xaggitin xl (I'm in the uk, this is the standard methylphenidate they prescribe here, )

hi everyone!
I was diagnosed a couple of years ago at the age of 46! but didn’t want to medicate. Fast forward to this year and I wanted to try the meds because I was exhausted and needed a break from me. Ive been working up through the doses starting at 18mg which had no effect, then 36mg which was good but I was still feeling the overwhelm and anxiety, then 54mg which was fine in the mornings and I could sleep no problem with it in the night. But by the afternoon all I wanted to do was sleep, like I was drugged, felt terrible though the overwhelm and anxiety were gone.
So the dr dropped me down to 36 again which is fine and less like I’ve been mickey-finned but the overwhelm and anxiety creeps in round the edges and Im really feeling it again… I realised that during the month I was on the 54mg dose I kept forgetting to get my sertraline prescription filled so I was abruptly without for about 10 days/2 weeks. When the penny eventually dropped and I looked up the symptoms of withdrawal it was all the things I was feeling and thought the 54 dose was causing…sigh…yes I am that rubbish at joining up the dots sometimes.
so I have another appt with my adhd dr in a couple of weeks, do I stay on the current dose, go back up to 54 xl or ask for immediate release equivalent of 54 and try that see if its better? I’ve no idea. I’m really bad at tracking things so I find it hard to tell what difference the meds are making at all. I think I’m a bit more focused but its certainly not the dramatically better that I’m reading other people describing. I thought I’d turn into Mrs Woman and have organisational superpowers. but sadly no!
Has anyone else had an experience like this?

Hello Jen, I’m similar age and still trying to find the right meds for myself too, I’m on IR methylphenidate. My current dose is 45mg per day split into 3 x 15mg, b/fast, lunch & dinner.

Do you have anxiety before taking the ADHD meds? Anxiety is a common side effect and one thing that stimulants are very unlikely to show an improvement on.

I think the effects of these drugs and anti-depressants can be quite subtle, they are to me anyway, I seem to be quite Alexithymic or unaware of my emotional states. It’s easy to miss or mistake what effects or side effects are attributable to which drug, especially if you are taking different types.

You really need to figure out if the afternoon slow down was due to the MPH wearing off or the lack of Sertraline. I’m assuming you don’t have any of the 54s left to try with the Sertraline?

One option to suggest, you could ask the doc if you can have the morning dose of 36 XL and then an IR tablet for topping up in the afternoon. I think 54 IR would be a big dose to go straight on to, and doubt the doc would approve this.

Hope you find a solution soon, I’m seeing the consultant on monday and will be asking to try a different med. I’m also not really noticing much benefit and feeling a definite increase in anxiety.

hi Neil, thanks for the answer, I’ll ask my doctor about breaking the dose up over the day. The anxiety has always been there and gets worse when I get overwhelmed and theres too many things I have to do.I never understood it before but now the more I read the more it falls into place. The 54 dose seemed to calm the anxiety and the feeling of overwhelm down but thats maybe because it made me so tired. Let me know how you get on with the new med and if it works better for you.

It does sound to me like you are ‘crashing’ when the dose is starting to wear off, which I think is a little bit unusual for XL meds and more common with the IR formulations.

After a quick search I have figures of:
max. time = 6.8h +/- 1.8h
half-life time = 3.5h +/- 0.4h

5.2 Pharmacokinetic properties

According to those figures, although a dose will last between 5 and 8.6 hours, it’s not that you use up all of the medication before the effects are noticeable. So half of the dose will have been absorbed between 3.1 and 3.9 hours after taking your med. This drop in levels is enough for your brain to register that there is no longer so much dopamine available and react accordingly.

I’m no expert but the options seem to be, 1) an afternoon top up might work, 2) alternatively you could try changing to IR methylphenidate with split doses through the day, or 3) try a different medication altogether.

I’m optimistic that there is a better response for me, I’ll let you know what happens at my appointment on monday.

hi Neil how did you get on?

Hello Jen, not so good for me with treatment, they have put a hold on it for now. I’m just looking at other options and if i can start back on medication at some point I’ll deal with it then.

Have you had any success yourself?

I’m seeing the dr on Wednesday, if you find anything else that works for you let me know, I’ve not got a huge amount of faith in the meds right now, I might stop mine.

I totally understand how you feel, try not to be too discouraged, there are still quite a few options available to you.

I’m just going to concentrate on dealing with my depression and anxiety, hopefully I can improve on this and that will open up the options to try ADHD medication again.

First of all be nice to yourself, look after yourself, eat well, do some exercise and plan for decent quality sleep.
I’m currently looking to do some courses at The Recovery College, enrollment opens on Monday for starting in the new year. You need to have time available in the week for this, if you have that then maybe there is one near to you, just have a search online.
CBD oil seems to work for some people, I have tried one brand and did not feel any results myself. The ones available on the high street are generally not strong enough to effective for most people, again you need to search and buy online.
Do you have anyone to talk to? I go to a counseling session, it’s only 1 hour every 2 weeks but much better than bottling everything up.
Last thing that I’m about to try is microdosing, again plenty of information on the web, search online and see what you think.

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thanks Neil, good luck and keep me posted on the micro dosing :smiley:

Did you see the doctor? How did it go?

I have what I need for my experiment, but so far this week I’ve been really busy, stressed and a bit low so waiting for a better day to try this. Hopefully should be good for Friday.

It went well, she gave me two 5mg doses that I can top up with in the afternoon. I’ve just picked them up so not tried yet.
good luck with your experiment! :grin:

So you now have 36mg extended release and the option of 2 x 5mg immediate release? I hope this works out for you.

I currently trying my experiment, the first day that I’ve had free so far. A little bit more powerful than I expected but only positives so far, I’ll let you know how it turns out.

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hey Neil how are you getting on? experiments working?

Did we ever here from Neil again. I was completely invested in this journey!



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Welcome to the HowToADHD forums, @Naturalwhitch!

You can take a look at another forum user’s profile by clicking on (or tapping on) their user name above one of their posts in a thread. It is a hyperlink. (You could also use the :mag: search icon at the top of the page.)

  • While looking at their profile, you can see their Activity on this forum site.

To answer your question, I checked Neil’s profile, and I saw continuous activity right up to this month (March '21).

If you want, you can ping a user directly in this thread by putting the ‘at’ symbol immediately in front of their username, like I did in this reply to you. You could ask Neil directly that way.

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WELCOME :sunglasses:

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Hello all, I took an extended break from the forum, don’t come here too much anymore.
Microdosing was a fail for me, some benefits but outweighed by an increase in anxiety. I started on Elvanse in 2019 which started to work for me at the max dose, then had a new antidepressant added and had a very bad reaction which was a hypomanic episode, taken off of both meds, in the end I was diagnosed with bipolar last january and then anxiety a bit later in the year. I have spent the last year trying to get the right combo of meds for bipolar and anxiety, because of this I’m still not on any meds for ADHD.
Hope your all doing well, cheers, Neil

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