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Re: Focalin XR dosing Concerta

Posted by cindy lou on February 19, 2006, at 13:39:38

In reply to Re: Focalin XR dosing Concerta alohashirt, posted by Sarah T. on January 31, 2006, at 19:31:14

Hi,
I am glad to have found this thread.

My question:

- Can I take Concerta twice a day to ward off the inevitable "crash" when it wears off? (If not, any other ideas?)

Here is some background:

I had been taking Dexedrine for a few years (combined with Lexapro and Klonapin -- both of which I took at night.) The Dex was basically an adjunct to the Lexapro (or whatever SSRI I was taking at the time -- all ADs tend to make me very tired.)

I took about 30 mg. of Dex a day -- 10 mg. 3x a day, as needed. At first, I only needed 5 mg. at a time to feel more energized -- like a boost to my coffee. It would last about 4 or 5 hours. In time, I needed to increase to 10 mg. to feel the "boost," and the energy didn't last as long. I wasn't more focused either, just more "awake."

For a few months now I have been experiencing extreme fatigue, depression, brain-fog, irritability, and I've been so scatter-brained it almost feels like disorientation. Dexedrine barely makes a dent -- I have tried 15 mg. at a time, which makes me hyper, a bit over the top, and then I "crash out" in a few hours.

My pdoc just switched me to Concerta, and also wants me to stop the Lexapro. His theory is that perhaps my depression has been caused by ADD all along (rather than the other way around).

I have been treated for depression for about 15 years on various different meds and combos. I began having strong ADD symptoms about 6 years ago after having my first baby. The ADD has continued to get worse as more is added to my plate (adopted a baby 2 years ago -- she had major surgery, etc. etc.) My pdoc surmises that I could have had ADD all along, but I managed it better without so much chaos and responsibility. His theory does sound right to me -- I have always been a good student, but also a big daydreamer all the way through school. Lots of doodling and staring out the window.

I took Concerta for the first time yesterday. I waited until Noon to take it, and I was very tired for a couple hours, so I took 5 mg. Dex. This really helped, and I felt very good and "smooth" until 8:30 when I could tell that everything was wearing off -- that familiar "crash."

I did not stop the Lexapro yet, but I am tapering off (from 10 to 5 mg.)

All this rambling leads me back to my original question: Can I take Concerta twice a day, to ward off that crash 8 hours later? (like taking one at 8 a.m., and another at 2 p.m.?) Or should I just take a Dex. half the way through?

Thanks for listening! I appreciate any feedback --

cindy

PS. Today I took the Concerta at 9 a.m., and began feeling quite tired around 2 p.m.

PPS. We have explored the possibility of me having Bipolar II, but it doesn't seem like an accurate dx for me. Have tried mood stabilizers, but they make me more volatile.

> Hi. Hmmm. So you took methylphenidate and Dexedrine on the same day, separated by quite a few hours. I've heard of others doing that. I'm not sure I could tolerate that combination.


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