A couple years ago I was diagnosed with BPD after being treated for MDD for about 25 years. Once I got a BPD diagnosis and on some proper medication there seemed to be a lot of improvement in my life. However my psychiatrist has been talking to me for over the past year that he thinks I have inattentive ADD with impulsivity tendencies. I did some testing and now have a diagnosis for ADD.
He prescribed me concerta. I started out at two 18 mg tablets in the am. I was on this dosage for 8 weeks. I returned for a follow up visit. Initially for the first two weeks I felt really motivated and eager on this dose but it wore off. I explained this at my appointment.
This is what he changed my prescription to
One 36 mg tablet in the am
One or two 18 mg tablet(s) in the afternoon if I think I need it(them)
I feel like this is excessive and I honestly feel overwhelmed. Is this a normal prescription?
Also I am wondering why I am feeling guilty about taking a prescription stimulant?
I’d appreciate hearing any feedback or thoughts on my post or anything that you’d be willing to share someone new to ADD.
I get the guilt. But remember our brains are different. Do people feel guilty for using crutches with a broken leg? When I was first diagnosed, in 2001, I took one 36mg extended release Concerta in the morning. Now I take one 18m extended release Concerta in the morning. But my life is less complicated and chaotic now. How is your heart rate on the medication? Do you have any negative side effects? Appetite okay? When I take two 18 mg, I feel like I'm wearing glasses that are too strong, if that makes sense. That's too much meds for me. Also the amount of sleep and exercise I get affects the severity of my ADHD symptoms. Medication is not enough. Skills and pills. You need to find different ways to help you manage your symptoms. I recommend Russell Barkley's book, "Taking Charge of Adult ADHD." Good luck.
Thank you for the reply and the book recommendation. I stayed up most of the night listening to the book lol. That was not my intention.
I know I need to make some changes in my life as far as exercise and eating right. I feel very lost disorganized and I have no schedule right now.
Part of my concern about the freedom to dose myself and the fact that I’ve been given a stimulant is that I am a recovering alcoholic of 8 years but I e been battling cocaine addiction for the past 3 years(clean for 4 months) but dabbling in meth for the last year. I have been very open and honest with both my GP and my psychiatrist about my drug use. This is why the Concerta makes me nervous scared etc.
I have started to keep a daily symptom tracker mood journal and I am trying to take just 18 mg in the am and will see how I do o. That dosage for the weekend and next week. If I have to I will go back up to the 36 mg.
I understand your concerns better now. Yes, proceed cautiously. Sounds like you were self-medicating, which many people do (myself included) before getting a correct diagnosis and treatment. Taking the Concerta could help you overcome your other addictions, if your ADHD symptoms subside, you will, hopefully, feel less of an urge or need to use other drugs. Keeping a daily journal is an excellent idea. I use a small notebook to help keep me organized - to-do list, schedule, etc. If I don't write something down, it doesn't exist! Hang in there!
18 mg is a starting dosage, there's no shame in going up, thats the normal process and very few people can get away with only 18 unless their body weight is really low. If you find that the higher dosage begins to wear off in the same way maybe theres a problem, but the fact that 18 mg wasn't enough isnt suprising as it is a really low dosage.
Remember that concerta is a long acting medication, the one tablet you take contains 3 doses that release seperately throughout the day. On 18mg you're getting 6mg three times a day. On 36mg you're getting 12mg.
Concerta is really hard to build a resistence too because the dosage in your blood stream is so steady, it's a super safe medication, it's really unlikely that you would have gotten used to it, and more likely that the burst of energy and productivity had a second cause along with the meds. You might have gone into burnout after the productivity boost as well, since youre not used to having much energy.
The maximum dosage of concerta is 72mg I think, I'm on 54 at the moment, your dosage is really aroung the average mark.
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