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Thanks for your comments. I don't understand much of it, but I will come back to it every now and then. I'm generally very satisfied with my Rilatine. It helps immensely, I can actually get stuff done without my thoughts branching off in multiple directions and getting stuck in inaction. I am still surprised by my lack of awareness of the (lack of) symptoms. When it wears off I don't feel different, really. I can now recognize from experience that the symptoms return, but there's no concious switch happening. It's hard to put in to words, but for me it definitely shattered the illusion of free will. Anyway, back to methylphenidate, thankfully the side effects are very minor for me. The only annoying thing is my cold hand & feet. And the fact that I have to take 2 pills, the 2nd dose is easy to forget.
I could switch to Concerta, but at twice the cost the switch is harder to justify. For some unexplicable reason ADHD medication is covered for children, but not for adults here. Speaking of children, two different child psychiatrists recommended to try Omega 3 & 6 fatty accids (specifically "Eye q"), but I can't find much supporting evidence. IIRC one study showed an improvement in symptoms when combined with methylfenidate, but not without. Have you read anything about this? Personally, I would like to try vyvanse, but like you said it's not prescribed in Europe. My doctor looked it up and would be willing to, but no pharmacy has it.
Technically they can order it, but they would have to buy in bulk, which they understandably don't want to do for one patient.
It's good to know that the patents will expire soon. The arrival of generics could make them an option, hopefully. |
Omega 3 have mixed evidence, they probably help slighly as augmentations, like guanfacine.
Your cold extremities are probably because of vasocontrition, you can cancel this with low dose (1-3mg) daily tadalafil (yes the sex pill), which is available OTC btw.
As for the methylphenidate half life, if that is a huge problem you can try atypical stims cf my original comment (selegiline, amantadine, moclobemide or the inferior moda/armodafinil) or get prescribed serdexmethylphenidate (probably not yet possible in europe) or you can do the easy fix, buy 4f-mph which is an OTC methyplhenidate variants available on https://rarechems.com/ however while unlikely, it is possibly more cardiotoxic and neurotoxic. Anyway you should fight cardiotoxicity and neurotoxicity (the former via e.g. tadalafil, the latter via magnesium l-threonate, ALCAR and antioxidants such as NAC)
> Thanks for your comments. I don't understand much of it Feel free to ask any question for clarification