Problems with seizures

[Tadhd666]

Hi I'm 39 and recently diagnosed adhd. Was prescribed 18mg concerta xl. Worked great at first but wore off after 5/6 hours. Started taking another 18mg at 1.30. Worked until 6.30 ish. On both levels I developed seizures and still have them every night around the same time. Mt Doctoe took me off conceta and now i have to await for a Brian scan, but am totally back to square 1 mentally and physically. Does anyone know if the seizures are concerta linked? Any one offer advice on alternative? DR prescribed clonazepam to help seizure but still having them. Any advice/ help offered as to a way forward would be appreciated greatly. Thanking you in advance

[TheDoubtfulMedic]

Hello! Sorry you had to wait a few days for a response. I know how hard to get a diagnosis as an adult. Now i won't be able to answer your question specifically, but i think what i have to say may be of help.

First thing, don't panic. It's normal for different people to react differently to different ADHD/ADD drugs; it can be a miracle for someone and a torture for another. So treatment-wise, i'd say just follow up with your doctor, keep him/her updated on any side-effects, feelings, emotions and thoughts to try and find the best option for you. There are many things to try such as adjusting the dose, changing administration time, checking for any allergies (or hypersensitivity), trying to CBT. Everyone is different, you may need medications or therapy sessions or both. Be open to explore your options till you find the best treatment for you.

Secondly, there are some tips about mental health for having a late diagnosis of ADHD/ADD. Hopefully, you won't need to read them but understandably accepting and adjusting to a late diagnosis isn't easy, wasn't easy for me certainly (thinking back on how it effected your entire life without knowing can give you the chills). I was a bit mad and anxious as my doctor somehow failed to mention what might happen even thought it's very common. So if you feel anxious, panicked or depressed at random times, i recommend just googling how to adjust to a late ADHD/ADD diagnosis and you will find a lot of useful information.

I hope this is helpful, and if you need to talk or vent i'm more than happy to help you with that. I was diagnosed a few months back myself, so i do relate to many of the things you're feeling at the moment.

I wish you all the best, and believe me getting the diagnosis (Even if it's late) is a lot better than now knowing! And after you understand yourself/mind more, you will see it as a superpower.

[Tadhd666 in reply to TheDoubtfulMedic]

Thanks for you reply. Very kind of you to say so much. I seem to be managing better meds wise... still get seizures but it happens mostly when I am stressed out. Not sure how I should feel on ritalin or if i know it's the right dose... so up and down during the day?? Guess my doctor will know when I see him next. Hope all is working out for you?

[TheDoubtfulMedic in reply to Tadhd666]

You're more than welcome It's good to hear that you're managing better. I'm still a medical student not a doctor xD but if you think the seizures are mostly caused by stress, it might be worth it to treat the stress itself rather than the seizure (the cause instead of the aftermath), try to discuss that with your doctor (meditation works for many people and a "stronger" option may be a beta-blocker like Inderal).

I'm not sure if you're using Ritalin (your reply) or Concerta (your post), but they have exactly the same active ingredient in them (methylphenidate). The only difference is how fast the drug is absorbed in your body. Ritalin is fast/instant release while Concerta has a slow release mechanism. Consequently, people tend to have more ups and downs during the day when using Ritalin but on Concerta you get a longer controlled release.

This paragraph is going to be a bit sciency but can be really useful to anyone interested in knowing the difference between Ritalin and Concerta, so skip this one if you're not really interested Concerta pills are designed to give you an initial peak concentration in about an hour (~20% of dose), and then the concentration will keep building up for hours till it reaches maximum blood plasma concentration in about 6-10 hours followed by a steady decrease. This pattern is called an ascending pattern. Why is all this important? well, your body MAY develop something called acute/instant tolerance to the drug, decreasing its effectiveness on your body. And clinical studies proved that an ascending patter is the most effective way to reduce the counter-effects of acute tolerance (compared to an instant, descending or sustained patter). Another reason why Concerta may be the preferred option is to avoid crashes (or ups and downs) during the day (as you usually take 1 dose of Concerta a day and the crash is a lot smoother). I hope this made sense.

Now back to you. Your problem seems to be purely medical and somewhat unusual. And trust me the best person to help you with this is going to be your doctor. Make sure to tell him all your concerns and ask for his opinion about using beta-blockers to deal with the stress thus preventing the seizures. If your doctor is a good doctor, he will be happy to discuss and explain every question or concern you have without being irritated or annoyed.

P.S. what i wrote about the beta-blockers and stress is my personal opinion, and as i said i'm a medical student and not a doctor so don't consider it a medical opinion. But it makes sense to me anyways and i think it might be worth discussing with your doctor. I wish you all the best, and please update me after you see him! i'm genuinely interested.