Archive for December 20th, 2007

I was going to add this to my last post but it would have been just too incongruous. Talk about ADD.

I went to see Merlin #2 yesterday. I’m making a med swap. I am currently on 36mg of Concerta/extended release Methylphenidate. I wasn’t sure how I was doing. It has been helping, there is no doubt about that but I’m still struggling in the motivation, concentration and yes, the impulse control department.

Now, the stupid thing (I find) about Concerta is the titration schedule. It runs up in 9mg dosages from 18mg to my 36mg and then it doubles to 54mg. There is no 45mg! It doesn’t make sense to me from either a pharmacokinetic or a pharmacologic perspective–why you’d need to skip the next 9mg level. You’ll see why momentarily.

Merlin #2 was hesitant to go the distance to the maximum dose of 54mg. That’s fair. It is possible that it might be too much even though I haven’t had any problems with taking the Concerta. So what am I moving on to? Adderall XR? Nope. Dexedrine? Nope. Ritalin? Nope…I just shortformed it to Ritalin as that is basically immediate release Methylphenidate. It wouldn’t really make sense to switch me to the same drug I’m on would it?

Sure it would.

I’m going to start taking Biphentin. Haven’t heard of it? Well, maybe you have but I hadn’t. Oh, for shame PA! You didn’t know of it??? I’m just kidding. It’s not like I am so brilliant that I know everything about every med out there.

Alright, so here’s the deal with Biphentin. Why you may have never heard of it is because it’s only available in Canada and it was introduced in, as far as I can tell, late 2006. Biphentin is exactly the same as Concerta. Yes, I can hear you all saying, “What? PA, why are you now going to take Biphentin?” Well, there are some advantages to the drug.

It comes in capsule form with little balls so you can break it apart and sprinkle it all over your ice cream to make a little Biphentin/AD(H)D Sundae! That’s better for the kiddies or perhaps, people who can’t take or don’t like taking pills. Or you can be evil and dose someone without them knowing? I’m joking… However, I’m fine with taking pills so this doesn’t matter for me. The benefit for me is…as I was heading…the titration schedule. It is much more flexible and has way more wiggle room.

I’m starting at 40mg and can move up to the maximum dosage of 80mg in 10mg increments. That’s a lot better than sitting at 36mg of Concerta and being “stuck.” And there you go: No skipping incrementally.

Beyond that in terms of no benefits, I’ve read a bit of differing information but some small things conflict. Some of the literature states that Biphentin and Concerta work basically the same, some say that Biphentin releases more of the Methlyphenidate faster but only lasts about eight to 10 hours as opposed to Concerta’s 12 hours. Alright, does it really matter? Probably not that much. And again, with regular daily dosing…eh.

But it’s the same molecular structure–exactly! So, I am assuming that what is perhaps happening is the outer shell of the Biphentin capsule is breaking down faster than that of the Concerta’s and the wee balls are being absorbed faster than the formulation of the Methylphenidate in the Concerta. Again…whatever.

And hey, my starting dose of 40mg pills are pink! Right now, all of my pills are of only two colours. It will be nice to add some variety? And oh…whoops! Good thing I just called my pharmacy…it’s so new that they have to put in an order for it! They’re not carrying it regularly? I should have it by tomorrow. Not that I’m all hepped up to start it…I’m just not sure how much Concerta I have left and with all of the holiday stuff coming up, stores will be closed, I will be off work and not as close to my preferred and much better pharmacy…ugh. I just don’t need the hassle of chasing down a script.

So there’s some ADD med news that you might find somewhat interesting…a new drug on the scene.

In my post about Sartre and Cycling, amy mentioned that it must be very frightening to be an Ultradian Cycler. I replied that it wasn’t so much as a) I have learned to monitor my cycling patterns well over the years, b) sometimes it can be so fast that it is over within a day–yes, one day and c) I am on meds so I am doing better than I would be off them! I also said that something else is more “frightening” to me these days.

I am seeing things. No, I am not hallucinating. I am seeing things in my life. About my life. I would like to say that I am learning? That this is an opportunity? But that is a hard thing for me to say at this moment…for it is causing me to feel uncomfortable. It is causing me to feel pain.

I am simultaneously seeing events from my past, present and future collide. Alright, the part about the future makes me sound like I am psychic or have some kind of magical, crystal ball or something but it is true. I can see (to a degree at least) where some things are headed.

I mentioned in a previous post how I can have a mind that is like a freight train where some things are concerned (well…probably a lot of things, really.) It runs at great speed down a straight ahead track. There are no curves and even if there were, no one is around to turn the switch.

Well, guess what? The track has changed. It now twists and turns and the trainman has shown up early for his shift! The train is climbing a route that is now on its way up a craggy, mountainous hill. At the very end, there is a steep cliff. If PA doesn’t put on the brakes, there’s going to be one hell of a train wreck.

All of these thoughts and feelings are disturbing. This task ahead seems daunting. I would much rather ignore everything, just shut it all out but I simply can not. Do I simply bury my head in the sand when I keep receiving bitchslap after bitchslap?

This may be a point, the point(?) where I have to do the most amount of personal work, soul searching…I don’t know…in my life. I know that logically, things need to be done in steps. You start with one issue or item and then once that is tackled you move on. But when you are bombarded with so much emotion and internal turmoil, it is both hard to know where to start and if you can get there, how do you stay there. How do you stay focused.

You know, if anyone wants to go a few rounds on the wrestling mat fighting over who loathes PA the most, I’ll tell you who will win. The vast majority of you are most definitely much larger than tiny PA but she’s wily, wiry and can outmanoeuvre you in any contest there. So failures, backslides, more bitchslaps… *sigh* Again, looking ahead to my future, this is going to be fucking hard.

So I’m really not sure what else I can say about all of this. On to my ADD med news?