Concerta dose | ADHD Information

the time limit on extended release meds are variable on many levels.  It depends on metabolism, acidity, digestion speed and tolerance.  For me with dexedrine XR spansules the time is supposed to be about 8-9 hours but I find that it peters out in 6.  I've heard on the concerta side that people find a doziness after it wears off and I think it comes from people who are not very energetic and their metabolism goes from high to low fast. 

If you start work or school at 9 and you're taking your meds at 7 it's possibly too soon.  Maybe have a coffee and a meal then wait an hour before you take it.  Maybe a short release after 3 might help too.  Consult your doctor for sure.

I was wondering who was taking Concerta and what dose is working for them??  I am currently taking 54 mg at 7 am.  The extended formula is supposed to last almost 12 hours.  I am pretty good until about 3 pm and then all hell breaks loose!!  It is like I have triple the adhd I should have when it wears off.  I see my doctor weds, and was hoping I didn't have to increase the dose.  Maybe it is not a dose problem, but a timing problem or something.  Also, getting to sleep is a challenge and staying asleep.  I have seen some advice on that on the board, but am also concerned about taking an additional drug!!   

I will keep you all posted on what the Doctor says!!!  There are so many types of medication out there it makes my head spin sometimes.  Sometimes when I talk to the Doctor I just kinda zone out and forget all the medical talk he tells me. 

 I do like the Concerta when it is working.  Just a strange effect when it wears off!!  Maybe I am just more aware of the affect and it is more obvious then when I was off medication.  I have adhd and the hyperactive sypmtom is obvious as the med tapers off.   

When ds took concerta, it may have lasted 6 hrs and then doc prescribed a second dose to get through the day and homework time.  It dropped off more quickly than the ritalin LA which he takes now.  The LA is a lot smoother experience for him.  What you are experiencing sounds like  a "rebound" effect making the symptoms appear worse than before.  Even dd at 10 noticed this in her younger brother when he first started Ritalin.  We haven't seen it in the LA, but I do not know if part of it is that he is older now. 

A short acting dose in the afternoon may help ease the effects of the drop off of the Concerta.

I'm interested in what your doctor says.
Say LCdc,
I read that you are in the NW.  So am I. we live in the Seattle area.  Love the cherries these days.

Definitely sounds like rebound. It varies on how doctors handle this. Some of them just want you to deal with it. Some of them increase your dose. Some of them will give you another afternoon dose, and some will give you a short acting ritalin dose for the afternoon.

My doctor told me right off if the pills fell really short for me then to increase them. I started out on 18mg and it last 4 whole hours. I went to 27mg and it lasted for 6 hours. 36mg lasted for 7 hours. I also had rebound issues with all of those doses, but I slept really good. I was dead tired by the end of the day, slept great, and woke up feeling refreshed, which is all very unusual for me.

I still wasn't really happy with my focus though, and only getting 7 hours coverage, because it was wearing off right as my day gets the most difficult. My doctor bumped me up to 54mg, which is where I am still at. I get 9 hours out of it now, so I'm pretty happy with that. I'm happy with my focus, although I think I'm a bit hyper-focused. It's thrown my sleep off though, and I'm back to my regular sleeping habits. My rebound issues have gone away though. I was surprised at that because I figured more medication would mean more rebound, but my doctor urged me to just try it out, as he said many people have rebound issues when their dose is to low.

So, I'll get to my point here, it could be that a higher dose would help not only extend the coverage time, but also help with rebound. On the other hand it's all a balancing act, and you can get thrown over the top with meds too, and end up with issues because the dose is too high. Were you ever on 36mg? Just wondering how things were with that?

Good luck at your appointment. I hope you find a good combination

If you are happy with the dose in all other regards, then you might do well with just a short acting Ritalin pill, taken about a 1/2 hour before to ease you out of the Concerta.

If you want a more "natural" type drug for sleep, some people have luck with Melatonin. I haven't ever tried it, but many here do, and like it.

Try eating something about a 1/2 hour before your meds wear off. This really helps a lot of people. Getting some exercise in can help as well.

Keep talking to your doctor though. Tell him what aspects of the medication you are thrilled with, and which aspects you are not. Most doctors will keep working with you until you get to a happy medium at least.

Good luck!

I started with 36 mg - worked pretty good for the 1st couple weeks.  54 mg worked better.  The first couple of days on 54 mg were kinda wierd.  I felt as if someone had beat my upper body muscles.  This went away though.  My blood pressure actually went down at the higher dose by 7 points, kinda wierd!! 

Life is good - I am not complaining.  Life was wild before meds so I am happy to have moved this far ahead.  I am just a happy hyper person when the medication wears off now!!  I told the doc. I had problems sleeping, he asked if I had problems before meds - answered yes.  so maybe it is no big deal.   

Maybe I just notice more because one of my bothersome issues with adhd is the hyperactivity.  It is physically obvious when it wears off to me - I go into LCdc's hyper world!!!!

I may also notice it more since the meds are so calming and when it wears off now it is just obvious to me!!

I originally started on Focalin and I had some negative side effects and I didn't like to have to carry around the pills all day so the doctor recommended Concerta and gave me a one month sample of the 18mg caps.

He told me to start off taking 2 and that I may have to eventually take 3.  I took 2 the first couple of days and it just was not getting the job done like the Focalin had, so I took 3 on the 3rd day.  This gave me pretty good results, but by about the time my sample ran out I noticed that it was wearing off earlier and earlier. 

He prescribed me 72mg (2 x 36 caps) and since then it's worked great for me.

I take 72mg between 7:30 and 8:30 AM and it seems to get me through the entire day.

Yup - next visit this may be an option if the time keeps getting shorter or it loses it effectiveness. 

Did you have any trouble adjusting up to that dose?

Yeah I am noticing the 54 mg wearing off earlier and earlier.  It used to last 9 to 10 hours, then 8, now about 7 hours!!!  Rebound was and is terrible!!!

Some evenings, when the medication has worn off,  I am so hyped up I feel like a top someone pulled the string on!!!

I have noticed really positive physical effects right off - my blood pressure went down, I don't have headaches any more, this along with all the good effects on the adhd symptoms!!  My fingernails are growing back cause I don't bite them to the nub, no more leg shaking, finger tapping figdeting, clear and calm (all until the meds wear off).

Did you notice any physical symptoms when you increased to 72 from 54?

Well, I'm not really sure because I never really thought about it at the time and it was like a year ago, but I've definitely felt the general boost of my coordination that goes along with the dopamine reuptake inhibition that the Concerta causes since I've started taking it.

I've played guitar off and on for about 10 years and I never really was able to get above "mediocre", but I've improved more in the last year than I did in the last 5 before starting the meds.  I always struggled dribbling basketball, but my dribbling has improved tenfold.  My handwriting is better as well.  My blood pressure is down, my weight is down, my metabolism and energy are up.  Overall - it's been extremely helpful.

Good to know it is working for other people also!!!

I noticed that I have a lot more patience since taking concerta, I am able to see projects through and take them in logical steps now instead of being all over the place and doing too many at one time!!!

My coordination has always been pretty good, I was just always in a hurry and would sometimes run into walls or cut doorways to soon and smash my shoulder or hand. 

 

my hand eye coordination has always been very good, it's just my "blind" coordination was not..  the noticible differences are in multitasking type of activities like dribbling a basketball and watching the defender/goal/etc at the same time or picking and moving around the frets of the guitar without having to look..

Maybe you are more relaxed now.  That is the case for me!!!

No rebound issues for you when the meds wear off?

nope, that was my main issue with focalin and it's not an issue with concerta, I can't really even tell when it wears off except for the fact that i feel a bit more hungry than during the day.

Thanks - I know nothing about it at this time.  is it over the counter,health food store kinda stuff?

melatonin is classified as an herbal treatment so it's on the shelf.  It's by the same note unregulated so I'd check with people who use it for brand name to use as with many herbals you can't get a guarantee of how much active ingredient is in any one bottle. 

What I do know is it's one of the only herbal remedies that has passed muster in the science community and is actually useful as a sleep aid. 

 

Thanks Glen, I am going to read up on it.  I can't find herbal treatments in my town but I think Vancouver might have some stores or I can stop in Portland, I am on my way up there later today for a few days.most BC pharmacies have melatonin now.  I know that I've seen it at pharmasave, safeway's pharmacy and london drugs.  Ever since they approved it for canada it's all over.  Just ask.Here's the key: exercise a lot during the day... you'll be too tired to be hyper at night and sleep better.ok awesome38915.2696064815

I wish exercise was the key!!!!  I work mostly in the woods and hike all day, seems I have been in the office too much this week!!!  I do exercise, running 4 times a week and yoga 2 times a week.  I crash hard maybe once a week if I am lucky. 

I am thinking of trying melatonin as suggested on other boards, just have not had time to research it. 

if you do take melatonin don't take more than 1mg at first.  Some places sell 3mg pills and that will often make you groggy the next day.

I saw the Doctor yesterday and I am changing the timing of the medication to see how that works on how long it lasts!!!  It is the rebound thing someone mentioned above!!  We are both pleased with the way the medication is working at this point - I am now on monthly visits unless I need something!!!  Yahoo - no more hour drive every week and 2 weeks. 

I still want to work on my sleep issues though!!  Is melatonin a Rx or is it in health food stores?? 

You all are some educated folks on these issues, that was verified at the docs yesterday.  

Hey

About the melatonin thing. Really all it does is promote a sleeping patern. It will help you if you are trying to make a routine everynight and stuff like that. Another really good one that is herbal is 5HTP which is actually like a natural seratonin and does wonders for sleep and relaxation at night. I definately would start at the lowest dose though. I had gone through trying so many different things and finally that was the ONE for me and now alot of my friends use it also. I cant take it anymore though because I had a weird pop in my head a while back that caused vertigo so I went off it then. (NO it didnt cause it)

Dizzy

I am back from my trip up north and found the melatonin!!  I have been trying it for 3 nights now.  I slept uninteruppted in the hotel, but am reserving any comments on if it is helping until I try it a few nights at home.  Thanks for the suggestions and I will keep you posted.

LCdc - I work shift work on rotation so here's some other help for an ADHDer with bad sleep patterns. 

- Use dark curtains in the bedroom.  Either that or use extra heavy-duty black garbage bags taped to the windows.  Believe me that can help a lot as light in the summer messes up the natural pattern.

- Try white noise.  I use either boring talk TV like CNN, etc. or a static channel.  The hissing can often put me right to sleep.

- don't overfill your bladder before bed.  I find once I have to get up to go - it's so much harder to get back to the rythym.

- don't stay in bed when you aren't sleepy.  Bed should be just to sleep and trying to force it makes you frustrated and doesn't help at all.

Hope it helps!  Good luck with the melatonin!