I started on 36mg of Concerta over a month ago and it kinda sorta seemed to help, to the point where I at least thought it had potential, although it wasn't exactly a huge change and I tended to wonder if it was mostly in my head.

My psych bumped me to to 36's about a week or two ago. He gave me the option of going to 56mg as a stepping stone (he said it wasn't likely to get me where I needed to be) or going for the full 72, and I figured, you know, what the heck.

Well, I definitely can't concentrate twice as well (maybe a bit better, but it's not consistent), but the side effects are all amplified. Sometimes I feel like I'm hardly any better off now than I was before I started, only now when I'm staring off into space I'm sweating and have my jaw clenched. This is what I imagined that being on stimulants would be like way back before I started taking them.

I stopped taking it yesterday because I've had really bad chapped lips for days. I think I've been getting dehydrated and chewing on my lips without realizing it.

I'm going to talk to him about this but I thought I might run it by you guys. Should I give up on the stuff or try a lower dosage? Maybe just tough it out until my body adjusts? (my first week or so on 36 was kind of rough too, but in different ways)

Sigh...how long have you been at this higher dose? I really need to make a bulletin:

When you titrate up on Concerta you will have a period of feeling sped up and a gritty too-much-caffeine feeling. THIS STAGE WILL PASS. If the mind is reacting better, the body will adjust. This happened to me and yes, it took several weeks to stabilize out into something comfortable. In other words if you need 72 mgs and that works for your brain, give your body time to adjust.

If you feel like it would help, titrate back down. Perhaps your body will adjust better slowly. Also, if its not better clarity, you need to titrate back down. That is how this process works: titrate up until seide effects are amplified and benefits are not felt, then titrate back down.

Sounds to me like you need to go back to 56. If necessary, Concerta comes in different size tablets so that you can reach dosages between the doses reached by using 18 mg. tablets.

HTH and keep us posted.

Well, thanks, but that leaves me about where I already was. I know that I can expect the side effects to wind down a bit, and they haven't really been that bad so far compared to what I've heard other people complain about, but the thing is 1) 36mg didn't seem to help that much and 2) 72mg doesn't seem to help that much so far either, so I was wondering if it would be worthwhile to keep on with it, either at 54 or 72, or if I'd be better off trying something else.

I said in the OP that I started on 72 in the past couple weeks... thinking about it now I think I took it for exactly seven days and now it's been two days off. I think I'm going to go back on it today. I've been second-guessing myself about whether it's actually really helping or not, I can't make up my mind. I expected there to be a really obvious improvement in my concentration at least when I bumped up the dosage but I don't think that's been the case.

Stick with it, don't give up. It takes time! Read the Titrate Up (http://www.addforums.com/forums/showthread.php?t=34796&highlight=titration) thread. I think it will help you a lot!

It took time for 72mg of Concerta to work for me! Now, it is just right with added doses of 10mg Ritalin at noon and 5pm. Maybe you need ritalin to help you stay focused through the day and evening. I do, very badly. Otherwise, I can't do anything cognitive at night, at least not well. I am reading again on this dosage! I used to read like a vacuum sucks dirt. Age affects ADD too. Hang in there, it takes time to find the right meds and dosage! Keep a little notebook or journal your progress, it helps you see the progress. I went on meds June 2004, it took 2 years to find the right dose. But once you find it, never let it go! Part because of a non pdoc not prescribing enough!

RADD

in my point of view (and i will NOT get into my bad experience just want to say one thing) but if you DONT HAVE hyperactivity i really (personally atleast) think you should NOT take methylphenidate products as from what ive seem methylphenidate products calm you down a lot more than amphetamien products do if you have ADHD take methylphenidate if not and you have ADD take amphetamine based i was ADD mor ethan ADHD and concerta and focalin and ritalin just made me into a zombie worst part of my life was takign ocncerta horrific uggghh i get freaked out thinking about those few months of my life just plain scaryyyy

I am inattentive type and take Concerta. The difference in my cognitive functioning is amazing. I cannot take Adderal. Since the Concerta et al works, I see no need to change. Each individual reacts differently, that, I believe is the key to finding the right doseage and medication.

RADD

If I didn't know this stuff was supposed to be making me concentrate more easily I doubt it would ever occur to me. If I look for it, I think I can see it, but subjectively I don't feel very different.

What prompted me to post this thread was the fact that I didn't miss the Concerta at all the two days I was off of it, apart from the fact that I didn't get a lot of sleep Thursday night and I felt really sleep Friday (been a while since I've truly felt sleepy during the day).

When I first started on 36 I had a really good burst of enthusiasm for about a week, and then it tapered off really quickly. So maybe it's working for me and I've just gotten lazy, or maybe I would've done about as well if the doc had prescribed me a bottle of sugar pills without telling me. In general there's not any serious difference in the way I've been living my life, so one way or the other I'm obviously doing something wrong.

I know that the meds aren't supposed to do all the work for me, but I feeling like I'm back to where I was before I knew anything about ADD, trying to get myself to try harder and not being able to pull it off and not being sure if it's my fault or not.

Print out what you just posted. It is perfect to share with your doctor. They know how to sort this stuff out! You explained what is going on very well. It will really help your doctor understand and help you!

RADD

Cheek chewing, lip biting, skin picking and hair pulling can all happen on stimulants and other drugs (marijuana).

(I've seen this especially in 'drug abusing' [high high] doses. Almost every Meth user i have seen has their face all scabby and picked, or lips chewed up.) :O

The stimulants increase "stereotyped" behaviors, such as turning in circles, tail biting, overgrooming, etc. I remember that from my Rat class (experimental psychology: animal learning).

Obviously the doses we take are not IV/smoked and not high doses, like drug abusing individuals, but i have myself noticed the increased tendency to pick at a zit, etc.

If I didn't know this stuff was supposed to be making me concentrate more easily I doubt it would ever occur to me. If I look for it, I think I can see it, but subjectively I don't feel very different.

What prompted me to post this thread was the fact that I didn't miss the Concerta at all the two days I was off of it, apart from the fact that I didn't get a lot of sleep Thursday night and I felt really sleep Friday (been a while since I've truly felt sleepy during the day).

When I first started on 36 I had a really good burst of enthusiasm for about a week, and then it tapered off really quickly. So maybe it's working for me and I've just gotten lazy, or maybe I would've done about as well if the doc had prescribed me a bottle of sugar pills without telling me. In general there's not any serious difference in the way I've been living my life, so one way or the other I'm obviously doing something wrong.

I know that the meds aren't supposed to do all the work for me, but I feeling like I'm back to where I was before I knew anything about ADD, trying to get myself to try harder and not being able to pull it off and not being sure if it's my fault or not.Ahhh OK its possible that you have confused the initial rush of euphoria that comes with newfound clarity for the typical expected results of the meds. This period never lasts for anybody, so maybe you are correct when you noticed the enthusiasm slacking back. Meds are a tool but we have to pick up and use the tool, a tool does not do the work without someone applying it ;). Then again perhaps you need a dose in between 36 and 72? 18 + 27 == 45 after all :).

Ahhh OK its possible that you have confused the initial rush of euphoria that comes with newfound clarity for the typical expected results of the meds. This period never lasts for anybody, so maybe you are correct when you noticed the enthusiasm slacking back. Meds are a tool but we have to pick up and use the tool, a tool does not do the work without someone applying it ;). Then again perhaps you need a dose in between 36 and 72? 18 + 27 == 45 after all :).

Maybe. I don't think I was ever all that euphoric though; I don't think I got any further than cautious optimism, thinking it had some potential.

At the moment I'm kind of leaning toward believing that Concerta just isn't working for me. I'm not sure how to tell the difference, but I know one of the things your supposed to do when you feel like you're "tolerant" towards a drug is take a couple days or so off... and I did, like I said, and if anything I'm almost better off without it I think.

It makes me feel alert and awake, but there's not much of a sense of clarity. There's sort of a zombifying effect that helps me sit still and get stuff done -- sometimes -- but it's not a great feeling, and especially on this dosage it's just too much. People keep asking me if there's something the matter with me. The only person I've told about my medicating is my brother, and he keeps urging me to stop taking it as soon as the semester's over. I was just joking with him a couple minutes ago that now that my daily dose of meds is wearing off I can finally settle down and get some work done. That's about where I'm at right now.

So maybe backing down to a lower dosage could be the solution, but on the other hand I get the feeling that even if it works out a little better, I'm not going to fall so in love with it that I wouldn't want to possibly try out a different med anyway.

In the meantime I've still got most of a month's worth of prescription left, and I'm not totally sure what exactly I'm going to do.

I would just call the doc and try something else then. I certainly knew the difference between Concerta (which actually worked) and Metadate (which sucked more than I can adequately convey). Although both may be forms of methylphenidate? They were worlds apart and hey, you can always go back to tweaking Concerta doses if other meds do not work for you.

Sure. Thanks for your help. For today at least I'm just going to give it another go and try to give it its fair chance. There's also the fact that I haven't been sleeping very well. And there's the fact that I'll get on the internet (like now, argh) or whatever and can't get my brain to change gears to where I need it to be. That was always a problem but I think Concerta's might be making it a little worse. That might be something I can correct for.

Looks like I'm going to get prescribed Adderall now. Can I realistically expect it to work any better?

Yes! Adderall makes me physically ill. It was horrible for me. Concerta/Ritalin work so very well! Check out the Adderall threads.

Perhaps you should re-consider the diagnosis, well the doctor should. Their are many things that can effect attention negatively(depression,anxiety,etc). How's the adderall doing, keep us posted.