concerta--what should I expect? | ADHD Information

I am on 27 mg. concerta and it hasn't done much. I'm supposed to increase to 36 mg. in a few days, but will that really make much of a difference? If it's not working now, does that mean it's not the right med? Is it unusual to not notice nothing at all, until you get to the right dosage? I thought normally, you will notice an effect, but only briefly, until the dosage is increased again.

I am in summer school and my mind still drifts in class; I still have trouble reading because I can't focus on what I read and my mind is too "noisy" to do something that quiet and stick to it; basically, everything's the same. What I have noticed, though, and this may just be a placebo effect, is that I am more motivated to actually learn and do the work, but my focus on it once I get started is the same as w/o meds.

Is it likely (or even possible) to notice little to nothing at all until the optimal dose is reached? I'm kind of concerned if concerta doesn't work for me because I need a med as long-acting as is available. So does this all mean it probably won't work, or is my dose just way too low?soberxinsanity39274.683668981527mg of Concerta is pretty low. I wouldnt give up yet! Keep going! People have lots of luck with Concerta. It's not your only option for long acting. Ritilan LA is a 10 hour and can be given twice a day. Dose needed in the am then a second dose of equal or lower amount early afternoon to carry you. The new medication Vyvanse is also now available and that is a 14 hour med. Dont get discouraged.OK I'll try not to worry so much about what's going to happen in the future. I think I started doing that because it's taken me nearly two years to actually find a doctor who even considered treating me, or that I would benefit from medication. Let's just say the combination of my parents and my previous doctor was limiting my progress and I felt like I was at a standstill for 1 1/2 years. I think that's long enough and I don't have the patience to go another 2 years the way I went the last 1 1/2 years having trouble with every aspect of my life because I either can't focus, focus on the wrong things, have little to no motivation to do simple and routine tasks, and spend my entire life doing schoolwork with nothing in return.

Sorry if I sound upset. I'm not really now, but that's how I felt up until recently. I've had enough of that and I'm not going to experience it again. That's basically why I have all these concerns and "what-ifs" about everything. Sometimes I have trust issues with my doctor because there were times when my ideas worked better than my docs' had (not this doctor, but previous ones). But thank you for pointing that out. I get way ahead of myself sometimes. don't apologize, we all do it. I said it becasue I sometimes need some one to tell me to slow down and stop worrying about things that haven't happened yet and may not . It's hard to know whats working if you're already worrying that it not working and what you'll do next.Well, today was my first day on 36 mg. and so far not much effect. I'm being optimistic and thinking that it will not have an effect on me until I reach the optimal dose, even though I don't here much about that here. But if I don't notice a a change by 54 mg. I think I'll ask my doc to change meds. Focalin and Vyvanse are on my mind, but I'll see what my doc suggests next if concerta doesn't work. Is Vyvanse only approved for children so far? I just read that in another thread..If you have no side effects and get mild effectiveness, I would consider going as high as 72mg of the concerta (the max recommended for adolescents). Just because a med is not approved for a population, does not mean the doc can't prescribe it to that population. That is part of the practice of medicine and is called off label use. It is more a matter of what the doc is comfortable with.I was talking to my therapist yesterday, (she is a clinical social worker) and she told me about an ADHD conference she went to a few weeks ago, where they spoke about the meds. She said they are seeing the most success with the original meds (concerta, adderall/xr, ritalin) and that she heard mixed things about vyvanse and focalin, which are the two I would have asked my doc about next if concerta doesn't work. I don't know how accurate her info is since she's not an MD, but lately I don't really know who to listen to. I hope she's wrong, actually. She does tend to generalize sometimes. I do hear good focalin stories here
I would have to know more about vyvanse before I try it because there's not much on the forum yet, and like I said, I don't know if I should believe my therapist. There is also a new member here (sorry, whomever it is, I forgot your username ) who had a terrible experience with vyvanse, worse than what I've heard about the other meds, but that's only one person of many. So it's too soon to tell for me, but a 14-hour med would be great as long as it does as much of a job as the others do.

About ritalin LA-doesn't short-acting ritalin tend to work better than LA? I feel like my best way to find a good med is to start with the best ones, and then work my way down to the less-reputable only after all the "better" ones have failed. I don't know if this is logical or if I shouldn't be making my own rules--I think my doc has the same idea, since he prescribed concerta rather thana less prescribed med, like, say, metadate or dexedrine. Not that there's anything wrong with those--I just figure if the others are used more often, they probably have the most success.

Is there a dose b/w 36 and 54..that sounds like a big jump...soberxinsanity39274.7771064815

I just think what you are calling the "better" meds have been around longer so that is why they are prescribed more. Concerta has been around longer than Ritilan LA and it is a 12 hour as opposed to a 10 hour. Most people wanting a long acting want the longest coverage. So you'd go for the med thats been around the longest and prior to Vyvanse the longest coverage time.

I believe the Concerta does go up by 50% (so 18 to 27, 27 is 50% more than 18), then 36 is 50% more than 27 so 54 is 50% more than 36 and next would be 72 which is 50% more than 54.

Don't get too hung up on who takes what and what they say about it. As you can see from here one persons miracle can do nothing for the next perosn or cause side effects for the next. Go by your own body and your needs.

Most of these meds have basically the same side effect risks, appetite suppression, insomnia, nervousness/anxiety, those are the "biggies" and jst what stmualnts can do. As you know very well this just varies WIDELY person to person.

Thanks everyone for your input. I have to pull through another month on the 36 (my visits are every four weeks), because I'm making changes with other meds, and my doc didn't want to make too many. I told him I have a little more motivation to actually start doing things, but I still don't have the focus to work through it. My mind drifts when I read and when people talk to me for a long time, I still have that "mind hyperactivity"--my mind races about things that I find more interesting, like music, internet, etc., and I don't know if that's an ADD thing but I was hoping it is so the meds could help with that.

Are many people who take meds on the max dose? I don't really want to do that if I have better options, or if it's not something that's really done that often.

I am concerned about tolerance because as you can see, I have a fairly high tolerance for drugs (starting doses usually do nothing for me and I need higher ones to get maximum effectiveness) I would prefer not to take vacations because I think my life would run more smoothly across the board with the right meds, so even if I'm not in school I could probably still use the meds for everything else (sports, reading, games, chores, whatever else I do in my free time...) Does anyone know how frequently tolerance occurs?

Is the mind racing an ADD thing? If it is, shouldn't the right med help with that? So far concerta hasn't. I'm hoping a higher dose will.

"tolerance" varies person to person. Don't get too hung up on that term. Try not to be worrying too much about what to try next. For one thing you dont have to make that decision. Your doctor should be the one making the suggestions.  It is GREAT to be informed and know what people are using and what is working for them or not, but you are your own person and your choices are for you. You are not the doctor though and dont have to know everything, nor worry about what works for who and for how long, you're going to make yourself crazy.

Yes the mind racing is very likely related to your ADHD and the right med should help that.

My 11 year old is on Concerta...36mg does next to nothing for him but 54mg is a huge improvement. He also tends to build up a tolerance so after a while the 54mg doesn't work as well so we give him a med vacation in the summer and then once he starts back on the meds it is more effective. Good luck.