Health QuestionsCategory: TreatmentsRitalin for Depression
vagus_nerve asked 3 years ago

Today my therapist and I read the Ritalin page in  the PDR. Here is what we learned
“Ritalin should not be used for severe depression of either exogenous or endogenous origin.
Ritalin should not be used for the prevention or treatment of normal fatigue states.”
Those are the two reasons why my psychiatrist (not to be confused with my therapist) prescribed it to me last October.
“Ritalin should be given cautiously to emotionally unstable patients, such as those with a history of drug dependence or alcoholism, because such patients may increase dosage on their own initiative.”
I come from a family of alcoholics, a cocaine-snorting dad, a pothead brother, a wine-every-night mother. I upped my dosage and frequency of doses a couple weeks ago. I didn’t tell anyone for a while. I was embarassed. When I told my psychiatrist yesterday, she said we need to start tapering off. Never have I felt so utterly alone and beat-to-shit and sad as when I took the new bus route to the new apartment I wanted so badly having gone four hours without Ritalin.
“Careful supervision is required during drug withdrawal, since severe depression as well as the effects of chronic overactivity can be unmasked.”
Great, I have something to look forward to.
“Long-term follow-up may be required because of the patient’s basic personality disturbances.”
My doctor warned my boyfriend that this would be a long road, that I may have personality problems that will hinder my recovery, yadda yadda yadda. By the way, what are the recommended doses?
Tablets: Administer in divided doses 2 or 3 times daily, preferably 30 to 45 minutes before meals. Average dosage is 20 to 30 mg daily. Some patients may require 40 to 60 mg daily. In others, 10 to 15 mg daily will be adequate.”
Until I upped to 40 mg per DOSE (not per day) six times daily on my own addicted-ass self, I was prescribed 30 mg five times daily. So I take between 200-240 mg daily.
“Daily dosage above 60 mg is not recommended.”
When I’m coming off my last Ritalin high of the day, usually early evening, I feel so awful: so craven, lonesome, anxious, helpless, bored, sad. A very sad girl. I usually smoke pot and ache and wait for someone to come home. I am always alone at this time. Always alone.
As far as psychotropic medication goes, I am very pro anti-depressants. But FUCK the Ritalin, FUCK the sleeping pills, fuck the Xanax and all the other bullshit symptom-management meds that define my existence right now. I am always monitoring my mood in relation to whatever drug I just ingested. For example, I just took my Ritalin dose 15 minutes ago. In another 15 minutes I will start to feel the warmth, the bonhomie, the bracing energy that lasts about an hour and a half. Apres ca, la deluge. I will feel so uncomfortable I will need some weed or at least a Xanax to obliterate my raw nerves. My hunger will return–in reality I was starving all day, calling a soy protein smoothie “lunch” and feeling lightheaded all afternoon–but my appetite will creep up on me around 9pm. Last night, I fried up bacon. It’s fucked. Marilyn Monroe died doing this shit. I’m not about to get buried in the crypt with her and Hef.
So sorry Dr. I—, you’re a good doctor but I’m getting a second opinion like whoa.
Here’s another story:
Tuesday I was in the breakroom, smoking a cigarette, reading about Susan Powter’s lesbian comeback in Elle and the next thing I remember I was  lying on the floor, my jeans smelling like sweet piss  and some woman rubbing my back and saying “It’  OK, it’s going to be OK.” Apparently I had a seizure.  A fucking SEIZURE. I had started jabbering and shaking and then started to  slide off my chair. Darryl from the mailroom–bless his heart–broke  my fall and then I was out for several minutes. As I woke up, I kept  looking at my jeans and the liquid on the floor; I asked, “Where did this  water come from?” (Later at the hospital we figured it out). EMTs came  through the door–I thought all of this was quite unnecessary and all  needed to do was go throw up. “What medications are you on?” they  asked me. I shook my head–I didn’t remember, couldn’t speak, was so  overwhelmed with nausea and confusion. They forced me onto a gurney  and took me outside to the ambulance. Inside the ambulance I started  listing my meds: “Cymbalta, Wellbutrin, Lexapro, Ritalin, Restoril  Xanax…” I asked if I could call my boyfriend and was surprised to hear  that John was already at the ER waiting for me and my mom was on the  way. Then I started vomiting my spaghetti. The hospital is two blocks  away from work, which was convenient. I was admitted to the ER with a lot of other fucked-up looking folks and given my own bed, an anti-nausea injection and a series of questions to determine what happened
I stayed at the hospital for 24 hours. I had a CAT scan, an MRI, bloodwork, pisswork (I’m not pregnant, thank god). My mom and I spooned each other in my tiny adjustable hospital bed. It was determined that my meds caused the seizure, and according to the neurologists on my case, I am taking way too much medication and, to be specific, “cocaine levels” of Ritalin. Well, I know this already. Anyway, it was a scary, scary experience and a real wake-up call. I’m glad I made it through.
Any thoughts?

5 Answers
mania answered 3 years ago

Re: Ritalin for Depression
Yeah.  You’re the poster child for why I tell people not to seek out stimulants to “lift the grogginess” of their other meds.
If a person is THAT groggy from their other meds, perhaps the other meds need adjusting!
Best of luck on your detox, and thanks for the warning/story.  

Morgan answered 3 years ago

Re: Ritalin for Depression
I can definitely sympathize with your plight. Before I was diagnosed and treated with Bipolar Disorder II, I had serious issues with Adderall and Ritalin.
Drug addiction/alcoholism runs in my family, also.
When I was hospitalized last July, I had enough Ritalin in my system to kill three elephants. I was out of control and injecting it intravenously.
Ritalin is definitely not for depression or fatigue, or for those with a history of drug addiction (like myself).
I still take Concerta (12 hr. Ritalin), but I have taken it correctly ever since I have been treated for my bipolar disorder.
Of course, Geodon (a drug I take) blocks certain dopamine receptors in the brain that (I have concluded) are responsible for the pleasure/reward system responsible for contributing to addictive behavior. Ritalin stimulates dopamine like crazy.
Best of luck to you,

lunksmoo answered 3 years ago

Re: Ritalin for Depression
Oh great.  My PDoc just put me on 30 mg Ritalin, after taking me off of Lamictal (which did jack squat for my depression), and keeping me on the Lexapro.  I have been down-in-the-ground depressed for the last 3 years, and have also had problems with no motivation, horrible lethargy with terrible insomnia.  Now I hear the Ritalin he put me on is going to make my condition worse.  Oh well, what’s another thing to bring me down.

red1970 answered 3 years ago

Re: Ritalin for Depression
My PDoc just put me on concerta two weeks ago because I was getting the to the point where I was shutting down and just couldn’t focus on things.  It def has helped but I find at the end of the day I just start crying for no reason and just sad.  It’s werid because it’s the same time everyday….I’m thinking it when the shit wears off. I have a follow up in two weeks…

momma j answered 3 years ago

Re: Ritalin for Depression
That come down you describe is the reason I can’t take any stimulant. I was on small dose of Rit when Dr. started me on Lexapro, but quit after two weeks as arranged . It did help with fatigue – but this was a tiny dose, like 5 mg. The larger doses make me have that crazy plunge you describe in late afternoon that can pitch me into black depression till morning, when I have to take next dose of stimulant to get the day going. Bi-polars have enough mood crap without this see-saw and I could see how it could escalate quickly into addiction. I’m just wary of all stimulants, from diet pills to ADD drugs, because truly, what goes up must come down. And coming down sucks.