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Quick update on the ADHD. Saw a psychiatrist today who had already reviewed my diagnosis report, so the session was spent a lot talking. At the end we both agreed that methylphenidate would probably be a better choice among all the stimulants because I’m really prone to becoming irritable, as it has less severe side effect potential compared to amphetamines. He recommended I start with 5mg twice a day. I preferred 10mg tablets because I can just halve them and save money, and if needed I can easily up the dose. My plan is to only use the drug twice per week and evaluate how it’s affecting me.
Also, the good doctor gave me the tip to use goodrx.com for coupon discounts. You can get a 30 day supply of methylphenidate for around $12-25 depending on the pharmacy.
Welcome to the club! I also can get a bit irritable at times, not nearly to the point of having anger management issues, but stupidity sometimes annoys me. Meditation has helped me a lot in this regard, of course. Nonetheless, to some extent this has been a problem for me all my life. On MPH, I still notice morons and idiotic decision-making all around me, but I am emotionally detached instead. I am a more agreeable person on MPH.
Here in Europe, doctors are strongly opposed to prescribing you a higher dose of whatever meds you are on to help you save money. There are two main reasons, as far as I can tell. One is their sense of responsibility. If you are supposed to take a dose of x, but you get a prescription for 2x, with the expectation of cutting your pills in half, how can your doctor guarantee that you will do this every time or that you manage to always perfectly break pills in half? This may even be a liability issue. Also, it is not generally the case that the active ingredient in your meds is evenly dispersed, so even if you manage to cut your pill into two identical halves, you cannot guarantee that the amount of the active ingredient is also perfectly split between both halves. The other reason seems to be your medical record. If you are supposed to take a certain dose then there would be a discrepancy if there are suddenly prescriptions for twice the amount. In the case of MPH, my psychiatrist offered to issue two prescriptions at once the last time, basically a two to three months supply, based on my progress, i.e. stable health and virtually no side effects; me coming across as a responsible adult probably also helped.
I have a really busy week behind me, so much so that I took 2 x 10 mg on four days, and 1 x 10 mg on one day. I am extremely pleased with the outcome. For instance, I had to brush up on a complicated technical topic I used to be quite well-versed in but had not done any work on for a few years. On MPH, this took me less than two days. Without it, about a week to a week-and-a-half would probably have been more realistic. When you work on a topic deeply and for a long time, you enjoy staggering compounding effects of your learning efforts, i.e. if you are able to fully focus for seven to nine hours in a day thanks to MPH, you get a lot more done compared to getting perhaps three to four hours of serious work out of a day. Numerically, you may think that three days of the latter may be as effective as one day of the former, on MPH, but it’s probably closer to around five or six times, i.e. 1.5 days vs seven or eight days in the aforementioned example.
Regarding consumption of MPH, I have found that taking it about 45 minutes before a proper meal, or at least a bowl of muesli with a copious amount of full-fat yogurt, leads to the best results, i.e. I perceive a more steady rate of absorption. There is also the recommendation of taking it with a bite of food. This leads to faster absorption, i.e. it kicks in a bit sooner, more intensely, but it lasts less long. Taking it without any food is probably not a good idea. I have not tried this and do not plan to. Presumably, the effect kicks in really quickly but you only get about one to two hours out of it. Also, I read conflicting reports about interference due to vitamin C. I can confirm that it is better to avoid it. Oranges are not a good idea but I noticed reduced effectiveness even when taking MPH together with a banana. When eating an orange, the effect was greatly diminished.
Aaron:
It’s a function of the pH-level. Since oranges and orange juice are quite acidic, that’s likely the cause of the decreased effect you saw.
If you try taking the medication along with something basic, you should see an increased effect. You could try taking it along with a calcium tablet, or one of those tablets of a basic nature that you use for an upset stomach. That should neutralize the negative effects of something acidic like orange juice, at least partially, without interacting with the medication.
If you take something like that along with the medication, but without anything acidic for it to neutralize, you may just see an increased effect of the medication overall. Whether that would be a positive or a negative would depend on the individual and his situation.
Thanks for your input. I had not thought about this angle, nor did I look into it further. I had come across some remarks about vitamin C and MPH online, so I decided to see for myself if there was any truth to it. I find the approach you suggest interesting, but I am not sure I want to engage in this kind of experimentation as it seems error-prone, compared to taking my meds as prescribed. Besides, I can easily sidestep the issue of acidic food by avoiding its consumption. Also, I do not need to find workarounds to get a stronger effect as I am totally fine with 10 mg, as long as I do not eat oranges and other acidic food, presumably. My psychiatrist recently even suggested that I temporarily increase my dose to 20 mg, just to see if that would lead to even better outcomes. The reasoning is that if Ritalin works for you, then taking a higher dose would lead to a stronger effect. There is supposedly an optimal or near-optimal amount per individual and, ideally, you should get as close to it as possible. Of course, this has to be balanced with side effects, i.e. if you get much worse side effects, then increasing your dose may not be worth it.
So far, I have not even considered improving my dose. I am really happy with the results I get with 10 mg. My ability to focus goes through the roof and I only experience dry mouth, intermittently, as a side effect. As I take breaks for at least two days a week, I also do not have the problem of MPH losing its efficacy, like it was with one guy I know who speed-ran his prescription from 10mg/day to 80mg/day in three months. I could imagine taking 3 x 10mg on some days, if there is a very good reason for it. So far, this has not been the case.
Is there any possible way to be “invisible/unnoticeable” if you’re big and tall?
Self-defense wise, “invisible” is probably better than “more trouble than you’re worth”. However, for some people, becoming invisible just seems impossible, so the next best thing is being too dangerous or at least too much trouble to victimize.
I’ve definitely just realized another piece of the reason I got bullied as a kid. I TRIED to be invisible, but because I was the biggest and the tallest (and my clumsy mannerisms), it was a strategy that was just never going to work.
I think I’ve said before that one of the things I would have done differently if you sent me back in time is to absolutely demolish the first bully who ever tried me. I most definitely could have gotten away with it at that age.
That certainly would have sent the message to keep me off radar for the rest of my school years, first impressions are powerful. lol.