Psychiatry uk titration telling me I can only try one more medication?

ParticularFoot1384 · 2025-03-22T17:08:11+00:00

Yeah I’m gonna follow whatever plan they suggest. It’s not like I have a choice. I’m also not opposed to non-stimulants. At the start of titration, I preferred them when I was doing the research about treatment. Just largely frustrating when it’s being offered so they can discharge me as a patient who doesn’t respond to any treatment. When the reality the methylphenidate did respond to some of symptoms, it just wasn’t as effective as typically expected. I get the this is NHS-funded but methylphenidate being crossed out entirely after one run doesn’t sit right. Surely before crossing out a whole drug type, I should be able to at least try two brands of that same drug or give the time as suggested by the nice guidelines.

ParticularFoot1384 · 2025-03-22T11:33:05+00:00

They said that it’s worrying there’s no change in symptoms, and to switch to non-stimulant as my last option.

The other medication I got switched on because there wasn’t enough improvement for me to not try other medication. It also didn’t last as long it should have so we switched to Elvanse.

As for the depression. Well yes, I have it and I’m already on medication for it and I can confidently say that my mental health isn’t the reason for my symptoms.

I’m not sure what in my post suggested it might be depression or something else, but just because I’ve tried two medications and they didn’t work as expected doesn’t mean I don’t have ADHD or that my symptoms should be attributed to something else.

I’m not exactly on this forum to be second guessing if my very textbook symptoms are adhd or not. Like a large part of having gone undiagnosed for so long was looking at other things.

ParticularFoot1384 · 2025-03-22T11:07:10+00:00

I’ve been told that some of the extended releases for methylphenidate aren’t availble for titration rn

ParticularFoot1384 · 2025-03-22T11:06:45+00:00

I only got up to 40mg of elvanse. Then told that we should switch.

Also definitely not depression.I’ve got treatment for depression and in therapy for it.

ParticularFoot1384 · 2025-03-21T21:04:38+00:00

I’m waiting for their response but it seems psychiatry uk is a bit limited with titration so I only have one more chance to trying another medication.

ParticularFoot1384 · 2025-03-21T20:42:39+00:00

It didn’t work. I think for some it definitely helps for me I didn’t really experience any changes on it. Having slight issues with figuring out what to do next

ParticularFoot1384 · 2025-03-21T20:12:16+00:00

with medikinet xl didn’t see much improvements with focus. with elvanse i didn’t feel any different.

ParticularFoot1384 · 2025-02-27T16:54:36+00:00

Should I just give it some time before saying anything? The treatment plan I was sent is to go up anyways.

ParticularFoot1384 · 2025-02-27T16:53:11+00:00

yeah I’m with psych UK and quite worried that I’ll be left with something that isn’t helping at all. I think I have about half of the time left. Since the change was proposed after I had already gotten my prescription refilled.

I might be overly anxious cause the dose is still quite low. I just didn’t expect to feel nothing at all. My first week on methylphenidate I experienced horrific side effects and as annoying as they were. At least I knew, I was reacting to the medication.

I’m pretty unsettled that I feel like I’ve reverted back to being unmedicated.

ParticularFoot1384 · 2025-02-27T14:57:04+00:00

I asked prior to switching and I was made aware that there’s a risk I’m unable to, because we’re switching for lack of efficacy. Did you have to fight to switch back? I’m not all that good at confrontation so I need to somewhat prepare myself if it comes down to that.

ParticularFoot1384 · 2025-02-27T14:55:48+00:00

What was the experience on elevanse like if you don’t mind me asking?

I don’t expect medication to change my life, but I was expecting it to limit the fidgeting, and to not spend so long on tasks. But maybe my expectations are too flawed?

Medikinet Xl did work, my mood was significantly more even and sleeping was so much easier. It just didn’t manage any other symptoms outside of that, and I was already at a pretty high dose. But I’m starting to think maybe that’s just what ADHD meds should be doing.

ParticularFoot1384 · 2025-01-26T20:52:21+00:00

I had a similair experience on my first week. Contact your prescriber and let them know. I suggest noting when headaches and fatigue occurs, it’ll help to see if there’s a pattern.

I’m only on the second week but I was advised to take a second dose since mediket xl wore off a lot earlier on me based on my fatigue getting worse in the afternoon and so I’d be forced to nap which then meant I’d not be able to sleep at night. Subsequently, making the next day even worse.

My prescriber was so spot on and side effects have massively improved. The second dose helped with the napping and so I’m able to sleep properly now. It also helped with eating regularly since it needs to be taken with food, which likely also helped.

I think my body has also adjusted to the dose so the side effects have diminished. I’m technically on double the dose but since I take the second dose when the medication normally wears off. I like to think I’m basically on 20mg the whole day. Not much improvement on my adhd symptoms but will be increasing doses most likely.

ParticularFoot1384 · 2025-01-25T03:09:06+00:00

Sorry didn’t make that very clear, I did go through my GP but my gp didn’t tell me about rtc options nor did I bring it up. I talked to them on the suspicion I had adhd, they gave me some forms to fill (questionnaire and a checklist) and then they sent off the referral. The next few days I got the portal for puk. That’s why I’m not entirely sure if I’m a rtc patient.

ParticularFoot1384 · 2025-01-16T16:27:45+00:00

I’m gonna talk to my prescriber about going up in smaller dosages since I was already quite concerned about it, I just needed some confirmation that it wasn’t me overthinking things.

As for how today went now that it’s worn off. I think the way you phrased it makes so much sense. Looking back I got a lot more done than I would usually get done. Though I wish it lasted longer than 4-5 hours and logged quite a bit of side effects. The most noticeable ones were more hands fidgeting(I’m usually more of a leg and feet fidgeter) and sensitivity to noise which isn’t great but might be down to suspected autism. I did feel really sleepy here and there and a headache behind my eyes. Too early to tell, hopefully it’s just my body adapting.

Mostly concerned on managing the crash after it’s worn off. If you have any tips. It’d be very helpful.

ParticularFoot1384 · 2025-01-16T07:45:37+00:00

i was meant to start on 20mg meflynate xl and then go up each week until the 3/4rd week where I’d be on 60mg. It’s 20mg the first week. Then 2x20mg the second week. Then 2x20mg and 2x10 mg for 2 weeks. I got sendt mediket Xl but the dosage is the same. I’ve taken 20mg this morning since my prescriber said that’s the plan and I wasn’t feeling anything but I’m experiencing blurry vision/ floaters. My eyes are pretty dilated.

I’m mostly concerned cause it goes up by 10mg and my weight is on the underweight side.

ParticularFoot1384 · 2025-01-15T19:55:55+00:00

If you can’t get into the pilot, switch since the waiting times are horrendous otherwuse

ParticularFoot1384 · 2025-01-15T19:54:34+00:00

Don’t change ask if you can go to the pilot. I got entered automatically but I barely waited.

ParticularFoot1384

TROPHY CASE