![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 50. This is the beginning of the thread.
Posted by liliths on August 27, 2006, at 9:55:23
hi all,
I recently had to change my health insurance and now must deal with "switching" drugs.
I just received a letter that said that due to the generic equivalent of methylphenedate hcl (yeah right!), they're dropping Concerta from their formulary!!
I've been on 108mg concerta daily (2-54mg) for the past few years with no problems but haven't a clue how that will relate to the methyphenedate hcl
my pdoc had said the ritalin equivalent would be 100mg daily but I'm not sure if methyphenedate hcl is an extended release like Concerta. Will I have to take it twice a day? Will I 'crash' like I used to on Ritalin?
Is he correct in 108mg Concerta = 100mg methylphedate hcl??
I believe my insurance only covers 60mg and I have to pay the rest out of pocket - I know their cap on Concerta was 72mg but as I JUST switched, I haven't even had a chance to fill a script.
I also now must have my primary care physician, who IS on this plan, re-write the presciptions from my pdoc, who is not. This is the first time I've had to do this and the doctors are being really good about it but I know it stresses my primary. It's important I know exactly what I need.
And I also need to know what I'm in for.. something I KNOW I can only get help from here :)
I'm going to call my pdoc monday (tomorrow) morning as I must refill the meds immediatedly but I really am hoping for some input from all of you out there.
sorry for the rambling... this entire ordeal of changing insurance has been very stressful and this latest turn is by far the scariest!
Thank you for ANY & ALL help! :)
namaste,
lilith
Posted by psychobot5000 on August 27, 2006, at 13:15:57
In reply to PLEASE HELP! concerta dosage conversion?, posted by liliths on August 27, 2006, at 9:55:23
Methylphenidate Hcl and Concerta have a 1:1 equivalence, so you would want the same number of miligrams per day (100, or 108). It's all the same substance--all methylphenidate--but Concerta has a much longer, smoother release mechanism. Methylphenidate Hcl is just generic Ritalin, and all gets pushed into the bloodstream in an hour or so.
So yes, 'crashing' may be a problem on the methylphenidate. But if you're willing to stagger the doses, and take them, say, three (or even just two) times a day, you should be able to get around that.
Hope it all works out for you,
Pbot
Posted by liliths on August 27, 2006, at 13:33:12
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by psychobot5000 on August 27, 2006, at 13:15:57
Thank you so much for your help.
So it isn't even a time release version? It amazes me that insurance companies can get away with considering generic Ritalin as even remotely the same as Concerta.
thanks again for replying so quickly :)
namaste,
lilith> Methylphenidate Hcl and Concerta have a 1:1 equivalence, so you would want the same number of miligrams per day (100, or 108). It's all the same substance--all methylphenidate--but Concerta has a much longer, smoother release mechanism. Methylphenidate Hcl is just generic Ritalin, and all gets pushed into the bloodstream in an hour or so.
>
> So yes, 'crashing' may be a problem on the methylphenidate. But if you're willing to stagger the doses, and take them, say, three (or even just two) times a day, you should be able to get around that.
>
> Hope it all works out for you,
> Pbot
Posted by momofdnd on August 29, 2006, at 10:43:04
In reply to PLEASE HELP! concerta dosage conversion?, posted by liliths on August 27, 2006, at 9:55:23
I have taken both and I prefer the Methylphidate. You wouldn't want to take 100mg of it at once though. Wow!!! you would be flying. The other good thing about it is that it is a lot cheaper!!!!
I was taking 72 mg concerta and 10 mg. of methylphidate daily. I would choose the methylphidate any day....
Posted by liliths on August 29, 2006, at 11:39:42
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by momofdnd on August 29, 2006, at 10:43:04
thank you so much for your reply.
I tried Ritalin before changing to Concerta. I actually didn't think it was working at first - took a couple of days but I experience no 'up and down' on it, which I definitely did with the Ritalin. It's much more gradual.
I'm glad you found something you like! I'm curious though how you managed to switch from 72mg to only 10mg. Are you taking standard Ritalin? How long did you try the Concerta?
and yes, I could hardly have taken 100mg at once! LOL
That was one of the reasons I hated the thought of switching. In addition to the 'crash', I dreaded having to figure out and doing a multiple dosing schedule.but I just had the strangest experience at the drugstore... I went to fill the 'generic' and it turns out that Concerta is listed as having a generic Methylphenidate and the subscription information was the same... meaning they gave me 2-54mg tablets and oddly enough, look enough like Concerta for me to think the pharmacy and my health insurance provider is crazy!
I only hope the refills continue like this and it works the same (if it even IS, in fact, a generic version :) as I really wasn't looking forward to switching to something so different. I guess I'll see over the next couple of days if I feel any difference and find out next month when I fill yet another prescription if it's the same :)
thanks again for your help.
namaste,
lilith> I have taken both and I prefer the Methylphidate. You wouldn't want to take 100mg of it at once though. Wow!!! you would be flying. The other good thing about it is that it is a lot cheaper!!!!
> I was taking 72 mg concerta and 10 mg. of methylphidate daily. I would choose the methylphidate any day....
Posted by momofdnd on August 29, 2006, at 12:12:29
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by momofdnd on August 29, 2006, at 10:43:04
I didn't switch from concerta to methylphidate. I take the concerta in the a.m. and methylphidate in the p.m.
I did just go to the doctor yesterday and she took me off of the concerta and put me on 20 mg of focilin. WOW I am feeling "geeky" today. I am sure after a few days I will feel better. She said the difference between concerta and focilin is that all the feeler junk is left out and it is not time released but time extended...the focilin hits you like a brick wall and continues at the same pace for twelve hours. Plus I am still taking the methylphidate in the late afternoon.
Posted by liliths on August 29, 2006, at 13:13:20
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by momofdnd on August 29, 2006, at 12:12:29
ahhh.... now I get it LOL
I just did a search for focilin & it sounds interesting - and strong! It's referred to as "refined Ritalin"
I assume (dangerous I know :) if you're only taking it once, you're probably taking the extended version, as they recommend multiple doses on the standard. Maybe you'll even be able to stop your late afternoon dose of ritalin
I certainly hope it helps :) Please keep me posted on your progress with it.
good luck!
namaste,
lilith
> I didn't switch from concerta to methylphidate. I take the concerta in the a.m. and methylphidate in the p.m.
>
> I did just go to the doctor yesterday and she took me off of the concerta and put me on 20 mg of focilin. WOW I am feeling "geeky" today. I am sure after a few days I will feel better. She said the difference between concerta and focilin is that all the feeler junk is left out and it is not time released but time extended...the focilin hits you like a brick wall and continues at the same pace for twelve hours. Plus I am still taking the methylphidate in the late afternoon.
Posted by alohashirt on September 2, 2006, at 14:30:13
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by liliths on August 29, 2006, at 13:13:20
Two points -
1. focalin xr is similar but better than concerta see old posts here. 55mg focalin xr = 108mg Concerta
2. To get insurance to pay correct amount you may need to appeal with a letter from your pdoc. the insurance coimpany should pay.> ahhh.... now I get it LOL
>
> I just did a search for focilin & it sounds interesting - and strong! It's referred to as "refined Ritalin"
>
> I assume (dangerous I know :) if you're only taking it once, you're probably taking the extended version, as they recommend multiple doses on the standard. Maybe you'll even be able to stop your late afternoon dose of ritalin
>
> I certainly hope it helps :) Please keep me posted on your progress with it.
>
> good luck!
> namaste,
> lilith
>
>
> > I didn't switch from concerta to methylphidate. I take the concerta in the a.m. and methylphidate in the p.m.
> >
> > I did just go to the doctor yesterday and she took me off of the concerta and put me on 20 mg of focilin. WOW I am feeling "geeky" today. I am sure after a few days I will feel better. She said the difference between concerta and focilin is that all the feeler junk is left out and it is not time released but time extended...the focilin hits you like a brick wall and continues at the same pace for twelve hours. Plus I am still taking the methylphidate in the late afternoon.
>
>
Posted by liliths on September 2, 2006, at 14:47:47
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by alohashirt on September 2, 2006, at 14:30:13
thank you so much for the info and I'll check out previous posts as recommended... I'm curious to know what's better about it
I see my pdoc in a few weeks and will to ask about it. Looks like my insurance may cover it, but at a 'premium' rate and I'll also need to find out what their 'cap' is since they supposedly top out concerta at 72mg and ritalin at 60mg (I'll know that for certain when I receive my next statement since it went through the pharmacy ok... insurance companies drive me crazy (crazier? :)
thanks again for your help
namaste,
lilith> Two points -
> 1. focalin xr is similar but better than concerta see old posts here. 55mg focalin xr = 108mg Concerta
> 2. To get insurance to pay correct amount you may need to appeal with a letter from your pdoc. the insurance coimpany should pay.
>
>
>
> > ahhh.... now I get it LOL
> >
> > I just did a search for focilin & it sounds interesting - and strong! It's referred to as "refined Ritalin"
> >
> > I assume (dangerous I know :) if you're only taking it once, you're probably taking the extended version, as they recommend multiple doses on the standard. Maybe you'll even be able to stop your late afternoon dose of ritalin
> >
> > I certainly hope it helps :) Please keep me posted on your progress with it.
> >
> > good luck!
> > namaste,
> > lilith
> >
> >
> > > I didn't switch from concerta to methylphidate. I take the concerta in the a.m. and methylphidate in the p.m.
> > >
> > > I did just go to the doctor yesterday and she took me off of the concerta and put me on 20 mg of focilin. WOW I am feeling "geeky" today. I am sure after a few days I will feel better. She said the difference between concerta and focilin is that all the feeler junk is left out and it is not time released but time extended...the focilin hits you like a brick wall and continues at the same pace for twelve hours. Plus I am still taking the methylphidate in the late afternoon.
> >
> >
>
>
Posted by liliths on September 2, 2006, at 15:43:59
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by alohashirt on September 2, 2006, at 14:30:13
hi again.. I just looked at some of the threads on focalin and I was surprised to read that it took you 2-4 hours to feel the Concerta. Granted, it doesn't 'kick' like Ritalin and it took a few days when I first began to take it to realize it even was working... just a lot more smoothly.
and that's what I like about it... no 'kick' meant no 'crash', at least for me
You mentioned that because of the front loading, you felt it was rougher.... and since you're having to take it twice a day, it doesn't sound like it's holding the 10-12 hours it's supposed to.
So you get your bang in the morning? Do you feel like you're crashing as it wears off or do you take your 2nd dose before that happens? And then how do you feel at the end of the day when it does wear off?sorry to ask so many questions. If I have to lose my Concerta to a 'generic version' which won't work at all like the original, I need to consider every alternative I can.
I really did hate that up and down (well, the down part mostly - can't say I mind the 'brightening' :)
thanks for your consideration
namaste,
lilith> Two points -
> 1. focalin xr is similar but better than concerta see old posts here. 55mg focalin xr = 108mg Concerta
> 2. To get insurance to pay correct amount you may need to appeal with a letter from your pdoc. the insurance coimpany should pay.
>
>
>
> > ahhh.... now I get it LOL
> >
> > I just did a search for focilin & it sounds interesting - and strong! It's referred to as "refined Ritalin"
> >
> > I assume (dangerous I know :) if you're only taking it once, you're probably taking the extended version, as they recommend multiple doses on the standard. Maybe you'll even be able to stop your late afternoon dose of ritalin
> >
> > I certainly hope it helps :) Please keep me posted on your progress with it.
> >
> > good luck!
> > namaste,
> > lilith
> >
> >
> > > I didn't switch from concerta to methylphidate. I take the concerta in the a.m. and methylphidate in the p.m.
> > >
> > > I did just go to the doctor yesterday and she took me off of the concerta and put me on 20 mg of focilin. WOW I am feeling "geeky" today. I am sure after a few days I will feel better. She said the difference between concerta and focilin is that all the feeler junk is left out and it is not time released but time extended...the focilin hits you like a brick wall and continues at the same pace for twelve hours. Plus I am still taking the methylphidate in the late afternoon.
> >
> >
>
>
Posted by momofdnd on September 5, 2006, at 7:52:10
In reply to Re: PLEASE HELP! concerta dosage conversion? » alohashirt, posted by liliths on September 2, 2006, at 14:47:47
As my Doctor explained it to me. Focalin is pretty much the same as concerta except they cut out all the filler ingredients that don't serve any purpose. Unlike concerta, Focalin is a time extended, not a time released. When you first take it, it comes on with a "punch" and continues with the same strength for 12 hours. This is how my Doctor explained it to me and she was totally correct in her explaination. I have felt better in the past week then I have felt in a long time. I enjoy my job, I am communicating well, my house is clean, just to mention a few of my accomplishments in only one week. Normally the Dr. will start you out with a small dosage then work up a week intervals. My Doctor choose to just jump my to the full dosage right off the bat and wow...what a difference it has made.
If I were you I would ask your Doctor. This is a new drug out so that why you probably haven't heard much about it. All I can say about it is "God bless the scientist that made it and my Doctor for prescribing it to me." For me, it is a miracle drug. You see, I was addicted to crank for many years and have been off of it for 18 months. For the first time in 18 months I feel that there is hope that I will be able to function again...
If you Doctor decides to let you try it, it him/her up for a coupon. They should have free coupons for the first month. My Doctor gave me one. Good luck.> thank you so much for the info and I'll check out previous posts as recommended... I'm curious to know what's better about it
>
> I see my pdoc in a few weeks and will to ask about it. Looks like my insurance may cover it, but at a 'premium' rate and I'll also need to find out what their 'cap' is since they supposedly top out concerta at 72mg and ritalin at 60mg (I'll know that for certain when I receive my next statement since it went through the pharmacy ok... insurance companies drive me crazy (crazier? :)
>
> thanks again for your help
> namaste,
> lilith
>
> > Two points -
> > 1. focalin xr is similar but better than concerta see old posts here. 55mg focalin xr = 108mg Concerta
> > 2. To get insurance to pay correct amount you may need to appeal with a letter from your pdoc. the insurance coimpany should pay.
> >
> >
> >
> > > ahhh.... now I get it LOL
> > >
> > > I just did a search for focilin & it sounds interesting - and strong! It's referred to as "refined Ritalin"
> > >
> > > I assume (dangerous I know :) if you're only taking it once, you're probably taking the extended version, as they recommend multiple doses on the standard. Maybe you'll even be able to stop your late afternoon dose of ritalin
> > >
> > > I certainly hope it helps :) Please keep me posted on your progress with it.
> > >
> > > good luck!
> > > namaste,
> > > lilith
> > >
> > >
> > > > I didn't switch from concerta to methylphidate. I take the concerta in the a.m. and methylphidate in the p.m.
> > > >
> > > > I did just go to the doctor yesterday and she took me off of the concerta and put me on 20 mg of focilin. WOW I am feeling "geeky" today. I am sure after a few days I will feel better. She said the difference between concerta and focilin is that all the feeler junk is left out and it is not time released but time extended...the focilin hits you like a brick wall and continues at the same pace for twelve hours. Plus I am still taking the methylphidate in the late afternoon.
> > >
> > >
> >
> >
>
>
Posted by momofdnd on September 5, 2006, at 8:04:17
In reply to Re: PLEASE HELP! concerta dosage conversion? » alohashirt, posted by liliths on September 2, 2006, at 15:43:59
I take one focalin around 6:00am and within an hour I am feeling fully functional. I am taking the extended release which last 12 hours and I feel great. Around 4:30pm, I take 10 mg of methaphidate to get me through the evening. I don't experience any "crash" (and I know what you mean by "crash"). I wake up in the morning feeling great.
I don't know if I mentioned this but I also take 75 mg. of effexor (anti-depressant) in the morning as well. I don't know how this contributes to the big picture either. I was taking this before I started taking the focalin so I know it doesn't play a huge role in the success I have had since I started taking the focalin.
Posted by liliths on September 5, 2006, at 11:15:52
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by momofdnd on September 5, 2006, at 8:04:17
thank you SO much for both of your replies... you have so idea how much you are appreciated!!
Ever since I wrote this email, I've been all too acutely aware of just how lousy I feel.... ALL the time! I'm obviously in need of a change. Fortunately, I have an appointment with my pdoc for friday :)
Like you I'm also on anti-dperessants, though my cocktail is a bit more convoluted. I tried effexor a few times and though it seemed to help the depression, between the anorgasmia (though it doesn't do that to everyone, it certainly did me), and my EXTREME fear about its potential for weight gain, I was terrified of the damn drug!!
does your health insurance cover both your focalin and the methyphenidate?
Thank you again & again.
I needed something to hope for today.As much as I hate being on meds (and truly fear what I've done to my brain chemistry from so many years on them), I don't know whether I have an alternative. So if a drug will help me function, then I will gratefully take it!
I'll definitely keep you posted on what happens, if you like :)namaste,
lilith
> I take one focalin around 6:00am and within an hour I am feeling fully functional. I am taking the extended release which last 12 hours and I feel great. Around 4:30pm, I take 10 mg of methaphidate to get me through the evening. I don't experience any "crash" (and I know what you mean by "crash"). I wake up in the morning feeling great.
> I don't know if I mentioned this but I also take 75 mg. of effexor (anti-depressant) in the morning as well. I don't know how this contributes to the big picture either. I was taking this before I started taking the focalin so I know it doesn't play a huge role in the success I have had since I started taking the focalin.
Posted by momofdnd on September 5, 2006, at 11:40:22
In reply to Re: PLEASE HELP! concerta dosage conversion? » momofdnd, posted by liliths on September 5, 2006, at 11:15:52
My health insurance covers both of them although it still costs more for the focalin. I pay 8.50 a month for the methalphidate and 45.00 a month for the focalin but it is definatly money well spent and it beats the "heck" out of the $1000 plus I was spending on meth in the past...
I just can't get over how well this medication is effecting me. It is a dream come true. My only fear is that my body will build up an ammunity to it. Hopefully not.
As far as a problem with anorgasmia (which I didn't even no what that meant till you mentioned it and I looked it up). I have had a problem with it since I quit doing meth. The same time I quit, I was also pregnant so I kind of blamed it on being pregnant. But now it has been 10 months since I had my baby and I continue to have problems with it. But believe it or not, after taking focalin for just a week, last weekend my husband and I had a sexual experience just like it used to be when I was on meth....WOW!!! As for gaining wait on effexor. I have noticed that I have gained weight which bugs me but once again, in the past week I have been more energetic then I have been in months and already I can feel my jeans getting loser. LAstly, just like you said, I felt that because of my excessive drug use in the past, I am also afraid I have permanant damage...
I hope that all goes well for you at your Doctors appt. and if he does put you on the same medicine that you will have the same results I have had. I am the person I used to be but I am no longer haunted with the thought of taking meth. Just remember, like I said before, normally Drs. start you out on a low dose and work up so if that's the case you may not see the same results I have in one week, it may take a few. My doctor knows that I did meth for years and she knows all the other medicines that I have built up an ammunity to so she decided just to through me on the full strength immediately. Yes I felt geeky the first day but beyond that it has been a dream come true.
Please keep me posted. I will be praying for you!
Posted by alohashirt on September 7, 2006, at 0:35:33
In reply to Re: PLEASE HELP! concerta dosage conversion? » alohashirt, posted by liliths on September 2, 2006, at 15:43:59
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.
Posted by liliths on September 7, 2006, at 6:52:01
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by alohashirt on September 7, 2006, at 0:35:33
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.
Posted by momofdnd on September 7, 2006, at 7:25:35
In reply to Re: PLEASE HELP! concerta dosage conversion? » alohashirt, posted by liliths on September 7, 2006, at 6:52:01
Hi again lilith,
I get that same feeling about pushing my Doctor and being afraid how she will react. I am always afraid that she will think I am just trying to get more drugs. Honestly,I think that this is all in ours heads, I don't think any Doctor is just going to leave you hanging as long as we are honest with them...
also, wanted to let you know that I found a site on the internet where you can print off a coupon for a free 30 day trial of focalin. I can't remember the address but I am sure if you do a search for focalin 30 day trial you should find it. If you can't find it, let me know and I will look it up and send it to you.
Good luck at your appointment tomorrow, have faith and everything will work out.
Momofdnd
Posted by liliths on September 7, 2006, at 8:35:45
In reply to Re: PLEASE HELP! concerta dosage conversion?, posted by momofdnd on September 7, 2006, at 7:25:35
THANK YOU SO MUCH!!!
I found the site and printed out a voucher!the problem with my doctor is that she is having to re-write my "nut" med prescriptions as my pdoc isn't on my health insurance. This new (but affordable!) insurance comes with a lot of restrictions, but it's better than nothing. I couldn't afford to even take meds if I had to pay for them myself. I did have to switch from generic klonopin to generic valium as they don't cover benzos and I have to pay for them out-of-pocket. I'm starting to worry though that the diazepam is exacerbating my depression as I've really been doing poorly.
Days go by that I simply can't leave the house and when I do get out, I don't get much done - just what I HAD to and then I just come running home. It used to be that if I could get myself out of the house, I'd be able to stay out and get more things done which help - like working out!!!!!
But now I seem to be in that awful "frozen" place of depression, which drives me mad, as I 'know' that movement of ANY kind will help, yet feel totally incapable (unwilling) to do anything. Chores/plans/life just keep piling up as I dread the advent of every day. I don't think it's just the switch to diazepam. I'm just depressed. But the diazepam might be making it worse. The concerta used to at least help focus and motivate me but my depression feels stronger than my ADHD, not that I think one can 'separate' those things - obviously much more complicated and intertwinedI'm hoping the free trial will cover at least 40-50mg per day as I currently take 108mg concerta. If it works like it sounds, I could possibly just take 1-20mg in the morning and maybe another one at noon or 40mg at once? Hopefully that would be enough.
I haven't a clue :)I can't thank you enough for the free trial info. If my pdoc will write the script on friday, I can go ahead and fill it without bothering my primary!
I'll keep you posted! you're wonderful for thinking of me :)
Sometimes I'm so grateful for this place and the people on it... considering how the media makes depression look so damn easy to treat, we're lucky there's a place we can gather to compare notes. I used to think it was just me but I've been coming to this board for so many years now, I am simply amazed how many of us there are and how little our needs are really addressed. Wish there was some way of making this farce more public.LOL obviously I'm capable of rambling on and on :) oh well, at least I'm still able to laugh at the ridiculousness of being me
namaste,
lilith> Hi again lilith,
> I get that same feeling about pushing my Doctor and being afraid how she will react. I am always afraid that she will think I am just trying to get more drugs. Honestly,I think that this is all in ours heads, I don't think any Doctor is just going to leave you hanging as long as we are honest with them...
> also, wanted to let you know that I found a site on the internet where you can print off a coupon for a free 30 day trial of focalin. I can't remember the address but I am sure if you do a search for focalin 30 day trial you should find it. If you can't find it, let me know and I will look it up and send it to you.
> Good luck at your appointment tomorrow, have faith and everything will work out.
> Momofdnd
>
Posted by momofdnd on September 7, 2006, at 8:59:28
In reply to Re: PLEASE HELP! concerta dosage conversion? » momofdnd, posted by liliths on September 7, 2006, at 8:35:45
I am sure that you already have, but make sure that you tell your doctor the same stuff you are telling me. from what you are telling me, you are really depressed. After I had my last baby, at the age of 40, I was very depressed. Same symptons like you are discribing. Things I really enjoyed doing I no longer did if it meant I had to go into public. When I would go see my Doctor I would give her actual examples of experiences I was having and the way I felt. Sometimes it seemed awkward talking to her about it because I felt like she wasn't going to believe me or she would think that I had different motives...
It sounds to me like your med for depression isn't working at all...! Sounds like it is doing more damage then good.
Once again, good luck tomorrow. Keep in mind that you are just as important as everyone one else God put in this world, he loves us all the same, don't ever think or feel differently.
Let me know how your appt. goes. I will only have access to the internet till noon on Friday so I will check with you on Monday to see how you are getting along.
I will be praying for you... : )
Posted by alohashirt on September 9, 2006, at 0:18:43
In reply to Re: PLEASE HELP! concerta dosage conversion? » alohashirt, posted by liliths on September 7, 2006, at 6:52:01
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.
>
>
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.
> >
> >
>
>
Posted by liliths on September 10, 2006, at 14:04:40
In reply to DAY 1 focalin XR !, posted by liliths on September 9, 2006, at 7:22:23
just checking in... besides appearing to have a bit of a headache, yesterday went fine.
didn't even notice anything different this morning except that I WAS able to get out... a wonderful thing :)
I did wonder today if perhaps the dose was too low but it's way too early to tell and I can play with the clonazepam or diazepam (whichever I end up - am going to try the diazepam tomorrow and take only 5mg) to see if that makes it any betterI have also been through some real emotional turmoil the past few days and I'm aware that will influence anything I may be taking. Someone reappeared and dissapeared, bringing back memories, wakening slumbering emotions only to then run off again... his issues, not mine... though that doesn't lessen the confusion nor the sadness.
I'm finally admitting my inability to get out in the evening is most likely exacerbated by my adhd drugs wearing off (and that was true for the concerta), so we'll see what tweaking needs to be done so that I may have a social life again LOL
But all in all... I'd say the focalin XR is a definite success!!
I am very pleased and VERY grateful to you both :)your support has been invaluable and momofdnd: Thank you always for that link to the free trial. It allowed me to try it NOW, instead of in 2 weeks!!!
blessings...
namaste,
lilith
Posted by momofdnd on September 14, 2006, at 12:22:41
In reply to DAY 2 focalin XR, posted by liliths on September 10, 2006, at 14:04:40
how's your medication been working out...it has been close to a week. Just wondering...
Posted by liliths on September 14, 2006, at 14:38:56
In reply to Re: DAY 2 focalin XR, posted by momofdnd on September 14, 2006, at 12:22:41
hi there
Thank you so much for inquiring. I've been very happy with the focalin XR!!! Definitely crisper & brighter and I do like that I feel it faster. :)
No crash, like I feared and the 2-20's, though less of a dose (using the 1/2 dosing conversion) than the concerta 2-54's, still seem to work just fine.
I realize, like I mentioned earlier, that coming off of my adhd meds by the end of the day probably contributes to my inertia in the evening so I have considered whether I should take something, like you do, later... but right now, I'm just going to stick with this regimen and see how it goes
as I also said, I've been dealing with tremendous stress as well (bureaucratic as well as emotional), the timing for trying a new drug was really scary and though it can't take away the emotional problems, at least it was able to help me accomplish dealing with the bureaucratic stuff - though I was having meltdowns every day LOL
whew!
I so appreciate your support and help. Getting me that info about the free 30-day supply was a real blessing, as it gave me a 2 week trial immediately! (since they only give you 30 pills and I take 2 a day)
I am eternally grateful to you for that one!! :)
oh yea, I do have 1 question... did it make you feel a bit gassy at first? I don't know if it's from the focalin or something I'm eating but I've had some stomach bloating and gas - I think it's going away or at least I hope it is :)
hope you continue to do well... thank you again and again
namaste,
lilith
Posted by liliths on September 14, 2006, at 14:57:06
In reply to Re: DAY 2 focalin XR, posted by momofdnd on September 14, 2006, at 12:22:41
it's me again... figured I should give you an update on the depression while I'm at it
after the 'honeymoon' period ofthe first few days AND also being emotionally battered (so who really knows what's at work here) I've once again had to deal with the "frozen demon" the past few days... though I will say that when up against the wall, I've at least gotten done what I HAD to... that's good enough or at least, it has to be
and honestly, I don't think they make a pill that can fix that. I think it's being exacerbated by what's going on in my life.... I'm just going to have to do battle with that myself and push back against it
thanks again
namaste,
lilith> how's your medication been working out...it has been close to a week. Just wondering...
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