# Worried about Concerta



## Arisa1536 (Dec 8, 2009)

I am starting Concerta tomorrow on 18MG for two days then 36MG for two days and then 54MG if needed. I hear bad things about it on here from people have ADHD I and have tried it and other ADHD meds. I was hoping to Ritalin but the psychiatrist suggested this first as he said it was less harmful side effect wise to me, now thats not to say everyone will be affected by it the way i am but has anyone ever had a positive experience with it?

I know it will be stimulating and cause headaches but my main concern is the terrible depression, suicidal tendencies and the horrific feeling of cramps and wanting to die that can come with meds that do not work well with me then again the pdoc said effexor will aide its use so if i do have ADHD he basically says it should work and the good will outweigh the bad if there is any bad :|

Otherwise he may try me on ritalin but is skeptical because its IR as he said Sustained Release ritalin would not be helpful and Concerta is XR and will last twelve hours

i am confused and new to these meds
can someone help?


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## hanzsolo (Jan 2, 2011)

Arisa1536 said:


> I am starting Concerta tomorrow on 18MG for two days then 36MG for two days and then 54MG if needed. I hear bad things about it on here from people have ADHD I and have tried it and other ADHD meds. I was hoping to Ritalin but the psychiatrist suggested this first as he said it was less harmful side effect wise to me, now thats not to say everyone will be affected by it the way i am but has anyone ever had a positive experience with it?
> 
> I know it will be stimulating and cause headaches but my main concern is the terrible depression, suicidal tendencies and the horrific feeling of cramps and wanting to die that can come with meds that do not work well with me then again the pdoc said effexor will aide its use so if i do have ADHD he basically says it should work and the good will outweigh the bad if there is any bad :|
> 
> ...


Hi,

Just to clarify (which I'm sure you already know); concerta is ritalin in extended release form. Same thing except it releases something like 22% of the med right away, and then the balance over the next few hours in doses.

That being said, I don't have a lot of experience with ADHD meds either to be honest, but I can tell you that everyone is different and what may not work for someone else may work for you, and vice versa.

It's very important (if possible) to try and keep an open mind when starting a new med, otherwise you will almost be looking for the side effects and sometimes even bringing them on.

Some people love concerta and are very happy on it. Others don't like it at all. XR versions of any med tend to be easier on most people, as they have a smoother uptake and drop off (versus the instant kick and drop off from the IR meds). Again, some love them, others hate them.

I personally didn't have many bad side effects on the concerta, it was very smooth, and lasted me a good 6-7 hours (I tend to metabolize very quickly). I just personally prefer being in control of when I want another dose and not relying on the meds to deliver my 2nd/3rd doses to me. But that's a personal preference. I also have to deal with the ups/downs of the IR, which can be rough at times. And timing is everything with the IR as well.

So my conclusion? Give concerta a chance, and then if you really don't like it, try the Ritalin IR. Or a different med altogether (like adderall, vyvanse or dex if they are available in your area). You may be pleasantly surprised and it will work really well for you.

This is all trial and error with the type of med, dosing, frequency.. But with determination, I am sure you will get it right 

Hope that helps and have a great weekend


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## Arisa1536 (Dec 8, 2009)

Thank you for your reply :hs
thats good to know it was very helpful too 
So ritalin IR is not the miracle drug? And due to it being instant release it may be way to stimulating for me and i would likely abuse it but so far so good on the concerta, its been three hours and i feel great, a lot of that crazy fidgeting and not being able to sit still has calmed right down and i have energy at last
being bored and having no motivation at the same time was the worst so its nice having more concentration in such a short span of time.

Well i take very well too Effexor XR and that took a good month to work in my system but i still swear by it and i was told it works well with Concerta as they are both reputake inhibitors so heres praying it works 

i metabolize things fast too, usually something intended for twelve to fourteen hours does not last that long with me so hopefully i wont be awake all night.

concerta is best taken early in the morning right?
I want to take it the same time everyday and yes we get dex here but not adderall although dex would be the final option as its our strongest one, dextro amphetamine is abused i guess because of its stimulant and diet pill uses. Ritalin is abused here illegally too, the Instant release stuff that is


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## hanzsolo (Jan 2, 2011)

Arisa1536 said:


> Thank you for your reply :hs
> thats good to know it was very helpful too
> So ritalin IR is not the miracle drug? And due to it being instant release it may be way to stimulating for me and i would likely abuse it but so far so good on the concerta, its been three hours and i feel great, a lot of that crazy fidgeting and not being able to sit still has calmed right down and i have energy at last
> being bored and having no motivation at the same time was the worst so its nice having more concentration in such a short span of time.
> ...


Am happy to hear it's working for you so far 

Yes best to take it early in the morning. Then once you have a feel how long it actually lasts, you can play with the timing to suit your actual needs (when you need it working the most).. It should not keep you up at night if taken early enough..

As for Ritalin IR, what can I say. Lots of ups, downs, lefts, rights, very inconsistent if my doses aren't timed right. And the doses tend to last less and less time as the day goes on, so timing becomes more and more of an issue and very hard to calculate.

In spite of all that, I still personally like the IR best as I said, because I like to have more control and know when my doses start/end and customize them to suit my needs. Also they pack much more of a kick initially (some like this as it's very stimulating, but has a much higher potential for abuse IMO) and more of a drop when wearing off (most don't like this). Pros /cons as in anything.

Btw if you do metabolize fast like me and find that the concerta is wearing off too quickly and early in the day, and assuming you want /need more focus in the later hours of the day - some doctors will allow you to supplement 1-2 ritalin IR later in the day just to help smooth things out into the evening.

Best of Luck


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## Noca (Jun 24, 2005)

My only problem with Concerta was that it gave me gut aches from time to time. Don't be worried about this medication Arisa


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## Noca (Jun 24, 2005)

Arisa1536 said:


> Thank you for your reply :hs
> thats good to know it was very helpful too
> So ritalin IR is not the miracle drug? And due to it being instant release it may be way to stimulating for me and i would likely abuse it but so far so good on the concerta, its been three hours and i feel great, a lot of that crazy fidgeting and not being able to sit still has calmed right down and i have energy at last
> being bored and having no motivation at the same time was the worst so its nice having more concentration in such a short span of time.
> ...


Metabolism rate shouldn't matter for people taking the brand name Concerta. It has a technologically designed capsule that it is in and the capsule itself cannot be broken down by the body. The drug is released into the body at an equal rate regardless of who is taking it. The only part where metabolism comes into play would be once the drug is already released, and how fast your liver eliminates it.


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## Arisa1536 (Dec 8, 2009)

Cool thanks for the replies so i should not be worried then?
I have noticed now that its a bit later on in the day, stomach cramps and ache but thats all and my energy levels are up which is a good thing. I do not know about appetite since its only been a day but i read that most ADHD meds to decrease appetite, can concerta make people gain weight? or would that be extremely rare?
i guess it would be like Ritalin IR making people gain weight 


so with ritalin IR u would need to take it more than once a day and calculate times and such? the psychiatrist said that type of med is needed up to three times a day and this one is just a once a day thing


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## hanzsolo (Jan 2, 2011)

No I would not worry about concerta. But I would keep a log of how you are feeling every day, on different doses and at different times, so that you can properly assess which dose is working best for you, and the timing of them (up/down)..

Yes most ADHD meds tend to decrease appetite, especially initially. Since I am relatively new to all this, I cannot speak about the longer term effects. But I have read mixed things; some claim it's only weight loss at the beginning, others that its consistent. 

As for Ritalin IR, exactly.. I take it 4-5 times per day, starting from around 8am. First dose usually lasts 2.5 hours, subsequent doses less and less. So timing becomes an issue, as I need to calculate how long before I "anticipate" the crash to be so I can take my next dose. And since I metabolize quickly, my doses tend to last much less then the 4 hours people claim... Lots of trial and error. And that's not even taking into account the tolerance that builds up over time and makes the doses last even less time then when I started.. 

Hope today was a good day for you overall, and have a great weekend


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## Noca (Jun 24, 2005)

Arisa1536 said:


> Cool thanks for the replies so i should not be worried then?
> I have noticed now that its a bit later on in the day, stomach cramps and ache but thats all and my energy levels are up which is a good thing. I do not know about appetite since its only been a day but i read that most ADHD meds to decrease appetite, can concerta make people gain weight? or would that be extremely rare?
> i guess it would be like Ritalin IR making people gain weight
> 
> so with ritalin IR u would need to take it more than once a day and calculate times and such? the psychiatrist said that type of med is needed up to three times a day and this one is just a once a day thing


Methylphenidate will never cause weight gain, at least not directly. As for multiple dosing, why would someone who wants to have the medication last all day opt for multiple IR kinds of a medication over something that lasts all day, ill never know why. The only reason I possess the IR medications of Ritalin and Dexedrine is to give me a SINGLE dose at some point later in the day when taking a long acting medication would prevent me from ever getting to sleep that day.


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## Arisa1536 (Dec 8, 2009)

Thanks hanz and Dr house for your replies 

IR does not sound too bad as the effects would wear off in time for bed but then again sleep might not be a problem on concerta if i take it early enough
i guess with the appetite thing it wont change until the dose is increased or i get used to taking it regularly

I was given a sheet of paper and am to write down each day the dosage, time i took it and the good and bad side effects so if in seven days when i see the pdoc i am in a really bad way then he will change the med to an IR but he also suggested wellbutrin but i did not know that was ADHD

anyway thank u and hope u all have a good weekend too


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## hanzsolo (Jan 2, 2011)

Dr House said:


> Methylphenidate will never cause weight gain, at least not directly. As for multiple dosing, why would someone who wants to have the medication last all day opt for multiple IR kinds of a medication over something that lasts all day, ill never know why. The only reason I possess the IR medications of Ritalin and Dexedrine is to give me a SINGLE dose at some point later in the day when taking a long acting medication would prevent me from ever getting to sleep that day.


Hi doc, good question lol.. My issue with the XR is that they don't last all day. Not even close to that for me. In addition, I find them very inconsistent. I don't feel like i have any control over when and how i want to feel. Maybe its just me and my crazy mind :teeth

In any case, i know most prefer XR and if I could find one that really worked consistently for me all day, or at least until 2-3pm then i would gladly take it over the IR route in a heartbeat. But I have yet to find one and i tried vyvanse, concerta and adderall. All have a slow onset of action, then a peak, then "where am I" stages, maybe another smaller peak, then drop off. That's me anyways. I wonder why ?????

At least with my IR, i know exactly when they start and end. And i get relief within 30-45 minutes and a nice kick from it. So if i dose every 2 hours more or less, I get consistent relief all day, unlike the XR. Then again, timing is not a science and always tough to get down exactly. Plus the downers are more harsh. Pros/cons i guess..

Have a good one


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## Arisa1536 (Dec 8, 2009)

hanzsolo said:


> Hi doc, good question lol.. *My issue with the XR is that they don't last all day*. Not even close to that for me. In addition, I find them very inconsistent. I don't feel like i have any control over when and how i want to feel. Maybe its just me and my crazy mind :teeth
> 
> In any case, i know most prefer XR and if I could find one that really worked consistently for me all day, or at least until 2-3pm then i would gladly take it over the IR route in a heartbeat. But I have yet to find one and i tried vyvanse, concerta and adderall. All have a slow onset of action, then a peak, then "where am I" stages, maybe another smaller peak, then drop off. That's me anyways. I wonder why ?????
> 
> ...


Hey  i know its only been two days but i am finding concerta is not lasting all day, not even five hours well basically all my energy and the stimulating clear headedness goes by 1PM  I would much rather IR but the psychiatrist was pretty adamant about XR being better because it lasts longer but thats not the case. Maybe a higher dose would help? That is my only real complaint as the side effects are minimal aside from a sore stomach and the odd bit of dizziness and nausea which is easy to handle. The good effects are good but last so briefly and i feel as though i have taken nothing by afternoon


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## hanzsolo (Jan 2, 2011)

Arisa1536 said:


> Hey  i know its only been two days but i am finding concerta is not lasting all day, not even five hours well basically all my energy and the stimulating clear headedness goes by 1PM  I would much rather IR but the psychiatrist was pretty adamant about XR being better because it lasts longer but thats not the case. Maybe a higher dose would help? That is my only real complaint as the side effects are minimal aside from a sore stomach and the odd bit of dizziness and nausea which is easy to handle. The good effects are good but last so briefly and i feel as though i have taken nothing by afternoon


Hi Arisa,

I had very similar experiences when I was using any XR med, which is why I moved to IR (which again have their own set of problems I mentioned, albeit different ones)..

I'm not sure if a higher dose will make it last longer, have read different things. I believe when I tried a higher dose it may have lasted slightly longer, but I was not on the concerta long enough to say for sure. Maybe someone with more experience can comment here ??

What time are you taking the concerta at? Because even if it only last 5 hours, thats at least double what an IR lasts, if not more (for me). So it is lasting longer, but nowhere near as long as it does for some others.

My pdoc told me I had 4 options when it came to this particular issue you are having;

1. Try taking another concerta around noon and see if I can sleep, how I feel, ups/downs, etc
2. Continue with the concerta in the morning, and then take Ritalin IR in the afternoon as needed (for example at 1pm and 4pm you can take 5-10mg of ritalin IR). 
3. Stop the concerta altogether and just switch to Ritalin IR all day (which he was also VERY much against due to the addictive nature of it i.e. popping pills every 1-2 hours, the peaks/valleys, etc)
4. Stop the concerta /ritalin altogether and try something else

I would discuss all these options with your pdoc and see what is recommended. Since you like the concerta but its losing effectiveness early for you (as it was for me), I would try to supplement with the IR med in the afternoon, or try the second lower dose of concerta at noonish and see if that helps.

I recommend the above mentioned options before the strictly IR route because with a fast metabolism (like me), the IR route is a lot of timing, peaks/valleys and other issues you may not like. Granted, it's working for me (so far) but it's only been 7-10 days so very early to make any conclusion here. You can always try the IR route after you have exhausted all the other options (as I have) 

Please keep in mind that I have limited experience here with ADHD meds and am only sharing based on my very limited personal experiences

Hope that helps and best of luck,
Hanz


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## Arisa1536 (Dec 8, 2009)

Thanks hanz
i do not think my psychiatrist will let me ever have IR ritalin AND concerta both at the same time to take every day but he may be okay with IR ritalin as i do not think the reason why concerta is not lasting is because i do not have ADHD otherwise it would over stimulate me wouldn't it? i doubt it would work then stop in the afternoon

yeah i was wandering about taking one in the afternoon, if i am on three x 18MG then i could take two in the morning and one at 1PM? I have been trying to take it the same time everyday as it gets me out of bed early, if take it at 7am when i am half asleep, by 7:45am i am out of bed with energy which is awesome and a clear mind like right now but it does not last so yeah i have written all of this down

Is it true that if am not sleeping because of them then i do not have ADHD? and the meds are too strong? because heaps of people tend to be on both zopiclone and ADHD meds, even the patients he sees, i have seen one who is on zopiclone, ritalin and seroquel


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## hanzsolo (Jan 2, 2011)

Arisa1536 said:


> Thanks hanz
> i do not think my psychiatrist will let me ever have IR ritalin AND concerta both at the same time to take every day but he may be okay with IR ritalin as i do not think the reason why concerta is not lasting is because i do not have ADHD otherwise it would over stimulate me wouldn't it? i doubt it would work then stop in the afternoon
> 
> yeah i was wandering about taking one in the afternoon, if i am on three x 18MG then i could take two in the morning and one at 1PM? I have been trying to take it the same time everyday as it gets me out of bed early, if take it at 7am when i am half asleep, by 7:45am i am out of bed with energy which is awesome and a clear mind like right now but it does not last so yeah i have written all of this down
> ...


Hi,

Not sure about the over stimulating part, depends what kind of ADHD you have. If you are not hyperactive, then a lot of these meds stop working after awhile due to burnout (as they are actually stimulating you). But that doesn't mean you don't have ADHD. I am one of those people that the ritalin stimulates; but it helps me focus, and gives me clarity. For others, it does the opposite and does not stimulate. A proper ADHD diagnosis clarifies this either way.

And us fast metabolizers burn through the meds much quicker, so 12-1pm sounds about right, I was in the exact same position as you.

As for the 18mg afternoon dose, definitely worth a try. See if it keeps you up at night, if it carries you into the evening, if it blends well with the earlier doses, etc...

Not sure about that third question. Could be that the meds are too strong, and that they are over stimulating you. You can always try a lower dose and see how you feel + how your sleep is. I know plenty of people that most definitely are ADHD but have trouble sleeping and take sleeping pills.

But again, I have very limited experience here, have not been on ADHD meds for long and am still experimenting myself. So please keep that in mind as well 

Hope that helps clarify things a bit
Take care


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## Arisa1536 (Dec 8, 2009)

thanks again for your response
i do not know how common this is but since my dose is higher i am getting increasingly anxious :afr like anxiety over everything and i know not to mix concerta with zopiclone, the zopiclone intensified everything to the point where i could not stop shaking or crying but i should have known since zopiclone is more of a stimulant for me anyway :afr

i am thinking of asking about wellbutrin because at least over time it will curb the anxiety and side effects do not sound as bad as the effexor and SSRI meds do

Do u know if the mild side effects eventually go away once u get used to the concerta? because aside from increased anxiety, my mind is clear and have energy and hardly any appetite  i also feel generally happier its just this anxiety feels as bad as it did when i was a teenager, its so high ut i wonder if that could also be the withdrawals from Clonazepam, since its been well over a week since i last had one
would concerta take away withdrawal symptoms?
my anxiety was sky high when i tried tapering klonopin last time


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## hanzsolo (Jan 2, 2011)

Hi, So sorry to hear about your issues today..

It could be the higher dose of concerta that's causing the anxiety, that's happened to me many times when I took too much concerta, vyvanse or ritalin. 

As for wellbutrin, I am too new on my current regime to comment on whether it will actually cause or curb anxiety. True the side effects are not as bad as the SSRI /SNRI, but it is usually used in conjunction with those. Not sure as a stand alone, have read very mixed reviews to be honest. 

What mild side effects are you referring to with the concerta? Also keep in mind that stimulants do stimulate us folks that are not hyperactive, so it is very possiblt to get anxiety from the stimulants themselves, especially if the dose is too high. I have some days that I am really anxious on the ritalin, even though my dose didn't change. 

I imagine it could be withdrawal from clonazepam, although you probably would've felt it sooner then 1 week after stopping, so not sure there. I never tried stopping clon so cannot comment.. Maybe someone else can ???

No I don't think concerta would take away withdrawal symptoms from clonazepam.

I would try a lower dose of concerta tomorrow and see how that works out for you. It's a lot of trial and error with the ADHD meds, hope tomorrow is a better day 

Once you find something that works for you, then you can explore other options like multiple doses, timing, etc.


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## Arisa1536 (Dec 8, 2009)

Thanks for the post 
yeah it could just be too much Concerta and i know not to take it in the afternoons again as i would much rather the afternoon slump than that terrible anxiety.

Maybe wellbutrin used with effexor and a benzo would be helpful?
i shall ask the psychiatrist on friday

EDIT: I have no idea how or why but 72MG of concerta is amazing and 54MG is anxiety hell
how does that work? i thought 54MG was too high and caused anxiety, it must have been the other way round and i was not on enough because i am so calm and able to sit still, even though i have energy i do not feel like i have to run a marathon or pace up and down, and no panic attacks either, just a clear head and sound mind, within one hour of taking two extra. Well one extra as i took 3 pills yesterday and this morning felt like i would die and now on four its the opposite


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## jim_morrison (Aug 17, 2008)

Arisa1536 said:


> thanks again for your response
> i do not know how common this is but since my dose is higher i am getting increasingly anxious :afr like anxiety over everything and i know not to mix concerta with zopiclone, the zopiclone intensified everything to the point where i could not stop shaking or crying but i should have known since zopiclone is more of a stimulant for me anyway :afr


Perhaps try switching to Zolpidem-CR instead of zopiclone, in my experience zolpidem is non-euphoric (unlike zopiclone) so your more likely to actually want to go to bed and fall asleep whilst on it.

I guess this may have something to do with Zolpidem being more selective.


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## Arisa1536 (Dec 8, 2009)

I shall ask the psychiatrist about it  or else i know he will be tempted to put me on an antipsychotic for sleeping even though he is not a fan of quetiapine they are not actually antipsychotics :/


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## jim_morrison (Aug 17, 2008)

Yeah given your previous response to quetiapine, I think that a trial of Zolpidem-CR would be a better first option. 

Trazodone may have been good also but AFAIK is not available there .

I've also heard some good reviews about Trimipramine for sleep, which is an atypical tricyclic compound (but not really anything like the other tricyclics).


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## Arisa1536 (Dec 8, 2009)

is trimipramine the same as imipramine? 
the psychiatrist mentioned imipramine for helping with sedation and as a non stimulant ADHD medication. 

i do not know if ambien is available here in new zealand


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## jim_morrison (Aug 17, 2008)

Arisa1536 said:


> is trimipramine the same as imipramine?


No, they are related, but different medications.


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## Arisa1536 (Dec 8, 2009)

yeah i looked them both up.
yeah i looked them both up. thank you for that, i will add that to the list of questions i am asking my pdoc tomorrow 

*UPDATE* I really do not know what i am going to do
yesterday the four pills (72MG) were amazing but today the depression is so bad i am battling with suicidal tendencies and my morning and afternoon anxiety today was so horrific i was irritable and screaming and crying, it was horrendous.

I learnt the tough way on monday that mixing zopiclone with concerta did not work and makes me terribly depressed, but i wonder if it was the zopiclone at all since i have not taken anymore zopiclone since then but am still a depressed/anxious mess

also the aches in my arms have been quite bad but i would ride that out in favor of those wonderful highs and extreme concentration spells and morning energy but these depressive lows and hideous over anxiety is not worth it, i am so confused :hide


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