Stimulants What’s a safe but also effective dosage for Concerta?

[perpetually_unsynced]

New here, so I apologize if this is in the wrong forum. I figured Harm Reduction would be suitable, since I’m seeking advice to reduce…harm.

As someone who’s never really been able to get his ADHD under control, I was recently prescribed a 2 week trial of Methylphenidate (Concerta), 36 mg to take once every morning. I have no tolerance, by the way, but I’ve heard not-so-great things about it. I took one the first morning, which made feel lethargic and sleepy soon after taking, and did nothing for my focus throughout the work day.

The next day, I tried taking two of ‘em (76 mg). Although, I didn’t feel the sleepiness I did the day prior, it was still virtually ineffective at treating my inattention and lack of focus. Maybe just a little more wide-eyed than usual.

Now I’m here on the afternoon of the third day, having not taken any at all this morning. I see my doctor in a week and a half to voice my concerns, but I’m frustrated, and have a final research paper to knock out this week that I haven’t even started.

My question is — If I bump it up to 3 pills, or 108 mg, will I be okay, or will I deeply regret it? Alternatively, is there another method in which I could take 36 or 72, that might be more effective?

I’m not trying to get blitzed, but wouldn’t mind the chattery, energetic side effects I’ve heard it comes with. Most importantly, I’m just trying to get some motivation and productivity.

 

[Jabberwocky]

Have you tried any other medications for your ADHD? It’s not uncommon for patients to be trialled on a couple of different things before they find what works. And paradoxical effects like4 sleepiness are also quite common for ADHD people on stims. I started on Methylphenidate but it made me super jittery so I was switched to dexamfetamine.

I would not keep upping the dose. That particular med is clearly not the answer to your problem. Most ADHD sufferers get results from modest doses when they are on the right drug. I’d do your best to slog your way through your research paper and talk to your doc about trying a different drug.

 

[perpetually_unsynced]

Thanks for the reply. Outside of Wellbutrin and Strattera (both of which are naaaasty), I haven’t tried anything else yet. I’d prefer something long lasting, so I don’t need to redose.

While I have you, I have another question in line with what you’re saying here. I’d like to try out Vyvanse because I’ve heard good things about it in ADHD communities, but I’m worried if I bring it up directly, my psychiatrist might think I’m drug seeking. I also live in an area with a lot of addicts, so I’m sure he has his guard up. Since you’ve gone through this process as well, how would you recommend I tackle that conversation? Any other experiences with ADHD meds, outside the two already brought up?

 

[Jabberwocky]

Thanks for the reply. Outside of Wellbutrin and Strattera, I haven’t tried anything else yet. I’d prefer something long lasting, so I don’t need to redose.

While I have you, I have another question in line with what you’re saying here. I’d like to try out Vyvanse because I’ve heard good things about it in ADHD communities, but I’m worried if I bring it up directly, my psychiatrist might think I’m drug seeking. I also live in an area with a lot of addicts, so I’m sure he has his guard up. Since you’ve gone through this process as well, how would you recommend I tackle that conversation? Any other experiences with ADHD meds, outside the two already brought up?

I think these days it’s reasonable for patients to educate themselves about treatment options before consulting a doc. Then you can have an informed conversation with the doc. If the doc agrees you have ADHD you could say:

1. My understanding from reading up on the literature is that stimulants are still the first line treatment for ADHD, is that correct?

Then if he concurs

2. I also understand that different stimulants work differently for different people. The Concerta does not seem effective and it gives me these side effects....Do you think it would be worth trialling something else. I’m interested in extended release medications where I only have to dose once a day.

Nothing in that would make you look like a drug seeker and it puts the onus on him to say you need stims, If he does not mention Vyvanse you could then casually ask about it as well as XR Adderall and whatever else they have in your part of the world.

There are also some promising research results that show Abilify and Catapres can help with ADHD. But they are normally only prescribed as an adjunct to a stimulant.

 

[Gaffy]

Thé outside peely thing is 6mg concerta and 12mg inside for thé 18mg pulls, work it out for higher doses. Put 2*2 of thèm under your tong until thé coatage is gone, take 60mg morphine and there you go, extase. If for studying, 36mg chewed is perfect

 

[Jabberwocky]

My question is — If I bump it up to 3 pills, or 108 mg, will I be okay, or will I deeply regret it?

If you don't have any tolerance then please don't take 3 pills. It is much more probable that you will suffer only more negative effects (anxiety, palpitations, insomnia) than that you will obtain any true benefits from a higher dose. Listen to your doctor and if you have the chance to try different stimulant medication maybe that is the way to go.

 

[perpetually_unsynced]

I think these days it’s reasonable for patients to educate themselves about treatment options before consulting a doc. Then you can have an informed conversation with the doc. If the doc agrees you have ADHD you could say:

1. My understanding from reading up on the literature is that stimulants are still the first line treatment for ADHD, is that correct?

Then if he concurs

2. I also understand that different stimulants work differently for different people. The Concerta does not seem effective and it gives me these side effects....Do you think it would be worth trialling something else. I’m interested in extended release medications where I only have to dose once a day.

Nothing in that would make you look like a drug seeker and it puts the onus on him to say you need stims, If he does not mention Vyvanse you could then casually ask about it as well as XR Adderall and whatever else they have in your part of the world.

There are also some promising research results that show Abilify and Catapres can help with ADHD. But they are normally only prescribed as an adjunct to a stimulant.

This is all super helpful information. Thank you!

 

[perpetually_unsynced]

If you have hyper active symptoms like pacing and fidgeting the standard in medical literature is to start with 36 to 54 mg of concerta per day, the brand name has extended release options if you are worried about the shorter duration of methylphenidate.

If you present without hyper active symptoms the standard is to start on 20 to 30 mg of amphetamines per day.

People report that amphetamines give a better mood lift than methylphenidate, but if you adjust for strength and take equivalent dosages I think it is pretty similar. 30 mg of methylphenidate will give me similar effects as 20 mg of amps, with a shorter duration though. your mileage may vary.

This is really interesting to know. I’m actually diagnosed with a pretty severe case of Type C, so It’s all of the above for me. I guess the symptoms that get in the way most, though, are the lack of focus, inattention, and impulsivity. Those are the biggest reasons I started seeking psychiatric therapy. I am pretty fidgety, but have managed okay in that regard.

So, in my situation, are saying that amphetamines might be the way to go? It seems obvious now that you mention it, but I had no idea the types were treated in different ways.

Edited to add that the three aforementioned symptoms are what make ADHD so debilitating for me. This doesn’t really add to the topic, but I’m a 28 year old guy and was only just diagnosed a few months ago. And so many aspects of my life have been significantly impacted because of it. I really wanted this medication to work.

 

[CFC]

New here, so I apologize if this is in the wrong forum. I figured Harm Reduction would be suitable, since I’m seeking advice to reduce…harm.

As someone who’s never really been able to get his ADHD under control, I was recently prescribed a 2 week trial of Methylphenidate (Concerta), 36 mg to take once every morning. I have no tolerance, by the way, but I’ve heard not-so-great things about it. I took one the first morning, which made feel lethargic and sleepy soon after taking, and did nothing for my focus throughout the work day.

The next day, I tried taking two of ‘em (76 mg). Although, I didn’t feel the sleepiness I did the day prior, it was still virtually ineffective at treating my inattention and lack of focus. Maybe just a little more wide-eyed than usual.

Now I’m here on the afternoon of the third day, having not taken any at all this morning. I see my doctor in a week and a half to voice my concerns, but I’m frustrated, and have a final research paper to knock out this week that I haven’t even started.

My question is — If I bump it up to 3 pills, or 108 mg, will I be okay, or will I deeply regret it? Alternatively, is there another method in which I could take 36 or 72, that might be more effective?

I’m not trying to get blitzed, but wouldn’t mind the chattery, energetic side effects I’ve heard it comes with. Most importantly, I’m just trying to get some motivation and productivity.

Did the lethargy and sleepiness reduce on the first day after a few hours? It usually takes some time for the brain to settle into a new equilibrium after commencing ADHD treatment. So I suggest you go back to taking a single 36mg dose as prescribed, and give it at least a couple of weeks before deciding it's not right for you.