Concerta Dose: Getting It Right

Concerta is a newer, long acting preparation of Methylphenidate – which is the medication name for Ritalin.

It has been out for several years in the USA and Canada, and many other countries in the world.

Despite the fact that it has been around for quite some time, I still see dosing mistakes in patients who are sent to my office.

Allow me to explain to you how Concerta should be dosed.

To start off, we need to go back to the original Ritalin.

Here are the dosing guidelines for Ritalin:

Recommended daily max = 60 mg
Timing: as each dose only lasts 3-4 hours, it is generally dosed 3 times daily – i.e. morning, noon and 4 pm
It is not dosed too late in the day, as it may lead to insomnia
Children would be started at 5 mg twice to three times daily, and the dose would be increased upwards as needed.

When Concerta was developed, they used a fascinating technology called OROS. OROS refers to: osmotic-controlled release oral delivery system. What OROS does, is use the water in the gut to cause the medicine to be absorbed gradually, through osmosis. Suffice it to say that this new pill takes a medicine that has to be taken 3 times daily, and makes it once per day. You can see a short video of how this works here.

Concerta comes in 4 doses:

18 mg
27 mg
36 mg
54 mg

The way to convert Concerta doses into the equivalent of Ritalin doses is this:
Take 22% of the Concerta dose, and that becomes the effective Ritalin dose, three times daily. In other words, the initial 22% is quickly released, and the whole rest of the pill supports that dose.

You need to remember that not all of the medicine is released from the Concerta pill – about 10% is not absorbed.

Why?

Just picture a ketchup bottle – can you ever get the last bit out?

So, here is a conversion:

18 mg Concerta = 4 mg Ritalin 3 times per day
27 mg Concerta = 6 mg Ritalin 3 times per day
36 mg Concerta = 8 mg Ritalin 3 times per day
54 mg Concerta = 12 mg Ritalin 3 times per day

Here is an example of how some people get into trouble:

Let’s say that a teen required 60 mg of Ritalin per day – i.e. 20 mg three times daily.

If the doctor converts the dose of 60 mg Ritalin to 54 mg of Concerta – because they seem close, this can have dire consequences.

54 mg of Concerta is like 12 mg of Ritalin 3 times per day, so there would be a significant dose drop from 20 mg 3 times per day to 12 mg 3 times per day (i.e. a 40 % dose reduction!). It would be no surprise if the people noticed a change and felt that Concerta wasn’t working.

In the recent past, there has been approval in the US for 72 mg of Concerta for teenagers if needed.

Recent ADHD practice guidelines published by CADDRA – the Canadian ADHD Resource Alliance, suggest that teens and adults with ADHD may require up to 108 mg of Concerta daily.

To put these doses into perspective:

72 mg Concerta = 16 mg 3 times per day
90 mg Concerta = 20 mg 3 times per day
108 mg Concerta = 24 mg 3 times per day

To achieve these doses, you can use:

72 mg Concerta = two 36 mg tablets, or 54 mg + 18 mg
90 mg Concerta = 54 mg tablet + 36 mg tablet
108 mg Concerta = two 54 mg tablets

What’s the bottom line ?

If you or your loved one was switched from another form of methylphenidate to Concerta, and it seemed that Concerta didn’t work, please consider the information above.

You may even want to print this article, so that you can take it with you to your next doctor’s appointment.

Concerta is a great preparation of methylphenidate, and can work very well.
Don’t give up on it unless you are sure you have had the right dose.

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Comments

  1. My grandson has been on concert a 54mg for 4 years. He is starting to struggle in school and having more trouble concentrating. What dose is safe for him. He weighs 98 lbs.

    • I have been on concerta for four year. In that time I have increased my dosage may times. I went from 18mg at the beginning to 74mg right now. As you get older either your system gets used to it or you need more to support you. This is totally normal.

      • I am a 54 year old male who did not have the benefit of where science is today on these matters of ADHD and Executive Functions issues.
        I am not a doctor but I consider myself a ‘student’ on this subject.

        TONYA, with all due respect I feel that you have your hunch backwards. Most people, especially teenagers do not rely on a healthy eating life style…probably most Americans. Anyhow I would be willing to bet it is the inability to efficiently metabolize converta is most likely the problem. Please check into this.

        Regarding doses higher then 36 I would strongly recommend employing what I would call a “jumper”… After the long acting Concerta appears to run its course make an appointment to see your Psych-Phar, but not for a higher does of Concerta (though the Pharmaceutical company would like you to!!!) discuss getting a script for 10mg generic Ritalin….Maybe a try 10 to 20mg’s…they’re fast acting and have been a great source to bridge my need remain
        in the ‘productive zone’ from 3PM to 6PM.

        I still get my good nights sleep to!

        I hope this helps?
        Cheers – Tony

        • hey tony,
          its really nice to see a patient to has done their own research and know what works for them so well – if we could all do this for ours selves it would be great. i do think that all ADHD people should treat themselves.
          i’m trying to do the same but i live in the UK so when i tell them what i need (and i do know – i have proper qualifications and all!!!) they treat me like some kind of weird drug addict. ah well at least i don’t get drugs pushed on me.
          well done mate!

          Lois

  2. My son is 10, has ADD, he has tried Vyvanse (30mg) could not believe the change in my son, he was talking at a regular speed( normally when he talked you could finish his sentences for him because it was hard for him to process what he wanted to say) and telling me everything about his day. It felt like Nicholas was set free from him his shell….. he was happy! after a week being on it, i noticed changes for the worse,lost 5lbs, crying all the time, he didn`t know why, Nick lost his smile, and to know Nick he is known as a smiley boy. Doctor changed his doses to 40mg, which still didn`t help.
    We started Adderall XR (15mg) his smile was back, and the crying stopped, but not much change when it came to focusing in class, 20mg still nothing, and wasn`t able to gain weight.

    Now on day 7 with Concerta 18mg, after 14 days on the 18mgs i am to switch him to the 27mg. He is still eatting good smiling. but the teacher notices no differents with him on it or not. he is not a hyper child, he is one that well sit at his desk just not get much work done on his own. processing info. is hard for him.
    where to turn to next….. these medications scare me, the doctor mentioned a medication that would be in his system 24-7, I`m not liking that idea. It`s so hard what to do next….

    • We went through much of the same with our son who is now 11, almost twelve. Those side effects are causes of anxiety which is exacerbated by a stimulant like concerta of Vyvance. His Dr. prescribed a low dose of Zoloft which really helped with the anxiety. It can be a useful tool to help with anxiety that tends to come with ADHD. We have also tried other ADHD drugs like stratera and Intuniv. They definitely calmed him down, but the focus was NOT there.

      Good luck

    • Lori,
      My son is 6 and I am having the same issues. He is on 5mg of Ritalin 1x per day. His teacher called yesterday and wants me to come talk about setting up an IEP. I hate the thought of it. The neurologist says there are no learning disabilities, just ADHD. He sits still and isn’t disruptive, but just doesn’t seem to be able to work independently in the classroom. I know its not a cognitive problem because he will bring unfinished work home from school and have no problem completing the work at home (with no help from me). I’m not sure where to turn for help. We are trying neurofeedback therapy, but that will take months before we know if its making a difference. Months is a long time to be struggling in 1st grade… Let me know if you find any good resources out there.
      Best of luck.

  3. My 16 year old is was put on (18) concerta just over a year ago now to disappointment we have now agreed to put him on 27, but i am still concerned about the side affects. We were asked a lot of questions about his health, he had his weight, height and blood pressure taken, but is this enough i have heard children died from this medication or get addicted.

    • THAT IS ROUTINE, AND A VERY LOW DOSE FOR A 16 YEAR OLD, WITH MY SON THE SIDE EFFECTS HAVE ALWAYS BEEN VERY MILD

    • I am 17 and started taking 18 mg when i was 13. As i got older i needed to increase my dose. I am not taking 74mg a day. The tests are all standard procedure. The only thing about concerta is that there is a bit of an appetite loss. I have been very skinny my whole life even though i eat lots, so this was a concern for me. I noticed the appetite change. some days it affects me more than others, but it isn’t that big of a drawback. I went from getting really low grades to now being at the top of my class. Kids usually only get addicted if they are diagnosed and prescribed incorrectly. Those who are prescribed concerta when they should not be get high (hence the addiction), but for us, concerta doesnt get us high it only fixes broken links in the chain. I cant express how greatful i am for concerta. it has literally changed my life. there was no way i would have been able to accomplish the things i have without it.

      • Jay, I completely agree. I am 37 and was just diagnosed with adhd and panic disorder (I drew the lucky straw j/k). I am an elementary teacher and some of the kids
        don’t take it regularly and end up sleeping or uncontrollable. Although, I think the medicine will make a great change. If your child isn’t improving think about ruling it out. I would have loved someone to tell me I was normal when I was a kid and as an adult. This diagnoses explains so many things that I had long claimed as my faults and shortcomings. It sucks that I spent half my life feeling isolated. I knew I was smart, but I had insomnia and adhd and I dropped out after first semester. Trial and error…..

  4. HI MY SON IS ON 54MG A DAY, HE WILL BE 9 IN APRIL AND WEIGHTS 86 POUNDS, HIS WEIGHT WITH THIS MED HAS NEVER BEEN A ISSUE, HOWEVER A COUPLE MONTHS AGO HIS TEACHER SAID HIS CONCENTRATION AND ABILITY TO STAY ON TASK HAS DECLINED, SO THE DOC UPPED HIM TO 54 FROM 36 WE STILL SEE NO IMPROVEMENT, HE WASNT LIKE THIS LAST YEAR, THIS YEAR HE FORGETS THINGS EVERYDAY, THINGS THEY HAVE BEEN DOING ALL YEAR THAT IS ROUTINE, FORGETS PAPERS, BOOKS, COATS, EVERYDAY HE LEAVES SOMETHING, IS IT POSSIBLE THAT THIS MED COULD JUST STOP WORKING FOR HIM?

    • Have u tried different diets? That’s one thing that worked for me when I was around that age. Sometimes my mom would drop off a little sugar free treat it’s also helped me stay healthy at this age. A great age to develop a healthy life style.
      J

  5. Hi I’m 35 yrs old and I got diagnosed about 4 months ago. I have been on concerta for a couple of months and It’s not really doing anything. My Doc has been upping my dose steadily and I’m just about to go on the 54mg dose. It has had No effect on me be it negative or positive. No more focus then before, no added energy or jitters either.

    Anyone know if I should be asking about Adderall or something else? Is this unresponsiveness normal? I don’t really like the idea of going up a lot higher. I always thought 54mg was the max you can really go before the side effects outweigh the benefits.

    • since you are older you will need higher a higher dosage for you to notice improvements. They start low so they can see how much you need. I would keep trying. i started at 18mg and over the years increased to 74mg.

  6. Hello,
    I hope you can help. My son just started on Concerta 18mg on Saturday – he is 12 (almost 13) and weighs about 140ish pounds. We started him on such a low dose because as a parent, I have been VERY leary of putting my child on meds. Not a big fan at all…however, I know it is for the best and decided to give it a try – Also, my doc said ” low and slow” as I’ve heard so many times. Which is a good thing. So since I gave it to him starting Saturday, I have seen no side effects at all.. no loss of appetite, no sleep issues, no stomach aches, etc, etc…. which sort of concerns me because I’ve read that this med is supposed to work immediately. I’m not complaining, because I dont want him to have those side effects, but should I give it a little more time and see what happens before I call the Doc ? he has a follow up in 2-3 weeks. Thank you so much !!

    • That’s totally normal. When I started (around the same age I might add) I started on the 18mg. It seemed to have no affect on me. We slowly increased the dosage. Eventually I found a good dosage that worked for me. Not everyone experiences the same side effects (for example I never have stomach aches). The main thing you want to look out for is his concentration levels and performance, not appetite or sleep issues. It sounds like you’re nervous about this, which is totally understandable. But the difference it can make in his life is immeasurable. I am very grateful for concerta. It literally changed my life.

  7. My son has been taking generic Concerta 54 mg daily and can use 10 to 20 short acting Methylin as needed, since the long acting is less effective after 6 to 8 hr. His psychiatrist tried to increase him to 54 mg twice daily, but the insurance denied it. Now, I have lost my job, so we will be using generic, but since he is not dependent on insurance auth, and he is 5′ 11″ tall, 18 years old, and weighs 310 lb, what other options might he have for dosing. Obviously without insurance cost is a factor but approval is not.

  8. I got perscribed the 27 mg and the 36 mg concerta’s and was initially told to try the 27 once a day and see how that works and if needed see if the 36 mg is any more effective. Well it’s been about 2 weeks and within the time I took it upon myself to start taking 90mg (two 27′s and a 36). My question is is this okay? and how should I know which dose is the best for me? I’m 16 and weigh around 150 if that information is relevant to giving me an accurate answer. Also, I took the 27′s for about a week, then I tried the 36 for a day or two, one day I tried 3 of the 36′s, and tomorrow I plan to begin trying the 90mg dose. My question with that regard is are my observations on how its working plausible if I’m sort of switching my doses that frequently? Basically, can I judge how the dose is working from just the one or two times I may try that dose to decide weather to change it or not?
    Any info would really help and I’d really appreciate it, thanks~

    • Please stop what you are doing and go back and speak with your doctor. You’re playing with fire. Your body needs time to adapt to the medication. Your doctor gave you two separate dosages, not to be combined to make it a higher dosage. You cannot judge in the span of a couple of days if it is right. And under no circumstances should you be taking 90mg, let alone 108. Your parents should be in control of your medication and dosing it to you as prescribed.

    • I don’t recommend switching up your dose that frequently, and to the increased extent that you have without talking with your doctor. Concerta also has addicting properties which could be dangerous for your health, so I’d be careful. It’s difficult to see the improvements if you are switching that often.
      Cheers

  9. Hi Dr Kenny,

    Thanks for all the great info on your blog, I wanted to ask you a question on the info you have on the Concerta dosages above.
    I am recently diagnosed ADHD Feb ths year 48 year old male with 8 year old son diagnosed ADHD prior to my diagnosis. After reading the info on dosages of Concerta you have on your BLOG the penny dropped for me regarding my recent conversion from Ritalin 5-6 10MG day to 54mg Concerta with 2-3 10mg ritalin later in the day 10mg at a time. my 8 year old son who is on 27mg is having similar problems.
    My Pdoc says he will put me on another 18 or 27mg Concerta after next visit to replace the Ritalin tabs.

    I have printed out the dosage rates like you suggest and I will take them to my next appointment with my doctor, Is there any technical / pharmicutical / anecdotal evidence I can take to my doc as well cause I am thinking he may not take a web page print out that I hand to him to seriously. Not suggesting that the info is incorrect or anything like that because it certainly coincides with my prior uncollected thoughts on what was going on in my head. Also my son has been topsy turvy throughout most days since starting on Concerta.
    Thanks again.

    • Greg, I don’t know of any specific studies that you can quote – but all of the Concerta literature discusses the 22% immediate release. By using this logic, hopefully your Pdoc will understand. He/she could call a colleague, or even as the pharmaceutical rep for Cocnerta to give some insight/suggestions around the dosing. I hope that helps. good luck!

  10. My was diagnosed in feb of this year with add. He was put on 18mg to start, now he is at 27mg. The school part has improved immensly. But before and after school is utter hell. He is so angry,more then before. He freaks out over everything, and I can only handle so much. Anyone else have this problem?

    • Yes! My son who is 12 has been on Concerta for almost 2 yrs and he does the same thing. I think its when the med wears off in evening thats makes them soo moody and angry. Also he always has headaches after school. He was on the 36 mg but i cut it down to 18 mg because the headaches were ALL the time. I could not handle it. Does your son have the headaches?

  11. hi. i have been on a few of the adhd meds. I was on Adderrall which really worked great but after a couple months i started to break out horribly, and i tried everything to help it. I knew it was the adderall because as soon as i was off of it a couple days my acne would clear up and then flare up again once i restarted. so i have been on conerta for over a year at 72mg per day. everything was fine, but the last 2 months i have seen an decrease in my focus and am now tired alot and irritable so I was started on zoloft as well. the irritability has gone down but the focus and energy is still getting worse. what should I do

  12. Hello,

    I’m hoping that you can help me. I am a 36 year old woman and I take 18 mg of Concerta (in addition to a hefty dose of Strattera, also some other mood stabilizers, including Lamictal). I like the concentration aspects of Concerta, I think that it could be even better by increasing the dosage, but I really feel the insomnia side effect. If I take 18mg at 8:30 am, I’m awake until 1am. The one time that I tried taking 36 mg, I was awake until 4 am. I’ve tried Adderrall, Focalin, and have just tried Ritalin, but I don’t think that the dosage was high enough. I know that I’m someone who is sensitive to caffeine, so this perhaps explains the sensitivity to the stimulant in these meds. Is the Concerta effective at all in an 18mg dosage for an adult?

  13. Hi everyone,
    I was diagnose with ADD in february 2011 on my 49th birthday, after doing specific test with my psy. That’s explain a lot of thing for me and my wife regarding my emotion and my concentration.

    In september 2011 after 6 months waiting for a doctor, I was prescribe Vivance 18 mg and after 4 weeks, we increase to 40 mg, but I started to have side effect, I had hard time to urinate, so the doctor switch to Concerta.

    We start at 18 mg slowly increase to 36, 54 and now i’m at 72mg per day since january 2012. One dose every morning between 06h00 at 07h00 during the week and between 08h00 and 09h00 on weekend. At 72mg I have notice some irregularity with my heart beat and talk about this with my doctor in April 2012 and we will monitor my heart for 24 hours, but this will be done during the summer because of the waiting list.

    Since my last appointment with my doctor, I think the dose is less effective but I would like to know if it’s possible this is because I started to exercise more, I do two bike exercises during the week, which are exercise that will help increase my endurance and resistance, which push at 110% for short period of time and steam down for 1 or 2 minutes. And on weekend we go for a bike ride of 60, 80 or 100Km (40, 50 or 60 miles).

    Is it possible those exercises will reduce the affect of the Concerta on my body and do I need to be more careful because of my training?

    Since then I have less palpitation from my heart, is it OK?

    Thanks you in advance to take the time to read me.

    Hope to hear from you all soon.

    Jean-Pierre from Quebec, Canada.

    • Hello JP,

      I have exactly the same age and questions. Since the beginning of this year I have been diagnosed ADD because we found out after my daughter and my wife had the same diagnose. I am still in the try out cycle with now 4x20mg Ritalin but it is very difficult for me to take it on a regular base. So I hope to go for Concerta in the future. Because I also like to cycle and run I was curious for your experience with it. The next couple of weeks I will figure out with my psychiatrist how to dose the Concerta. Please keep me informed here in the Netherlands. Thanks in advance.

      Baldwin

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  15. I have been taking concerta 54mg 2x/day for 8 years. My concentration ability has been progressively declining-especially over last 2 years. It is affecting my ability to complete my job duties. I spend 3 hours 3 times per week working off the clock to complete all my work. This has to get better. I don’t want a different job, I just want to be able to concentrate. Is it safe to take a higher doseage than 108mg of concerta? What about adding another ADHD medicine to the concerta? Insomnia is not an issue since I also have narcolepsy. Thank you!

  16. Hello,

    I have been on Concerta 54mg in the past but had to quit taking it due to losing my insurance unexpectedly. I now have health insurance once again and just started taking vyvanse after my doctor told me he had a lot of patients tell him that they like the way they feel when taking it compared to the way other ADD meds make them feel. So far I agree with that statement. I am taking 50mg of vyvanse and it feels much smoother compared to concerta and I can still go to sleep. I still may have to adjust my dosage some but concerta did seem to offer better hyper-focus and worked almost instantly.

  17. i started around 3 months ago on 18mg concerta. after a month and a half (6 weeks) i doubled it myself to 36 (which the doc’s agreed was ok) after the 6 weeks. i’m on that dose now and it seems that after the initial 2-3 days of buzzy feelings (which helps but not that much) the drug does nothing ( not even any of the side effects that people talk about like reduced apatite).
    i dont want to have to go in to detail with my psyc about past drug use but could this be a factor in the ineffectiveness of the concerta?

  18. Our seven year old daughter was put on ritalin and it helped her a lot 10mg [once a day]
    We have just introduced concerta, the 17mg and she seems to be doing fine.
    While on ritalin, we only gave it to her during the week and not weekends.
    can we do the same with the concerta?
    Regards, Martina

  19. I have started my medication since Feb. 28th, 2008.
    FIrst I tried Focalin XR, but it was not compatible with me.
    Then I tried Vyanse, but I ended up in the hospital due to negative outcome.
    (By the way, dont feel too overwhelmed by the hospital. it was just a precautionary measure, it isn’t something to be too worried, just a tad is fine.)
    Last I am on Concerta. I went from 18mg to 72mg, there was a few times I forgot to take it, but when I took it i remembered that I had already taken it, so I sorta overdosed on the 72 + another 72 totaling incredible 144 mg, but that high made me nose bleed non stop until the meds wore off… bad experience.

    Back to the topic, this is how my medication timeing works.
    Take medication around 9-10 am (or when I wake up).
    I feel it becoming active around 12 (it takes me 2h 15m to feel it working).
    It starts to wear off around 7pm.
    The Withdrawl happens around 9pm to 10pm (this is the hard part, since paranoia happens).
    From the 12th hour to the 14th hour, my meds are actually on low activity, but enough not to be totally depleted from my meds. but after the 14th hour, my mind/brain is like a rock, cant think, cant move.

    this is my extensive details about my concerta experience.

  20. I have been on 36 mg of Concerta for a few months, seemed great at first, now I am noticing more and more its making me tired. I was originally feeling great and focused but noticed I had insomnia and when I fell asleep I couldn’t wake up at all I was completely exhausted. I also started getting migraines. My dr attributed this to everything else but concerta, and when I asked to change to adderall because I have heard more positive responses, he suggested I either stay on concerta or stop treatment which I didn’t find very encouraging. I feel like if I don’t take this he won’t give me anything else and with 5 children I can not afford to be unfocused and irritated by several distractions

  21. Omg, this blog is both enlightening and terrifying! Is anyone also seeking non-drug support for their conditions???
    My step son is only now turning 10 in Sept and only weights 57-60lbs!!! He’s been on Concerta 27 my for 4 years however it was alway in conjunction with therapy, groups and initial support in class. It was only just last fall where his dose was bumped up to 45mg (27+18). His Mother had moved her growing young family out of town, new school and he was no longer getting any non-medical treatment or support…never mind a total lack of support and attention at home. I’m just all around terrified for him.

  22. My daughters, 14 and 18 are both using 36mg in the morning. I would like to know if I can stop the meds over weekends and then continue again in the week for school?

    • I wouldn’t modify the dosage or routine of the dosage in that manner all. If you google Concerta there are explicit directions to only modify the dosage on a weekly basis. I also strongly advise against modifying any drug intake without the guidance and consultation of a physician.

        • I agree with April. You can hold a break during the weekend.I started from a 54 to 45 and now a 36 dosage but since my systolic blood pressure raised above the 140-150 I went down to 36 mg. Stopping in the weekends is ok and gives you a good feeling towards the difference. Because of the real important blood pressure disadvantages of this drug I decided to use the 36mg Concerta or maybe a 30mg Ritalin when I really need to focus on my work.

  23. How do i know if i need concerta I hyper all the time get axious very qwickly i try to do certain taks and can not complete them cause im swiching my mind like my underware

  24. Please help I been taking Concerta 36mg for a week now but I feel not working for me. I been calling the doctor hes out for 2weeks I was thinking taking 2x36mg=72mg but Im scared if I should or shouldnt… what do yall think I should do?? Please help

  25. My 7-year-old son has Down Syndrome. After completing his first 3 years in regular preschool and 1 year in general ed kindergarten, we agree with his school team that he is high functioning, except for his behavior…aggressive, very defiant/obstinate most of the time, antagonistic. School was difficult often but only because his mood took him out of focusing on his work. We finally agreed to a trial of Concerta ER, 18 mg. Has been on for one week. We notice hands shaking when writing and dry or sore tongue, definite appetite loss, trouble falling asleep. Much of the aggression has stopped and is more compliant but also seems withdrawn, maybe even sad, i.e. asking for hugs, uninterested in many usual activities. We have a list of just as many pro’s as con’s. Any comments or ideas?

  26. Hello. I am a 22 year old law student who has not been diagnosed with ADD/ADHD..I need to do well on this upcoming test so I have been taking 2 simultaneous 54g doses of Concerta daily (a friend who has a prescription is lending me them) for a week now. My studies have been absolutely phenomenal and my concentration unprecedented. I am thinking about going to my doctor and telling her that I need Concerta in order to focus on school, otherwise my grades will seriously decline. This seems to good to be true though, and my internet research has shown that 108mg (2 54g doses) is pretty high for a first time user. What are your thoughts doctor? am I in any real danger? I am 22 years old, 160 lbs, in good shape and have always had a very high tolerance for alcohol/drugs.

  27. My son is 9 yrs old he has just started concerta. we started at 18 for 3 days then 27 for 3 days and now its been about 5 days on the dose the doc wants him at wich is 36. so far i still find he is in to alot, but i find his moods dont swing as much. when he was on the ridalin he would go from mad to happy to crying in the blink of a eye. I am just hoping that the meds will help him slow down too, as for side effects he still eats like a horse and is not show anything else so far. he goes back to the doctors every three months to make sure everything is going well, but school starts in 1 week and i hope the meds will start working on slowing him down by then or it will be really hard on the school. does anyone know how long it takes for the meds to take full effect.

  28. My son is 11 and was diagnosed with ADHD at 8. Since then he has been on Ritalin,focalin, straterra, adderal and is now on concerta. My question is with the dosing he is 105 pounds and seems to be taking a lower dose than kids half his size. Should your weight be considered when it comes to the dosing? He has been on concerta for a month at 36 mg and it doesn’t seem to be working. Also his appetite is fine but he has problems sleeping. His dr. Said to give him Benadryl to help him sleep but giving him benadryl to sleep at night worries me. Any help or comments would really be appreciated.

  29. At 64 years of age I received an ADD diagnosis. I started Ritalin treatment with 30 mg twice a day. Wow! After 30 minutes, for the first time in my life, I felt in contrtol of my emotions. But the side effects were considerable so we began experimenting with lower doses: 20 mg three times a da; 15 mg 3 times/day; 10 mg 3 times/day (just a bit too low – ADD symtoms showing their ugly heads again); and finally 15/15/10 mg/day.

    Before converting to Concerta I read this blog about Ritalin/Concerta conversion. My Doctor did not agree but gave me a week’s prescription for 18, 27, 36 and 54 mg of concerta saying try em out.

    On me 54 mg of concerta gave about the same positive/negative results as 20X3/day of Ritalin; 27 mg of Concerta seemed quite like 10X3 of Ritalin; 27+18=45 mg of Concerta was pretty much like 15/15/10 of Ritalin. Concerta 36 mg is now provdinging me with results that fall about where one would expect between 30 mg and 40mg/day of Ritalin.

    I feel great! But I also feel that Concerta dosage is directly equivalent to Ritalin dosage. Go figure?

  30. My son 21 self medicates with marijuana. One of his doctors prescribed concerts and that he would stop his marijuana addiction. Anyone with experience with this?

  31. I submitted a coment in early September explaining the results of my own experimentation with Concerta dossage. My conclusion is that Concerta is equivalent to Ritalin, Mg for Mg but I don’t see my reply on the site. Do you eliminate comments that contradict your own conclusions?

  32. Hello,
    I’m 17 and I have been taking concerta for about two months i started at 27 mg but it didn’t help so my doctor upped the dose to 36mg about 3 weeks ago but all its been doing is making me very angry and more confused. before i started concerta i was taking vyvanse which did the same thing that concerta is doing but it was much worse. Please tell me what i should do i need to be able to focus I’m in 12th grade and I’m graduating early but i can’t focus well enough to be able to pass.and make scores i need to get to the college i want to go to

  33. I am 24 years old a single parent to my 5 year old daughter. She was diagnosed with ADHD by the time she was 4. At first she was priscribed 5 ml of ritalin she seemed to be doing okay for the first part, but the effects started to wear off. Two month later her doctor put her on 10 ml twice a day. Once in the morning and then the afternoon. Side effects became different not eating, not focased and became very disruptive in class. Then we switched to concerta. She is know on 27 ml of concerta. I do not see a change. She is not focasing and is often disruptive. Over the past 3 months I have recieved a phone call atleast twice a week from the teacher that my daughter needs to be picked up because of her behavoir issues. I have no control over her emotions, she seems to be going backwards. She often becomes very emtional and very fusterated towards me.

    • Hi Nora,
      She may need a different med all together. How is she off meds? There are many different types out there and its all about finding the right med at the right dose. Along with outside factors coming into play, such as lots of exercise. Hang in there.

    • Hi Nora,
      The same was happening to my son. He was diagnosed with ADHD at age 4 and put on Ritalin 3x per day. The first month or so he showed improvement in school as far as staying focused and on task, completing his school work and sitting still. After the first month the dose was not working. He was back to being hyperactive again and not focusing, so the doctor upend his dose and it did not work. The side affects were horrible, he started losing weight, not having an appetite, not sleeping well, complaining of stomache aches. He started having emotional breakdowns at school and violent outburst at school and could not deescalate. He was tried on concerta and just about every other ADHD/mood drug on the market. None of them worked even with the increased doses. I watched his happy, hyper but loving personality change right before my eyes. When he was on the meds he started saying weird, dark and gloomy stuff and even drawing monster like cartoons at school from visions he said would pop up in his heads. I finally made the decision when he was six years old to take him off the meds and I forced his school to put him on a ARD. Within about 3 days of coming down off the meds his personality started coming back to normal and the emotional breakdowns stopped and so did his violent outburst at school. Through his ARD at school he is able to be in the general Ed classrooms and the teachers have learned how to refocus him when he starts getting distracted. They allow him to move around to burn off some of his hyper ness. Since I have taken him off the meds he is doing rather well in school and making A’s & B’s in every subject. I think the meds make the ADHD worse in very young children because their little bodies are to young to handle those types of drugs and they end up bringing out psychosis in children rather than helping with the hyperactivity. 2 months after I took my son off the meds a friend of ours called to say her 12 year old daughter was in the hospital because her kidneys had shut down and she had to go on dialysis for several days. Her daughter had been on the different meds since she was 6 years old. I am helping my son without the meds and it seems the older he gets the better he is able to cope and deal with his hyper ness. He seems much happier.

      • I think often times kids are just hyper when they’re younger, and then you get these doctors trying to peddle ADHD meds on any kid they can like it’s going out of style. I’m 27 and growing up I knew a lot of kids who got put on ADD meds who aren’t ADD. They’re fine now and do well in school without any meds, they were just simply hyper kids and grew out of it. They concentrate just fine. I’m actually the opposite however. When I was a young child, I was hyperactive but I did very well in school, concentrated perfectly. Then around the age 9 I started to slip and hated school, could never learn and concentrate and went from being a straight A student to a horrible student. I tried ritalin but it made be feel sick so I went off it.

        Fast forward to 15~ years later, some time last year I decided enough was enough and I got put on Ritalin SR 20mg x2 a day. At first my brain felt foggy but then after it started working, I improved at my job greatly and began being able to concentrate. I was doing so well at work I earned bonuses, promotions, everything in my life started to go right. I used to be into drugs and I got out of that, I used to spend all my money and live pay check to pay check and now I’m saving money. But now even though it works, I get headaches, I sometimes feel it’s losing its effectiveness and the motivation I have at work, I seem to lack at home when I need it most for working out and being with my fiance.

        I’m being put on concerta now to see if it will help me. I’m glad your son is OK, the point is for some people like your son, they don’t need the meds, and that’s a good thing, doctors just sometimes jump the gun. Kids will be kids. But some people like me, even though it may appear like I didn’t need them being a good student up until I was around 9, we actually do need the meds, and it’s a fine line between too low or too high a dose I guess. ADHD runs in my family, and I’m actually just ADD, I’m not hyperactive, like many people in this comments section mentioned, I was the type to sit at my desk and not run around like crazy, but I could never pay attention in class.

        These meds pretty much saved my life, I don’t know where I would be today if last year I didn’t give it a shot, but for some people they’re the total opposite. Those people either don’t need meds or need something different, you have to be quite careful especially with young kids. In your sons case, he never even needed them, he’s just a hyper kid who will grow out of it. If he’s getting A’s and B’s without meds, I highly doubt he’s ADD or ADHD in reality, just a kid being a kid. Time will tell but hopefully for your sake he’ll be fine.

  34. I have a 14 yr old son (will be15 in April) and he weighs 93lbs. He has been on Concerta for a many years. He started low and then was on 36mg, then 54mg + 2mg of Intuniv & in the last year his dr upped him to 72mg + 4mg of Intuniv before school started in Fall 2012. His weight has always been a concern for me in the way of not weighing enough. He was 1lb 8 oz when he was born at 29 weeks gest. We have been blessed. Besides tubes in his ears, ADHD is the only issue we have had. However, this school year it has been getting worse. A-typical: can’t concentrate, doesn’t finish or turn in his work, forgets school assigments, looses papers, and his grades have fallen to the point he failed 3 classes this last grading period (passed the semester though). The only thing he is succeeding in is Athletics (100) and his new thing now is Band (100). He is doing GREAT in band. Infact his teacher is very impressed with his quick learning. Before he was on Concerta we tried him on Stratera. That did not work because he was having anger issues. I’m concerned about upping the dosage of Concerta that it maybe to much. But I’m also concerned about changing his medication before the school year ends. How much is TOO much of Concerta and is it safe for him? The only side effects he has had is an occational upset stomach and if he misses a dosage while he is at his dad’s he comes home with a bad headache, and the loss of appetite every once in a while.

  35. I’m a 71-year-old widower and have recently found that a combination of Venlafaxine and Ritalin are almost 100% successful in helping me cope with a life-long range of problems, that range from severe anxiety to almost the whole spectrum of Adult ADD problems. I’ve given up on trying to find a label that fits — I rely entirely on the results obtained from meds. My son (aged 27) has been struggling all his life with very similar, but far more severe, problems. (He did take Ritalin as a child, but was driven away from it by the hysteria spread by the anti-Ritalin lobby.) His current psychiatrist eventually found that a similar combination of medications working principally on norepinephrine and dopamine brought about an astonishing improvement. This was after we had both wasted time and money on a whole range of SSRIs (which I now believe to be quite useless and of dubious real value for anything; one must wonder why the French drug Stablon — which lowers serotonin levels — has been found by many researchers to be more effective than SSRIs). My three daughters are also coping with a range of problems, and there is obviously a genetic component. Restless Legs Syndrome [RLS] and behavioural problems such as low motivation, under-achievement and career restlessness have occurred on both sides of the family for at least three generations, and I suspect a familial problem with low dopamine levels. (The most effective medication for RLS also happens to be a dopamine-elevating drug, but in a different part of the brain — Pramipexole.)

    I recently switched to Concerta starting at 54mg. It worked very well — but I developed bad bruxism. It was then reduced to 36mg — same result — and then 27mg. It still seems to work well, but the bruxism persists. I did not experience any side effects on Ritalin (but I was taking only 10mg/day). I also suspect that slower clearance due to my age is having an effect — although I have no problem falling asleep, I find that I wake up after only five hours, feeling mentally alert but soon tiring physically; and the bruxism persists for a while. It’s difficult to know what a safe dose would be — I now fall into the 65+ age group, which is a kind of terra incognita: anything can happen when taking medication — from nothing to going into space orbit. I use a digital sphygmometer to monitor my blood pressure and pulse and, if anything, they are lower on even high doses of Ritalin/Concerta than otherwise, so I’m not worried about any effect on my cardiovascular system or dropping dead soon. (The fact that I’m vegetarian and exercise daily may also have had a beneficial effect.) But I do suspect slower clearance and will have to be careful.

    I find that my lack of energy and motivation varies from day to day and according to time of day. At my age I have to stay mentally alert and active to avoid age-related depression, and Ritalin has come to my rescue as it once did at university. I also do mentally challenging work at home via the Internet, which had begun to suffer because of flagging mental energy and alertness…

    I am now considering going back to Ritalin in divided doses so that I can gain better control over the levels of methylphenidate lingering in my blood at different times and adjust it according to varying need. By avoiding the 12 hours plus persistence of Concerta in my blood I hope to avoid the effects of reduced elimination speed.

    Three things I’ve wondered about:

    Has anyone any experience of the use of methylphenidate by the elderly?

    How prevalent is bruxism as a side-effect of Concerta and is it also associated with Ritalin in other forms?

    Has anyone any experience of Restless Legs Syndrome occurring with ADD/ADHD? This might only be relevant to adults because RLS tends to be uncommon in children.

  36. Hello all, I am a 32 year old male who has been diagnosed with ADHD at the initial age of 18. I actually seem to have a particularly bad case and struggle constantly to remain contented and focused anywhere doing anything. I have some personal experience with little tricks and tips that work for me in helping many different aspects of my illness which I have taken years to self-discover. They may only be helpful to me but if even a couple people are helped by anything I’d feel glad to know. I know for me I wish I’d known some of this stuff years ago and anyone with this disorder can empathize the difficulty in being organized and scientific when it comes to trying different things and sticking to anything long enough to really figure out what works and what causes what.

    Diet really really seems to affect my restless agitation levels however I seem unable to stick to any sort of strict diet at all. When I become hungry I have no patience to go around finding only the foods that are safe and healthy and do not affect me. Therefore I’ve found that a digestive enzyme is absolutely a lifesaver for breaking down the proteins that agitate. Hehe its in a way like a ”lazy-man’s” allergy diet. It must contain protease of decent quantity, 20,000 to 35,000 HUT.

    I’m beginning to go too long so I’ll have to only provide one more, this one being the absolute best of them all (for myself of course). Many people speak about finding insomnia or residual anxiety of sorts a problem with Ritalin or Concerta. Restless Leg Syndrome can also seem to go hand in hand with these feelings as methylphenidate wears away. I find I can get any to all of these feelings as the medication reaches the end of its therapeutic range and often on far past it at the higher doses. I’ve been on every single ADHD medication at many different doses of each in my search to find the one that seems to best help the relentless condition. And for me the best little ‘discovery’ of all for myself in relation to this side effect from methylphenidate taken in any form is the ingestion of pure protein as this anxiety begins to set in. Once even as a higher dose of Ritalin began to fade, and the focused productive energy turned to anxiety I felt myself nearing a bit of a panic attack. I ran to the fridge and ate a large handful of sliced turkey meat. Within around 20 minutes the anxiety began to wear away and after about 45 minutes I found that instead of the usual unwelcome energy and felt completely relaxed and sleepy, the most perfect vegged out state that we’re all familiar with though NEVER following a dose of methylphenidate wearing away!

    I have heaps more but fear my comments are unwelcome or entirely unhelpful. Would love to hear any feedback.

    • I’d wanted to add one more thing I think may be found useful to so many who’ve commented throughout the entire page. The protein eaten in such a way will not only return the person to a relaxed state but also return the appetite long lost during the period ‘on’ the methylphenidate.

      I feel that I have answers to many of the questions posed throughout this page but I don’t even know where to start posting or how to share my own fixes with so many individual posts. If it helps I can share this of myself. I could easily have gone ‘either way’ in this life, in high school I was expelled several times, smoked marijuana and generally got into all sorts of very bad situations. I could easily, right now, be dead or homeless, be in jail, or be some sort of dysfunctional member of society such as a drug dealer. I feel lucky actually that I was diagnosed and able to figure out everything I was able to about myself and this disorder to prevent that way of life from being the one I live. Currently I am a senior design engineer for General Electric Aviation, I design jet engines for our main customer Boeing who puts them on their planes. I am married to a great woman and am soon to become a father. I personally feel this disorder is a very serious one and also that it needs to be seen in a very different light by society than it currently does. At this time ADHD seems to have the general feel among those around me as a trivial or minor disorder in children. It is most definitely not. I feel that this disease ends up killing many teens and those in their 20s and 30s, mostly by taking risks, drug overdoses, suicides. I think many of the teens you hear who sadly pass away taking crazy risks or those with this disorder, and the 25 year olds who end up in motorcycle crashes, MAY also be the same with this disorder. Though my life is seemingly organized and together I have had too many close calls and am very drawn to high risk activities. Hehe I once drove my motorcycle at 170mph down I75 in Ohio for example. I digress, apologies for rambling.

  37. My 7 year old just started concerta for ADD and has been on it for 10 days and her focus and attention has improved. Does concerta actually change the way the neurotransmitters “talk to each other” and if they improve these pathways between these transmitters, are these improved pathways now permanent? Or do they still need the concerta? How will I know when my daughter does not need it anymore? Thanks for your help?

  38. Hello Dr. Kenny,
    I am a 62 year old man and was diagnosed with ADHD 19 years ago. I have been taking short-acting Ritalin since this initial diagnosis. I see a psychiatrist 4 times per year and I am currently prescribed 20mg tablets to be taken 6 times per day. I have also been taking Prozac during these 19 years and am currently taking 60mg a day. Both of these medications have worked quite well for me and continue to do so to this day. However, I would like to try taking Concerta rather than the Ritalin because it would be much easier for me to take 1 dose each day as opposed to 6 times every day.
    My question for you is this. How many milligrams of Concerta would be equivalent to the 120mg of short-acting Ritalin that I presently take? Thank you for your help.

    Sincerely,
    Male Adult with ADHD

  39. HI MY KID IS 15 YEARS OLD NOW AND HAD BEEN ON CONCERTA FOR 3 YEARS. HE GOT BETTER AT SCHOOL DESPITE THE MOOD SWINGS HE GOT FROM TIME TO TIME.
    CURRENTLY HE IS REFUSING TO TAKE IT ANYMORE . ACCORDING TO HIM IT MAKES HIM FEEL UNEASY AND DOWN. MY QUESTION IS HOW CAN I GIVE IT TO HIM WITHOUT HIS KNOWLEDGE? CAN IT BE DISSOLVED AND GIVEN WITH JUICE ? OR CRUSHED AND SPREAD OVER HIS FOOD? IS THIS OK TO DO BECAUSE I AM CONCERNED IT MIGHT HARM HIM IN SOME WAY IF IT GETS IN HIS SYSTEM ALL AT ONCE? I REALLY NEED YOUR PROFESSIONAL OPINION. THANK YOU.

  40. Don’t sneak the medicine. That will cause bigger issues. My son is 15. Hated the stimulants. Has been on strattera since January. No side effects and providing good effects. If your son needs stimulants-bribe him to take them.

  41. Please… my grandson is spending the night. He is only 8. His mother sent his medicine. 2 54 per day. 108 miligrams daily! Seems way too much for me! I asked her about it, but all she says is the dr said to do it! This seems wrong to me!

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