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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 Raisinb on September 15, 2012, at 23:28:33
After my difficulties with Adderall, the pdoc thought it would be worthwhile to try another stimulant before moving to non stimulant options.
I've been on concerta for two days (18 mg). My question is it supposed to make me feel like I'm on speed? I feel very sped up, heart racing, etc. Will this go away in time as I adjust?
Both stimulants have had a dramatic effect on my organizational skills and task completion. My house is clean, I'm caught up on bills and work, and I even just gave my dog a bath. So I don't want to ditch them without giving them a fair shot.
Does anyone have thoughts/experiences on concerta (which is Ritalin just extended release, in my understanding) vs. Adderall?
Posted by SLS on September 16, 2012, at 0:20:23
In reply to Concerta, posted by Raisinb on September 15, 2012, at 23:28:33
Hi.
Adderall (amphetamine) versus Concerta (methylphenidate)
I'm sure you already know that the two drugs work via different mechanisms. Amphetamines like Adderall are predominantly neurotransmitter releasers while Ritalin and Concerta are neurotransmitter reuptake inhibitors. There is Focalin - another version of methylphenidate that some people find more tolerable (smoother).
I think it is worth for you to extend your trial of Concerta for a few more days in order to see if the "speed" feeling disappears. If you just can't get either of the two types of psychostimulants (amphetamine and methylphenidate) to work for you, I think Strattera (atomoxetine) is worth considering.
I am optimistic for you that you will find one of these drugs to work.
- Scott
Posted by jono_in_adelaide on September 16, 2012, at 1:07:30
In reply to Re: Concerta » Raisinb, posted by SLS on September 16, 2012, at 0:20:23
Agree, I think you need to give it atleast 2 weeks to let your body get used to the drug before you ditch it, unless the side effects are intolorable
Posted by SLS on September 16, 2012, at 8:14:39
In reply to Concerta, posted by Raisinb on September 15, 2012, at 23:28:33
If you do decide to go with Strattera, and find that it is somehow helpful but inadequate, you can research adding guanfacine or memantine. Even Wellbutrin has been used. It might cause you anxiety, though. There are people here who know more than I do about ADHD. I would try Focalin first, though.
I hope the Concerta works out for you. Please post update reports.
- Scott
Posted by Raisinb on September 16, 2012, at 16:34:05
In reply to Re: Concerta » Raisinb, posted by SLS on September 16, 2012, at 8:14:39
Thanks, Scott. I am still sped up today, but I think not as bad as yesterday. I'll post updates.
Posted by phidippus on September 16, 2012, at 22:45:10
In reply to Concerta, posted by Raisinb on September 15, 2012, at 23:28:33
You should not feel like you're on speed. I was very calm when I was on Concerta.
Have you tried Vyvanse?
Eric
Posted by Raisinb on September 17, 2012, at 22:19:28
In reply to Re: Concerta » Raisinb, posted by phidippus on September 16, 2012, at 22:45:10
Hi Eric,
Nope, the ADHD possibility was brought up just recently when I got a new doc. Is vyvanse a stimulant?
Posted by phidippus on September 17, 2012, at 22:29:48
In reply to Re: Concerta, posted by Raisinb on September 17, 2012, at 22:19:28
Vyvanse is long acting formulation of dextroamphetamine. It is a stimulant and FDA approved treatment for ADHD. I recommended it because you might find it a more calm experience than you've had so far.
Eric
Posted by schleprock on September 17, 2012, at 22:33:33
In reply to Concerta, posted by Raisinb on September 15, 2012, at 23:28:33
> After my difficulties with Adderall, the pdoc thought it would be worthwhile to try another stimulant before moving to non stimulant options.
>
> I've been on concerta for two days (18 mg). My question is it supposed to make me feel like I'm on speed? I feel very sped up, heart racing, etc. Will this go away in time as I adjust?
>
> Both stimulants have had a dramatic effect on my organizational skills and task completion. My house is clean, I'm caught up on bills and work, and I even just gave my dog a bath. So I don't want to ditch them without giving them a fair shot.
>
> Does anyone have thoughts/experiences on concerta (which is Ritalin just extended release, in my understanding) vs. Adderall?No, but it has a very catchy name.
Posted by SLS on September 18, 2012, at 0:22:35
In reply to Concerta, posted by Raisinb on September 15, 2012, at 23:28:33
I am confused.
> After my difficulties with Adderall, the pdoc thought it would be worthwhile to try another stimulant before moving to non stimulant options.
What were your difficulties with Adderall?
> I've been on concerta for two days (18 mg). My question is it supposed to make me feel like I'm on speed? I feel very sped up, heart racing, etc. Will this go away in time as I adjust?
I'm not sure. You should ask your doctor this question.
> Both stimulants have had a dramatic effect on my organizational skills and task completion.
Which two stimulants?
Answering these two questions will help people offer feedback. Focalin and Vyvanse are often reported to feel "smoother" than other versions of methylphenidate and amphetamine respectively.
- Scott
Posted by Raisinb on September 19, 2012, at 15:50:25
In reply to Re: Concerta » Raisinb, posted by SLS on September 18, 2012, at 0:22:35
Hi Scott,
I had real trouble tolerating Adderall. I was supposed to start at 10 mg and titrate up to 60, but even 10 mg gave me intense anxiety, freaking out, just feeling like I couldn't stand being in my own skin. I couldn't sit still or listen to people. I was just freaking out.After Adderall, I've been prescribed Concerta 18 mg. I still feel very "sped up" but it's a much more tolerable speedy feeling. Both Adderall and Concerta have, despite their challenges, had a dramatic effect on me paying bills, getting work done, and cleaning the house. Looking back over my life, an ADHD diagnosis would account for many problems I have had, problems I (and my therapists at the time) attributed to depression, trauma, or inner emotional pain. My current therapist doesn't think my poor credit history, procrastination, and inability to get detail-oriented things done is a psychodynamic issue. He thinks it's neurobiological, and after having the response to these meds and actually cleaning out my sink and mailbox every day, I tend to agree. So now it's a matter of finding the right ADHD med that I can tolerate.
Posted by SLS on September 19, 2012, at 19:34:22
In reply to Re: Concerta » SLS, posted by Raisinb on September 19, 2012, at 15:50:25
> So now it's a matter of finding the right ADHD med that I can tolerate.
I think Focalin XR (dexmethylphenidate) should be on your list of things to try. It is a "purified" form of methylphenidate. It contains only one of the two enantiomers (D and L stereo isomers) that make up regular (racemic) methylphenidate. The thinking is that you get the therapeutic effect of the D isomer without the side effects of the L isomer. Some people report that Focalin feels "smoother" than Concerta. It should also produce milder autonomic side effects (sympathetic activation).
- Scott
Posted by Raisinb on September 20, 2012, at 0:06:28
In reply to Re: Concerta » Raisinb, posted by SLS on September 19, 2012, at 19:34:22
Thanks Scott, you are truly a wealth of information. I'm going to give the Concerta a decent trial and then if it doesn't work out ask about the Focalin.
There have been a lot of anxiety provoking situations in my life recently, so I don't want to blame the Cincerta for everything. Once everything settles down, I'll be able to see more clearly how it is affecting me.
One interesting thing about these ADHD meds is they make intense exercise (running, in my case) much easier. I can go more intensely and longer. I like that effect, because I'm sure the intense exercise has to be good for my depression in some way.
Posted by phidippus on September 20, 2012, at 8:51:22
In reply to Re: Concerta » SLS, posted by Raisinb on September 20, 2012, at 0:06:28
Focalin is the dextrorotatory enantiomer of methylphenidate. It is a norepinephrine-dopamine reuptake inhibitor (NDRI) and releasing agent and thus a psychostimulant.
It is not as effective as Methylphenidate.
Eric
Posted by SLS on September 20, 2012, at 9:22:37
In reply to Re: Concerta » Raisinb, posted by phidippus on September 20, 2012, at 8:51:22
> Focalin is the dextrorotatory enantiomer of methylphenidate. It is a norepinephrine-dopamine reuptake inhibitor (NDRI) and releasing agent and thus a psychostimulant.
>
> It is not as effective as Methylphenidate.It may not be. I haven't looked into it. I can't imagine that any difference that exists in efficacy would be that great, and there may be much to gain if tolerability is a critical issue.
- Scott
Posted by rjlockhart37 on September 20, 2012, at 13:24:02
In reply to Concerta, posted by Raisinb on September 15, 2012, at 23:28:33
usally people with adhd have a calming effect from stimulants....but it varies with people....you should check into focalin XR...its cleaner than concerta
rj
Posted by phidippus on September 20, 2012, at 21:41:51
In reply to Re: Concerta » phidippus, posted by SLS on September 20, 2012, at 9:22:37
Some stats on each drugs effectiveness are here:
Eric
This is the end of the thread.
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