Hello All,
I recently have had to change insurance that took effect today. I am currently using Aderall to counter the lethargic effect of morphine and percocet used for pain. The aderall has been a godsend for me, allowing me to actually have a normal life again instead of sleeping all the time. It never gave me the “hyper-focus” that I have read about nor did it give me any kind of energy burst. Instead it woke me up, allowing me to wake up at a reasonable hour and stay awake until late evening. I would always seem to wake up around 5am because of pain. I would then take the aderall and like magic I would “pop” awake about 8am and feel like getting up and stay awake.
I have been without the aderall for about 3 weeks now as my prescription ran out and I had to wait until the new insurance started the 1st before refilling (I could have gotten the aderall refilled under my old insurance, but the co-pay was $40. When you are on Social Security Disability every penny counts, so I made the decision not to refill until the new insurance kicked in). The new insurance does not cover aderall and it isn’t cheap. So, looking around the plan I discovered that it does cover ritalin with only a $6 co-pay. My doctor agreed to switch me to it. Got it filled today and will be taking it for the first time tomorrow morning. I am just wondering what to expect. Will the effect be any different than what the aderall did? Will it be as effective as aderall and keep me awake?
I am really hoping that it does the same thing. The last three weeks without the aderall have been in a word depressing. I found myself going back to being lethargic, moody and just not able to overcome the sleeping effects of the morphine. I also hear that ritalin acts as a mild anti-depressant. While I don’t think that I am severly depressed, I do think that the pain and not being able to work, combined with the financial limitations that my condition has put me under have made me somewhat down in the dumps. Is it possible that the ritalin will overcome some of the depression as well?
I realize that most of you aren’t doctors and I am not really looking for medical advice, although I am not adverse to well meaning direction. For you doctors on the board any thoughtful advice you might have would be appreciated. I wish the narcotics weren’t a part of my life, but medical science doesn’t seem to have a solution for the pain other than the drugs, so it is what it is.
My son had ADD when he was a little boy. I’ll qualify that by saying he probably still has ADD behaviors as an adult, but he’s not medicated today.
Anyway, the very first medication the doctor prescribed was Dexedrine. It worked beautifully. His problem was that after nine months or so on the Dexedrine, it lost effectiveness. The doctor would have to switch him to a new drug for several months, and then he could go back on the Dexedrine. One time, he was prescribed Ritalin.
It didn’t work. He actually got violent on Ritalin, and we had to deal with the results of that behavior. It was a huge relief when he could return to Dexedrine. Several years passed, and he had to change doctors. The second one put him on Adderal. It did work, but nothing was ever as effective for him as the original Dexedrine.
Different things work in different ways.
I do think, besides your current medication regimen, you absolutely should talk to your doctor about separate antidepressant medication. You might even find your pain meds can be adjusted with the right antidepressant.
~VOW
Thanks for the information. I was on the immediate release form of aderall. The doc put me on the same dosage of ritalin to start, but may increase it depending on the effect.
I have taken both Adderall and Ritalin. When I become overwhelmed with details and tasks with many steps, I get very sleepy. I found Adderall gives me more energy, but can also make my muscles clench. Ritalin didn’t give me the energy of Adderall, but I did have more mental focus and accuity. I wish they would come up with a combination of the two.
The thing to remember is that these drugs work differently for everybody. The only way to really know is to try. I also heard that Vyvanse is a good one to try.
Sounds like perfectly normal and appropriate situational stress to me. If it persists beyond 2 weeks, you should have it checked out. IMHO, depression is a broken brain. You can stress your brain a little to strengthen it. But if it’s too much stress or goes on too long, your brain can “break” and you develop Depression (much like you can exercise to strengthen, but too much stress on your ankle will sprain it, or use acid to digest your food, but too much acid and bacteria and you’ll form an ulcer).
But yes, the increased energy from Ritalin makes many people feel better, mood-wise. It’s used off-label as part of a regimen to treat depression in elderly patients, particularly after a stroke. But it’s not FDA approved to treat depression, and it’s not in the classes of drugs known as anti-depressants. It’s more like cocaine or caffeine - it’s a central nervous system stimulant.
Just an update for anyone who might be curious. I took the Ritlan yesterday morning and have to say that I was very dissapointed at the result. It did seem to wake me up a bit, but only lasted a few hours and I was right back to dragging ass again.
I apologize if I am sounding like I am whining about being "tired, but it needs to be understood that I am not talking about just being tired I am talking about being so out of energy that getting out of bed after 9 hours of sleep is considered an accomplishment. And the overwhelming feeling of wanting to sleep constantly from the morphine is enough to take all of the life out of you.
I talked to my pharmacist and I think that problem I am having with the Ritlan is two-fold. One is the dosage the doc started me on is WAY too small. He has me on 10mg (I am 6’ 230lbs and HIGHLY tolerant to all drugs from the years of pain control). It seems that the average dosage for an adult is somewhere north of 20mg with many taking as much as 60mg. The second is that the ritalin has a very short 1/2 life of only 2 hours or so, while the amphetamine that was in the aderall had a 1/2 life of around 12 hours. This means that the ritilan is wearing off quickly and the lethargy is coming back. Perhaps an extended release ritilan like ratatsokK mentioned is the way to go.
I will ask the doc to increase the dosage and to put me on the XR version and hopefully that will take care of the problem. I will also inquire about the Vyvanse as literalist suggested. Thanks to everyone who responded. It is always comforting to be able to talk to others about one’s problems.
I’ve never used Ritalin, but your note that it only lasted a few hours is interesting. I’ve got a daytime sleepiness issue as well, though in my case it seems to be idiopathic vs. caused by medication (I also have sleep disorders, though as far as we can tell those are adequately treated).
And on my most recent doctor visit, we talked about the wakefulness medications (Provigil, to which I switched because Nuvigil was too spendy) and how even when I take those, there are days where I crash HARD about 4 PM.
So, a small dose of Ritalin - as in, short-acting stimulant - was mentioned. She said it would hit quickly (like 15 minutes) and wear off well before bedtime, so the idea is I’d take a dose shortly before leaving the office.
We’re tweaking the Provigil dosage right now then make a decision on the Ritalin.
Thanks for the input. I did try Provigil but found it not coming close to putting a dent in the lethargy. The aderall was certainly the best I have tried lasting all day. I think that I am going to ask the doc for the extended release and see if that helps. The reason I responded again is perhaps you might want to ask your doc about the aderall, it was very effective for me. I am very disappointed that my insurance won’t cover it. The only downside is that I was building a tolerance very quickly which is usual with aderall.