Half life and the perils of xr

[anonymous]

I was recently prescribed an ADHD medication. It is a name brand of methaphenadate HCL. I was warned when it was prescribed that it could spike my anxiety (which is already pronounced). My doctor said that if it required an increase in anxiety meds to control the anxiety that we would stop the drug. He had no plans to medicate a side effect. He also warned me that it can cause a spike in BP, and severe cardiac issues in those with pre existing heart trouble. He said if I began to experience any chest pain, etc. He would order an ekg.

I asked about how the drug would increase focus in anybody who took it (ADHD or not). He agreed, but said lack of focus was affecting my ability to function so we would give it a try.

It took some time for insurance approval on the name brand, tier 4, drug (a couple of weeks). Flash forward a bit.

Ive taken the drug a few times. The focus has been amazing and Ive been super productive. The problem is that, at night, it seems like all of the bad effects hit all at once. During the day I am fine.

The drug is designed to have a biphasic concentration profile, with about 40% of the drug released up front, and 60% released over the next several hours. Allegedly, it has concentration peaks at 2 and 8 hours.

Here is my quandry. I am fine all day. I can take the drug about 8 am, get my work done, do things after work, etc. About 9:30 or 10:00pm, all hell breaks loose. I feel as though im going to die. My chest hurts and I feel like an elephant is sitting on it. My ears ring loudly and I have a headache. Is this BP? Is it a heart thing? Or is it the spike in anxiety my doc warned could happen?

It seems odd this would happen at hour 13 or 14 when the last medication spike is supposed to occur at 8.

I have an appointment with the doc in a couple of weeks and we will discuss it. For now, I am scared to take the medication again.

 

[Tornadic Thoughts]

Can you call your doctor to report and inquire about the effects you're feeling since your next appt. is so far away? Personally, I would stop taking it.

I was prescribed a couple different meds for adhd for a while, too, although not of the XR variety. They helped temporarily, and I thought for sure I'd found the answer to so many problems, but it was a constant battle of tweaking the dosage to find my sweet spot of perceived functioning once my body became "adjusted" to a different dose.

With each adjustment came a new set of side effect challenges, often feeling worse than the initial symptoms ever did. Not to mention the different manufacturers ever changing when I'd pick up a prescription. Each varied greatly in effectiveness, and there was no way to gain control over what you would receive based on who stocks the pharmacies. Requests for certain brands can certainly be made by your doc, but if the pharmacy doesn't have it, sorry 'bout your luck.

I also had to increase my xanax frequency to keep up with the the anxiety and aggravated moods and such that accompanied the adhd meds at any dose. I was even advised to add extra xanax to my sleeping meds routine (ambien) if I couldn't stay asleep at night. Then I was directed to open the capsules myself and measure out the dosages that way when learning the dosage was way too high. No thanks. It was a chemically induced nightmare for my body.

The side effects ended up greatly outweighing the benefits and I had to find other ways to work around my symptoms. The elephant on the chest thing always greatly concerns me as I remember being told my grandfather said that's how he felt prior to having a massive heart attack. Don't ignore what your body is trying to tell you. Best wishes for finding relief from the symptoms as well as the treatment of said symptoms.

 

[joeylittle]

It seems odd this would happen at hour 13 or 14 when the last medication spike is supposed to occur at 8.

Those predictions are based on average absorption rates. They won’t tell you what to expect if you are either a rapid metabolizer (generally hitting peak concentration sooner) or the opposite (delayed peak).

You will also get different release profiles depending on whether you are taking brand formulation or generic.

I’ve discovered, due to my own metabolizing patterns, that very few extended release drugs work well for me. Whenever possible, I use immediate release, and then have just had to experiment a bit to get the timing right.

It’s very important to maintain consistent dosing times as well. That can be a challenge for many of us - but when your body isn’t absorbing the med on a typical curve, it just becomes essential.

Do you know if the drug is at all effected by caloric intake? It’s worth checking.

And, is it available in a shorter release form?