RUBIK
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Post by RUBIK on Jan 9, 2017 20:08:12 GMT
Day 9
Last Tuesday, I returned to work (and thus back to a routine!) and began taking Strattera. I started on a 40mg dose in the morning, with the intention of moving up to 40mg x2 a few days later.
Almost immediately I was hit by the tiredness that seems to be so prevalent. Mephylphenidate kept me awake all day, and I often didn't feel tired until after midnight or so, but was still able to maintain a 7am start with no apparent negatives. Strattera seemed to do the opposite, it felt like all my tiredness had caught up with me and I found myself struggling to stay awake, let alone focus, while at work. I found myself daydreaming, and nearly fell asleep a few times, but managed to ultimately get through. After moving up to 8mg a few days later, I found myself napping after getting in from work. I'm someone who can count on one hand the amount of times I've slept during the day in the last 20 years, so this was a very big surprise to me!
I had a lot to do at the weekend, so I decided to take 20mg of MPH IR in the morning to help me out, giving the Strattera a break. Needless to say, it worked a charm, and I got that famous appetite loss too meaning I almost didn't get any lunch (boy would I have regretted that later). I began to wane later in the day, but it was enough to let me know that MPH clearly was more effective than I ever realised.
Back on 80mg Strattera today, and I'm really just counting down the days until my next review, and hoping we can get back on the stimulants. I think I've got an idea on how this drug is supposed to work, as I've felt a certain degree of clarity a few times. The best way I can describe this is I feel like my mind is working in slow motion, it has a calming effect that gives off a feeling of content. It reminded me very much of SSRIs, and as I understand it the mechanism is similar, so that makes sense. I didn't find this feeling very productive, as my mind still wonders, I just feel it gives me more time to contemplate my thoughts.
I imagine the effect will get stronger over time, but I have to say I much prefer the stimulant mechanism. I'm happy with racing thoughts, having an active mind defines my personality, and MPH gives me the power to take control of my mind and direct the thoughts as I choose. I can only hope that moving up to dex or something similar allows me to get even more consistent control than MPH was able to give me.
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RUBIK
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Post by RUBIK on Jan 1, 2017 18:30:37 GMT
DAY 1
Yesterday turned out to be particularly stressful for me (New Year's Eve). Just to give you some background, I've been having increasing difficulties in my personal relationships that I've been trying to iron out. I've always had difficulties in social situations (I now understand that this is likely an ASD thing, but that's the least of my worries compared to the behemoth that is ADHD), but since receiving treatment I finally realised I can take more control of my personality and that's been a focus of mine for a while. Sadly, as soon as I've stopped taking MPH I'm back to square one, only I've forgotten all my old coping mechanisms so I'm basically worse than ever. The main issues for me are as follows: - Uncomfortable in social situations generally.
- Find it difficult to "small talk".
- Am more than happy to respond to questions, but completely forget to return the favour. (E.G. Q. Have you had a good Christmas? A. Yes thanks, it's been great.)
- Become uncharacteristically talkative when conversations interests me, which is in stark contrast to most other issues.
- Respond impulsively and without being able to observe the reactions of others.
Before treatment I got pretty good at "faking it", but on MPH a lot of these issues just generally improved. I was more "self aware" when speaking to people, and could actually keep a train of thought going while speaking and listening without being distracted. That's gone, and I've forgotten how to fake it, so I've become a boring robot that can't stop thinking about other things when I'm not particularly engaged. I'm not concerned about this long-term, as I know it's going to be dealt with and I'll be fine, but unfortunately the people around you often notice the negatives and obviously don't share the same enthusiasm and forgiveness. I've now been made aware of my behaviour and am quite upset at the impact it's had on those around me who've falsely believed I've not enjoyed the Christmas period and have been generally negative. Thankfully things are good now, and it's made me more determined than ever to get things sorted and improve who I am. But it's a stark lesson that as long as medication is part of my treatment, things can go back to square one at any time.
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RUBIK
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Post by RUBIK on Jan 1, 2017 18:10:51 GMT
Hey marionk, happy new year to you too!
What you say about MPH does indeed sound bang on. The munchies bit tickled me as that's the perfect description for it. I only realise now I'm off it how it reduced my impulses for snacking throughout the day! I think overall it did help me sleep better, but I found myself staying up much later on it, but I think that's in part due to my increased alertness and desire to get things done later in the day.
It's really unfortunate to hear about your experience with Strattera, and even more so about the difficulties you're facing now. I get the impression from my specialist that they don't particularly expect atomoxetine to be successful, but it's a matter of course that I try it first as in a small amount of patients it does the trick. I hope if there are any negatives they aren't nearly as bad as you describe, but I'm wisely waiting to start after the festive period just in case! I was very worried as MPH started to lose it's effectiveness that I'd be stuck on it due to finding it moderately effective, but I was reassured that if necessary, we can try everything available until we find something that I'm happy with, even if that means going back on MPH at the end. I was under the impression that the NHS could only give me a limited number of appointments during this process, but I was told in no uncertain terms that it'll take as long as necessary. Of course, I need to commit to something I'm happy with as I'm unlikely to get this opportunity again when things switch to shared care and I only see the specialist annually.
I received a very useful leaflet about the types of medication and order of treatment that my local NHS trust uses, I haven't seen anything like it posted on here so I'll have to scan it at some point. I believe my NHS trust is under the umbrella of Cambridge and I know a lot of work is done at Cambridge University on Adult ADHD, so perhaps it's for that reason that they are a little more progressive than in some other areas of the country.
It sounds like you've got a plan to move things forward at least, and I appreciate now that having a plan can make all the difference.
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RUBIK
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Post by RUBIK on Dec 31, 2016 13:19:11 GMT
DAY -1 (Yes, a prologue if you will)
Having been in medication limbo for the last week, I've taken 20mg of MPH IR this morning to try and kickstart my day and tie up some loose ends before I go back to work next week. I'm currently finishing up around 2 weeks supply I have of Concerta XL and IR MPH that I still have before starting Strattera.
I've had some positive reactions to MPH, but I've seen diminishing returns as my dosage has been increased. Having spent a few "controls" days in the last couple of weeks with no medication, there is undoubtedly an improvement when I'm on MPH over nothing at all, but apart from a few days early on in my treatment, I've been unable to consistently control my focus. As I'm nearing the maximum dosage, I decided to try the next line of medication rather than wasting a month or two on MPH. I'm comforted by the fact that my life on MPH would still be an improvement, but I'm hoping I can find something that gives me results a lot more consistently, especially when I need them most.
I don't particularly like the sound of Strattera, especially as I've done so well on stimulants so far, but it appears to be the policy of my NHS trust to prescribe Atomoxetine as second line before moving onto amphetamine type treatments. I'll nonetheless approach things with an open mind. I worry about the tiredness, as that's something I tend towards anyway, and the stimulants have been great for me to overcome that. Strattera sound similar to SSRIs, and I had big issues with tiredness on those, so I can't say I'm confident.
To be honest, the fact I'm writing this is a big clue that the MPH isn't doing so great. I have a lot more important things to do, yet my mind has wondered a long way to get to this point. I have an important assignment to complete in the next couple of days, but it feels like I've regressed to pre-treatment levels of attentiveness where I just can't control myself. After posting this, I'm going to get up and make a start. Before Christmas, I had taken to writing lists with some success, so maybe I need to get my little notebook out and plan today out properly while I still can.
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RUBIK
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Post by RUBIK on Dec 31, 2016 13:08:14 GMT
Good afternoon all. This seems as good a time as any to start a diary. Tomorrow is the start of 2017, which for me is likely to be a very eventful year.
I was diagnosed with inattentive type ADHD a few months ago, but that was the culmination of almost 2 years on an NHS waiting list, and over a decade of having my life influenced by this invisible disorder.
I am very fortunate to be in a good place right now, and I've managed to get where I am despite the things that try to hold me back. I've battled depression before, and I'm finally in a place where I can let go of my past shortcomings and failures and accept the things I have managed to achieve. Looking forward, I know that now I'm getting to grips with who I am and what my needs are, that I can hopefully fulfil my potential going forward and live a more peaceful life than I would've otherwise had.
ADHD led to me failing at school, letting down friends, family and teachers, barely getting into university and then dropping out anyway. It tore down my confidence and destroyed my aspirations. When I finally realised what was wrong with me, it started this upward trajectory I am now on. The vindication I felt when I was officially diagnosed has boosted my confidence to no end.
Right now, my focus is on getting the right medications and learning to live with the needs that I have. This diary is going to be a place for me to record where I'm at and how I'm doing, and hopefully it'll help me to reflect and see how I've been doing over the next year. I'm probably not going to post every day, but I'm going to try to check in at least weekly for my own benefit.
Hopefully there's some value in my ramblings that might help others. At the very least, it might give someone else some context if they're starting on this journey too. I scoured this website like mad when I was first thinking that I might have ADHD, and I can only help that my experience might help others too.
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RUBIK
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Post by RUBIK on Dec 21, 2016 18:39:26 GMT
Hello all. I've been a lurker around here for a couple of years, dropping in from time to time when I've been looking for some information or advice. I'm at a place now where I think it'd be beneficial to share my own experiences, or at the very least have somewhere to write them down in the hope that it'll help me reflect. I imagine I'll set up a diary post soon, but to summarise my journey so far: - High achiever at school, inattentiveness caused issues as I got older (teachers assumed I was gifted, but lazy).
- After a couple of bouts of depression (low self-esteem due to perceived "laziness") I realised it was ADHD, not me, that was the problem.
- Recently started treatment (medication only), things are going well so far but a long way to go.
The above is a very cut down version from what I originally typed (I've included that below if anybody is interested!). I know that I can get too carried away at the best of times, but I know that you bunch in particular would prefer succinctness so I'll try to keep that up! Thanks, and I hope to speak to you soon. (Extended introduction) - High achiever at school from a young age up until ~16 years. No concerns about mental health.
- 16-18 began to significantly underachieve during A-Levels. My inability to study outside the classroom suddenly became a serious issue.
- Managed to get into University via clearing at 18 (failed to be accepted at any of my previous choices due to bad grades). Previously unnoticed anxiety and depression kicked in.
- Dropped out of university within 6 months. Received treatment for depression, including counselling. Began work full time at my weekend job, with the intention of making a career out of it. Rebuilt relationships with family that were damaged by my failures.
- 3 years or so later, I was frustrated at my lack of progress at work (career opportunities were non-existent due to economic climate) and I wanted to do something intellectually stimulating again.
- Enrolled on a foundation degree course in my original uni subject with the intention of entering my dream career. Found employment in that field and have been supported well in that department ever since!
- Within the first year of the course, started having the same difficulties I had back in school. I wasn't happy to accept I was "just lazy" as I had been told before. Did some research. ADHD was clearly the problem, but I generally accepted that my difficulties were not something I could control.
- Saw my GP and explained my issues, mentioned ADHD. He was impressed with my research and conceded that it did fit the criteria, but he wasn't sure what I hoped to achieve. I told him if it was ADHD, at least I could get treatment and maybe improve. He put in a referral.
- 18 months later, I finally got to the front of the 6 month waiting list. Diagnosed as inattentive type in my first session.
- Started MPH (extended release in morning, immediate release in afternoon) and increased dose accordingly for first few months.
- Recently switched to atomoxetine due to diminishing returns with MPH. Starting this very soon!
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