Help Please? | ADHD Information

About a month or two ago I was diagnosed with ADHD (I'm 23). Around two weeks ago I was put onto 18mg of Concerta.

The first day, I experienced a fairly immediate boost to my mood and motivation, but not necessarily to focus -- I cleaned my room for the first time in years, etc, etc. I'm not sure if this was psychosomatic, though, just because I was so happy to have had a pill to solve all my problems. ;)

On Monday my dosage was raised to 36mg of Concerta. The first day at work I experienced a headache, and for the following three days (taking us to now), I've had this sort of muddled feeling in my mind... almost like trying to concentrate on something after athletically exerting yourself. Not tired, but it's as if my thoughts are slippery and I feel a bit disjointed, a little bit out of whack, like there's a teensy bit of dizziness all the time or something. It's very subtle, but pretty much always there.

I have heard these symptoms are transient, but what kind of timeframe should I reasonably expect? I haven't felt any particular increase in focus yet.

My doctor is clearly wary of stimulants, so I'm reluctant to describe all of these symptoms to her because I fear she'll overreact and refuse to prescribe what I think could be a very beneficial medication. These symptoms are hardly serious, but there's a further complication...

A week from now, I write my LSATs. A fairly important test that's going to govern whether or not I get into law school. I'm worried that if these symptoms persist, they might adversely affect my performance.

I realise it's easy to say 'trust your doctor,' but my doctor was quite unknowledgable about ADHD medication (I'm in Canada, which might explain the lack of knowledge) and there's a severe doctor shortage around here so it's unlikely that I'll get a second opinion from anyone.  I was diagnosed by an ADHD specialist, but he is unavailable to contact and left me in the hands of my family doctor until he returns from vacation.

I am planning to maintain the 36mg treatment until around next Thursday. If these symptoms persist, I will reduce the dosage on Friday to 18 mg so that I'll have two days worth of 18 mg instead of 36 mg when I write the LSAT on Saturday. Does this sound reasonable? Does anyone else have any further advice on when to take the pill in the morning, how much I should eat, etc, etc, to maximize my chances?

Basically, I want to be sure I'm in top form writing the LSAT. I'll worry about all my other pesky problems the day after. For now, any advice you can give me on how best to ensure I'm as focused as possible yet free of as many adverse symptoms as possible would be greatly appreciated.
DONT always trust your DR. if you feel "off" then may b you shoul lower your dose. definately talk to you DR.

My son was on Ritalin for a year and then the new medical opinion here was to change everyone to concerta. He tried it for two months and was adamant that it made him feel unwell so he went back to ritalin which seems to suit him. In the early days he was switched to a generic form which was cheaper and he felt unwell on that. that it gave him a rush when he first took it. The psych said it was the same  so that could not be but having friends that are pharmacists I asked them and was told this could be the case because he could be having a reaction to the binding agent.

He is 26 by the way

I intend to do everything you've said, but most of your advice regarding the medication won't be possible until after the LSATs: I will of course request switching to another medication if these symptoms persist, but as the specialist who diagnosed me is unavailable and as my doctor is wary of stimulants, I highly doubt that I'll be able to switch medications before the LSAT. It seems I'm stuck with Concerta or nothing.

While I am reluctant to admit this, a few years back during my 'experimentation' years in early University I did try a single child-sized dose of Ritalin (I've heard that child-sized doses are, counter-intuitively, generally larger than those given to adults?). It helped my focus and hyperactivity immensely; I sat still, perfectly serene, for five hours studying physics with nary a single distractive impulse. I understand Concerta is similar in chemical make-up to Ritalin, so to me it doesn't make sense that a smaller Concerta dose would be inappropriate to me...?

Again, I'll be reducing my dosage to 18 mg if the symptoms persist up to two or three days before the LSAT, so that's covered.

It seems you're reasonably confident that these symptoms aren't transient (I have read that they are), and that I should be feeling the benefits of Concerta by now (I have heard that it can take some time before the benefits of treatment are realised; it's been just over two weeks).

I suppose my questions are:

1) Is it reasonably possible to respond well to Ritalin and not to Concerta?
2) Can I still expect these symptoms to be temporary and the effects yet to be felt, or is the evidence fairly compelling that Concerta isn't for me?

I realise no one here can be counted upon as a medical authority, but I'm unable to get in touch with any knowledgable authorities at the moment so any advice you can impart would be greatly appreciated.

Eat healthily, get plenty of sleep, and think optimistically. Work efficiently, but don't get too caught up in "hurrying" (this sometimes forms a mental block) Talk to your dr. about trying a different med. Perhaps adderall would work better....or strattera (although strattera takes a long time to build up in your system to begin working.)

Also, perhaps 36mg is too high of a dose....maybe the 18mg is "your optimal dose for concerta?"

Good luck and keep us posted!

response 1.) yes, it is possible for you to experience different responses to different "types" of methylphenidate.

response 2.) If you have been taking concerta for just over 2 weeks, you should be seeing results pretty much "as they are"....meaning; your body has had time to adjust to the med and possible short-term side effects should have passed by now. The side effects you seem to describe would lead me to think that either the dose is too high, or the med isn't for you.

It's possible that you have some co-morbid condition such as anxiety or ocd, which is clashing with the medication.   I have ocd which is pretty common for ADD, and stims alone make me worse in the long-run.  Check out Dr.  Amen's website for ADD typing and proper medication.  I also highly recommend his books.

http://www.amenclinic.com/ac/addtests/

It's also possible that you are taking too high of a dose, and the side-effects are working against the drugs clinical effectivness.