the ritalin files, volume 1

so wednesday afternoon i started ritalin for the first time, in the interest of getting my major inability to focus somewhat more under control. my new doctor is excellent, and we talked for forty-five minutes about options before developing a plan of attack. wellbutrin hadn’t worked for me in the past, so she and i both agreed we should try a stimulant this time. general school of thought is that individuals with my particular issues (severe adhd, and depression/anxiety disorder) do best tackling the big one, which in turn brings the other two into check.

our options, then, were primarily ritalin or adderall, both stimulants, both commonly prescribed for adhd. both with their own share of funky side effects. both with similar but slightly different ways of attacking the chemical source of the problem. we opted for ritalin first because she’s had slightly more experience with it, but it was not much more than a stab in the dark at this point. unfortunately, it’s all about experimentation to get it right.

the worse part about this phase of the process is that we had no idea about dosage. for the specific type she prescribed, average adult dosage is anywhere from 20mg to 80mg a day. and because this is just a test, there’s no reason to start big with an extended release version – i have to wade through a number of shorter acting doses during the day as we play around with the total amount.

the upshot of this is that it is immediately apparent that ritalin can help. the downshot is that i’m not sure i can handle the side effects of this particular incarnation.

because of the short duration of the effects, i get these peaks, plateaus, and valleys throughout the day. while predictable now, they are not hugely pleasant. i am taking the maximum dosage – 20mg every 6 hours. the effects break down like this:

*after about a half hour, i start to notice the start of a difference. it becomes easier for me to concentrate, i am fully engaged in conversations, i can fully complete tasks without getting distracted. it’s really hard to describe to someone who doesn’t know what it’s like to start with the same sort of deficit, but trust me – the feeling i had after i realized d and i had just completed an entire conversation without my mind wandering was absolutely incredible. more on this in the next post.

*from that point until about two and a half hours after taking it, i experience maximum effectiveness.

*between hour three and hour four, there are diminishing returns on the concentration improval, but the bonus feelings of heightened anxiety kick in.

*after about four and a half hours from taking the 20mg, effects are negligable.

so then i just wait an hour and a half and start the cycle again. it’s somewhat tedious, but like i said, also promising because of the intial effects. i don’t feel “speedy” or anything like that, either, would be the biggest indication that it’s incorrectly prescribed. ritalin doesn’t get you high if it helps you; it only has a street reputation among people who have no chemical need for what it an do.

i go back to see my awesome new doctor on the 15th, so we can reevaluate. the choice at that point will be probably between bumping to an extended release ritalin (thereby removing those pesky peaks and valleys) or trying adderall (which also has an extended release, but again, we’d start with the shorter form to determine dosage).

so yeah, that’s the first couple days so far. we’ll see how it continues.

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