Concerta has stopped working 18mg

[Wildcard547]

Hello newly diagnosed Adult ADHDer here. I started on Concerta 18mg a few weeks ago and it started out great! I was able to do all the things I wanted to do and social anxiety was very low. Now after a few weeks, the last couple days I don’t really have any energy throughout the day and cannot properly function as well as I could. I also have been going through crashes the last couple days in my energy levels etc. Has anyone else dealt with symptoms recurring like this and have any tips on improving this? I have an appointment next week for this, but called and talked to my PA and was not really given any advice other than to give it time.

[Reformschooldropout]

Hi, I'm newly diagnosed too, and in a similar situation to you but with Elvanse, so sorry I'm not sure if it's very helpful but I'm finding the same, where the effect was great when I started medication about a month ago, but it feels like it's doing less and less now and it is definitely wearing off by about half way through the day. I am going for a check up today so will ask the doctor if I just need a higher dose and if this is normal. Sorry I don't have any advice but just to sympathise!

[Mamamichl in reply to Reformschooldropout]

It is very common for people to need to raise dosage or even change meds to get the benefit over a long time, especially with stimulant medications. This is partially why some people take breaks on weekends and over holidays; so the med is more effective when on it.

[mikl_pls]

18 mg is a low dose for Concerta, it's just a starting dose. Some people are lucky enough to do well with it for a long time, but chances are you will need to talk to your prescriber about possibly increasing the dose. The typical range for an adult patient is probably 36-72 mg, and the dose can be adjusted every week according to tolerance of side effects and efficacy. You may need to be a little more assertive at your next appointment, advocating for your remaining ADHD symptoms and requesting a dose increase. There's nothing wrong with advocating for yourself (you are your own best healthcare advocate), and if the doctor has a problem with you asking for a higher dose, then they're not a good doctor for you.

[LisethHIS]

Good day, Wildcard547,

Thank you for contact CHADD National Resource Center on ADHD. I'm glad to hear you have a follow-up appointment with your doctor! Be sure to write down everything you've experienced, as this will give the doctor helpful feedback and could lead to adjustments in your medication or dose. Since you mentioned being newly diagnosed with ADHD, joining a support group chadd.org/affiliate-locator/ or taking a course on ADHD might also be really beneficial for you. chadd.org/adult-to-adult/

If there is anything else you need, please let me know.

Best,

Liseth

Health Information Specialist

CHADD's National Resource Center on ADHD

chadd.org

[STEM_Dad]

When the Concerta was working, how well did it work for you?

If it was working well, then you might just need the dosage adjusted. Many people need a dosage increase a short time after starting on a new ADHD medication. (Some people actually need a decrease, but that's much less often the case.)

Sometimes, a change to a different formulation of the same type of medication is needed (e.g from Concerta, an extended release form of methylphenidate, to Ritalin, an instant release form of the same). Or, a change to a different type of medication (e.g. from Concerta to Vyvanse, an extended release form of lisdexamfetamine, or to a non-stimulant like Strattera, aka atomoxetine).

~~~~~

I advise that before your next appointment, you should write down everything that you can about your experience with the medication:

• The initial effects

• The peak effects and when they lasted (approximate date range) and for how long each

• Any side effects you've been experiencing (including effects on sleep, appetite, mood, any other physical effects)

• When it seemed to stop working so well

You know best what you are experiencing. Be inquisitive of yourself, but try not to overanalyze yourself.

Do not over-exaggerate anything. Do not leave out anything out that you're fairly certain has been caused my the medication (positive or negative).

This information might help your PA with the decision of how to proceed with your care.

[Wildcard547 in reply to STEM_Dad]

Thank you for the advice. I’ve put together a medication journal highlighting all of this so I can share this with my PA. It worked until last week then there were more diminishing gains. I do believe hydration and taking care of myself has a big role in the drop off as well, as my energy today isn’t bad with proper hydration and getting better sleep last night. The attention issues are there which leads me to believe I need a higher dose, but the energy burnout or medication rebound I’m hoping won’t be too bad considering the self care today.

[STEM_Dad in reply to Wildcard547]

Excellent!

I'm glad you're keeping a medication journal.

I'm also glad that you're doing well with self-care. Yes, proper hydration and adequate sleep are essential to feeling and doing your best, particularly with ADHD. Eating regularly and meeting your nutritional needs is also essential.

Those are the basic needs all people have. After those needs are met, for most people with ADHD, medication will be the biggest factor in treating ADHD.

On top of those, there are other lifestyle factors which can help or hamper ADHD.

[rhondaeby]

is it a generic? If so then it’s not concerta. Concerta is a one source drug with a specific delivery system. I would report it to your pharmacist and they will write it in your file that the side effects. Then talk to your doctor. And your insurance to see what else they cover. I have similar effects with adderal generic depending on the manufactuer and each one is different. I’ve found that the manufacturer that works isn’t making the medication anymore. My insurance doesn’t pay for name brands and I have to get a pre authorization each time I change medications or doses. My advice just make sure you report it because the more we keep these company’s from messing with our minds and ruining the medication that already has a stigma, the better we have it..

[Mamamichl]

18 mg is the smallest dose possible. If you have extra pills, try taking 2 for a day and see if that helps. They probably will raise your dose anyway. Definitely hydrate and eat healthily. Those along with taking any other stimulants, like coffee or caffeinated drinks can change the effects you feel.