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Concerta Side Effects - Unsure of What To Do?

I was diagnosed with ADHD (to add to my list of other mental health issues) at the age of 21 and was put on Concerta as treatment. Well, three years has passed and my dosage has increased to 108 mg/morning. At 72 mg I started developping speech problems and then they worsened at 90 mg. It was so bad, that ny doctor reduced my dose but later on he decided to increase it back up as I was having a lot of struggles. On the 108 mg, my speech problems are actually better than when I was on the 90 mg dosage.

Anyway, the problems I am having is rapid speech, sometimes I will slur words/say things with a lisp, I will repeat words or phrases numerous times (like a stutter but instead of repeat a syllable, I repeat a whole word(s)). When I get stuck on certain parts of my sentences and then cobtinuously repeat them with people other than immediate family, I get embarrassed/flustered which intensifies/worsens the issue.

I also have several facial tics such as winking, excessive blinking (which I never even noticed until people would tell me or talk about it a mutual friend later on)...

I have difficulty swallowing (especially breads and heavy foods) but I do not feel like I have a dry mouth or anything. I cannot sit still - always have to shake some part of my body or be fiddling with something...

The reason for my questions is... is it normal to have so many side effects? And should I tell my doctor how much they are bothering me again? I am worried that if reduces the medication that I will crash or be worse off mentally than I was.

Just in case it is important, I have also been diagnosed with bipolar disorder, OCD and anxiety (general/social).  I also have fibromygia but I doubt that matters here. :/

Thank you for reading and I appreciate any responses.

P.S. I apologize for any typing mistakes. I am on my phone and did not proof read this...
17 Responses
189897 tn?1441126518
COMMUNITY LEADER
    Are you on any other meds for the bipolar, or anxiety?  Sometimes, there can be interactions between the stim meds and the other meds.  Main ones with problems are Prozac and Paxil.
   Yes, you should tell your doctor what is going on.  Those are signs of an overdose.  I would also ask about switching or trying an Adderall based med.  They are stronger then the methylphenidate based Concerta.   It may well be that a much smaller dose of Adderall (even better would be Vyvannse) would do the same thing for you with less side effects.
Avatar universal
Hi there, thanks for the quick reply!

I have been on vyvanse before in combination with a lower dose of concerta but was taken off of it. I found it was less beneficial for me.

I also take Pristiq (150 mg/morning), then as you know the Concerta (108 mg/morning), Abilify (15 mg/night) and Epival (1000 mg/night).

I also take Meloxicam and Tramadol as needed. But I rarely bother with the Tramadol as it barely does anything for my pain.
189897 tn?1441126518
COMMUNITY LEADER
      A little weird to be on both V and Concerta at the same time.  They both are long lasting - 8 to 10 hours.  I can see being on V and perhaps adderall in the late after noon.  Or concerta and ritalin in the late afternoon.  Since the Concerta/ritalin are the same type of meds.  Same thing for Vyvannse and Adderall.  
   Point being,  why was the V not working for you?   What symptoms did you have.  I would think that the two could have been over dosing you.  Did you ever try just V alone?   Typically if you have ADHD - the adderall type of meds are the first choice and if you have ADD - then the ritalin meds.  But everyone is different.
   Don't think that the other meds should be a problem.
   Oh, don't drink orange juice before the Concerta.  And have a good high protein breakfast.
    Is the doc you are seeing now the one that had you on both Concerta an Vyvannse?
Avatar universal
Yes, my current psychiatrist had me on the vyvanse and concerta. Concerta wakes me up so if I take it late I have trouble sleeping. However, a specialist in ADHD in young adults (18-25) diagnosed me. I can't remember exactly all my symptoms and if we tried vyvanse alone too or not. But I do remember that my memory and concentration along with my mood were worse on the lower concerta and vyvanse combo than it was on a higher dose of concerta.

I am not sure if this matters, but I have been told I am anemic (apparently my iron levels are very low)... and I have not been taking my supplements/vitamins. Except I took them yesterday as the exhaustion is killing me.
1029273 tn?1472231494
I don't mean to interrupt your conversation, but I must say that I find what both of you are discussing is relevant to what my 13 y.o. son has be dealing with since we lowered his Concerta dosage, regarding slurred speech, tightness in throat/ difficulty swallowing heavy foods, and blinking. These are all new symptoms that he never had before the Concerta. His speech became such an issue at one point, that he began seeing a speech therapist who was baffled as to why my son just developed issues ( a lisp, esp. with 'sh' words) at the age of 13... His pediatrician (who prescribes his meds) seems to think that it isn't the Concerta, yet I disagree and am starting to think that my son is having an allergic reaction to the drug... Any thoughts on this?
189897 tn?1441126518
COMMUNITY LEADER
    I would think that an allergic reaction would have happened very soon after starting the concerta.   Did I read you correctly that this reaction happened after you LOWERED the dose?   If so, how long after lowering the dose did this began to happen?  And how long has this been going on?  Is the tightness in the throat only when eating?
     Does he have any stomach problems?
189897 tn?1441126518
COMMUNITY LEADER
   As I said, I would talk to your Doc.  I have never heard of Concerta and V prescribed together.  And ya, it would wake you up since it is good for about 8 hours.   I really think that you need to talk to your doc and start over with a low dose of one type of med and slowly work your way up.  
    And, by the way, exhaustion caused by lack of sleep, lack of vitamins, whatever will make all your symptoms much, much worse.   Get a high protein drink and take it with breakfast.  \
    Are you having trouble sleeping at night?  one sign of an overdose is that the med lasts longer then it should.  If the Concerta is lasting more then 8 or 9 hours, then that also is a sign of an overdose.  
    By the way, shaking is a normal and highly useful way to deal with ADHD - http://************.com/blog/archives/2014/03/29/fidgeting-strategies-that-help-people-with-adhd-focus/
1029273 tn?1472231494
Yes, you understood correctly, we noticed the changes after lowering the dosage of Concerta. The changes were apparent just within this year, in fact he started seeing the speech therapist (on school grounds) 2 months before school ended for the summer...

He has been taking Concerta since he was about 7 yeas old, before that we tried Adderall which was not the correct med. for him due to the strange side effects it caused...

He hasn't had any stomach issues, and he claims to only have tightness in his throat while trying to swallow foods like bread ( sandwiches, pizza, etc.), and anything solid like meat or chicken. First I thought, he was becoming a picky eater, but he claims to still enjoy eating those foods...

It was until just recently, that I considered that it possibly might be the Concerta?? I'm not sure, although some of the online articles I've read suggest that it could be a reaction to the med.
Here's the thing, right now I can't take him off of the Concerta because he is currently enrolled in summer courses (engineering & science) at the university for the next few weeks. I don't want him to have to go through withdrawals from taking him off the meds. during class time, plus he needs to stay focused with all of the homework. The tuition is nonrefundable at this point, and it was costly. I don't consider it an emergency situation regarding the current issues he's been having, but I would like to get this under control soon...

What would you suggest?
I'd appreciate your input :)
Avatar universal
Sandman2, I habe difficulty falling asleep and staying asleel during the night. However, I am able to sleep in.

Clement4now, I would not suggest taking him off Concerta without first consulting  his doctor. I was taken off Concerta all at once while in hospital and I had such terrible withdrawals. It was awful. I was also taken off all my other medication so that probably would not help.

Has anything else changed in his lifestyle besides the lowering of the concerta? It seems a bit odd that these symptoms would only appear when switched to a lower dose than he was used to. How much concerta does he take a day?
1029273 tn?1472231494
Hi,
Yeah, I really don't want to take him off of Concerta especially right now, for the exact reason you mentioned, awful withdrawals :(  I got a taste of how bad the withdrawals are when I took my son on a road trip to southern California (10 hours driving time) for a one week vacation without the Concerta ~ I totally forgot to pack his meds ( huge mistake!);  he was so miserable the entire trip and there was nothing I could do for him, it was heartbreaking to watch my kid go through that...Cold Turkey is not the way to go...

He is on 27 mg. of Concerta . He was up to 42 mg. at the beginning of this year. I can't wean him off of it until late July, which is okay, but I want to do this before he enrolls for school in September. He really should be on some type of meds. for his ADHD, otherwise his attention span is shot and he has difficulty focusing in a crowded classroom...

Nothing traumatic, or too overwhelming has happened with him recently, as far as I know. He is going through puberty, but according to his Dr. and therapist, that shouldn't be such a big issue enough to affect his speech, swallowing/tightness in throat, and the new tic (blinking)... I don't know for sure if it is the Concerta, but that is the only idea that I can come up with right now ~ btw, he doesn't take any other meds... The Concerta has been so helpful to him in the past few years, but maybe it isn't working for him anymore? Maybe it's time for another med?  I agree, it is strange that he has new issues, that's why I am stumped over this, I don't know what to make of it...
Thanks for commenting, I can use the helpful input and advice :)
189897 tn?1441126518
COMMUNITY LEADER
     If he did not have the problems before you lowered his dose, then maybe it is the lowering of the dose that is the problem?    The eating/chewing problem and speech could be due to rushing through things faster then he should - which his med would normally correct.
    One way to tell how well a med is working is how long it lasts.  If it doesn't last long enough - dose is low.   If it lasts too long - dose is high.  Concerta should last for about 8 hours.   Was he having his speech problems all day long or only more so in the afternoon?
   What made you decide to lower his dose?   I had assumed that these problem happened before you lowered the dose?
1029273 tn?1472231494
Hi,
Yeah, I'm starting to think that the lowering of the dosages combined with possible side effects is the culprit here in my sons case.
We lowered his dosage due to problems he was having in his classroom with bullying, thinking that maybe it would help with the outbursts and arguing between my son and the other boy.  I'm not sure if you recall my post in May, although I didn't comment on his lisp or other problems at the time because I hadn't yet made the connection.  Anyway, it was his teacher that suggested my son go into speech therapy at school, because she believed the boy bullying my son was encouraging other kids to make fun of my son's apparent lisp ~ at first I thought her comment was odd because I never noticed my son having a lisp, nor was it ever an issue prior to that in any of his other classes. It wasn't just me who thought this was odd, but also his therapist, his doctor, and my son's father were perplexed. It was around that time, that I started noticing the blinking tic more often, and my son mentioned the swallowing issues. The problems seem to happen from morning till late afternoon; he takes his meds. in the early a.m. w/ breakfast & protein smoothie...
He's always done well with Concerta in the past, but maybe it's time to change meds, or try to go back up to the original dose before he resumes school in the fall.

I'm an advocate of meds. and therapy due to the fact that I believe my son's life has improved with them before these recent problems came about.  This isn't an issue of us wanting to quit the meds altogether but more of a question as to how we should go about dealing with them.

Thanks again for your insightful advice :)
189897 tn?1441126518
COMMUNITY LEADER
    Thanks for mentioning the May post.   You know I am beginning to wonder how much of this might be related to anxiety?  Given what was going on in May, and up to that point.  It is possible that a lot of the symptoms may be anxiety related.   I don't know if I can find any symptoms like that on line, but I do think that anxiety can cause some of these problems.   So do talk with his psyc about that.  It will be interesting to see if things get better over the summer.  I'll see if I can find anything online.   Best wishes.
1029273 tn?1472231494
Well, the anxiety might definitely be a factor, it does run on my side of the family tree unfortunately.  My son has an appointment to see his doctor/therapist in a couple of weeks, and he'll need a prescription refill at that time, so I plan on bringing up the possibility of anxiety and my other concerns...
On a side note, we've enrolled my son in a different school for Fall, hoping that he'll be in a less crowded and more structured classroom environment...
Let me know what you come up with regarding any on line links or info.
As always, I appreciate your help!
Take Care
189897 tn?1441126518
COMMUNITY LEADER
       I think (hope) the new school will work out.  Do be proactive with his teachers and counselors.   Let them know what happened last year. Keep in contact with them via email, etc.   Is he in any special ed classes or have a 504?
      The nice thing about middle schools is that they usually are big enough that when the new year starts - a lot of kids are with different kids then the prior year, so it isn't quite as clicky as elementary schools.
      Keep your eye open for after school activities, clubs, etc. that he can get involved in.  This is a pretty good link on building social skills:
         http://www.additudemag.com/resource-center/friendships-for-adhd-kids.html
         And just in case you haven't seen it - these are good school accommodations for kids:
         http://www.additudemag.com/resource-center/friendships-for-adhd-kids.html
          The sources I used above has tons of really useful info - check out some of there other topics which are listed at the top of the page.
          Hope these help.  
          Do let me know how things are going.  I am very curious to see if his speech and other problems lessen during the summer.    Best wishes.
1029273 tn?1472231494
Hey, thanks for the links ~ I'll check those out later this evening when I have more time...
He's never been in any special ed. classes or special needs, I think because his grade point average is so high he's hard to place and usually his behavior isn't an issue unless the bullying starts up...

I will definitely keep you posted about my sons issues and follow ups with the dr./therapists regarding any diagnosis (if any?)...
Take it easy :) have a good summer
189897 tn?1441126518
COMMUNITY LEADER
   :)
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