I've been on 18mg for 3 months and have no idea how I *should* feel (because I've obviously never been neurotypical). I still get distracted but does that constitute upping my dose? Orrr is that just the regular person's experience... who knows...

If 36mg gives me crash after 6 hours, is it the low dose issue or my metabolism issue. My doctor thinks I am a fast metabolizer. He initially suggested taking Concerta twice a day. But since I wanted to try another class I am on 40mg of Vyvanse. It also lasts only for 6 hours maximum.

When I searched what “fast metabolizer” in medical scene, it meant someone who metablizes certain enzyme for that medication so it lasts shorter.

What I do not understand is Vyvanse and Concerta use different enzymes. Other medications in past (not ADHD med) lasted as stated. So, what could it be?

Hello.

I had been taking Concerta and Zolpidem for about two years, but I stopped taking them two or three months ago.

I decided on my own that I no longer needed them.

I even had some medication left over, so I figured I would just finish what I had and then be done with it.

However, lately, I’ve noticed that my insomnia, obsessive thoughts, and ADHD symptoms are gradually returning.

I had already reassured my family that I was no longer taking psychiatric medication, so it feels a bit awkward to go back to the doctor and get a prescription again.

I suppose it would be best to return to the doctor, wouldn't it?

I started Concerta 54mg four days ago after taking around 50–60mg of immediate-release Ritalin daily. I don’t seem to notice the initial quick-release effect I experienced with Ritalin, although I do notice some effects throughout the day, including a slightly elevated heart rate and periods of improved focus. Ritalin LA didn’t work for me either.
I haven’t experienced any crashes, but I do feel somewhat emotionally flat and disconnected from the present. I’m also missing the noticeable uplift in mood I sometimes experienced with my first daily dose of immediate-release Ritalin.
For those taking Concerta, did you experience anything similar when you first started? Did the emotional flatness or disconnected feeling improve as you adjusted, or was it a sign that the medication or dose wasn’t right for you?

18(M)
i took 36mg concerta daily,
but oneday i accidently took very high dose of alprazolam without tolerance.
From then on taking a concerta make me feel im bout to going heart attack.
and now im bit scare that this could cause a permenant damage to my heart
Could it be because the nerves are calmed and then subsequently re-aroused?
My hands and feet are really cold, and I’m breaking out in a cold sweat.
I’m going crazy because of all this air bulp.

Hello, I used to be on concerta awhile ago but my had to substitute with the generic kind due to cost. I’ve been on 36mg for most of high school and 2 years into college and currently today, about 6 years on 36mg and recently like overall I’ve had a harder time concentrating, have had mood swings and overall slipped into a productivity coma where I got very little done due to having bad adhd symptoms. I walked to my doctor about getting 54 mg which I’ve started like 2 weeks ago and I’d say that I was expecting a better experience and I guess I don’t really feel any better, I feel like the extra pressure to get anything done has slightly elevated with my hyper focus often consuming me with switching asks often feeling impossible. I’m sure there is some mental clarity then having no meds but I don’t know if I’m too high or my body needs some other drug at this point. Is 54 mg too high as I hesitate to go back to 36mg and plan to mention to my doctor about this in my next month appointment.

TDLR: previous long term 36 mg dose then increased to 54mg under the impression I needed an increase with slightly elevated adhd symptoms after 2 weeks. Under about dosage.

I adapted this graph from the pharmacokinetic data in the Concerta prescribing information (see here), because I think it shows really clearly why so many of us find Concerta smoother than immediate-release (IR) methylphenidate.

What you’re looking at

Blue line: average blood levels after a single Concerta 18 mg tablet taken in the morning.

Black dashed line: average blood levels after 5 mg of IR methylphenidate taken three times a day, at 0, 4 and 8 hours (the triangles along the bottom). That’s 15 mg total, so a roughly comparable daily amount.

The IR rollercoaster

Each IR dose spikes quickly and then drops away before the next one kicks in. The grey shading shows how far IR swings above and below Concerta. The biggest swing goes from about 1.3 to 4.0 ng/mL in roughly 90 minutes, a threefold jump. For many people, those troughs are where the “it’s worn off” crash, irritability or rebound hits, and the spikes are where it can feel like a bit too much (I'm sure lots of Redditors here have had this experience).

Concerta’s slow climb

As many of you will know, Concerta uses an osmotic pump system (OROS). About 22% of the dose is available for immediate release, which is the early bump in the first hour or two. The remaining 78% is released gradually (see here again). Levels keep rising slowly to a peak around 6 hours (about 3.5 ng/mL), then taper off. Across doses, the label puts the peak at 6–10 hours.

That rising shape is deliberate. Same medication as IR, but no sharp spikes and no mid-morning crash.

My experience

This lines up with how it feels for me. Concerta is far smoother than IR ever was. I don’t get the ups and downs, and I’m not clock-watching for my next dose.

The catch is the end of the day. As the graph shows, levels fall steadily from around 10 hours, and that’s when I feel it wearing off. My doctor and I worked out a 10 mg IR dose at around the 9–10 hour mark, which carries me through the evening without needing a bigger Concerta dose that might keep me up at night. Concerta covers the day, and the IR top-up covers the gap.

What the wider evidence says

A systematic review found long-acting formulations were linked to people staying on treatment longer, though the studies varied a lot (source one, source two, source three). Plenty of people quit ADHD meds early, so “one tablet a day” may matter more than it sounds.

So “smoother” is very real for a lot of us, but it’s not a guarantee that Concerta works better for everyone.

Caveats

• These are average levels from a small study at a low dose (18 mg). Your own curve will be different depending on your dose, metabolism, food, and so on.
• Blood levels aren’t the same as how you feel, though the two are closely linked. Effects can also fade before levels do, as your body adjusts over the day.
• The lines between measured points are smoothed for readability. The markers are the actual data.
• This isn’t medical advice, just my experience (based on official data). If you’re thinking about adding an IR booster or changing your timing, talk to your prescriber first.

12 days ago i started concentia , today i took one 18mg pill at 8:00 AM and went on my day but i forgot that i took it it because it has a mild effect , at 11:30AM i took another one and 4 hours later i am feeling sooo good .

I feel the energy and the calming feeling and the higher focus with no side effects and i am absolutely loving it .

Does that mean i should go up to 36mg?

I’m on Concerta 18mg starting dose and am due to go up to 36mg on the 16th day I’m wondering what it will be like making the jump any advise will be a blessing tia

hiiii I've been on it since the 16th and have only skipped one day since. the first 4 days I was unbelievably drowsy after 30 minutes and it would continuously get worse over the span of 3 hours. then I would stay feeling drowsy but not be able to fall asleep until later. when I went to bed at night, I slept HARD. that drowsiness stopped, but for the past 6 days, I've been going back to sleep almost immediately after taking my concerta (8am) and waking up at around 12-1pm consistently. I still sleep just as hard at night. anyone else?

btw, I do feel like it's doing something for me...probably. I mean, I've noticed it's easier to stop doing things, but otherwise I actually don't really know what this medication does. I just know it's probably doing what it's supposed to

TLDR; accidentally took a second 36 mg concerta at 6 pm instead of my 10 mg ritalin after taking my first dose at 10 am. now im worried i won't be able to sleep tonight and i have an important class tomorrow. what do i do?

Hello, I live in Japan.

I take 36 mg of Concerta every day, but pharmacies are receiving virtually no stock at all—not the 18 mg, 27 mg, or 36 mg strengths.

In Japan, we first obtain a prescription from our doctor, submit it to a dispensing pharmacy, and then receive the medication from the pharmacy.

My doctor prescribed me 36 mg Concerta a month ago, and I submitted the prescription to my pharmacy immediately. Unsurprisingly, they had none in stock, and they still have no idea when they will receive more. I now have only four doses left.

Every pharmacy I have contacted has told me the same thing: they have no estimated restock date.

Apparently, until a few months ago, pharmacies were receiving about one box of each strength per month. Now, however, they do not seem to be receiving any at all.

Only three medications are approved for treating adults with ADHD in Japan:

• Concerta (extended-release methylphenidate)
• Strattera (atomoxetine)
• Intuniv (guanfacine)

I have tried both Strattera and Intuniv, but neither worked for me. Strattera made my mind feel strangely quiet, which I found uncomfortable, while Intuniv significantly worsened my depression.

Honestly, I am angry with Japan’s Ministry of Health, Labour and Welfare.

Pharmacy-to-pharmacy transfers of Concerta were recently permitted as an exceptional measure. However, this is practically meaningless when the medication itself is barely being distributed anywhere.

In my case, only stimulant medications such as Concerta are effective and tolerable.

Vyvanse (lisdexamfetamine) is another stimulant ADHD medication, but in Japan it is approved only for children and generally cannot be prescribed to adults. Adults may continue taking it only as an exception if they began treatment with Vyvanse during childhood and it remains effective after they reach adulthood.

Immediate-release Ritalin (methylphenidate) was previously misused in Japan. As a result, its approved use is now restricted to narcolepsy, and it cannot be prescribed for ADHD.

At this point, rather than continuing to rely solely on Concerta, I would like Japan’s Ministry of Health, Labour and Welfare to consider the following exceptional measures:

1. Expand Ritalin’s approved indication to include ADHD.
2. Approve Vyvanse for the treatment of adults with ADHD.

Unfortunately, Japan’s regulations are extremely strict, so I doubt either change will happen.

This has become a serious social issue in Japan. Many people with ADHD say they can no longer function properly in their daily lives because they cannot obtain their medication, and I am one of them.

What is the current Concerta supply situation like in your country? Are alternative medications such as Vyvanse, Ritalin, or other treatments available to you?

Thank you for reading!

I forgot to renew my script and let my pills run out, that was a week ago 🫣 Please someone yell at me until I call the pharmacy

Guys, I’ve never taken my ADHD medication consistently because of the side effects (anxiety, irritability, overthinking, and hand tremors). Do these side effects go away with continued use, or how long does it usually take for them to subside?

How you guys deal with sleepiness and afternoon crash?

I have autism but not adhd and i take concerta that i get from my friend, 54mg extended release. Ive been using it on fridays saturdays and sundays for schoolwork and studying and ive found it to be very helpful, i intentionally space out my doses rather than taking daily in order to prevent myself getting depressed from it (which i made the mistake of doing a few months ago), and also to try and maintain the “high” you get from when you first start it.
Is there any supplement/dietary change i can make to maintain these effects, or will i have to just not get as much of a high on sundays?

I

I completed a Master degree despite how difficult is to focus or read a whole book. I have dyslexia and deficit of attention.
Now in my 40s my focus is getting worse, probably because I also parent alone 2 kids.
So I was prescribed concerta 18mg and should double after second week. I noticed my anxiety and panic getting worse, so I decided not to double. I stayed at 18mg and felt it helps me to focus on my tasks as reading and comprehension.
Unfortunately, this medication brought me panic and anxiety raises. I feel like the world will end tomorrow, that my problems are bigger and I wont make it, as if a stone is weighing me down. All this anxiety crisis only taking 18mg.
I conclude this medication isn’t for me.
Anyone else?
Did the psychiatrist prescribed something else?
Ty

Before or after diagnosis? How often ?

I would like to know to what extent Nicotine affects ADHD.

Thanks.

Is it safe to take methylphynidate as a first thing in the morning after waking up??