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Ritalin dosage

Hello, I have pretty severe ADHD. Diagnosed twice in late childhood and early teen years, severe concentration, wakefulness and focus issues, even in fun things/hobbies. It "ruined" my late high school years (when I was taken off it), and that word is in quotation marks because I am autodidact (I learn very fast and by myself, given I have the motivation and energy) and very intelligent. (I know they aren't very accurate and that there are different types of intelligence, but an IQ test given by a professional gave me more than 140). Even though living with ADHD can be a complete hell because it can cause, and even be misdiagnosed as, anxiety and depression (I've gone to docs for depression and anxiety, but they sent me for an evaluation which I didn't even have the motivation to show up for), I've never fell into drug abuse. I've used some, though. More details on that later.

I'm going to include all the details I can think of right now.

I went to my family doctor, who prescribed me 10mg Ritalin twice a day for 7 days, then 20mg twice daily in the morning and noon. He didn't ask much because he was the doctor who diagnosed me in my childhood. They are of generic brand (pms-methylphenidate), and instant release. This is a life-long treatment (he wrote the prescription for 12 refills, or one year).

He told me to mess around with the dosage to find what feels right. I've tried 10 and it didn't do anything noticeable. With 20mg (took one an hour later), I was feeling half-awake, noticed that my concentration was a little better, but I didn't get the effects I was expecting. Since it's a derivative of amphetamine, I know that the effects are supposed to be noticed on the first dose as opposed to some medications that can take weeks to notice any change.

Around four hours and a half later (scheduled dose), I tried 30mg, and wow. I wasn't "high" (I know the feeling of a recreational amphetamine dose), but I was fully awake, concentrated, focused, VERY ambitious (got an internship at the local radio station the same day I started the medication, I have no education in the domain but convinced the director that I'm passioned about learning the trade), more social (I feel more genuinely interested in people), and my head and thoughts are clear as crystal, compared to the feeling of having 20 TV channels open at once before. I actually feel more relaxed, no anxiety at all. I get very limited side effects, which is loss of appetite (pretty strong, but I eat breakfast and dinner) and nausea if I don't take it with a little food (even at 10mg). The intended effects start around 30 minutes after swallowing the pills, and start wearing off after around 3 1/2-4 hours.

I also tend to keep occupied during the evening (teaching myself audio recording/mixing/mastering, which has been my dream for 10 years), and the doses are to be taken in the morning and around noon, which leaves me with a pretty strong rebound effect of my ADHD in the evening, as early as 6PM. My sleep schedule is normally 1-2AM to 8-9AM.

Is three doses of 30mg, in the morning, around noon (1PM since I take the first at 8AM) and around 5-6 for the evening a good (and relatively safe) dosage/schedule to take Ritalin? (maybe 20-30-30, I don't really do anything productive in the morning). I will need to ask my doc to change the prescription, but again he gave me the OK to tweak my dosage a little bit, I'm guessing because there's various factors and he can't guess how I feel.

What I've taken so far:
Day 1:
11AM - 10mg. Did absolutely nothing. Took another 10mg at 12PM, noticed some changes, ate lunch, I was energetic and in a good mood during the afternoon.
6PM: 30mg. Had the effects I described above.

Slept for 8 hours. I wake up naturally with no alarm.

Day 2:
8AM: 20mg. Ate a little breakfast (2 toast), and did my things. I was very tired around noon and tried taking a nap, ended up just laying down for about an hour while listening to music.
1:30PM: 30mg. Same effects as the day before.
6:30PM: 30mg. I hesitated because it's not prescribed, but I would have gone to sleep at like 7PM otherwise. I think I definitely need a dose for the evening.

Physical stats: Male, 23, 6'1", 212lb, good heart as far as I know (on 30mg and one ~8oz coffee I had with dinner at 6:30PM (8:30PM at this moment) BPM is 90, counted just now. Regular, not arrhythmic.). Never had any surgery or severe health problems other than a pneumonia when I was around 12. No family history of heart disease.

Prior medication/drugs:
-Ritalin (forgot the dosage) from around 10 to 15 years old;

-Occasional cannabis (once a month socially, sometimes once a week, mostly for inspiration, socialization, introspection and simply because it's a fun, safe occasional escape and I dislike alcohol. Usually smoke about a third of a gram of top grade cannabis sativa. I consider that responsible use);

-Amphetamine (speed) once at a party two months ago, didn't plan on it but it made me realize that I *needed* to treat my ADHD. When I was offered the pill, I thought that it would increase my anxiety, but it did the opposite. I don't know what the dose was, but I approximate about 80mg of amphetamine. Overall, I felt a stigma with stimulant drugs and ADHD meds. Still took me two months to see a doc, though. Worth noting is that I got a very nasty "down period" of 3 full days where I was completely miserable, which permanently put me off abusing drugs, that was no fun at all, but the experience and eye opening probably changed my life for the better;

-Zero alcohol (incl. beer) in years, and it was one time. Don't like the effect at all. Family history of alcoholism (Father and an uncle, but they haven't drank in well over 10 years. I didn't even know until they told me around a year ago), no history of drug addiction. Recently learned though that they all experimented when they were the age of my own experimentation.

Might be worth noting:
-stopped smoking two days ago with a 10-week nicotine replacement therapy (21mg patches). I was a pack a day smoker for about one year only. Had some cravings yesterday, but today they've been mild and I don't think about it much. I tried to quit cold turkey before but I had a very, very nasty withdrawal.
1 Responses
Avatar universal

I've lived with the condition for years untreated because I knew and felt the stigma associated with stimulant drugs. I've talked to a few doctors (not on appointments, asking their opinion and knowledge on the matter) and alot of patients, and it seems like the consensus is that stimulant drugs, especially for adults, have different effects on everybody.

It affects all aspect of my life because my CNS is never "stimulated". For example, I'm the guy who was tired everyday and who is bored in a rollercoaster. Or I will feel something when meeting new people, then be bored with them overnight. You can imagine how mundane tasks were boring. Stimulants for me don't give a "rush", but allows me to have those, and feel "satisfied" when I accomplish something.

If you've ever heard of the term "high on life", that is something I never experienced. Not even with illicit drugs, which is probably why I never fell into drug abuse. They made me feel good temporarily, but I wouldn't accomplish anything so I wasn't drawn to them. I wasn't depressed - I had some coping mechanisms (and a be happy with what you have philosophy), but I wasn't advancing in life at all. I'm actually ambitious, I just lacked the motivation and concentration because everything got boring very fast, including entertainment and things I enjoy.

The effects on my life were amplified by the fact that I'm highly intelligent. I was interested in a dozen different graduate degrees, and wanted to switch from one to another constantly. Electrical engineering, quantum physics, mathematics. I ended up settling for sound engineering, which I am self-learning right now.

Something that came up at least half a dozen time, is that the effective dosage to treat adult ADHD (which is an off-label prescription in Canada) is:

1) The dosage that gives the maximum benefits in relieving ADHD symptoms;
2) Has no dangerous side effects, and minimal non-serious side effects;
3) The average effective therapeutical dosage range for adult ADHD is 1.3mg/kg to 2mg/kg for methylphenidate. Weight is a limited factor in dosage, but that's 96mg-192mg. Some heavier people need less, some lighter people need more.

The dosage I've found for myself does seem a little high. I'm a little worried that my doctor will disagree with me, but without it I can't function even if I try. For me, it is a tool. I realize that if I abuse it, it might ruin my life.

I'm aware of the health risks associated with lifelong treatment and accept them because I was beginning to be on the downward spiral to depression, starting to ask myself what the point of life was and such.  With stimulant drugs, I can use the full potential of my brain (as well as be happy in life, through success and not seeking being "high"), so I accept that it may shave a few years off my life. I'm not religious, don't believe in an afterlife, and I want to make the most out of this life.

I don't care what class it is in the Controlled Substances Act, because that's decided by the U.S. government who has Cannabis as a Schedule I substance, when research overwhelmingly shows that it has many therapeutic uses in different conditions, is safe for consumption by anybody (safe alternative to alcohol for the occasional escape), and is not even physically addictive.
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