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Concerta (methylphenidate) Time released Ritalin - 10 hour long acting tablet.

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Old 01-09-05, 12:04 AM
Carstarreader04 Carstarreader04 is offline
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Why did my doctor switch me from Concerta to regular ritalin?

I have recently been diagnosed with ADD (I'm in my 20's.)

First, my doctor prescribed 36 mgs of concerta. After a month on it, I saw no change. The concerta didn't help me.

I told the doctor that the concerta wasn't doing anything. It made me feel about as alert as I am after a cup of coffee. During my last visit, the doctor said that if the concerta didn't help, he didn't know what would have. He then prescribed me regular ritalin to be taken twice a day and said it should help. He didn't clarify how the ritalin would help if the concerta didn't. It is my understanding that they are basically the same except concerta is in a time released form.

So, why would he prescribe this and not something else such as Straterra or Adderall?

(Note to mods: New to forums. If this is in the wrong place, please accept my apology and move where needed.)
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Old 01-09-05, 05:04 AM
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Welcome to the forums!

I agree that there are many other options for treatment. Maybe finding a different doctor would be helpful? Is your dr. a general practioner or a psychiatrist, and do they have experience with Adult ADHD?

Concerta doesn't have the intensity, as far as I am concerned, that regular Ritalin has.
It builds up slower in your system and doesn't have as strong an impact at peak. My son takes 10 mg of regular ritalin with the concerta which gives us faster results and seems to work well. This would also be an option to consider.

Again, welcome, and I am looking forward to seeing you here!
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Old 01-09-05, 11:57 AM
Carstarreader04 Carstarreader04 is offline
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Thanks for the welcome...


He is a psychiatrist. I have been skeptical about him from day one. He is an older man who seems set in his ways. Everytime I have a visit he reminds me of the potential for abuse of these medications and "street value" as if I plan on getting the prescription just to turn around and sell it on the streets. I also believe his untrusting is another reason why he is very hesitant to prescribe adderall or other more powerful stimulants.
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Old 01-09-05, 01:12 PM
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Quote:
Originally Posted by Carstarreader04
Thanks for the welcome...


He is a psychiatrist. I have been skeptical about him from day one. He is an older man who seems set in his ways. Everytime I have a visit he reminds me of the potential for abuse of these medications and "street value" as if I plan on getting the prescription just to turn around and sell it on the streets. I also believe his untrusting is another reason why he is very hesitant to prescribe adderall or other more powerful stimulants.
Hi and welcome, I would definitely get another doctor if at all possible. ADHD requires a lot of experimenting to get the med and then the dose right, and frankly it sounds like you would be in a battle with your doc as opposed to a positive, goal-oriented relationship. I would be offended if my psych reminded me over and over about the "street value" of these meds, because to me that would mean he didn't have a thorugh enough knowledge of my personal condition, my history, and even adhd in general. people who genuinely need this drug aren't looking to make a buck off of it, we're looking to be well. i hope you can find a doc who understands that philosophy. best of luck!
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Old 01-09-05, 04:38 PM
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Concerta and Ritalin don't work in all people. Maybe it's time to try a direct dopamine stimulant, such as adderall, dexedrine, etc. These medications work at the opposite ends of the dopamine spectrum from Concerta/Ritalin, so if one doesn't work, try the other and see.
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Old 01-12-05, 12:10 PM
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It may be that your dosage isn't high enough - how much Ritalin did he prescribe? While I am very hesitant to suggest that you try taking a little more to see what happens - I am NOT a health care pro, and I don't know you, so taking more could be a health risk! - a lot of people do experiment with their dosage to see what works best (I know I did and I was able to get a good idea of what my upper limit was - the point at which the drug starts working against you!).
It doesn't sound as if you've got a psychiatrist who knows a lot about ADHD - some of these "old school" types don't even beleive that adult ADHD exists (the first p-doc I saw said exactly that, and I didn't make a second appointment!), and if he's talking about "street value" it sounds like he doesn't trust you completely. This "distrust" isn't uncommon however, especially given your age, as ADHD can be faked without too much difficulty by someone who knows the symptoms, since there is no test that can definitively tell you that you have ADHD or not, and lots of students and young adults want stimulants to help them study or stay awake, or to sell to others. Doctors have to be careful, as the FDA does examine prescriptions for schedule II drugs and doctors get understandably nervous when the FDA starts asking questions. Developing a good relationship with your doctor is very important - you may well have to go through the same type of crap with the next doctor you see, if you decide to go that route. If you can find an expert on ADHD in your area, I recommend that you try to see them - it'd be worth the time and trouble in the long run.
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Old 01-12-05, 01:47 PM
Carstarreader04 Carstarreader04 is offline
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I believe he prescriped 10mgs of ritalin. I don't know if that is on the high or low end of the spectrum. However, he told me to take it twice a day. I hear what you are saying about his distrust which it seems. He also kept asking me whether or not any of my friends have told me about these drugs and things of that sort. It got under my skin. I think I will try this regular ritalin and if it doesn't work I am going to switch doctors. You all really brought into light for me things that the doctor has not.... and to think, that is his job!


(By the way, upon further googling and research of this man, he settled out of court with a malpractice case for misdiagnosing a patient. go figure)
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Old 01-12-05, 03:06 PM
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10mg is a typical starting dose for adults and it's pretty light, for most people - there is a great deal of variation in dosage, 2 people of the same weight may find that their optimum dosage may differ by 200 or 300% - differences in neurochemistry! It does sound like this fellow is testing you somewhat. When it comes to questions about friends and drugs, I would probably tell him that you haven't told your friends about your ADHD or your prescription - he'll be less likely to assume that you're sharing your meds. It is probably a good idea not to advertise the fact that you're being prescribed stimulants - it's a pain in the a## when "friends" try to hit you up for a few pills and you know that you're rationing them as it is! At my age (40) it's not a big problem, but I still don't advertise 'cus you never really truely know who you can trust - I've been ripped off once by a "friend" that I thought I knew quite well, but when presented with the opportunity he valued money over friendship (he didn't steal pills, it was something else).
My advise with regards to this doctor is to stick with him for a while longer - he could be testing your patience to see if you're sincere - be honest with him and tell him how the drug makes you feel (or not feel) and then if he is unwilling to help you find a medication and dosage that works, switch doctors.
A new doctor will probably take his or her time with prescriptions too - he/she might even have you try Strattera (a non-stimulant that helps a lot of people) first, since it's not a stimulant. So switching doctors won't necessarily get you the medication you think you need any faster! Anicdotal evidence suggests that a lot of doctors put college aged patients on Strattera first, before trying stimulants, and I suspect that this is one technique they use to screen out those that are just trying to get stimulants for recreational or "economic" reasons - doctors have to cover their a##, lest the FDA chews it off for over-prescribing stimulants. If questioned about their precribing practices they can tell the FDA "I tried Strattera for 2 or 3 months,it was ineffective, so I prescribed Ritalin". And the FDA IS completely paranoid w.r.t. this issue and has been know to pull a doctors license or restrict thier ability to prescribe schedule II drugs if they even suspect the doctor of over-prescribing!
It took a couple of months before my own GP was comfortable enough with me to prescribe what I thought I needed, since I was a new patient - and this was WITH a diagnosis from a nationally recognized expert in adult ADHD who teaches at the U. of Toronto's medical school and works at the Centre for Addiction and Mental Health! (I was lucky to have contacted him at a time when he was actually taking patients, and I still had to wait 2 months for my first appointment!). It took almost exactly 6 months from the time I made my initial appointment with the psychiatrist, to the time I was given my first scrip for Ritalin, and then another month before I was taking enough medication that I was happy with the results. For most people, getting diagnosed and treated is a real test of patience! The more time and effort it takes you try to get the treatment you need, the more sincere you will appear to your doctor, so don't give up, it's worth it in the end!
Oh, and while it's not a good thing that your doctor settled a malpractice suit for misdiagnosis, I wouldn't say it's necessarily an indication that he's a quack - doctors get sued all the time, and insurance companies often settle because it's cheaper than court. Psychiatrists would likely have a higher ratio of disgrunteled patients, since many of their patients are unstable to begin with, and mental illnesses/disorders can be difficult to diagnose and treat. I'd judge the man by the way he treats you, unless you find out that he's been previously disiplined or his licence suspended by the State College of Physicians.
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Old 11-21-06, 03:37 PM
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concerta and ritalin X 3 a day are the same. Yes i would stick with him a little longer. Perhaps it's his way of reminding you to go slow and try to keep the dosages at the lowest dose that treats your symptoms. I am sure he has had many patients in the past that continually want there dose increased, etc. I really believe that when you are dealing with your mental health a psychiatrist is the way to go, as it sounds like you are. I don't mean to put down doctor's, it's just that they have so many areas of medicine to attend to, you want a specialist, not a jack of all trades.
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Old 11-21-06, 03:41 PM
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concerta and ritalin X 3 a day are the same. Yes i would stick with him a little longer. Perhaps it's his way of reminding you to go slow and try to keep the dosages at the lowest dose that treats your symptoms. I am sure he has had many patients in the past that continually want there dose increased, etc. I really believe that when you are dealing with your mental health a psychiatrist is the way to go, as it sounds like you are. I don't mean to put down doctor's, it's just that they have so many areas of medicine to attend to, you want a specialist, not a jack of all trades.

Last edited by nzkiwi; 11-21-06 at 03:41 PM.. Reason: delete something
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Old 11-21-06, 08:25 PM
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Why did my doctor switch me from Concerta to regular ritalin?


We don't know your health file info or history, and we aren't doctors.

Talk to your Doctor and ask? (So many folks here don't seem to talk to their doctors candidly and take in lists of their questions!)
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Old 11-24-06, 05:19 PM
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Gregster's post is dead on.

It is a weird relationship between the doctors (trying to help, but fearful of the feds), the feds (trying to villify ADD drugs), and the patients (just trying to figure their issue out).

This whole process takes time, and lots of it to figure out what works and what doesn't. I can't speak for everyone, but when I found the right dose it was an aha moment for me.
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Old 05-15-09, 01:50 PM
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Re: Why did my doctor switch me from Concerta to regular ritalin?

I agree with alot of what Gregster said, but your doc seems to be way to cautious with the dosage. Do you have ADD or ADHD(hyperactive)? Adderall and Vyvanse(newer, same med with smoother time release and great pricing) seems to work better for ADHDers. Ritalin type, Concerta, etc seem to work better for ADDers.

Personally I'd still have problems too if I was at your prescribed levels. I'd suggest finding a psychiatrist that specializes in ADD/ADHD or a younger one that realizes that higher doses are widely used now and needed for some patients. Concerta (time released Ritalin) is very hard to abuse so he might be willing to prescribe a higher dose. Another option is to double your dose of Ritallin and see if that helps. If it does you've found your answer. Concerta initially releases 22% of the 'ritalin type med' it contains, so find what dosage works in ritalin and switch to concerta for a more even release of the med into your system. Docs usually start with a lower Concerta dose since it gives a more steady amount through the day compared to the peak and valleys of 2 x or 3 x a day ritalin. So if initially Concerta doesn't work, try a little higher dose that x 22% will equal what worked with Ritalin before giving up on it. And watch your intake of acidic foods and drinks like juice, if your stomach is too acidic (from food or stress) you will metabolize many XRs too fast and not have results that work for you long term. A good night sleep and daily exercise also really helps, because it raises dopamine which is one of 2 chemicals not reacting strong enough in a ADD/ADHD brain. That's why many get misdiagnosed with ADD/ADHD, when its a sleep, snoring, sleep apnea and or lack of exercise problem. Good Luck.
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Old 03-21-11, 12:34 PM
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Re: Why did my doctor switch me from Concerta to regular ritalin?

Quote:
Originally Posted by Carstarreader04 View Post
Thanks for the welcome...


He is a psychiatrist. I have been skeptical about him from day one. He is an older man who seems set in his ways. Everytime I have a visit he reminds me of the potential for abuse of these medications and "street value" as if I plan on getting the prescription just to turn around and sell it on the streets. I also believe his untrusting is another reason why he is very hesitant to prescribe adderall or other more powerful stimulants.

Hey I am completely new to this, too but I just googled about the same issue and found your post. I am in the exact same position with the exact same doctor. I have been trying for the past week to switch from him to my regular doctor who has no problem prescribing me the adderall, but my the psychiatric business I attend is so disorganized and uninformative that I can't even be informed if they've faxed it over or not. On the other hand, concerta did work for me but not like adderall's effects. The doctor was relentless on putting me on ritalin and not adderall that he barely listened to what I had to say. I've heard horrible things about ritalin that it has horrible side effects like paranoia, stomach rolling, the shakes, and that's it's only usually prescribed to children with A.D.H.D. I do not even have ADHD. I have problems with not having enough energy, not being hyperactive. I need some advice on what's right and wrong in this area. Do you have any? lol
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