Concerta - chest / muscle tightness | ADHD Information
Thank you for your response. Well you're probably right, especially considering that a) I only took Concerta on the weekends so far (it takes away my impulsiveness and sense of humor and I need that for work) b)all these "symptoms" only started AFTER I took my BP and found that it was high (and as I said, the monitor I've been using is not to be trusted) and I'd had a panic attack at least once before in my life which felt very similar c)my counselor suggested that I'm trying to find a way to find an excuse to stop taking the Concerta and not to have to face the fact that it takes away the problems I've depended on as excuses to not do anything serious in my life...But I was mainly concerned with the fact that the tightness I felt was not only in my shoulder/arm and neck but also my chest (well actually, my left pectoral muscle). But many things could have caused this, adding to my panic attack and psychosomatic reaction, like the vasoconstrictor I had been on for a week and the fact that I did not drink too much fluids that weekend and also, the weather changed and it was really hot, which always means I will feel weird for several days and will need time to adapt. But I wanted to post to discuss these many reasons before I see my doc this Friday. I can just take no more of the waiting My next apointment will probably be in September or sth, and it's the ONLY doc I could find who works with ADHD adults. So I REALLY don't want to be sent away with "oh just do a couple more EKG's and we'll see about the Concerta the next time you see me".
My new thoughts on my "effects" -
1. They did not subside over the next 2 days (without Concerta). Also, my high anxiety did not go away.
2. Yesterday, my tingly feeling in my throat went away as I started coughing and realized I had a slight cold
3. I often felt chest/muscle/left arm tightness and anxiety (also: slurred speech, low mood and tightness in my scalp) in bad weather, or before the weather changed (even if there were no signs that it would), and before I realized it's probably due to a migraine-like aura (apparently, you can have migraines without headaches), it always made me panic and think I was having a heart attack. I woke up today to rainy weather following a period of scorching hotness - and my research into the weather over the last few days did reveal there were drastic changes in barometric pressure
4. I forgot that 6 days ago I decided to flip my memory-foam pillow to see if the big "bump" should really be under my neck (I also forgot that the reason I didn't use it that way was that it used to give me neck and head pain)
5. More research revealed that all my symptoms were symptoms of high anxiety, and I also recalled having the exact same symptoms, including a panic attack, without any Concerta twice in the past, always accompanied by weather changes and trips to the ER where I would be diagnosed as having a panic attack ;)
6. Feeling all this while on the Concerta, compounded by the fact that I had been feeling anxious about first using it during a real work day, and my knowledge of the possible side effects of Concerta, made me think the Concerta was causing all this and freak out - and of course, methylphenidate enhances any anxiety, which caused a feedback loop.
7. These symptoms were unpleasant but manageable the first 2 days I felt them but then I decided to up my dose from 36 mgs to 54 mgs just to recall what it felt like. And as usual, the experience was just too intense for me - the 2 times before that I'd tried it, I always ended up feeling anxious for the next two days. 54 is just too high for me it seems.
8. Before my symptoms started, my counselor made me realize that the meds were probably very good for me but that I was trying to find a way to use my "disorder" (or at least the parts of it that sometimes caused problems in our modern ADHD-unfriendly society) to not face my problems, as I did before. The sudden occurrence of "side effects" is just too much of a coincidence.
symbolt39603.0228703704I can't speak for the adult dosages of this, but my son was on Concerta for about a week and had to come off of it due to chest pain. Yes I know it is a common side effect, that's why I became concerned, but I didn't expect any chest pain, really. I experienced chest muscle tightness, like after a workout, and a feeling of numbness. And like I said, these are my common migraine-like symptoms (exacerbated by my subsequent panic attack), it's just that for some reason I had not experienced them for over 2 months and I forgot about them. :) I didn't make the connection until I saw the weather changed so much when I woke up today. I freaked out every time I had them before, but then I learned that they're caused by migraine (I don't experience any headache, but apparently, the headache is just the most typical symptom of the condition). The migraines/auras went away after I started exercising regularly (well they did appear from time to time but were not too intense, I would mostly notice the slurred speech), but my exercise machine broke over 2 months ago, I guess I need to start exercising again. One other telling symptom I've been experiencing is sensitivity to light, I just didn't pay much attention to it since the Concerta influenced my vision (my vision got a little blurry sometimes during the "crash") so I thought it was just related to the concerta... I always freaked out about these symptoms before (like I said, I had a panic attack twice before while feeling them) and knowing that concerta could cause severe side effects and seeing my blood pressure and heart rate were elevated (though within the norm) I started freaking out and worked up a panic attack.
To my knowledge, the adult dosages of Concerta are the same as for non-adults (although I personally think medication should be held off before the child enters an educational institution i.e. school, except in extreme cases).
symbolt39603.2609606481I'm a 28 year-old male with 3 independent diagnoses of ADHD that I received only in the last year. I have been trying out various dosages of Concerta for the last month. I was given a prescription for 18 mg and was told to experiment with the dosage a little. I only did that on the weekends as I was unsure how well I'd do at work while on the med.
I generally found the experience very positive and just like I expected (I had done a tremendous amount of research into ADHD medication and its effects, which was one of the reasons I was encouraged to experiment, having that much knowledge and knowing what to expect). I had severe social and personal problems due to the symptoms of ADHD, but managed to develop my own coping strategies (I had managed to come up by myself with almost everything I later learned the literature suggests). However after I got my degree I realized that without an external structure pushing me to discipline myself, I just would not, and just sailed by going by the "least effort" rule. Also, my ADHD is not mild, so I have to use all my time and energy on managing and preventing the associated trouble. With a plethora of additional personal problems, I've been seeing a counselor who is an expert on ADHD, among other things, and she agreed that testing out the medication would be good for me.
I've generally found that the 18 mgs is too little for me, the 36 mg is a little too much but generally right for me, and 54 does more of what the 36 mgs did for me but with added severe anxiety and zombiefication. I was going to report this to my ADHD doc this Friday (June 6th) and ask for a 36 mg prescription. However, as I decided to test-drive the 36 and 54 mgs dosages again this weekend, I experienced new strong side effects, which greatly worried me. Before, I did experience some side effects, which were very small and manageable - mostly a dry mouth, sensitivity to heat and cold, and slightly blurred vision when the meds wore off, and I also "crashed" a couple of times (low mood, anxiety, feeling spaced out) but it was not that bad since I knew it would go away and it did, after 2 or 3 hours. Once I felt pretty anxious all day on the 36 but it might have been due to the weather (atmospheric pressure changes).
Last weekend I took 36 mgs Friday, 36 Saturday, and 54 mgs Sunday, and the effects I felt were high anxiety and, most disturbingly, a sort of muscle tension in my left pectoral muscle, neck and my left arm. I also had a tingly feeling at the base of my throat like I was going to cough but just wouldn't. This feeling started Friday morning with the anxiety, which was due to the fact that I was going to go to work on Concerta for the first time, and also, due to the fact that I measured my blood pressure with a wrist monitor and got a reading of 139/89 with a 90 pulse, which I found scary since before, even on the 54 mgs my blood pressure was around 120 / 78 with a pulse of 85 (I was told to measure blood pressure regularly while on the Concerta). I have since realized that the wrist monitor is not reliable at all, since it can give 4 consecutive readings varying by 30 points in the same body / hand position, with readings done in 5 second intervals. Still, the anxiety this initially caused was carried through the day and over the weekend, and the tightness in my left pectoral muscle, neck, jaw and left arm came back every day I took the Concerta that weekend. Initially I thought this was chest pressure, but I tracked the location of the pressure to my muscles, with slight pain at the top of my chest. The left side of my neck was rock-hard to touch. I also experienced some shortness of breath (like I had to make more of an effort to expand my chest while taking a breath).
Has anyone experienced anything like that? What are your thoughts on the symptoms? I must point out that I did have a very similar experience once in the past (3 years ago), including the tightness in my arm, pectoral muscle and neck, and the slightly shallow breathing, in what was probably a panic attack. I went to the ER, they examined me, took my blood pressure, x-rayed my chest, and gave me a diazepam, an electrolyte drip and sent me home after 3 hours telling me to relax ;) Also, for the week before the weekend when I felt these effects, I had been taking a new med for my varicose veins, i.e. Diosmin, which "prolongs the vasoconstrictor effect of noradrenaline on the vein wall, increasing venous tone, and therefore reducing venous capacitance, distensibility, and stasis" (Wikipedia entry), so maybe its vasoconstrictor action intensified Concerta's effects on noradrenaline. I had an EKG and full bloodwork done before I saw my doc for the first time and there was nothing wrong with anything there. Also, I had some ticks as a child, one of which included tilting my head to the left and bringing my shoulder up to support my cheek (the only way I can describe that), which is directly reflective of which muscles became tense in my last weekend's experiences.
It's very important for me to find an explanation for these effects so I can talk about ways of combating / preventing them with my doc. Although Concerta takes away some of my sense of humor and makes me a little too serious, its effects on the sense of time, making and sticking to plans and sensing my thoughts has been incredible, and I can't emulate that with any coping strategy. Without it, I don't see how I will be able to make the crucial changes in my lifestyle I need to make (e.g. finding a better job), even though I can't take it every day because I need the disorganized impulsiveness for my current (dead-end, low-paying) job (of 6 years). The problem is that the only ADHD meds available in my country are Concerta and Strattera, and Strattera is cost-prohibitive (at over 0/month). So I really want to find a way to be able to use Concerta at least on the weekends until I can maybe move to another country.
Oh and I forgot to mention that my doc has an eight-week waiting list, and probably more now during the summer, so I would really like to come in with some options to avoid having to wait for 3 months just to bring her a new EKG or whatever.
symbolt39601.3398263889 The first week that I started Concerta 36mg, I had tension/aches in the back of my neck and shoulders. My head hurt pretty bad, had trouble sleeping the first few nights, but it all went away after a week or so. Don't stress yourself out by taking your BP so much. Stick to the 36mg for a few weeks, monitor your progress, drink tons of water, then, if things aren't going good, up it to 54. Just relax a bit, overthinking all the side effects makes them way worse. 36 is probably just right - give it time -
My son started taking Concerta on May 31st. He says he has chest pain, dizziness, stomach ache, and not very hungry. He saw his Dr yesterday and his heart sounded normal, his blood pressure was normal, and his EKG came back normal. Should I worry? Do these side effects start to go away soon?
Thank you, katastrophee! I just came back from the doc with an EKG of a model healthy heart ;) Now let me try to break the response up into bits.I read the diagnostic criteria for panic disorder, and I do not meet them. I often imagined how people who had it felt, and I do no envy them, so I am sorry for your experience and happy that now you feel different!! As far as I can tell, I've only had panic attacks (or high intense anxiety) a few times in my life, and two of those times I wound up at the ER confident I was having a heart attack ;) However, I do experience anxiety in my life. It's something about my past (a lot of anxiety there) and also, it has something to do with the way I get inspired or get my mind around things - once I was very anxious and worried for several days after watching the modern adaptation of "The Time Machine" just struck by the fact that it is SO possible that very soon people will blast the moon out of its orbit just to make room for an entertainment complex and a spa - we are stupid enough. So I walked around feeling anxious and depressed for a few days, and then it went away. I guess you could say I am prone to bouts of existential depression and anxiety. Sometimes this anxiety would be caused by health issues, and I thought would no longer happen, especially after I adopted a healthy lifestyle (=channeled my hyperactivity into exercise). It all goes away after a few days and it's not a paralyzing fear. Concerta is just new for me, and it brings with it some psychological burdens that I need to learn to live with, i.e. finally admitting that I do have a problem (like a lot of people with undiagnosed ADHD, I adopted both a low self esteem and an unhealthy attitude where I try to pretend I have no problems and people who find fault with me for my behavior are just stooopid or sth ;)). I generally try to keep these things under control using humor and logic, but sometimes I lose that control, especially since I find it so difficult and demanding to keep to a routine (and now I haven't exercised for over a month so my physical hyperactivity has nowhere to go).
About the medication - sadly and unfortunately I live in Poland (as in I am Polish). The only options I really have are Concerta and Strattera, with simple Ritalin only available via a complicated and unreliable bureaucratic procedure of importing it on demand from another country - and it's still good old methylphenidate. Like I said, Strattera's exorbitant price makes it a non-alternative, really (approx 0 for a monthly dose, and this is Poland we're talking about, so I do not earn that much, which makes the 0 even more of an expense than it would be in the US). I can get Concerta for around 0 a month which is high but important enough to cut some spending. I know of Focalin and would prefer that version of methylphenidate, but alas, I am limited in my choices.
Importantly, though, it's only last week that I felt these side-effects with the concerta, and considering how many people are coming down with migraines these days - or so they tell me - and the fact that I just assumed that Concerta will magically take care of all the things I used to have to be careful about, i.e. when I started taking it I stopped eating healthy, I didn't exercise too regularly, I overate, I gorged on candy, etc... Well it's no wonder I became weaker in mind and body. This is kind of obvious, actually - I am trying to sabotage the medication to avoid the responsibility that it allows me to take :D
And the last thing - I experience the same effects as you did, i.e. the Concerta did not normally rev up my anxiety, quite the opposite! I would spend my days thinking "I can't believe I am not normally like this!!" I was always very "in the moment" - even if I started worrying about something, it just entered my mind and went away. Like I wouldn't worry about not being late to work the next day at 3 - I would just think about it and go on with my day. Normally each such thought would mentally knock me off balance. It's a little like talking on your cell phone while walking down a very busy and loud street with hordes of people making noise all around you and then turning into a small isolated quiet street and realizing after some time has passed that although you're still doing the same thing (talking on the phone) something is markedly different (no noise battling for your attention) and not quite being able to put your finger on it ;) So generally my experience with the Concerta has been brilliant, although I did feel a little anxious once or twice and it was always connected with a weather change. Normally I would even sometimes feel the 36mgs was too little for me - it must have something to do with what I eat or something like that (an acidic environment prevents the absorption of a stimulant, for example). The first time I felt real anxiety was when I first took concerta on a workday and realized that I was feeling different and usually depended on my lack of focus and distractability to get me through the day at work and now I was a lot more aware of what was going on and had to act up to come across as seeming the same as before, and the next time I felt anxious was the next time I took concerta and went to work so... the reasons are psychological I think. :)
Hi Symbolt,
I used to suffer from panic disorder years ago. I would have multiple panic/anxiety attacks a day and eventually became agoraphobic. I recovered from this but still have occasional attacks (1-2/yr). I know what they are and can get through them fine now.
Last year I was diagnosed with ADHD. I was afraid to try a stimulant becuse I feared it would trigger my panic disorder. I actually started Prozac first (for depression associated with the ADHD and a tendency to obsess about things) and then added Wellbutrin (my wonder drug).
When that was not enough I started taking various forms of methylphenidate. I was really nervous about this, but it ended up doing the exact opposite of what I feared. I couldn't believe how calm I was.
I tried Concerta and although I liked it because it was strong, I felt a little artificially amped. I would also get ravenously hungry 2-3 hours after taking it, no matter whether I ate in the morning.
I prefer Focalin because it seems "gentler". It still does the trick, but without the other side effects.
Try not to overanalyze things. I too have a tendency to freak out when I get any sort of chest tightness/pain. Letting it scare you will just make it worse. It IS a vicious circle and I realize that is easier said than done! Try and distract yourself when it happens and it should go away. Exercise, read, whatever will heklp take your mind off of it. You can also try to physically relax, which can take time and practice to master.
It could be that 36mg really is too high for you and you should try a different long-acting methylphenidate. Your doc may also bump you down to 18mg and supplement with small doses of short-acting methylphenidate. That may be able to get you where you need to be....?
It is also possible that you have an anxiety disorder that needs to be treated along with ADHD (like me). Being so concerned about your side effects could be making it worse, which could be why you still have anxiety now even when you don't take the Concerta.
I used to get those types of migraines so I know what you mean about freaking with those symptoms! My vision would tunnel/distort and my hands went numb. One time I actually could not read when I tried to look up my symptoms in a medical book! THAT was scary. This was all before I went to a neurologist who told me that these are typical migraine symptoms. I always got the headache later though.
My mom gets those ocular migraines that give her a visual distortion (aura or whatever) with no pain. They used to stress her out until she found out what they are.
Good luck and hang in there!
katastrophee39603.5544212963If he has chest pain, I would worry, and try to get more tests done (e.g. see a cardiologist). But chest pain can be many things, so considering his stomach ache and not being very hungry, maybe he is experiencing heartburn? I didn't even think about that, thank you for the advicethank you symbolt i didnt even think about that thought. I love this forum and all of the adviceI'm glad I could help. The most important thing is to keep your kid happy and healthy! Yes you are very right. That is the main thing. Happy and healthy. I just feel so overwhelmed. Well I almost forgot - keeping the caretaker happy and healthy could be even more important ;)There are certain kinds of food that give people heartburn, and they might not be the same for everyone. Also, not every kind of antacid will work for everyone, and some of them will only start working after a day or two of use. Heartburn-like sensations can also be caused by more serious conditions like gastroesophageal reflux disease or ulcers. I've read a lot about it because I suffer from heartburn myself and have to be very careful about what I eat. Having an empty stomach can contribute.
If it's possible, I would still have a cardiologist review the data (e.g. the EEG results). Also, knowledge is power - you can use google to find a lot of useful information (looking at more than one source usually helps to build a more complete picture). Perhaps it might also help both your kid and yourself to meet with someone - a counselor, psychologist, social worker, etc - experienced in dealing with ADHD - who could help both you and your kid gain more insight into what ADHD involves and how the meds work, and many other things. Good luck!
symbolt39605.4987037037I would still be careful about chest pain and see a cardiologist. Also, about heartburn - there are many kinds of antacid (including strong and effective prescription antacid). Just FYI, I discussed all those symptoms with my ADHD doc, and she made me realize they were due to anxiety (maybe to the migraine, a little). I have been taking 36 mg Concerta regularly for the last 2 month, and experienced almost no side effects, and when I did, I knew how to manage them. Taking the medication regularly (5 days a week) and education helped me to alleviate or get rid of the symptoms. :)