Concerta? Does it work for you?

[Anonymous]

Hi! I’m Heather. I’m 25, an active duty Navy Corpsman, and have had ADHD all of my life. I took Ritalin as a kid, then went off of it at the age of 10 and suffered the consequences ever since- I’ve got the good qualities, but the bad cancel them out. (Flunking high school with an IQ of 135, scoring in the top 98th percentile of ITBS tests nation-wide, getting an A in my college Psyc class with only reading one chapter, and being so disorganized and chaotic that I’ve almost been put on a disciplinary review board in the military… but more on that later.) After saying “enough”, I made an appt with the behavioral health clinic at the hospital I work at. I’ve been taking 18mg Concerta 2x a day for about a month now. I have noticed it helps out a little, but my life is still in complete disorder. My kitchen, for example, is destroyed. This voice inside of me says “Hey slob! Go clean!” But the ADD’er in me says “Yeah, how about no!?” I know that coaching is a necessity when it comes to treatment, and I haven’t started it yet. I am just curious if anyone else is on Concerta and if it’s helping them, or if there is something better that I should try out. Less side effects would be awesome! I really don’t like that I’m posting this at 1:55 am, not 1:55 pm! :o) I know it’s helping a lot in the attentiveness department, but other areas of my life are still lacking. Any suggestions? Did I lose you? ;o)

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[gerastos]

You take it twice a day? I was told and read up on this and I was of the understanding that I would only take it once a day, though I am not a doctor. I am not surprised that you are wired at 1:55am. I usually take 36mg around 9 am and I still have issues with sleeping: I work-out for about 1.5-2 hours in the morning and ‘work’ on my dissertation (completely different disaster) until about around now: being 11:30pm. I have done the coaching, and some of the techniques worked well for me, along with Concerta.

Side note: I was not diagnosed until I was 41 years old, this last August… sigh!

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[Anonymous]

When I saw the doctor recently I needed something immediately while I worked through what I know should happen which is a proper assessment and diagnoses (by someone else). I am predominantly inattentive with hyperactive subtype. I was having more serious issues with both the last couple of years and with insomnia getting worse to the point it was negatively effecting my ability to work or deal with home.

I have had no negative reactions to Concerta so far and considerable improvement with focus and lessening of impulsivity. It wasn’t immediate nor a total fix yet, but only been on it 2 weeks. I am also starting to get back to normal sleep. I have gotten more done in the last 2 weeks than the last 5 years, if that gives you a good idea of what I would call negative effects of ADHD. I guess I never thought seriously about getting it diagnosed before now as I thought it’s what got me to where I am today as a successfully engineer. I hadn’t thought of the negative effects. Maybe it’s the accumulative effect that if you can balance 3 balls, why not 5 or 7 until they all come down.

I was the same way about cleaning my house and while Concerta helps with staying focus it doesn’t teach you the skills you need to cope.I hadn’t cleaned my home office 3 years, just kept adding more tables and bigger stacks of paper. Just before I started taking Concerta I learned some techniques for staying focused from this site and cleaned it in 2 days and begun organizing the rest of my house. After I started Concerta I went through 3 years of technical magazines in one night (about 200), where before the thought of sitting still long enough to just finish one caused stress. Small successes build on each other, provide yourself and incentive/reward for completing something and break it down into smaller tasks. It didn’t get that way overnight don’t expect it to be resolved overnight or you may burn yourself out.

I’m not sure when to know I should be taking more or less yet. I take 18mg and think more might help. I would still like more focus and a little less impulsivity, but I also understand it takes time for the meds to have full impact, which is why I’m not sure I should be taking it everyday or only occasionally. I guess I would like to reach a little more improvement and if it’s possible then to take it less often unless it doesn’t function well that way. I know better than to decide that on my own so will find a more knowledgeable doctor and I think maybe a Life Coach would be useful. I tried one before Concerta, but couldn’t focus on what was being suggested.

Due to chronic pain I developed insomnia. I got the pain addressed but the insomnia stayed. Now that I am on Concerta I am starting to get back to normal, which for me is still around midnight.

The following neurological illnesses found at age 47:

Dyslexia, probably since childhood.

Fibromyalgia diagnosed 6/2010, probably at least 6 years earlier. Gabapentin (Neurontin 1500mg)

Adult ADHD 2/2011, probably since childhood. (Concerta ER 18mg)

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[Rick Green – Founder of TotallyADD]

Concerta works well for me, though most days I have a coffee in the morning as well–half decaf/half regular–cause I love coffee.

Like most of the medications now it’s one pill a day, in the morning. And it lasts all day. There are a number of different kinds, but they are all what’s called extended release. In fact the XR in Adderall-XR stands for eXtended Release. (How quaint!)

As many people have pointed out in the Forums, the medication levels the playing field, but it doesn’t win the game. Or even really play the game. It’s still up to you. But as Kate Kelly told us when we made the documentary, though she is no longer taking medication, she doubts whether she could have stayed with it to develop all the other tools and strategies she uses (Yoga, meditation, various organizing tools) now to manage her ADHD. When I asked her, “If you could snap your fingers and make your ADHD vanish, would you?” she paused and said, “Hmm, well… I kind of already have.”

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[Rick Green – Founder of TotallyADD]

And yes, Gerastos is correct, you should only be taking Concerta once a day. That’s the whole point. You only need one in the morning. Or, since you’re in the Navy, one when your day starts.

That would certainly explain why you are up late!

R

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[Bill]

I’m on 36mg of Concerta taken in the morning. It has helped with the focus. I find that I feel depleted at the end of the day, particularly on Friday. I am also paying a lot of attention to sleep, diet (i.e. protein) and exercise. To “turn off* my mind, I use meditation and self-hypnosis recordings.

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[Anonymous]

ER or SR or XR, I find Concerta gives me about 9 hours, however my day is 18 hours long.

I’m up at 5:30 AM, get a coffee on my way to work at 6:15 and arrive at work for 7:00. I take my 18mg Concerta at 9:00 and by 10:00 I’m focused and energetic. That doesn’t make me want to do my job any more or less, but I am able to do pretty much what ever I set my mind to. By 6:00 PM I’m ready for bed, but it’s time to make supper for the kids, my wife isn’t home for another 45 minutes, the dogs need to be walked and there are a pile of jobs I have to get to here as well before bed, but I’m sooo tired and for 30-40 minutes pretty grouchy. This puts extra work on my wife and I end up feeling guilty about that and that I’m not doing more.

Just my thoughts about the one a day options. Make sure you know what the active period is and what the down will feel like. Will this satisfy your needs or will it make things more complicated? What might be a better fit?

Actually this is why I tried Straterra first. I didn’t want to ride the roller coaster everyday.

Another point worth mentioning is that while generics are often substituted for brand names they are not the same. Before dismissing a treatment make sure you are taking the medication you think you are taking, if its a generic get the right stuff. It may cost a little more but you can recover that through the manufacturer in most cases. The difference is like Lada to Porsche.

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[Anonymous]

callme…….

Is a higher dose of Concerta an option for you…….

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[Anonymous]

@njadd

I just started on the 18mg day 6 I believe. My Dr is on vacation, so going back isn’t an option for another week, and I have a follow already booked for the week after that, so for now I’m taking my Concerta later in the AM so it sticks around until at least 7:00.

It is taking LOTS of self discipline not to test or experiment with two a day.

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[Anonymous]

Wow, see? This is what I get for forgetting to log back in the day I signed up for this site after seeing the documentary on PBS… I get a ton of responses! And Rick… well I certainly wasn’t expecting a response from you! I have to tell ya, the chemistry between you and Patrick is phenominal- I was laughing so hard because you two have the same goofy and comedic personality as me! Then I cried, because it was so comforting to hear that others are going through everything I have ever experienced in my life. I even called my mom and apologized to her because of the stress I put her through growing up with them trying to find out what was wrong with me. But I digress :o)

About the 2-a-days of Concerta… I kind of have no choice but to do it. I started at 18 mg when I got my first script. By noon, I was about to pass out while listening to the soothing sound of a patient’s heart through my stethoscope. But, you are right Rick- I’m in the Navy. My typical day? Wake up at 04, get my kids ready for daycare with my husband, get myself ready for daycare errrr I mean the Pediatric clinic I work in, leave the house by 6, start work at 7, take a quick lunch at noon (we don’t get breaks!), get off at 5 pm, get home at about 5:30/6 depending on DC traffic (which only infuriates the imaptient child in me!) and get dinner ready at 7. Not only that, but sometimes I work weekends if I have duty, which happens about one a month. So after going through this for the last 2 years, I’ve hardly been able to catch up on sleep. Oh, did I mention my son has ADHD as well? :o) That makes my day even more eventful!

So I called my doc and told her that I was getting very tired and inattentive by about 2 or 3 on a regular basis. She gave me a script for 5 mg Ritalin to supplement the Concerta once it wore off, that way it would be pretty much gone from my system before bed, unlike the ER effects of Concerta. Needless to say, Ritalin didn’t do it for me either. I asked if upping my dosage may alleviate the fatigue, but she made a good point by saying all that will do is give me a bigger jolt in the start of the day, and still wear off at the same time. So, that’s how I came to 2 Concerta a day. I don’t exactly think the Concerta is causing the insomnia. I typically get to bed at a decent time, around 11 or midnight, it’s usually my brain that I have trouble turning off. But I must be honest with you, the Navy (at least my chain of command) doesn’t give a flying rats behind about ADHD. Apparently, my supervisor has ADD. When I told her how bad my symptoms were affecting my job performance, she used the excuse “Well I have ADD, and I don’t take meds, and I have 3 kids, and I get 3 hours of sleep a night, you think I don’t have it bad?!” And not to mention when I was pregnant and diagnosed with an inflammatory disease that made it impossible to walk, she said “I worked 12 hour shifts at a ward while I was pregnant, and I didn’t get a lunch most day!” Well, apparently she is Super Woman. I however, am not. I have been told multiple times that I need to “suck it up and do my job”. It hurts so bad to hear that, because it almost makes me feel like they think I dreamed up this disorder, just as a cop out. I have even been threatened with a medical review board, which is where they determine if you are medically “fit” for active duty service. Hence the reason I was very leery of making that call to get a diagnosis- Navy don’t mess around! Another downfall of ADD in the military- They don’t exactly like the “goofy nature” of us ADDers. Of course, I make the whole clinic laugh when we are enjoying a pot luck in our conference room and I go on a rant about something crazy that’s happened to me, but usually it’s the civillians that get a kick out of me. The military members giggle a little, but the hard ones stare at me with their firey gaze that says “HOW DARE YOU LOSE YOUR MILITARY BEARING!!!!” Anyway, wow, I really went off subject there. I think the problem with me taking one Concerta a day is that my symptoms of ADHD are so severe, they aren’t doing the job. Like… seriously… I have never met anyone that has it as bad as I do…. An example? (And I promise I’ll click “send post” after this)… I was making a note in a patient’s record on the computer the other day. Not only did I put their vital signs in once, but I went in 3 MORE TIMES to put them in after the fact, and each time I wondered how they got there! Luckily, when it comes to patient care, my memory serves me well- I have never had a patient safety mishap due to a glitch in my overactive brain, it’s just little things that get me. I have started writing a book on being ADHD in the military, but keep putting it on the backburner because I don’t feel like I would give good advice at this point to anyone, but a memoir would definitely be an enjoyable read. If I get a good method of coping with it while I’m active duty, I’m definitely going to pick it up again because I know there are SOOO many people who could benefit from it!

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[Anonymous]

Squirrrel……. Please take the time and read my keyboarding as somewhere in the black colored texts are a lot of thoughts about what you typed. MY words may seem off topic at times as unfortunately my key punching skills are not nearly as quick as the racing thoughts in my head.

First I respect your skills as a Nurse. My X wife is a RN and I was there during her obtainning that degree and supported her endeavors. I had been there during her first job and movement within the ranks to including hooking up with a Dr and dumping me. Bitter NO only pissed that I did not know that I had ADHD and because of the lack of knowledge and education about it at 48 I am faced with many a life challenges because of this syndrome and symptoms of ADHD. (More on the x another day and her/family history of ocd/adhd/bipolar issues that I did not realize she had to which she was very educated about and used that knowledge against me WHATTTTTTTT a florence nighting gale would never do that …. Please! Oh and the ADHD symptons that run rampet in my family but only now am I starting to uncover!) hehehe You might read about it In the mental health magazine for men with adhd I am trying to create. You know to coincide with the televsion show called “C.R.A.P (kinda like NCIS) where did I put those keys”… my production company will be called POOP that way like oprah even backwards it will be memorable! and refer back to the show title…lololol

It does make perfect sense the Dr.s reasoning for not upping the dose… I guess they need an xxr or xxxr. please keep us informed as I believe your trainning might provide some good insight and provide us with some great data from a educated professional that actually is living through what so many of us are.

I love to hear that you apologized to your mom…… Family is such a huge support structure in combatting ADHD my hands off to you Really!…. Next time ya see her give her a smooch on the cheek from this totallyadd guy. Tell her i thank her for putting up with you also so that we ADHDers may have another educated professional as an advocate and example that ADHDers can suceed and make a difference in the world for good…

Ok. May I ask what type ADHD er you may be,,,, what are your 3 greatest symptoms that indicate you are one of us… and what techniques you use to combat them. Come on make me feel good…….. I love success stories… Do some of your uniqunesses require different solutions to overcome there potential threat of disaray in your life and those around you? The reason you take concerta is? I also applaud you in not double dosing the med. I bet it is because(partially at least) of your education that you did not go that route. I have observed many a persons on this ADD site experimenting and I remember my X often talking about her many patients (as she was first a psyche nurse before heading off to surgeon land in PACU) doing the same with substantial negative consiquences.

Psyche Dr visit for meds for me just days away although I have talked to MD s regarding drugs and my ADHD/PTSD issues, Counsellors have also been part of the treatment/education process which i will lean on even more heavilly during the med introduction and tuning there of. I had been on meds briefly when first diagnosed with ADHD but because of the lack of education about what I was being treated for I suspended there use as I felt changes taking place but to be honest I did not know why, how and what I was suppossed to do with these new feelings in my head…

I unfortunately because of my ADHD symptoms resisted many skills needed to cope with even the simpliest normal every day life adventures and necesities to just survive in a reasonable manner. I had always been a very creative and physically hard working person but my support systems were definately not a good fit for me and unfortunately even used against me for there selfish gain in a variety of ways not known to me. Of course not until it was to late!

K nough said have an awesome day!

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[Anonymous]

Thanks for the reply njadd! What kind of ADHDer am I…. hmm… Well I am more inattentive than anything. Like I said above, I took a Psychology class last semester and got an A by only reading a chapter or so. I didn’t want to do it that way. It just kind of happened. I had that motivation, but everytime I would sit down, I would find myself reading the same paragraph over and over because I hadn’t grasped what was being said. My 3 greatest symptoms…. I would say slobbiness, inability to organize a schedule/remember important tasks and dates, and hyperactivity. For being slobby, I have my husband to pick up after me ;o) lol just kidding…. kind of. He’s a stay at home dad with OCD so he completes me haha. We have put our kids in a daycare for the last couple of weeks to take care of some personal business, so it’s been a nice break! Honestly though, I haven’t been able to get a grasp on the slobbiness. My car is full of things I just throw in there when leaving work and never taking them up, my room has clothes all over the floor, and my bill folder is empty… mainly because all of the bills are still in the car after getting them from the mailbox or scattered throughout the house. As for not remembering tasks, I got myself a Blackberry the other day. I am a sexual assault victim advocate for my command (If someone is raped, they call me to respond first) so when I am on duty, I carry a Blackberry that receives the calls. I noticed whenever I had it, I was able to organize better because I used the calendar and planner. If I don’t write something down, it doesn’t get done… that’s basically it. My supervisor actually makes me write things down in front of her when she’s tasking me with something. I’m also the computer nerd in my clinic so I do all of the IT stuff. We got a Pyxis machine (a computerized pharmacy basically, with a fingerprint log in that pops open a drawer of meds to give to a patient) and when we got it, I took the task of getting everyone access to it. It included getting applications sent to everyone and turning them in to the main pharmacy when they were filled out. Well, the basic jist of the story is that there are still applications sitting in my “out” box that were handed to me about a month ago. I have gotten emails about when their log in will be ready, and always forget to reply. It’s a vicious cycle, and unless I really put my mind to it, it doesn’t get done. As for motivation in the work department, I fluctuate. Some days I’m a hard-charger, and other days I’m a total dirt bag and my self esteem goes rock bottom. Hyperactivity…. it will be the death of me. I sit in traffic and fester. I have actually hit a red light, gone down a side street to avoid it, and when I got back to the same intersection, that light has turned red, making my original light green. I love talking. I love keeping busy (sitting down, like on a computer) and I love stimulating my brain. I’ve recently gotten back into art- it was my outlet as a child and I’ve found my artistic talent once again. For the holidays, I painted murals on my clinic’s windows, as well as mine and my neighbor’s. All of them said I should do it on the side from the Navy. When I paint or draw, my brain shuts off- it’s the ONLY thing I can do without thinking about other things. I have no clue why, but it is. I take Concerta mainly for the “anti-venom” effects… like when you’re bit by a snake and the ER uses the same snake’s venom to combat the effects of it. Basically, Concerta is a stronger and more metabolically sustainable drug compared to Ritalin (meaning it doesn’t wear off in an a couple hours). Since we are so hyperactive, the stimulation of Concerta or other drugs similar to it counteract the hyperactivity (as to the chemical reasoning behind this, I’m clueless). I take Concerta also because Ritalin gives me wicked headaches. I’m still learning, and I was dx’d with ADHD over 17 years ago, so now that I’m more mature (by ADHD standards), have some medical training and a better grasp on my coping and actions, I have been noticing the effects much more. But like I said above, I’m going to write a book on dealing with ADHD in the military, and if I can somehow find a way to stay in 20 years and retire at the ripe young age of 42 without being kicked out for it, the book will help in ANY profession. As for any other questions, please, ask away! I love talking with others about this. And I’m so excited I found this website!!!!!!

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[Anonymous]

I’m using Concerta as well but it doesn’t seem to work for me, I’m just following the Doctors orders even though I’m growing very impatient, I want it to work now! I know she is trying to fix me up but waiting a week or two to me is like telling a kid that Santa will be here in a few days, mean while the kid is rolling around on the floor barely able to contain themselves. I do my best though and I try to stay away from everyone which comes naturally. I must say that I have cheated and tried a larger dose 72 mgs. It didn’t do anything, just made my ears ring a little more. I’m not recommending that anyone adjust their medication, but I just have a really hard time with patients when it comes to doing something. I can’t seem to do anything myself but I expect everyone else to get it done now. I’m very aware of the way I am now and that has been my biggest help thus far. Try not to be like me and follow your Doctors orders. There is one thing about this that I find kind of funny. After 12 hours I feel tired, that’s a good thing because sleeping for me is a major challenge. I wake up several times a night and the sheets on my bed are always off the mattress when I wake. Come to think of it the elastic on the bottom sheet on my side are always broken.

John

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[Anonymous]

John-

I have been tempted to try upping my morning dosage on my own, but it’s too risky to do with something as potent as Concerta. It’s possible to overdose on it- it’s basically prescribed methamphetamine if you compare it’s chemical components. Just like a drug addict who isn’t used to using a big amount of meth, they may overdose and cause their nervous system to shut down if they use too much- and Concerta can do the same thing. The biggest effect of a high dose of it is your heart having to work overtime. Your pulse goes up, you get less oxygen to your brain/muscles/organs and your heart can just say “that’s it! I’ve had enough!” 72 mg is a lot- even though it’s been approved to be dosed that high. Just watch out and try not to self-prescribe your doses. If anything, you should try 18 mg, then 2 18mg pills/day, and slowly work your way up over a few months. Just give your body time to get used to it- pay attention to how you act and feel. After a while, If Concerta isn’t working for you, you may need Adderall or something of the like. I’m going to stick it out with Concerta for a bit longer and supplement it with coaching… when I get in for an appt for it :o) Good luck and I hope that you (and I) find some relief soon!

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[Anonymous]

Screammmm! I just wrote a long post and then deleted it by mistake!!!

Well, maybe that’s a good thing for you since I’ll just give you the precis instead. According to CADDRA website, (The Canadian Attention Deficit Hyperactivity Disorder Resource Alliance http://www.caddra.ca ), the top dosage per the product monograph is 72 mg for kids, adolescents, and adults. But…… the physicians who are involved with the site have listed other top dosages for Concerta for use for adolescents (I think it was 80 mg) and for adults- 108 mg. It was clearly listed as take ONCE a day.

I see a psychiatrist who deals primarily with ADD/ADHD adults and those with other comorbid conditions. He has me on 72 mg once a day and has given me regular ritalin(a tiny 5 mg dose) to use for the tail end of my day. Many of my ‘normal’ work days are 18 hours and my body effectively is done with the Concerta after about 9 hours.

He did ask me if I felt I needed my dose raised the last time I was in to see him but I didn’t think so. I started out at 18 mg and yes, I did notice a difference but not an optimal one. I felt a lot calmer, almost sleepy but didn’t have the focus I have now. My current dose gives me focus but without the sleepy feeling.

Anyway, since this is the short version of my original post I just wanted to add this- the doses should only be raised 18 mg once a week by your own physician. I think our own Dr. J is somehow or other affiliated with the caddra group (or at least I think I remember him making a comment to that effect when I heard him speak one evening at a meeting I happened to be attending).

Now I’ve got to run and try and locate my DH since we’ve been unable to catch each other due to time zone issues. I think he should be long out of bed by now so I’m off to talk his ear off instead!

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