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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Haley on March 11, 2002, at 14:01:39
I am taking Effexor XR 300 mgs. a day. This makes me very sleepy during the day, so last week my doc put me on concerta for energy. I started out on 36mgs. did not work, then I went up to 54 mgs. over the weekend. My first day taking the 54mgs, I did not feel any different. I took it at 9:30 a.m. felt nothing until around 3:00 that afternoon. Felt good, and kinda anxious, and very anxious that evening. Today is my second day. I felt it about 2 hours after I took the pill. I feel awake and kinda good off and on. Anxious off and on also. I want to know if anyone else has this side effect with concerta, if it passes, and what the outcome is. Is concerta a good medicine?? Thanks!
Posted by rxcuriousity on March 11, 2002, at 17:59:21
In reply to CONCERTA, posted by Haley on March 11, 2002, at 14:01:39
I also take 300mg of Effexor XR daily, and have experienced the lethargy you describe. I have tried Wellbutrin, Provigil, and most recently Ritalin IR (Ritalin and Concerta are both methylphenidate; Concerta employs a delivery that allows for once daily dosing). I am most happy with Ritalin. I take 5mg 3X/day. I'm equally interested in Ritalin's ability to augment the antidepressant qualities of Effexor as well as its ability to counteract the Effexor's sedative qualities. My mood has definitely immproved. The Ritalin has also successfully counteracts Effexor's sedative effect, in addition to many other side effects I had experienced from Effexor (loss of libido, carbohydrate cravings, constipation, etc.).
Like you, I have experienced some anxiety under Ritalin's influence. I haven't been able to establish any kind of correlation between the time I take the Ritalin and when I experience the anxiety. I also haven't yet correlated my experience of anxiety under the influence of Ritalin with my variable caffeine intake. This will require further investigation.
I have used .25mg - .5mg of Xanax to extinguish the anxiety, on an as needed basis. Does anyone see anything "wrong" with my using a small dose of a benziodiazepine, on an as needed basis, while taking Ritalin?
Posted by fachad on March 11, 2002, at 18:55:26
In reply to CONCERTA, posted by Haley on March 11, 2002, at 14:01:39
I just wrote an explanation of why you don't "feel" Concerta like you do Ritalin to answer someone else's question. Here it is:
http://www.dr-bob.org/babble/20020307/msgs/97508.html
I think Concerta is an excellent sustained release formulation of mehtylphenedate.
> I am taking Effexor XR 300 mgs. a day. This makes me very sleepy during the day, so last week my doc put me on concerta for energy. I started out on 36mgs. did not work, then I went up to 54 mgs. over the weekend. My first day taking the 54mgs, I did not feel any different. I took it at 9:30 a.m. felt nothing until around 3:00 that afternoon. Felt good, and kinda anxious, and very anxious that evening. Today is my second day. I felt it about 2 hours after I took the pill. I feel awake and kinda good off and on. Anxious off and on also. I want to know if anyone else has this side effect with concerta, if it passes, and what the outcome is. Is concerta a good medicine?? Thanks!
Posted by Bekka H. on March 12, 2002, at 0:26:10
In reply to CONCERTA, posted by Haley on March 11, 2002, at 14:01:39
Hi Haley. I think Concerta is the best of the methylphenidate formulations. It is the most sustained and consistent form I've found. I have terrible rebound and "ups and downs" on Ritalin immediate release. I've never tried the Ritalin SR, but I have tried Metadate CD. That seems to peak earlier in the day than Concerta, so that might be good for people who have difficulty getting going in the morning, but for me, the Metadate CD didn't last long enough. Concerta takes longer to peak, but it lasts about 10-12 hours and is the smoothest of all of them.
The main problem I've had with Concerta is that 36mg doesn't feel like enough, and 54mg feels like too much, and there's no way to cut the pills.
Posted by Hattree on March 13, 2002, at 8:38:26
In reply to Re: CONCERTA, posted by Bekka H. on March 12, 2002, at 0:26:10
Bekka, How does Concerta compare w/ Dex?
> Hi Haley. I think Concerta is the best of the methylphenidate formulations. It is the most sustained and consistent form I've found. I have terrible rebound and "ups and downs" on Ritalin immediate release. I've never tried the Ritalin SR, but I have tried Metadate CD. That seems to peak earlier in the day than Concerta, so that might be good for people who have difficulty getting going in the morning, but for me, the Metadate CD didn't last long enough. Concerta takes longer to peak, but it lasts about 10-12 hours and is the smoothest of all of them.
>
> The main problem I've had with Concerta is that 36mg doesn't feel like enough, and 54mg feels like too much, and there's no way to cut the pills.
Posted by fachad on March 13, 2002, at 10:02:11
In reply to Re: CONCERTA » Bekka H., posted by Hattree on March 13, 2002, at 8:38:26
It would only be a fair apples-to-apples comparison if you were to compare Concerta to Dex Spansules, because they are both extended release forms.
As far as to how methylphenedate compares to dex, that is very subjective and will vary from person to person.
You can search PSB for lots of peoples opinions on the Dex vs. Ritalin vs. Adderall comparisons.
> Bekka, How does Concerta compare w/ Dex?
>
> > Hi Haley. I think Concerta is the best of the methylphenidate formulations. It is the most sustained and consistent form I've found. I have terrible rebound and "ups and downs" on Ritalin immediate release. I've never tried the Ritalin SR, but I have tried Metadate CD. That seems to peak earlier in the day than Concerta, so that might be good for people who have difficulty getting going in the morning, but for me, the Metadate CD didn't last long enough. Concerta takes longer to peak, but it lasts about 10-12 hours and is the smoothest of all of them.
> >
> > The main problem I've had with Concerta is that 36mg doesn't feel like enough, and 54mg feels like too much, and there's no way to cut the pills.
Posted by Bekka H. on March 13, 2002, at 19:38:16
In reply to Re: CONCERTA » Bekka H., posted by Hattree on March 13, 2002, at 8:38:26
Hi Hattree.
I think Dex is much better for my mood. I wish they'd make Dexedrine with the same technology they use for the Concerta capsule. I do have to switch around every few months, though, in order to avoid tolerance. I mean, I have to go off of Dex for a few weeks (or even a few months) in order to keep the dose as low as possible. More Dex doesn't help anyway. I just get tired if I go above 20 mg. The main difficulty I find with switching stims is that when I get off Dex to take Ritalin or Concerta, it takes one to two weeks before I can really feel what the Ritalin/Concerta is doing on its own. The first week or so off of Dex is like a withdrawal period of sorts, and I feel pretty dull, so I'm tempted to think that the Ritalin or Concerta just isn't doing ANYTHING. The longer I stay off of Dex, the easier it is to get benefits from Ritalin, but basically I like Dex better. It was the first stim I ever took, so maybe if I'd taken Ritalin first, I would have liked that better.
Posted by fachad on March 13, 2002, at 20:35:22
In reply to Re: CONCERTA, posted by Bekka H. on March 13, 2002, at 19:38:16
Bekka,
Have you tried the Controlled Release Dexadrine "Spansules"?
I've been taking regular Dex for two months now, but next visit to the pdoc I'm going to ask for the Spansules.
> Hi Hattree.
>
> I think Dex is much better for my mood. I wish they'd make Dexedrine with the same technology they use for the Concerta capsule. I do have to switch around every few months, though, in order to avoid tolerance. I mean, I have to go off of Dex for a few weeks (or even a few months) in order to keep the dose as low as possible. More Dex doesn't help anyway. I just get tired if I go above 20 mg. The main difficulty I find with switching stims is that when I get off Dex to take Ritalin or Concerta, it takes one to two weeks before I can really feel what the Ritalin/Concerta is doing on its own. The first week or so off of Dex is like a withdrawal period of sorts, and I feel pretty dull, so I'm tempted to think that the Ritalin or Concerta just isn't doing ANYTHING. The longer I stay off of Dex, the easier it is to get benefits from Ritalin, but basically I like Dex better. It was the first stim I ever took, so maybe if I'd taken Ritalin first, I would have liked that better.
Posted by Bekka H. on March 13, 2002, at 23:44:37
In reply to Re: CONCERTA » Bekka H., posted by fachad on March 13, 2002, at 20:35:22
> Bekka,
>
> Have you tried the Controlled Release Dexadrine "Spansules"?
>
> I've been taking regular Dex for two months now, but next visit to the pdoc I'm going to ask for the Spansules.
>
************************************************Hi. Yes, I have taken the Dexedrine Spansules. They are OK, but I seem to do better on the immediate release tablets. I WISH I could do better on the Spansules. That would be so much more convenient. I really dislike taking my meds with me when I leave the house. You might do well on the Spansules; you just have to try them and see. I might try them again soon since I have some left over. I think the release system of Concerta is much better than the Dexedrine Spansules, though. I wonder if Smith Kline is working on a time release Dexedrine formulation like Concerta?
Posted by Hattree on March 14, 2002, at 8:30:02
In reply to Re: CONCERTA, posted by Bekka H. on March 13, 2002, at 19:38:16
Hi Bekka.
Hm. I tend to rotate my stimulants every few days, not months. I totally agree that Dex is a better mood drug than Ritalin, so I'd probably agree about Concerta, too. Have you tried timed-release Phentermine?
Posted by Haley on March 14, 2002, at 9:20:49
In reply to Re: CONCERTA » Bekka H., posted by Hattree on March 14, 2002, at 8:30:02
Do you think the lower dose of concerta you are on, the better it works? I started out on 36 mgs.took that for 3 days, nothing happened, just a little irritable, then went up to 56 mgs. Today is my 5th day on 56 mgs. Makes me kind of Anxious, and not too much awake. Should I try going back down?? I did this with Provigil, and that worked.
Posted by Bekka H. on March 14, 2002, at 20:29:42
In reply to Re: CONCERTA » Bekka H., posted by Hattree on March 14, 2002, at 8:30:02
Have you tried timed-release Phentermine?
**********************************************
Hi Hattree,
No, I haven't tried Phentermine, but I've heard about it being used for ADD/ADHD because it's not as restricted a drug as the other stimulants. It's supposed to be quite effective. Why do you like it? Do you like it because it's better for mood, or does it have fewer side effects? What other stim is it most like?
Bekka
Posted by Hattree on March 15, 2002, at 14:45:11
In reply to Re: CONCERTA, posted by Bekka H. on March 14, 2002, at 20:29:42
<Why do you like it? Do you like it because it's better for mood, or does it have fewer side effects? What other stim is it most like?>
More like Dex than Ritalin or Adderall in terms of mood. Also, I notice little difference between the 60 mg timed-release and the 30 mg immediate release (is that the term?), other than duration (whereas I find the spansules less helpful than regular dex.) This is useful, since I tend to get anxious if I take a second dose in a day.
Posted by helenbpd on March 16, 2002, at 2:08:31
In reply to Re: CONCERTA » Bekka H., posted by Hattree on March 15, 2002, at 14:48:03
Could either of you comment on the diff between adderall and dex, if you've tried them both (if you're taking it for ADD)?
I *hated* concerta, even at 18mg it knocked me flat all day. Now I'm taking 20mg AdderallXR, which has more of an antidep effect (I love it) than anything I've tried, but I haven't tried dex.
The thing is, I'm definitely experiencing sleeplessness/lack of appetite on the 20mg adderallXR, but it's the smallest XR dose, and I am terrible at remembering the shorter-term adderall (plus, I swear the XR works better, but it's probably psychosomatic) (heh). Perhaps I should look into Dex?Thanks for any info,
Helen
Posted by Hattree on March 16, 2002, at 16:10:45
In reply to Re: CONCERTA » Hattree, posted by helenbpd on March 16, 2002, at 2:08:31
Both dex and adderall are helpful for focusing on work but unlikely to keep me from losing my keys. I tend to be in a better mood on dex. Have tried only the short-acting Adderall, though.The appetite supression tends to pass (unfortunately for me) but I've never found a way around the sleeplessness, other than sleeping pills or letting the dose wear off early and being exhausted in the evening (not a great mom condition).
Its probably not psychosomatic that the XR works better. Can you take a sleeping pill without being wiped the next day?
Posted by BLPBart on March 16, 2002, at 21:00:08
In reply to Re: CONCERTA, posted by Hattree on March 16, 2002, at 16:10:45
My doctor explained that dexedrine is simply dextroamphetamine. Adderall is a mixture of that and three other amphetamine type drugs. It's different from ritaline and concerta. I started on a low dose of dex and when it didn't seem to be working my doc switched me to concerta. I didn't like it-it seemed to make me edgy but didn't seem to help with the ADD. Then when I upped the dosage I got pretty irritable. I decided to give the dexedrine another shot and tried a higher dosage the last couple of days and I think it may be starting to work. I go back to see my doctor on Tuesday and was thinking of asking him about Adderall.
Posted by helenbpd on March 16, 2002, at 21:53:27
In reply to Re: CONCERTA, posted by BLPBart on March 16, 2002, at 21:00:08
Thanks you guys!
For me, the Adderall XR is smooooooth like buttah -- vastly preferable to the short-term pills. Ritalin made me sleepy, ditto concerta, but those are all I've tried. I also take some Zoloft (small amount) along with it, so if the Adderall has an edgy quality to it, I can't tell. Actually though I'm considering going off the Zoloft altogether (slowly, of course) since I go a few days without it and feel only the headache, but if I go without the Adderall I can really tell an increase in depression/agitation.
Keep me posted...
Helen
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