First days on Concerta

[shyQ]

So I'm finally on a real (i.e., stimulant) ADD medication.  I had been on Strattera for a month about a year ago, and all it did was make me very tired.  When I finally added a pshrynk to my support team back in October, he told me that he didn't believe in ADD - it was just a collection of symptoms.  Finally, I saw the clinic's new part time pshrynk (they canned the old one) and told him that the big thing missing was any treatment for my suspected (by the LCSW therapist, no formal diagnosis yet) inattentive ADD.

The new pdoc said that he hadn't known anyone who got significant results from Strattera, and that he would put me on his favorite med, Concerta - "a different life form from Strattera".  So I'm now on the minimum (18 mg) dose of Strattera, and I'm on day 3.  And the results are mixed.

The first day (Sunday - at home) I didn't experience massive ADD changes, but the new med lifted me out of my flat mood, and I had one of those "see the flowers" moments.  For the first time in weeks, I was seeing beauty.  I also picked up some productivity, finally filling out the mail-order prescription forms which had been sitting on my desk for weeks.

Day two was more dramatic.  I experienced the mood elevation again, and I made it to work on time - and without any great rush or drama.  That was a first in itself - the first time in ***many*** months.  When I got to work, I worked with focus and intensity for about 6 hours - until about 3 PM, or about 9 hours after I took the pill.  I stayed at the office until about 6 PM, but my focus was weak and I struggled to finish the program change that I was working on.

Now early evening is where it gets interesting.  I was reading the paper (I ate out at Burger Thing last night), and I read some stuff which triggerered my fears about money and I had a mini panic attack, then I was all restless / irritable / discontented (mixed???) for the rest of the night.

And now today I'm not experiencing any massive effects from the med.  I made it to work on time and without drama again, but I've got no particular mood improvement (back to flat), and my focus just isn't all that hot.  So what's going on here?

J.

[celestia]

So I'm finally on a real (i.e., stimulant) ADD Now early evening is where it gets interesting.  I was reading the paper (I ate out at Burger Thing last night), and I read some stuff which triggerered my fears about money and I had a mini panic attack, then I was all restless / irritable / discontented (mixed???) for the rest of the night.

And now today I'm not experiencing any massive effects from the med.  I made it to work on time and without drama again, but I've got no particular mood improvement (back to flat), and my focus just isn't all that hot.  So what's going on here?

J.

<{POST_SNAPBACK}>

talk to your doc. it's not uncommon for stims to wear off in late afternoon early evening and leave you irratible.

I have the same kind of ADD, but ufortunately, due to past abuse of amphetemines, I don't trust myself with them. Edited to add: But I did take them for awhile, Concerta and Ritalin, so I know a bit about the s/e's, relative to my experience anyhoo.

But you probably just need your dose adjusted. At a minimum give 'em a phone call. It's encouraging that you had an initial positive response!

Good luck! Call them!

S9

[Penny Century]

you said minimum dose of strattera, but i'm going to guess that you mean concerta...

if you're not feeling the effects, it's likely that you need a higher dose.  tolerance builds up fairly quickly, but most people level out at a certain dose and don't become tolerant to the right dose as long as they take it as directed and don't abuse it.  (if there are tolerance issues at the right dose then med holidays may be needed, but at a low dose like you're on it makes more sense that you just need a higher dose than you need to do holidays, esp. as you've only been on it a few days.)

as for the wearing off issue, the extended release ADD meds are designed to last out a school day.  for many adults that's just not long enough, and so an afternoon dose of the instant release form of the medication can help. 

as for the mood... personally i found that concerta wrecked havock with my moods when it wore off, leaving me a sobbing useless mess.  i'm much happier on adderall.  but this is just my experience, something else could be going on.

when do you see your pdoc next?

penny

[shyQ]

S9 and Penny, thanks for the replies.

I'm scheduled to see my tdoc on the 18th and the pdoc on the 25th.  The good news is that this new pdoc will actually take phone calls, even though he's a part-timer at the clinic.  I'm thinking of emailing a copy of my original post to the tdoc and getting her opinion before I call the pdoc.  Actually, this will be news to the tdoc - she only knows that I was scheduled to see the new pdoc, not that I'm now on Concerta (that's right, not Strattera - ADD moment).  So it would be good to keep her in the loop, even if the med wasn't pooping out.

Thanks again,

J.

[ldo]

The mood improvement is pretty much a temporary thing. Your focus may still vary some, I think, but on the average I find stims improve this. It's not magic but in my experience the average focus can be better. For instance, I don't lose nearly as many things as I used to, although I still don't know where that ~!!@#$$$ tfe tubing I need for a project went to. You might try going to a party and seeing if you can understand more of what's going on. Your ability to argue and make logical points may go up. (I used to tell my ex that just because I couldn't argue well or remember examples of what I was talking about didn't  mean I was wrong. After I started to take Adderall, she conceded that I'd been correct about this.) Anyway, we all react a bit differently

Remember that once you get used to an improvement, it becomes the new normal. But you're still making it to work on time, without drama. You might want to ask close friends about any changes they see. When I started taking Focalyn a few days ago, my s.o. said that my voice seemed MUCH more relaxed, the same way it is when I start talking about my hobbies. I can't really hear this myself, but I believe her.

Lots of people report crashing when the stuff wears off. And people report different times to get to the crash point.

[shyQ]

Day three and I'm at work - got here early and with a slightly positive mood.  So far so good....

I think that part of the problem yesterday was lack of sleep.  I got a full 8 hours last night, instead of the 6 hours night before last.  That, and the mood switch Monday night.