be diminished but you handle it better.

With drugs of this class, you gain more control over your eating habits. Typically the result is weight loss, but you can *choose* to eat if you want to.

> Overall I just feel more engaged in life. Effexor helped somewhat but seemed to leave me progressively more detached (socially and interest wise). I actually want to do things (read, watch a movie, talk to friends etc).
>

This case report comes to mind:
https://neuro.psychiatryonline.org/doi/full/10.1176/jnp.14.4.461

I first read it many years ago (think 10-15 years). It's about Parkinson's, but there is a lot of symptom overlap between depression, the negative syndrome of schizophrenia, and Parkinson's disease.

-undopaminergic

 

Re: Restarting Methylphenidate

Posted by undopaminergic on March 4, 2020, at 7:34:35

In reply to Re: Restarting Methylphenidate, posted by beckett2 on March 3, 2020, at 15:48:12

>
> ... I have chronic apathy.

Me too. It's my main residual symptom of depression, and it seems to be particularly resistant to drugs, especially antidepressants. Stimulants like methylphenidate used to help a *lot* but not any more.

I haven't given up hope.

-undopaminergic

 

Re: Restarting Methylphenidate linkadge

Posted by SLS on March 4, 2020, at 9:01:41

In reply to Re: Restarting Methylphenidate, posted by linkadge on March 3, 2020, at 14:53:37

> Overall I just feel more engaged in life. Effexor helped somewhat but seemed to leave me progressively more detached (socially and interest wise). I actually want to do things (read, watch a movie, talk to friends etc).


Nice!


- Scott

 

Re: Restarting Methylphenidate

Posted by bleauberry on March 6, 2020, at 18:40:25

In reply to Restarting Methylphenidate, posted by linkadge on February 29, 2020, at 7:12:02

Ritalin is an amazing medication. One Nurse Practitioner and one Doctor told me the same thing about it. I am paraphrasing, but it was something like this, "I prescribe Ritalin more than any other medicine because it helps the most people with a variety of symptoms". It has been successfully used for major depression in assisted living seniors, and of course ADHD, but in my opinion is also excellent for the anhedonia side of psychiatry, where it can restore motivation and pleasure to pre-depression levels. It can work on depression a lot or somewhat. But even when it is only somewhat, the motivation to enjoy life again is a powerful thing to help beat depression naturally. Anyway, I am a huge fan of Ritalin in psychiatry and I am chronically disappointed at how little it is used. In my world it would be the first line med for depression, not last.

I've been off of psych meds for about a decade now, because lyme treatment and mold treatment cleared up the vast majority of the psychiatric symptoms. Treatment resistant - gone. Major depression - gone. But there is permanent damage in the part of the brain where pleasure/motivation/anhedonia happens. So I am thinking of going back on it.

I was on it for a year. Toward the end I was doing between 40mg and 60mg per day, as needed, days were different, in 10mg doses, one dose lasted about 3-4 hours. I tried the extended release versions and higher doses but I did not get the same good effect. I had to take 10mg 4 to 6 times throughout a day.

Being a stimulant I was afraid of anxiety and insomnia side effects. But the opposite happened. Ritalin was amazing for social phobia and anxiety, just melted away, and I slept great. The best I ever slept was on Zyprexa, but the second best I ever slept was on Ritalin. I can't explain. It has something to do with whether dopamine receptors are up regulated or down regulated.

I like Ritalin and I think it should be utilized way more than it is.

 

Re: Restarting Methylphenidate

Posted by undopaminergic on March 7, 2020, at 9:07:00

In reply to Re: Restarting Methylphenidate, posted by bleauberry on March 6, 2020, at 18:40:25

>
> The best I ever slept was on Zyprexa, but the second best I ever slept was on Ritalin. I can't explain. It has something to do with whether dopamine receptors are up regulated or down regulated.
>

I slept well thanks to methylphenidate (Concerta in my case), but that was when the dose was wearing off. The main withdrawal symptom of Ritalin is temporary fatigue.

> I like Ritalin and I think it should be utilized way more than it is.

It is used a lot, and maybe too much, for ADHD, but for depression and Parkinson's it is used too little.

-undopaminergic

 

Re: Restarting Methylphenidate

Posted by beckett2 on March 7, 2020, at 13:03:40

In reply to Re: Restarting Methylphenidate, posted by undopaminergic on March 7, 2020, at 9:07:00

> >
> > The best I ever slept was on Zyprexa, but the second best I ever slept was on Ritalin. I can't explain. It has something to do with whether dopamine receptors are up regulated or down regulated.
> >
>
> I slept well thanks to methylphenidate (Concerta in my case), but that was when the dose was wearing off. The main withdrawal symptom of Ritalin is temporary fatigue.
>
> > I like Ritalin and I think it should be utilized way more than it is.
>
> It is used a lot, and maybe too much, for ADHD, but for depression and Parkinson's it is used too little.
>
> -undopaminergic
>


The transdermal, Daytrana, is an excellent product, and I did much better w it than ingesting. The patches are a pia though.

According to my doctor, Adderall is better for me than Ritalin, at least from my genetic testing.

 

Re: Restarting Methylphenidate

Posted by undopaminergic on March 7, 2020, at 13:12:40

In reply to Re: Restarting Methylphenidate, posted by beckett2 on March 7, 2020, at 13:03:40

>
> The transdermal, Daytrana, is an excellent product, and I did much better w it than ingesting. The patches are a pia though.
>

I assume pia is a pain in the a.?

> According to my doctor, Adderall is better for me than Ritalin, at least from my genetic testing.
>

I think you'd have to try both and compare the effects. Based on my experience with phenylethylamine (PEA), I think Adderall or Dexedrine would be better for my ADHD too. I never got the chance to try yet.

-undopaminergic

 

Re: Restarting Methylphenidate undopaminergic

Posted by beckett2 on March 7, 2020, at 17:16:37

In reply to Re: Restarting Methylphenidate, posted by undopaminergic on March 7, 2020, at 13:12:40

> >
> > The transdermal, Daytrana, is an excellent product, and I did much better w it than ingesting. The patches are a pia though.
> >
>
> I assume pia is a pain in the a.?


Yes :D
>
> > According to my doctor, Adderall is better for me than Ritalin, at least from my genetic testing.
> >
>
> I think you'd have to try both and compare the effects. Based on my experience with phenylethylamine (PEA), I think Adderall or Dexedrine would be better for my ADHD too. I never got the chance to try yet.
>
> -undopaminergic
>


I do better with Adderall. Ritalin has stronger 'body effects'.

 

Re: Restarting Methylphenidate

Posted by linkadge on March 8, 2020, at 17:04:33

In reply to Re: Restarting Methylphenidate undopaminergic, posted by beckett2 on March 7, 2020, at 17:16:37

>I do better with Adderall. Ritalin has stronger >'body effects'.

I would agree with that. It tends to slow my motor activity down - sometimes to the point of wanting to sleep / nap. I had tried Dexedrine in the past and found it was a bit better for reading. I find Ritalin a bit more emotionally grounding however.

Interestingly, I am finding that methylphenidate is blocking some of the effects of marijuana (which I had been using medically). This may be a good thing if I find a don't need it (at least cost wise). We'll see.

Linkadge


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