How do you know if Concerta is working?

[Whitecarnation]

This may seem a strange question. My son is on his 3rd week of Concerta. 18mg week 1, 36mg week 2 and now on 54mg. He is having trouble saying if it is having any positive effect. The first week he had a low level headache for a few days, which wore off. Now he is on the high dose he said he is having trouble getting to sleep at night ( not that he usually goes to bed early), and his appetite is reduced. He also said today that he feels like something isn’t quite right but he doesn’t know what. If these feeling continue over the next couple of days, we will report to his prescriber.

It’s a bit awkward because he has left school and isn’t starting college until 12th September, so he hasn’t had to focus on things he is not interested in.

How long does it take for positive effects to be noticed, and the side effects to reduce? I would be grateful for any information you have .

[Gettingittogether]

This is a question for your psychiatrist. And I know I'm being a bit annoying, but really the best treatment involves asking these questions to your prescribing doctor.

The answer, though to your question, is the change usually is immediate. Now, it can take time to understand the change. Sometimes the changes aren't what they predicted. So for example, when I first when on Concerta, I noticed a serious increase in energy and enthusiasm. Now, that was at the right dose. I started probably at 18mg a day or maybe 27a day ... my peak dose was 54mg a day ... So your son may need a bump in dose. But doctors do like to start at the lowest dose--that's the proper protocol.

But you should see the effects on the same day you take the med, usually within a few hours of taking the meds. Now, a qualifier. There are some times when people don't "feel" anything, but suddenly, they're cleaning up their room and completing tasks they have long needed to complete. So it's not necessarily a feeling you're looking for, but results.

But report this to your son's provider and most likely they'll up the dose.

[Whitecarnation in reply to Gettingittogether]

Thank you. I have asked the prescriber and she has just said everyone responds differently! Not very impressed with her to be honest. We probably need to give the meds time, and when he goes back to college, the effects may be more obvious. If not I will message the psychiatrist.

I just really want him to have a positive effect and help him transition into adulthood and be able to do things.

[STEM_Dad in reply to Whitecarnation]

The prescriber gave a factual answer, but not a helpful one.With stimulant meds at an effective dose for the person, they ought to notice something (or a change in their behavior might be noticeable by others).

Not all ADHD medications work well for all people with ADHD. I've only tried two, a stimulant (Adderall) and a non-stimulant (Strattera), both at different dosages. In my case, the non-stimulant is a better treatment. But it took 6 months of working with my doctor on medication adjustments to figure that out.

It can be frustrating, but try to be patient with the process.

I did find it helpful to journal about what I was experiencing on the meds, vs what my experience was like before I started meds. The contrast might be more of an indication of how effective the treatment is than just focusing on present state.