Starting ADHD medication

After several years of pondering, waiting for a diagnosis, getting a diagnosis and then waiting to start titration, I’m finally on ADHD medication. 2 weeks in and, well, are they doing anything?

There are two main types of medication you can get in the UK. Methylphenidate, commonly known as Ritalin but goes by many brand names, and Lisdexamfetamine which is known as Elvanse. I find it hard to take tablets and the doctor would have prescribed me Elvanse except only one company makes it and it is very hard to come by at the moment. Instead, I’m on Concerta XL. A brand of methylphenidate and despite a few brands being making it, there’s a shortage. Oh and essentially, it’s speed.

If you don’t know, titration is the process whereby you slowly increase the dosage of a medication to understand how it will affect you. I am on a dosage of 18mg for the first week, doubling to 36mg the next and 56mg for 2 weeks after that one. While I have issues taking pills, I’m doing fine with these. I’m using the Medication feature in Apple Health to log and remind me to take them.

Every medication has side effects. When I tried anti-depression medication I did not enjoy the side effects so I stopped. For methylphenidate, the common ones are headaches, dizziness, unable to sleep, anxiety, irritability and an increased heart rate. I take my blood pressure every morning to monitor the last one. It’s increased as the dosage has but I don’t feel like my heart is pounding. I wouldn’t know if I didn’t monitor it.

Side effect-wise I had headaches every morning for the first 10 days. Thankfully the headaches did not increase as the dosage did. I’m maybe a little bit more easily irritated now and then. I had to lock my cat out of the office as she kept jumping on my desk and wouldn’t lie down. I had work to do and needed to see the monitor. I love that she sleeps on my desk, but I need to work.

The other possible side effect is that I’m a little bit more fidgety in the afternoon. While my computer is processing my hands want to do something. Doomscrolling social media is the go-to, but that’s bad. I’m currently using an old Nintendo Joy-Con as a fidget toy while mounting my phone on top of my computer so it’s just out of reach. This may be the lower doses wearing off.

I do not believe I’m any more anxious than I was before. That’s still at a “Why?!” level of anxiety. As I write this I’m off into town later to do some photography and then I’m going to a queer safe space gig to do more photos. It’s been on my mind since I booked a ticket. Why? No idea. I’ll be fine when I’m in the moment, but getting to that moment is a lot of work. That is normal for me. The medication hasn’t made that worse. I wouldn’t say that I’m overthinking whether the medication is working or not either. No more anxious than “normal”.

The side effects are fine so far. The benefits? I’m not feeling anything. I had hoped that this pill would feel like that first coffee in the morning. Unfortunately coffee doesn’t affect me so I’m not sure what that feeling is like. The way people describe it, it’s a real kick to get you going. I wanted that. I wanted to sit down and work, to get things done, to answer emails right away without all the mental processing and leaving till late due to anxiety. I wanted to be blogging each day, to build my Instagram following by posting coherent work daily and sort my portfolio site. I wanted to finish that Amazon order I started a month ago. Did I expect too much? I’m getting things done, but it doesn’t feel like I’m focused and driven.

So far the only thing I’ve managed to achieve is closing my exercise ring and hitting my water goals every day since starting the medication. I’m drinking 2.5 litres every day. No caffeine. No alcohol. My pee colour is mountain spring clear. I guess that’s something?

I’m doing everything the NHS and various sites suggest you do. Reduce your alcohol intake. Drink plenty of water. Get a good night’s sleep. Exercise daily. Yet I still feel like 2023 me. Sure I’m too hard on myself, but I’ve got 25 years to build a retirement plan and only I can do it. I need to be doing better. Make work, get work, make invoices, get paid. Rewatch Doctor Who.

Maybe this is it? I was never good at hitting my water goals or closing my exercise ring. When I finish a bottle of water I simply go and top it up. No complex thoughts. I just do it. I’m just doing exercise without too much pushback from my brain. Is this it? Hard to know. Let’s see how easy it is to do invoicing and monthly accounting.

This series of videos by Rachel Walker are an interesting look into how I’m feeling.