What Should I Be Expecting From Concerta?

[addDani]

Hi all -

If any of you haven't met me yet, I'm AddDani (Danielle) in Houston, TX. I was diagnosed a couple of weeks ago with ADD and prescribed Concerta. I started on 18 mg for a week, and then was upped to 36 mg. I am to meet with my psych on the 17th to discuss my progress. The only thing is, I'm not sure what I'm supposed to be experiencing. My mind does seem to be a bit quieter, but I'm not sure if that's because I'm working so hard on behavior modifications. (Like writing ideas, thoughts, etc. down on a pad as soon as they pop in to my swiss-cheese mind).

I've noticed that the past couple of days (36 mg) that I've been really distracted; my husband is playing his guitar out in the living room and I'm focusing on that, or at least dividing my attention between that and this.

Please someone tell me what their psych/therapist/counselor has advised on expectations of the meds. As I mentioned in another post somewhere in the forums (oh please don't ask me to remember! lol) my diagnosis was pretty casual. (Shrink: You have ADD. Here's some meds. Me: Huh?) I am working on getting my son and I both in for a complete evaluation, but in the meantime I would love some guidance.

Thanks!!!

[Gregster]

As the dosage of a stimulant increases past a certain point, the positive effects on focus and attention do start to go away. This is one of the reasons that finding the right dose is tricky. If you find that you are less distracted at the lower dose, you may have gone past your "ideal" dose. You have to decide what dosage gives you the maximum benefit.
Regards,
Greg

[addDani]

Oy! If that's the case, tricky is an understatement! lol

I sure hope I haven't passed my ideal dose - I really didn't see much of an improvement at 18 mg. Does this mean that I surely have, or do you think that my doc will want to try the next one up?

I'm getting a headache just thinking about this....lol

Thanks for your answer(s)!!

[Gregster]

18mg is not a lot of methylphenidate. Studies indicate a moderate doseage level - about .5mg/kg/day - gives the best results for attention (this is an average, so the "best" amount may be very different for you). 18mg would give this level for a 79lb person and 36mg for a 158lb person. At higher doseages you see improvements in impulse control, with a lessening of the attention effects (but still better than untreated attention).
Because of the limited dosages of Concerta (18mg, 36mg, & 54mg I think) and the fact the pills can't be split, it doesn't give many options for fine tuning the dose.
Another thing to mention is that it does take some time to get used to the drug, so you may find that with time the effects improve. How long have you been taking the Concerta?
I'd discuss the dosage issue when you see your Dr next.
Regards,
Greg

[addDani]

I haven't been on it long at all - ten days or so. I just needed a point of reference. I do have a follow-up appointment with my psychiatrist tomorrow and I plan on discussing these things with her.

I see a definite improvement in impulse control, but it's really the inattentiveness that I'm more concerned about. Although, it's hard to say which one has more negatively affected my life. lol

Thanks again for your input. Slowly but surely I'm learning.