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Post by scatterbrain on Aug 11, 2014 16:01:22 GMT
Was on 18mg Concerta for a month. It helped in the first few weeks and then it stopped and I got depressed. I retained some hope that when my dose was upped it would once again help and in turn lift this depression. I'm now at the end of my first week on 36mg and it hasn't made any difference. My psych will only adjust the dose at monthly intervals which seems such a long time to wait when I'm depressed, especially if it isn't going to help anyway.
Can anyone answer the following:
1. Why do some psychs wait so long to adjust doses when others don't?
2. Having not felt anything or had any result from increased dose is it unlikely that Concerta will work for me? I did expect to feel a difference at each increase before I built up a tolerence.
3. If psych decides Concerta isn't going to help, is he likely to make me come off it slowly before letting me try something else?
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Post by blaze on Aug 11, 2014 17:53:01 GMT
Iv been.switched straight from conchetza to strattera, low dose but upped rapidly. My pysch upped meds as quick as my bp coped w, i was 20 then so its possibley different when younger. Strattera might suit you better, it was designed to be an anti d but wirks on the organisation part of the brain, but i was told it lifts mood also. if its not jst feeling down because of adhd brain struggles then the right adhd meds wont effect depression, thatd need different treatment, but likely along side addressing adhd also
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Post by danherts on Aug 11, 2014 18:25:41 GMT
No need to give up on Concerta yet, I think 108mg is the highest recomended dosage.
I'd imagine monthly increases are to do with your psych wanting to assess you in between, I know it's hard to be patient but after a while I found the extended titration beneficial in being able to really assess what was happening and overcome any side effects before compounding them with an even higher dose.
I was only asked to take a day off between different meds. Never did though.
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Post by scatterbrain on Aug 11, 2014 20:19:42 GMT
Just found this in NICE guidelines
........... gradually increase the dose until there is no further improvement in symptoms, behaviour, education and/or relationships and side effects are tolerable. Methylphenidate and dexamfetamine should be titrated over 4–6 weeks
To me, that means increasing the dose over a 4-6 week period not increasing it every 4 - 6 weeks. Agreed???
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Post by blaze on Aug 12, 2014 11:51:59 GMT
Nice guidelines are jst a guide, individual hosptials and psychy will have their own ideas. In all honesty the nice guidelines are pretty innadaquate in most areas, the way the get put together certainly isnt.the wisest in general (although i dont know the criticisms of adhd nice guidwlines or cochranr libary reviews of these)
You said in a different post you were feeling dizzy from.concherta, is that roght? Maybe your pysch id taking things sliwly because of this. Meds shd never be upped til the benefit stops, they shd be upped to the optimal dose, which id the best effect w minimum side effects, for sm people that will mean lowest dose because increasing to most benefit poses too many risks in terms of side effects.
You sound v frustrated (,which i understand, im waiting to go back on meds and tearing my hair out).,do.you have any other support? Smone you can talk to about all this? Cpn, support group, councilor?.getting the right meds (,& depression treatment) can take along time and is zrial and error, maybe sm support wd help the difgiculties of this period?
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Post by shapes on Aug 12, 2014 21:36:58 GMT
Mine did explain basically that they do it to minimise side effects.
Also I don't know if it will improve depression, and if you are suffering from depression you might not notice the improvements in ADHD symptoms.
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Post by resprayedmonger on Aug 19, 2014 7:06:20 GMT
I was on Concerta and it turned me into a lunatic, then I went to Methylphenidate which were much more controllable but I had gone into thyrotoxic storm and not even realised it are all the symptoms are the same as ADHD and I nearly died. Now I don't use any meds and I just plan out tomorrow today . Meds aren't going to work as well as you yourself can
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Post by Deleted on Aug 19, 2014 12:53:15 GMT
I'd have to disagree with the previous post - thyrotoxic storm is not a common experience. Having issues with medication is a major topic on here, unsurprisingly.
A clarification - Concerta is methylphenidate hydrochloride but in a clever pill format to extend its release.
We're not really in a position to say much about your current predicament with 36mg - it looks like the psychiatrist is following standard procedure with a slow increase of dosage every few weeks. You're nowhere near the big dosages so don't fret about the numbers (over 100mg/day is large).
It's a conservative approach (usually a good thing) but can leave you stuck for considerable periods on the wrong dosage.
I'd try to ride it out till the next review. If it's obviously too difficult to do that bother your psychiatrist - they're there for your health!
A minimum would be a chat on the phone to establish what's what.
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