Ritalin

[shannon_xray]

My neuro put me on Ritalin for this bone crushing fatigue a week ago.  I realize some medicines take a while to get into your system before they actually work and some medicines are fast acting and you get immediate results.  The Ritalin has made me slightly more mentally aware, but I am still bone tired.  Should I give it more time or call him and tell him it isn't working?  
Thanks,
Shannon

[shannon_xray]

Cognitive brain farts!  I like it!  It's me!  You have a sister ;)  Sometimes I speak alien when it's very bad.  I do get embarrassed at work.  My husband still gets annoyed with me.  

I have had so much blood drawn I should be anemic or dead!  LOL  I have been nagging my primary about my thyroid for years because I was convinced it was the cause of all my ills.  It always tested out fine, he tested everything to be tested with thyroid.  He also tested my adrenals and other stuff I have never heard of.  And when I got to the neuro he tested even more things.  

Isn't dysautonomia a symptom of sorts of MS?  I am new to MS.  Since my MS mainly attacks my brain, my flares are hard for me to understand.  Weird stuff happens to me all the time, like the other day part of my nose went numb and it still is.  That could be a flare.  Fatigue, on the other hand, is my constant companion :/

Shannon

[cmmd]

Chronic fatigue with autoimmune disorders is common. I wonder if the severity of your fatigue follows any flare ups with the MS?  When your MS is under control, is the fatigue better?  I'm assuming your doctor has checked the basics as well and ruled out anemia, hypothyroidism, low Vit D, adrenal dysfunction, heart problems...  Just because you have a diagnosis of MS doesn't mean everything is related to that, although I understand fatigue is common in MS.  Dysautonomia is also common with autoimmune diseases and it can also cause severe fatigue.  Have you looked into that?  Some people say CoQ 10 helps with dysautonomia but it hasn't really made much of a difference for our son.

[mikeysmom1995]

It's all good. Cognitive brain farts are my specialty!!!!!!!!
Yesterday I opened the door for my dogs as they were all waiting to come in and I said, "how", instead of hi to my dogs. I quickly looked to see if my neighbor was out then laughed. It's like where did that even come from.
This was happening pretty regular at work except I was embarassed there. With my coworkers not so much but with the customers for sure.  
No worries here. This is a safe place for brain farts. Lol
Regards, barb

[shannon_xray]

It's very frustrating isn't it.  :/  I sometimes speak an alien tongue when I get too tired.  I just have to stop, breathe and try again.  

At least we know we aren't alone.  We have the CRS disease!

Shannon

[bbassel]

No worries it happens to us all. I just ordered books online with the wrong address. When they got sent back I put in the 'correct' address and it was wrong again! Three times a charm.

I also ordered takeout two days ago and couldn't remember my address. I had to call back when I figured it out. So embarrassing lol! At least I can always use ms as an excuse ;)

Take care,

Barb

[shannon_xray]

I get Tramadol and Trazadone mixed up all the time.  I used to take Tramadol for pain in my neck and back (which I always have pain there).  You are right it is Trazadone.  My bad, sorry.  As of late, my cognitive function is worrisome.  When I get really really bad tired at work, there are brief moments that I forget how to do my job and the words that come out of my mouth are not what I am trying to say.  That gets frustrating and patient must think I am insane.  I have been an xray tech for 22 years now..

I do have the ups and downs, Ritalin gives me a very minor boost and it only lasts about 2 1/2 hours.  I will put a call in and see what he recommends.  

Thanks guys!  You're the best!

Shannon

[bbassel]

I am guessing that you were talking about trazadone for sleep. From what I can remember they were light pink and round?

Some patients were on it for sleep and. It seemed to work well ;)

Take care,
Barb

[mikeysmom1995]

Hi Shannon,  
I'm surprised your doc gave you tramadol to sleep. Tramadol is a non-opiod pain reliever. I use it when Tylenol doesn't do the trick for pain. It has no sleepy side effects for me.
I tried modafanil/provigil and took a nap on it. I did get the Maca root in pill form and only took it one day. The bottle says take 3x a day so I need to figure out what works.
I agree that the extended release adderall may be a better route as it keeps it at a constant level in your system so you shouldn't experience the up and down like with the Ritalin.  
Adderall will be my next step if the maca doesn't work. The doc was good with giving the maca a try first.
My fatigue has been much better since I retired from my job at the pharmacy,
but I know that is not an option for everyone.
I'm sorry you are having so much fatigue. It really can be debilitating. I hope you can find something that helps.
HUGS, barb

[shannon_xray]

I don't have an addictive personality either, thankfully.  It was fatigue that kept me going to the doctor's for years.  The ataxia earned me the brain MRI that landed me in trouble with MS.  My neuro, thankfully, is being aggressive.  He wants to help me stay in the work force for as long as I can.  

I just drink coffee in the morning.  One or 2 cups, just depends.  During the day I drink mainly water.  I cut the diet sodas pretty much completely out, not for the caffeine component but for the other preservatives they put in them.

You guys are all awesome!  Thank you SO much!

Shannon

[essdipity]

I do get not wanting to be on speed, and that's a big reason I take it seldom. But I'm not the addict type, so that's one fear I don't have. If it came to a choice between that and losing my job, though, I'd pick the amphetamine without blinking an eye.

For those with addictive tendencies, this remedy is not a good idea. Otherwise it can help a lot. A great many people use it responsibly every day. This is one of those times when a talk with the doctor is in order.

ess

[immisceo]

So far, nuthin' from the modafinil. But I'm on a low dose. I'm to try it for a month, then double it if it didn't do anything. Guess I'm doing that! I'm really not keen to use anything that's stronger. We all have our risk v. benefit sweet spots, and anything that's speed with an addictive component is just not tempting me so much at present. (could change!) I know our Kyle recently cut out caffeine with great results, but me at present I drink coffee. A lot. It's not ideal, but most days it's that or a day in bed.

[bbassel]

I have tried everything else as well and say boooo to that!

I understand the fatigue oh so well! Either talk about long acting ritalin or at least to be put on three a day if anything! I hope you can get help quickly. It took two years before I got to even try ritalin!

All the best,

Barb

[shannon_xray]

I tried Amantadine too and I agree!  BOO!  Thanks, Ess, this is excellent advice.  

[essdipity]

I think you should contact your doctor asap and explain that Ritalin is not working. Be forceful in saying that you will lose your job if this continues. Also say that your life collapses totally because of fatigue, which is certainly not good for you or your personal relationships. Don't ask for any particular drug, just ask for something strong. You have given this level of this drug an adequate trial, and it is not working.

I tried Provigil/Nuvigil (generics available) with no results, also Amantadine. Boo. So then I went to the big guns, one of which is Adderall. If Ritalin doesn't work well for you, these lesser drugs are very unlikely to. So I urge you to be as forceful as you can in talking to your doctor.

[shannon_xray]

Is the Modafinil helping you?  Would it get me through a work day?  

[immisceo]

My understanding is the same as Ess. These types of medications don't play the long game. They are quick and dirty, to get the job done. They can be titrated if need be, but you should get a sense of the effect fairly immediately.

They can, however, build a tolerance. For this reason, I've personally opted for the less effective and less addictive modafinil. Do I yearn for something more along the lines of adderall or ritilin some days? Heck yea. But I had a less-than-fun experience coming off an unrelated prescription last year and it's a once bitten twice shy situation.

[shannon_xray]

Ess,
He had mentioned Adderall before, but instead gave me Ritalin.  The fatigue is literally taking my life away.  I get so weak in the evening, my legs can give away.  I have fallen twice now.  Thankfully I have healthy bones, but you can only fall so many times before you get hurt.  

I am in a particular mess next week.  I won't have any help in the xray department at all.  This equipment is old and heavy and some patients I literally have to lift.  It is exhausting on a healthy person, but for me it will be devastating.  I am afraid my employer is going to see how bad I am getting and will start trying to find ways to fire me.  I've learned that loyalty and reliability mean nothing anymore and all of us are nothing but numbers.

I don't want to fall at work. I think my neuro wants me to give it more time.  How long should I wait?  I don't want to look like I am some sort of drug seeker, I just need help so I can work and not die.

Shannon

[essdipity]

Shannon, I am prescribed the generic form of Adderall, continuous release, 40 mg. Mostly I don't take it, since it sometimes makes me feel a little nervous, and I don't like the idea of being on an amphetamine. But it works, sort of, in that I can get things done when I really have to.

Unlike you, though, I am retired, so I don't absolutely have to get things done every day. (There's actually an upside to being old!) If I were you I'd try to get a different med, and/or a stronger prescription. For me, Adderall works about 8 hours with one morning dose. I certainly can tell when it wears off. It does not need to build up in the system over days or weeks, and I'm pretty sure that's also true of its competitors. So talk to your doctor about this.

ess

[shannon_xray]

Hey Barb!

I would love naps but working full time won't allow it.  I am doing my best to stay in my job, I can't afford to go on disability.  I am on 10 mg twice a day and it does wear off after 3 hours.  I take it in the morning and at lunch.  By the evening, I struggle making that 45 minute drive back home.  The second dose at lunch doesn't last as long as the morning dose but I never really feel more energy, only a little better mental awareness.  

Thanks!

Shannon

[bbassel]

I was put on ritalin 10mg x 3 a day. It is the fast acting and works fairly well. I can still sleep on it though because I can feel it's effects stop at the three hour mark.

The is a long actinng version my docc mentioned maybe try that? I am happy with short acting because I like my naps since it is just me ;)

Good luck and keep us posted

Barb

[shannon_xray]

Hi Corrie,
No I don't have apnea, I've been tested for that stuff before MS.  My fatigue was explored in depth before I finally got a brain MRI that got me in trouble.  LOL  He also has me on Tramadol for sleep, just be sure I am sleeping well I suppose.  

I hope your physiatrist is able to help you feel better.  

Thanks for the reply:) Good luck to you too!

Shannon

[Corriel]

Hi there, I can't answer about the Ritalin unfortunately but I wonder if there might also be a sleep disorder that you are contending with.

I mention it because a lot of folks with MS seem to have issues with sleep apnea (either obstructive or central).

I tried Modafinil (Provigil I think in the US) for my fatigue and it did nothing. I was diagnosed with sleep apnea years ago before my MS diagnosis but it didn't help a lot.

My physiatrist mentioned that maybe the anti-fatigue meds didn't help because I may have another sleep disorder. She's leaning towards Restless Leg Syndrome or Periodic Limb Movement Disorder so she's sending me for an overnight sleep study to see. If I have either or both of those she thinks that the anti-fatigue meds would only help me after I treat the other disorder.

Not sure what I think about all of that but it would make a strange kind of sense.

Others here have had success with Ritalin so they may be able to tell you how long it takes to be effective.

Good luck!

Corrie