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Old 10-05-2011, 12:14 PM   #1
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Should I up my Concerta dose?

Hi everyone.

I'm new to the board, but came across some nice responses while looking around and was hoping that someone could help me with a question.

I was first diagnosed with ADHD years ago and got a prescription for Ritalin but never tried it because my parents were nervous about me taking it. I was 14 and there was a lot of bad press about it at the time. After struggling for years and not ever being able to accomplish anything I sought help as an adult and was diagnosed again as having ADHD.

My psychiatrist prescribed Concerta 18mg and I started taking it last Saturday. The first couple days I had bad headaches and couldn't sleep but all that's gone now.

I take it in the mornings and feel calmer but energized and in a better mood (better than I've felt for years) for about 2 hours, but then it starts wears off or something. My thoughts are still going 90mph constantly through my head, I feel distracted still, continue to have a hard time getting anything done, focusing and remembering things. The worst part is though everyday between 4 and 6pm I get super tired, almost exhausted feeling. I have to drink coffee and keep physically moving / doing things in order to keep myself up 6 to 8 more hours. I usually end up going to bed between 10pm and midnight now and before I was on Concerta it was usual for me to stay up until 3am or so.

Sorry this is such a long post, but does anyone who's had experience with Concerta or any other ADHD meds know if this sounds like I need an increase?

I have a follow-up appointment with the nurse next week, but it'd be nice to know what I'm supposed to be looking for and feeling in regards to the medication working or not.

Thanks!

 
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Old 10-06-2011, 09:14 AM   #2
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Re: Should I up my Concerta dose?

18 mg is a starting dose and it is a rare person who stays on such a low dose. Go to your follow up appt and explain what you are experiencing and changes will likely be made. Please listen to the instructions carefully, so you will know what to expect in the coming weeks as your dosage is being determined.

 
Old 10-06-2011, 06:20 PM   #3
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Re: Should I up my Concerta dose?

If the first 2 hours feel great, it might actually be that 18 mg is too HIGH a dose, and the great feeling is what happens before all the drug hits your bloodstream. The fact that you had trouble sleeping the first couple days supports this possibility.

The "right" stimulant dose varies enormously from person to person, but here's a decent way to guess: Do you drink coffee? If so, how much coffee does it take to energize you? How much would be too much?

Or maybe you just need a slow-release medication.

 
Old 10-09-2011, 03:40 PM   #4
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Re: Should I up my Concerta dose?

My son ( 7 1/2 ) takes Concerta as well and is now on 37mg.

ANYWAYS, My dr explained to me that concerta is a slow release caplet that releases in 2 dosages throughout the day. The first dosage which kicks in within an hour after taking the concerta pill is the higher of the two dosages, the second lower dose is released in the afternoon and then by dinner time it's pretty much starting to "wear off". (With my son it's about 4 or 5 pm)

 
Old 10-09-2011, 03:47 PM   #5
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Re: Should I up my Concerta dose?

Concerta is a slow-release medication that is released in 2 separate doses, the higher of the 2 being the first to be released within an hour after taking the one a day pill.

18mg IS the smallest script of Concerta you can get, so your dr did start you off on the proper dosage. It is likely however that you need a higher dosage due to the size of your body and how quickly it is digested and expelled.

My son lasted on 18mg's for about 3 weeks before he completely plateaued and had to be upped to the next level. He was then switched to 27mg which lasted a couple months before progressively becoming less and less effective then needing to be raised to 36mg.

The higher the dosage, the long it takes for him to plateau and need a higher dosage. I am not sure if Concerta is going to be the proper medication out there for him, as there are MANY different kinds of add/adhd medications.

Well, I hope this information helps.

 
Old 10-09-2011, 05:21 PM   #6
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Re: Should I up my Concerta dose?

Thanks TeeJay and I hope you find something that works for your son.

Concerta is slow release like your doctor said. On one end of the bullet-shaped tablet (or whatever it is) you can see a tiny little spot, the nurse said that's where it medicine comes out as it's slowly released throughout the day.

My appointment is on Thursday so we'll see what they say.

Thanks again!

 
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