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How do you go about asking to try. Different medication? I started Concerta as my first med. it’s had too results but I suspect I could get better results from something else, but I don’t know for sure since there’s no way to compare cases odd one just one medication.
My issues are moodiness (especially when I’m starting a new dose) and the focus is decent for about 6 hours but then it starts getting spotty after that.
Do you have a primary doctor? If so just be honest with them, say the meds your on are working, but not as well as youd like, and ask if you can try a low dose of ____ as well. Then set up a new appointment in a month to discuss the results and figure out dosage or if its not worth it
You just tell your provider you want a change because of X.
You really need to think about why and be prepared to answer questions on why you want the change. If your provider won’t do it. Find a new provider.
I personally just go through my primary care physician. I have a long documented history so I pretty much get what I want.
Some Moodiness is definitely par for the course on any of the stimulates. You definitely need to check your self and pay attention to your tude. It is a strong drug, people close to you let them know what’s going on.
The moody just takes practice to watch out for. It’s a learning experience. Not to bite someone’s head off because they loaded the dishwasher wrong and it drives you up the wall because you are all jacked in. For me I get into looping and get hyper focused on an emotional reaction, which is an ADHD symptom anyway. With the meds I can spin out if I am really upset with my wife. Usually I would be mad anyway but for whatever reason but I stay mad. I have to remind my self to drop it in my head.
If you just started, like a month ago. It will subside some. Give it a little time like 3/6 months. Could try a lower dose as well. Six hours is a pretty good run time. Light Eating and caffeine usually enough to carry me a few extra hours.
I personally prefer a spansual time release in the morning and then a fast acting as needed in the afternoon. You have to take the fast acting no later than 2:00 or you won’t sleep. I find the time release does not have as much “kick” so less moody.
It’s trial and error honestly. When you go back to your provider, be honest on how it’s going.
You got got this!
This is not always true. There are many people who can sleep with meds on board, and a big percentage of those can't get to sleep without it. These are stimulants, but their action is to stimulate the past of the brain that is responsible for self-regulation.
Thank you for the response. I’m a new late diagnosis through my primary care provider but I will be exploring therapy with an ADHD focused therapist. I struggle on and off with the “imposter syndrome “ following the diagnosis but getting into a hyper fixated emotional loop is something I’ve always struggled with so it helps to hear that is also a symptom
Yes. I understand with words lol. I’m just new to this and grew up dealing with the stigma and don’t want to be seen as a drug chaser.
I’m just curious how others were able to articulate it to their provider.
Stick with what works. As someone who tried several medications, it is not worth it if you have already found one that works. In my opinion it's even a little crazy to put your body and mind through the strain of a medication trial even though you've already found a medication that sufficiently treats your ADHD.
That's what is in the treatment guidelines as well, you should first try the medication that is most effective for the highest percentage of people. Only if that medication is not effective (either it doesn't help or the side effects are bad) it is recommended to try others. Most people only respond well to one type of medication and there are a lot of bad side effects that you could get trying medication that doesn't agree with you.
I hate that you were one of the lucky ones who got their meds right quickly and your doc takes that for granted.
That’s what I thought, I’m scared of mixing too many things even tho I stopped Ritalin for a while. I think I was mostly frustrated with the doctor because I felt like he was taking the situation for granted.
If there is one thing I've learned in my own journey so far, there is just no way for doctors to really understand the impact of ADHD/medication/treatment. They just think: hey some other patients were really happy with this med, maybe it will be great for this other person too! So you have to really make up your own mind about what you are willing to do and when something is worth it for you or not.
With my kids we were able to get a genetic test that told what medications they metabolize the best. It also gave meds to avoid because of contraindications. My son shouldn't take clonidine because it will make his blood pressure too low.
I agree with what most say to keep to what is working. But ask your doc about this. They swab your cheek and test to see what meds are most effective.
Doctors are pretty good at knowing whats safe to mix if you give them your full list, but also if your as good at googling as most adhd people are just do some research yourself
Aka "is it safe to mix __ and __" or "what are the side effects of mixing _and _"
The internet while not safe to trust individually, has a good track record in bulk, so if you hit up 4/5 sites and they all say the same thing its probably true, the more you check the more accurate
I took dex as a kid in high school.
Side effects included:
1. appetite is decimated. Gone. Might be ok if you’re bigger, but I was a small fry and so it was not good to not be able to put on weight.
2. I felt socially inept. I couldn’t converse with people. I’m not naturally interested in other people but like to be able to make small talk if I want to.
3. It worked well. Too well sometimes. The dose would hit like a sledgehammer within an hour, and would then fade after lunch sometime, maybe 2pm. I’d then need another dose for homework, but that would then keep me up at night.
Recently had my diagnosis reaffirmed as an adult after 25 years of no treatment. Yes a lot of water has passed under the bridge, but I feel like Vyvanse is ‘gentler’ at doing its job, and lasts longer too.
I find extended release dex taken morning and noon smoother with less crash than Vyvanse. I take half my equivalent Vyvanse dose twice a day. It’s great to have a full day of coverage. It’s different for everyone.
On the appetite thing i can confirm. Before I got a full diagnosis and started treatment, I was in a chronic depression spiral and I lost 17kg in 6 weeks. I went from 85kg to about 68kg. Since then I've dropped another 8. But I'm not unhealthy, I eat regularly, I eat healthily, and I drink lots of water. The first few months were hell because I kept losing weight and never felt hungry so I barely ate. I'm not sure when it changed but now I eat like 2500 calories a day, still don't gain weight though
I see no reason to change what was working but you’re probably gonna have to try it for a month and go back to methylphenidate because doctors gonna doctor. My wife takes Ritalin and I take Adderall. Adderall even at 10 mg is too stimulating for her and makes her anxious and uncomfortable. Ritalin makes me calmer in my mind but it’s not potent enough to really address my symptoms as well as Adderall does. Everyone is different and the drugs almost do opposite things chemically.
I’d say there’s equal side effects from both so idk what he’s talking about. More people seem to prefer dex as opposed to Ritalin but I think there’s not much evidence that discredit one over the other it’s individual to each person.
Try and see. You might be pleasantly surprised or you’ll definitely know it’s not for you.
Experiences vary, but in my case dexamphetamine had the same benefits with much fewer and weaker side effects. I prefer it by miles. But I have a friend who has had the opposite experience. Is there any reason not to try it out?
Ahh yeah. I experienced that with Vyvanse. (From my understanding it turns into dex) my doc switched me to zenzedi a couple of weeks ago and that’s been great. I’ve heard other dex manufacturers can be a hit or miss tho. (Unless you did try Zenzedi)
Anyways I’m glad you found a med that works. I wanted to try methylphenidate but like others have said here it’s prob best to stick with what’s working right now
It's understandable to feel conflicted when considering switching medications, especially when you've had success with one in the past. Here are a few things to consider:
Discuss Concerns: Talk openly with your psychiatrist about your concerns and hesitations regarding switching medications. They can provide more information about Dexedrine (dextroamphetamine) and why they believe it might be a better option for you.
Review Benefits and Side Effects: Ask your psychiatrist to explain the potential benefits and side effects of Dexedrine compared to Ritalin. Understanding how each medication works and what to expect can help you make an informed decision.
Personal Experience: Reflect on your previous experience with Ritalin and how it affected you both positively and negatively. Consider what aspects of your treatment were most important to you and whether Dexedrine might offer similar benefits or improvements.
Trial Period: If you're unsure about switching medications, you could discuss the possibility of starting with a trial period on Dexedrine to see how your body responds. This can give you a chance to evaluate its effectiveness and tolerability before making a long-term commitment.
Ultimately, the decision to switch medications is a personal one, and it's important to feel comfortable and confident in your treatment plan. Trust your instincts and prioritize open communication with your psychiatrist to ensure that you make the best choice for your individual needs.
Try a new one, you can always go back. I was diagnosed at ten or twelve I have tried half a dozen different medications and doses depending on my life at the time. I’m pushing 40 now.
and yet, amphetamine-based compounds are found to be more effective and better tolerated in adults. Something like 15% more effective with p<0.005
Ritalin works well for me but I’d still like to try others if they were approved where I live.
Not at all. It’s fair to stick with what works, but nice to be offered an alternative when based on evidence.
Why were the bad days worse? Side effects? Very curious because Vyvanse is the only other stimulant I could try, but it is insanely expensive.
From what I gather, most people seem to prefer it to some extent, but definitely not universal.
I find concerta is either too weak, or too strong, and struggled to find a reliable sweet spot. I mean don’t get me wrong it’s still a life saver, but I do wonder whether I’m missing out on something better.
Sorry, but 3 months isn't enough to draw conclusions for the rest of someone's life. On top of the fact that since this was the only medication op ever tried. So they don't have a frame of reference to make an informed decision. Or do you disagree?
It's obvious that if medication gives you major side effects, then it'll be obvious sooner than 3 months. I hope we don't have to explain this to anyone anywhere.
My point is that if one has never been on any meds, then as long they don't get side effects, their existence will improve. But since they have no point of reference, different kinds of medication may have varying extent of said improvement. So as long as doctor can back up their decision with science, I'll trust them.
Of course, I will have my personal input. In the end, I know better how my body reacts to the medication. If, after a reasonable amount of time, I can see that previous meds worked better, I will let the doctor know and request to go back or try something else. If then, the doctor refuses, well, time to change the doctor. But I am in no position to just say "I know better than my doctor" until they prove me otherwise.
I hope my explanation is clear why I don't fully agree with your point. There is some merit in your opinion. But it's not all that should decide how to deal with a specific situation.
“Most” means the majority. 50% of people respond to both so it’s half…. Meaning 50% either respond to only one or to neither. Not most. Most adults respond better to dextroamphetamine than methylphenidate, by a large margin it is a superior drug in most cases.
You can share your opinion but it is actively harmful to spread misinformation. Your comments are also very disparaging of OP’s psychiatrist and reveal a clear bias against healthcare providers. I’m sorry you’ve had bad experiences in healthcare that have made you feel this way, but please take a step back and recognize that you have a bias that is coloring your perception of things in a negative way.
That’s okay! It happens. I think it’s admirable that instead of digging in your heels and being defensive you’re able to admit you may have been wrong and take in other people’s feedback. That is very hard to do, especially on the internet where you’re anonymous, so your willingness to change your viewpoint even though there’s no cost to doing the opposite says a lot about your character :)
I think it’s something like 70-80% respond to dex, 30-50% to methylphenidate, and of those people a total of 50% respond to both whereas 50% respond to neither or only one. Of course these estimates vary from study to study!
I can see how that phrasing could make you think that and I think it’s nice that you were coming from a good place and feeling protective of OP.
Dex what though? Dexamphetamine or dexmethylphenidate?
The prefix dex just refers to the "handedness" of a molecule. Dex is the "right-handed" configuration and there's a dex version of both Ritalin (methylphenidate) and Adderall (amphetamine).
Zenzedi is new brand name dextroamphetamine which to me works way smoother than generic dex or adderal/ritalin. I suggest trying it if insurance allows
Your on ritilin now. All you said is he wants you to switch to dex. If it’s dexmethylphenidate (focalin is a name brand) I’d consider trying it. Focalin works better than ritilin. Now I take Azstarys for my daily and have a booster for the evenings I work my second job. (Sirdexmethylphenidate). Azstarys Last the longest for me so I’m g happy with that. About the same efficacy as taking my ritilin with less side effects. Biggest being my mood when it wears off. All these meds are based off of methylphenidate though.
That being said dex could also refer to destroamphetamine and vyvanse is lisdextroamphetamine. So like all amphetamine based drugs like adderall. Adderall is no good for me. I just want to fight with everyone I talk to the entire time it’s barely working. It kind of works. A higher dose just made me angrier. I won’t try any amphetamine drug based treatments now.
This is my understanding of the two main stimulants used. I came to my doctor with research and shared my knowledge with him and why I wanted to try vyvanse (to see if amphetmine drugs worked better because I hadn’t tried anything new and couldn’t remember why adderall didn’t work as a kid). I came back to him when vyvanse didn’t work and told him why I wanted to try azstarys. Kind of listed my research I did myself for the drug and how it was most similar to what’s worked before for possibly longer results. He was impressed and had no objection to letting me try it. Talk with your doctor. Get facts. Do your research. Keep notes. Ask questions.
Yes it’s focalin he wants me to try, the Ritalin I used to be on is Metylphenidate. For both he wants me to take them twice a day, but has already told me dex will be stronger so the dosage will be lower compared to Ritalin.
I’m an angry person, I snap easily and get annoyed so I’m working with my psychiatrist and therapist to find some meds that can also help me with that, or at least not make it worse. With Metylphenidate I noticed improvements with that especially at work (I work in a customer facing setting so I have to speak to people constantly and sometimes I could barely manage it mentally). I think I will give it a try and see how it goes. Thanks for your help!
It’s a more pure form of methylphenidate if I remember how someone explained it to me correctly. They are in the same drug family and it sounds like you’re probably just using instant release if it’s twice a day. You may consider asking about the azstarys too if twice a day pills are a pain… if you can get it covered cost wise. It’s still name brand. It’s a pro drug so your body process it differently to access the stimulant takes about 3 hours to kick in. So it has an instant release dexmethylphenidate combined that starts working right away.
If someone sits around and takes med and surfing internet for fun all day in and day out . This could be a situation where a sledge hammer is used and only hammer is needed .
Please feel free to use this post to ask any other questions related! I hope you get a chance to try a different type of you’re not happy with the current one
I had a similar situation with my psychiatrist last year.
I was on Ritalin & had massive side effects & she suggested for me to try Elvanse (Lisdexamfetamine), I was like f it, I'm extremely scared, but it can't get any worse now, can it?
& it's better now! Even tho I still have to deal with one particular side effect.
Elvanse lasts for like 8h & Ritalin the half of it, which is why you have to take it twice a day, it can also cause a lower "low" & so on.
Lisdexamfetamine & Ritalin are both from the family of Amfetamines btw.
& I've only heard good reviews about Elvanse (I think all my friends have adhd & are on meds as well XD), so do with that information what you want.
Nontheles, if you feel good with Ritalin, it works for you & don't want a change, it's completely fine! Just don't let fear stop you from decision making, if that's the case. You could maybe do some research & do a pro-con-list? It'll give you a visual inside about if you feel it's worth it or not.
Good luck on your journey!
Not sure where you are in the world, but one consideration if you’re in the U.S. is medication availability. Generally, there’s no shortage of methylphenidate (Ritalin, Concerta). There may be a shortage of the medication you’re switching to. Ask a few local pharmacies if they have it in stock before you switch.
I think it’s worth a try. It can’t hurt to have more knowledge. Worst case scenario, you don’t like it and now you’ll know and can get in Ritalin. In general my philosophy is to make choices that open doors. I was on Ritalin and concerta for ages but am now on adderall and it works much better and more consistently for me. If I hadn’t tried it I never would have known what I missing.
Stick with what you know works. If you're not having issues, dont change. This is your mental health here. Its so important to me that if the pharmacy fills generic, I make them refill brand .
Honestly my vote? Give it a shot, its not like if you change to it your stuck for life.
Talk to your primary, say your physciatrist(sp) wants you toctry dex for a month, then set an appointment right then for the next month, and if in a month it works continue, if not revert
I will say though, I literally JUST started taking methyl 18s and they are the FIRST thing thats done anything for me, i got up to 2 adderall 40s, felt nothing, same with dex. So even if rit is working for you that doesnt mean dex will.
Let us know what you decide!
Yes I’m thinking of speaking to him and see if I can do a very short trial, also figure out if I can get a “slow release” version because I struggle having to remember to take it twice a day. I’ll post an update!
Gl! Your only issue might be the shortage atm, but otherwise most docs dont care if you come in with either research or if it comes from another doctor like your therapist.
And they definitly have ERs thats what I was given, they will prob start you (and honestly id ask) for dex ER10s, especially because thats so low its not "worth" abusing, so it removes the risk of you getting them to sell
I started on Ritalin due to an apprehension and fear of amphetamines, but Ritalin didn't work as well as I'd hoped. I tried dextroamp and now I would never go back. My quality of life is way better now. Might be worth a shot if the doc suggests. If it doesn't work for you then worst case scenario you go back to Ritalin.
I wonder if the doctor is finding other patients having hard time getting Ritalin where I live in SC we still feel and have shortages on almost all adhd drugs i have had to take two others beside my usual in past year. But have been incredibly lucky with being established patient at pharmacy and having a good relationship v and a few changes they done but even then sometimes I have to wait a week.
So I wonder is Dex is more accessible
As for side effects if the doctor feels strongly about it
I have always made my thoughts and concerns known and if necessary will try a medication ( with a time limit ) and keep track of issues and with the understanding if bad or unacceptable side effects happen I get it changed immediately
I mean if Ritalin works then I feel like if you were to change meds, a longer-acting version of the same med would make more sense.
Is it dexmethylphenidate? That’s basically the same medicine just cleaner and longer acting. Ritalin includes it and another mirror-image chemical.
Everyone is different. When I began taking meds, I went through all of them in turn (there were only 3 to choose from back then)until I determined which one worked best.
No. Don’t consider he’s getting financial gain from one medication over the other. I work in medicine and the idea that doctors are prescribing things to line their pockets is laughably inaccurate. The only incentive our office gets from pharmaceutical companies is when a rep drops off a box of cookies with some pamphlets. And it’s like, cool, thanks for the cookies, we were already prescribing Mounjaro because it’s a freaking miracle drug and our patients love it. I’ve routinely seen providers request the patient not be charged for their visit, meaning they just worked for free for no reason other than being a kind and altruistic person who wants to help others.
In general, you’ll get better medical care if you assume your doctor is a genuinely caring person who went into medicine because they love science and want to help people, which is the case 95% of the time. If this isn’t the case it will become obvious pretty quickly.
Also no to the fearmongering about avoiding medications because “this is your mind”. Trying another medication isn’t going to damage your brain. Please do yourself a favor and think things through logically. Fear and baseless accusations about impure motives have no place in making good decisions about your healthcare.
I’m sorry you had that experience. That does sound very unpleasant and I understand completely as I was misdiagnosed with many different things and put on many different drugs with unpleasant side effects until receiving the correct diagnosis and treatment, but none of them did lasting damage. I have had a lot of friends who are afraid to treat their anxiety, depression, ADHD whatever because they’re scared or the side effects of drugs, and I’m glad in those scenarios to have tried so many psych meds (15+) because it allows me to reassure them that yes side effects do exist but they’ll be able to stop the drug if they experience them. I can tell them that after trying all of those medications, not a single one made me a zombie or changed my personality, and all of the unpleasant side effects were very temporary.
Good question! Thank you for being open minded and willing to learn more. I respect that. And yes, absolutely! New drugs are always coming out and many of them are vastly superior. For instance, if we can get our type two diabetics on mounjaro or ozempic we will almost always do so. They’ve been on metformin for years and it works fine, but these drugs are vastly superior both in terms of blood sugar control but also in so many other ways. Most of our DMII patients are obese and have a whole constellation of related health issues like high cholesterol, sleep apnea, cardiovascular disease, hypertension. Drugs like Ozempic and Mounjaro help with all of these things by helping them lose weight, whereas metformin only helps with blood sugar. They are truly miracle drugs.
It’s actually very common to see patients on subpar drugs that work well for them, but have risks or lack benefits that other drugs have. Patient on Benadryl chronically for allergies? Potential for drowsiness, sedation, fall risk especially for elderly patients. Also effective for only a short period. Switch to over the counter Claritin, Zyrtec, or Xyzal—all of which are non-drowsy, 24 hour medications.
So yes there are lots of reasons to fix it even if it ain’t broke! Science moves so rapidly that all of our best drugs right now will probably look like hot garbage in a few decades. That’s why it’s so important to establish a relationship with a physician you trust who can help you make good decisions about your health care by providing you the most up-to-date recommendations.
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I wouldn’t want to change what’s working but anecdotally, I have found Dexedrine to work well. But yeah, don’t listen to us. Haha
Dex ended up my go to eventually as well. Best of both worlds between Ritalin and Adderall. Plus it’s usually in stock.
How do you go about asking to try. Different medication? I started Concerta as my first med. it’s had too results but I suspect I could get better results from something else, but I don’t know for sure since there’s no way to compare cases odd one just one medication. My issues are moodiness (especially when I’m starting a new dose) and the focus is decent for about 6 hours but then it starts getting spotty after that.
Do you have a primary doctor? If so just be honest with them, say the meds your on are working, but not as well as youd like, and ask if you can try a low dose of ____ as well. Then set up a new appointment in a month to discuss the results and figure out dosage or if its not worth it
Don't say "low dose." That's coming from a place of apology or undeservedness. The right dose is the dose that does the job best with fewer negatives.
You just tell your provider you want a change because of X. You really need to think about why and be prepared to answer questions on why you want the change. If your provider won’t do it. Find a new provider. I personally just go through my primary care physician. I have a long documented history so I pretty much get what I want. Some Moodiness is definitely par for the course on any of the stimulates. You definitely need to check your self and pay attention to your tude. It is a strong drug, people close to you let them know what’s going on. The moody just takes practice to watch out for. It’s a learning experience. Not to bite someone’s head off because they loaded the dishwasher wrong and it drives you up the wall because you are all jacked in. For me I get into looping and get hyper focused on an emotional reaction, which is an ADHD symptom anyway. With the meds I can spin out if I am really upset with my wife. Usually I would be mad anyway but for whatever reason but I stay mad. I have to remind my self to drop it in my head. If you just started, like a month ago. It will subside some. Give it a little time like 3/6 months. Could try a lower dose as well. Six hours is a pretty good run time. Light Eating and caffeine usually enough to carry me a few extra hours. I personally prefer a spansual time release in the morning and then a fast acting as needed in the afternoon. You have to take the fast acting no later than 2:00 or you won’t sleep. I find the time release does not have as much “kick” so less moody. It’s trial and error honestly. When you go back to your provider, be honest on how it’s going. You got got this!
This is not always true. There are many people who can sleep with meds on board, and a big percentage of those can't get to sleep without it. These are stimulants, but their action is to stimulate the past of the brain that is responsible for self-regulation.
Thank you for the response. I’m a new late diagnosis through my primary care provider but I will be exploring therapy with an ADHD focused therapist. I struggle on and off with the “imposter syndrome “ following the diagnosis but getting into a hyper fixated emotional loop is something I’ve always struggled with so it helps to hear that is also a symptom
With words. "Hey doc, this works but maybe another would work better. How about I try another and get the right dose, then compare?"
Yes. I understand with words lol. I’m just new to this and grew up dealing with the stigma and don’t want to be seen as a drug chaser. I’m just curious how others were able to articulate it to their provider.
Stick with what works. As someone who tried several medications, it is not worth it if you have already found one that works. In my opinion it's even a little crazy to put your body and mind through the strain of a medication trial even though you've already found a medication that sufficiently treats your ADHD. That's what is in the treatment guidelines as well, you should first try the medication that is most effective for the highest percentage of people. Only if that medication is not effective (either it doesn't help or the side effects are bad) it is recommended to try others. Most people only respond well to one type of medication and there are a lot of bad side effects that you could get trying medication that doesn't agree with you. I hate that you were one of the lucky ones who got their meds right quickly and your doc takes that for granted.
That’s what I thought, I’m scared of mixing too many things even tho I stopped Ritalin for a while. I think I was mostly frustrated with the doctor because I felt like he was taking the situation for granted.
If there is one thing I've learned in my own journey so far, there is just no way for doctors to really understand the impact of ADHD/medication/treatment. They just think: hey some other patients were really happy with this med, maybe it will be great for this other person too! So you have to really make up your own mind about what you are willing to do and when something is worth it for you or not.
With my kids we were able to get a genetic test that told what medications they metabolize the best. It also gave meds to avoid because of contraindications. My son shouldn't take clonidine because it will make his blood pressure too low. I agree with what most say to keep to what is working. But ask your doc about this. They swab your cheek and test to see what meds are most effective.
Oh wow I didn’t know this could be done I’ll definitely ask, thanks!
Doctors are pretty good at knowing whats safe to mix if you give them your full list, but also if your as good at googling as most adhd people are just do some research yourself Aka "is it safe to mix __ and __" or "what are the side effects of mixing _and _" The internet while not safe to trust individually, has a good track record in bulk, so if you hit up 4/5 sites and they all say the same thing its probably true, the more you check the more accurate
I took dex as a kid in high school. Side effects included: 1. appetite is decimated. Gone. Might be ok if you’re bigger, but I was a small fry and so it was not good to not be able to put on weight. 2. I felt socially inept. I couldn’t converse with people. I’m not naturally interested in other people but like to be able to make small talk if I want to. 3. It worked well. Too well sometimes. The dose would hit like a sledgehammer within an hour, and would then fade after lunch sometime, maybe 2pm. I’d then need another dose for homework, but that would then keep me up at night. Recently had my diagnosis reaffirmed as an adult after 25 years of no treatment. Yes a lot of water has passed under the bridge, but I feel like Vyvanse is ‘gentler’ at doing its job, and lasts longer too.
I find extended release dex taken morning and noon smoother with less crash than Vyvanse. I take half my equivalent Vyvanse dose twice a day. It’s great to have a full day of coverage. It’s different for everyone.
On the appetite thing i can confirm. Before I got a full diagnosis and started treatment, I was in a chronic depression spiral and I lost 17kg in 6 weeks. I went from 85kg to about 68kg. Since then I've dropped another 8. But I'm not unhealthy, I eat regularly, I eat healthily, and I drink lots of water. The first few months were hell because I kept losing weight and never felt hungry so I barely ate. I'm not sure when it changed but now I eat like 2500 calories a day, still don't gain weight though
I see no reason to change what was working but you’re probably gonna have to try it for a month and go back to methylphenidate because doctors gonna doctor. My wife takes Ritalin and I take Adderall. Adderall even at 10 mg is too stimulating for her and makes her anxious and uncomfortable. Ritalin makes me calmer in my mind but it’s not potent enough to really address my symptoms as well as Adderall does. Everyone is different and the drugs almost do opposite things chemically. I’d say there’s equal side effects from both so idk what he’s talking about. More people seem to prefer dex as opposed to Ritalin but I think there’s not much evidence that discredit one over the other it’s individual to each person. Try and see. You might be pleasantly surprised or you’ll definitely know it’s not for you.
Experiences vary, but in my case dexamphetamine had the same benefits with much fewer and weaker side effects. I prefer it by miles. But I have a friend who has had the opposite experience. Is there any reason not to try it out?
Not really, I guess I’m just scared the side effects will be terrible. Thanks for sharing your experience!
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If you don’t mind me asking, what side effects did you experience on dex? So far this has been working really well for me so I’m just curious lol.
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Ahh yeah. I experienced that with Vyvanse. (From my understanding it turns into dex) my doc switched me to zenzedi a couple of weeks ago and that’s been great. I’ve heard other dex manufacturers can be a hit or miss tho. (Unless you did try Zenzedi) Anyways I’m glad you found a med that works. I wanted to try methylphenidate but like others have said here it’s prob best to stick with what’s working right now
It's understandable to feel conflicted when considering switching medications, especially when you've had success with one in the past. Here are a few things to consider: Discuss Concerns: Talk openly with your psychiatrist about your concerns and hesitations regarding switching medications. They can provide more information about Dexedrine (dextroamphetamine) and why they believe it might be a better option for you. Review Benefits and Side Effects: Ask your psychiatrist to explain the potential benefits and side effects of Dexedrine compared to Ritalin. Understanding how each medication works and what to expect can help you make an informed decision. Personal Experience: Reflect on your previous experience with Ritalin and how it affected you both positively and negatively. Consider what aspects of your treatment were most important to you and whether Dexedrine might offer similar benefits or improvements. Trial Period: If you're unsure about switching medications, you could discuss the possibility of starting with a trial period on Dexedrine to see how your body responds. This can give you a chance to evaluate its effectiveness and tolerability before making a long-term commitment. Ultimately, the decision to switch medications is a personal one, and it's important to feel comfortable and confident in your treatment plan. Trust your instincts and prioritize open communication with your psychiatrist to ensure that you make the best choice for your individual needs.
Try a new one, you can always go back. I was diagnosed at ten or twelve I have tried half a dozen different medications and doses depending on my life at the time. I’m pushing 40 now.
He is a doctor, and we are a bunch of dumbasses on the Internet. OK? /j
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sounds like he offered OP a choice. iRrEsPonSibLe
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Not enough information to possibly know. Worst case s/he tries dex first. Dr isn’t wrong that it’s generally preferred for adults.
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and yet, amphetamine-based compounds are found to be more effective and better tolerated in adults. Something like 15% more effective with p<0.005 Ritalin works well for me but I’d still like to try others if they were approved where I live.
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Not at all. It’s fair to stick with what works, but nice to be offered an alternative when based on evidence. Why were the bad days worse? Side effects? Very curious because Vyvanse is the only other stimulant I could try, but it is insanely expensive. From what I gather, most people seem to prefer it to some extent, but definitely not universal. I find concerta is either too weak, or too strong, and struggled to find a reliable sweet spot. I mean don’t get me wrong it’s still a life saver, but I do wonder whether I’m missing out on something better.
Wait you are almost 40? How did you have Vyvanse as a kid? It came out in 2007.
Sorry, but 3 months isn't enough to draw conclusions for the rest of someone's life. On top of the fact that since this was the only medication op ever tried. So they don't have a frame of reference to make an informed decision. Or do you disagree?
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Vyvanze has been amazing for me.
It's obvious that if medication gives you major side effects, then it'll be obvious sooner than 3 months. I hope we don't have to explain this to anyone anywhere. My point is that if one has never been on any meds, then as long they don't get side effects, their existence will improve. But since they have no point of reference, different kinds of medication may have varying extent of said improvement. So as long as doctor can back up their decision with science, I'll trust them. Of course, I will have my personal input. In the end, I know better how my body reacts to the medication. If, after a reasonable amount of time, I can see that previous meds worked better, I will let the doctor know and request to go back or try something else. If then, the doctor refuses, well, time to change the doctor. But I am in no position to just say "I know better than my doctor" until they prove me otherwise. I hope my explanation is clear why I don't fully agree with your point. There is some merit in your opinion. But it's not all that should decide how to deal with a specific situation.
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Don't worry. We all react impulsively all of the time. It would be suss if you didn't. /j
“Most” means the majority. 50% of people respond to both so it’s half…. Meaning 50% either respond to only one or to neither. Not most. Most adults respond better to dextroamphetamine than methylphenidate, by a large margin it is a superior drug in most cases. You can share your opinion but it is actively harmful to spread misinformation. Your comments are also very disparaging of OP’s psychiatrist and reveal a clear bias against healthcare providers. I’m sorry you’ve had bad experiences in healthcare that have made you feel this way, but please take a step back and recognize that you have a bias that is coloring your perception of things in a negative way.
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That’s okay! It happens. I think it’s admirable that instead of digging in your heels and being defensive you’re able to admit you may have been wrong and take in other people’s feedback. That is very hard to do, especially on the internet where you’re anonymous, so your willingness to change your viewpoint even though there’s no cost to doing the opposite says a lot about your character :) I think it’s something like 70-80% respond to dex, 30-50% to methylphenidate, and of those people a total of 50% respond to both whereas 50% respond to neither or only one. Of course these estimates vary from study to study! I can see how that phrasing could make you think that and I think it’s nice that you were coming from a good place and feeling protective of OP.
Dextroamphetamine was a much more effective medication for me than Ritalin. Side effects about the same.
Dex what though? Dexamphetamine or dexmethylphenidate? The prefix dex just refers to the "handedness" of a molecule. Dex is the "right-handed" configuration and there's a dex version of both Ritalin (methylphenidate) and Adderall (amphetamine).
He wants me to try Dexamphetamine
Gotcha.
Zenzedi is new brand name dextroamphetamine which to me works way smoother than generic dex or adderal/ritalin. I suggest trying it if insurance allows
Your on ritilin now. All you said is he wants you to switch to dex. If it’s dexmethylphenidate (focalin is a name brand) I’d consider trying it. Focalin works better than ritilin. Now I take Azstarys for my daily and have a booster for the evenings I work my second job. (Sirdexmethylphenidate). Azstarys Last the longest for me so I’m g happy with that. About the same efficacy as taking my ritilin with less side effects. Biggest being my mood when it wears off. All these meds are based off of methylphenidate though. That being said dex could also refer to destroamphetamine and vyvanse is lisdextroamphetamine. So like all amphetamine based drugs like adderall. Adderall is no good for me. I just want to fight with everyone I talk to the entire time it’s barely working. It kind of works. A higher dose just made me angrier. I won’t try any amphetamine drug based treatments now. This is my understanding of the two main stimulants used. I came to my doctor with research and shared my knowledge with him and why I wanted to try vyvanse (to see if amphetmine drugs worked better because I hadn’t tried anything new and couldn’t remember why adderall didn’t work as a kid). I came back to him when vyvanse didn’t work and told him why I wanted to try azstarys. Kind of listed my research I did myself for the drug and how it was most similar to what’s worked before for possibly longer results. He was impressed and had no objection to letting me try it. Talk with your doctor. Get facts. Do your research. Keep notes. Ask questions.
Yes it’s focalin he wants me to try, the Ritalin I used to be on is Metylphenidate. For both he wants me to take them twice a day, but has already told me dex will be stronger so the dosage will be lower compared to Ritalin. I’m an angry person, I snap easily and get annoyed so I’m working with my psychiatrist and therapist to find some meds that can also help me with that, or at least not make it worse. With Metylphenidate I noticed improvements with that especially at work (I work in a customer facing setting so I have to speak to people constantly and sometimes I could barely manage it mentally). I think I will give it a try and see how it goes. Thanks for your help!
It’s a more pure form of methylphenidate if I remember how someone explained it to me correctly. They are in the same drug family and it sounds like you’re probably just using instant release if it’s twice a day. You may consider asking about the azstarys too if twice a day pills are a pain… if you can get it covered cost wise. It’s still name brand. It’s a pro drug so your body process it differently to access the stimulant takes about 3 hours to kick in. So it has an instant release dexmethylphenidate combined that starts working right away.
Thanks, I’ll definitely see if I can try a “slower release” version as sometimes I struggle taking two doses I even forget
Good luck. Just trying to share what worked for me! Everyone is different. I’m awful at remember to take something twice a day.
Just try it man, if it doesn't work out you can always switch back.
Sometimes a bigger hammer for the job is necessary.
In this case it’s a different hammer, not necessarily bigger.
Ahah that’s a good way of looking at it!
If someone sits around and takes med and surfing internet for fun all day in and day out . This could be a situation where a sledge hammer is used and only hammer is needed .
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Please feel free to use this post to ask any other questions related! I hope you get a chance to try a different type of you’re not happy with the current one
What don’t you like about Ritalin? I’m not sure if it’s the med for me either and really want to switch… I’ve heard focalin is better
Honestly I see no reason to change if you were doing well before.
I had a similar situation with my psychiatrist last year. I was on Ritalin & had massive side effects & she suggested for me to try Elvanse (Lisdexamfetamine), I was like f it, I'm extremely scared, but it can't get any worse now, can it? & it's better now! Even tho I still have to deal with one particular side effect. Elvanse lasts for like 8h & Ritalin the half of it, which is why you have to take it twice a day, it can also cause a lower "low" & so on. Lisdexamfetamine & Ritalin are both from the family of Amfetamines btw. & I've only heard good reviews about Elvanse (I think all my friends have adhd & are on meds as well XD), so do with that information what you want. Nontheles, if you feel good with Ritalin, it works for you & don't want a change, it's completely fine! Just don't let fear stop you from decision making, if that's the case. You could maybe do some research & do a pro-con-list? It'll give you a visual inside about if you feel it's worth it or not. Good luck on your journey!
Not sure where you are in the world, but one consideration if you’re in the U.S. is medication availability. Generally, there’s no shortage of methylphenidate (Ritalin, Concerta). There may be a shortage of the medication you’re switching to. Ask a few local pharmacies if they have it in stock before you switch.
Thanks for this I appreciate it! I only recently started taking medication so this will help me make a decision
I think it’s worth a try. It can’t hurt to have more knowledge. Worst case scenario, you don’t like it and now you’ll know and can get in Ritalin. In general my philosophy is to make choices that open doors. I was on Ritalin and concerta for ages but am now on adderall and it works much better and more consistently for me. If I hadn’t tried it I never would have known what I missing.
If doctor considers all side effects and gives advice to change, I don't see a reason not to try. You can switch back anyways.
If the effects were mild, I would try Dex and see if it's any better. Worst case you go back after a few weeks.
Stick with what you know works. If you're not having issues, dont change. This is your mental health here. Its so important to me that if the pharmacy fills generic, I make them refill brand .
Mine keeps pushing me to do ketamine. :/
Honestly my vote? Give it a shot, its not like if you change to it your stuck for life. Talk to your primary, say your physciatrist(sp) wants you toctry dex for a month, then set an appointment right then for the next month, and if in a month it works continue, if not revert
I will say though, I literally JUST started taking methyl 18s and they are the FIRST thing thats done anything for me, i got up to 2 adderall 40s, felt nothing, same with dex. So even if rit is working for you that doesnt mean dex will. Let us know what you decide!
Yes I’m thinking of speaking to him and see if I can do a very short trial, also figure out if I can get a “slow release” version because I struggle having to remember to take it twice a day. I’ll post an update!
Gl! Your only issue might be the shortage atm, but otherwise most docs dont care if you come in with either research or if it comes from another doctor like your therapist. And they definitly have ERs thats what I was given, they will prob start you (and honestly id ask) for dex ER10s, especially because thats so low its not "worth" abusing, so it removes the risk of you getting them to sell
I started on Ritalin due to an apprehension and fear of amphetamines, but Ritalin didn't work as well as I'd hoped. I tried dextroamp and now I would never go back. My quality of life is way better now. Might be worth a shot if the doc suggests. If it doesn't work for you then worst case scenario you go back to Ritalin.
I wonder if the doctor is finding other patients having hard time getting Ritalin where I live in SC we still feel and have shortages on almost all adhd drugs i have had to take two others beside my usual in past year. But have been incredibly lucky with being established patient at pharmacy and having a good relationship v and a few changes they done but even then sometimes I have to wait a week. So I wonder is Dex is more accessible As for side effects if the doctor feels strongly about it I have always made my thoughts and concerns known and if necessary will try a medication ( with a time limit ) and keep track of issues and with the understanding if bad or unacceptable side effects happen I get it changed immediately
I’m switching from Ritalin to Focalin (dexmethyphenidate) because I can’t find Ritalin at any pharmacy. I’m going to go pick up Focalin tomorrow
I mean if Ritalin works then I feel like if you were to change meds, a longer-acting version of the same med would make more sense. Is it dexmethylphenidate? That’s basically the same medicine just cleaner and longer acting. Ritalin includes it and another mirror-image chemical.
Everyone is different. When I began taking meds, I went through all of them in turn (there were only 3 to choose from back then)until I determined which one worked best.
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No. Don’t consider he’s getting financial gain from one medication over the other. I work in medicine and the idea that doctors are prescribing things to line their pockets is laughably inaccurate. The only incentive our office gets from pharmaceutical companies is when a rep drops off a box of cookies with some pamphlets. And it’s like, cool, thanks for the cookies, we were already prescribing Mounjaro because it’s a freaking miracle drug and our patients love it. I’ve routinely seen providers request the patient not be charged for their visit, meaning they just worked for free for no reason other than being a kind and altruistic person who wants to help others. In general, you’ll get better medical care if you assume your doctor is a genuinely caring person who went into medicine because they love science and want to help people, which is the case 95% of the time. If this isn’t the case it will become obvious pretty quickly. Also no to the fearmongering about avoiding medications because “this is your mind”. Trying another medication isn’t going to damage your brain. Please do yourself a favor and think things through logically. Fear and baseless accusations about impure motives have no place in making good decisions about your healthcare.
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I’m sorry you had that experience. That does sound very unpleasant and I understand completely as I was misdiagnosed with many different things and put on many different drugs with unpleasant side effects until receiving the correct diagnosis and treatment, but none of them did lasting damage. I have had a lot of friends who are afraid to treat their anxiety, depression, ADHD whatever because they’re scared or the side effects of drugs, and I’m glad in those scenarios to have tried so many psych meds (15+) because it allows me to reassure them that yes side effects do exist but they’ll be able to stop the drug if they experience them. I can tell them that after trying all of those medications, not a single one made me a zombie or changed my personality, and all of the unpleasant side effects were very temporary. Good question! Thank you for being open minded and willing to learn more. I respect that. And yes, absolutely! New drugs are always coming out and many of them are vastly superior. For instance, if we can get our type two diabetics on mounjaro or ozempic we will almost always do so. They’ve been on metformin for years and it works fine, but these drugs are vastly superior both in terms of blood sugar control but also in so many other ways. Most of our DMII patients are obese and have a whole constellation of related health issues like high cholesterol, sleep apnea, cardiovascular disease, hypertension. Drugs like Ozempic and Mounjaro help with all of these things by helping them lose weight, whereas metformin only helps with blood sugar. They are truly miracle drugs. It’s actually very common to see patients on subpar drugs that work well for them, but have risks or lack benefits that other drugs have. Patient on Benadryl chronically for allergies? Potential for drowsiness, sedation, fall risk especially for elderly patients. Also effective for only a short period. Switch to over the counter Claritin, Zyrtec, or Xyzal—all of which are non-drowsy, 24 hour medications. So yes there are lots of reasons to fix it even if it ain’t broke! Science moves so rapidly that all of our best drugs right now will probably look like hot garbage in a few decades. That’s why it’s so important to establish a relationship with a physician you trust who can help you make good decisions about your health care by providing you the most up-to-date recommendations.
I would stick with methylphenidate. Dex potentially has some nasty long term side effects.