Concerta – Wrong dose or wrong medication?

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    • #102271
      blueboi
      Participant

      I have been diagnosed with ADHD for about 3 years now, currently 22. I was first put on adderall IR 10mg. It was effective, but seemed very sharp and intense. I lowered the dose to 5mg IR and this helped a lot with managing the negative side effects. I took a break from medication but recently wanted to go back on. I started with 20mg Vyvanse but it effected my mood and anxiety. It only lasted for around 5 hours then I felt a big crash. I switch to Concerta 36mg. When I first take it, it seems to work well. I didn’t have as bad physical side effects and it lasted the whole day. I focus and have the motivation and clarity to get work done. However, after the initial come up around 1-2 hours, I can’t really focus at all and lose all motivation. I get sleepy and can’t do anything efficiently. At first I thought that my dose may be too low, but then I also realized that my heart is definitely pounding stronger than usual. Are these signs that my dose is too high? Is it a dosing issue or more of a medication issue? I am thinking of switching back to adderall possibly trying the xr version of the drug, just hesitant because the crash from the medication was much more significant that concerta. I notified my doctor, but just want opinions from those that may have experienced something similar. thanks for the help!!

      • This topic was modified 2 years, 1 month ago by blueboi.
    • #102289
      Penny Williams
      Keymaster

      It sounds like you were taking short-acting Adderall. Yes, there’s quite a crash with short-acting — it dumps all the medication in your system at one time and wears off pretty harshly. You might well do better on the time-release version (XR).

      There are two types of stimulants: amphetamine (Adderall, Vyvanse, Evekeo…) and methylphenidate (Ritalin, Concerta, Quillivant…). Almost everyone does well on one type or the other, but not both. Consider which type you had the best symptom relief with.

      Also, the standard of care for prescribing stimulant medication for ADHD is to start at the lowest dose and only increase if and when needed. You were not started on the lowest dose of Concerta, but the 3rd step up (18mg, 27 mg, 36 mg, and 54 mg are the doses).

      A Patient’s Primer on the Stimulant Medications Used to Treat ADHD

      10 ADHD Medication Mistakes Even Doctors Make

      Penny
      ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism

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