Is 54mg a low dose? I'd like to titrate up, and didn't think to mention this to my doctor since it's so sensible. what's a good dose to start at, and can I cut these beatles in half?

I'm not a doctor(I should really put this in my signature, its the preface to so many of my posts), but from what I've read, and my own experience, 54 mg is a relatively high dose. I believe that 60 mg/day is the maximum recommended dose of methylphenidate(the active ingredient in Concerta) for the treatment of ADHD.

So, 54 mg isn't far off. However, there are people who are prescribed more. There is a 72 mg concerta capsule manufactured, which I believe is intended to treat narcolepsy, but I think is also prescribed for ADHD.

Regarding your other question:


Because of the tablet's non-deformable shell, the Concerta pill cannot be cut to decrease the dosage. This aspect causes trouble for people with Attention Deficit still working to find the best dosage levels or for those who wish to give their child a lower dose for half-days at school. Increasing or decreasing by any amount requires a new prescription.
Parents cannot crush the tablet and mix with food for children who have difficulty swallowing pills since crushing the Concerta medication will also destroy the release mechanism.

http://www.mental-health-matters.com/index.php?option=com_content&view=article&id=237

People commonly start on 18 or 36 mg of Concerta, depending on the severity of their AD(H)D. :) Your doctor may have a solid reason for giving you this (IMO, moderately high) dose, so I wouldn't too worried until the side-effects become unbearable. ;) If you're still concerned, I'd try asking for a week's trial of the 36 mg or the doc's reasoning on the prescription.

54 mg = 12-15 mg MPH 3 times a day

http://adhd.emedtv.com/concerta/concerta-dosing.html


*Disclaimer: I'm not a physician either. :p Just a regular Concerta/Ritalin user.

Unless you've already been taking some form of methylphenidate already, 54 mg is a crazy high dose to start on. You're going to get mostly side effects and very little medical treatment. Go back to your doctor and start on 18 or 27 mg. Print out a dosing PDF from concerta's website and show him/her why you should start lower.

Edit: I'd link you to the PDF, but they've changed their website. Here's a good starting point:

http://www.concerta360.com/mcneilpediatrics360/concerta360/concerta-solutions-dosing.html


The way concerta works, within 1 hour of taking it, ~22% of the mg of the pill is Ritalin IR, and then that level gradually doubles to its peak around 6 hours after taking it, and then it gradually exits your body over another 6 hours. It's meant to be a seamless all day lasting dose. If you managed to split a pill, it would mostly be just a Ritalin IR (maybe SR depending on where you cut).

it really depends. 54mg is 11mg of ritalin released 3 times daily . It's not a whopping dose nor is large by any means. Yet by all means I would try and start lower and titrate slowly just in case you don't need that much. If less works then that would be optimal .

My doctor started me on 18mg and then titrated up. 54mg to start with seems kind of high. Also do NOT cut it in half.

thanks for the updates guys I really appreciate this. A long time ago I was forced to take ritilin by my parents against me will because I wasn't learning to read and it made me extremely sad and I'm really not feeling good about going back but am desperate (a longer story omitted).

I called my doc office a while ago and asked how I could get things worked out and they transfered me to the nurses thing and put me on hold till I tired and hung up (ironic circumstance). I've been trying to sit st--

I forgot to mention I am used to taking the amphetamine salts at 20mg, so maybe they're similar enough to where I'm already tolerant somewhat.

Aimless story talk talk apparently>> I've been doing these summer college classes, and trying to sit still in class with out any meds other than fish oil, and that's actually somewhat awesome other than the fact that 'I have to constantly be shaking my leg or I'll explode or something' (not totally sure yet). I've been hearing everything the teacher says instead of daydreaming like on adderall.. I've actually been connecting socially to the people around me, and responding with lightning speed to the questions posed by the teacher... the only problem is that I can't submit any homework in this stat, and I'm not sure that I can study for a test.

In the mean time i'm going to cut out a very small sliver of the concerta (towards the out hole thing I guess??) and see if it's agreeable or not.

Maybe... I'm not sure... I don't wanna mess up my socialability, especially considering it's summer for god's sake.