Tuesday, February 3, 2009

Listen to Your Doctor.....

I finally got through the hell of trying to get into a doctor and went to the one I grew up with yesterday. I am now on regular old methylphenidate (Ritalin), which will allow me to exert a great deal of control over my dosing. So on days when I need to go to class, I can take two 10MG in the morning, one at lunch and generally call it good. On days when I need more time to study, I can take two in the morning, one at lunch and one mid-late afternoon, while on weekends I can minimize, unless I am studying.

Though I have to admit that I really would love to try Vyvanse. Unfortunately, at ten dollars a dose, it's just not feasible, as it's a total out of pocket cost. Basically, Vyvanse is a prodrug equivalent for Adderall. It is theoretically superior to Adderall and Ritalin, because instead of being an extended release because the pill is made a particular way, it's release is extended through metabolizing. This apparently reduces many of the side effects found especially in Ritalin, but which are also occasionally found in Adderall.

We also discussed the possibility of a close generic equivalent to Adderall, dextroamphetimine which is the actual generic for Dexedrine. The thought was that this might decrease or eliminate the headaches I often get when I take methylphenidate. The problem with that being that the script is twenty some dollars to fill, as apposed to six for methylphenidate. Unfortunately, cost is a significant factor, so for the time being, I am taking methylphenidate.

I was also prescribed Alprazolam, which is the generic for Xanax. I am not going to take it often, as I really only need it for certain, specific cycles. I am starting out with the ability to get a refill before I see the doctor next, because he felt that it might help me getting used to the methylphenidate. Mostly I am keen on having it to help me nip off the cycles that got me diagnosed with bipolar. Though it was nice to see my old family doctor again, as he agreed with my assessment that it is more likely that the symptoms are a result of a lifetime with far less sleep than most people should get. The other reason I was interested in Alprazolam, is to help me through therapy. Last Friday's session was really intense and left me pretty shell-shocked.

So now we get to listening to the doctor.....

I have a really tough time remembering to take my meds, when I am on meds. Even worse, is if I have to take more than one, at different times. It is much easier if I can just take them all at once. So my doc explained that I should probably not take the Alprazolam, until I am getting towards lunch time, or unless I really felt the need for it before then. But he wanted me to take my first dose of methylphenidate without it, figuring that if I really was going to have trouble, it would be with the second dose of the day. He also warned me that I probably would do better to offset the mythylphenidate and the Alprazolam by at least forty minutes to an hour. I asked him if taking them at the same time was dangerous, which he said it really isn't, it just causes a lot of people to get a little buzzed.

So what do I do? Screw that, I say to myself. I'm going to forget the Ritalin if I don't take them together. Then came my remedial algebra (yes, I am math inept - failed pre-algebra in high school, twice). I had no trouble focusing on class. I was able to pick up the concepts we were learning today. I could not however, ask either of the questions I had, to save my life. I was actually afraid if I tried to talk that gibberish would come out. Thank the gods for email and a instructor who is happy to answer them.

Amusingly, when I was out having a smoke after class, I mentioned it to the smoking clan. One of them explained that he had experienced the exact same thing. He said that the offset in taking them really makes a difference. Of course he also mentioned his fondness for taking them together on weekends. I have to admit, that while not at all conducive to full functionality in class, it did feel pretty good. Thankfully, I have years of memories of getting high and don't feel the least urge to abuse the drugs that are here to help me function. I did seem to have an easier time in humanities, which follows the math.

No problems contributing to the discussion - though that may be because we were talking about the Roman Empire, a topic that really gets me excited. Though I should admit that I did have to leave class early, but that was because we were watching a documentary I've seen twice and really hated. There's a twit who makes the assertion that the Romans built Hadrien's wall and never went north, because they felt it was a wasteland. That was just their excuse. The reality is that the naked blue warriors had the invulnerable Roman Legions pissing themselves in terror. So by building Hadrien's wall, the Romans saved face and the Picts were left alone again. Watching the video might have worked anyways, but the sound was kind of warped in my head and was making me very uncomfortable.


Juniper Shoemaker said...

I sympathize with the hassle of paying out-of-pocket for psychotropes and having consequently limited choices. One of my medications is bupropion, which never sells more cheaply than seventy-five dollars for my month's supply. Moreover, since no one sells generic Wellbutrin in sustained-release form, I must remember to take mine twice a day no more than three hours apart, and never without a meal or snack.

During the busiest of days, this ritual gets pretty hilarious fast. Especially around nosy coworkers and fellow students to whom I do not feel like explaining my use of antidepressants.

Whatever, I tell myself. At least it works.

scicurious said...

It helps to remember medications if you tie it to your routine in the morning. Example: get out of bed, get a drink of water, the pill goes with the water. Leaving the bottle out right next to the water may help. That's what I do. Still forget sometimes, though.

So you get headaches with MPH? I work with stimulants a lot in my research, but I never really get to hear about the side effects, though I know anxiety is one of them. I'd also be curious to know how taking it affects your sleep cycles. But of course if you don't want to answer, that's totally fine.

DuWayne Brayton said...

scicurious -

I am actually planning on writing a post about the whole experience when I've been on meds for a while.

But yes, I do get headaches. I already have anxiety issues, but oddly enough, my anxiety goes down a bit when I am on them. In part, I think it's because it slows my brain down a little. I am less frazzled by my inability to focus - which is a large part of the anxiety.

It really doesn't usually do much to my sleep cycles. As a baseline, I only sleep about three and a half hours on average. By the time I go to sleep, it's been enough hours that it's just not an issue.