Concerta vs Adderall or other? | ADHD Information

Yeah, Concerta was recently approved to be taken up to 72mg for adolescents. They didn't make a new tablet... you have to take 2 of the 36mg tabs, but it has been FDA approved to be taken in that dose.

Also, some people alternate stims every so often, ie- taking Concerta for 6 months and Adderall for 6 months, rotating to side-step the tolerance issue.

Good luck and Godspeed! 

Also, as a lot of people on this site have posted, many people do a booter dose of short acting meds like Ritalin in the afternoon or early evening (after school) to get through homework time.

I think that Concerta released a 72 mg dose recently. I am not sure if that is for children your son's age, but I thought I would just let you know.

Best of luck!

My son, Steven, now nine yrs old,  was diagnosed ADHD in May of 2003.  He started taking Concerta 18mg and has gradually worked up to 54mg over the past 2+ years.  Whatever dose he is on works for about 4-6 months then he loses a ton of focus.  I know that 54mg is the highest dose of Concerta, and it was fine for the lighter summer activities, but with the start of the new school year, it has become apparent to me that the current dose will not work now that school schedule and homework come into play.  Not sure what the best options are right now.  Do we try something like Adderall? 

After reading what others are going through on this site, I feel very fortunate.  Steven is not at all agressive and is not depressed.  He is very hyperactive - literally bounces off the walls without meds and definately needs help focussing.  Without meds, I have to basically tell him to write each letter of each word on his homework.  He takes his meds at 6am so  getting through homework at 3pm is tough, and his teacher is having to sit on him in school to stay focused as well, which is causing more work to come home to be completed in the afternoon.

I am sure you have all had med issues.  Can anyone offer advice?

Barb in New York

in my experience, raising the dose doesnt always help and sometimes it makes things worse. ive found that if a higher does doesnt help, its actually best to drop the dose (rather than up it to even more) and take less for a while and then when that becomes less effective take more (ie instead of alternating meds, alternate how much)

alternating meds might also work but depending on the adjustment/withdrawl period it might make things worse. also some people get worse on some meds (concerta  only helped minimally while adderall works extremely well (although i have had trouble with keeping it 'effective'), and strattera made me completely miserable) 

also, the "pick-me-up" of adderall or something short acting in the afternoon works really well for me. since thats often the time when im most tired/exhausted. however this also affects my ability to fall asleep...

I agree annelise. I do horribly on Concerta. I've known people who have done quite well rotating meds, but I myself don't practice it. What does interest me is that you have found success in lowering the dose. I've known that approach to be useful with antidepressants and occasionally with antipsychotics, but I've never heard of its use with stims. Do you do this just to lessen your tolerance or does it actually work better for you at the lower dose?

The reason I suggest a booster dose rather than an escalation of the dose (ie-to 72mg) is because there seems to be a relatively narrow therapeutic window when dosing stimulants. Too low is ineffective. Too much doesn't improve concentration and actually frequently worsens it, in addition to causing additional side effects like anxiety and social withdrawal.