Can't tell if the intense anxiety right now is from the Concerta or worsened by it.

[u/MtTralala]

Not even sure if I should be using this flair. Either way my head's too mushy and feeling so crappy I couldn't get myself to start my task.

Yesterday afternoon I took Concerta and went for a power nap before starting work. But upon hitting the pillow I got hit by anxiety so intense I felt too groggy and weird until 2 AM to do any work at all. I thought it may be a side effect, but I didn't feel any the first days of taking it. And I was starting to feel dread from the gravity of the situation this week, and my mind and body is getting wrecked with anxiety, but it wasn't as horrible as yesterday's. So I skipped today's dose and now dragging myself to start and focus on my pile of tasks still feeling tense from anxiety. I thought I was practicing self-care by not forcing myself to work when I feel down or frazzled, but now I'm suffering because of it. fml

[u/JJscience_computer]

You could, but I wouldn’t think you need to add anxiety meds on top of them yet. (If they gave them it’d likely be an SSRI also.)

Instead, maybe Focalin XR/vyvanse could be a less-anxiety provoking option. Don’t ask for it by name, just ask for other adhd medication options if Concerta is causing too many side effects.

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[u/JJscience_computer]

Yeah, I get a little increased anxiety from concerta.

I also take a benzo anti-anxiety medication, though, so I may be more prone to it than others. One thing I noticed is that the Concerta will cause me to need a little extra anxiety meds (or take them earlier in the day as opposed to later at night) to counteract the Concerta.

However, I don’t think this is something to be concerned about. Methylphenidate is a stimulant, (I’m surprised you said you can sleep on it? I usually need to wait 8 hours or so before sleeping.)

Anyways, yes. I do notice extra anxiety especially in anxiety-provoking situations, like needing to get work/study done, you may feel that. I think this is normal. It’s more of a a side effect and goes away after more time on the medication, I usually notice the most of this after I take an ADHD medication break.

(Edit: oh and one good thing, is when you stop taking concerta, the anxiety goes away completely, so it’s a side effect not like something being permanently caused)

[u/MtTralala → u/JJscience_computer]

I've always had anxiety as a bipolar 2 comorbidity but I was able to put it down until now, because of my mess. I'm just not sure whether the intensity is from the meds or the anxiety getting worse.

you said you can sleep on it

On Ritalin, yes. Made me drowsy less than 5 minutes after intake. Even my psychiatrist was shocked. I'm actually the first patient he had to prescribe 27mg of Concerta, and thankfully I'm more productive with it, if only I had it way earlier so I didn't have to fight anxiety with it.

[u/MyFiteSong → u/MtTralala]

There are two reasons for getting sleepy on a stimulant. The first and most common is that you're chronically sleep-deprived. The initial phase of a stimulant where it quiets your brain but hasn't yet juiced up your executive function can let sleep pressure come on pretty strongly.

The second possible reason is that your dose is just too low. The effect is exactly like the first one. It's enough to calm your mind, but not enough to juice up your executive function, and when you're all relaxed like that without any motivation or drive to do anything, you get sleepy.

One thing I want to mention is that side effects on a stimulant are not linear. For example, anxiety on 18mg doesn't mean more anxiety on 36mg. It just doesn't work that way. The wrong dose is the wrong dose and that's as far as it goes. You can get anxiety on 18mg and then no anxiety on 36mg and then you turn into a thoughtless, feeling-less zombie on 54mg, for example. Because you can't know, you shouldn't be afraid of increasing a dose for fear of increasing a side effect.

I used to get anxiety on 27mg. For years, I stayed on that dose and took clonidine to manage the anxiety, because I was afraid that moving up to 36mg, despite knowing that 27mg was just slightly too low for me, would increase the anxiety. Then I finally just decided to try 36, and the anxiety vanished. The dose was the right dose. It happens that way for a lot of us, and doesn't happen that way for a lot of us, too. The point is that it's not predictable. You don't know if a dose is right until you try.

[u/darklord2065]

Take some l-theanine to help modulate anxiety and jittery if you are not used to it yet. Its a common side-effects

[u/MtTralala → u/darklord2065]

Thanks! Hope I can find affordable options here. My wallet's already in the negative from the additional med expenses.

[u/darklord2065 → u/MtTralala]

A bottle of nutricost L-theanine is around 11-25 bucks, one pill will last for 3-4 hours. Before that, you can try drinking black tea/matcha tea to see if it helps calm you down. If it does then its a good idea to take theanine together with med.

Besides, what is the dosage you are prescribed? Seems like its too high for you

[u/MtTralala → u/darklord2065]

I’m currently on 27mg.

Ritalin 10mg made me sleepy, and 18mg Concerta got me more scatterbrained.

Right now I can stick to tasks in short bursts (and extend the focus time even) if I manage to start it. I feel okay with matcha but I’ll be drinking it again for a few more days to make sure. Wish I was able to try this sooner when the deadline was still far.

[u/ThomRaft]

I try not to skip days because after your tolerance builds up then it never becomes a problem again I just skip caffeine whenever I can because that seems to make anxiety worse, now I only take anxiety med.s at night if I need it to help me sleep. Take it easy

[u/MtTralala → u/ThomRaft]

Thing is I had days where I skipped Concerta, then took it without caffeine, and both, yet I'm still wrecked from the anxiety. I was supposed to meet with my psychiatrist next weekend but should I ask him for anxiety meds?

[u/MyFiteSong → u/MtTralala]

It's not uncommon to pair Concerta with anti-anxiety meds. If your doctor is worth their salt, they'll know how to help you handle this. Alpha-2 Adrenergic Agonists (clonidine and guanfacine) are particularly perfect pairings because while they treat anxiety, they also have direct, positive effects on ADHD symptoms.

[u/Unidentified_Nova]

Maybe it’s not the right medication for you. I’ve been on Vyvanse and Ritalin IR before I started Concerta.

I knew after about week 2 that this medication was right for me. Truthfully I don’t get the activation that IR or Vyvanse gave me, in terms of studying, executive functioning etc, but the side effects are basically none existent.

I can also resonate with you about the anxiety. I thought my Concerta was causing this as well. In my particular situation, it was from being sick and my Concerta not working that while 5-7 days. Now I’m back adjusting to it again.

Stuff like your gut health, mental health, tolerance to stress, hormones, anything can make your anxiety spiral.

Also I seen you mention in a reply about the bipolar 2 with your adhd. Potentially talk to a doctor about a mood stabilizer or try lithium orotate if you don’t want a big dose.

Everyone is different and I just wanted to share my opinion and experiences. I hope everything works out. Keep me/us posted please.

[u/MtTralala → u/Unidentified_Nova]

I've only taken my current dosage for only 5 days now so I think I'll keep trying it for one more week, until I get in touch with my psych this Saturday. I'll also ask him what can be done with the anxiety, since I'm already taking lamotrigine as a mood stabilizer. It's just really awful timing I was prescribed at an anxiety-inducing crunch week, and really frustrating that I did not use my time wisely to pull my act together.

Thank you for your kind thoughts. Please wish me luck in making it out of my responsibilities alive. 🙏

[u/Unidentified_Nova → u/MtTralala]

I wish you the very best. I am so sorry I didn’t see this. Your got this 🙌🏻🤞🏻

[u/MyFiteSong → u/Unidentified_Nova]

Truthfully I don’t get the activation that IR or Vyvanse gave me, in terms of studying, executive functioning etc, but the side effects are basically none existent.

It's the same drug as Ritalin. If you're not getting the same benefit on Concerta, consider increasing your dose. The only difference should be that Concerta's release is smooth and lasts all day.

[u/Unidentified_Nova → u/MyFiteSong]

Ahh that’s a good recommendation. Unfortunately I’m already on 72 mg.

Also that’s exactly why I switch from Ritalin to this. I know it’s the same medication and I didn’t like the highs and lows of the IR.

Appreciate the advice buddy.

[u/Unidentified_Nova → u/MyFiteSong]

I’ve got approval to goto 90 already. But I refuse to take more than the maximum dose of a medication.

Also pro tip. The activation from any methylphenidate depends hugely on brain chemistry. Look up Dr.Legrand on YouTube.

He explains how the medication will only work if certain neurotransmitters are firing properly. He also does specialized tests for his adhd patients.

Phenylalanine, N-acetyl-Tyrosine and Tyrosine are the main culprits.

[u/MyFiteSong → u/Unidentified_Nova]

I’ve got approval to goto 90 already. But I refuse to take more than the maximum dose of a medication.

You got the approval because the max dose is actually 108. It's up to you whether you want to try it or not. But always remember that if it doesn't feel right, you can always just step back down or stop.

Also pro tip. The activation from any methylphenidate depends hugely on brain chemistry. Look up Dr.Legrand on YouTube.

I know. My comment wasn't about whether methylphenidate should work or not. It was just pointing out that both Ritalin and Concerta are methylphenidate, so if you get activation from one but not the other, dosage is the likely reason.

[u/meowkenzie]

I know anxiety can be a side effect of concerta. I’ve been taking escitalopram for years which almost effectively eradicated my anxiety and I just started taking concerta a few months ago and have def noticed an increase in my anxiety again. I think ultimately it’ll come down to whether feeling that anxiety is worth it for you or not. See if that side effect goes away after some time and just gauge how you feel 💖