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Old 06-24-2007, 01:21 AM   #1
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The search for Ritalin - the adventure

i'm composing this off-line in order to get my thoughts in order, and what I'm actually posting here is a heavily edited version of the loooong saga that poured from my typing fingers. Whew! It's really hard for an ADD person to decide real-time what is appropriate to the topic and what's just a lot of colorful background filler. I'm soooo greatful for text editors.

12 years ago, in America, I was diagnosed with ADD and given a prescription for Ritalin. I took it for 3 months just before we moved to Germany. It calmed down the chaos in my brain and allowed me to: sort through my options for the day, prioritize the activities, set up plans for carrying through those activities, and then actually getting those activities done. What a concept. Not possible pre-Ritalin. Then we moved to Germany.

The first psychiatrist that I tried to get a Ritalin prescription from looked at me in a worried way and said something like "you're addicted and we have to wean you off this horrible drug." She gave me a prescription and told me to take it in smaller and smaller doses over the next month so that I would have fewer problems with withdrawal. Uh huh. Being a person with ADD, I often forgot to take my one single 10 mg pill per day when I was in the US. I had no withdrawal symptoms on those days. I was merely my normal space-cadet self. If I noticed by mid-afternoon that I had forgotten my pill, I shrugged and said, "it's too late to get anything started today, I'll just try to remember to take it tomorrow morning". This is not addiction, folks.

Being a person with ADD (and at that time pretty poor at understanding and speaking German), I didn't have the skills (linguistic or mental) to argue my case, or search for another doctor who might have a different view of Ritalin. So I gave up.

By the end of last year I was depressed about the fact that I have been living for 12 years just floating along, starting and then forgetting projects, being spaced all the time, not getting anything done during the day even if it was on a list.

My German has improved, and I decided that enough was enough. I started contacting people to see if I could track down a sympathetic doctor.

This is what I've learned about ADD in Germany: It's a children's condition. The theory is that if children get intensive intervention early in life (coaching, therapy, drugs if needed and tolerated), then the conventional wisdom is that they will outgrow it and go on to live their adult lives without Ritalin (and presumably without ADD). So therefore doctors rarely treat adults for ADD.

I attempted to get an appointment with recommended doctor #1 here in the small town where I live. He was booked up, and he wasn't adding any more patients to his list.

I was given the name of doctor #2 in the Big City. I explained to the receptionist over the phone: "adult with ADD, looking for Ritalin, blah, blah". She said sure, gave me an appointment for 3 months later. I showed up, told the doctor "adult with ADD, looking for Ritalin, blah, blah". He said he doesn't give out prescriptions for ADD because the special forms that are required would attract thieves to break into his office. He gave me the name of doctor #3.

I explained to the receptionist over the phone: "adult with ADD, looking for Ritalin, blah, blah". She said sure, gave me an appointment for 2 months later. I showed up, told the doctor "adult with ADD, looking for Ritalin, blah, blah". He said that he doesn't treat adults. He said that there are maybe one or two doctors in all of Big City that are willing to treat adults with ADD. I asked doctor #3 what doctors in Germany thought happens to children with ADD when they grow up. He said that doctors in Germany have just begun talking about that in the last year or two. He gave me the name of doctor #4.

I explained to the receptionist over the phone: "adult with ADD, looking for Ritalin, blah, blah". She said that her doctor was one of the one or two in Big City who treats adults for ADD, gave me an appointment for 2 months later.

Friday, two days ago: I see doctor #4. He asks a few questons, believes me when I say that I was diagnosed in the US and had taken Ritalin for 3 months. Didn't ask to see any pieces of paper (I had a copy of my US doctor's diagnosis with me). He said that normally he would give me neurological tests (I'm not sure just what those would be), and ask me to fill out a questionaire to see how well I fit the definition of ADD, and then start on a series of different drugs to see which (if any) would help me. But since I was already diagnosed and had already had good experience with Ritalin, he would write me out a prescription and see me again in a month. He said that legally, Ritalin is used for ADD only for children, and that its only use in adults was for Narcolepsy. So therefore I had to sign a form saying that I realized that I was taking a medicine for an "off-label" use, and that my health insurance probably wasn't going to pay for it.

I picked my jaw up off the floor, took my prescription and high-tailed it out of there to get it filled.

I'm taking the generic form, methylphenhydrat. The instructions are: for the first 3 days to take 5 mg once a day, for the next 3 days to take 5 mg and then 5 mg 3 hours later, and for the next 4 days to take 5 mg 3 times per day 3 hours apart. Adjust as needed, report problems to the doctor, otherwise see him in a month for the next evaluation.

Yesterday I took the first dosage. It took about 20 minutes to "kick in", lasted for about 4 hours before it started to taper off. Side effects: dizziness and dry mouth, both of which I experienced 12 years ago. Good effects: I felt a calm come over both my body and my mind. I was able to do some projects that would have had me tearing my hair out without the drug. I was able to interact with my husband in a pleasant manner while this and other projects were being discussed, planned for and acted upon.

I look forward to taking my one alloted pill for today. I'm glad the adventure has (so far) had a positive outcome. I look forward to painting. I look forward to writing. I may even be able to focus long enough over the next few months to consider how to set myself up as an independent something or other that will bring in a few Euros.

Sorry this is so long. You should have seen it before I shortened it.

--Rheanna

 
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Old 06-28-2007, 05:52 AM   #2
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Re: The search for Ritalin - the adventure

Rheanna,

So glad the adventure (marathon search?) ended in success.

I give myself a B+ on my ADHD management. It would have been an F- without the Ritalin. It is nearly impossible to make corrective habit and lifestyle changes without meds boasting our working memory IQ.

I am very happy for you.

Bob
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Old 06-28-2007, 08:17 PM   #3
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Callista HB User
Re: The search for Ritalin - the adventure

Wow... that's just weird. You'd think a doctor would know Ritalin doesn't cause addiction or withdrawal.

I know that Germany tends towards a more holistic, natural approach to medicine; and I know that they aren't near as quick to prescribe for mental/neurological stuff as we in the US are; but a person with clear attention-deficit, whose problems are much more manageable when taking Ritalin... even somebody reluctant to prescribe should see there's a clear benefit! I think you just got somebody who has been reading too much anti-med propaganda. It's silly to think NEVER or ALWAYS with Ritalin or any other psych med. You have to take it on a case by case basis, and I'm really astounded that a doctor would be so dogmatic about something like that.

Regarding neurological tests: These are usually done to rule out any other condition--most of them more serious than ADHD--that could be causing problems. Of course if you've had it all your life, it's pretty certain it's ADHD... but the doctors always seem to want to make sure. These days they can be sued at the drop of a hat.

Anyway, glad you finally tracked down what you needed! One caution, though: Remember Ritalin isn't a cure-all, and that you still have to learn those anti-ADHD skills yourself... Ritalin just makes it easier. Of course, the pro side of that is that once you have been on Ritalin and learned coping skills that way, they'll carry over even when you're not on it... taking the edge off the confusion even without drugs.

Last edited by Callista; 06-28-2007 at 08:19 PM.

 
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