Too old for Concerta?

This topic contains 35 replies, has 23 voices, and was last updated by  SaraBrey 9 months ago.

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  • #68363

    Jeff_K
    Participant

    I was diagnosed with ADHD Inattentive type 7 years ago. My doctor and I worked through several medications and dosage levels before we arrived at the “sweet spot” of Concerta 38 mg. It has made a tremendous difference in my life! Now my doctor has moved on and the new one claims that people over 40 should not be on it and refuses to write any refills. I am 55 years old and have had no side affects or any other detrimental reactions. I remember what my life was like before Concerta and I don’t want to go back. She also wants me to try a medicine called “Bupropion”. I researched that medicine and it can cause suicidal thoughts! Is what she said true? I can’t find anywhere on line that backs her claim. Does anyone here know?

    Thanks.

  • #68366

    hayes
    Participant

    Jeff – I’m 50 and have been taking Concerta 54mg for 15 years with no deiscernable side effects. It has made a huge difference in my life, too! As for the other med, I’ve never heard of that. My doc had never really mentioned new meds because Concerta continues to work well for me. Rather than try a risky new med, would a second opinion be the better route? I really hope this challenge works out right for you; keep us posted and good luck… Chris

  • #68372

    Jeff_K
    Participant

    Chris – thanks for the response. Yeah, this was my first appt with this new doctor and the first thing she wanted to do was change my meds! I think you’re right, I will seek a second opinion. It’s weird that I can’t find anything on line that backs her claim. <shrug>

  • #68396

    sally-c
    Participant

    https://www.mayoclinic.org/drugs-supplements/bupropion-oral-route/before-using/drg-20062478<a href=”https://www.additudemag.com/forums/reply/68372/”

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of bupropion in the elderly. However, elderly patients may be more sensitive to the effects of this medicine and are more likely to have age-related kidney or liver problems, which may require caution and an adjustment in the dose for patients receiving bupropion.

  • #68401

    _addprodtest
    Participant

    Hi, I am 55 and have been on Concerta XL 38mg and 54mg for 6 months having recently been diagnosed. No problems with dispensing on the UK NHS but paid Β£1200 incl to get assessed. I did have some anxiety issues with 54mg so dropped back to 38mg. But have now raised to 54mg again and seems OK. It made a big difference to my concentration and I will see how it goes over the next 6 months.

  • #68593

    sydmom
    Participant

    Be wise to the “Big Pharma” pushing drugs for the Dr. to prescribe. If you like your medication and it is working for you and there is no research that would should good cause to change.. I would find another Dr.
    *Most likely this Dr. is getting paid to push the new drug.

  • #68646

    ADHDmomma
    Keymaster

    My first thought is that the new doctor either doesn’t believe ADHD affects adults (unlikely since she’s offering a different medication), OR, more likely, she’s worried about “older” adults taking stimulant medication, because of possible cardiac side effects.

    Bupropion is often prescribed off-label for ADHD, usually when a patient can’t tolerate stimulants or receives no benefit for stimulants. It does help some people with ADHD symptoms.

    Wellbutrin

    An all-clear after cardiac testing might persuade her to allow you to continue Concerta. Some doctors are more focused on this than others. An ADHD specialist for medication management may be better for you.

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

  • #69349

    Calibizaro
    Participant

    Hi Jeff

    I’d get another opinion. I won’t guess at your new doc’s reasons or motives, but I would definitely seek another opinion. Obviously your previous doctor felt there was no problem with you taking it.

    I currently take citalopram at night and bupropion in the morning, but these are not for my ADHD symptoms specifically. They are meant to help me deal with my constant anxiety and low level depression which may or may not be related to my ADHD. However, neither treat my ADHD symptoms and aren’t meant to.

    They work for my anxiety pretty well, but I can say from my own experience that they don’t do much for most of my other ADHD problems.

    • #70434

      Jeff_K
      Participant

      ADHDmomma – I have had no side effects, I sleep fine and have no symptoms when I miss a day. I am not thrilled with the thought of taking an anti-depressant. I’m not depressed! Anyway, I am researching doctors and will let everyone know what I find out. It’s not as easy as I thought to change doctors.

  • #69361

    tranderson1966
    Participant

    I just started elvanse- Lis dexamfetamine 30mg – for 8 days and I’m 51. I have missed out on so much.I’m calm all of a sudden. Don’t miss the opportunity to see if your life will be better with an appropriate diagnosis and appropriate medication. We suffer so much as a result of other people and our own ignorance of our condition. Once we get our diagnosis and are no longer ignorant of why we mess up so much……do not tolerate a medic who is ignorant for a millisecond. Find someone who knows what they are doing.
    And best of luck.

  • #69373

    tranderson1966
    Participant

    Follow up. Buproprion is a known treatment for ADHD after ritalin based stimulants and dexamfetamine second. It is an antidepressant, not a stimulant, and is also used for smoking cessation( think dopamine increase to reduce craving from smoking cessation). All antidepressants, some more than others, can increase suicidal thoughts for a period after initiating the medication in some people at the beginning of therapy. However and it’s a big however- this isn’t generally (i.e 99.9% ish of the time) a problem in people who are significantly well into middle age- like me. Those under 25 are most at risk. The big scandal about this was, if I remember correctly, with Seroxat, aka paroxetine- a prozac-like drug that is in the group known as SSRIs. Ineffective in ADHD btw. The manufacturers suppressed(and/or denied when challenged) the findings of increased suicidal ideation ( ideas of suicide) in youths especially, that were found in their research studies.
    This was after families of young people had reported increased ideas of suicide and had either attempted or had actually killed themselves. It wasn’t good. And there was a lot of money changed hands as a result. So now there is a near-mandatory reporting and warning given in some countries. So, to sum up- The drug does work but not in as many people as stimulants(what does?), 2. it’s highly unlikely to cause you to commit suicide. 3. the thoughts pass after a bit anyway 4. It’s a widely used drug but some people don’t get on with it, just like any old drug. 5. Get a second opinion.

  • #69387

    hollyf.hudson
    Participant

    I’m 41 and I was diagnosed in August at NYU’s Adult ADHD center. They do research on ADHD in adults there, including medication trials, so I trust them to be up to date in their understanding of proper treatment of the disorder. They’ve been working with me to find the right medication, and never said anything about age being a barrier to taking meds, and never mentioned anything about stopping medications in the future. They did want me to get signed off by an internist for some heart issues I’ve had in the past before prescribing — but it was clear it was just that I had a preexisting condition, nothing to do with my age.

    Here’s a quote from my psychiatrist that might apply in your situation:

    “Several years ago, we surveyed 400 primary care physicians who treated mental health disorders, anxiety disorders, and depressive disorders, and asked them about their understanding and training regarding ADHD.[3] We found they were twice as comfortable treating depression and anxiety disorders as they were treating ADHD. And, in fact, they had received much less training in the management of adult ADHD than for the other mental health disorders. So there is a knowledge gap here, in part.”

    source: https://www.medscape.org/viewarticle/551840

    I would definitely get a second opinion. Best of luck.

  • #69408

    mrm0717
    Participant

    Wellbutrin works on norepinephrine and dopamine.

  • #69409

    sjkaplan
    Participant

    All SSRIs have the potential to cause suicidal thoughts. That’s why, during each visit, the last of the mandatory questions is, “Do you have suicidal thoughts?” You do not say what other medications you take. Some meds cannot be taken with SSRIs if you are over 40 because of P53 (ask your doc what this means). In fact, before you see your doc, make up a list of questions you need answered. You can do your own list or find a list online. If your doc can’t or won’t give you complete information, find another doc.
    Good luck!

  • #69410

    sharradog
    Participant

    Hi I just joined this forum. My 9 yo son has ADHD and I think it’s highly likely I do.
    I don’t know that I can afford the $1200 for an assessment. I”m in Canada. Would appreciate any advice on how to go about getting assessed. It is nice to see so many adults doing well on meds πŸ™‚ and I’m wondering if it would be the same for me.
    Caroline

  • #69411

    mrm0717
    Participant

    Wellbutrin is not an SSRI.

  • #69415

    sjkaplan
    Participant

    I did not write my previous post clearly. What you were taking IS an SSRI (Selective Serotonin Reuptake Inhibitor) and can cause suicidal thoughts. My mistake was in lumping bupropion into that group. Bupropion is a norepinephrine and dopamine reuptake inhibitors (NDRIs). A different drug class, but one that can still cause suicidal thoughts in some people. I apologize if I caused you any confusion. I will say, though, that it is unusual to take just one med for ADD (or other conditions). Often, two or more are prescribed, as together they work better than any one drug. The rest of my previous post stands. You need more information so you can be comfortable with what your doctor prescribes.

  • #69419

    withanie
    Participant

    Hello! I’m a med student and I take both bupropion and methylphenidate for my ADHD. So here’s what I know based on taking these meds and taking classes on them πŸ˜‰

    Neither bupropion nor methylphenidate (concerta) are SSRIs (selective serotonin reuptake inhibitor). Bupropion, like SSRIs, is an antidepressant, but as an NDRI (norepinephrine-dopamine reuptake inhibitor) it has significant stimulant properties – so it is very often used off-label for ADHD. Methylphenidate is a stimulant.

    Many psychiatrists think that antidepressants can cause suicidal thoughts in depressed people because, before taking the stimulant, they literally didn’t have the mental energy to contemplate suicide. As they begin to feel better, they ironically feel well enough to make serious plans to kill themselves but not well enough not to want to do so. Bupropion is not generally a medication you would worry about regarding suicidal thoughts, and especially if it’s not being taken for depression.

    A lot of psychiatrists do feel uncomfortable prescribing stimulants for adults, but there really isn’t data suggesting that we shouldn’t do that. According to UpToDate, a website that a lot of docs use as reference for treatment guidelines, methylphenidate is perfectly appropriate to be prescribed for adults, and geriatric dosing and guidelines are identical to adult guidelines. There IS a concern in people with heart conditions such as structural heart defects, problems with your heart rhythm, heart failure, and heart attacks. A lot of doctors will do an EKG on you before starting a stimulant to make sure this isn’t more likely. And, of course, heart problems are more likely as you get older.

    As for docs taking money from drug companies…in the US, at least, I’m pretty sure it’s illegal for doctors to make any sort of agreement with a drug company about what drugs they’re going to prescribe. They can accept free stuff from the drug company, like going to dinners where the merits of the drug are discussed, and…pens with the name of the drug they’re selling and stuff, but even if they take advantage of that stuff, they are under no obligation to prescribe the drug. Anyway, the vast majority of docs I’ve met are really altruistic people who care more about helping their patients than getting on the good side of a drug company. I think it’s more likely your doctor was uncomfortable prescribing a stimulant because she rarely does it for adults.

    Bupropion MIGHT work very well for you, but personally I think it makes more sense to keep with the meds you were on, if they were working well and side effects were minimal. Can you see if another doctor in your area is willing to prescribe? Or talk with your doctor about having a psychiatrist prescribe the stimulant instead?

  • #69420

    corpjester
    Participant

    Get a new doctor immediately. This one has not done any reading on adult ADD. I’m 56. Just diagnosed (properly) 4 months ago. Meds have changed my life, and I imagine I’ll be on them for the duration. See a psychiatric specialist who understand Adult ADD. It doesn’t just ‘go away’. It’s a birth defect.

  • #69423

    Jeff_K
    Participant

    All – many, many thanks for all your responses. Hearing your opinions and thoughts has been extremely helpful. I am not going to continue with this doctor and will seek out another one, probably in the same practice. I only saw this doctor once.

    Again, thank you all.

  • #69441

    STLGina
    Participant

    You know, I don’t really think it matters what bupropion or any other medicine allegedly does. The fact is that meds don’t work the same for everyone, so a med that works for me may not work for you. I tried Concerta and it screwed horribly with my emotions — had me crying all the time — so I stopped taking it and tried something else. But it works for you and you absolutely KNOW it works for you. And “if it ain’t broke, don’t fix it.” The doctor that told you you’re too old for it is full of crap. I’m 57 years old with ADHD inattentive type as well, and I wasn’t even diagnosed until I was over the age of 50. My psychiatrist started me trying different meds. Once we found one that worked I stuck with it. And I absolutely could not function at work without it. As a matter of fact, I’m sure I would have been fired eventually if I had not gotten on the meds. I know it, my boss knows it, and my doctor knows it. You definitely need to find a new doctor that knows about and understands adult ADHD. I wish you success with finding a new doctor.

  • #69473

    markm1955
    Participant

    Jeff, I’m 62 now and started taking Adderall at age 55 with no side effects other than I am much calmer and in better control of my emotions in general. I have been taking Bupropion, and a generic for Lexapro since I was 45. I was an undiagnosed child with ADD and didn’t know I had it until I went to the ADDitude web site and took the self test and read the symptoms. I discussed the possibility with my psychiatrist and was sent to a psychologist to interview with a written symptom evaluation and had to take home a questionnaire for my wife to fill out. I have combined-type ADHD so I need all the above medications to help me cope with ADHD and symptoms of depression and anxiety.
    I too had to change doctors and after reading my chart and a lengthy conversation, he determined I should maintain the regimen of medications.
    Don’t be too concerned about the warning on your Bupropion. By law all medications must list side effects, interactions, usage and precautions. Key words like “can” or “possibly”, etc. are to notify the patient a list of reactions to be aware of because some patients reported those symptoms to their doctors or pharmacists but not everyone suffers from any one or more of those symptoms. Just be sure to let your doctor know if you have any reaction(s) to your prescriptions.
    Keep looking for a doctor that suits your needs who is willing to work with you not against you. It may take awhile but don’t be discouraged. It’s your life you’re the one who needs to be happy.

  • #69523

    Cristoir
    Participant

    A word of caution on Bupropion. I took it years ago for smoking cessation. It is recommended that you don’t drink alcohol when taking it. That warning should not be underestimated. Have a drink too many and it will take you to Crazytown. Pick a fight with your best friend and not remember the next day kind of crazy.

    It did nothing for my ADD.

    I’m 45 and take 40mg Aderall. My age has never been an issue with my doctor.

  • #69538

    newenglandrose
    Participant

    NO ONE IS TOO OLD TO LIVE A BETTER LIFE. 47 yr old female here. Finally diagnosed with ADHD at age 39 (I cried in my doctor’s office and said: I think I have AdD!!! Please help me) He confirmed it & told me: if you have Thyroid disease or Diabetes do you pray it away? Do you do yoga? Do you just take a few vitamins? NO! You take doctor prescribed medication to help balance your body and feel/live better. The same for your children. You don’t tell them to just “tough it out” if they have juvenile diabetes! AdHD is an imbalance in our bodies. Reading Dr Hallowell’s Delivered From Distraction was like reading my childhood memoirs – sadly. My doctor put me on medication right away. It has taken 8 years to get it right. BUT I had to demand that my meds get changed because they weren’t working. My jobs and home suffered but my doctor kept saying “just wait 6 more months”….FOR WHAT??? YOU MUST ADVOCATE FOR YOURSELF!!!! AND YOUR CHILDREN. Doctors are just humans who studied in school. They are not miracle workers. Get a 2nd opinion. Ask questions, go into your appointments with written lists of questions, symptoms, concerns. Don’t just say “OKAY DOCTOR” and suffer for another year. Live the best life you can. Here is a quote from Dr Hallowell’s Wiki page. He is the guru of AdHD. Read his books, see him speak at schools, go to his office if you are lucky enough to live near Boston. QUOTE: {In 2012, Hallowell went on television in an advert with Ty Pennington and said “Undiagnosed, this condition can ruin your family life, ruin your school life. Among adults it leads to underachievement. The prison population is full of people with undiagnosed ADHD. The divorced, the unemployed, the addicted. It’s a good news diagnosis because if you get it you can skyrocket. You can soar. You can achieve your goals. You might be a straight-A student. You may be a Nobel Peace Prize winner. But you know you could be doing better. Go and get this diagnosis. 80% of adults don’t know they have it. Stimulants are very safe. See a doctor who knows what he or she is doing and it’s (Adderall) safer than aspirin”.} — https://en.wikipedia.org/wiki/Edward_Hallowell_(psychiatrist) JEFF K….DUMP YOUR DOC & GET HELP…YOU DESERVE A BETTER LIFE!!!

  • #69561

    mlettinga
    Participant

    I was diagnosed later in life post 50. Met with specialist md for ADHD. I’m on 54mg concerts. Works great and I also am type 1 diabetic. All the specialists I see concur that Concerts is fine and safe. Trust me when I say I’m a Realtor and my business doubled when I started meds. I can focus and don’t misplace or lose as often phone numbers and messages. Find a specialist or switch doctors.

  • #69662

    quandary
    Participant

    I’m almost 50, and prescribed Adderall, Effexor, Clonazepam and a number of other meds. You might wish to find another doctor.

    In my experience, doctors trained in Great Britaim tend to be against stimulants altogether. It’s a case of “group think” IMHO.

  • #70272

    Jeff_K
    Participant

    Update: Well, no other physicians in the practice are taking new patients or they will not write a prescription for me. Sloshing through the list of doctors who 1) Know what adult ADHD is, 2) will write me a prescription and 3) is on my insurance is going to be a long and painstaking process. I imagine I will run out of meds before I find one. This has me pretty broken up – I DO NOT WANT TO GO BACK TO LIFE BEFORE CONCERTA.

    πŸ™

    • #70276

      marko
      Participant

      I’m a 62 year old male who presents as high functioning to most of the world. At the urging of my wife, I was tested/diagnosed with ADD only six years ago and prescribed an 18mg daily dose of Concerta. It helps prevent the “fog” that I often would experience while working and performing tasks. In my case, taking a pill does not address my personal problems, but it does provide me with the clarity necessary to (sometimes successfully) address them. It’s known to raise your blood pressure, so make sure it’s closely monitored.

  • #70293

    withanie
    Participant

    Jeff_K, can you ask your doctor to refer you to a psychiatrist, or find one yourself?

  • #70312

    mrm0717
    Participant

    Hi Jeff, I don’t have ADD/ADHD, but I’m trained in psychology and marriage and family therapy. I’m not quite sure what specialty your uncooperative doctor holds, but if s/he is a specialist you might try to ask your primary care physician for a Rx for your meds until you can find a specialist (psychiatrist or neurologist) who can help you. Good luck.

  • #70844

    ken_whitten2002
    Participant

    Wow, it really is amazing how hard it is to get the medicine you need. I just started adderal 3 months ago at age 60. Along with counseling the world is so much better. The problems are that too many people abuse the stimulants. The biggest mistakes you could make are to assume your doctor is really up to speed about adult adhd. Combine that with their reluctance to prescribe and you lose. I have been seeing the same doctor for 30 years and they still treated me like a criminal. Use your hyperactivity to learn all you can and you simply have to be persistent and well armed with the facts. You need to know that stimulants are the first line treatment and are effective 88% of the time and that the risk for someone with adhd is minuscule compared to the risks of not treating. For me any kind of depressant was a disaster and I had to try several before they would give me the right prescription. Even the so called non-stimulants are stimulant like and have worse cardiac risk with much less chance of working, and chances are your doctor does not know this. Your doctor also doesn’t understand how debilitating it can be because adhd is still considered fairly benign by most doctors. I was on my second divorce, had two bankruptcies lost many friends and in danger of health problems from drinking 2 pots of coffee a day. Somewhere between 4-11 percent of adults have adhd and .5 percent are getting treatment so you have to fight the notion that adhd is over prescribed. Best of luck

  • #70848

    Jeff_K
    Participant

    Well, I found a doctor who, while not prescribing ADHD medicine themselves, would refer me to a psychiatrist who will. But I am pretty sure getting an appointment will take time and they are going to want to test me, etc. I’ve already been tested but I’m sure they will want to administer their own tests (and, cynically, to bill my insurance for it). So I’m probably looking at months with my meds. The new doctor has staunchly refused to write this prescription, she’s pretty stubborn for someone who doesn’t know me, I’m moving on from this practice.

  • #70861

    ken_whitten2002
    Participant

    Just a heads up Jeff, you will need all your patience. They will cover their ass and charge you as many co-pays as possible. Being a new patient is a distinct problem getting highly abusable prescriptions, which are the main line drugs for adhd. Once I got my prescription I found out most insurance companies now require pre approval so my prescription got delayed. You now have to hand carry a paper script every month no more than a day before you run out and show id when you drop it off and when you pick it up. I get what you said about how much it helps you so hang in there.

  • #70897

    Jeff_K
    Participant

    Thanks, Ken. I appreciate your feedback.

  • #71152

    SaraBrey
    Participant

    Hello Jeff, I am amazed at how medications affect each of us differently just like many of you have said. I am taking Bupropion for depression because it is the only antidepressant that helps even my mood and gives me a little more energy. My physician thinks I have ADD so we have tried Adderrall and Methylphenidate. The methylphenidate made me feel very strange. I was loopy, absent minded, more anxious and extremely jumpy and even paranoid. The Adderrall made my heart race really fast a few times which scared me, but I tried taking a quarter of a pill instead as my old physician suggessted and it actually helped my concentration immensely. I am now having the same issues as you, ironically with the Adderrall though, not the Concerta. My new doctor does not believe in prescribing anything for ADD because it is “bad for your heart and way too dangerous”. I can not find a psychiatrist who takes my insurance or will accept a new adult patient. Another psychiatrist did not have any openings until March 2018. I only have two pills left now and I am trying to save them for when I really need them. I feel you, brother. I wish I could give you my methylphenidate since it affects me in the opposite way of how it affects you. Good luck to the both of us in trying to find a good doctor. My prayer is that God will heal all of us and we will not need any meds in the name of Jesus. I thank Him in advance for answering this prayer. God has made us complete! Your faith has made you well.
    .

  • #71156

    SaraBrey
    Participant

    Clarification: Because giving these medications to someone else other than the prescribed person, I would never actually “give it”. I don’t anyone to get the wrong idea. I would also add that I am very glad to have this forum and be able to discuss these issues with medications. I am learning a lot by many of you sharing your stories. It helps to know that there is a group of people out there who understand your plight with ADD even if some doctors don’t.

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