concerta making me really tired

[vincent____]

I was diagnosed with ADHD about 4 months ago, but without the hyperactive part. About a month ago I decided to get stimulants from my primary doctor which in this case it's Concerta/18 mg.I took them around 10-12 in the morning. For the first 6 days I was happy, but really moody kinda like strict and also super focused. At the end of my 6th day of being medicated I had a pretty horrible anxiety attack (it later stopped when I was seen) and was rushed to the hospital and I told the doctor that was taking care of me that it was probably the come down and he ended up telling me that he doesn't believe the medicine caused it because it only lasts about 12 hours. After that night, I proceeded taking it for the next few days, but no longer felt motivated, focused, or any of the effects. I felt really lazy and had a headache.

So then I talked with my primary doctor and she said It's working but I to motivate my own self, in other words.... I can't be dependent on it so i have to force myself.

Has anyone had a similar experiences and/or give me some advice?

[CharlesH]

Originally Posted by vincent____

So then I talked with my primary doctor and she said It's working but I to motivate my own self, in other words.... I can't be dependent on it so i have to force myself.

Has anyone had a similar experiences and/or give me some advice?

Your primary doctor is right. It's really common for stimulant meds to increase energy/mood/motivation, but people build tolerance to these effects very quickly. People are less likely to build tolerance to the focusing effects of stimulants.

[vincent____]

Originally Posted by CharlesH

Your primary doctor is right. It's really common for stimulant meds to increase energy/mood/motivation, but people build tolerance to these effects very quickly. People are less likely to build tolerance to the focusing effects of stimulants.

Let's say I built a tolerance for the focusing part. Does that mean I have to put effort into it even if I built a tolerance for the energy part? It does make sense, BUT I can't really focus when I'm not motivated.

[CharlesH]

Well, 18mg Concerta is relatively low, so maybe you might do better on a higher dose? Also, it's common to be prescribed a booster IR dose to take during late afternoon, since extended release meds often don't cover 100% of your waking hours.

Tolerance is something that lot of people worry about, but IME if you and your doctor are using it correctly, it tends to not be as big/common of a problem as people think.

As to your question about motivation and focus, that's a difficult question. I think the increased energy/mood that often comes from starting stimulants gives people artificially high expectations for what the meds should do.

The meds should help you focus/persist at whatever task you're currently on. This can be a double edged sword. For example, if you decide to spend your time surfing the internet, the meds will probably cause you to waste even more time on the internet.

[vincent____]

Ah an IR booster does sound helpful for my situation. Although I might switch to Adderall XR just for the purpose of Concerta not giving me the side effects I'm looking for. What IR Booster would you recommend?

[CharlesH]

If you're on Concerta, your booster dose would likely be methylphenidate (Ritalin) IR, and if you're on Adderall XR, your booster dose would likely be either Adderall IR or Dexedrine IR.

[finallyfound10]

I was on Concerta (36mg if I recall) and it didn't make me tired.

[liliyalich]

My doctor told me to try 18mg at first, and if it's not effective enough, take higher dose on the second week.
I have read some ADHDers' reviews that they feel the boost at the beginning, and later the effect faded, but after they take higher dose the effect become stable.
It could also because you are not suitable for this med. I recommend trying higher dose first.

[ImaADHDGuy]

Originally Posted by vincent____

Ah an IR booster does sound helpful for my situation. Although I might switch to Adderall XR just for the purpose of Concerta not giving me the side effects I'm looking for. What IR Booster would you recommend?

That's what I was going to suggest you talk with your doctor about. Adderall has something that Concerta doesn't. 25% of it is a type of amphetamine that doesn't go to the brain, but rather increases body energy by giving a slight boost to your flight or fight mechanism. This increases energy and motivation while encouraging concentration and focus, supported by the other 75% that is bringing your brain into focus. Those that require a boost in bodily energy benefit more from Adderall for that reason.

But nutritional supplements and proper eating are more important on Adderall because you'll burn them up at a higher rate which will deplete your energy if not replenished.