Concerta: The First Long Acting ADHD Medicine
ByAs ADD/ADHD medications go, Concerta is a relatively new drug. But in the short time it’s been available, it seems to be an extremely popular choice. Concerta contains the same active ingredient that Ritalin has, the stimulant methylphenidate.
The advantage of this drug over many of the others is that you — or your child — only need to take it once a day. In fact, when it was introduced to the pubic, it was the only time-released formula available. And now you can see why it gained popularity so very quickly
One single tablet provides up to 12-hour coverage. But more importantly, in the eyes of those who created it, Concerta provides an evenly dispersed amount of coverage. When children take Ritalin several times throughout the day, they’ll experience the normal peaks and valleys that naturally come with the rising and falling of the medication in their bloodstream.
Concerta may be prescribed in four distinct dosing levels. Your physician may start you or your child out on the smallest dose, 18 mg. The other three dosages are: 27 mg, 36 mg and 54 mg.
And it’s this single use ease of the pill that sets it up as being unique from other ADD/ADHD medications when it was first released. Now there are other once daily ADHD medications as well. But it’s also this delayed release mechanism that may cause concerns for some people taking it.
Quickly let’s look at what the difference involved in taking 20 mg of Ritalin three times a day, to taking a 54 mg single pill of Concerta once a day. When looking at Concerta doses, it’s important to know that 22% of the medicine is released immediately, and the rest of the pill supports that dose. That means that the 54 mg dose of concerta is like taking regular Ritalin 12 mg three times per day. This is obviously quite lower than Ritalin 20 mg per day. This is why it is important that your doctor get the dose right when using Concerta.
Side Effects of Concerta
Of course, Concerta like any other prescription medication administered for any disorder or disease, is not free from adverse side effects. According to the medical community, the side effects of Concerta are less pronounced than some of the ones that accompany the use of the older medications. Some people not only complain of physical side effects, like abdominal pain, dizziness, and headaches. But some of the known effects of Concerta also include an increased feeling of aggravation, nervousness and even a pronounced hostility.
Others have reported, as a consequence of taking this drug, inability to sleep, loss of appetite, as coughing and the presence of sinusitis. Other side effects may include vomiting, allergic reactions as well as increased level of blood pressure.
Some individuals have even complained of experiencing symptoms most closely associated with psychosis, such as abnormal thinking or hallucinations. If when you’re taking this medication, you experience any of these side effects, let your doctor know immediately.
Concerta can be a real hope for many people — especially children — who only want to take one pill a day. For many students, this single tablet alleviates the need to visit the school nurse at noon. And that can mean so much in the way of self esteem.
Not taking it now, but think it might be right for you? Check with your doctor. He’ll be able to provide specific recommendations for your personal situation.
Please share any of your comments or experiences below.
Best,
Dr. Kenny
Hi, My 9 year old son recently started taking Concerta for ADHD (and ODD)and I’m concerned about what happened on the second day of using it. He felt a deep sadness which he couldn’t explain and cried all day(at school, then at home). He didn’t know what he needed to console himself. He didn’t want to be cuddled, he just wanted to stare out the window and cry.
Thankfully, this only happened that one day, but it was heartbreaking. It was also the first time we’d ever seen him like that. Now, he’s doing well, even on the lowest dosage, his behavior has improved both at home and school. But I still worry and wonder about that day where he seemed so depressed…is that normal? Should we be prepared for that to possibly happen again? Does this mean he’s depressed?
Lynn
Lynn – sadness can be a side effect of stimulant medicines. That said – if it was short lived, and isn’t recurring – it could be that it’s gone. Best to talk to your doctor for specific recommendations, and to review this side effect in the context of your son’s full health history.
Dr. Kenny
http://www.SafeADHDMedication.com
Hi, My partner and our son (nearly 9) have been taking Concerta for the past 2 years. We find it so much better than ritilin which although it worked, caused problems at school with the peaks and valleys of mood at midday.
We do find that sleep can be elusive and if we’ve given the med too late in the morning then we know he’ll still be awake when we go to bed. However when he does go to sleep he sleeps deeply. My partner doesn’t experience any difficulties with sleep, in fact finds sleep easier and says he is less teary during the day compared with rubifin.
Both my son and his dad take Concerta and life is calmer, less paranoid, and reasonable for all now. Remembering that lunchtime dose of ritilin was practically impossible for his dad, despite carrying the pills in has pocked, so Concerta for them is great!
Carolyn
Hi again Doc:
A previous post asked why there would be a percieved difference between 2 x 18 mg of Concerta and 1 x 36 mg of Concerta. One possible explanation would be that the surface area to volume ratio would be higher for the 2 x 18 mg option which would result in a higher rate of absorbtion. Alternatively, the lower the ratio, the higher the percentage of methylphenidate that would be releases from the internal mechanism. There there would theoretically be slight variatione between all dosages. Whether or not that translates into a difference in therepeutic effect, I have no idea. Just my thoughts.
Hi Doc,
I’m 42 (240 lbs) and was dx with ADHD a few weeks ago. I was rx 54 mg of Concerta for a period of one month. How do I know if this dose is not sufficient?
Dan,
Regarding dose – How high do you go?
Until you have great symptom control, side effects, or your doctor says you are at the limit…
Talk to your doctor about options for you.
Some doctors will use 72 mg, 90 mg, or even 108 mg of concerta. Your doctor will have to review it with you.
Dr. Kenny
Thanks for the quick response.
I don’t get high on this dose… at least I don’t think so. The first day I got the jitters, maybe because I had a few coffees in the morning. But since then, nothing. Should I wait a full month before having my dose re-evaluated?
Dan
correct** not corrent
is it true that concerta lasts 10-14 hours
Darrius – yes – concerta generally lasts about 12 hours.
does concerta last 14 hours
Darrius,
Concerta generally lasts 12 hours. For some individuals, it may last less, or it may last more. So, in general, no – it doesn’t last 14 hours. If it does last that long for you – it may just be ‘individual variation’.
My Grandson (now 8yrs 4 mo – at end of May) has been taking Concerta since early in the last school year; from 1st grade into 2nd grade this year. (18 mg to start – I think that is still the dosage he is taking.) I live on one side of the country and he lives on the other. I have noticed, in the last 2 visits, that he has had a cough (and sometimes a fever) that seemingly has no physical cause that his doctor can find… this cough is not responding to prescribed allergy or cold medications; I’ve also noticed that he is increasingly obstinate and oppositional.
His mom starts, but does not follow through on improving his diet or giving supplementation (he is not eating a well rounded diet – so I wonder about nutritional deficiencies); she does not clean house well or regularly, so if allergies are the cause of the cough, dust mites and dander are not mitigated… In reading about Concerta side effects, I see that his symptoms could be related to taking Concerta.
I believe that he did not take Concerta over last summer, and that his mom may do the same this summer. I am considering asking his mom to try 2 products – Flavay and Flavay Plus – starting as soon as possible, and continuing after school ends, over the summer, to see whether they might help him, and take the place of Concerta.
I have 2 questions of you:
1.) Do you know anything about Flavay and Flavay Plus? (Would you share, if you do..)
2.) Can he simply stop taing Concerta or should we worry about discontinuing Concerta if he is taking the minimum dosage… if so, what is the best way to wean off?
I hope you can help me help my grandson!
Thanks – C
A couple more things – since I have no access to his doctor…
My grandson does not always take Concerta on the weekends… would that make a difference? Can he safely take Concerta only 5 days one week and then 7 days the next?
At the start of 1st grade he couldn’t do ANYTHING right in the classroom, was constantly in trouble, and the stress showed each day when he came home from school. Concerta really helped him at school when he first started taking it (concentration, focus, ability to follow directions and willingness to do his classwork) but I’m not sure it is helping as much now. Is there an increased tolerance to Conderta, taking it over a period of time?
I appreciate your being a lifeline for me in understanding this medication and the possible alternatives (Flavay and Flavay Plus) to it.
Thanks — C
Generally it is best to take medicine 7 days per week – because ADHD affects a lot more than just academics.
That said – if it is taken only 5 days per week, it is OK, and generally doesn’t cause any problems.
Hi,
I don’t know anything about Flavay or Flavay plus.
Best,
Dr. Kenny
[...] Concerta is a long acting preparation of Methylphenidate. It was launched in the US in 2000, and in Canada in 2003. [...]
I’m a 49 year old woman who has been placed on 18 mg of Concerta in April 2010. I have developed a cough and my sinuses are stuffed (gets worse at night). I had a busy week and by Friday (had not slept well all week) I felt numbness in my left arm, sweating and nausea. I stayed at work and eventually felt better. When I got home I rested and called the pharmacist. She wasn’t too helpful. I hate to discontinue taking it but I’m tired of the coughing, not sleeping, slight headaches and increased heart rate.
The first day I was on it, I did go through deep sadness but felt great after that. I was eating better (no sweets in my diet), but once I began eating junk food and decreased my exercising for the last month I’ve certainly have not felt as good.
Any suggestions?
Suzanne – that doesn’t sound good. I’d suggest checking with your doctor – if he/she recommends sticking with the Concerta or not…
Maybe it’s worth switching or adjusting treatment…
Hi,
I’m a 17 year old female who was diagnosed with ADD put on concerta last August. I’ve only been taking it on the week days when I have school (and occasionally on the weekends if I have something I have to concentrate on) because my doctor warned about possible withdrawal side effects. I am currently on 54 mg. I was wondering if it would be beneficial for me to not take it over the summer, because I have ADD and am not hyperactive at all. I don’t foresee needing it, really. Would you recommend taking it on the weekdays during the summer, not taking it at all, or do you see no difference either way?
Thanks.
Audrey – we often suggest taking meds 7 days per week, all year round. This relates to the fact that ADD can impact on more than just academics – i.e. social aspects, psychological issues, self esteem, etc.
So, you’ll need to look at your own circumstance, and talk to your doctor about what’s best for you.