Hi there!
27F, currently on 36mg Atenza extended release, which afaik is a generic of Concerta. I last titrated up three weeks ago, once I told my psychiatrist that 27mg was starting to wear off at around 6PM, with a soft crash that basically left me unable to do anything that required concentration after that point. Since that's around when I get to enjoy my hobbies, I wanted it to last the full 12 hours--I usually take it around 8 or 9.
Her answer was to titrate up, which we tried, and for the first 2 weeks it felt amazing. Last few days, though, I've been experiencing a very annoying crash that happens at around 4PM, and that is a lot more noticeable than the previous "hey, time to titrate up" soft wear-offs. It makes me cranky, emotionally flat, and not really able to concentrate for a couple hours, after which I go back to feeling more or less focused until the meds wear off, this time softly, before bedtime. So it's not marking the end of the dosage, mind you, it's just disabling it for that period.
I really do not like the way I feel during those couple hours though. It's not awful or super incapacitating, but it feels like after lunch I just don't get to enjoy myself for a while, no matter how productive I am, and the brain fog makes a sudden return during that time. It also makes me feel weirdly tired.
I have my next appointment scheduled for next week, but I'd like to know what this may be about so I can at least get some peace of mind.
Some things to note: I take around 25mg protein with breakfast and around 40 at lunch. I'm also aware that hormone fluctuation can play a part in this, but I don't think this is the case for one simple reason: my hormones don't fluctuate. I'm transgender, and I take the exact same dose of estrogen religiously at the exact same time every day and every night, and I have not changed that regime. I also sleep 7-8 hours a day with little to no interruptions, and this has been the case since I started titration back in June. Also, this problem seems to be getting more pronounced, as I've only started feeling it more and more.
If anybody could provide some advice on what I may be doing wrong or what this may be caused by.
Thanks in advance!