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Old 06-23-11, 02:26 PM
killerschnauzer killerschnauzer is offline
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Talking First time on Concerta

Let me tell you a little bit about myself and my path to diagnosis before getting into treatment.

Oh and for easy reading I have titled the sections, so your free to skip the first half and go straight to the sections "Concerta Diary"

About Me and my Journey to Diagnosis

I am female, aged 23. I went un-diagnosed for most of my life. I had a very good idea something was wrong with me for most of my time in school. It became exceedingly difficult through high school. Everyone thought I was lazy, unmotivated, needed to apply myself better and that I was into drugs, even though I didn't even try drugs until I was out of school. I was trying very hard to make something of myself and by the 8th grade I began to give up. No matter how hard I tried I did not have very much success and I was then pigeon holed as being a defiant young teen.

It did not help that my home life was a mess too. From verbal to physical abuse from my mother and then school on top of that, I was destined to fail.

I ran away from home at the age of 16 and moved in with my friend and her family. Life was easier than before but I still was getting no where in my academics. They tried to help me the best they could but it didn't really help. I told them of my struggles and we booked an apt. to see my doctor, this was when I was half way through grade 12.

My friends mother was convinced that my problems came from a car incident I had in the 7th grade, where I had got hit by a car and hit my head. My doctor requested my school to give me cognitive testing, including memory and attention span. I was given the Woodcock Johnson III Tests of Cognitive Ability and the Woodcocks Johnson III Tests of Academic Achievement.

Test Results

The summary of the tests was this:

Savannah's measured cognitive ability is SS (92) which is in the average ranger. She scored the high average range in spacial relations, general information and sound blending.

Savannah scored within the average range in verbal ability, thinking ability and general intellectual ability. However her cognitive efficiency and short term memory were below average while her working memory was borderline moderately deficit.

Processing speed and short term memory are important aspects of learning, so it would be expected that Savannah may well experience some frustration in school.

Based on observations during testing sessions and around the school in general, I believe that there are times when Savannah experiences high anxiety and nervousness.

They noted with stress during the tests that I would fidget or tap feet or hands.

.. Back to "About me.."

After all was said and done. They did nothing to help me succeed. Even though there was evidence of my struggles. I did graduate that year but only thanks to my friend's family. (To this day I am not sure why they didn't think that ADHD might be to blame. As many of the things they mentioned were symptoms of this deficit.)

Shortly after school I went back to my doctor since even after school, my life had not improved a whole lot. (This is the point in my life where I started using drugs- cocaine, mushrooms, mdma, ecstasy) I told him I was still experiencing problems and would like to be tested for ADHD. I was told that there were no tests and that it was only detectable by trial and error with use of medication. At this point I was nowhere near wanting to take medication. I was prescribed Ritalin short acting and I took it hesitantly for a few days. I noticed the effect of medication but I wasn't sure that it was really helping me. My symptoms of ADHD were unbearable as the drugs wore off. (I've learned now that this was rebound.) I stopped taking them, convinced they were not helping and convinced that no one could help me.

3 or so years later I found myself back in the doctors office asking for help. I was sent to a psychiatrist, and I just didn't click with her. (I have a difficult time with relating to and trusting woman because of my upbringing.) I was transferred to another psychiatrist shortly after. I told him I thought I might have ADHD but wanted to fix it on my own, without medication. He told me that I couldn't fix a problem in my brain, with my brain. Since the problem is there he insisted, it's difficult to fix the problem using that same tool. I was offended yet I took the prescription of Ritalin and some anxiety medication home. I took a few days of it and stopped taking it. I didn't like the feel it gave me.

Abuse of Medication

I then began to abuse it. I tried to snort it a few times or to use it with or after cocaine use. I didn't really get anything from it though. All it would do is keep me up. That didn't mean that the temptation went away to use it though. Eventually I mustered up the mental strength to dump the remainder of my pills down the sink so I would not be able to touch them. I never bothered to go back to the psychiatrist, well at least for some time. (Part of me wanted to believe that I just didn't have this disorder that I was that loser everyone kept telling me about.)

In 2009 my father committed suicide. My whole life fell into pieces. He was always the one who kept me safe from my mother and protected me from her abuse. He was one of my only friends. He had sadly succumb to the pain of the many years of abuse he had also received from my mother. She left him once again (for had been many times) and said she was not coming back. So he left us 3 kids and his family behind. A part of me died with him.

Depression set in full force. I was in a abusive relationship at the time which only furthered my pain. I couldn't help but notice the parallel between my relationship and my fathers. I was essentially, my father. And my bf at the time played the role of my mother to a tee. How I ended up in this relationship is beyond me. I couldn't handle it and when my bf had cheated on me once again, I left him. (My life has been getting better ever since.)

I came to be with a guy who accepts me for who I am and I am truly grateful.

Closer to the present..

Now were coming up to today. My love life had been sorted out, but the rest of it was still in pieces. I had lost many jobs in the last few years and I could not keep up on top of my life. Although there were many problems that came from my ex, I came to learn that even in this new relationship some of these problems still existed and were mine alone. Even though my spouse loves me the way I am, the pain was still there. The inefficiency, the chaos, the stress, the low self-esteem. The constant loss of items and the ever daunting memory problems. I wanted more than I was getting, and to have it faster than I could achieve.

Depression set in once again and I found myself in the doctors office, once again. This time I was ready for any help that I could get. I tried my hardest and I haven't got any better. It was time for change. I requested to see the same psychiatrist I had seen last. I went to see him and told him that I hadn't come back because I had been hurt, but that he was right and I wanted real help this time. He said he didn't mean to make me feel that way and that he was sorry. This time he gave me a short written test to do and along with information he had collected in the past and present he came to a conclusion.

My diagnosis

He concluded that I do in fact have ADHD. My official diagnosis was set in stone. To be honest, I had to hold back smiling when he said the words "I believe that the problems that you are facing are because of ADHD and the other psychiatrist you seen 4 years ago concluded the same thing. ("Why didn't someone say so then?!" is all that ran through my head.) A burden lifted off my shoulder. All I had hoped for was someone to say that I'm not that lazy loser everyone talks about and that there was a reason for all of this.

Treatment

So then came treatment. I was prescribed Concerta (Sorry it took so long to get to this part.)

Ahem, so present tense..

I have been on Concerta for 6 days. I was told to play around with it to find the right dosage and decided (since my memory is not so grande) to take down my experience day to day.

A Concerta Diary if you will. I haven't found the right balance yet and I think it might take a while. This is my diary so far:

Concerta Diary

Friday June 17th: Took 18mg Concerta at 3pm. I split it in half. I felt some difference about a half hour later. I canít say whether it helped but I did get some cleaning done and with very little problems. Not sure if it was a placebo effect from my expectations or excitement, or if it was in fact helping. Never noticed a come-down from the meds and experienced no side effects Got to bed around 6 or 7am. (Not because of medication, it was my brothers b-day)

Saturday June 18th: Took 18mg Concerta at 8am. Woke up to an alarm so that I could take the meds early and then go back to sleep. I woke up around 9:30 and couldnít get to sleep again. Iím fairly certain the Concerta is responsible for my waking up again as I usually have no trouble sleeping in on the weekend. I was surprisingly pleased to get up early. I usually stay up too late to ever manage myself out of bed without help from some external factor. I still had a late night as per usual, so waking up on my own before noon is a new experience for me. Felt very awake, energized, happy, focused and motivated. I read for some time and then got up and cleaned. (This is also new to me.) My focus lasted until about 3:30-4:00. After this time, I was easily distracted and burnt my pancakes while cooking. I didnít really expect that Iíd see much improvement so early, but maybe Iím wrong. I still wonít disregard the possibility of a placebo effect though. Most new things go reasonably well for me until of course, they donít. This usually takes about 3 days. Very seldom can I stick with a new routine or get good results past that point. Iím excited to see how the rest of the week turns out. I got more done today then Iíve gotten done in the whole week. I donít know if I should feel happy about this, or annoyed. As far as side effects go, I did experience a migraine headache later on in the day and tiredness. The migraine headache subsided and was later replaced by another headache. Got to be around 1.

Sunday June 19th: Took 18mg Concerta at 12pm, I used an alarm to wake and went back to sleep. I stayed up way too late the previous night and opted to take the meds later in the day so I could get a more thorough sleep. Woke up at 1:30 due to an incoming phone call. I decided to get up since the first half of the day had already passed. I felt extremely tired upon waking and as far as I can tell, I did not feel any benefits from the medication at that time. Possibly the severe tiredness was to blame. There has been a drop in my appetite and I couldnít even come close to finishing breakfast/lunch. However my appetite was quick to return later in the day. No headaches today but I did experience some light sensitivity, which really wasnít that big of a deal. Tomorrow I think I will increase the dose and see how it goes. I got to bed around 12.

Monday June 20th: Took 36mg Concerta at 7:30. I was very tired so I went back to sleep. I kept waking up and falling back to sleep until about quarter to ten when I decided to get up. I could feel my heart rate was a bit fast when I was still in bed, laying down. I kept having the urge to get up and do something. I felt very full of energy, yet I was still yawning and very tired. Admittedly, I felt a little bit restless, maybe anxious. Possibly the dose was too high? Also I experienced dry mouth, but then, I donít drink a lot of water so that was probably most of the problem. I had little to no appetite. However, by two my hunger was back and I came to feel fully awake. I had a very stable mood and good energy. I Still had some underlying restlessness when staying still and a desire to stay in constant motion. I have been able to get much more work done than I have been doing in the past though so thatís very promising. The desire to switch between tasks is becoming more apparent. Instead of floating from one thing to the next, I am able to see the transition before it happens and am able more often than not to make a choice to stick with what I am doing. All side effects disappeared or were very tolerable by two. At seven fatigue set in and I had a headache. I got to bed around 12.

Tuesday June 21st: Took 36mg of Concerta at 7:30. Got up, did a few small things and then set out on cleaning my downstairs. I spent the greater part of the day doing that. I took a break a few times but it was not too difficult to get back into the motion of cleaning. I did many loads of laundry, 4 or 5. I probably still have about 8 more loads.. I more or less was living in a laundry hamper. Thereís a 4 foot by 5 foot pile of clothing still sitting in the laundry room. Iím just happy itís all in one place now. I only got one room done, but it took me 9 hours with breaks to do. I shouldnít be surprised at how much broken glass I found under the rubbish that was my downstairs room. I also found out that mice have been living there. I never noticed them before. Itís rather disgusting when you think about it.. all in all though, the day went awesomely. I didnít think to eat until around 4 since I never felt hungry. Stopped working at around 5. Extreme fatigue set in around 6. I noticed that once the medication has worn out that I become very fidgety. I donít think I was fidgety all day. I more or less noticed I had become fidgety once the meds had stopped being effective and no headaches today.  I got to bed around 11.

Wednesday June 22nd: Took 36mg of Concerta at 7:30. I felt very spaced out and tired most of the day. I did not end up eating until around 6 or 7 pm. I Havenít been eating well since I started the medication. Iím kinda thinking that all this energy plus doing things around the house and not eating are to blame for at least a good portion of the side effects Iím feeling. I did keep up on the chores but being tired made it very difficult to do. I got lots of baking done. I made two pies, bread, buns, and I ground up fresh deer meat to make burgers for supper. I noticed that by 4 my ADHD was back full strength. Itís exceedingly easy to notice when my meds are fading from my system. All of a sudden Iíll notice my surroundings and see chaos. Dishes left out, cupboards/drawers left open, laundry left in kitchen, appliances left out, etc. I know I should fix all of it but I donít even know where to begin. I know well enough that I could make myself do it but it just feels like so much work. The fact that this huge mess has surfaced from what seems like no where gives me this feeling of frustration. In some ways Iím bothered by the fact that it doesnít matter how hard I try to over come this, it will always be somewhere hanging over my head. My symptoms of ADHD feel a lot worse once the medication is gone, but maybe only in comparison. I have noticed that as the medication wears off I get fatigued. This has helped to get me to bed earlier than I normally would. I got to bed by 10:45 in fact, but my mind wouldnít stop to let me sleep. On top of that a storm was passing by and the dog we are babysitting wouldnít stop panting and shaking and making noise. I couldnít shut him out, so I ended up tying him to a far by couch so that I could get some rest. I probably didnít get to sleep until about 12 or 1.

..and that's all I got. I like to make an entry at the end of the day. I make side notes to remember the details of the day though.

I might have lost my focus..

Is what I'm experiencing normal? Today I took 18mg at 8, after I ate breakfast. I decided to cut the dose to see if side effects go down. They have. The effects of the medication on my focus are yet to be determined. I am either in a state of medicated focus or in a state of hyper focus. I'm kinda leaning towards the hyper focus since I haven't started my chores and am still on the computer. I'm 3 hours late into starting my usual chores.. I've been bouncing from writing this, and browsing the net.

What my goals are at this time for medication is to get the right dose so as to last until about 6 with minimal side effects. I think the meds are entering my system too fast and then wearing down before I'd like them to. Maybe a mid dose would be optimal? Any advice?

**On an additional note. I don't think that my meds are helping yet today. (I guess I stated that before.) These last few paragraphs have been really hard to complete. Is it possible the low dose of 18mg only helped for an hour or so and are already fading, or that I was in hyper focus?

In regards to other users, I'm not entirely sure where I am going with this thread. I had started out in the hopes of sharing my story and hearing other peoples experiences and stories. So, hopefully I didn't get too off topic.. Feel free to comment on any section that you want, give any advice, tell any story.. whatever comes to mind. I guess I'm just happy to have other people to talk to that might have had similar experiences, this is all so new for me
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Old 06-23-11, 11:37 PM
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Re: First time on Concerta

"Is it possible the low dose of 18mg only helped for an hour or so and are already fading, or that I was in hyper focus?"

Wow! That's ADDif I've ever seen it. After your lifetime of experiences you close with wondering what's happened to you in the last hour as a result of medication.

Slow down. Waaaaaaay down. It will take you years to come to terms with what ADD means in your life. 6 days is nothing compared to what you have lived so far - do you get that?

Be patient with yourself. There are no miracle cures, anyone suggesting instant results is fooling themselves or lying to you (snake oil salesmen). Concerta, or any other ADD medication, is just a first step towards a new way of perceiving your life. The medication makes it possible for you to think in a different way, make decisions differently, act differently. It's a tool and it will take a long time to master it's use.
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Old 06-24-11, 10:09 AM
Justinkt Justinkt is offline
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Re: First time on Concerta

Don't cut concerta in half, it won't work right. The pill around it is what slowly releases the medication.
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Old 06-24-11, 10:23 AM
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Re: First time on Concerta

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Originally Posted by SfumatoPants View Post
Slow down. Waaaaaaay down. It will take you years to come to terms with what ADD means in your life. 6 days is nothing compared to what you have lived so far - do you get that?

Be patient with yourself. There are no miracle cures, anyone suggesting instant results is fooling themselves or lying to you (snake oil salesmen). Concerta, or any other ADD medication, is just a first step towards a new way of perceiving your life. The medication makes it possible for you to think in a different way, make decisions differently, act differently. It's a tool and it will take a long time to master it's use.

Slow down??? How?
I can relate here, wanting it ALL, NOW.

But it's a very good advice!
I would like to follow your progress here if you would be so kind to post.
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Old 06-24-11, 11:24 AM
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Re: First time on Concerta

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Originally Posted by gerwin View Post
Slow down??? How?
I can relate here, wanting it ALL, NOW.

But it's a very good advice!
I would like to follow your progress here if you would be so kind to post.
I will be sure to post as I remember I have to recap my day yesterday as I forgot to do it and then I will post it.
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Old 06-24-11, 11:29 AM
killerschnauzer killerschnauzer is offline
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Re: First time on Concerta

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Originally Posted by Justinkt View Post
Don't cut concerta in half, it won't work right. The pill around it is what slowly releases the medication.
My psychiatrist and the pharmacist suggested this. Although the time release doesn't work as good, they said it's okay to split it. No crushing or chewing though.
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Old 06-24-11, 12:00 PM
killerschnauzer killerschnauzer is offline
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Re: First time on Concerta

Thursday June 23rd: I took 18mg at 8, this time after I ate breakfast. Felt some initial effect which faded early in the morning so I took a second dose of 18mg at around noon. From this dose on I felt no effect on concentration or attention. I got very little done, except with navigating the internet and with grooming the dog I had scheduled for around 2. o_o. I went for tea with a friend around 4 and had a hard time keeping my focus on what she was saying. The background noises from Tim Hortons seemed to draw me away from her which was sadly unfortunate, as we rarely have the time to get together to talk. I have my suspicions that splitting my doses spread out the medication too thinly. I experienced almost no side effect, but at the cost of the desired effects of the medication. I guess I will stick with two doses of 18mg after breakfast and tough it out to see if the side effects go away in time.
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Old 06-24-11, 10:03 PM
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Re: First time on Concerta

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Originally Posted by killerschnauzer View Post
My psychiatrist and the pharmacist suggested this. Although the time release doesn't work as good, they said it's okay to split it. No crushing or chewing though.
That's really bizarre. Have you dissected one of the pills before? They're set up so the meds are basically packed into one side and the spongy stuff is on the other to help administer the meds. If you were to slice them in half, you'd either get all the meds at one time or no meds at all. I can't see how any doctor or pharmacist would make such a suggestion.
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Old 06-24-11, 10:54 PM
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Re: First time on Concerta

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Originally Posted by killerschnauzer View Post
My psychiatrist and the pharmacist suggested this. Although the time release doesn't work as good, they said it's okay to split it. No crushing or chewing though.
This contradicts everything I have learned about Concerta and its proper usage. There are some important things you should know.

The outer shell of the Concerta capsule contains 22% of its rated dose.
So for example- An 18mg Concerta has 4mg of its dose in its fast dissolving outer shell, this is to provide a fast acting dose to cover you until the secondary slow release mechanism starts working.

To test this you can simply pop a single Concerta in your mouth and let the coating dissolve in your mouth. If you do this with an 18mg Concerta you will have just given yourself a 4mg dose of regular Ritalin. Other dosages have a shell content as follows- 27mg=6mg, 36mg=8mg, 54mg=12mg, 72mg=16mg, the coating always contains 22% of the total rated dose of the capsule, the slow release mechanism then works to maintain that dose over a 12hour period.

So, now take the de-shelled capsule out of your mouth and look at it, you will see a semi transparent capsule made of a mixture of wax and cellulose, this capsule is meant to pass through the entire digestive tract intact and be passed in your stool(poop).
Inside the capsule you will see 3 different colored layers
-The bottom part will be a dark green.
-The upper two layers will be slightly different shades of white.
-You can identify the top of the capsule by the small indent at one end.

The green part is the sponge, it absorbs water through the capsule walls and expands to push the medical ingredients out, the sponge is made of a non toxic polymer that becomes a sticky expanding goo when wet, it contains none of the active dosage and is intended to be passed in your stool (poop).

The 2 white layers are the active medication, each layer contains an additive to control the consistency of the medicine and help control rate of release, the lower layer has a different rate of release than the top layer. The 2 medicine layers absorb water like the sponge then turn into a toothpaste like consistency, the expansion of the sponge below puts pressure on the medicine and slowly pushes it out the the small hole on the top of the capsule (remember the small indent at the top?, that's where the medication is pushed out).


Do you see how cutting the capsule in half is wrong?.
Which half?, did you just swallow the sponge and a tiny dosage sitting on top or the other side with the greater dosage content?
How do you know how much you are taking?

Also to add, there is the process of titration where you start with an initial low dose of stimulant and carefully adjust the dose upwards to adequate levels to let the body adjust and minimize side effects. This process is called titration.

Destroying the capsule will screw up the process of titration, for example-

Taking one 18mg Concerta daily is the equivalent of 4mg of regular Ritalin 3x a day at 4 hour intervals because of the way the capsule released the dose.
Now cutting the capsule in half and swallowing the half without the sponge will result the capsule sitting in your gut oozing out it's entire contents within a very short period of time and giving you a dosage way above the 4mg sustained dosage.

The results of this are-
-A large increased risk of side effects.
-Doing this with the larger doses of Concerta will greatly increase the risk of addiction/dependency (regular therapeutic doses for Ritalin run in the 5mg to 25mg range 3x a day every 4 hours, so for example, cutting a 72mg Concerta and taking it would result in an extremely high dosage in the realm of hard core abusers, lower doses contain much lower risk of dependency).
-Greatly increased tolerance in a very short period of time rendering normal therapeutic dosages ineffective and causing your Doctor great concern.


The whole thing works like a bell curve and you want to sit at the very top.
Too little and you won't get the full benefits, too much will cause strong side effects and actually cause loss of concentration/focus.

A normal titration scenario is like this-
Start 18mg for one week, is it working?, does it last close to 12hours?.
Move up to 27mg for the next week, same questions.
Move up to 36mg for next week, same questions.
move up to the 54mg- whoa, bad side effects, focus and concentration disrupted, I just don't feel right Doc.
Move back down to 36mg and stick to it until effectiveness and duration become a problem.


Added note- I see many complaints of Concerta causing headaches, I have experienced these myself and have some thoughts on to the possible cause.

For me the headache would always be a mix of eyestrain and tension head ache. Now Considering the nature of Concerta this makes sense.
-The stimulant effects make us more alert and in turn our eyes open wider and focus more actively resulting in eyestrain.
-Jaw clenching and increased use of "alert" muscles in the scalp resulting in tension.

After 3 months my headaches have almost completely disappeared, I suspect the scalp muscles have become accustomed to added activity, eyestrain is occasional but not as as bad as when I started taking Concerta.



Place witty, well written conclusion to post here-.........
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Old 06-24-11, 11:14 PM
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Re: First time on Concerta

Also, a somewhat more helpful observation. From reading your Concerta "diary," it seems as though you weren't quite content with 18mg, but you showed a lot of symptoms of over-medication at 36mg. You might want to ask your doctor if you can try the "in-between" dose of 27mg.
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Old 06-24-11, 11:47 PM
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Re: First time on Concerta

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Originally Posted by trishcan View Post
That's really bizarre. Have you dissected one of the pills before? They're set up so the meds are basically packed into one side and the spongy stuff is on the other to help administer the meds. If you were to slice them in half, you'd either get all the meds at one time or no meds at all. I can't see how any doctor or pharmacist would make such a suggestion.
These pills are yellow and both sides are the same in the center. They look like regular pills. No spongy stuff, no different colours.. they just look like a Tylenol dipped in a yellow coating. Hm..
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Old 06-25-11, 12:21 AM
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Re: First time on Concerta

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Originally Posted by stones View Post
This contradicts everything I have learned about Concerta and its proper usage. There are some important things you should know.

The outer shell of the Concerta capsule contains 22% of its rated dose.
So for example- An 18mg Concerta has 4mg of its dose in its fast dissolving outer shell, this is to provide a fast acting dose to cover you until the secondary slow release mechanism starts working.

To test this you can simply pop a single Concerta in your mouth and let the coating dissolve in your mouth. If you do this with an 18mg Concerta you will have just given yourself a 4mg dose of regular Ritalin. Other dosages have a shell content as follows- 27mg=6mg, 36mg=8mg, 54mg=12mg, 72mg=16mg, the coating always contains 22% of the total rated dose of the capsule, the slow release mechanism then works to maintain that dose over a 12hour period.

So, now take the de-shelled capsule out of your mouth and look at it, you will see a semi transparent capsule made of a mixture of wax and cellulose, this capsule is meant to pass through the entire digestive tract intact and be passed in your stool(poop).
Inside the capsule you will see 3 different colored layers
-The bottom part will be a dark green.
-The upper two layers will be slightly different shades of white.
-You can identify the top of the capsule by the small indent at one end.

The green part is the sponge, it absorbs water through the capsule walls and expands to push the medical ingredients out, the sponge is made of a non toxic polymer that becomes a sticky expanding goo when wet, it contains none of the active dosage and is intended to be passed in your stool (poop).

The 2 white layers are the active medication, each layer contains an additive to control the consistency of the medicine and help control rate of release, the lower layer has a different rate of release than the top layer. The 2 medicine layers absorb water like the sponge then turn into a toothpaste like consistency, the expansion of the sponge below puts pressure on the medicine and slowly pushes it out the the small hole on the top of the capsule (remember the small indent at the top?, that's where the medication is pushed out).


Do you see how cutting the capsule in half is wrong?.
Which half?, did you just swallow the sponge and a tiny dosage sitting on top or the other side with the greater dosage content?
How do you know how much you are taking?

Also to add, there is the process of titration where you start with an initial low dose of stimulant and carefully adjust the dose upwards to adequate levels to let the body adjust and minimize side effects. This process is called titration.

Destroying the capsule will screw up the process of titration, for example-

Taking one 18mg Concerta daily is the equivalent of 4mg of regular Ritalin 3x a day at 4 hour intervals because of the way the capsule released the dose.
Now cutting the capsule in half and swallowing the half without the sponge will result the capsule sitting in your gut oozing out it's entire contents within a very short period of time and giving you a dosage way above the 4mg sustained dosage.

The results of this are-
-A large increased risk of side effects.
-Doing this with the larger doses of Concerta will greatly increase the risk of addiction/dependency (regular therapeutic doses for Ritalin run in the 5mg to 25mg range 3x a day every 4 hours, so for example, cutting a 72mg Concerta and taking it would result in an extremely high dosage in the realm of hard core abusers, lower doses contain much lower risk of dependency).
-Greatly increased tolerance in a very short period of time rendering normal therapeutic dosages ineffective and causing your Doctor great concern.


The whole thing works like a bell curve and you want to sit at the very top.
Too little and you won't get the full benefits, too much will cause strong side effects and actually cause loss of concentration/focus.

A normal titration scenario is like this-
Start 18mg for one week, is it working?, does it last close to 12hours?.
Move up to 27mg for the next week, same questions.
Move up to 36mg for next week, same questions.
move up to the 54mg- whoa, bad side effects, focus and concentration disrupted, I just don't feel right Doc.
Move back down to 36mg and stick to it until effectiveness and duration become a problem.


Added note- I see many complaints of Concerta causing headaches, I have experienced these myself and have some thoughts on to the possible cause.

For me the headache would always be a mix of eyestrain and tension head ache. Now Considering the nature of Concerta this makes sense.
-The stimulant effects make us more alert and in turn our eyes open wider and focus more actively resulting in eyestrain.
-Jaw clenching and increased use of "alert" muscles in the scalp resulting in tension.

After 3 months my headaches have almost completely disappeared, I suspect the scalp muscles have become accustomed to added activity, eyestrain is occasional but not as as bad as when I started taking Concerta.



Place witty, well written conclusion to post here-.........
Witty, well written post -> I already answered this question with one of the other members but I think the answer requires more detail than I first gave, so here goes. The pill I have does not look anything like what either of you have described, and upon further inspection I have come to the same conclusion. Rather confused, I decided to look up this medication online and oddly, it doesn't look like what is featured online either. For money reasons I opted for generic, so maybe this is why?? I did some follow up research and going with generic may have been a poor choice. When I asked the pharmacist if there was any difference he said no. A few minutes online and I have found reason to believe otherwise.

http://www.addadhdblog.com/generic-c...-canada/#25d93

The bottle I have says Teva-Methylphenidate ER-C and not Nova-Methylphenidate ER-C but I'm positive it is more or less the same thing as described in the link above.

The pill looks like this:

http://www.tevacanada.com/Products/S...1-6925377e76d9

but yellow with the number 18 instead of 54. Inside the pill is white and it snaps in half much like a Tylenol, the inside is identical on both sides.
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Old 06-25-11, 12:22 AM
killerschnauzer killerschnauzer is offline
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Re: First time on Concerta

Quote:
Originally Posted by trishcan View Post
Also, a somewhat more helpful observation. From reading your Concerta "diary," it seems as though you weren't quite content with 18mg, but you showed a lot of symptoms of over-medication at 36mg. You might want to ask your doctor if you can try the "in-between" dose of 27mg.
I was thinking the exact same thing, thanks for the good advice
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Old 06-25-11, 12:48 AM
trishcan trishcan is offline
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Re: First time on Concerta

I guess I learned something new. Apparently the generic Concerta is totally different from the name brand. I imagine the way the medication is administered is also very different, which seems like that would make it a different drug entirely. If it doesn't have the sponge, is it really still Concerta? Not to hijack the thread, but I'm just curious if anyone has any thoughts about that...
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Old 06-25-11, 01:42 AM
stones stones is offline
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Re: First time on Concerta

Hmmm..

Generic Concerta is a completly different animal, it is formed like a jaw breaker with layers that dissolve at different rates and could conceivably be split into smaller doses.

Has a bit of a stronger starting kick but shorter working time and less consistent dosage delivery but a considerably lower cost.

I came across a blog entry from ADDventures of motherhood where a woman describes her experience with the generic variety of Concerta vs the real Concerta.
http://nurturedmother.ca/2010/05/new...ta-name-brand/
It's worth a read.
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