How much can I reduce my Ritalin dose for the withdrawal effects to be tolerable?

[Sir.otonin]

As some of you may know, I've been taking huge amounts of Ritalin for the past few months. around 800 mg of IR pills plugged and 600 mg of slow-release pills taken orally. now I literally can't afford it anymore, but the problem is that I can only taper very very slowly otherwise I can't work (zero concentration and motivation) and at that rate, it would take forever, and I can't continue paying for it (among other problems). Now I have 2 weeks off of work which I am gonna use to lower my dosage as low as possible so that it doesn't take years when I go back to tapering slowly afterward. I don't know how much of a low dose I can take and have the withdrawal symptoms be tolerable with a bit of help from benzos (and other things if you guys have suggestions).
Can you tell me what dose should I try this with? if I take half of what I'm taking now, would the WD be too harsh to handle? or can I go lower and try with 1/3 of my current dosage? any other suggestions? please respond and help me get through this, I have only one chance to take this right

 

[ninjapirateroberts]

800mg and 600mg are very high doses at this point; you should probably try amphetamine-based stimulants if methylphenidate isn't doing its job anymore.

If you don't have access to pharma-pressed Adderall or amphetamines, buy crystal methamphetamine and try a 25mg dose (always start with small and increase gradually).

There are only so many things a drug can do, and increasing the dose will not give you the same therapeutic effect. At that point you should switch to a more potent drug rather than increasing your current drug.

Potency (pharmacology) - Wikipedia

en.wikipedia.org

 

[Sir.otonin]

800mg and 600mg are very high doses at this point; you should probably try amphetamine-based stimulants if methylphenidate isn't doing its job anymore.

If you don't have access to pharma-pressed Adderall or amphetamines, buy crystal methamphetamine and try a 25mg dose (always start with small and increase gradually).

There are only so many things a drug can do, and increasing the dose will not give you the same therapeutic effect. At that point you should switch to a more potent drug rather than increasing your current drug.

Potency (pharmacology) - Wikipedia

en.wikipedia.org

if I can't quit Ritalin I would have to switch to Meth because I can't afford to pay for this much Ritalin anymore, but switching to Meth is no joke as I have a long history of addiction and that can soon turn into a much bigger problem. thus the importance of using these 2 weeks off of work to try and quit Ritalin. so can you answer any of the questions I asked? would the withdrawal symptoms be very hard if I suddenly halve my dose?

 

[ninjapirateroberts]

if I can't quit Ritalin I would have to switch to Meth because I can't afford to pay for this much Ritalin anymore, but switching to Meth is no joke as I have a long history of addiction and that can soon turn into a much bigger problem. thus the importance of using these 2 weeks off of work to try and quit Ritalin. so can you answer any of the questions I asked? would the withdrawal symptoms be very hard if I suddenly halve my dose?

To answer your question, yes. The withdrawal symptoms will be very harsh given you take an insane amount of Ritalin dose through unconventional ROA.

 

[4meSM]

If you don't have access to pharma-pressed Adderall or amphetamines, buy crystal methamphetamine and try a 25mg dose (always start with small and increase gradually).

I get what you're saying, but I don't think this is good advice for someone who has significant issues controlling his methylphenidate intake.

Personally I've never tapered with stimulants, I think cold turkey is more efficient if you don't have to work.
Since you have 2 weeks I'd just stop cold turkey and recover as much as possible, it will at least lower your tolerance significantly. You'll probably be sleeping and eating a lot, which is not that bad IME. The mental aspect is another issue though, expect some anhedonia and a complete lack of motivation for a couple of days at least.

 

[ninjapirateroberts]

I get what you're saying, but I don't think this is good advice for someone who has significant issues controlling his methylphenidate intake.

Personally I've never tapered with stimulants, I think cold turkey is more efficient if you don't have to work.
Since you have 2 weeks I'd just stop cold turkey and recover as much as possible, it will at least lower your tolerance significantly. You'll probably be sleeping and eating a lot, which is not that bad IME. The mental aspect is another issue though, expect some anhedonia and a complete lack of motivation for a couple of days at least.

I agree. If someone has a history of substance abuse or cannot take drugs responsibly, my advice probably wouldn't suit them.

I also agree with going cold turkey. Neither have I tried tapered with stimulants when I used to self-medicate with crystal meth for ADHD. Personally, for me, going cold turkey works the best in terms of tolerance build-up.

But AFAIK, most stimulants have only psychological dependence and not physical dependence (unlike benzos), so I guess it's safe to go cold turkey with stimulants when compared to something like benzos. But I could be wrong, given OP takes very high doses.

 

[Sir.otonin]

I get what you're saying, but I don't think this is good advice for someone who has significant issues controlling his methylphenidate intake.

Personally I've never tapered with stimulants, I think cold turkey is more efficient if you don't have to work.
Since you have 2 weeks I'd just stop cold turkey and recover as much as possible, it will at least lower your tolerance significantly. You'll probably be sleeping and eating a lot, which is not that bad IME. The mental aspect is another issue though, expect some anhedonia and a complete lack of motivation for a couple of days at least.

yea I am going to do whatever in my power so that I'm not forced to go the Meth route. that is why I have to make the best of these two weeks. if I lower my dose to a third of what it is now, it would be more sustainable and I can slowly taper from there, at a rate that doesn't take forever but also allows me to work. I just don't know if I can tolerate the symptoms if I suddenly cut my dose to one-third. that is my main question here, what dose should I try with? the second question is what helps with the withdrawal? I'll take Benzos, what else could help?

 

[4meSM]

yea I am going to do whatever in my power so that I'm not forced to go the Meth route. that is why I have to make the best of these two weeks. if I lower my dose to a third of what it is now, it would be more sustainable and I can slowly taper from there, at a rate that doesn't take forever but also allows me to work. I just don't know if I can tolerate the symptoms if I suddenly cut my dose to one-third. that is my main question here, what dose should I try with? the second question is what helps with the withdrawal? I'll take Benzos, what else could help?

Which symptoms are you afraid of? (Considering you won't have to work) Cravings?

Have you ever tried to stop before?

 

[Sir.otonin]

I agree. If someone has a history of substance abuse or cannot take drugs responsibly, my advice probably wouldn't suit them.

I also agree with going cold turkey. Neither have I tried tapered with stimulants when I used to self-medicate with crystal meth for ADHD. Personally, for me, going cold turkey works the best in terms of tolerance build-up.

But AFAIK, most stimulants have only psychological dependence and not physical dependence (unlike benzos), so I guess it's safe to go cold turkey with stimulants when compared to something like benzos. But I could be wrong, given OP takes very high doses.

I'm sure I can't tolerate the WD symptoms if I quit cold turkey, from this dose to zero. If I'm on a third of this dose after this 2-weeks, I'm gonna be fine, I'll taper slowly enough to be able to work. suddenly taking 2/3 lower would send me into withdrawal, but it probably is considerably more tolerable than suddenly taking zero, no?

 

[ninjapirateroberts]

yea I am going to do whatever in my power so that I'm not forced to go the Meth route. that is why I have to make the best of these two weeks. if I lower my dose to a third of what it is now, it would be more sustainable and I can slowly taper from there, at a rate that doesn't take forever but also allows me to work. I just don't know if I can tolerate the symptoms if I suddenly cut my dose to one-third. that is my main question here, what dose should I try with? the second question is what helps with the withdrawal? I'll take Benzos, what else could help?

Is your primary concern just lowering your tolerance to methylphenidate? Or lowering your tolerance AND ALSO help you focus? Because when people with ADHD try to lower their dose, the drug's ability to suppress the ADD symptoms will decrease (so their ADD symptoms would come back). So I'm not sure if you're a recreational user or if you need help with lowering your tolerance and also being able to suppress your ADD symptoms.

 

[Sir.otonin]

Which symptoms are you afraid of? (Considering you won't have to work) Cravings?

Have you ever tried to stop before?

well from what I've gathered, the WD comes in two parts, the first part I'm mostly asleep but not comfortable sleep, more like how you sleep when you have the flu. cold sweats and headaches and shivers and all. then after this part is over you are physically normal but immensely depressed. I can't tell which part I'm more afraid of as they both sound horrible.

 

[Sir.otonin]

no

Is your primary concern just lowering your tolerance to methylphenidate? Or lowering your tolerance AND ALSO help you focus? Because when people with ADHD try to lower their dose, the drug's ability to suppress the ADD symptoms will decrease (so their ADD symptoms would come back). So I'm not sure if you're a recreational user or if you need help with lowering your tolerance and also being able to suppress your ADD symptoms.

no it's not about lowering my tolerance. I don't have ADHD, I have a bad case of clinical depression and I began taking Ritalin as the euphoria helped with the depression, and then my dosage just sky-rocketed to what it is now. it is not about lowering my tolerance, it is about quitting Ritalin. but normally I have to taper very slowly because otherwise with the WD symptoms I can't work. So now that I am off I want to be on a lower dose that I can slowly taper from afterwards

 

[4meSM]

well from what I've gathered, the WD comes in two parts, the first part I'm mostly asleep but not comfortable sleep, more like how you sleep when you have the flu. cold sweats and headaches and shivers and all. then after this part is over you are physically normal but immensely depressed. I can't tell which part I'm more afraid of as they both sound horrible.

Well I don't have much experience with methylphenidate but I've quit both meth and amphetamines a couple of times and have never experienced flu-like symptoms or those things you described. The main WD symptoms are fatigue, lack of motivation, increased appetite, anhedonia and perhaps some anxiety which is related to cravings for the drug.
I honestly think it won't be nearly as bad as you imagine, it's mostly psychological.

On the other hand, if you wanted to quit stimulants completely you'd also have to address the underlying reasons why you've been taking such high doses in the first place.

 

[ninjapirateroberts]

Well I don't have much experience with methylphenidate but I've quit both meth and amphetamines a couple of times and have never experienced flu-like symptoms or those things you described. The main WD symptoms are fatigue, lack of motivation, increased appetite, anhedonia and perhaps some anxiety which is related to cravings for the drug.
I honestly think it won't be nearly as bad as you imagine, it's mostly psychological.

On the other hand, if you wanted to quit stimulants completely you'd also have to address the underlying reasons why you've been taking such high doses in the first place.

Yep, I've also only ever had psychological WD symptoms when going cold turkey with stimulants (usually only mental fatigue, lack of motivation and just being lazy). OP said he doesn't have ADHD, and that he's taking methylphenidate for clinical depression due to its euphoriant properties. I guess he'd just need to take the right drugs for his condition, which is depression, and not ADHD. So he should either switch to a potent euphoriant (so that he doesn't take insane methylphenidate doses and can quit it completely) or take drugs like MDMA or potent anti-depressants. Given what he's said so far his main WD fear seems to be the depression that comes along with quitting methylphenidate. So he needs to address depression.

 

[4meSM]

Yep, I've also only ever had psychological WD symptoms when going cold turkey with stimulants (usually only mental fatigue, lack of motivation and just being lazy). OP said he doesn't have ADHD, and that he's taking methylphenidate for clinical depression due to its euphoriant properties. I guess he'd just need to take the right drugs for his condition, which is depression, and not ADHD. So he should either switch to a potent euphoriant (so that he doesn't take insane methylphenidate doses and can quit it completely) or take drugs like MDMA or potent anti-depressants. Given what he's said so far his main WD fear seems to be the depression that comes along with quitting methylphenidate. So he needs to address depression.

Yeah pretty much.
Although treating depression is far from trivial (depending on his life situation).

But yeah I don't think his idea of doing a very slow taper will work in the long run, it's better to quit and let the brain fix the downregulation of his dopamine receptors as much as possible. Then after 2 weeks he could try to take the smallest effective dose if he feels like he cannot work at all without it. And of course get help or try to come up with a strategy to address his underlying depression (which will be worse after the stim abuse)

But overall the main short term issue I see here will be resisting the cravings to take more MPD during that time, because your brain will convince you that you NEED it to survive (which isn't true).

 

[ninjapirateroberts]

Yeah pretty much.
Although treating depression is far from trivial (depending on his life situation).

But yeah I don't think his idea of doing a very slow taper will work in the long run, it's better to quit and let the brain fix the downregulation of his dopamine receptors as much as possible. Then after 2 weeks he could try to take the smallest effective dose if he feels like he cannot work at all without it. And of course get help or try to come up with a strategy to address his underlying depression (which will be worse after the stim abuse)

But overall the main short term issue I see here will be resisting the cravings to take more MPD during that time, because your brain will convince you that you NEED it to survive (which isn't true).

Maybe he can go cold turkey from methylphenidate and temporarily take some other drugs for the first few weeks that would take the edge off when going cold turkey from methylphenidate (his primary concern being depression). That way, he can also quit Ritalin completely and not have the worst rebound depression when going cold turkey (at least for the first few weeks). That's what I'd do if I were in his situation.

 

[Sir.otonin]

Maybe he can go cold turkey from methylphenidate and temporarily take some other drugs for the first few weeks that would take the edge off when going cold turkey from methylphenidate (his primary concern being depression). That way, he can also quit Ritalin completely and not have the worst rebound depression when going cold turkey (at least for the first few weeks). That's what I'd do if I were in his situation.

I am taking Sertraline for depression, 300 mg a day, been 3-4 months I'm not sure how much better it has made me. The doctor that prescribed it also prescribed Olanzapine and Clonidine which I later realized probably was to inhibit stimulant psychosis and heart problems with such high dose of Ritalin I'm abusing. she believes that unless I'm hospitalized, I should taper Ritalin slowly as it can worsen my depression to degrees that could be dangerous (becoming suicidal an all). she is not at all agreeing with my current plan as well, since it's 2 weeks off and I wont have access to her if anything goes wrong. she was like if you're doing it it's on you and has nothing to do with me. she believes I should be hospitalized, and if not that then any change must be done very slowly

 

[ninjapirateroberts]

I am taking Sertraline for depression, 300 mg a day, been 3-4 months I'm not sure how much better it has made me. The doctor that prescribed it also prescribed Olanzapine and Clonidine which I later realized probably was to inhibit stimulant psychosis and heart problems with such high dose of Ritalin I'm abusing. she believes that unless I'm hospitalized, I should taper Ritalin slowly as it can worsen my depression to degrees that could be dangerous (becoming suicidal an all). she is not at all agreeing with my current plan as well, since it's 2 weeks off and I wont have access to her if anything goes wrong. she was like if you're doing it it's on you and has nothing to do with me. she believes I should be hospitalized, and if not that then any change must be done very slowly

Have you tried Ketamine in the past?

 

[ninjapirateroberts]

If you fear depression-induced suicidal thoughts when quitting Ritalin, Ketamine has been researched for treatment-resistant depression, particularly those with suicidal thoughts. If you haven't already, it won't hurt to try Ketamine.

Ketamine for suicidal ideation in adults with psychiatric disorders: A systematic review and meta-analysis of treatment trials - ORA - Oxford University Research Archive

Objective: Ketamine may reduce suicidal ideation in treatment-resistant depression. But it is not known how quickly this occurs and how long it persists. We undertook a systematic review and meta-analysis to determine the short- and long-term effectiveness of ketamine for suicidality. Method:

ora.ox.ac.uk

 

[Sir.otonin]

If you fear depression-induced suicidal thoughts when quitting Ritalin, Ketamine has been researched for treatment-resistant depression, particularly those with suicidal thoughts. If you haven't already, it won't hurt to try Ketamine.

Ketamine for suicidal ideation in adults with psychiatric disorders: A systematic review and meta-analysis of treatment trials - ORA - Oxford University Research Archive

Objective: Ketamine may reduce suicidal ideation in treatment-resistant depression. But it is not known how quickly this occurs and how long it persists. We undertook a systematic review and meta-analysis to determine the short- and long-term effectiveness of ketamine for suicidality. Method:

ora.ox.ac.uk

I do take Ketamin quite regularly, but in higher doses compared to what is usually suggested for anti-depressant properties (K-hole doses). though sometimes in parties I take lower doses. I plan to get help from the Super K during this 2 weeks if the withdrawal becomes too intense