Concerta has NOT changed my life–should I try another stimulant or am I SOL?

[Anonymous]

I’m on 56 mg of concerta daily, but I still want to fall asleep and hibernate by 3 pm even with a methylphenidate booster taken around that time.

I was really hoping that medication would be like a light switch turning on for me, but it doesn’t seem to do anything for my Hyperfocus and I notice only modest improvements in executive function. Inattention, Initiation and follow through are big issues for me, as well as big problems with lack of alertness, fatigue, and hyperfocus. Right now, I’m on the computer and know that I should leave the house to pick up my daughter, but it’s going to be very painful for me to get off the computer and stop this train of thought. ‘

So, medication: if you were me, would you stick with the concerta and accept the modest gains, try another stimulant, or try to switch to something like Wellbutrin or that drug that they use for narcolepsy? I am very willing and interested to try coaching and have tried several tricks and devices, but I was really hoping medicine would make all that easier.

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[Anonymous]

Oh, and in addition to the Concerta, I take Prozac.

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[Anonymous]

The off label maximum of Concerta is 108 mg. You can go up higher. Check with your doctor of course but the idea is that if you started to see a bit of improvement, you may just need to keep going up on the dose. Hope you are not on the generic Concerta because that does not last as long as the real thing.

Check out the Rick Rants on Generics Part 4

No problem with Prozac.

Always speak to your doctor before making any changes to medications. Dr. Jain provides advice generically and not for any one person. Advice does not constitute a therapeutic relationship or promise of care. Please consult the privacy policy for more information

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[Anonymous]

I was having the same exact problem when I first started taking concerta. I started with 56 mg, and was just like you, barely noticing any difference. My doctor then upped my dosage to 72, and i began to notice some major improvements. I am now able to follow through with the task I am going (for the most part) , and I am able to clearly think through what I am going to say before I say it, reliving the awkwardness of saying something that seems completely inappropriate to the conversation that is going on.

I personally have seen much success with Concerta. Last year was my first year of college, and I almost failed out. I was put on Concerta around the end of October, and now and achieving A’s and B’s in all of my classes. It is also much easier to retain information in class because I can actually pay attention. So I would suggest talking to your doctor, because as with my case, simply upping the dosage can create a major difference

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[Anonymous]

No offense to the medical industry, but perhaps you are looking for a magic cure in a pill.

It doesn’t exist.

Even if stimulants are a magic bullet – which for many of us they are – it doesn’t change the fact that you are taking amphetamines. Amphetamines make even non-ADHD people euphoric, filled with confidence, and goal-oriented. Unfortunately, with use, the ugly side of amphetamines start rearing their head. You start getting more tired than before, zapped of energy, and the days you don’t take it are starting to feel more like when you did take it.

I take very, very small doses of these drugs if at all.

Try as many behavioral things as you can. Getting an hour of vigorous exercise before doing anything else for me is far finer than anything the pharmaceutical industry has yet concocted. Think of the pills as tools you don’t need to rely on, but have as back-up.

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[Anonymous]

Make sure that you see the video

http://totallyadd.com/sponsored-video-3-holistic-treatment-approach/

We discuss just what you said MichaelDC, the need to use meds as facilitators, not cures. We want people to use holistic interventions.

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[Anonymous]

I take 108 mg Concerta daily (well, usually and cannot tell if I have taken it or not. My wife can tell. The family joke is – I take the meds and my wife feels better. The only consistent, first hand, effect I am aware of is: I eat less. Occasionally, I am aware that I can context switch (change focus) with less irritation.

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The meds do not interfere with my naps – interesting projects do They also don’t help with task avoidance, nor dampen the hyper-focus.

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Cure? Not likely! At best, a facilitator for developing cooperative habits. Exercise helps but, for my wife, is no substitute. I am oblivious to the issue.

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PS – I have two kids and two grandchildren with diagnosed ADHD. We (my family) strongly suspect that my mother, her father, and his father were ADHD.

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[Anonymous]

Went back and re-checked some factoids. Where does one come to the conclusion that methylphenidate HCL is an amphetamine? – other than common syllables in their names.

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[Anonymous]

methylphenidate HCL is not an amphetamine though it is very similar.

BVN- looks like things are ok. Keep working on lifestyle though.

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[Anonymous]

My Dr. has been titrating my dose of Concerta since my diagnosis 4 months ago. Started at 18 mg and worked up to 54 with no effect or side effects, even weight loss, which I understand is the most common. No problem sleeping; if anything I was sleeping better. My dose was increased up to 90 mg–still no improvement with some tightness in my chest at night and when running up stairs. Also, dryness of mouth which was particularly bad when exercising and slight weight gain.

As a result of the “issues” created by AD/HD–i.e. being fired, the other AD/HD challenges, as well as other stuff going on in my life, at the same time as taking Concerta, my Dr. prescribed Lamotrigine as a mood stabilizer; again with no improvement. Neither of the drugs have have any impact on either of the issues. His current approach is, over a 6 week period, eventually taking up to 175 mgs of Lamotrigine combined with 54 mgs on Concerta in the morning; 36 mg in the evening. I’m in my 4th week of both and again, no improvement. If anything, my ADD has worsened which has become extremely frustrating and beginning to impact me emotionally. At this moment I’m feeling even more “distressed” as I have had difficulty composing this post and writing is a large part of what I do for a living. However, apparently I’m “well” enough to notice that ‘separated’ is spelled incorrectly below in the tag guidelines….

I go back to my Dr. in mid-January. I trust him and appreciate his efforts to find something that works. I suppose he will continue to try different approaches to find a course of treatment that is successful. His feeling is that once that is achieved, I can introduce other things like cognitive behaviour therapy. On top of all this is the high cost of the medication which would be easier to handle if it actually worked.

What this long, somewhat scattered post is asking is, given my recount of my current situation, is/are there any other approach(es) that might be successful? Perhaps others have been in a similar situation and can share their experiences.

I am a 52 year old woman and peri-menopausal. Does the latter have any impact?

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[Anonymous]

Keep trying different doses and different meds. I recommend Daytrana patches. Once you get the right dosage they last 12 hours so you can avoid that “up and down” feeling with you get with pills.

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[trashman]

hi ME JANE idont’ write for aliving iam on 108mg 72mg in the am and 36mg after lunch. I start my day at 5am take my top up at 1pm this will carry me untill about 9 to 10 pm . so i don”t know if I should expect more . this is a adveture I did not ask to be on . having said that I can say that I understand how you feel having just been fired on december the first. so what i see is that the sadness gets way worse and it at times seens hopeless, then I slow down my thinking and the I can chose to start to reason through what hapen was , I have abig MOUTH and it and my brain try to defend me without thinking of the reality of the out come. I am learming that if they want to yell at me that I should not try to defend myself at that time. it seems that at that moment if I respond I will say some thing that I should not have said. so I think that my meds are working , it”s time to see if someone I can say something that I will beable to defend myself with out having to get angre and lose my temper and yell back. thats my new goal for the new job whatever it is. so I think the concerta is working for me . I would rather become totally functioning person , but I can tell from readig alot of the other post thats not going to hapen. I left school and that was because my attention was not strong enough to read more then a few pages . I would make mastaks and get so upset that I could not think . so as you see it is a slow go , and reading what you all are writing with not getinng so overwellemed that I could not follow along . the sad thing is that I am forty seven and if I pay close attention I can now join in whitch i was never able to before. the problem is my brain wants to go faster than my fingers can typ. so all in al . the meds are working . hope this helps.

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[Anonymous]

I took Concerta for a month. Felt like meth to me. Not sure it helped all that much. I could focus. Did not actually mean I did focus but I could at times. However the crash when the pill wore off each afternoon was terrible. I became touchy and grouchy. Psych had my wife come with me when we did an evaluation session to decide if the Concerta was working. She asked him to take me off it. I did not like my self in the afternoon and neither did she. He suggested an additional dose of Ritalin in the afternoon. However I did not want to be that speedy going into the evening and figured it was just delaying the crash.

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