Expert: Dr Billy Levin - 9/17/2011

Question
I have been taking celexa for 5 years, I was diagnosed with adhd 6 months ago ok..I have weaned off celexa due to the fact it wasn't helping anymore with my ocd and gad. I've been taking two 5 mg doses of ritalin per day, I have been experiencing severe anger mood swings and irritability is this due to celexa withdrawal and if so how long does this last or could it be the ritalin thats causing these feelings help I have been off celexa for 5 weeks

Answer
Without examining you I can  only comment ,not advise. Firstly Celexa is well known for problems of withdrawal lasting several weeks. If you now have ADD or ADHD, then  you had it then and thus you were on the wrong treatment for ADD/ADHD. If your dose of Ritalin in not optimal and covering a continious 12 hour peroid you will have rebound symptoms exactly as you describe.Two 5mg of Short acting  Ritalin, each tablet lasting no more than 4 hours will most certainly  not be optimal and will certainly give rebound symptoms.  To obtain an optimal dose ,3 doses a day at exactly 4 hourly periods increased every 3rd day till optimal and monitered with the use of Conners rating scales to establish an optimal dose will give a good result. Your current dose cannot.   
   Sometimes "add on" medication needs to be given with the Ritalin , once the optimal dose of Ritalin is achieved, such as Rispidal for aggression. You need expert advice!