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    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

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Hello everyone,

I have had fatigue, depression and attention problems all my life and worse the last decade or so. After postponing and postponing for years I finally took the plunge and saw a psychiatrist who diagnosed me with ADHD inattentive. It didn't exactly come as a surprise as I had suspected it for a long time.

Anyway, she decided to start me off on methylphenidate 10mg twice a day on top of my already established venlafaxine 225mg once a day dose and 100mg thyroxine for hypothyroidism.

I took the tablet and didn't feel much different except for extreme sleepiness about 90 minutes are the tablet. It didn't improve with subsequent doses of methylphenidate either. The 2nd day I ended up taking 10mg every two hours over an eight hour span. I told the doctor all this and we decided to try Concerta 18mg instead. This was marginally better. I felt more focused and productive but the dose stopped working after about 6 hours. Considering this was supposed to last 12 hours I can't say I was impressed. The next step was to try 36mg. This was again better and gave me about 8 hours of normality. The doctor suggested that I could try having it twice a day and I did for about a year. I improved a bit nothing stellar.

Over the last few years I had tried various supplements and I still had a significant number of things in my medicine chest. I'm not sure why but one fine day a couple of months ago I decided to take some alpha GPC that I had lying about. That first night was weird. I got immediate and significant REM activity. The next morning I was amazingly awake. No brain fog whatsoever, hugely organized and extremely productive for a change. My mental capabilities felt normal. Encouraged I did some research and figured this must be the acetylcholine. I decided alphaGPC should become a staple. A couple of days in I started getting palpitations and I decided it was time to drop one of the Concerta doses. Even with 36mg less my functionality was still much better than normal. Wary of potential serotonin issues with the venlafaxine I dropped that to 150mg. I didn't even get my usual venlafaxine withdrawal! Conscious of the need for cofactors and vitamins I added a methylated B complex, Vit C, Omega Oils and Magnesium and Calcium to the mix. After a couple of weeks on this I decided to see if anything happened if I decreased venlafaxine further. Again I experienced no withdrawal with just 75mg venlafaxine. I have come off venlafaxine twice in the past so I'm familiar with the sensation. After a week of this I added some tyrosine and tryptophan to the regimen. This went well for a while. However, the last few days I have been feeling a bit fatigued and I was wondering if this could be related to running out of something in some biochemical pathway. I'm not an expert but my working theory is that the choline is being deviated into acetycholine production and my Krebs cycle is somehow faltering. I have been getting a lot of sugar cravings too. Is my reasoning sound? What should I do? I have some citicoline, acetyl L- carnitine and phosphatidylserine on order but I think I might try increasing the B complex and the cal/mag too at this point.

Sorry for the very long post. I would appreciate any pointers.

Thanks xxx