I believe I may need to up my current 18 mg dosage to 36, yet I'm hesitant about doing so. I will be meeting my doctor this Wednesday and I'm positive that he'll recommend it once I report my experiences on the 18 mg.

So far I have been receiving almost no side effects, though the Concerta is not as effective as it was during the first 5 days. (The first five days offered me a great level of focus. ...And 10 mg of Ritalin 3 times a day seemed to work best for me, previously.)

I've heard plenty of horror stories about changing Concerta doses. Despite my relatively good experiences and confidence in the methylphenidates, I'm particularly concerned about how different doses could affect me after a negative incident with the Dexedrine.

Has changing from 18 mg to 36 mg made a difference for any inattentives? What about 18 to 27? Did it give anyone a higher heart rate? Tics? Better concentration? Etc. If so, explain in detail. (I am also interested in daily one-hour runs. I hope it impacts my exercise routine minimally.)

*Note: I'm a 5'1, 20-year-old female.

- Thanks. :)

My only advice is: "suck it and see" and tell your doctor of your concerns. Everyone reacts differently to medications

I know that's what I'll ultimately be doing, but I'd like to ease my nerves by familiarizing myself with the potential side effects.

Most of the experiences I've read about were written by people who've preferred the amphetamine group, has the hyperactivity or very young children.

hello.... I just finished my second week on concerta and I started at 18mg. I am a inattentive/hyperfocused/thrill seeker/procrastinator. 18 mg worked a bit for the first 3 days then I noticed a very quick wear off. I then took 18 in the morning and then another 18mg at 3PM. It had a little efffect but still not much. For the last 5 days I have been taking 36mg in the morning and that has worked preety well. The first day i had a strong effect that lead to a quick down but since then it has been pretty good all day. At night i get a bit sleepy but it is not bad and I sleep like a baby. I have not had any side effects other than appetite loss. I have lost almost 10lbs in the two weeks. It definetly improves my ability to ignore rapid random thoughts and mindless hyperfocusing on dumb things. It also stops alot of my nervous energy. No more constantly cracking everybone in my body. Hopefully it continues to work.

Amaryste,

i am on my first week (6th day today) with Concerta and have had some annoying side effects. you said you do like the methylphenidates and i need some good feedback! why didnt you like the Dexedrine?

i am wondering if when you switch your dose you will get the stuff i am getting! if so, i would say its more annoying than anything. it hasnt stopped my life, but it sure seemed like i would never recover. definitely down and nearly despondent--more about having the bad effects than anything in my life. totally unmotivated. very foggy and struggling. i had to just accept that that was going to be my day. it sucked, but since i had that for 3 days with Strattera, i recognized it and i skipped a dose the day after the worst side effect day and today i am fine on my normal dose.

it sounds like tdogg3278 has had a good reaction and good results, i am hoping when i move up i will see more benefits and less annoying side effects. and i would kill to sleep like a baby (insomnia not strictly from the concerta)!! i will be thrilled to have found something that works this fast if that is the case.

Amaryste,

i am on my first week (6th day today) with Concerta and have had some annoying side effects. you said you do like the methylphenidates and i need some good feedback! why didnt you like the Dexedrine?

i am wondering if when you switch your dose you will get the stuff i am getting! if so, i would say its more annoying than anything. it hasnt stopped my life, but it sure seemed like i would never recover. definitely down and nearly despondent--more about having the bad effects than anything in my life. totally unmotivated. very foggy and struggling. i had to just accept that that was going to be my day. it sucked, but since i had that for 3 days with Strattera, i recognized it and i skipped a dose the day after the worst side effect day and today i am fine on my normal dose.

it sounds like tdogg3278 has had a good reaction and good results, i am hoping when i move up i will see more benefits and less annoying side effects. and i would kill to sleep like a baby (insomnia not strictly from the concerta)!! i will be thrilled to have found something that works this fast if that is the case.

Pros:
+ Developed a realistic sense of time.
+ Was more motivated to get the work done.
+ Less impulsive. Didn't jump from topic to topic; activity to activity.
+ Became very calm - even under intense situations.

Cons:
+ It didn't allow me to concentrate as well as I could on the ritalin. (Motivation is something I could handle on my own, but to achieve a consistent, productive level of concentration is beyond challenging.)
+ My 'space cadet' persona exacerbated. :rolleyes: Felt 'day-dreamy' while working and would frequently forget ideas in the middle of a conversation.
+ The rebound effects/crashes were intense and caused extreme fatigue.
+ Lost too much weight in a short period of time. Eating was a chore. Experienced muscle weakness.
+ Had difficulty breathing. Even walking caused me to loose breath.
+ Withdrawal symptoms were just as uncomfortable: I was anxious about being left alone. I needed to be with people 24/7 - a desire that highly uncharacteristic for myself. Always sleepy. Spent most of the day sleeping. Was moody and depressed about life.

Too much norepinephrine, I guess. No wonder why I felt like I was on an anti-depressant.

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Dexedrine has worked tremendously well for some (particularly the inattentives), but the side-effects I had were too much to handle. It also didn't help me with the most crucial aspect: concentration. I wanted to switch back to the methylphenidates even though I experienced increased jitteriness, impulsivity and irritation.

My doctor and I decided that I should try the long-reacting medications instead of giving up on stimulants entirely. And worked. Concerta, for me, was like having the best attributes of the ritalin and dexedrine in one pill (with an unfortunately high price tag, of course.) Nevertheless, finding the right dose and med combination was hassle; I was tired of undergoing a series of side-effects just to finally have a normal day as the average individual. :confused:

I've finally titrated up to 36 mg today and I love it. I'm not impulsive. I'm not sleepy while working. I'm alert with a quick reaction. And I can focus with 100% clarity. My stamina for uninteresting activities could be better, but there are several mental techniques I could implement to rectify that.

With the 18 and 27 mg, I became tired at certain times of the day, but I haven't had a sleepy moment on the 36 mg. :) Like tdogg3278, I hope this continues to work.

Good luck to you. If the methylphenidates has offered you at least some valuable benefits, it may be an issue of dosage or MPH type. If not, you have an option of the amphetamines.

I also felt (slightly) despondent on the Concerta as it wore off, yet it disappeared as I adapted to the medication. The 18 and 27 mg hardly did anything for my motivation. I always had to push myself.

Can i just say, Amaryste, that that post was amazing. very succinct and easy to read and not rambling and not seemingly ADD at all!

and it's good for me to hear that the 36mg is seemingly the "answer" to some of the issues of the lower dosages. which must be expected when starting a new medication. sounds like tdogg did better on 36mg as well. i just had such a hard time with Strattera i think i was apprehensive about keeping at it.

i will be back at my doc on tues and imagine he will raise the dose. will keep you posted. thanks everyone

Have you experimented with taking concerta 2x a day (18mg+18mg)?

I am moving up from 18mg to 36mg this week in the form of 18mgx2 and was wondering if I should take them both at the same time or a few hours in between. (hoping to increase coverage for more of the day)

Have you experimented with taking concerta 2x a day (18mg+18mg)?

I am moving up from 18mg to 36mg this week in the form of 18mgx2 and was wondering if I should take them both at the same time or a few hours in between. (hoping to increase coverage for more of the day)

Not yet. I need a higher concentration more than an extended period of the lower dose, so I take them both at the same time. If you're just looking for extended coverage of the 18 mg, take the second pill four hours after the first.

i went back to the doctor on tuesday and instead of upping the dose to help with the tiredness, he suggested i take it at night.

i posted on the "makes me sleeeeepy" thread, but basically.....i am too chicken to try it! i am so afraid of having a sleepless night since i am either getting up for work or getting up to care for my toddler that no day seems like a good day to be sleep deprived. yikes. yes it stands to reason that if 3 hours after i take it i get seriously sleepy then it will work like that at night, but i just dont know!

so, i may just try the 18mg on my own 2X a day and see if that gets rid of the sleepiness. i dont know what to think anymore.

Not yet. I need a higher concentration more than an extended period of the lower dose, so I take them both at the same time. If you're just looking for extended coverage of the 18 mg, take the second pill four hours after the first.

*Edit: The timing for the second pill depends on your body's tolerance. Some people do four, six, eight, etc.

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i went back to the doctor on tuesday and instead of upping the dose to help with the tiredness, he suggested i take it at night.

i posted on the "makes me sleeeeepy" thread, but basically.....i am too chicken to try it! i am so afraid of having a sleepless night since i am either getting up for work or getting up to care for my toddler that no day seems like a good day to be sleep deprived. yikes. yes it stands to reason that if 3 hours after i take it i get seriously sleepy then it will work like that at night, but i just dont know!

so, i may just try the 18mg on my own 2X a day and see if that gets rid of the sleepiness. i dont know what to think anymore.

I suppose you could give it a shot with the nighttime dosage, but I honestly question his reasoning. Why would anyone want to be sleeping during the medication's most effective hours is beyond me... unless they need help sleeping.

Aside from the tiredness, did the 18 mg offer you any benefits recently? If you're not seeing any improvements for your ADD and the side-effects are at least tolerable, then it wouldn't be a bad idea to try the next concentration level. (It took me a week to titrate to 36 via the 27 mg due to my sensitivity. You may be luckier.) If you do see ADD relief, I'd try your doctor's recommendation first.

Aside from the tiredness, did the 18 mg offer you any benefits recently? If you're not seeing any improvements for your ADD and the side-effects are at least tolerable, then it wouldn't be a bad idea to try the next concentration level. (It took me a week to titrate to 36 via the 27 mg due to my sensitivity. You may be luckier.) If you do see ADD relief, I'd try your doctor's recommendation first.


actually, i havent seen any benefits since the first couple of days of taking it. and that could have been placebo effect, who knows. but since then (tomorrow is beginning week 3), i have had more drowsy/spacey/unmotivated symptoms than any type of help with ADD issues.

last night i took the nighttime dose and today, about 12 hours later i took a morning dose. so 36mg (18mg x2). i posted in the other thread as well, but wonder if i should just go ahead and take 2 18mgs at the same time in the morning and see how i do? i won't see the doctor for another 3 weeks now and hope he isnt mad -- i have read they get a little upset with us for messing with our dosage, or should i call? (sorry if this is similar to other post, just need some good advice and seem to be getting lots so far ) ;)

actually, i havent seen any benefits since the first couple of days of taking it. and that could have been placebo effect, who knows. but since then (tomorrow is beginning week 3), i have had more drowsy/spacey/unmotivated symptoms than any type of help with ADD issues.

last night i took the nighttime dose and today, about 12 hours later i took a morning dose. so 36mg (18mg x2). i posted in the other thread as well, but wonder if i should just go ahead and take 2 18mgs at the same time in the morning and see how i do? i won't see the doctor for another 3 weeks now and hope he isnt mad -- i have read they get a little upset with us for messing with our dosage, or should i call? (sorry if this is similar to other post, just need some good advice and seem to be getting lots so far ) ;)

I'd urge you to try the next dose then. Two weeks is too long to not have any benefits. Stimulants are supposed to work quickly.

My doctor trusts me to adjust my dosage as I need to -- in fact, he always encourages me to. (Or perhaps I annoyed him that much with those endless calls each time I change my medication routine. :D ) After all, your body is the one that chooses how it responds. I absolutely loathe negative side-effects, so I'm extremely (hyper)vigilant about avoiding careless errors. For major medication changes, however, I do consult him. I haven't received a 'no' for my request yet. And it's usually me that resists upping the dose. :p I admit, I'm a complete drug-pansy.

Your doctor may or may not get frustrated about your decision. Regardless, I think it'd be unwise for him to recommend you stay on the 18 mg when you are showing no improvements. If you sense his intolerance for unexpected dose changes, then give him a call and describe your experiences. (You should be reporting this to him the next meet anyway.) Do emphasize your lack of ADD relief and ask him about the higher concentration. An extra 4 mg three times a day won't be that troubling, if your only problem is being a space cadet. I would not offer the same advice to someone who's having major headaches, tics and anxiety on the 18 mg.

i don't know how to do that little "thank you" post, but i want to thank you Amaryste. because of your suggestion i called the doc and his staff got back to me with a go-ahead for a dosage increase and a new Rx waiting at his office for 36mg.

i tried the 36mg today (2x18mg) and noticed that i had a great day. much like the first day i tried the 18mg. i was motivated, still a teeny bit of dashing from task to task-- almost like i could finally remember everything i needed to get done and had some "anxiety" about not remembering to do it! HA. but i did remember to do everything, followed thru on each task, made my to-do list, etc. i didnt accomplish everything but that was due to having a toddler along on my errands. it was more about getting him home before serious meltdown than not being interested in finishing, etc.

what a difference, lets hope it keeps up. i felt energized, not drowsy and umotivated. i know i will need to have good habits to keep up my motivation but the energy and follow-through are so new to me, i cannot believe i did what i did today. much more to be done.

thanks again for encouraging me to just call in and not be too worried about what the doc might say or just waiting around until my next appointment.

Very few people take 18mg, especially adults. It's meant as the initial dose. Most people end up on 36mg or 54mg. I take 45 mg (18+27) because it's the best balance of effectiveness without significant side effects. I have inattentive ADD, and as I went from 18 to 27 to 36, I noticed substantial improvements. Seems like the OP is set, but to anyone else, don't be afraid to gradually titrate up. That's exactly what is outlined in the dosing information provided to doctors from concerta.