View Full Version : It's not working - Dosage?


Skydiver
06-21-15, 07:04 PM
So I've been diagnosed and medicated for ADD for just over two months. I was initially prescribed 18mg Concerta, which had absolutely no effect. 34mg also had no effect, but about 8 hours in I would get a wave of overwhelming tiredness as I assume it was wearing off so was moved to Equasym XL (Metadate CD in the US). Annoyingly I was started at 10mg, but titrate up every week, so am now taking 30mg and am due to call my doctor tomorrow to increase it to 40mg.

The point is I feel nothing. I don't feel it kick in, I feel no different while I'm on it and my behaviour is exactly the same. I was wondering what other peoples experiences with dosage and titration for this medication have been. Particularly those who have ended up needing a high dose.

dvdnvwls
06-21-15, 07:10 PM
If these dosages are doing nothing at all, it seems likely that this whole class of medications simply doesn't work on you.

What you've been given have all been different formats of exactly the same drug. Like "I can't eat potatoes" - "Okay, have you tried mashed potatoes?" :)

Skydiver
06-21-15, 07:19 PM
So you think its doubtful that I just need a higher dose?

The problem is I really don't want to take Strattera and the only form of amphetamine available in the UK is Dexadrine - which doctors are normally reluctant to prescribe. So I was hoping that I was not alone in just needing a higher dose then 'normal' to achieve therapeutic benefit :S

dvdnvwls
06-21-15, 07:26 PM
It's possible you do just need a higher dose. However, most who need a high dose will see at least some benefit from a medium dose.

Fuzzy12
06-21-15, 07:28 PM
So you think its doubtful that I just need a higher dose?

The problem is I really don't want to take Strattera and the only form of amphetamine available in the UK is Dexadrine - which doctors are normally reluctant to prescribe. So I was hoping that I was not alone in just needing a higher dose then 'normal' to achieve therapeutic benefit :S

I take dexamphetamine. Usually methyl phenidate is tried first mainly because it's much cheaper I think but if that doesn't work they should prescribe dex.

Skydiver
06-21-15, 07:49 PM
I take dexamphetamine. Usually methyl phenidate is tried first mainly because it's much cheaper I think but if that doesn't work they should prescribe dex.


Was that the reason you were prescribed Dexadrine? If so how high did you go dosage wise on methlyphenidate before your doctor switched you?

RogerL63
06-21-15, 08:45 PM
I'm at 54mg concerta myself. We came to using Concerta because I had tried a few meds that didn't work. I took some kind of dna test or something like that which determined the types of meds that work on me. I don't really feel more focused. What I feel is less fatigued. I'm still forgetting stuff and bouncing from one thing to another but at least I keep going. I also feel a crash after 8-10 hours.

Skyf@ll
06-21-15, 09:18 PM
So you think its doubtful that I just need a higher dose?

The problem is I really don't want to take Strattera and the only form of amphetamine available in the UK is Dexadrine - which doctors are normally reluctant to prescribe. So I was hoping that I was not alone in just needing a higher dose then 'normal' to achieve therapeutic benefit :S

It's strange you never felt anything off Concerta.

My first dose of 18mg turned me into a complete zombie for a week.

Long story short Concerta wasn't for me.

If I was you I would be requesting my psych to put me on dex.

I'm from the UK and it was a straight forward swap from Concerta to Dex.

I have an open-minded Doctor and a private psych tho.

As long as you don't have drug addition on your record you are in with a shout.

Nice name by the way ;)

SmashPotato
06-22-15, 04:27 AM
Lisdexamfetamine is also available in the UK now, AKA. Vyvanse. That might be easier to get prescribed because of it's lower abuse potential.

Fuzzy12
06-22-15, 06:12 AM
Was that the reason you were prescribed Dexadrine? If so how high did you go dosage wise on methlyphenidate before your doctor switched you?

I never tried Concerta but I got an initial improvement in systems on Methyl phenidate IR, which very quickly stopped. When I increased my dose to 30mg a day I got a rash so my psychiatrist thought I might be allergic to methyl phenidate and switched me to dex, which I prefer in every way.

Lisdexamfetamine is also available in the UK now, AKA. Vyvanse. That might be easier to get prescribed because of it's lower abuse potential.

Yes, it is but it's super expensive so I think, the advice is to first try the other (stimulant) options. I've heard very good things about Vyvanse though (Elvanse in the UK) and I know people who have got it prescribed through the NHS.

sarahsweets
06-22-15, 11:37 AM
What the hell kind of dna tests are there for determining what drugs work for people?

RogerL63
06-22-15, 02:45 PM
I found an article at https://www.psychologytoday.com/blog/two-takes-depression/201407/genetic-testing-better-depression-treatment

One article I found explained that your genes produce specific enzymes and it's these enzymes that determine how your body metabolizes different medications.

Skyf@ll
06-22-15, 05:42 PM
I believe you, I googled it.

But are you not living proof that the testing is hocus pocus lol?


I took some kind of dna test or something like that which determined the types of meds that work on me. I don't really feel more focused. What I feel is less fatigued. I'm still forgetting stuff and bouncing from one thing to another but at least I keep going. I also feel a crash after 8-10 hours.

Skydiver
07-19-15, 08:09 PM
Okay, so here's the update.

From 30mg my doctor put me straight up to 50mg. The first day I felt quite anxious. I think that was just my body getting used to the new dose as the next few days I felt no anxiety at all. But also, surprise surprise, no increased concentration. No effect at all.

I haven't taken it for just over a week now, mainly due to the fact that as its my summer break from university I've been going out a lot so don't want to mix it with drinking, nor do I have anything that really needs concentrating on. I'm going on holiday but when I get back I will start my internship so will start taking it again then. I guess it would be easier to judge if its working when I am in a work environment. Though it seems like this really isn't the medication for me.

I wonder what this says about my brain chemistry. Any thoughts?

Skydiver
07-19-15, 08:12 PM
Nice name by the way ;)


Back at ya :p

dvdnvwls
07-19-15, 08:14 PM
Skydiver: What has been the effect on your ability to get work done? Forget whether you feel sharper or more able to concentrate - nobody (including you) ought to care if you FEEL like you're concentrating, as long as you ARE. :)

Skydiver
07-19-15, 08:35 PM
Skydiver: What has been the effect on your ability to get work done? Forget whether you feel sharper or more able to concentrate - nobody (including you) ought to care if you FEEL like you're concentrating, as long as you ARE. :)

Its quite hard to judge as I haven't had much to concentrate on. Though it would seem that for the things I have had to do I am just as prone to procrastination and easily distractible ect. But that's why I am kind of giving up on it for now and will try again when I'm working. I guess I'll take it for a few days and then not take it to see if I notice a difference.

Though I still always thought I was supposed to feel SOMETHING :confused:

dvdnvwls
07-19-15, 09:26 PM
Though I still always thought I was supposed to feel SOMETHING :confused:

Not necessarily, and not consistently. And (as I said) what difference does it make how you feel when medicated, so long as you don't feel significantly worse?

(That said - if you DO feel significantly worse, then get right back to the doctor and say so.)

Skydiver
07-19-15, 09:48 PM
That does make sense. I guess it's just hard to measure the effectiveness of the medication without feeling some sort of change. I will try to monitor my behaviour more closely, rather than how I feel :p

maysarieltiff
07-27-16, 12:25 AM
Gene sight. I have had it done! The ritalin family of drugs will have less effect. It says I am either a slow metabolizer or ultra rapid at the enzyme where amphetamines are metabolized. It also says I have a lower effect from some ADHD medications. In addition, this affects my aripiprazole and wellbutrin dosages.

I know I have an ultra rapid metabolism of these types of medications because I get no effect at all from them, even at max of the "recommended" dosages.

if you can get the testing, get it! it is really informative and I have done a bunch of research based on my results.

Amy