Posted by medlib on January 8, 2001, at 19:28:52
In reply to Questions about Concerta, please help!, posted by Shell on January 7, 2001, at 23:11:19
Since you really want to try an increased dose of Concerta, how about asking your pdoc to prescribe a 2nd 18mg Concerta/day to be taken 4 hrs. after your initial dose? That would "cover" the whole day while providing the max. effect during afternoon and early evening hours when most people have the most problems with fatigue and concentration. Hope you have prescription coverage--Concerta averages $2/pill here.
Well wishes---medlib
> A few weeks ago, my doctor added 18 mg of Concerta (for ADD) to my daily doses of Effexor and Wellbutrin (for depression). I have noticed a small improvement in attention, motivation and reduction of fidgetiness (is that a word?). However, my family has pointed out to me that after the medication wears off (11-12 hours after taking it), I am worse than I was unmedicated. I am more emotional, more unreasonable, more irritable and less logical. Is this similar to the rebound effect that Ritalin users experience?
>
> I had thought that since I noticed a slight, but less than overwhelming improvement with 18 mg, I would ask my doctor to increase the dosage. Now I am wondering if a larger dose would magnify the end-of-day meltdown effect. Would this necessarily be the case?
>
> I am unsure of the best way to proceed. I like the positive effects of this medication on my ability to concentrate and to screen out things that would normally overwhelm me. However, my family dreads the time when it wears off so much, that they think it might not be a bad idea to discontinue it altogether.
>
> Is there anything I can do to extend the duration of the medication? I really only get ten hours of benefit from it, as it seems to take almost two hours after I take it before I notice any effect. If I take it early (i.e. 6:00 am), it works from aproximately 8:00 am to 6:00 pm, which is a huge help to me at work and with dealing with my children at home. However, this leads to some unpleasant evenings, where my poor husband usually ends up going to bed early to get away from me (which I don't take well!). If I take it later in the morning (i.e. 11:00 am), it will work from approximately (1:00 pm to 11:00 pm). We have a much better evening together, but I don't get any of the effect of the drug until my work day is half over.
>
> I suppose my ideal scenario (however unrealistic it may be!) is a 16-18 hour extended release version that takes effect within a few minutes. Since that is obviously not an option, does anyone have any ideas on what might be helpful? Has anyone else had a similar experience with Concerta? I would be very grateful for any solutions or insight (and so would my family!).
>
> Thanks,
> Shell
poster:medlib
thread:51125
URL: http://www.dr-bob.org/babble/20001231/msgs/51208.html