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How Much Ritalin Is Enough?

Q:

"I'm 39 and started taking Ritalin 2 weeks ago. I have been trying to find the right dose to take during the day. I feel better with a higher dose (15-20 mg every four hours), because a lower one gives me a headache. What should I do?"

Dr. Larry Silver specializes in treating children with attention deficit disorder (ADHD).
A:

The goal with Ritalin is to find the dose that helps the most with no side effects. The dose is not based on age or body weight. It is based on how quickly each person metabolizes the medication. Thus, it appears that 15 or 20 mg every four hours may be best for you. If this dose is working with no side effects, it might be the plan to stay on.

Larry Silver, M.D., is the author of Dr. Larry Silver's Advice to Parents on AD/HD and The Misunderstood Child: Understanding and Coping with Your Child's Learning Disabilities. He is also a clinical professor of psychiatry at Georgetown Medical Center in Washington, D.C.

1 Comments:

  • Posted by Limbusman - Apr 3 2009 @ 4:23 PM
    54 year old President and Chief Innovative Officer struggling.
    Dr. Silver, I have a Medical background from the University of Chicago. I went into business as a catch-up financially and discovered opportunity to help people there also. I have been very successful and happy helping make this a better world and now boost the job market. I have intangible assets such as patents and intellectual trade secrets that pass by in almost every store you visit. I also teach other fortune 500 Chiefs the disruptive innovation model that I created with the gift that God gave me. I wouldn't read and had D's until my parents intervened in Jr. High. High School through Medical School I was an honor student and received my only C in appreciative art. Thus I know my brain can function under pressure and perform high end skills. Two male doctors (Psychiatrists) one I was with for 20 years both suddenly passed away, I was a patient with a psychiatrist for 2 years who then retired..... and a female Psychiatrist who was just helping me went to Mayo Clinic and left me hanging. I had post traumatic stress and anxiety when my home burned and lost my bride of 25 years. My mind is my tool and I have called the FDA and DEA about off label and dosage and the final word is up to the doctor. 60 - 80 mg /day is affecting my ability to prioritize and function in a capacity where mistakes can be catastrophic. I was on 3 54mg Concerta by the Doctor who retired. I found that the generic is adequate if I take L-Carnitine, Magnesium, Lipoic Acid, B complex and most importantly 3 table spoons of Omega 3 a day. Is my attention deficit, not so much hyperactivity, and the trauma I have been through throwing off how my Amygdale prioritizes outgoing impulses and is there documentation or a doctor in Chicago that understands/communicates that Ritalin breaks down differently as individuals? I had a blood test by a doctor 1 month ago and it came up positive for benzodiazepines, negative for methamphetamine and negative for all illegal drugs. The panel 9 is a confirmed test using spectrometry and some other high end forensic tests. He had put me an Adderal 3 x's a day because 60 mg of Ritalin he said was not cutting it. Neither is the Adderal. I am concerned. The FDA sets those based on side effects, What if my side effects are nothing at 100/day - 120/day (no side effects)and disastrous at 40 -60/day. Finally I should have screened ++ for the Adderal. He didn’t understand. Thank you for any advice or guidance. I am praying for a MD that lake phobia of a heart attack and I am in perfect organ health accept the most important one – my electrical system. I am grateful for your availability to comment. Warm regards
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