Question after 1st day on Concerta (generic) for suspected ADHD inattentive type

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    • #106168

      Some background info: after doing a bunch of online research into some symptoms I’ve had my entire life that have caused me an increasingly large number of problems as I get older (I am a 26-year old male), I became almost certain I have ADHD Inattentive Type. I have NEVER been hyperactive as far as I can remember. I’ve always been teased for being a bit of a ditz despite being academically intelligent. I did extremely well up through high school and moderately well in college, so I never considered anything was seriously wrong. But I was always the last one done tests, one of the most unorganized kids in class, and was frequently not prepared. I was always the kid borrowing a pencil. I frequently had to call home because I left homework assignments sitting on the counter, and I’d walk into the classroom with papers sticking out of my binder in every directions. But I always ended up with the best grade in the class. I am quite introverted and have some bad social anxiety with things like presenting or leading discussions (I have presented and given speeches multiple times, but I am really good at hiding my anxiety and can come off as a pro as long as I memorize my speech and practice a million times). I get in these weird brain fogs where I put things in places they don’t belong (e.g. putting refrigerated items in the bread drawer, usually this happens either when my thoughts are racing or I’m just “out of it” in general). I am CONSTANTLY daydreaming, usually about the future or some stupid thing that will never happen. I sometimes have this feeling in a social environmental where I can’t think of something to say or a question to ask and I start feeling anxious. I sometimes don’t notice small details or things right in front of my face. I’m OK with big picture stuff but have a terrible memory about small details. I sometimes have trouble following what people are saying, especially fast talkers. I sometimes zone out and realize I didn’t absorb what the person said (I often hit the rewind button on podcasts). I have to take notes at work or I’ll forget what was said 5 minutes later, but I remember weird facts or have images in my head of memories from years ago. I love helping people but sometimes am not aware enough to recognize they need help until the last second because I’m in my “own world” or my brain just doesn’t register that the person needs help. I’m having trouble at work as more and more projects and responsibilities end up on my plats. It’s super frustrating. And to cap it all off, my long-term girlfriend recently broke up with me and cited reasons like my “lack of planning” or that I wasn’t “there” (i.e. I was never in the present moment). She called me out on never doing romantic gestures or taking her on dates at least “once a month”. And later when I thought back I realized she was totally right….it had been multiple MONTHS since I did anything like that and all I wanted to do was get a time machine and go back and slap myself in the face. How could I be so oblivious and not even realize how much I was slacking? I thought about her literally 24/7, I called and/or texted her every day and made sure I was with her every weekend. But how the hell did I forget the gestures, that I actually did like to do for her. I It’s worth noting that we were an hour and a half away from each other and only saw each other on weekends. And I think recently I had been daydreaming a lot about our future, how I could get a job closer to her, where we’d live, etc. etc. And in the process I lost track of the present….anyway, before I rant anymore, this breakup with the person I thought I’d be with forever was the final straw and led me to seek some help with all this.

      So…..I went to the doctor and described my symptoms. She decided to give me a 30-day prescription for 18mg Concerta (generic). I will go back to discuss results in a month. I took my first dose this morning around 9am (took with a high protein breakfast and no caffeine). The only major benefit I saw was a slightly happier feeling earlier in the day. This is probably the “high” that people talk about when you first start taking a stimulant, which I know eventually goes away. I also saw a fairly significant decrease in my daydreaming. However, I feel some of the symptoms I get most frustrated actually got WORSE. I was making more typos in emails than I already do, was taking WAY too long in general to write the emails (the words weren’t flowing out of my mind in a cohesive manner), my typing in general was worse than normal (I’d hit the wrong keys a lot). Even while writing this, I’ve found it hard to find the right words and to form sentences that flow well. The whole “fog lifting from the brain” and “feeling of clarity/focus” that some people cite simply wasn’t there. I know it’s not supposed to be a cure, but still….it shouldn’t make things worse. Does this sometimes happen the first day or week? Is there still any hope this medication could help? After reading my background information, does anyone think I might not have ADHD? I know I can’t just take advice from the internet and will need to work more with the professionals that are helping me, but I’d appreciate any feedback or advice.

    • #106191
      Penny Williams

      It takes time to adjust to your brain working differently. You can’t use the first day to judge the efficacy of medication for you.

      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.

      ADHD medication treatment results are very individualized. Which type of medication and the dosage you need depend on your neurochemistry, metabolism, and genetics. A large man could take the smallest dose and do great and a small child need the max dose to get the same benefits (size and age having nothing to do with these medications).

      The standard of care is to titrate ADHD stimulants — start with the lowest dose and increase if and when needed until you determine the best dose for you. It sounds like that’s what your prescribing doctor is doing, which is great.

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

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

    • #114454

      Finding the right medication and dose is a lengthy process. I think you actually have ADHD. Typing the wrong key is an indication of impulsivity, which can be another way the “hyperactive” aspect can manifest. Keep a list of everything you notice, so you can discuss it all with your doctor next time you meet. Watch your sleep, too. Us ADHD folks tend to be lousy sleepers to begin with, and the wrong meds can make it even worse, negating any benefit from it.

    • #114456

      And about the girlfriend: there’s a school of thought that says different people express and feel loved in different ways (it’s called the five love languages, if you want to look it up). So not everyone needs romantic gestures. But we ADHD people need partners who can be clear and direct about what they need from us. We usually can’t focus on subtle hints long enough to puzzle them out.

    • #114558

      I started taking Concerta 4 months ago. We tried adding/subtracting methylphenidate. Tried amphetamines. Back to Concerta. It’s definitely the right drug for me, but I haven’t nailed down the dose. It would probably help if I could find a therapist in my area, but that’s another story.
      Patience is not an ADHD virtue, but accept the fact that there isn’t a shortcut. Medication management is a tedious art.
      Good luck!

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