Health

Methylphenidate: Day One

In this post I describe my first experiences with methylphenidate. I want to make it very clear that I do not condone any kind of illicit use or purchasing of stimulants. My backstory is that I went to see a psychiatrist because I was curious if I would get an autism diagnosis (“Asperger syndrome”), and in the course of that I underwent a battery of tests, not just related to autism but also the major comorbidities of autism. For the time being, I will keep it for myself whether I am a verified autist, but I am revealing that I received an ADHD diagnosis. I scored zero on the “hyperactivity” part of ADHD, but I have a mild case of attention deficit disorder that justifies treatment. There are two primary medications for ADHD, either amphetamine, e.g. Adderal and Vyvanse, or methylphenidate, e.g. Ritalin and Concerta. The psychiatrist I go considered methylphenidate more suitable in my case, so that is what he prescribed.

With the preamble out of the way, let us get to the meat of this post: Today I took my first methylphenidate pill (10 mg). The brand is Ritalin Adult, but there are obviously others. I am supposed to take up to two per day, one with breakfast, another one, if needed, during lunch. The positive effects of this drug are supposed to kick in about 20 minutes after taking it, and last for about four hours. You are not supposed to take them close to bedtime as this might interfere with your sleep. This post is a journal of my first four hours on methylphenidate. I only took one pill.

09:30
I get up, late, as it is the weekend, and go through my morning routine. I do intermittent fasting, so I normally only eat between 12:00 and 18:00, so I normally skip breakfast.

10:10
As I am supposed to take methylphenidate with some food, I prepare a small breakfast and take my meds. The pill is tiny and easy to swallow.

10:22
My wife involves me in a conversation about a Chinese friend of hers. I normally would have found idle chatting distracting, in particularly in the morning, when I first want to go through my to-do list. Not this time. There is some background noise in the house due to guests, which I perceive, but is just there and does not distract me very much.

10:30
I think the effect of the medication has fully kicked in. There is an odd sensation in my mouth, perhaps the onset of dry-mouth syndrome. My head feels a bit strange. It is not headache but there is some muscular tension.

10:35
The door to my study is open. The house is currently a bit busy, but the background noise is just there. There is a perceptible difference in my ability to focus. I used to have the habit of listening to music, either classic or retrowave, when writing or working from home, but it seems this is no longer necessary.

10:37
Background noise appears a bit muffled. I am doubting my own perception, though. I start to work on an article for my blog as I want to see how productive I will be when I am on these meds.

10:52
My wife walks into my room for some idle chatter, interrupting my writing. I can easily shift my attention to her and back. The moment she leaves, I return to writing, hardly missing a beat.

11:05
I am noticing a minor headache, perhaps a mild migraine.

11:15
I have finished writing the first draft of article for the blog. My phone was on my desk the entire time and I did not feel the urge to look at it once. Also, when I looked up a YouTube video for that article, I was able to go to that website, quickly identify a suitable video, and continue writing. Normally, I tend to get sidetracked a bit, for instance by at least skimming the channels of some of the creators I follow.

11:35
Within an hour, I have not only written but also edited a 1,300 words article for my blog. This is perhaps just half the time I otherwise need. While writing I did not even hear any noise around me. Now that I am done writing, and tooking a moment to reflect, I notice the sounds of the radiator and some background noise in the house.

11:45
I cannot help but think that I am a lot more mellow on methylphenidate.

12:10
I just published a 500-word piece, which I wrote and reviewed in 20 minutes, without listening to music, and despite some background noise at home. Methylphenidate seems to be a very potent drug.

12:38
I just published a 770-word piece, which I wrote and revised in 25 minutes. On a related note, for quite a while I have not had the time or the right setup to work on a book. With methylphenidate, however, I seem to be able to write one article after another, completely shutting out distractions. As a crutch, I used to shut down my web browser in the past. Right now, I have a few dozen open tabs but they just sit there, not tempting me at all to go back to them.

About two hours in, my initial impression is that methylphenidate, even at a rather low dose of 10mg, is potentially life changing. I do not recall having ever been this focused. In the past, I often wrote at night or late in the evening because that is when I normally find peace and quiet. This approach is not compatible with having a day job, though. In the last two hours I have already written more than in the last two weeks combined.

Speaking of side effects, the headache has subsided but my head feels a bit odd, as if it has been packed in cotton wool. I also feel some tension in my masseter muscles, but I do not clench my teeth, or at least I was not aware of it while writing. I will ask my wife to observe me for the next 30 minutes or so and tell me what she notices. My mouth also feels a bit drier.

13:00
I just spoke to my mother-in-law. In general, when I speak to people and the conversation is of the idle chit-chat category, my mind wanders quickly. I noticed that this still happened, but to a much lesser extent. On that note, 10 mg is the lowest dose for methylphenidate, so I wonder how much more I will be able to suppress distracting thoughts with a higher dose. In fact, this is probably the biggest benefit of this drug: you fully focus on whatever you are focusing on and you are not really concerned about anything else. You can even shift your focus back and forth with ease, reducing the cost of context switching drastically. As mentioned above, my wife walked in on me earlier when I was in the middle of writing an article, so we briefly spoke and I returned to the article I was writing on right away.

13:20
Fifteen minutes, 500 words. Methylphenidate is incredible. I also notice that the effect is starting to wane as I am getting a little bit more distracted by background noise, and I just caught myself wanting to click on some random links in my browser.

13:40
I just finished some errands, quickly and efficiently, fully focused on the task at hand. Performance gains are not comparable to writing but even my errands were done faster.

14:00
I start watching a movie in order to see how my perception changes. I opt for an Hollywood action movie. It is not deep but I am able to pay full attention. Without my meds, I may have stopped watching it after fifteen minutes or moved on to doing something else. Of course, it is a matter of debate if this effect is positive or negative.

Beyond
The effect of methylphenidate is supposed to last about four hours. This is perhaps on the short side. After about four hours, I certainly noticed that the effect was no longer as strong, but there was still a clear difference compared to my unmedicated self. Probably only after about seven hours had the effect completely worn off. I am currently revising this article, at around 20:30, and I notice how my mind focuses on subtle sounds around the house. I also perceive the very low radiator noise constantly.

The side effects I experienced were minor. There was some migraine-like headache that came and went. The feeling of my head being packaged in cotton wool persisted a lot longer but this was not particularly concerning. In fact, without actively paying attention to it, I barely noticed it.

I have been reading that people often feel a bout of euphoria when they start taking methylphenidate. I cannot confirm this at all. My mood was completely unchanged. Similarly, I cannot confirm a lack of appetite. If anything, I ate slightly more than usual, probably because I was a bit more active today than I otherwise may have been. I also noticed that I had to yawn twice at around 16:00, which I found highly unusual. I had slept well last night. Perhaps I was expending too many calories. Another hypothesis is that this was due to the drugs waning, i.e. only at that point did it hit me that the movie I was watching was not all that engaging.

In summary, my first experience with methylphenidate has been highly positive. I almost get a bit wistful looking back at the past. Arguably, my life could have taken a much different turn had I been put on this medication twenty or twenty-five years ago, but not thirty years ago as one side effect of long-term use is inhibited growth. All throughout my adult life I have been having the problem that I care little for tasks I perceive to be a slog. I did pretty well academically, but on this drug I probably would have done even better. I would likely have found it much easier to pick a field and, more importantly, stick with it. I could probably have been much more well-adjusted with methylphenidate, with the consequence of leading a pretty normal life. I recall not wanting to hang out with women because their blathering gave me a headache. Well, this can be medicated away. This blog and my somewhat bizarre life story most certainly would not have happened on methylphenidate. In a parallel universe I am probably the accountant Aaron S. whose biggest ambition in life is to fit in.

19 thoughts on “Methylphenidate: Day One

  1. Thank you for writing this, this is very informative.

    “All throughout my adult life I have been having the problem that I care little for tasks I perceive to be a slog.”

    I have the same problem, if it is a problem. Avoiding time-wasting makework (as most modern work is) can motivate you to find better work. One writer, I forget which, said he could only seem to focus on writing when he was procrastinating on something else that he saw as a waste of time. The more worried he was about putting off the time-wasting task, the better was his focus on writing. I’ve noticed the same tendency in myself, not just with writing but other productive/worthwhile undertakings.

    Your point about context switching is also an important one. Paul Graham writes that if you schedule a programmer for a meeting, you cut his productivity for the day in half, because his brain will never really focus on his work so as to reduce the pain of context switching for the (usually unnecessary) meeting. Two meetings, and you shouldn’t even bother having him come in to work that day.

    Of course, the modern workplace is feminized, and therefore chock full of meetings, and it’s no wonder nothing gets done. I once looked at my female manager’s Outlook calendar, and her entire work week consisted of nothing but meetings. Women are good at multitasking because they have to be to raise kids, but it’s a terrible way to organize the workplace.

    1. Women can not really multitask either. They are perennial busybodies. Your remark on context-switching in the context of programming is most relevant. Normally, software development consists of adding to an existing code base, or making a modification to it. The closest analogy is making a change to a book or a master’s thesis you have not written, in a time frame that makes it impossible to understand the whole project. In fact, many software systems are so complex that you can no longer understand them completely. Unfortunately, non-technical managers do not seem to understand this at all. Even a concept like “hidden complexity” is foreign to them.

  2. This is someone else right? This is not Sleazy, right?

    There are references that resemble Sleazy.

    Hope everything is fine for him.

  3. I’m envious. It gave me tics that started once I was 10 or 11 (side effects including the lack of appetite kicked in immediately when I was put on the drug at 7). Wish it were an option for me. Need to score some modafinil as I seem to tolerate that one better. It doesn’t help me focus AS much as ritalin, but it does help.

    1. Stimulants for children is a much different issue. There is also a trend to sedate boys, basically because they want to move around and not be forced to sit still. This is yet another example of school being designed around women, i.e. female teachers and the girls in the classroom.

  4. Are you still meditating? Does meditation help with concentration? I’d think it would help although not to the same extent as ritalin

    1. I thought about asking the same thing, honestly. I think Aaron’s mentioned to me that he no longer meditates as much as he used to.

      Ramping up the practice might be a potential solution. Then again, maybe its not practical for him to dedicate 6 hours of his daily routine to meditation anymore. (because he has more responsibilities to take care of now.) Medication in this case is the more practical solution.

      Come to think of it, I imagine your wife might not particularly appreciate you going back to that Meditation routine again. Would certainly take away bonding time between you. haha.

    2. I still meditate. Also, I think that my baseline regarding my ability to focus is pretty high. It is not as if I am unable to function. However, there is an obvious difference with Ritalin.

    1. I had to look up these medications, but I am not sure I follow what is going on. Bupropion is an antidepressant whereas Atomoxetine is an alternative ADHD medication. If your psychiatrist is willing to prescribe you that, then what is stopping him from handing out a prescription for methylphenidate, which is a far more common prescription?

    2. I would not use arbitrary labels such as “antidepressants” or “ADHD medication” if I were you. Bupropion and atomoxetine act mainly as norepinephrine reuptake inhibitors and only to a lesser extent as dopamine reuptake inhibitors. However, norepinephrine reuptake inhibition can indirectly promote dopamine release. Methylphenidate acts primarily as a strong norepinephrine–dopamine reuptake inhibitor (NDRI) and is a superior medication. In Germany, methylphenidate is subject to narcotics regulations and therefore requires a separate prescription. No doctor prescribes it “only” for restless legs syndrome. I myself suffer from restless legs syndrome, which is caused by a hypodopaminergic condition.

      Combining a Dopamine Agonist (e.g. Pramipexole) and a Noradrenaline-Reuptake-Inhibitor might be a wise course of action.

    3. I appreciate the clarification. Your initial comment made it sound as if you wanted to get a prescription for methylphenidate and the medications you got are substitutes.

    4. Neither. Methylphenidate would certainly be worth a try, although dopaminergic drugs are generally associated with the risk of augmentation, i.e. the drug loses its effectiveness and you are worse off afterwards than before.

      This is the reason why I hesitant to try dopamine agonists.

    5. I spent quite some time on looking into existing research on methylphenidate. From what I gather, drug tolerance is often observed in people who take excessively high amounts, and then it may happen within days or weeks. Also, tolerance seems to develop primarily in people who take such medications for their performance-enhancing aspects and not in order to treat ADHD. There are longitudinal studies showing that over a time span of ten years, about 98% of patients did NOT experience a loss of effectiveness of treatment. With responsible use, which includes taking “drug holidays”, I think that the risks are quite minimal, both in terms of long-term side effects and building up tolerance.

  5. Whoa.
    Lookout! Sleazys on speed!

    This whole blog gonna change bros.

    “A chaaaange is gonna come”🎵- Sam Cooke

    Hope it works for ya Aaron – sounds like it’s pretty effective. Can’t beat that meth!

    Just don’t start crushing it up and smoking it outta a glass pipe ok. Stick to the dosage!

    1. Just to be clear, methylphenidate is different from amphetamine. “Meth”, i.e. crystal meth, is an entirely different category. On a more serious note, methylphenidate should not be prescribed to patients who are prone to addiction. My psychiatrist’s assessment was that he does not even have the slightest indication that this is the case with me. Otherwise, he would have tried a different medication. According to him, all alternatives to methylphenidate for treating ADHD are less effective.

    2. I know mate . Just kidding around.

      From the wiki I just read this Ritalin seems like ‘speed lite’ . Street speed would be much stronger hey. And crystal meth wayyyy stronger.

      I would never mess with meth. It’s stupidly addictive from reports. An a big problem here down under in Aus. Some country towns have been overrun with an “Ice” epidemic. A very dirty drug.

      I’m on a low dose of ‘Sertraline’ . It’s an anti anxiety Anti – Depressant afaik. Works well and the least side effects of all I have tried over the years. I don’t like trying depression meds tbh. The much touted theory of brain chemical imbalance /Seratonin / dopamine reuptake etc has never actually been proven and many sources say it’s incorrect. There are many side effects to the commonly precrisbed and most popular Depression meds. Most worryingly low libido , genital numbness and inability to cum or ED.

      Now THATS one hell of a bad side effect !

      They’ve given it a syndrome name PSSD or something. I’m sure u know this tho,

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