Ritalin-SR and a strange, early-evening daily bout of depression…

[Anonymous]

I was taking Concerta 36mg for a few weeks before switching to Ritalin SR (20mg 2x/day) due to the Concerta causing some side effects (muscle tension, nervousness, etc). I found the Ritalin SR to be much more gentle, and gave me the same effect without the unfortunate effects.

Anyway, I take the SR around 8 in the morning, then again around 1pm. For the past week though I’ve noticed that around 4 pm, I get this terrible, depressed feeling. It comes out of nowhere– I just feel like I suddenly have no energy, I am extremely pessimistic, and on the verge of tears. This lasts for maybe an hour or two, then I start feeling better. So… What gives? Is this an effect of the Ritalin wearing off? Is there anything I could try?

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[Patte Rosebank]

That would be the “crash & burn” that comes as the medication wears off. Your dosing schedule may need to be adjusted.

Talk to your doctor or pharmacist. Maybe they can suggest something.

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[Anonymous]

I suspected as much… Kind of disappointing though, since I thought SR was supposed to last for 6 to 8 hours….

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[JimC.]

What Larynxa said!

I too come down around 4 from 20mg Adderall RX, and tried 5 mg then to augment the meds. Then I couldn’t sleep. Now I try to make sure I have some sort of food that will boost my blood sugar a bit like fruit or a juice drink; sometimes I just eat dinner early and that too seems to help.

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[Patte Rosebank]

Funny thing about those “supposed to last for” times. Some people have much faster metabolisms, so the drugs don’t last nearly as long as they should. Other people have very slow metabolisms, so the drugs last longer than expected. And if you have a digestive issue where you’re constantly running to the loo (a common side effect of lots of drugs for mood disorders or diabetes), that capsule or pill may end up getting flushed away before it’s had time to finish its work.

Everyone’s different, so you really need to keep a journal of what meds & doses you’re taking, the times you’re taking them, and how you’re feeling. Then, you take that journal with you to your doctor, and together, you can determine if you need to adjust the dosage or frequency.

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[Anonymous]

Maybe the sleepiness I feel in the afternoon is me coming down from the generic ritalin. I’m probably not taking it at the right time but it’s hard to know when. I’m only taking 10 MG and only twice a day. Either it’s not enough, or it’s not working period.

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[Anonymous]

Do you take your meds when you’re sick? I haven’t been taking mine with this bad cold as I don’t feel like doing anything anyway, so it seems like it would be a waste? Today, on about the fourth day of this cold, I took my Ritalin, but it didn’t seem to “kick in” and I’m wondering if I should have just not taken it.

Also wondering if I should just turn to my family doc now for dose adjusting? The nurse-practitioner I see is in a city over an hour away and I’m wondering if my family doc whom I’ve seen for the last 25 years would do just as well?

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[Anonymous]

If a person has trouble with a drug (generic Adderall), how long does it take for the bad effect to wear off. I guess it would depend on the person, huh? I went right from Ritalin 10 2X a day, to the generic Adderall XR, and then found I couldn’t take the Aderall XR generic because it really wrecked my stomach. I have GERD. So I went from that to no meds, and it’s been 2 days since I stopped taking it and I still feel totally tired after two days off. Now I’m wondering if I had a virus and it wasn’t the drug at all–but I’m sort of afraid to try it again, as I was really miserable. (sigh)

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[JimC.]

@MonkeyBarb: if you’re sick then 2 things: don’t mix Adderall with any over counter or prescription meds, without checking with your doc 1st. and 2: Adderall Rx wears off after about 8-sh hours (depending on each patient’s individual reactions)and there is no residual effect or “tiredness” if you will. As for taking it when your sick, if you don’t need it and it’s a day of couch surfing and nose-blowing, then why bother?

Family doc: ask s/he if they can work with you and ADHD, and what experience they have, then decide.

Best advice I can say is to “listen to your own body” and don’t mix meds if you’re ill. for that matter, don’t mix meds. Period.

Good luck, Jim

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