ADHD medication questions

[Shelly4]

Hi Everyone! I was wondering if anyone can tell me what feeling you get from methylphenidate? My husband started these meds 12/31 and has increased it every month since. He has had past addictions and currently battling the last one. He claims it stops working after about 2 weeks and only last a few hours, any help would be greatly appreciated! Ty!

[Yogi_Mo]

There should be an extended release meds. They last for about 12 hours.

[Shelly4 in reply to Yogi_Mo]

He is currently taking the extended release and also takes Effexor ER for anxiety and depression. Ty for your help!

[somiya_2003]

Hi! i take Concerta (methylphenidate hydrochloride) it is an extended release medication, lasts about 6-12 hrs. If your husband is taking the lowest dose then he can ask the doctor about increasing the strength but since he did have a past addiction tendencies you have to be extremely careful handling the medication, if the doctor denies increasing the dose please try to give the recommended medication a day because your husband can forget and take the pill more than the required amount and overdose, some people have felt high when they overdose(personal accident) when I take my medication I just have the energy to do more things than i usually do and do not have impulsive thoughts also normal concentration rate, it's my choice to do the task or not because the medication only help me in distractibility and focus

[Shelly4 in reply to somiya_2003]

He is currently taking methylphenidate(Ritalin) 50 mg, and Effexor XR 150mg. He started methylphenidate at 10 mg and is now at 50mg currently. He had been dealing with our regular MD as I couldn’t get him an appointment with a psychiatrist. I was able to get one now for next Tuesday, so I’m hoping we will get some answers. He has had past addictions about 20 yrs ago, but has a very impulsive and addictive personality. He mentioned that after the two weeks of the increased dose he has no focus and his head is all over the place as he puts it lol I have told him that maybe he’s expecting more from these meds than they are meant to do. Thank you for all your help!

[somiya_2003 in reply to Shelly4]

Hi! i am not a health practitioner but I did have restlessness and blurred vision when I was overdosed, there are a lot of reasons for the medication to not work there os also a possibility the doctor might prescribe a different medication and dose, also its quite common for people with ADHD to use drugs and alcohol to self medicate, hope your husband recovers and I am happy that I was a help

[Gem1n1]

It sounds like his medication is the wrong brand/type/dosage/form/etc.

My ADHD is severe, and I’ve tried about 6 or 7 different medications in the last 8 months, both dextro-amphetamine and methylphenidate. Some work better than others, I’ve “maxed” out the dosage that my prescriber will allow, and the only medication that gives me the most relief of my ADHD symptoms does not last long enough in the day. So I can understand where he is coming from. I’m now looking into potential foods, supplements, digestive issues, etc that could be impacting the effectiveness of the medication.

There’s a few articles on ADDitudemag.com that explain different medications, extended release forms, and various routes of administration (Capsule, tablet, liquid, patch, etc.).

I’d recommend he bring up the ineffectiveness with his prescriber and keep trying to find the right treatment!

[Shelly4 in reply to Gem1n1]

He has tried two brands so far and almost maxed this one out. He also was on several antidepressants before the Effexor XR. When he was trying to balance that one he maxed it out, but he was extremely tired and irritable. So the dr said that was to much for him then. So he’s taking the 150 mg currently. I also have heard that vitamin c will lessen the effects of the meds. So he stopped taking that as well. I’m planning to discuss his vitamins at this appt to see if any may be interfering in any way. I keep doing research and trying to find more answers. Thank you for all your help! I hope you can get yours regulated!

[Testarossa1975]

Has your husband indicated why he thinks the medication stops working? Often times people start a stimulant and expect to "feel" a certain way. The first week I was on a stimulant I was very aware that my focus and mental clarity were very sharp; although I didn't have any physical sensations or euphoria, I felt good that I could tell the medication was definitely helping. It has never felt like that since then, even with dose increases. However, my understanding is that when we first start a stimulant our brain is not used to the increased availability of dopamine, but very soon the brain compensates by producing less dopamine. As the dose is slowly increased, there is a "sweet spot", as my psychiatrist called it, where the dose is not too low to be ineffective or too high resulting in ineffectiveness or increased side effects.

So while your husband may not perceive the effects of the medication that does not necessarily mean it is not working. I would recommend that he write down a list of specific symptoms he is hoping the medication will help with. Then he can take that list to his doctor and get feedback on whether or not the medication will target each symptom listed or if there is something else he needs to do in conjunction with the medicine to achieve the desired results. He can also asked his doctor for input on other ways he can decipher if the medication is working effectively.

After the doctor has helped set realistic expectations, then your husband should track how well he is doing on each of the symptoms. For example, once a week he might rate each symptom with a number that corresponds to the frequency that symptom was experienced/noticed (e.g. 0=never, 1= sometimes, 2= often, 3 = very often). Doing this will help clarify whether the medication is helping and to what degree. He can then let his doctor know what improvements he has experienced and what is still a problem. The doctor may then recommend a dosage increase, a different medication, or other strategies to increase the effectiveness of the medication.

Best wishes!

[Shelly4 in reply to Testarossa1975]

I actually did bring this up to him and he said he doesn’t have or loses his focus. He seems to want that focus from the time he gets up until he goes to bed. I’ve tried explaining that the meds don’t work that way. I do feel it’s a feeling he’s getting in the beginning, and then wants that to continue. I’m not sure at this point If it all about the focus though. I think he’s relying on the meds to manage all the intrusive thoughts and stress of currently staying sober from his current addiction. I have read it’s also learning to manage your lifestyle and changing old habits and routines. I agree with the realistic expectations of the meds themselves. As I’ve stated I think he’s looking for the magic pill to fix everything, and I don’t believe that’s how the meds work. I will absolutely talk to him about what he’s feeling again and what his expectations are of the meds. I will also try to see if he can journal his days and times of how the meds are effecting him. I think that may be a process all by itself to get him to do that lol thank you for all your help!

[BatWoman87 in reply to Shelly4]

Hi Shelly, It sounds like maybe he would benefit from some counselling or psychotherapy, if he's not already. As you know medication is only one piece of the puzzle and there are many other pieces. I think therapy would help him deal with the "thought chaos". 2 years of psychotherapy helped immensely with mine.

[Shelly4 in reply to BatWoman87]

Hi, he is currently in therapy. He started last June and that one didn’t work out. So we had trouble finding another one in our area and that took our insurance. He had been with his current therapist since November and has done much better. I have mentioned this as well several times, and also to his therapist and our couples therapist. I do feel like he’s holding onto things that need to be dealt with more. I’m hoping as he continues he may be able to work through more. I’m having a hard time helping him because he doesn’t open up and really talk about things. I’ve tried to get him to go to a group, purchased many books, couples therapy and have even gone in on some of his sessions to help him discuss things from his younger years. We’ve been together almost 28 yrs/married 22 yrs next month. I’ve seen him give up 2 addictions, but he can’t seem to stop the cycle. I don’t know if it’s because he hasn’t done all the work he truly needs to do. This is the first time he’s been in therapy. No groups or 12 steps so far for any of his addictions. Thank you for all your help! I’m happy that your therapy is helping!!!

[BatWoman87 in reply to Shelly4]

It can be a struggle sometimes to find someone who connects with you. I'm glad his therapist since November is working out better. As someone who literally couldn't get words out of my mouth about anything at the start, having to nod answers to yes/no questions posed by the psychologist, it took a long while to be able to really dig deep into specific issues, points of concern from my past, things I wish had turned out differently, where I've felt losses and grief, and learn the tools to manage my thoughts on my own going forward, and being able to recognize when I'm in a situation that I can't manage on my own.

Do you know what type of a learner your husband is? Or, are there things he really connects with? e.g. I'm a very visual person. Things need to be colour-coded and visually arranged in a way that makes sense for me or I go bonkers. I ask because for me, I tried to express my brain's chaos on paper once. Later on, I found a visual cartoon of therapy that really made a LOT of sense to me and helped me understand my therapy and its role better, partly because the visual expression of thoughts in my brain was a scribble on paper like the tangled string shown below, but on steroids.

Maybe there is something similar, either visually, or auditory, or tangible/touch, scent? that might help. Either for him to express his intrusive thoughts and/or to relate them externally.

Congratulations on 22 years of marriage. That is certainly commendable, and I want to sincerely thank you for being so supportive for him!

[Shelly4 in reply to BatWoman87]

Hi, well that sounds like my husband lol he usually answers with I don’t know. He’s so fearful of opening up and being vulnerable. His therapist has been trying to work on this with him as well as myself. I’ve expressed that as well. I’m not sure he has been able to do that though. I bring it to his attention when I see he seems to be struggling and try to talk with him, but it usually doesn’t help. He learned to not open up and talk about things from a young age, so the pattern has continued even though I try to get him to work on it. He doesn’t want people to help him it seems. He has told me he has never felt connected to anyone in his life except me, but I struggle with why he can’t be honest and open up to me then if he feels this way. I’m not sure about what type of learner he is or the visual part. Do you feel like you want to express how your feeling , but afraid you’ll be judged or treated differently? I ask because my husbands therapist brought this up in one of the sessions I was in with him. He stated the anxiety is fear based and usually with some of those things. I believe my husband answered yes to a point. I will ask my husband if he has this feeling and if he would be able to express it on paper like you said. Thank you so much for your kindness! I don’t feel I deserve it right now, because in dealing with his current addiction/ sobriety I’ve had a lot of anger and frustration. This has brought me to my knees and broke me like nothing I’ve been through in my life! It’s a daily battle to fix myself and help him also, but I have to learn to take care of me too I guess! Wishing you lots of happiness and success in your journey! Thank you for all your help!

[BatWoman87 in reply to Shelly4]

The main reason why I couldn't get words out was fear of judgement from others, because of a lack of experience addressing mental health or being around people who talk about it. No one around me talked openly about mental health. So it was a deep lack of understanding that so many of us deal with these issues and that owning them allows you to move on to the next step.

Learned very well from my father who never discussed his mental health concerns with my mother and this was the biggest contributing factor to their divorce.

[Shelly4 in reply to BatWoman87]

I’m so very sorry that you had to go through that. I do understand and often wonder why our families thought it was ok to not talk about things with us growing up. I’ve asked my Mom why this was and she said that’s how she was raised. So I guess the cycle repeated. I know my husbands family is very judgmental and critical. It has left a very big impact on him and a lot of resentment. His therapist has said he has now transferred it all on to me. I’m not sure why he did this. I know things have become so angry a lot of times, so maybe it reminds him of his Mom. I’m hoping that’s not the path I’ll end up on, but it’s getting harder and harder to manage. I’m truly sorry and I hope your able to work through it as time goes on. Have you confronted either of your parents? This was suggested to my husband, but he said he would never do that.

[Gem1n1 in reply to Shelly4]

Shelly4, you are a wonderful person for being so supportive of your husband and his struggles!!! I can understand that it’s frustrating and difficult!

From my ADHD perspective and struggling with the “right” kind of support from my family, just make sure you aren’t “parenting” him (in his eyes - I know you aren’t trying to do that) because that makes it worse for the ADHDer. He is the expert of his health and knows what he needs and what works for him, so I wouldn’t disregard or make assumptions about his medication or what he’s relying on.

I’d recommend “family ADHD treatment,” as I think that’s what I wish my family did. Where everyone is counseled on how to properly support your loved one with ADHD. I know my family is trying, but they’re actually making it worse for me (and my symptoms), and I have a hard time reaching them to get them to understand. It makes me pull away from them when I don’t want to, but I’m trying to protect my mental health. We all really have the same goal and good intentions! It’s our approach that may be lacking!

[Shelly4 in reply to Gem1n1]

Hi, I appreciate your kind words and to be honest I’ve always tried to be as supportive as I could. I think I may have lost my way at some point. I’ve always been the care taker, helper and mother of most people in my life. I never had to do that in the early years with my husband until his depression and anxiety became overwhelming. I have two children and I’ve had to become a single parent for a long time. I come from a single parent myself and I was always the strong, responsible one and I think I have thought I’m helping and doing the right things, but I’m learning that may not always be true. I have been reading Codependent No More and I’m learning a lot, but struggling knowing I can’t fix this. I’ve always been able to fix things and clean up the mess and I’m learning I can’t do that anymore. I can tell you from my point of view that as a parent everything we do comes from love and always trying to take care of our children. To protect them and guide them, but for me I guess maybe I try to a little to hard. I’m sorry you don’t have the right support from your family and have struggled. Please know they probably have the best of intentions, but maybe like me are having a hard time. If there’s anything else you could suggest I can do or not to to help, I would greatly appreciate it! Thank you for all your help!

[Gem1n1 in reply to Shelly4]

Absolutely! You are Wonder Woman! You have your plate full and overflowing!!!!

In the last year, I’ve realized that my mental health has to be prioritized and in a good place before I can help anyone else. I have taken on a similar role in previous relationships (trying to fix/help), but it wasn’t working for them nor me. Who knew I was living with undiagnosed/untreated ADHD myself!?

A few personal tips for support:

- Reframe what/how you say things so he views it as positive and uplifting - if you don’t know how he’s perceiving it/you, just ask him! Positivity goes a LONG way for ADHDers!

- Don’t try to diagnose him (only he can do that)

- Ask him questions to gain an understanding of his symptoms, not to find a solution for his symptoms, not to “figure him out,” so he feels heard (why, how, what, when); what’s working for him? what’s not working for him? what barriers are he experiencing? what can you help with to remove those barriers?

- Most things/advice/rules taught to us really only apply to “neurotypical” brains. We have to do/find what works for us as an individual, and it’s likely not what was taught to us. It’s a long journey and it’s frustrating at times.

- remember it’s not “him,” it’s his “brain.” ADHDers want to do/be “good.” Be frustrated with his brain, not him!

- if he’s not opening up, based on my own experience, it could be lack of trust or feeling unheard when he does open up. When it comes to his ADHD, you really have to just listen and not question the validity of his answers.

ADHDers know what to do, how to do it, they just need help doing it. So when they feel trusted and heard, they will tell you exactly what they need, but it may not be what you expected!

A few articles I like regarding support:

Www.healthline.com/health/adhd/dating-someone-with-adhd#listen-to-them

Www.additudemag.com/add-relationships-support-loved-one/

Www.additudemag.com/category/manage-adhd-life/relationships/

[Shelly4 in reply to Gem1n1]

A.. ty! I’ve come to that realization that I really have to fix me at this point! As we’ve had to go through this addiction and he’s also trying to regulate his medications, this has been by far the greatest challenge we’ve ever faced. I wish I knew more about this years ago. I have learned so much within this past year and I’m still learning and researching. I’ve asked him for over 10 years to go to the dr and try to figure out what was going on, but he didn’t want to go. My therapist has said I’m doing all the work in regards to his addiction and trying to help him with his medication treatment. She has said I’m codependent... something else we learned in therapy is about the transference process. He has said after that was discussed with his therapist he didn’t realize he was doing that. I think for me, I’m having a hard time learning to deal with his ADD and also this addiction. In the conversations we’ve had recently, I’ve not been doing any of those things according to my husband. I’m really at a point we’re I don’t know what to do anymore. He doesn’t seem to want to learn about this illness. I’ve printed out numerous articles from the Attitude emails I get, but he only reads them after I ask if he’s read them. I guess at this point I shouldn’t be asking? As far as his meds and treatment he claims he just wants to have focus and not have the thoughts in his head. I’m also reading a ADD book for couples and relationships. It also explains a lot about the proper communication techniques when dealing with the two different types of brains. I asked him about why he can’t be honest with me and he said because I get mad. Honestly, I get mad sometimes because I’ve been lied to for 27 years about a lot of things, things I’ve only just realized within the past year or so. I guess I have believed he had been mostly honest with me and always trusted me. He said I’m the only person in his life that he’s ever felt connected to. I appreciate all the tips and group links so much. I will make sure to look at them as soon as I get a chance. Thank you for all your help and support. I’m so very grateful!

[Siggy1972]

Hello Shelly4. I was recently diagnosed ADD/Inattentive and am just starting to take methylphenidate generic 36mg. I don't notice anything really. I tried Adderall and had upped my dose and started to feel very anxious and irritable. So I switched meds. I'm gonna speak to the doctor about bumping up my dose. I'm also going to check into using actual Concerta, not the generic.

I watched a webinar with a Dr. William Dodson through ADDA about medication. He's also on Additude magazines board also. So evidently a very well renowned Dr in the field. He did say that vitamin C would effect how these meds worked if taken within the first hour of taking your medication. He also stated that he pushes for his patients to take the name brand medication. Generics change all the time he was saying. But it obviously depends on how your insurance works also.

I'm also in recovery. Have been for a long time. I was leary of taking these meds but everything I've heard and read is they're safe as long as your taking them under a competent Dr's care.

[Shelly4 in reply to Siggy1972]

Hi, I’m sorry your having a hard time regulating your meds as well. My husband tried the Adderall and it made him very nervous and nasty, but I didn’t realize at the time he was still in his addiction. I do receive emails for attitude and print them out to read for myself and my husband. I will look into the dr you mentioned. He has switched taking his vitamin c, but I don’t think he noticed a change. I believe his meds are generic and I would have to check to see if my insurance will cover the name brand. I believe I’d there’s a generic they fight it. Congratulations on working your recovery! I have seen what a hard road it is and come from a family of alcoholics. It’s one day at a time and lots of support. The meds are a huge concern for me with his past addictions and something I have voiced to him, our Dr. as well as our therapists and only my husbands therapist and myself seem to feel this way though. He has an appointment for the psychiatrist next Tuesday and hoping they will be able to provide some answers and also diagnose him. He hasn’t had a clinical diagnosis as of now. Thank you for all your help and wishing you continued success in your recovery!

[Hidden]

I lost some weight while I’m on it, but it makes me feel less anxious. I mean at first I didn’t notice any big changes because when you start a medication that’s a controlled substance, they put you on the lowest amount possible. But once I got on the right dose, I did notice a change. I was more organized, more focused, more able to have follow through, I was still anxious, but my ability to handle the feelings that come with ADHD improved significantly. I hope this helps, but I’m not a doctor.

[Shelly4 in reply to Hidden]

Hi, I know for my husband he had anxiety and depression also, so they have him taking Effexor as well. We’ve been told they are two different things being treated, so both meds are helping to address these. I do know the addiction itself as well as the ADD causes these symptoms, but I’m trying to explain to my husband that the meds will only help so much. I’m glad your meds are helping you and hope you continue to feel better! Thanks for all your help!

[GregorysMom]

My psych put me on 20 mg when I was 69 and I'm 70 now. She won't go higher but I wish she would give me more. I wish I'd had it most of my life to help me focus.