Concerta

[devadmin]

Recently my wife started worrying that the medication I take, (Concerta) was making me jumpy and edgy. I didn’t notice it. I realized I was edgy sometimes but we’re going through an avalanche of stuff in our life, thanks to the recession, so I figured it was normal.

When I reminded her how I used to be, how I used to handle a crisis, she could see that I am in fact much much better. Part of that’s just age. I’ve lived through three recessions at least. Anyway, one day there was a ton of stuff to do and my wife finally said, “What’s the matter with you. You’re so out of it.” I told her I’d forgotten my Concerta, two days in a row. She could see the difference. Not that I’m a mess without the medication, it just really helps on the days I could get overwhelmed.

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[Anonymous]

My father and have bad sinuses, and when a Chinook rolls though, we would get severe headaches, this is something that happens to many other people. I have been on Concerta for over a month and I have yet to have these headaches.

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[ADDled]

Perhaps the dosage is to high? I’m at about 230 lbs and my dose is 72 mg of Concerta per day. How long have you been using it?. My Doc also has me on Lamotragine as a mood stabilizer (for the comordant anxiety and depression thing). That has helped with the agitation aspect.

I hear you about the recession thing: done that, been there also several times…..These are certainly trying times even for people that are “well adjusted”.

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[Anonymous]

It is important to record your observations and the observations of others and see your doctor for a review. Everyone is different. However, don’t jump to conclusions or make changes to medications on your own without the advice of your doctor.

The medications are not necessarily related to weight. For example, certain people have what is called slow metabolizing livers so that the amount they need is much less than the average person. It is not common but if you are one of those people, taking the same dose as your friend might put you over the top. Look at my video on Compliance for some helpful hints.

But…..talk to your doc.

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[Bettyboo]

Hi there, First time posting I want to comment and ask a question….Dr. J is absolutely right. I’m on 72 mls and i’m 135 lbs and I’m almost thinking I may need to adjust my dosage. I see the doctor in a couple of weeks. Concerta for me has been great. I tried other meds and was very gittery…so you never know. I do have a question. I’m very tired, unfocused, gittery the week before my period. I’ve googled every site I know…and all of them are some what different. Some say adjust meds others say have to live with it…what is right…does anyone have any idea…Dr. J what do you think? I have been monitoring now for 3 months and the symtoms are always the same. Thanks Elizabeth

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[Anonymous]

Premenstrual problems add another level of neuroendocrine changes to the body and one aspect is that it heightens catecholamine discharge anyway (i.e. the amount of adrenaline running through your body). So, when you take the psychstimulant you might be getting an over-the-top effect accounting for your jitters. Yes, see your doctor and look to find an optimal dose during this period which might be slightly less than you are on to compensate for what the PMS is doing to you.

One would arguably say, treat the PMS independently. For example, increasing your exercise routine, slight dehydration (to combat excess bloating) and watching your nutrition. PMS can lead to emotional mood swings, tiredness and feeling unfocused just as much as ADHD.

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[Fearwidg]

SO good to see Dr. J say – IN PRINT – that your weight and dosage are not necessarily related.

You have no idea how many Doctors I’ve fought over that point- especially in rural Canada. (I do a fair bit of advocacy work for kids {and Adults} with ADD.)

Also…

GREAT ADD Doc I used to have (she moved out west. Grrr <g>), told me: “As it’s all about correcting Brain Chemistry, it frequently takes more than one med.” (Note: She had a phd in Chemistry.)

In my case, I’m right on the cusp of Tourettes – Severe ADHD with Motor Tics (Twitches {Hate that word}.)

The ADD meds “fixed” my brain, but at the cost of increased Motor Tics (some so bad, I didn’t want to leave the house).

My latest ADD Doc worked with me through several med trials. Some made things worse, others made me EXPLOSIVE! (I stopped IMMEDIATELY.)

Then – my Doctor added Clonazepam (a very inexpensive med) to my Adderall and – just 30 minutes later – the tics STOPPED (as did the accompanying anxiety) for the first time in SIXTY YEARS!!!

So, it may take a while to find YOUR “magic combination,” but work with your Doctor and it CAN happen.

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[Anonymous]

clonazepam (Rivotril) is a triazolobenzodiazepene which is just fancy way of saying it is a high potency benzo. It is a very effective anxiolytic medication but be careful of abrupt withdrawal or stopping it suddenly. Anxiety increases noradrenaline which aggravates tics. We often use medications like clonidine, an alpha two agonist, which also is used to reduce anxiety but specifically goes after peripheral adrenaline. One advantage of clonidine is that it does not have a cognitive effect (except sedation) where clonzepam can cause antrograde and retrograde amnesia.

Make sure you also consider non-pharma solutions like Tai Chi, TM, or Yoga

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[Anonymous]

I wanted to respond directly to Rick…

Although its only “anecdotal”, myself and one other ADD person (female) I know have been on both Concerta and Ritalin, and both of us found that we were more ill tempered on the Concerta. On Concerta I also found I was crying a lot more – not depressed, but more “sensitive” – you know, those “touching” emails people send, etc. I’ve been on Ritalin SR, with a backup of the quick release, for around 6 months and am really content on it.

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[Anonymous]

About a month ago, I brought my GP up to speed about my ADD. I don’t think i ever mentioned that I was diagnosed years ago but it should be in my thick medical file. Anyway, he put me on Concerta, 27mg. I was already on Wellbutrin XL, (an anti-depressent) at the time and have been for the last year or two. (I have no concept of time, I have a call into my pharmacy). Anyway, my question is two-fold:

(a) I just stopped taking these anti-deppressents cold turkey. Yea, I’m quite a bit more emotional but I still haven’t gone back to reading the obituary section in the paper, so in my book, I’m still further ahead.

(b) I really didn’t notice any difference other than a splitting headache while on the Concerta. My prescription just finished and I’ve ordered another batch, but I still feel like I’m in a fog. I still have to look for my lost keys and look for my glasses that were on-top of my head all along. How can I tell if this stuff really is working?

What are you supposed to feel exactly, other than jittery and shaking while in my sleep ( according to my wife).

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[Rick Green – Founder of TotallyADD]

Responding to Nory:

What you say is interesting. I’ve been through so much in the last while, at work and in my life, that I’m not sure if the ‘frustration’ I feel sometimes is due to the Concerta. But I do know that the days I forget my pill, are more of a struggle. And for me to notice that says something. My wife wondered if I was being made more agitated by the Concerta, but again, she can tell when I haven’t taken it. Of course sometimes when there’s a lot going on, and I’m flustered, she thinks I’ve forgotten. The medication doesn’t eliminate the fluster, it just reduces it. And I can see that everything we’ve been doing for 8 months to get this website up, working seven days a week at some points, is a lot to be flustered about. Dunno. I’ll keep watching it. Thanks for sharing.

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[Anonymous]

Just to join in and show how everyone is different….. I started Concerta back in June and by July figured I should be at 54mg. My GP and I seem to agree it isn’t doing anything. I think I’m better with social cues, but don’t feel “aware” of stuff. Going to try going back to Ritalin until I can figure this out. Bottom line is that a monitoring and figuring out a balance b/w meds is likely best. I know of a few people that are mixing meds (under medical supervision, of course).

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[Fearwidg]

Dr. J.

YIKES!

Just checked this thread for the first time in a while and read your notes re Clonazepam & Clonidine.

Laughed at first because I’ve been taking Clonidine for years to control my high B.P.

Knew about it’s assistance to ADD, but Clonidine alone does nothing to stop my tics.

It’s only since taking Clonazepam that they finally stopped.

However:

a) I did NOT know you can’t stop abruptly (which explains my 7 hours of sleep in 72 hours when I ran out of money {& Clonazepam}).

b) Didn’t know about the memory problems and I HAVE started to have those.

Thanks for the heads-up. Will discuss this with my ADD Specialist.

PS: Over the past 15 years, I’ve tried all the other possible non-medicinal treatments. None work on me. My ADD is so extreme.

PPS: Another thought – when I was in my late teens, I developed an allergy to Penicillin. Swelled up likr a balloon and was rushed to Emergency where they gave me a shot of Benzedrine. I quickly recovered, but I remember thinking this was the calmest I’d felt in years. Interesting!

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[Anonymous]

I take 54mg Concerta XL with 20mg Fluoxetine in the morning and a top up in the afternoon of 20mg Equasym XL and am very happy with this combination ! I feel better when medicated all day as my son has ADHD and I need to be calm in order to deal with him in the evening when his meds stop working !I have a slow metabolism but I do know of parents whose children only get 4hours from Concerta XL as their child has a fast metabolism which is very difficult to cope with !

I am truly grateful for my medication and cannot express my gratitude enough ! HALLELUJAH !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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[Anonymous]

Interesting. 54mg of Concerta. I’ll have to try that. These last few weeks, I’ve been experimenting to see the effects of increasing, decreasing, adding, subtracting doses. I took a razor blade and cut half of the 27mg pill. Popped that and 1 full to see what happened. That was the day before yesterday. Yep. I felt MUCH clearer. Slept like a baby… all the way through. No jumping, no tic’s, no violent hand or leg gestures……. I thought, wow. Maybe I need a heavy dosage… Let me try it again… So last night, I reluctantly turned in @ 1am-ish….only ‘cuz wifey was nagging to… Didn’t have quite the same reaction this morning. Lots of jumping, tic’s….. irritation. Zero patience….. ( /sigh) back to square one…. I do notice I’m much less irritable when I’m alone….. maybe I’ll change my wife and see what happens… ;0)

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