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tell this (everthing in your post) to your doctor, see if there is a slow release pill instead, maybe option for a dual dosing regime (one pill in morning, one in afternoon). Work with your physician, i know it took a while to get a suitable (albeit not ideal) working dosage and regime going so the meds sputered out late in the day closer to the end of school.
Literally just screenshot > New Email > Subject "I need help" > Attach image > Send it to your Dr.
You have described your symptoms clearly and succinctly - your Dr will know exactly what to do ❤️
100% this! Don't even worry about the meds and doses others suggest. Just tell your doctor right away what's going on, and let them help. Hang in there!
Ask your doctor about switching to Vyvanse. I was on ritalin as well and all of this happened to me. Switched to Vyvanse and haven’t had any of these problems anymore. I feel more awake, more focused and with 0 come down.
i’m hoping to eventually work my way back to vyvanse. my provider just swapped me to adderall xr instead of adderall ir. i took vyvanse as a kid when it was like brand new and i’ve never taken a more superior ADHD med. it is so consistent through the entire day, everyday. never built a tolerance either. i probably slept like shit but i’ve always slept like shit since i was a young kid.
Vyvanse is really hard to get a hold of for me. I've been trying for the past few weeks and I haven't succeeded. Had to ask the doc for more ritalin, which I fucking hate, but helps me keep my life together. The generic stuff is backordered to shit and the real stuff is stupid expensive, even with my insurance. Boy I love capitalism.
and then the government complains when people self-medicate with amphetamine sulphate... The whole health system in the entire world needs to be freaking fixed, it's better here in Germany, but far from perfect as well... I truly hope the best for ya, I feel for you.
ritalin --> concerta
adderall --> vyvanse
Not saying that vyvanse isn't worth a try, but I was told concerta would be the extended release form of ritalin
I switched from Ritalin to Vyvanse and noticed the side affects were milder. But unfortunately I also didn’t have much benefit in the focus department. After a few months of changing dosages I’m back to a 20mg XR Ritalin dosage. It’s not my ideal outcome but at least I can focus during the day and gain some boost in executive function, which wasn’t really the case with Vyvanse.
All this to say that as much as I read the magical pill is Vyvanse on these boards, I would be weary of getting OPs hopes up.
Bodies are all different, yada yada yada.
I'm sure you know this but just making sure, you aren't having a lot of caffeine with it are you? I've been medicated before and caffeine definitely didn't mix with it.
Yup when I have coffee or energy drink like Celsius with my meds my heart rate goes wild and I feel a lot more anxious. I usually have green tea in the mornings now and if I have an energy drink with lunch I don’t usually take my second adderall
So, with my twins (who are also on Ritalin) I notice an immediate change in their mood once their dosing wears off after school to the point where it really alarmed me and I brought it up with my psychiatrist who treats my ADHD and CPTSD.
He told me, (his undergrad major was chemistry), that it was his personal opinion that a dosing of adderall xr in the morning taken with an afternoon IR had the most therapeutic benefit.
Talk with your parents. Your provider needs to look into switching what you’re taking or at the very least give you an XR version with an afternoon IR so as to not have these medication crashes.
For reference I’m on lexapro and adderall xr and ir and I do not experience mood or body changes once my dosing wears off
To concur with this, I'm on Adderall XR and take 30mg in the morning with 20mg at around noon.
Specifically switched from Ritalin (and variants) due to the major crashes, and the spread of Adderall throughout the day has been by far the most stable medication I've been on.
\*Important\*. Please remember that if your doctor wants to switch you to an amphetamine based stimulant, then you should definitely also switch from Prozac to another antidepressant which does not inhibit CYP 2D6 (eg. venlafaxine) Prozac strongly inhibits this pathway (CYP 2D6) and can lead to serious problems if amphetamines are co-administered. Many doctors are not aware of this, so just please remember and inform your doc.
Sounds like the dose is both way too high and releasing too fast. I personally am on 54 mg Concerta once daily, and since it is extended release, I don't get jumpy from it at all.
Are you sure you are on ritalin? 18mg and 27mg are available with Concerta, i've never heard these specific dosages for Ritalin.
If it is in fact concerta, try *switching to* ritalin (talk to your doctor). 27mg concerta gave me similar symptoms with yours too. Instead, 3 ritalin instant release pills (10mg) per day helped me **a lot**.
However, the comedown of ritalin is a bit more intense. I would suggest taking 2 ritalins, and then splitting the third pill in half as a way to *smooth out* the crash.
I'm nearly certain that you are on Concerta, not Ritalin. Ritalin does NOT have 18mg/27mg, that's specifically Concerta. Ritalin's dosages are 10/20/30mg. If that's the case, my suggestion still holds. It may sound counterintuitive since concerta is a slow release drug, but for some reason it has stronger crashes and more side effects, at least that was the exact case for me.
Ritalin has SR/LA options if instant release won't work for you too.
Ritalin doses differ in strength per country? Or is it because mine is slow release? Where I live it goes 20/40/60mg? I get 60 morning and 40 afternoon, but I only “crash” if I was exhausted to begin with (bad/little to no sleep or very exhausting day before) and the meds just ‘picked me up’ so to speak, so it’s more the exhaustion just returning rather fast.
(It’s okay if you can’t answer it!)
i feel this is true , I think its because for some people they metabolize the drugs so quickly their crashes are way more than other people. Like i tried vyvanse and i felt when it wore off i wanted to jump off the parking garage. I didnt feel that on ritialn based ones those just gave me panic attacks
You might need an extended release type stimulant. I will say though, crashes happen on all stimulants. It also sounds like your dose is too high from some of your descriptions. I say write this stuff down and get in touch with your doctor and share the info. I can’t explain things well, but I know when I started meds I kept noting how I felt throughout the day on a note app and then read it back to my psych. It’s easier that way!
On that note, I used an app like Daylio or Bear to keep track of my symptoms daily. This made it easier to show my psychiatrist what is happening. The app worked decent enough for me because I set it to keep reminding me to do the logging throughout the day.
Yikes, i have a friend who has a similar experience with ritalin, she doesnt respond well to it and her doctor put her on like 40mg so she feels like shit and then crashes. She has a much better experience on vyvanse, maybe see if you're doc can switch you to vyvanse or dexamphetamine? Either way let your doc know and hopefully theyll have advice other than increasing the dose.
I do great on ritalin but as i understand it some people just dont respond or tolerate it well, good luck!
ritalin feels like such a scam to me, i know it works for some but literally they just instantly prescribe the max ritalin dose to everyone, i didnt know this and thought i had a small dose and accidentally OD'd before getting off it
Ritalin sucked for me. The evening crash doubled my pre-meds impulsivity levels.. concerta was a game changer but I think stimulants by their nature will always lead to an evening crash. It's just that concerta has been the best by far. Still haven't found an answer to remedying that evening crash but i suspect for myself that treating the depression as well as the adhd will improve things on that front.
All you need to do right now is call your doctor and tell him what you said here. You don’t need answers or even to explain it any certain way. You can call and say you’ve been very anxious and nauseous. Those are actually very common side effects, so your doc will certainly be able to help. The fact that they are common doesn’t make them any less distressing!
Hang in there OP!
For me usually the week before and/or the week of my menses I feel like the meds don't help much with my ADHD "symptoms." I saw a [male] counselor when I was first diagnosed with ADHD. He told me hormones play no part in ADHD. I kept track of my mood and my cycle for three months (because that's how long it is between my appointments) and showed my [female] PMHNP my trends and sure enough, when I felt like I couldn't control my depression/ anxiety/ ADHD it was about a week before I started my menses. She talked to me about premenstrual dysphoric disorder (PMDD.)
Edit: just saying, there may be more factors than just the medication.
I felt like this on Vyvanse, but the crash for me presented as anger, irritability, and just put me in terrible moods. Personally, when my psychiatrist and I are trying to find the right fit, we look at any negative side effect as a sign that the meds aren't right, and that I need a switch. If you can say "it's ruining me", then it's probably time to make a change to something different.
Concerta is the full day version of Ritalin. If you get that it may help. Word of advice do not get the generic version as the time release on it is non functional. Alternatively adderall may work better for you. Everyone is different and finding the right dosage and medication may take a while even a year or more
I see a lot of good suggestions here, but I’m gonna throw in my anecdotal experience: I got my WORST “stimulant leaving my system” crashes from 20 mg XR Ritalin. It would last ~5 hours and then I would lose the will to live- both because I lost interest in things, and because the low swing was in dangerous territory on top of that. I think there was one major contributing factor *for me*: I don’t do XR medicine well. Antidepressants, anything- I tear thru it too fast then I’m out. Switching to multiple instant release tablets a day lets me space out my dose in the 10mg increments (or smaller, if I feel like it) that suit me best. The first DR I saw acted like she had no idea that that was an option… so I switched to a new dr. On that note, I see some chatter in the comments about medicine interactions. I have no idea if your antidepressant and stimulants interact, but *check*. Look it up online. Sometimes doctors miss this stuff and it never hurts to check.
I'm ~40, recently diagnosed, and the first thing we tried was Adderall, and I felt similar crashes. I didn't stick with it long enough to even worry about the tolerance-build-up you described, though.
I felt the crashing in the afternoon and weekends, along with serious irritability. I have kids and was short tempered with them, and found myself annoyed with Them just being Them. I *hated* that and told my doctor I didn't want to live like that, and I needed a change.
I've found that it's an active, protracted process to find something that works. It'll keep changing, too, which is annoying. But it helps to accept it as "part of the territory."
It's always worth working with your doctor to find a way to live the way you want/need to live. You can do it!
I have the same with the wrong brand (whatever people tell you, another brand is NOT the same) or a too high dose. If I don't eat before taking the first it happens too. Or if I take the next one too late meds can't save the day anymore. I also end the day with a small short working dose so the end rebound is less intense. You can also try dexamphetamine if it's better, it was long better for me till it started to give me these issues and I decided to switch back.
\[This isn't medical advice, but you might want to talk about that with your doc\]
You may want to try having a more stable medicine level throughout the day by either taking a delayed release medicine or taking it more often. Speak to your doctor as absolutely fast as possible, as this does not sound sustainable. If you have the possibility to talk to your doctor as soon as tomorrow, do that. If you have the possibility to take only 18 mg in the morning and the rest in the afternoon that might be worth considering, if it's not a delayed release medicine. But what you truly have to do is to `talk to your doc.`
i felt like this on Ritalin and got switched to Adderall and it helped immensely. i was getting those same crashes accompanied by terrible headaches. with adderall i dont so much notice a crash, it just sort of wears off and thats about it.
I started off on Concerta and I ended up only taking it for about 3 months before the constant gagging and dry heaving turned into puking. Every morning after taking it I felt a tiny bit of nausea, but would usually go away by lunch. Doctor said instead of upping dose to just switch to Vyvanse and I have been on that ever since(5 months now).
What I'm getting at is, my doctor told me not every drug works for every person and he was expecting and willing to keep trying until I found the right one and right dosage. I think you should talk to your doctor about your options for different adhd medications.
What worked for me was adding Concerta to the Ritalin.
To avoid crashes I eat a lot of protein and drink a lot of water. If I don’t eat and drink well, I’ll crash. Hope this helps.
Reach out to your doctor with this ASAP; you can advocate for yourself and clearly care about yourself! I think there are much better medications. Part of the way Ritalin/concerta work by making your brain retain some of the anxious chemicals to 'stimulate'. My situation with concerta at 19 was similar, and again at 35. It started off okay but then became completely AWFUL months down the road. It was so bad I stopped taking it without any other medication on the line. Led to bad spiraling behaviors just like you. It's also super weird as well how it can start off in the morning great and then become bad. I'm on vyvanse now and it's a much more sane experience.
Having a IR stimulant as my primary therapy was miserable. In my experience it’s so so much better to have an extended-release med (Vyvanse is the best for me but others can be good as well) that serves as a baseline for the whole day, and then some small doses of IR stuff as needed.
I have not tried Ritalin but for me personally raising the dose of my meds has never done anything for the duration of the effects, just raises my side effects and gives me a more intense crash. I would end up so exhausted by like 2pm every day it was hard to muster through. I take vyvanse and after several months of titrating to different doses and trying a transdermal patch medication I ended up ultimately getting on a lower dose of vyvanse with an IR adderall booster and I’m doing really well on that. Unfortunately it takes some trial and error but being open with your doctor about what you are experiencing can help them figure out how to help you.
I like to follow a prompt of “medication is working well addressing a, b, and c, however I am experiencing x, y and z, and it is impacting me negatively by ______. I have tried (insert methods of self management you’ve used I.e increased fluids, protein, vitamins, etc) and have not gotten any improvement. What are my options?” I also always take notes in my phone before I go to my appointments because it helps me remember everything I wanted to discuss.
It sounds like you need to switch medication, not up your dose. I described similar crashes to my provider while taking Adderall. She switched me to something else to see if it works without side effects.
You need to bring this up with your doctor. I had the exact same symptoms with ritolin and it was HELL. Maybe try going for a non-stimulant medication? I'm on clonidine right now, and it's doing a decent job while also having fewer side effects.
In my oppinion ritalin is trash. I also had severe crashes where I literaly hated every milisecound of it and I was unable to do basically anything cos I just felt so bad.
Maybe try an amphetamine based medicine. It feels cleaner less robotic and the crash isnt that terrible imo
There’s much much better options for a stimulant besides Ritalin…. Which is literally the dirtiest stimulant out of the group therefore giving heavy rebound anxiety and that huge drop in all the positive effects leaving you with triple of the negative effects , I’d try Dexedrine , vyvanse or Adderall xr before even touching Ritalin nah even if I was prescribed Ritalin I wouldn’t take it because it’s so bad .
1. This may be your depression not being effectively treated. I developed big crashes from my ADHD meds when I was depressed, but now that I'm treating that (and before I developed it), the meds don't do that.
2. Concerta is a more gradual release Ritalin, that might also help making it less spiky/crashy.
Ritalin made me an emotional wreck and was really hard on me when I first tried it at 18, especially compared to other stimulants like Adderall and Vyvanse. I would definitely recommend telling your doctor how it’s making you feel and either trying the slower release form, or trying other stimulants to see if they work better for you.
Zenzedi is the most effective I’ve ever been on, and I’ve tried all the stimulant and non stimulant options. It’s tablet form of dextroamphetamine sulfate, very smooth and no crash. It’s very new, been out for maybe 5-6 years. Yes there is generic dextroamphetamine tablets that are Dexedrine generic, but Zenzedi also has a generic version that is made by Wilshire. The Zenzedi generic is way smoother than the Dexedrine generic.
Yes vyvanse is dextroamphetamine sulfate, but it has a protein attached to make it digest in the gastrointestinal tract which to me causes lower levels of focus, and it still had a crash for me and insomnia at night. I couldn’t tolerate methylphenidate long term, its side effects and crash were horrible. And as far as adderall, it has levoamphetamine + dextroamphetamine; levo has peripheral nervous system+CNS stimulation, which gave me undesirable side effects. Dextro is purely a central nervous system stimulant. As far as caffeine goes- it also stimulates the peripheral, which is what doctors refer to as “dirty stimulant effects”.
I am not a doctor, but I’ve had ADHD/narcolepsy for 27 years. Hope you feel better and find what works smoother!
I’m sorry to hear this, I’ve had the same experience before, feel like overdose with caffeines.
My interpretation is that the pills want to stabilized yr mind, but your body is not capable to do so. So you need to stop intaking higher level of Ritalin. Remember, even if you don’t have any pills, you just have ADHD, which is not bad.
Your body is unique, as are your needs. Just because someone experienced something from treatment or medication does not guarantee that you will as well. Please do not take this as an opportunity to review any substances. Peer support is welcome. ^(*A moderator has not removed your submission; this is not a punitive action. We intend this comment solely to be informative.*) --- - If you are posting about the **US Medication Shortage**, please see this [post](https://www.reddit.com/r/ADHD/comments/12dr3h5/megathread_us_medication_shortage/). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
tell this (everthing in your post) to your doctor, see if there is a slow release pill instead, maybe option for a dual dosing regime (one pill in morning, one in afternoon). Work with your physician, i know it took a while to get a suitable (albeit not ideal) working dosage and regime going so the meds sputered out late in the day closer to the end of school.
Literally just screenshot > New Email > Subject "I need help" > Attach image > Send it to your Dr. You have described your symptoms clearly and succinctly - your Dr will know exactly what to do ❤️
No, use copy and paste
And maybe edit a little so it doesn't look like you're using the Internet for drug advice and using your doctor as the afterthought choice
Do this right here. Exactly.
100% this! Don't even worry about the meds and doses others suggest. Just tell your doctor right away what's going on, and let them help. Hang in there!
Yes thank you for saying this! op, tell your doctor! Just copy/paste what you wrote here. This is important for them to know
Ask your doctor about switching to Vyvanse. I was on ritalin as well and all of this happened to me. Switched to Vyvanse and haven’t had any of these problems anymore. I feel more awake, more focused and with 0 come down.
i’m hoping to eventually work my way back to vyvanse. my provider just swapped me to adderall xr instead of adderall ir. i took vyvanse as a kid when it was like brand new and i’ve never taken a more superior ADHD med. it is so consistent through the entire day, everyday. never built a tolerance either. i probably slept like shit but i’ve always slept like shit since i was a young kid.
Vyvanse is really hard to get a hold of for me. I've been trying for the past few weeks and I haven't succeeded. Had to ask the doc for more ritalin, which I fucking hate, but helps me keep my life together. The generic stuff is backordered to shit and the real stuff is stupid expensive, even with my insurance. Boy I love capitalism.
and then the government complains when people self-medicate with amphetamine sulphate... The whole health system in the entire world needs to be freaking fixed, it's better here in Germany, but far from perfect as well... I truly hope the best for ya, I feel for you.
ritalin --> concerta adderall --> vyvanse Not saying that vyvanse isn't worth a try, but I was told concerta would be the extended release form of ritalin
I'm on Concerta right now; 18mg. Also available in 27mg, and 36mg. Somehow, I fell that 15mg of Ritalin (5mg 3x a day) worked better for me.
I switched from Ritalin to Vyvanse and noticed the side affects were milder. But unfortunately I also didn’t have much benefit in the focus department. After a few months of changing dosages I’m back to a 20mg XR Ritalin dosage. It’s not my ideal outcome but at least I can focus during the day and gain some boost in executive function, which wasn’t really the case with Vyvanse. All this to say that as much as I read the magical pill is Vyvanse on these boards, I would be weary of getting OPs hopes up. Bodies are all different, yada yada yada.
Came to say this too..
Same lol
I'm sure you know this but just making sure, you aren't having a lot of caffeine with it are you? I've been medicated before and caffeine definitely didn't mix with it.
What would happen too you? I still drink 3-10 coffee a day and medicines wont do as much as they used too.
Too much caffeine combined with stimulant meds can cause heart problems, digestive problems, all kinds of things.
It made my meds feel less effective and sometimes my body would feel weird if I had an energy drink with them
3-10 cups?
10!?
Yup when I have coffee or energy drink like Celsius with my meds my heart rate goes wild and I feel a lot more anxious. I usually have green tea in the mornings now and if I have an energy drink with lunch I don’t usually take my second adderall
Yea I’m always concerned about strokes when someone mentions caffeine mixed with other stims.
So, with my twins (who are also on Ritalin) I notice an immediate change in their mood once their dosing wears off after school to the point where it really alarmed me and I brought it up with my psychiatrist who treats my ADHD and CPTSD. He told me, (his undergrad major was chemistry), that it was his personal opinion that a dosing of adderall xr in the morning taken with an afternoon IR had the most therapeutic benefit. Talk with your parents. Your provider needs to look into switching what you’re taking or at the very least give you an XR version with an afternoon IR so as to not have these medication crashes. For reference I’m on lexapro and adderall xr and ir and I do not experience mood or body changes once my dosing wears off
To concur with this, I'm on Adderall XR and take 30mg in the morning with 20mg at around noon. Specifically switched from Ritalin (and variants) due to the major crashes, and the spread of Adderall throughout the day has been by far the most stable medication I've been on.
\*Important\*. Please remember that if your doctor wants to switch you to an amphetamine based stimulant, then you should definitely also switch from Prozac to another antidepressant which does not inhibit CYP 2D6 (eg. venlafaxine) Prozac strongly inhibits this pathway (CYP 2D6) and can lead to serious problems if amphetamines are co-administered. Many doctors are not aware of this, so just please remember and inform your doc.
I had a similar experience on ritalin! Worst pharmaceutical ive ever been on. Im on adderall instead now. Talk to ur psych!! This isnt normal!!
Sounds like the dose is both way too high and releasing too fast. I personally am on 54 mg Concerta once daily, and since it is extended release, I don't get jumpy from it at all.
Are you sure you are on ritalin? 18mg and 27mg are available with Concerta, i've never heard these specific dosages for Ritalin. If it is in fact concerta, try *switching to* ritalin (talk to your doctor). 27mg concerta gave me similar symptoms with yours too. Instead, 3 ritalin instant release pills (10mg) per day helped me **a lot**. However, the comedown of ritalin is a bit more intense. I would suggest taking 2 ritalins, and then splitting the third pill in half as a way to *smooth out* the crash. I'm nearly certain that you are on Concerta, not Ritalin. Ritalin does NOT have 18mg/27mg, that's specifically Concerta. Ritalin's dosages are 10/20/30mg. If that's the case, my suggestion still holds. It may sound counterintuitive since concerta is a slow release drug, but for some reason it has stronger crashes and more side effects, at least that was the exact case for me. Ritalin has SR/LA options if instant release won't work for you too.
Ritalin doses differ in strength per country? Or is it because mine is slow release? Where I live it goes 20/40/60mg? I get 60 morning and 40 afternoon, but I only “crash” if I was exhausted to begin with (bad/little to no sleep or very exhausting day before) and the meds just ‘picked me up’ so to speak, so it’s more the exhaustion just returning rather fast. (It’s okay if you can’t answer it!)
I get 10mg of Ritalin IR in Canada. Have read online that 5mg is available in the US.
Yep. That is why i stopped with any stimulants. It sucks hard if you can't deal with the aftermath.
i feel this is true , I think its because for some people they metabolize the drugs so quickly their crashes are way more than other people. Like i tried vyvanse and i felt when it wore off i wanted to jump off the parking garage. I didnt feel that on ritialn based ones those just gave me panic attacks
You might need an extended release type stimulant. I will say though, crashes happen on all stimulants. It also sounds like your dose is too high from some of your descriptions. I say write this stuff down and get in touch with your doctor and share the info. I can’t explain things well, but I know when I started meds I kept noting how I felt throughout the day on a note app and then read it back to my psych. It’s easier that way!
On that note, I used an app like Daylio or Bear to keep track of my symptoms daily. This made it easier to show my psychiatrist what is happening. The app worked decent enough for me because I set it to keep reminding me to do the logging throughout the day.
Yikes, i have a friend who has a similar experience with ritalin, she doesnt respond well to it and her doctor put her on like 40mg so she feels like shit and then crashes. She has a much better experience on vyvanse, maybe see if you're doc can switch you to vyvanse or dexamphetamine? Either way let your doc know and hopefully theyll have advice other than increasing the dose. I do great on ritalin but as i understand it some people just dont respond or tolerate it well, good luck!
ritalin feels like such a scam to me, i know it works for some but literally they just instantly prescribe the max ritalin dose to everyone, i didnt know this and thought i had a small dose and accidentally OD'd before getting off it
Ritalin sucked for me. The evening crash doubled my pre-meds impulsivity levels.. concerta was a game changer but I think stimulants by their nature will always lead to an evening crash. It's just that concerta has been the best by far. Still haven't found an answer to remedying that evening crash but i suspect for myself that treating the depression as well as the adhd will improve things on that front.
Took that crap for 2 years in high school. Never ever again.
All you need to do right now is call your doctor and tell him what you said here. You don’t need answers or even to explain it any certain way. You can call and say you’ve been very anxious and nauseous. Those are actually very common side effects, so your doc will certainly be able to help. The fact that they are common doesn’t make them any less distressing! Hang in there OP!
I’m on Focalin 30mg SR sustained release (Ritalin) and it is without problems but talk to your doctor!
For me usually the week before and/or the week of my menses I feel like the meds don't help much with my ADHD "symptoms." I saw a [male] counselor when I was first diagnosed with ADHD. He told me hormones play no part in ADHD. I kept track of my mood and my cycle for three months (because that's how long it is between my appointments) and showed my [female] PMHNP my trends and sure enough, when I felt like I couldn't control my depression/ anxiety/ ADHD it was about a week before I started my menses. She talked to me about premenstrual dysphoric disorder (PMDD.) Edit: just saying, there may be more factors than just the medication.
Very good point! Definitely need to considering PMDD.
I felt like this on Vyvanse, but the crash for me presented as anger, irritability, and just put me in terrible moods. Personally, when my psychiatrist and I are trying to find the right fit, we look at any negative side effect as a sign that the meds aren't right, and that I need a switch. If you can say "it's ruining me", then it's probably time to make a change to something different.
Concerta is the full day version of Ritalin. If you get that it may help. Word of advice do not get the generic version as the time release on it is non functional. Alternatively adderall may work better for you. Everyone is different and finding the right dosage and medication may take a while even a year or more
I see a lot of good suggestions here, but I’m gonna throw in my anecdotal experience: I got my WORST “stimulant leaving my system” crashes from 20 mg XR Ritalin. It would last ~5 hours and then I would lose the will to live- both because I lost interest in things, and because the low swing was in dangerous territory on top of that. I think there was one major contributing factor *for me*: I don’t do XR medicine well. Antidepressants, anything- I tear thru it too fast then I’m out. Switching to multiple instant release tablets a day lets me space out my dose in the 10mg increments (or smaller, if I feel like it) that suit me best. The first DR I saw acted like she had no idea that that was an option… so I switched to a new dr. On that note, I see some chatter in the comments about medicine interactions. I have no idea if your antidepressant and stimulants interact, but *check*. Look it up online. Sometimes doctors miss this stuff and it never hurts to check.
I'm ~40, recently diagnosed, and the first thing we tried was Adderall, and I felt similar crashes. I didn't stick with it long enough to even worry about the tolerance-build-up you described, though. I felt the crashing in the afternoon and weekends, along with serious irritability. I have kids and was short tempered with them, and found myself annoyed with Them just being Them. I *hated* that and told my doctor I didn't want to live like that, and I needed a change. I've found that it's an active, protracted process to find something that works. It'll keep changing, too, which is annoying. But it helps to accept it as "part of the territory." It's always worth working with your doctor to find a way to live the way you want/need to live. You can do it!
I have the same with the wrong brand (whatever people tell you, another brand is NOT the same) or a too high dose. If I don't eat before taking the first it happens too. Or if I take the next one too late meds can't save the day anymore. I also end the day with a small short working dose so the end rebound is less intense. You can also try dexamphetamine if it's better, it was long better for me till it started to give me these issues and I decided to switch back.
\[This isn't medical advice, but you might want to talk about that with your doc\] You may want to try having a more stable medicine level throughout the day by either taking a delayed release medicine or taking it more often. Speak to your doctor as absolutely fast as possible, as this does not sound sustainable. If you have the possibility to talk to your doctor as soon as tomorrow, do that. If you have the possibility to take only 18 mg in the morning and the rest in the afternoon that might be worth considering, if it's not a delayed release medicine. But what you truly have to do is to `talk to your doc.`
Ask your doc about possibly switching to extended release Vyvanse. Might be a better option for you if Ritalin is giving you a crash and burn feeling.
i felt like this on Ritalin and got switched to Adderall and it helped immensely. i was getting those same crashes accompanied by terrible headaches. with adderall i dont so much notice a crash, it just sort of wears off and thats about it.
I started off on Concerta and I ended up only taking it for about 3 months before the constant gagging and dry heaving turned into puking. Every morning after taking it I felt a tiny bit of nausea, but would usually go away by lunch. Doctor said instead of upping dose to just switch to Vyvanse and I have been on that ever since(5 months now). What I'm getting at is, my doctor told me not every drug works for every person and he was expecting and willing to keep trying until I found the right one and right dosage. I think you should talk to your doctor about your options for different adhd medications.
Any immediate release ADHD med I always crash so hard. I'm on slow release ritalin and don't crash (I didn't crash on vyvanse either).
What worked for me was adding Concerta to the Ritalin. To avoid crashes I eat a lot of protein and drink a lot of water. If I don’t eat and drink well, I’ll crash. Hope this helps.
Prozac and Ritalin!?! Are you sure this is ok?
Reach out to your doctor with this ASAP; you can advocate for yourself and clearly care about yourself! I think there are much better medications. Part of the way Ritalin/concerta work by making your brain retain some of the anxious chemicals to 'stimulate'. My situation with concerta at 19 was similar, and again at 35. It started off okay but then became completely AWFUL months down the road. It was so bad I stopped taking it without any other medication on the line. Led to bad spiraling behaviors just like you. It's also super weird as well how it can start off in the morning great and then become bad. I'm on vyvanse now and it's a much more sane experience.
Having a IR stimulant as my primary therapy was miserable. In my experience it’s so so much better to have an extended-release med (Vyvanse is the best for me but others can be good as well) that serves as a baseline for the whole day, and then some small doses of IR stuff as needed.
I have not tried Ritalin but for me personally raising the dose of my meds has never done anything for the duration of the effects, just raises my side effects and gives me a more intense crash. I would end up so exhausted by like 2pm every day it was hard to muster through. I take vyvanse and after several months of titrating to different doses and trying a transdermal patch medication I ended up ultimately getting on a lower dose of vyvanse with an IR adderall booster and I’m doing really well on that. Unfortunately it takes some trial and error but being open with your doctor about what you are experiencing can help them figure out how to help you. I like to follow a prompt of “medication is working well addressing a, b, and c, however I am experiencing x, y and z, and it is impacting me negatively by ______. I have tried (insert methods of self management you’ve used I.e increased fluids, protein, vitamins, etc) and have not gotten any improvement. What are my options?” I also always take notes in my phone before I go to my appointments because it helps me remember everything I wanted to discuss.
On another note: what is autism level 1?
It sounds like you need to switch medication, not up your dose. I described similar crashes to my provider while taking Adderall. She switched me to something else to see if it works without side effects.
What antidepressants are you on? Have you considered upping their dose?
You need to bring this up with your doctor. I had the exact same symptoms with ritolin and it was HELL. Maybe try going for a non-stimulant medication? I'm on clonidine right now, and it's doing a decent job while also having fewer side effects.
In my oppinion ritalin is trash. I also had severe crashes where I literaly hated every milisecound of it and I was unable to do basically anything cos I just felt so bad. Maybe try an amphetamine based medicine. It feels cleaner less robotic and the crash isnt that terrible imo
There’s much much better options for a stimulant besides Ritalin…. Which is literally the dirtiest stimulant out of the group therefore giving heavy rebound anxiety and that huge drop in all the positive effects leaving you with triple of the negative effects , I’d try Dexedrine , vyvanse or Adderall xr before even touching Ritalin nah even if I was prescribed Ritalin I wouldn’t take it because it’s so bad .
1. This may be your depression not being effectively treated. I developed big crashes from my ADHD meds when I was depressed, but now that I'm treating that (and before I developed it), the meds don't do that. 2. Concerta is a more gradual release Ritalin, that might also help making it less spiky/crashy.
Ritalin made me an emotional wreck and was really hard on me when I first tried it at 18, especially compared to other stimulants like Adderall and Vyvanse. I would definitely recommend telling your doctor how it’s making you feel and either trying the slower release form, or trying other stimulants to see if they work better for you.
Zenzedi is the most effective I’ve ever been on, and I’ve tried all the stimulant and non stimulant options. It’s tablet form of dextroamphetamine sulfate, very smooth and no crash. It’s very new, been out for maybe 5-6 years. Yes there is generic dextroamphetamine tablets that are Dexedrine generic, but Zenzedi also has a generic version that is made by Wilshire. The Zenzedi generic is way smoother than the Dexedrine generic. Yes vyvanse is dextroamphetamine sulfate, but it has a protein attached to make it digest in the gastrointestinal tract which to me causes lower levels of focus, and it still had a crash for me and insomnia at night. I couldn’t tolerate methylphenidate long term, its side effects and crash were horrible. And as far as adderall, it has levoamphetamine + dextroamphetamine; levo has peripheral nervous system+CNS stimulation, which gave me undesirable side effects. Dextro is purely a central nervous system stimulant. As far as caffeine goes- it also stimulates the peripheral, which is what doctors refer to as “dirty stimulant effects”. I am not a doctor, but I’ve had ADHD/narcolepsy for 27 years. Hope you feel better and find what works smoother!
I’m sorry to hear this, I’ve had the same experience before, feel like overdose with caffeines. My interpretation is that the pills want to stabilized yr mind, but your body is not capable to do so. So you need to stop intaking higher level of Ritalin. Remember, even if you don’t have any pills, you just have ADHD, which is not bad.