Posted by liliths on September 9, 2006, at 7:22:23
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by alohashirt on September 9, 2006, at 0:18:43
good morning
well, I took my first dose about 45 minutes ago at about 6am. I'm nervous - don't know what to expect. My ADHD meds have pretty much been the mainstay of my 'cocktail' for years - this is the first change in a long time
momofdnd gave me access to the coupon for a free 30-day supply (Bless you for that!!!!!! :) and I saw my pdoc yesterday. My concerta dose was 2-54mg per day, so we thought I'd be ok on 2-20mg focalin XR. The coupon would only cover 30 pills so I only ended up with 15 days worth but that's enough for a trial and I'd need a new script by then anyway, so I'll be in the right timeline for having to deal with my primary. This new health insurance makes me provide prescriptions written my someone in their plan. I never had to deal with that before. I've been paying my pdoc out of pocket for years but insurance always picked up the scripts. I guess insurance companies are only making it harder and harder to get care these days. My primary was a bit freaked when I first asked her to do this (the panic on her face was palpable), until I reassured her I didn't want her to take over prescribing my meds, just re-write the scripts my pdoc would provide so that the insurance company would cover them. She accepted, but I don't like to push it. I can tell she's not entirely comfortable and it'd be very easy for her to just say no to doing it.
I received a letter stating my health insurance was dropping concerta from their formulary, saying there is a generic version available, though to my knowledge, it's just plain old ritalin.... none of dosing mechanisms that make concerta unique. Oddly enough one of the reasons I even picked the damn plan was because they covered concerta and even had it as a tier 2 ($20). The focalin XR will be tier 3 on my health plan ($60). The insurance also covers NO benzos or opoids so I had to switch from clonazepam to daizepam to pay out of pocket as it is much less expensive. I'm not sure about it though - I think may exacerbate my depression. I have some clonazepam left so I'm taking that with the focalin xr just to be on the safe side. If all goes well over the first few days, I'll try the damn diazepam again LOL
I also take wellbutrin, buspar & hydryocodone (my original script for that was for 1-7.5 2x daily - the new one is for 1-10mg split in half to take 2x daily - to save $ since it's also out of pocket) but I went back to school a bit over a year ago and cut down all my meds except the concerta and buspar. I cut the hydrocodone down to 1 afternoon dose at first and then went off it entirely for awhile, even though it helps focus and energize me, dropped wellbutrin from 300mg daily (1-150mg 2x day) to 100mg, and dropped my afternoon clonazepam dose. I know buspar is considered basically a pabulum medication, but for some reason it seems to help my depression. I read once that it has some effect on seratonin, so that's my guess. All I know is that the 3 different times I went off it, there was a definable increase in my depression.
I had board exams coming up so I kept the wellbutrin low, as I've always been concerned about losing any mental acuity and the wellbutrin can sometimes give me 'word finding' difficulties.
anyway, I realized that was obviously part of the deepening depression. That plus having achieved my goals. I graduated with high honors in May and just passed my national boards with "highs" in all content areas! I'll be getting my LMT: Licensed Massage Therapist Whew! I'm a bit old for all this (in my 40's - ok... 47!!!) LOL but I could never handle school when I was young. I have hundreds of unaccredited university hours simply because I coudn't handle tests or schedules... on top of being totally overwhelmed by dailiness itself. And I'm very hard on myself. I have to do things really well. Don't compete with anyone else but myself but I'm impossible to please. Anyway, there's always a 'crash' for me after an achievement. Part of me thinks I'm a fraud anyway so that old stuff kicks in too... sheesh.. when does THAT go away?
well, I can obviously feel the focalin but so far it's ok.... yes, a bit 'more' than the concerta but not too bad. I feel pretty good actually, more alert and dare I say it aloud: more alive?
how scared of that am I!!??I'm REALLY curious to see how the day goes!
My current regimen is:
about 6am:
40mg focalin xr
1mg clonazeoam OR 10mg diazepam
22.5mg buspar2pm:
200mg wellbutrin (realized I had to go back up on that!)
22.5 buspar
5-10mg hydrocodone (considering dropping it though, mostly to save $)
"psychotropin" supplements mostly made up of l-carnitine, arginine, taurine, b vitamins etc7pm:
1- 10mg valium
(used to be 2-1mg clonazepam and when first switched to the diazepam I went to 2-10mg of that but I just think it's a dirtier drug, though I know I could be wrong)
2- soy supplements for womenI also take a LOT of vitamins in the morning with my meds but I cut the 'psychotropins' from my morning vitamins as I really want to just get a take on the focalin XR without anything else 'activating' me.
well, this is so long I'm almost embarrassed to send it!
oh yeah, you asked about my insurance. I had to go on medicare using a supplemental drug program as my insurance costs had become unaffordable! I've been on disability for a couple of years and it takes 18 months before you become eligible for medicare. Unfortunately, the plan, though good, is still an HMO and ALL the medicare drug formularies are pretty much the same in that they won't cover benzos or opoids and like almost ALL other insurance, look to cut costs by making you take generics
ok... hopefully I haven't bored anyone to tears or not made sense!
Time to take a deep breathe and hit 'send' :)
namaste,
lilith> No problem. Its always interesting to hear others experiences.
>
> I was on Concerta and seemed to be losing some mental agility . I tried adderall, which was clearer and sharper but my blood pressure went through the roof. Next was Concerta + small amount of dexedrine. I ramped up dexedrine whilst ramping up Toprol to get the BP down. When focalin xr came out my pdoc suggested I might get the sam eresults as concerta+dexedrine without the bp effects. It did, and it was more consistent.
>
> What si your health plan? Are they removing concerta from their forumulary? that seems weird for such a popular medication.
>
> > hi there... thank you for the extra info :)
> >
> > About how long before that second peak you mentioned and also about how long do you think the drug is effective for you before wearing off?
> >
> > sounds like there isn't much of a crash - just a let down - which I certainly hope is true for me - I like the sound of those words "clearer and crisper"
> >
> > did you switch to focalin from concerta and did your pdoc give you the same (1/2 right?) dose or make you start over and taper up?
> >
> > I haven't a clue how my pdoc will react to this - but seeing how they're discontinuing coverage for concerta on my health plan, switching to generic ritalin just doesn't sound like an option I want anyway.. and I really am battling incredible lethargy & depression, despite my meds. I can feel them 'trying' but it just isn't enough
> >
> > I am SO tired of feeling like garbage day after day. Though even if he does give it to me, I'll probably wait until my current concerta script is done as this new health insurance makes me have everything written by my primary - I bring her the scripts the pdoc writes and she has to write new ones. She's not crazy about doing it, so I don't want to tax her patience and go in too often. I'm afraid she'll simply pull out and I'll REALLY be stranded
> >
> > thanks again
> >
> > namaste,
> > lilith
> >
> > > Focalin IR is cerainly rougher as it wears off. The Focalin XR, which I take, has a sharper feeling than Concerta - clearer and crisper. I take my second dose justafter the second peak of dose1. I should really use a shorter acting med in teh afternoons (for the sake of my sleep habits)
> > >
> > > When it wear s off there is no unpleasant feeling, just sleepiness.
> >
> >
>
>
poster:liliths
thread:680492
URL: http://www.dr-bob.org/babble/20060909/msgs/684418.html