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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Dade on June 10, 2008, at 7:35:30
A specialist i saw suggested a dose of 40mgs at morn, noon, and early eaving+20 in the evening.
I have taken a lesser dose for a while, doose this this seem alot?
A pharmacist thinks so as these are 10mg tabs so his dispensing asked some questions.
??
Posted by eric wagner on June 10, 2008, at 8:00:39
In reply to Ritalin-140mgs? daily, posted by Dade on June 10, 2008, at 7:35:30
Are they the instant release form?
How much were you taking prior to this suggestion?
What is your age, weight, & stimulant usage history?
Possibly I can share my experience
Posted by Dade on June 10, 2008, at 9:22:50
In reply to Re: Ritalin-140mgs? daily, posted by eric wagner on June 10, 2008, at 8:00:39
> Are they the instant release form?
> How much were you taking prior to this suggestion?
> What is your age, weight, & stimulant usage history?
> Possibly I can share my experienceHey!
yer,
I have used methylphenidate for some years and found it very usefull for mood, energy, and all round social effectiveness-type effects.
Althis was under MD supervision.
My dosage has altered from 20mgs -140mgs daily.
When it worked it felt like i was in 'the zone' almost opiate like where everything 'just fit' however the IR effects i found short lasting.i have also trialed Dextroamphetamine, 10mgs dosage, and found it less satisfactory.
YMMY
Thanks
Posted by B2chica on June 10, 2008, at 10:43:48
In reply to Ritalin-140mgs? daily, posted by Dade on June 10, 2008, at 7:35:30
i'm just wondering why the 10mg, why not even 20mg tabs?
then you can still dose as needed without splitting.it doesn seem a bit high, but i think after a while of usage some folks need to climb.
maybe it might be time for a switch even?
i know sometimes i'd have to give myself a week or so off Ritalin (hated that) but when i'd start back up it seemed to make that difference.
so maybe a little break might be helpful..but then again, your' already pretty highly dosed so it might not. i'd say more likely your next step would be to try a longer lasting one like Ritalin LA or adderalXR or something. whats that new one ...Vavysne or something...pretty much same as adderal XR but little different.long story short. if it works and you've asked your doc to make sure your body's ok with the high dose of ritalin and all's OK. then don't worry about it. as long as it works.
good deal.
but if your at all worried. then i'd say time for a change. but first clear out your system. go a couple weeks without any stimulant in your system. then start new one.PS. i'm not a doc.
always check with your pdoc first.
Best wishes.b2c.
Posted by Phil on June 11, 2008, at 19:17:44
In reply to Re: Ritalin-140mgs? daily » Dade, posted by B2chica on June 10, 2008, at 10:43:48
That's a lot of Ritalin. I'm surprised a doc will write for that much.
I suggest an EKG to be on the safe side.
Posted by undopaminergic on June 14, 2008, at 10:44:11
In reply to Ritalin-140mgs? daily, posted by Dade on June 10, 2008, at 7:35:30
My usual dose is 216 mg in a 24 hour period of wakefulness, followed by more than 12 hours of sleep.
Dr. Nora Volkow (current director of the NIDA, by the way) and co-authors published their findings on dose-effect releationships for immediate release oral methylphenidate in the article referenced below:
Am J Psychiatry. 1998 Oct;155(10):1325-31. PMID 9766762
http://ajp.psychiatryonline.org/cgi/content/full/155/10/1325
http://ajp.psychiatryonline.org/cgi/reprint/155/10/1325.pdfThe dose is measured in milligrams (mg) or milligrams per kg of body weight (mg/kg), while the effect is defined as the percentage of dopamine (DA) reuptake inhibition or in other words, percent of dopamine transporter (DAT) blockade.
The article found the following dose-effect relationships to be approximately correct for a single dose of immediate release methylphenidate taken by a person weighing 80 kg:
5 mg (0.06 mg/kg) ~ 12% DAT blockade
10 mg (0.13 mg/kg) ~ 40% DAT blockade
20 mg (0.25 mg/kg) ~ 54% DAT blockade
40 mg (0.50 mg/kg) ~ 72% DAT blockade
60 mg (0.75 mg/kg) ~ 74% DAT blockadeTo calculate the total daily dose, the above doses need to be multiplied by the number of doses per day actually taken - usually 2-4.
According to my calculations, the above doses of immediate release (IR) methylphenidate (MPH) correspond to Concerta extended release (XR) tablets as follows:
5 mg IR MPH ~ 18 mg Concerta XR MPH
10 mg IR MPH ~ 36 mg Concerta XR MPH
20 mg IR MPH ~ 72 mg Concerta XR MPH
40 mg IR MPH ~ 144 mg Concerta XR MPH
60 mg IR MPH ~ 216 mg Concerta XR MPHGenerally, clincally useful doses result in at least 50% dopamine reuptake inhibition. In other words, 160 mg/day is not at all unreasonable. Of course, many do well on lower doses, whereas others will require even more.
This is the end of the thread.
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