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Crashing On Ritalin


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#1 allisonNYC

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Posted 22 September 2009 - 05:25 PM

This is my first posting in the online community, so hello everyone!

I just started taking long acting Ritalin about 2 weeks ago. I've been trying different combinations/times to see what keeps me awake the best (one long acting in when I get to work seems to work the best so far....although I feel like I need to incorporate one short acting pill in the afternoon next). For those of you who have been on Ritalin, when you do crash and if it doesn't work, are your crashes more severe? When on zero medication, my crashes are moderate; I usually feel it coming on, get up, walk around, get some water and wait till I snap out of it. On Ritalin, the same thing happens; I wander and try to wake up, however I literally black out. No idea what happens, how long I'm away from my desk at work, no idea who saw me, etc. I even have snapped out of it with candy and soda on my desk which I apparently got during my black out. Let me know if any of you have ever had similar experiecnes.

Back to the candy thing I mentioned before. I really feel like my key to staying awake is finding the right balance between food and medication. If I eat a bag of M&Ms, or a reasonably sized lunch, or really anything that isn't considered a snack... I usually end up crashing about 20 minutes later. And this is gluten or no gluten. So I try to eat extremely small meals periodically through the day, generally G-free, so I don't fall asleep. I really feel like food is a main part of the problem! I've not eaten all day to avoid this problem (not medicated at the time) and stayed awake! Once I crash during the day, my mind defaults to reach out for sugar, or anything to help me snap out of it. But this just creates vicious cycle until the end of the day. Just wondering if anyone has these types of problems and if a combination of meds and food intake works for any of you.

Looking forward to many posts and hopefully getting some help and advice from others who suffer like I do! Thanks in advance.

#2 Joyce

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Posted 23 September 2009 - 08:59 AM

i have been on methylphenidate sr 20mg (twice a day) for years - I get the same results as you! esp the desire for sugar after waking from a nap? - thought that was just me! i will be asking my sleep doctor for another solution - I dont like the SR (slow release) so I may go back to regular - but with that I hate the rollar-coast effect!

#3 allisonNYC

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Posted 24 September 2009 - 10:50 AM

Glad to hear I'm not the only one out there who has these effects! I always reach out for sugar after a nap too, and then it creates this vicious cycle of ups and downs until a go to bed for good. That's why I think there is some correlation between food and narcolepsy too. If I eat too much one time during the day, I'm doomed for the rest of the day! It's so frustrating! I've even been tested for all thing blood sugar related (before I had my MSLT) and all my results come back negative!

After reading the NY Times article on recent developments in narcolepsy and attributing it to hypocretin deficiency, I googled hypocretin. I didn't do extensive research whatsoever, but I did read on Wikipedia that "hypocretin-producing cells have recently been shown to be inhibited by leptin (through the leptin receptor pathway), but are activated by ghrelin and hypoglycemia (glucose inhibits orexin production). Hypocretin, as of 2007, is claimed to be a very important link between metabolism and sleep regulation. Such a relationship has been long suspected, based on the observation that long-term sleep deprivation in rodents dramatically increases food intake and energy metabolism."

Perhaps that would sort of explain the crazy high and lows of sugar intake! I really think eating a healthy diet, eating small meals and being conscious of the glycemic index and metabolism helps me stay awake, although its a crap shoot. I would love to hear more thoughts on this!

#4 psocoptera

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Posted 25 September 2009 - 10:19 AM

I don't know about the glucose thing, but I definately have had an increase in gastric motility/appetite issues along with my sleepiness issues.

Regarding ritalin, I only have problems like that when I take it without provigil. It makes me less sleepy most of the time, but when I crash, it is much more intense.

#5 Nyx

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Posted 30 September 2009 - 05:39 AM

Funny, but less than an hour ago I just heard a fantastic lecture about some new research that showed/confirmed that hypocretin producing cells were inhibited by glucose and mannose (but not any other types of sugars like fructose). I think this definitely corresponds to a lot of discussions I've seen about low-carb diets helping people who don't have N have more energy, as well as people with N who find a lower carb diet really helps too.

And while I'm NOT suggesting ANYONE hold their breath (to raise their CO2 levels), the same speaker said that they found that higher levels of CO2 (specifically a lower pH) stimulates hypocretin cells as well. I.e., like why people with sleep apnea have arousals during sleep - it seems to be that the higher CO2/lower pH stimulates hypocretin cells, which triggers arousal. So they think that hypocretin also has a role in regulating respiration as well. Fascinating stuff!

But again, take this all with a grain of salt since the above is simply recent research results, and not clinical practice or a doctor's advice!

As for ritalin, that harder faster crash definitely happens. To be honest, if I were you I'd see about changing to a different med. Black outs are NOT good, especially at work! But maybe first see if it's the short acting ritalin the coincides with the black-outs. Perhaps the slower release of the long acting is less crash-inducing for you?

#6 kmoonshine

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Posted 19 November 2009 - 07:15 AM

I couldn't help but respond since I noticed you're referring to long-acting Ritalin and "crashes".

It's my understanding that some of the longer-acting forms of Ritalin have quite a variable onset, peak, and duration. I remember reading some literature awhile back which stated that some of the formulations had a shorter duration of action than what was previously claimed (ie 3-4 hours instead of 4-6 hours). And I believe there is quite a wide variation between different patients; basically, it's not the most stable medication in terms of day-to-day reliability. So, if you notice the "rollercoaster" effect and your level of sleepiness varies greatly within the day, perhaps keep a sleep diary and document times when you feel awake vs. sleepy. Often, Concerta or Adderall XR are prefered as a long-acting daytime medication because they're "supposed" to last 10-12 hours.

#7 hathor

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Posted 19 November 2009 - 11:29 AM

i was taken off normal ritalin years ago because it causes me to get depressed and really nasty with people without even knowing it. i got told by one of the many specialist ive seen to play around to see what works best for me and told me the maximum amount to take. i was taking between 4 and 6 ritalin a day and 4 clomipramine. no matter how i timed the the pills i had about 3 hours in the morning being hyper and chatty to the point i just couldnt shut up and then crashing for the rest of the afternoon and night. so im not aloud to touch the stuff no more.
As for the sugar binges and food, i always wake up hungry doesnt matter if its day or night i wake up starving. christmas is a nightmare i cant move after eating christmas dinner and end up doing the whole rountine of falling asleep at the dinner table. so its a no win situation where food is concerned, if i stay awake i get hungry from not eating then eat and sleep or wake up and eat then fall asleep it just goes on and on and im forever getting told to loose weight from docs i just never figured out a way of eating anything and not sleeping to excercise!!! one sleep doc told me to cut out carbs because it could help, including chocolate but when i wake up and need sugar thats the first thing ill eat without thinking, and once again fall asleep so food does have alot to do with sleeping its just a case of figuring it out.

#8 ridgerunner1

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Posted 19 November 2009 - 05:36 PM

I have been taking Adderall 30 mg 2 x a day for the last couple of years (not medicated currently due to starting new job and no $$ or ins.). When I am on the meds I feel ok for around 2-3 hours ... and then hang on cause here comes the crash!! It's like hitting a brick wall at 80 mph. I have tried taking the meds at different times, taking drug holidays, etc. but nothing seems to help. I think the XR version of Adderall was the best for me -- I still crashed but not nearly as bad -- but I can't afford it.

Maybe you could switch to Adderall XR or try a different med?? I would definetly talk to your doc and if he/she doesn't listen and respond to your needs I would try to find one that does! Posted Image




#9 Mee

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Posted 13 December 2009 - 10:03 PM

I often crash 4 hours after taking my Ritalin. On bad days and days where I need to be attentive, I take the another pill before I start feeling the crash. Timing is pretty key. I found that drinking coffee helps "activate" the ritalin a little quicker. I don't know if a stomach acid thing or if somehow it makes the pill absorb faster. Maybe someone else knows?

I also have often reached to candy and anything sugary to help me through my crashes. To curb my candy jar pilfering, I've opted for peanut butter snacks (sandwiches or ritz bits), which satisfies the sugar need but is much healthier option. Also I found that if I munch on raw almond nuts before the crashes start, it really helps alleviating the intensity of my crashes (but doesn't prevent them). To avoid falling asleep at work, I eat a very light meal and if I get really hungry then I have a bowl of cereal to hold me over until I get home.

Also, my boyfriend and I debate about carbs vs. protein. I believe that carbs causes sugar highs and crashes. My bf believes that protein requires more energy to breakdown and therefore makes you more sleepy. Its an interesting debate which has merit on both sides. I just stick to eating both in moderation.



#10 Mirianda

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Posted 15 December 2009 - 11:25 AM

I have just started 200mg of provigil in the morning and um... I think its 10mg of ritalin in the afternoon. I have been on provigil for more than a year. I started with 200mg (100mg morning 100mg afternoon) Didn't work. So after I was on 200 mg morning 200mg after noon but I moved out of my parents house (lost my parents insurance) and stopped taking my afternoon dose. At one time, I didn't have the money so I stopped ALL medication. Bad idea. I fell asleep standing at work. So I started again taking 200mg provigil in the morning. I was on that dose for about at least 6 months and I saw my neurologist yesterday. He precribed fast acting ritalin in the afternoon. I tried the pills in the afternoon and after 1/2 an hour up to an hour I started having a little trouble, my heart was beating hard and I felt a little nauseaus. My eyes itched and my mouth was totally pasty. I will try it again today but If those symptoms continue, I don't know what I'll do. I don't really have cataplexy (other than my knees buck from time to another) So I don't want to take Xyrem... it scares me. Anyone knows if my symptoms are "normal" for someone to start taking a new med?

#11 Nyx

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Posted 29 January 2010 - 11:15 PM

I have just started 200mg of provigil in the morning and um... I think its 10mg of ritalin in the afternoon. I have been on provigil for more than a year. I started with 200mg (100mg morning 100mg afternoon) Didn't work. So after I was on 200 mg morning 200mg after noon but I moved out of my parents house (lost my parents insurance) and stopped taking my afternoon dose. At one time, I didn't have the money so I stopped ALL medication. Bad idea. I fell asleep standing at work. So I started again taking 200mg provigil in the morning. I was on that dose for about at least 6 months and I saw my neurologist yesterday. He precribed fast acting ritalin in the afternoon. I tried the pills in the afternoon and after 1/2 an hour up to an hour I started having a little trouble, my heart was beating hard and I felt a little nauseaus. My eyes itched and my mouth was totally pasty. I will try it again today but If those symptoms continue, I don't know what I'll do. I don't really have cataplexy (other than my knees buck from time to another) So I don't want to take Xyrem... it scares me. Anyone knows if my symptoms are "normal" for someone to start taking a new med?


I don't think the side effects you mentioned are all that unusual for ritalin - but that doesn't necessarily mean that that's ok. And you'll probably notice them the most right when you start taking the medication before your body acclimates to some degree. But I would call your doctor and let them know the side effects you're experiencing so they can determine if you should stick with the medication or switch (i.e., your blood pressure, past medical history, etc. would be important to make that determination).

But I think the bottom line to keep in mind is that everyone reacts to medications differently. There are norms, of course, but you may or may not fall into that category. So see how you do with a medication, and if it's problematic and the detriment of the side effects isn't worth the benefit that it's giving you (i.e., staying awake), switch to something else. It's not unheard of for someone with narcolepsy to go through 4 or 5 medications before finding one that's tolerable or that really works (and even then it may only last for so long....). And it's not just provigil, ritalin, xyrem or bust. In addition to other stimulants like nuvigil, dexedrine, adderall, desoxyn, etc., or other sleep aids (rather than xyrem) like ambien or certain anti-depressants, there are also all different types of releases. Sometimes the spike and crash of a short acting ritalin is terrible, but the long acting would be more tolerable. Or perhaps the two releases in one long acting ritalin capsule (one released immediately and the other 4 hours later) is still too much of a spike, but that a slow steady release works better. Unfortunately it's all about trial and error, and having a good physician who will work with you to find it. And then there's also benefit in trying to eat right, use good sleep hygiene and exercise. But a lot of that is of course easier to preach than practice religiously....

#12 ulooktired

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Posted 01 February 2010 - 04:52 PM

This is my first posting in the online community, so hello everyone!

I just started taking long acting Ritalin about 2 weeks ago. I've been trying different combinations/times to see what keeps me awake the best (one long acting in when I get to work seems to work the best so far....although I feel like I need to incorporate one short acting pill in the afternoon next). For those of you who have been on Ritalin, when you do crash and if it doesn't work, are your crashes more severe? When on zero medication, my crashes are moderate; I usually feel it coming on, get up, walk around, get some water and wait till I snap out of it. On Ritalin, the same thing happens; I wander and try to wake up, however I literally black out. No idea what happens, how long I'm away from my desk at work, no idea who saw me, etc. I even have snapped out of it with candy and soda on my desk which I apparently got during my black out. Let me know if any of you have ever had similar experiecnes.

Back to the candy thing I mentioned before. I really feel like my key to staying awake is finding the right balance between food and medication. If I eat a bag of M&Ms, or a reasonably sized lunch, or really anything that isn't considered a snack... I usually end up crashing about 20 minutes later. And this is gluten or no gluten. So I try to eat extremely small meals periodically through the day, generally G-free, so I don't fall asleep. I really feel like food is a main part of the problem! I've not eaten all day to avoid this problem (not medicated at the time) and stayed awake! Once I crash during the day, my mind defaults to reach out for sugar, or anything to help me snap out of it. But this just creates vicious cycle until the end of the day. Just wondering if anyone has these types of problems and if a combination of meds and food intake works for any of you.

Looking forward to many posts and hopefully getting some help and advice from others who suffer like I do! Thanks in advance.


Gee this is me. I work as a nurse and I have to only nibble on noncarbs while working, otherwise I'll crash. But, I get home and crash harder for not eating enough. If I have a bad day I have to time my provigil to what I have to do because I crash on it after 2 hours. I'm headed to the sleep doc tomorrow to see if I can try ritalin, or something else. At least my cat is less and very mild now with Xyrem-thank God. This is the first time I have been on this site in weeks. Just too tired!