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Post by conceptuallycurious on Nov 18, 2016 22:59:13 GMT
I've been taking MPH (Medikinet) for almost two weeks now at really quite minuscule doses, as the psychiatrist is being quite overzealous about safety owing to a lack of research about combining it with another medication I take. So far it's dried up my nose a bit which isn't so bad considering that I've got a cold.
Week 1: 2.5mg AM | 2.5mg PM Week 2: 5mg AM | 2.5mg PM
I'm wondering when other people started noticing that they'd taken a dose (as opposed to reaching an effective dose).
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Post by ForgotMyLogin on Nov 21, 2016 14:03:33 GMT
I assume you're on the immediate release tablets, not the Medikinet XL modified release? I noticed side effects on day one with mild improvements to my focus, but this wore off immediately after that.
I switched to 27mg Concerta XL with a 10mg topup for the PM and that's when it really clicked. In my case, doses have lost effectiveness after 2 weeks and I've been getting it increased every 4 weeks at the moment.
In some ways I've been fortunate, as the side effects have been mild, but a good indicator of how my body has adapted to the drugs. My appetite loss and headaches are proportional to the benefits I've received, so I know when one goes, so will the other. I'm just hoping my body can settle on a dose before I hit the maximum!
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Post by conceptuallycurious on Nov 21, 2016 23:26:35 GMT
Thanks for your reply.
Yes, it's the immediate release version - she says she wants me on a stable dose before I switch to XL (if I choose to) to have a better idea of how I react to it.
I hope your body settles on a dose too!
I'm beginning to fret I won't respond at all (side effects or desirable ones!) but it's early days. I've seen some suggestions online that my medication might cancel out MPH (it's designed to do the reverse of MPH - reducing the dopamine and serotonin) but it doesn't seem to be in the BNF book.
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Post by conceptuallycurious on Jan 15, 2017 18:32:18 GMT
Well, my psychiatrist continues to be paranoid about my dosing.
I am now on 20mg +10mg IR. I'm not sure that I'm seeing any benefit. I certainly didn't on 15mg +10mg which I was on for three weeks over the Christmas period. Except when I forgot to take it for four days and then took a dose - that made me feel a bit antsy? Like a busy sort of anxiety but not? By the next dose I was back to no effect. (I did tell the psychiatrist about this.) But now I'm driving myself slightly nuts trying to see if I'm improving or if I want to think I am.
I don't have a period where I notice it working, nor a period where it wears off. I think that maybe I feel marginally less sleepy? But then, I find a shower and being awake for the same amount of time is equally effective if I forget to take the dose until later in the day... I don't have any subjective side effects, nor have my pulse rate or blood pressure changed.
Will have been on current dose for two weeks at next dose increase. I was really hoping to be on a stable dose by the time I go back to university on the 27th of January.
Psychiatrist is planning to switch me to a extended release tablet once I'm on stable dose to minimise me forgetting to take the afternoon tablet. Mostly concerta as it's 30% IR/70% XR whereas Medikinet (my current IR brand) XR is 50%/50% which won't see me through until my evening lectures.
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Post by computermandan on Jan 25, 2017 20:05:16 GMT
I'm a little bit in No Mans land myself... I was prescribed by gp on maudsley recommendation... gp just kind of left me to it... at one point got to 60mg twice a day - but i rechecked the maudsley letter and it said a max of 100mg a day... been waiting months for a review because GP cant/isnt qualified to make a decision. It must be helping because I stopped for a month and family noticed return of symptoms. So im still taking it but at 20mg x3 for now.
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Post by marionk on Jan 26, 2017 13:27:03 GMT
Well, my psychiatrist continues to be paranoid about my dosing. I am now on 20mg +10mg IR. I'm not sure that I'm seeing any benefit. I certainly didn't on 15mg +10mg which I was on for three weeks over the Christmas period. Except when I forgot to take it for four days and then took a dose - that made me feel a bit antsy? Like a busy sort of anxiety but not? By the next dose I was back to no effect. (I did tell the psychiatrist about this.) But now I'm driving myself slightly nuts trying to see if I'm improving or if I want to think I am. I don't have a period where I notice it working, nor a period where it wears off. I think that maybe I feel marginally less sleepy? But then, I find a shower and being awake for the same amount of time is equally effective if I forget to take the dose until later in the day... I don't have any subjective side effects, nor have my pulse rate or blood pressure changed. That's about the same as for me. I'm taking 2x20mg pretty regularly, but if I forget the second dose too many days in a row, I do notice it's not enough eventually, or if miss a whole day I will know it by the following morning. Also I don't sleep so well if I haven't taken the whole 40mg. The paradox of it helping me to sleep without making me any sleepier while I'm awake always brings a wry smile to my face when I think about it. I guess it 'improves homeostasis'. eta, More paradox, my psych was quite happy for me to monitor my own titration, just made sure I would phone him immediately if I felt anything was 'off' or I started going psychotic, but he won't prescribe anything other than mph or atomoxetine. :?
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Post by conceptuallycurious on Feb 1, 2017 15:52:09 GMT
I'm jealous.
Mine is constantly having a prescribing crises. The consultant above her (who she discusses my case with) told her to ignore the 60mg/day limit and that 100mg is recommended for adults though obviously the whole thing is unofficial/off-label.
She, on the other had, has only once prescribed over 50mg/day and twice over 40mg/day. She doesn't want me any higher than 40 + 10 or one 50 dose in the morning. She'd prefer to keep me on 30mg + 10mg even if it is not the most effective dose though.
So pissed off. Apparently she was going to throw to towel in at 25 + 10mg, but I accidentally combined 20+10 and found that I noticed it.
Really frustrated. I admit that I'm not responding well, but I hate that her ideals about dosing are more important that my wellbeing. I really don't want to do the atomoxetine shebang.
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Post by conceptuallycurious on Mar 18, 2017 21:52:28 GMT
After 4 months and a very angry workplace after all the work I've missed, I decided that enough was enough and nervously requested a second opinion.
The new guy is less anxious about prescribing. I was approaching the limits of where they'd switch for no response, as I first 'noticed' it at 30mg + 10mg.
I am currently trialing 50mg + 10mg to see if we can get a single effective dose. I would settle for 40mg but am trialing to see if irons out of some of the remaining symptoms before working on the afternoon.
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Post by marionk on Mar 19, 2017 11:57:25 GMT
I understand completely why you want to have one dose only, but one big dose (IR) is more likely to lose it's effectiveness than smaller doses spread through the day. You should ask about extended release forms if you are having trouble remembering to take the second dose.
Personally, I have found that massively increasing my protein intake has been more effective against dopamine deficiency than mph ever was. mph does still seem to have some effect on my sleep problems, but I have yet to investigate fully, having not taken any mph for a week or so it is now time to start taking it again and see if it give me any further improvement reliably.
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