Posted by Ktemene on August 7, 2004, at 2:17:26
In reply to Re: Ritalin's Diminishing Returns, posted by KaraS on August 5, 2004, at 12:59:38
> Thanks so much for that comprehensive response. I read the chart from the address you gave me and a lot of the ADD descriptions match me but plenty of it doesn't. I guess you were right earlier (I think it was you anyway) when you said that the diagnosis per se is less important that the treatment. If Adderall or another medication helps me, then it really doesn't matter what the actual diagnosis is.
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> Several months ago my pdoc said that I should increase the Ritalin and see if I have that response at 10 mg. Sometimes people react one way to the smaller dosages and a different way as the dosage is increased. I was just too scared to try a larger amount. > Sounds foolish I know.Actually, it is very smart to be hesitant about taking these sorts of meds. It is the people who have no worries at all that are foolish. I certainly resisted my pdoc's suggestion that I start Adderall for a long time. But he told me that the people who are most benefited by Ritalin and Adderall are the very people who are least likely to become dependent. And there are certainly a lot of people on this board who have taken low doses of these meds for a long time and only had beneficial effects. Viridis is a good example. He has been taking low dose Adderall and Klonopin for years, and never felt any inclination to increase his dose. I think it might be worth while for you to take your doctor's advice on trying Ritalin on a slightly higher dose, and maybe letting the trial run for a few days, because it sometimes takes three or four days for the body to adjust to these meds. It took me almost a full week to get used to Adderall. But once I had adjusted the med was very helpful. Of course I realize that you can't do much because of the insurance problem right now, but whenever you have a chance, either Ritalin or Adderall might be worth a trial for you.
> It's not a bad thing for you not to develop tolerance or have withdrawal symptoms from stopping the Adderall - if there's a silver lining here... (I haven't seen my doctor in months > because of lack of health insurance so I can't really follow up on it right now.)
No, it is not a bad thing at all. I am very grateful that I don’t have to worry about tolerance or withdrawal because I know how much a lot of people on this board have had to go through in dealing with them. This is the one time when my ADD worked to my advantage.>
> I'm really surprised that current thinking holds that dopamine is implicated in ADD. I > would have thought it was NE or at least both of them.
Since DA and NE are so closely related, it is likely that anything that affects DA is also going to have an immediate effect on NE. E.g. Strattera has an effect on DA. It is rather strange that so many docs think that the key to ADD is the dopamine system rather than NE, but there is a lot of literature supporting this claim. Here's a link to a site that has collected some article abstracts on it : http://www.neurotransmitter.net/adhdda.html
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> I have tried selegiline in 5 mg. and taken it for a couple of days at a time. I haven't tried it steadily. How long before you got an antidepressant effect from it? Was it right away or did it take weeks?The antidepressant effect took several weeks to develop. It makes sense that it would. Since I am only taking 5mg it would certainly require several weeks for MAO-B to be eliminated. (I read somewhere that 5-10 mg Selegiline per day for several weeks will eliminate 90% of the brain’s MAO-B. A bigger dose would get the job done much quicker, but would also require conforming to the MAOI diet. But I did feel the activating effect from the very first day. By the way, you should always take Selegiline after a meal. The bioavailability of Selegiline increases more than 300% if it is taken with food. Also, you might try opening the Selegiline cap and pouring the powder into your mouth and holding it there for a few minutes. That would allow some of the med to be absorbed directly into the bloodstream. At such low doses it is important the maximize the bioavailability to the extent that one can.
poster:Ktemene
thread:373827
URL: http://www.dr-bob.org/babble/20040805/msgs/374973.html