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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Paulbwell on April 23, 2007, at 10:56:31
After my failed Dex trial, my Psych Doc refused to keep scripting 180mgs Ritalin daily, 3,Ritalin 20SR 3x daily, he added Imipramine to try to lower my dosage. He added 25mgs 2x daily, which he said "would lower my requirement for Ritalin", it's been two weeks and all it's done is diminish the Ritalins effects.
I was never more functional, and upbeat than on 3,20mg Ritalin IR 3x daily=9 tabs daily.
What gives?
Posted by psychobot5000 on April 23, 2007, at 11:21:25
In reply to Ritalin Dosages?-180mgs daily, posted by Paulbwell on April 23, 2007, at 10:56:31
That really is too bad, but that said, I can understand why your doc is wary--standard max doses are usually like 50mg, aren't they? The max Concerta dose is 54mg. 180mg -sounds- like an abusable dose--your doc might feel he/she had to worry about the DEA a little, since it's Schedule II and all...
Perhaps, though I'm not sure what you're taking the methylphenidate for, you could try and persuade your doc to switch you to desipramine--seems a lot more similar to ritalin, what with all its emphasis on noradrenaline reuptake. And might to block ritalin's effects less, too--much less antihistamine and somewhat less 5ht receptor actions, I believe. Seems a more natural complement that imipramine--though you'd want to be careful of your heart.
Best of luck!
Posted by Phillipa on April 23, 2007, at 11:28:30
In reply to Re: Ritalin Dosages?-180mgs daily » Paulbwell, posted by psychobot5000 on April 23, 2007, at 11:21:25
See that's the problem with TCA's the heart issue and if you have a history of cardiac sudden death in immediate family why would I want this med? Love Phillipa
Posted by Paulbwell on April 23, 2007, at 14:42:35
In reply to Ritalin Dosages?-180mgs daily, posted by Paulbwell on April 23, 2007, at 10:56:31
> After my failed Dex trial, my Psych Doc refused to keep scripting 180mgs Ritalin daily, 3,Ritalin 20SR 3x daily, he added Imipramine to try to lower my dosage. He added 25mgs 2x daily, which he said "would lower my requirement for Ritalin", it's been two weeks and all it's done is diminish the Ritalins effects.
>
> I was never more functional, and upbeat than on 3,20mg Ritalin IR 3x daily=9 tabs daily.
It is fact that only 30% of an oral dose of Ritalin is absorbed~10-50%, combined with my over many years use, where a dose is started low and eventually is raised to a satisfactory dose, which then stabilisers.This may seem a highest dose, but i have a rapid metabolism and with some tolerance, a dose only lasts three hours-i don't respond well to SR versions. It is not inconvient taking 3, 20mg tab doses 3x a day considering the benefits.
I am doing well and just wish to continue with this requime, as for now it's assisting my functioning, I just have to show my doc so.
Cheers
Posted by psychobot5000 on April 23, 2007, at 15:37:12
In reply to Re: Ritalin Dosages?-180mgs daily » Paulbwell, posted by Paulbwell on April 23, 2007, at 14:42:35
I didn't mean to suggest there was anything wrong with your original regimen--it totally sucks when you have one that's actually working, and a doc alters it because of some hang up about the drugs' risk, or because he doesn't like a certain drug.
Perhaps you could bring your doctor in some articles on high-dose stimulant use? I think somewhere in Dr. Bob's tips, there are some notes regarding stimulant use that include high dose treatment in some patients.
http://www.dr-bob.org/tips/split/Stimulants-for-depression.html
The specific case mentioned is of an elderly woman taking 100mg dexamphetamine daily--which would be roughly equivalent to 200mg methylphenidate...
> I am doing well and just wish to continue with this requime, as for now it's assisting my functioning, I just have to show my doc so.
>
> Cheers
Posted by Paulbwell on April 23, 2007, at 15:52:27
In reply to Re: Ritalin Dosages?-180mgs daily, posted by psychobot5000 on April 23, 2007, at 15:37:12
> I didn't mean to suggest there was anything wrong with your original regimen--it totally sucks when you have one that's actually working, and a doc alters it because of some hang up about the drugs' risk, or because he doesn't like a certain drug.
>
> Perhaps you could bring your doctor in some articles on high-dose stimulant use? I think somewhere in Dr. Bob's tips, there are some notes regarding stimulant use that include high dose treatment in some patients.
>
> http://www.dr-bob.org/tips/split/Stimulants-for-depression.html
>
> The specific case mentioned is of an elderly woman taking 100mg dexamphetamine daily--which would be roughly equivalent to 200mg methylphenidate...
>
>
> > I am doing well and just wish to continue with this requime, as for now it's assisting my functioning, I just have to show my doc so.
> >
> > Cheers
>
>
Thank you for your support,I am doing better than i have been in a while, Dex was a no go-made me ill. I appreciate different peole require different requirements of treatment. I was at a lower dose, but it was so-so.
Thanks
This is the end of the thread.
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