Comments on: Concerta Dose: Getting It Right http://www.addadhdblog.com/concerta-getting-the-right-dose/ A blog about Attention Deficit Disorder, and Attention Deficit Hyperactivity Disorder Fri, 12 Mar 2010 02:12:09 -0500 http://wordpress.org/?v=2.8.6 hourly 1 By: Dr. Kenny Handelman http://www.addadhdblog.com/concerta-getting-the-right-dose/comment-page-4/#comment-161314 Dr. Kenny Handelman Sun, 28 Feb 2010 23:23:50 +0000 http://addadhdblog.com/concerta-getting-the-right-dose/#comment-161314 Laurie - sometimes kids take higher doses than adults... It essentially comes down to the sensitivity to the medicine - not just the actual dose. Concerta doesn't come any lower than 18 mg - if you want a smaller dose, you may have to try a different methylphenidate preparation. Laurie – sometimes kids take higher doses than adults… It essentially comes down to the sensitivity to the medicine – not just the actual dose. Concerta doesn’t come any lower than 18 mg – if you want a smaller dose, you may have to try a different methylphenidate preparation.

]]> By: Dr. Kenny Handelman http://www.addadhdblog.com/concerta-getting-the-right-dose/comment-page-4/#comment-161284 Dr. Kenny Handelman Sun, 28 Feb 2010 17:36:45 +0000 http://addadhdblog.com/concerta-getting-the-right-dose/#comment-161284 Matthew - any stimulant can cause appetite suppression. It may not be any different than the focalin. If it is, speak to the doctor. Matthew – any stimulant can cause appetite suppression. It may not be any different than the focalin. If it is, speak to the doctor.

]]> By: Matthew http://www.addadhdblog.com/concerta-getting-the-right-dose/comment-page-4/#comment-159677 Matthew Thu, 25 Feb 2010 21:02:01 +0000 http://addadhdblog.com/concerta-getting-the-right-dose/#comment-159677 Dr. Kenny: My eight year old daughter has been taking focalin xr 10mg. for the last two years. Her doctor wants her to switch to Concerta 27. The doctor feels that the Concerta will give her another hour or two to complete her homework and will have a slightly better crash. I have heard that Concerta causes serious appetite suppression and am concerned as she is a little girl to begin with. Please advise. Dr. Kenny:

My eight year old daughter has been taking focalin xr 10mg. for the last two years. Her doctor wants her to switch to Concerta 27. The doctor feels that the Concerta will give her another hour or two to complete her homework and will have a slightly better crash. I have heard that Concerta causes serious appetite suppression and am concerned as she is a little girl to begin with. Please advise.

]]> By: Dr. Kenny Handelman http://www.addadhdblog.com/concerta-getting-the-right-dose/comment-page-4/#comment-158692 Dr. Kenny Handelman Tue, 23 Feb 2010 19:59:39 +0000 http://addadhdblog.com/concerta-getting-the-right-dose/#comment-158692 Nicole, Cutting concerta in half completely negates any of the its long acting properties. An increase in anger and agression could just be a side effect of concerta - though it could also be related to bipolar (i.e. if someone with bipolar took stimulants, they could have an increase in their anger level), or just other side effects. Explore these issues with your doctor! Dr. Kenny Nicole,
Cutting concerta in half completely negates any of the its long acting properties.
An increase in anger and agression could just be a side effect of concerta – though it could also be related to bipolar (i.e. if someone with bipolar took stimulants, they could have an increase in their anger level), or just other side effects. Explore these issues with your doctor!
Dr. Kenny

]]> By: Laurie http://www.addadhdblog.com/concerta-getting-the-right-dose/comment-page-4/#comment-158192 Laurie Tue, 23 Feb 2010 02:29:12 +0000 http://addadhdblog.com/concerta-getting-the-right-dose/#comment-158192 Dr Kenny, I read different people with their dosing how is it that my 5year old son can take 18mg of concerta and then I read that adults are on 18mg of concerta. Some times he seems a little mellow like he is high or something but he is still with us just seems a little too melow at certain times of the day. I like the concerta it does work but I wish it was maybe a lower dose. How is it that adults and children are able to take the same dose? Dr Kenny,
I read different people with their dosing how is it that my 5year old son can take 18mg of concerta and then I read that adults are on 18mg of concerta. Some times he seems a little mellow like he is high or something but he is still with us just seems a little too melow at certain times of the day. I like the concerta it does work but I wish it was maybe a lower dose. How is it that adults and children are able to take the same dose?

]]> By: summa http://www.addadhdblog.com/concerta-getting-the-right-dose/comment-page-4/#comment-158128 summa Mon, 22 Feb 2010 23:58:49 +0000 http://addadhdblog.com/concerta-getting-the-right-dose/#comment-158128 I had terrible adhd as a kid but in those days it wasn't understood by most people, so I went through life undiagnosed, through miserable school years, six unsuccessful college attempts, dozens of short-lived jobs, an adulthood cast in the iron of a moment's impulse, and finally came to suspect it after my child was diagnosed. In my thirties I grit my teeth and just decided I was going to go to college and finish it this time, used my hyperfocus curse as a studying advantage, and ended up getting a second degree in psychology alongside my major. Many professors at one point or another did bring up adhd and asked if I had ever been tested for it. Maybe college wouldn't have been such a struggle if I had, but I just couldn't devote the time, attention, or money for a doctor during semesters, and couldn't remember to do it during breaks. So I was not diagnosed until my forties and after many years of doctors trying one antidepressant after another, with no results. After a specialist finally decided to do extensive testing, it turned out there was virtually no depression in my personality at all, and I had been misdiagnosed for years, possibly due in part to some personal mannerisms that medical schools teach doctors that are hallmarks of depression! I am quiet and reserved, eager to please, and have a lot of "closed" and "minimizing" body language, which the specialist said can fool most doctors into assuming depression, including herself until after the testing and getting to know me. Finally, a tentative diagnosis of adhd, and appropriate medicines tried. Strattera had some benefits but some escalating side effects. Concerta seemed to help a bit with no side effects. We worked with the dose very slowly and at this point it does help, it's not magic, but there are definite positive effects and no bad ones yet. I am now taking a 36mg in the morning, and an 18mg at noon, so for a couple of hours in the slumpy part of the afternoon, it's like the 54mg dose. Then the 18mg wears off last so it's an easier letdown in the evening than the 36mg by itself. If I forget my medicine I usually realize it by noticing I am not getting anything done except some unproductive amusement thing... like now! Right now!!! I did forget my dose today, ha ha! And I haven't done most of the tasks I'm supposed to get done today, oops! and it's 4:55pm!!! Can I get like 7 hours of work done in 5 minutes? If I work super super hard??? maybe, well sometimes it's amazing what I can get done really fast if I'm motivated by enough adrenalin... or the fires of hell... or bosses... i think that's the same thing - i better go I had terrible adhd as a kid but in those days it wasn’t understood by most people, so I went through life undiagnosed, through miserable school years, six unsuccessful college attempts, dozens of short-lived jobs, an adulthood cast in the iron of a moment’s impulse, and finally came to suspect it after my child was diagnosed. In my thirties I grit my teeth and just decided I was going to go to college and finish it this time, used my hyperfocus curse as a studying advantage, and ended up getting a second degree in psychology alongside my major. Many professors at one point or another did bring up adhd and asked if I had ever been tested for it. Maybe college wouldn’t have been such a struggle if I had, but I just couldn’t devote the time, attention, or money for a doctor during semesters, and couldn’t remember to do it during breaks. So I was not diagnosed until my forties and after many years of doctors trying one antidepressant after another, with no results. After a specialist finally decided to do extensive testing, it turned out there was virtually no depression in my personality at all, and I had been misdiagnosed for years, possibly due in part to some personal mannerisms that medical schools teach doctors that are hallmarks of depression! I am quiet and reserved, eager to please, and have a lot of “closed” and “minimizing” body language, which the specialist said can fool most doctors into assuming depression, including herself until after the testing and getting to know me. Finally, a tentative diagnosis of adhd, and appropriate medicines tried. Strattera had some benefits but some escalating side effects. Concerta seemed to help a bit with no side effects. We worked with the dose very slowly and at this point it does help, it’s not magic, but there are definite positive effects and no bad ones yet. I am now taking a 36mg in the morning, and an 18mg at noon, so for a couple of hours in the slumpy part of the afternoon, it’s like the 54mg dose. Then the 18mg wears off last so it’s an easier letdown in the evening than the 36mg by itself. If I forget my medicine I usually realize it by noticing I am not getting anything done except some unproductive amusement thing… like now! Right now!!! I did forget my dose today, ha ha! And I haven’t done most of the tasks I’m supposed to get done today, oops! and it’s 4:55pm!!! Can I get like 7 hours of work done in 5 minutes? If I work super super hard??? maybe, well sometimes it’s amazing what I can get done really fast if I’m motivated by enough adrenalin… or the fires of hell… or bosses… i think that’s the same thing – i better go

]]> By: Kim http://www.addadhdblog.com/concerta-getting-the-right-dose/comment-page-4/#comment-157243 Kim Sun, 21 Feb 2010 15:03:19 +0000 http://addadhdblog.com/concerta-getting-the-right-dose/#comment-157243 My almost 14 year old son was recently diagnosed with ADD. He stared with 18 mg then 27 mg and now he is on 36 mg. He is doing better but still on and off, some day better then the other. His doctor said: I should only can expect his behave get better from med about 80%. How do i know that he reach 80%? Can he try a higher doze then go back to a lower doze? and how long should he try and be able to recognize it? He did not want to eat. Can he take the pill with ENSURE PLUS in the morning and only eat dinner in evening? Is he get enough nutrition? Thank you very much. and sorry about my poor English. My almost 14 year old son was recently diagnosed with ADD. He stared with 18 mg then 27 mg and now he is on 36 mg. He is doing better but still on and off, some day better then the other. His doctor said: I should only can expect his behave get better from med about 80%. How do i know that he reach 80%? Can he try a higher doze then go back to a lower doze? and how long should he try and be able to recognize it?

He did not want to eat. Can he take the pill with ENSURE PLUS in the morning and only eat dinner in evening? Is he get enough nutrition?

Thank you very much. and sorry about my poor English.

]]> By: Nicole http://www.addadhdblog.com/concerta-getting-the-right-dose/comment-page-4/#comment-156741 Nicole Sat, 20 Feb 2010 20:10:33 +0000 http://addadhdblog.com/concerta-getting-the-right-dose/#comment-156741 I'm a 28 year old female and I recently started taking 36 mgs of Concerta twice a day. I have tried several medications (SSRI's) for years with no improvement of my symptoms. I decided to switch Psychiatrists and the new one believes that I was misdiagnosed as Bipolar when I actually have ADHD. So, he put me on Concerta and I IMMEDIATELY noticed an improvement in impulse control, restlessness, joy for life, etc. However, the medication makes me EXTREMELY angry and irritated, almost violently. To combat this negative side effect and stay on the medication for the positives, my doctor allows me to break the 36 mg tablet in half and take one in the morning and one in the afternoon. I know that you mentioned earlier that you can't break Concerta in half and my doctor said this as well, but my pill cutter is able to break them, so my doctor has allowed me to do this so I don't have to waste the 36 mg tablets I already have. My doctor also added 0.5 mg of Xanax 3 times a day to calm the agitation. So, my questions are: 1. Is it OK to break an extended-release pill in half or does it totally negate the extended-release properties? For instance, would I need to take it more often? 2. Where is the aggression coming from? Is it happening because the medication is wearing off too soon or because this is just a side effect for some people? I want to give this medication the best shot that I can because it is the first thing that has helped me, but I am married with two small children, so I can't be in a violently angry mood for any period of time! THANKS!! I’m a 28 year old female and I recently started taking 36 mgs of Concerta twice a day. I have tried several medications (SSRI’s) for years with no improvement of my symptoms. I decided to switch Psychiatrists and the new one believes that I was misdiagnosed as Bipolar when I actually have ADHD. So, he put me on Concerta and I IMMEDIATELY noticed an improvement in impulse control, restlessness, joy for life, etc. However, the medication makes me EXTREMELY angry and irritated, almost violently. To combat this negative side effect and stay on the medication for the positives, my doctor allows me to break the 36 mg tablet in half and take one in the morning and one in the afternoon. I know that you mentioned earlier that you can’t break Concerta in half and my doctor said this as well, but my pill cutter is able to break them, so my doctor has allowed me to do this so I don’t have to waste the 36 mg tablets I already have. My doctor also added 0.5 mg of Xanax 3 times a day to calm the agitation. So, my questions are:

1. Is it OK to break an extended-release pill in half or does it totally negate the extended-release properties? For instance, would I need to take it more often?

2. Where is the aggression coming from? Is it happening because the medication is wearing off too soon or because this is just a side effect for some people?

I want to give this medication the best shot that I can because it is the first thing that has helped me, but I am married with two small children, so I can’t be in a violently angry mood for any period of time!

THANKS!!

]]> By: Dr. Kenny Handelman http://www.addadhdblog.com/concerta-getting-the-right-dose/comment-page-4/#comment-151057 Dr. Kenny Handelman Tue, 09 Feb 2010 17:53:44 +0000 http://addadhdblog.com/concerta-getting-the-right-dose/#comment-151057 Angie - concerta cannot be cut in half - but it does come in a 27 mg tablet. Talk to your doctor about this. Dr. Kenny Angie – concerta cannot be cut in half – but it does come in a 27 mg tablet. Talk to your doctor about this.
Dr. Kenny

]]> By: Angie http://www.addadhdblog.com/concerta-getting-the-right-dose/comment-page-4/#comment-150960 Angie Tue, 09 Feb 2010 02:36:24 +0000 http://addadhdblog.com/concerta-getting-the-right-dose/#comment-150960 Can Concerta be cut in half? My son is taking 18 MG of Concerta, however, I feel that needs to be increased. Is it okay to give him 1 1/2 tablets instead of just 1 to see if the increased dosage works better? Can Concerta be cut in half? My son is taking 18 MG of Concerta, however, I feel that needs to be increased. Is it okay to give him 1 1/2 tablets instead of just 1 to see if the increased dosage works better?

]]>