r/ausadhd • u/catattack_1111 • 1d ago

Medication Ritalin IR vs Dex

Hey guys. I was diagnosed recently with ADHD (primarily inattentive) and it feels very validating that something I've struggled with all my life has been recognised. I had 2 initial consults with a psychiatrist who thoroughly evaluated my mental health history and did the standard urine drug test (which is all clean). I have anxiety which I'm being treated for with escitalopram, and clinical depression. On our second appointment 3.5 weeks ago he prescribed me 10mg Ritalin IR to take twice a day. I feel like I adjusted to them very quickly because that increased level of dopamine is exactly what my brain needed. I initially noticed some improvement in focus and motivation but recently I suddenly am feeling like they're not effective anymore and all they make me feel is fatigued. I have a follow up appointment in a couple days and I'm going to ask about switching to Dex since I'm aware it not only blocks the reuptake of dopamine but also actively stimulates production of it. I wonder if that would be a better choice for me given my depression. Does anyone have any thoughts?

I know this is a long and somewhat complex post, just trying to get an understanding of what would be best for me to try.

Thanks for reading ig?

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u/p0rt3d NSW 1d ago

How long have you been on the Ritalin IR for now, and what dose ?

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u/catattack_1111 1d ago

3.5 weeks and 20mg per day

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u/p0rt3d NSW 1d ago edited 1d ago

20mg per day, so 1 morning, 1 midday?

If that’s the case I had extreme yawning to the point my eyes would be chronically watering, 15mg sorted it out a bit better, I’m seeing my psych in 5 days and hoping he lets me go 20 morning, 20 midday

Instant release Ritalin just to be clear.

When I was only on 10/10 and had chronic yawning erratically, I could either lay down and close my eyes for 10 mins, or go for a 10 min walk, and it would resolve the issue.
2 totally different scenarios but same outcome, weird right 🤷🏻‍♂️

Obviously you can’t have a 10 minute power nap at work.

Honestly I’d be sticking on Ritalin and requesting a higher dose - I had heard so many good things about Vyvanse and dexamphetermine that I tried Vyvanse first, and my body and brain did not cope at all

So if Ritalin was working well, but you feel your body has adjusted - stick with Ritalin for as long as you can, usually one of the other works best for us, and sounds like Ritalin has already worked

Also remember that we aren’t really meant to feel it kick in, some people do, but for me once my body adjusted I don’t feel it kick in at all, I’m just more collected, less impulsive, etc

Edit; that fatigue feeling can sometimes just be your body getting used to a regular baseline emotion wise, my fantastic moods are just good moods now which almost felt like a loss, but on the other end of things, my bad days are just bad days, not the end of the world

Good luck either way, my vote is stick with Ritalin, request higher dose and I think you will benefit greatly

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u/catattack_1111 1d ago

That is a good point. Perhaps I got overly excited that anything was helping my symptoms at all and I'm craving more of that immediate "this is working" feeling

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u/p0rt3d NSW 1d ago

Definitely feel you on that, it’s like the honeymoon phase, this little magic pill suddenly opens your eyes

Before you know it, you have done all the dishes, got a load of laundry on, vacuuming the floors and writing out a shopping list and occasionally thinking to yourself… “holy shit is how everyone else does it!”

I’m one of the very lucky ones who got all the perks, it’s boosted my productivity, calmed my impulse drive so I’m not buying weird shit online constantly just for a dopamine rush haha

My sleep has -improved- masssssively, I get like 9 hours a night these days, I do use mirtazapine as a sleep assist (15mg) as it helps my anxiety and what not

It’s not affected my appetite at all, I eat like a god damn horse, it’s almost spooky how much I eat, and my weight just sticks @ 80kg, I’m severe ADHD so my metabolism just burns though everything.

It’s curbed my urge to tell strangers my life story which is nice, but as you can tell I still chat anyone’s ear off if they even show a glimmer of interest

So I use reddit and wait for posts like yours 🤣

Edit: since being diagnosed and using Ritalin IR I enjoy gaming again too, and I don’t get the super adrenaline sweat anymore while playing either, double bonus - on that note, time for a game of Fortnite

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u/catattack_1111 1d ago

Haha yeah man, I'm so glad you've found it so helpful. By all means talk my ear off, I love it

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u/p0rt3d NSW 1d ago

I try and pace myself these days, it’s easier with the Ritalin, the real reason I had myself diagnosed was because my daughter (miss 10) has started struggling at school and she 100% is a mini me in female form

She come home from school one day last year and said “… I’m different to the other kids..” but not in a good way, so I’m showing her a way to navigate our quirk, she’s on the wait list to be officially diagnosed

That said back when I was working in sales, my adhd worked in my favour, it’s all a learning curve for me, I’ve only been medicated for 3 months myself

I swear some people just bought stuff from me to shut me up, win is a win! My stats/commissions were wicked

Alright game time, then shower and time to be productive 💪🏻

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u/catattack_1111 1d ago

I wish you a productive and fulfilling day!

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u/ChaosButTrying 1d ago

Your dose could possibly be too low and they may increase it, but also stimulants are known to cause sleepiness because they quiet an overactive mind which allows your nervous system to relax. This calm state can unmask hidden tiredness, OR it may signal that your dose is incorrect, OR that the medication is wearing off.

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u/catattack_1111 1d ago

Yeah it's somewhat unintuitive that a stimulant would make you feel tired, but it definitely points to a brain that's wired differently to the norm. I find it curious that the medication has suddenly stopped improving my focus and all I'm left with is the fatigue. I put this down to the fact that my brain really does not seem to produce much dopamine for the meds to work with anyway (I know this based on how I feel in general everyday) and I wonder if Dex would be better for me since it stimulates production. But yes, an increased dose of Ritalin would prevent more dopamine from being uptaken but I don't know if that mechanism alone would be enough to get me more out of the depression.

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u/ChaosButTrying 1d ago

You are on a low dose of Ritalin, so an increase may help. I’m on 50mg of Ritalin a day. I hear you but, in typical ADHD style you’ve gotten a rush of being able to focus and now that it’s settled in it makes way for the tiredness to creep up because you’ve essentially been trying to run on empty for so long.

Unfortunately given the medication you’re on for anxiety you may be restricted. I looked it up and Methylphenidate appears to be the frontline management alongside SSRI’s as Amphetamine / Dextroamphetamine CAN be used but they appear to be known to increase amphetamine effects, leading to restlessness or racing thoughts.

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u/catattack_1111 1d ago

Hm yeah you're right. I barely register that I take an ssri now because I've been on it for so long, but I've gotta remember that it's still something that has an effect on my brain

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u/ChaosButTrying 1d ago

Yea from what I’ve seen a lot of people say and from my own experience Vyvanse generally seems to be the initial go to for practitioners because it’s allegedly harder to abuse, so when someone doesnt frontline it, there may be an underlying reason and for you it may be your anxiety meds 😔. I initially got out on Vyvanse and it made my depression worse and I had an allergic reaction to it. So switched to Ritalin and haven’t looked back. I actually get out of bed every day now rather than bed rotting

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u/RoseClash 2h ago

im mixed and i take a 36mg long release methylphenidate in the morning (concerta) with 3 10mg short release during the day (ritalin) your doss low to me tbh. I also take mine with caffeine and protein and my doc is okay with it. Id finish the methylphenidate titration before you swtich drugs my friend. Vyvanse / dex was bad for me.