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
Hi,
I don’t know anything about Flavay or Flavay plus.
Best,
Dr. Kenny
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.
[...] 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.
my son was diagnosed with adhd and is into concerta for 5 months now. he started with 18 mg, then 27, and now 36. in that span of 5 mos i can say there were remarkable changes with his grades. but what worries me is he continues to loose weight, he really lost a lot of weight when he started to take the meds. i am in a dilemma to take him off the meds, that if he continue to use it, this might affect his health.. i read that if you have been using the meds for a long time, before stopping it, you should wean from it gradually. is 5 months a long time? or with 5 months usage is it ok to stop the meds at an instant or should i also wean him first gradually?
By the way my son is 10 yrs old now. hoping for your reply soon.. thanks.
Hi Ailene,
Concerta can be stopped one day to the next – because it is out of your son’s system by the night, after he takes it in the morning. Talk to your doctor about your concerns.
i am 35 and have been on ritilin,80mgs a day,when i first was diagnosed but i dropped myself thruogh my doctor,then 1 year later moved an changed docs and got put on 60 mgs of addrerall xr a day, but after 6-8 months i dropped my dose down to 30mgs with my new doctor thinking if i was on a lower dose for awhile it would work better if i got upped later on,2-4 months down the line, plus i wanted to see if i could stand being on a lower dose,but one weekend i went on vacation with friends and did not take it all weekend s, so my doctorcall me in on monday to check my blood pressure and took a urin and nothing showed up in my urinallsis, so he put me on straterra, i tried them for 3-4 months and they did not work, its been tough but i just got in to see anew pychiatrist and hes going to put me on concrerta, but what mg should i take if i am used to taking 60 mgs and all a 54mg dose has in it is 12 mgs of what ritilin has in it(methylanphandate) in a three times a day release, should i ask to go back on what worked,60mg of ritilin,or just play the ladder game until i get put on 108, which is 23 mgs of methylanphandate in three doses a day.
sorry for the bad quick typing,all i wanted to know is ,isit a good idea to ask this new doc about just being on 3 pills or just take the concerta, when the ritilin work for me,not saying that concreta will not just want to feel and act and have my mind back
thanks for the help
Hello. My son is 7 and is taking 36 mg of Concerta, for about 2 months now. He seems to have developed an incessant type of cough that I thought would go away but hasn’t. I think it’s a side effect of the medication and wonder if we should try something else. I’d like to know what you think. The other side effects are minimal.
I don’t know of cough being a side effect to methylphenidate medicines. Please review it with your son’s doctor.
Rachel–
I posted in May of 2010… my grandson was taking Concerta – over 2 years, his dosage had increased from 18mg to 36mg.
He had developed a cough that had become so severe that he was sent home from school on a couple of occasions. The Dr could find no cause for the cough, prescribed allergy and asthma medications, but the cough persisted.
My grandson also had fever spikes with stomach aches, again no cause found (his mom has migraines and was told by her MD that children’s headaches/migraines sometimes manifest as fever/stomach aches.)
When I researched Concerta side effects, I found that a cough is a side effect in 4% of those taking Concerta.
Frustrated, my daughter-in-law took my grandson to a wide spectrum medical group in their community for extensive testing – the outcome, as I understand it:
She took him off Concerta for the summer at the end of June; his cough had disappeared by the time I saw him in early August.
He has no allergies – though his lung testing suggested asthma and he is taking meds (which may also be a factor in the development and disappearance of the cough, though I am convinced it was a side effect of the Concerta.)
He is diagnosed ADHD – and his medication was changed to Strattera a few days before school began – I am waiting to hear how he is doing on this medication (it takes time to work, as I understand…)
He attends occupational therapy, now – his frustration and oppositional behavior is much diminished. (Whether it is the OT or being off Concerta – or both, I do not know.)
I do have to qualify my comment here with the fact that I am some distance away, so I do not see my grandson daily or weekly – I have only 2nd hand information; my presumptions are based on what I HAVE seen and conversations with my grandson’s parents.
Hi there!
I am currently on 36 mg per day of Concerta. and have been for 2 months after a slow change from 18-27 mg. I have a question about dosage. I have experienced some benefits which is great but I find that after about 5 hours i’m not so focused and evenings are really difficult. My Dr. is very careful and adjusts dosaging very responsibly so I want to be able to discuss this with him intelligently.
I am very sure my adhd is affected by my hormones (I am 40 )and the effectiveness of concerta is also affected. I chart my cycle and it is short so I have very few GREAT days. In any case, do you suggest “boosters” of concerta later in the day or would I have better luck with another medecine? I supplement with fish oil, B6, B12 and calcium.
Any sort of advice would be appreciated- btw I really liked your live presentation the other night. THANKS!
Ana – some people add a short acting methylphenidate when the concerta is wearing off – so that it provides some improved sympton control for the later hours of the day. Talk to your doctor about this or other options. I’m glad you liked the presentation!
Best,
Dr. Kenny
It only lasts 9 or so hours for me, and I don’t like taking the short acting methlyphenidate because I find that it has a rather uncomfortable crash.
Has there been any reports on Concerta possibly coming out with a 14 hour pill rather than a 12? I think that would be much better for me.
Hi John,
No – no word on Concerta having a longer formulation.
There is Vyvanse – which is a stimulant that’s been shown to last up to 14 hours in adults. Just an FYI.
(you can search for vyvanse on this blog and get more info).
My daughter was switched from Concerta 27mg to Vyvanse. What do I do with extra meds???
My 11-yr-old grandson was put on Concerta recently for ADD. He has always been a lively, creative, fun child to be with – but not able to squelch his nature in school. He was just not able to give his mind over to the teacher and the tests and was often “wool-gathering,” – never rude or hostile to teachers or anyone. I visited with him today while he was home with a sore throat and the change in him is remarkable. There was no smile upon my arrival and throughout the two hours he talked pretty much non stop about dogs, movies, etc. but all with a deadpan face and voice. No enthusiasm about anything. It is like a big part of his personality has been put under wraps. When I hugged him hello and then, goodbye, it was like hugging a log. I do not think drugs are the answer for our children. I think school curiculum has to change. Sad Grandma
My son is 15 years old he has been on concerta since June 2008 during this time he has had agood time at school.However the last three months he has become short tempered moody anxious and agitated the school say his behaviour isgetting worse lost of oppositional behaviour and he has had a sudden change in personality.Due to situation at school he became aggressive and received 5 days exclusion could this be the medication? he is on 54mg a day he has breaks from meds at weekends and holidays advised by his doctor.
My 13 year old son takes 120 mg of Methylphenidate a day. We have tried time released medication before and it is not enough to help him. Is there a way to take a time released medication like Concerta so that the dosage is equal to what he takes now? He is extremely ADHD and even the 120 mg doesn’t seem to work since he has hit a growth spurt. thanks.
That is very high dose territory. You’ll have to talk to your doctor about that…
I don’t feel comfortable medical-legally sharing advise on this on a blog. Sorry.
I am 32 and taking concerta but would like to try getting pregnant soon. What is the best way to wean my self off the medication and how long does it take to be out of my system?
Shayna – talk to your doctor about this. Best to be off the medicine while pregnant. The medicine only lasts in the system for under 1 day, so a quick taper is to just stop it. Your doctor can help you to tailor it or fine tune it to your needs. Good luck with everything!
my son was just switched from Adderal 20 mg to Concerta 30mg this past week…the Adderal has adequately helped his hyperactivity at school…teacher does not see any but not his attention which is terrible at best. Now he is very tired and lethargic on Concerta. Could he be getting too much?? All I want is for him to be focused at school but not lose his great personality and be too tired. He is also quite emotional that is crys at the drop of a hat on or off the meds…
Hello Dr,
My son has been jumping off the roof since he was 3 years old and his doctor wanted me to wait until he turned 5 to place him on any medication. He started with 18 mg by the end of the school years last year he was on 27mg. So this year he has moved from 27mg to 54mg, in a three month period. I am feeling so overwhelmed with him and the things he is doing at home and school. Can you please give me some advice? I feel so helpless right now. I don’t know where to start.
hi i am a 17 year old female, who was not long ago switched from concerta (18mg) to concerta (36mg). maybe likee a week, or two. the doctors complain about my BMI being 17.2. i’m 5’9 and weigh 119. but when i take it i’m not hungry. what should i do?