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

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Old 10-07-13, 01:45 AM
kelrodjr kelrodjr is offline
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Adult ADHD-Inattentive starting Concerta - adjustment period?

Hello all, new member here. I'm 31 years old and was recently diagnosed with inattentive type ADHD. My doctor started me on Concerta 36 mg. I noticed a HUGE difference immediately - the worst symptoms of my ADHD, forgetfulness, lack of focus and initiative, excessive procrastination - all seemed to disappear. I was ecstatic. After a week of this, however, the effects started to wear off, and by the beginning of the third week, I felt like I wasn't taking anything at all.

I had scheduled a follow-up appointment with my doctor exactly when my 1st month's prescription ran out. Due to a work situation, I was unable to make my appointment, and could not reschedule for a week. The stress of that situation, combined with other things that were going wrong that day and the overall feeling I had that the medication wasn't working anymore, threw me over the edge, and I had a mental mini-breakdown. That was probably the worst day since I began taking Concerta.

At my follow-up, my doctor upped my dosage to 54 mg. I had been off Concerta for a week due to my inability to get a new prescription in time. The next morning I started with a 54 mg tablet, and... nothing. At least, I couldn't really tell if it was working or not. I didn't have a life-changing experience like I had the first week when I started on the 36 mg tablet. Tuesday will be the start of the third week on the 54 mg Concerta and I feel like I'm in the same boat.

Has anyone else experienced this? I understand that everybody reacts to different levels of methylphenidate, but is it possible to build a tolerance so quickly? Is it just my body adjusting to the dosage? I know I could go to 72 mg but I'm afraid that may not work either, and the cost... Thoughts?
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Old 10-07-13, 02:16 AM
dvdnvwls dvdnvwls is offline
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Re: Adult ADHD-Inattentive starting Concerta - adjustment period?

No, no possibility of "tolerance".

It may be that the "nothing" feeling on 54 mg is the feeling of absolute perfection. You may have got the dosage nailed so exactly that it's working at full capacity but you feel nothing at all.

Test yourself on some work, instead of testing yourself on how you feel.



P.S. If you already had some kind of mini-breakdown when taking 36 mg, I think you would want to stay away from further dosage increases.
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Old 10-07-13, 06:30 PM
kelrodjr kelrodjr is offline
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Re: Adult ADHD-Inattentive starting Concerta - adjustment period?

Quote:
Originally Posted by dvdnvwls View Post
It may be that the "nothing" feeling on 54 mg is the feeling of absolute perfection. You may have got the dosage nailed so exactly that it's working at full capacity but you feel nothing at all.

Test yourself on some work, instead of testing yourself on how you feel.
Thanks for your response. It would probably help if I laid out the full history of my journey to this diagnosis but I don't have time right now for that, perhaps later. I can definitely say that I am not the only one who thinks Concerta isn't working as well as when I first started it. When I began this process, I asked my wife to keep a 'diary' of her observations of my behavior during the course of my prescription. She was not to divulge to me what she was writing down. I still don't know the contents of that, but she has told me several times over the past few weeks that my 'old habits' are coming back. I can tell that my focus is gone again, as just last night I asked my wife a question that she had already given me the answer to literally just seconds before (obviously, she was not pleased). It is definitely not just a feeling that I am basing my results on.

I'm going to finish out this month of the 54 mg tabs but I think I may need to go see my doctor again before I start the next month.

Quote:
Originally Posted by dvdnvwls View Post
P.S. If you already had some kind of mini-breakdown when taking 36 mg, I think you would want to stay away from further dosage increases.
In retrospect, "mini-breakdown" might be too strong of a phrase. That was just a really bad day, and because I missed my appointment, I was extremely angry, overwhelmed, frustrated, emotional, you name it. I'm not ashamed to admit that I broke down and cried for a good bit in front of my wife when I got home. That's what I meant by breakdown.

At this point, I guess I'm just wondering if you, or anyone else on Concerta for that matter has had a similar experience to myself when they started - immediate and visible positive results that quickly tapered off after a week or two. I'm just not sure if I should stay on Concerta (or how long I should allow for it to make a difference), or talk to my doctor about different medications.
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Old 10-24-13, 06:13 AM
aarondev aarondev is offline
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Re: Adult ADHD-Inattentive starting Concerta - adjustment period?

Hey keldrodjr,

I can relate in a few ways.

1) Loss of effecitveness
I'd definitely agree that longer-acting stimulants like Concerta seem to be more susceptible to this drop. I had this and it was really disappointing when I started out at 36mg. My doctor did a simialr thing where he upped me to 54, with still minimal results. He tried again recently with 72mg, and that didn't do a great job.

Solution: I found that if did cardio for about 20-40min either before or right after I took my Concerta, it helped a lot. Also, I noticed that I wasn't eating as much with my Concerta. Once I started eating regularly (higher protein meals with veggies; not much in the way of short-acting carbs) I got a bigger difference from my Concerta.

2) Concerta less effective overall

After I tried Concerta the first time and went through the above, I went to my doctor and got put on Vyvanse. It's the other branch of medicine stimulants that this is derived from (amphetamine salts as oppose to methlyphenidate). I personally prefer Vyvanse a lot more.

Overall, I'd offer that you've gotta remember a few things. For one, that initial relief is common because your body had never had that effect of this kind of pills before. I can recall the first time I took Adderall XR with real vivacity; it was like an 'epiphany' or something because all my symptoms disappeared. I wonder whether those first few days were not unlike this.

Also, to remember that there are a lot of choices for ADHD meds. I personally feel that if you have a choice between Concerta and say, Adderall, go with the latter. Like now, I only take Concerta because I live in the UK and their health system bizarrely only really has this and Strattera available for ADHD. Concerta, in my experience and in reading the forums, is like RC Cola compared to most long-acting stimulants.

Hope this helps and be sure to give us updates about what you've found so far sir!
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