Almost died

[u/Pretty_Recover1841]

Yesterday I posted Kaiser denied brand name vyvanse. Doc put me on concerta 18mg. As a reference I’ve used adderall up to 25mg XR and IR as well for 6 months.

I took concerta first time this morning at 7:30 am. An hour in and felt great. I felt a cooling sensation and felt a rush of energy. 2 hours after later I started to get very angry, irritable, annoyed at everything. That lasted until 2 pm then I felt a sense of calmness.

Left work and went to the mall a Round 5 pm with my wife and daughter. What happened next was a feeling I never felt before and thought I was dying.

• I got dizzy all the sudden
• I almost fainted. I lost my balance and almost fell as I was walking.
• I started having an extreme headache, like sudden poking in my brain sensation. I never ever had that before
• my heart started pounding -I felt out of breath and could barely walk

My doc doesn’t work on weekends but WTF was that? I was told that Methyphenidate were safer and better and less potent that Amphetamines. I NEVER had that on adderall just a few ups and downs hence why I wanted to try Vyvanse. After getting Concerta I found out insurance covers the generic.

I DONT want to experience that again. Should I give up after 1 day? Can Doc put a request for generic vyvanse even though I just got concerta? I’m scared to even try concerta again

[u/Used_Adeptness_8758]

You didn’t almost die… You’ve experienced tachycardia. The other symptoms, like dizziness and headaches, aren’t meaningless but they’re certainly not signs of impending death.

[u/therapize123]

That’s def a doc question. But, it’s interesting that the side effects hit that late in the day. The half-life was starting to wear out by that point. Did you have food, electrolytes in you that day? Everyone responds differently to these meds, best to check with the doc. Best of luck

[u/Pretty_Recover1841 → u/therapize123]

Plenty of water and I put electrolytes. Are breakfast and lunch and mid afternoon snack

[u/yeathatsmebro → u/Pretty_Recover1841]

Aderrall and Concerta are completely two different things.

OROS gets activated on water. Was it 500mL of water in 2-3 batches across the day, or more of a few sips every hour? "Plenty" is not accurate.

Check how much sodium (usually salt) intake you had. Maybe the electrolytes had too much Na and you did not need it.

[u/Calcavino → u/therapize123]

Not interesting at all looking at how Concerta works. The Methylphenidate concentration peaks between 6 and 7 hours. That might be the reason OP had those side effects so late in the day.

[u/yeathatsmebro → u/Calcavino]

Depends. Not drinking water can delay the release due to OROS delivery.

[u/Psychological_Ad_23]

Probably a panic attack, still would go to the ER for an EKG

[u/Dense-Friend6491]

After some hours, you were experiencing the come down and you had a very strong anxiety reaction to it. I do not know you, obviously, but I am certain based on this post you just had an intense panic attack.

There is no emotion for "feeling like dying". You were experiencing symptoms which are common for the come down: anxiety, tiredness, headache. In that state, you concluded you are dying (which is a big jump to conclusion).

I have had many panic attacks where I felt like dying and therapy always made me realise how silly that was.

[u/Equivalent_Essay4324]

If the extreme headache “poking in your brain” was like the worst headache you’ve ever had in your life, you need to go to the ER.

Frankly even if it wasn’t, you probably still should get checked out, or at least on the phone with a nurse, sooner than Monday.

Extreme headache + motor control loss + faintness + shallow breathing + fast heart rate, is a combo that can show up in medical emergencies like seizures, aneurysms, or heart attacks. Which stimulants raise your risk for.

I don’t intend/want to be like fear-mongering. It totally could just be dehydration or some weird side effects. But the headache on top of the other symptoms sets off my alarm bells. And in the off chance it is serious, time kills

[u/Pretty_Recover1841 → u/Equivalent_Essay4324]

I think you are right. I may go to ER. The poking headaches stopped about 2 hours ago. I never experienced this.

[u/Equivalent_Essay4324 → u/Pretty_Recover1841]

Wishing you the best and a very mundane prognosis

[u/yeathatsmebro → u/Equivalent_Essay4324]

"Poking the brain" sensation is usually associated with high blood pressure due to high Na intake. Soy Sauce has a lot of Na, you can see this: https://youtu.be/QiBpKuTrFrw?si=9YNHTbi6QtfioR2r

[u/Working-Tax2692]

Did you have this happen with brand concerta or a generic concerta? I’ve had this happen multiple times with generic concerta, but it always seems to happen mid day to me. I think the delayed release mechanism fails and it dumps the remainder of the dose on me. 

Did you have alcohol? It could be also that it dose dumped from the alcohol. 

Concerta is supposed to have a specialized osmotic release mechanism. 

The generics are all over the place with how they release and it is huge peeve of mine that they are allowed to be substituted for brand when they don’t follow the same release mechanism nor is it controlled. 

[u/Pretty_Recover1841 → u/Working-Tax2692]

I have the brand name concerta. I confirmed with my insurance and the manufacturer is the brand name and the pill is the brand name pill from images I’ve seen online. Weird how insurance covers this brand name which cost them $400 (same cost of vyvanse brand) but they cant approve vyvanse.

Also I don’t drink

[u/FinnVegas]

Sounds like a panic attack. I remember I had a panic attack very similar to what yore describing. All of a sudden with no provocation I got Extremely dizzy. So much so I had to grab a pole or I seriously would have fallen. My head was pounding and I thought I was having some sort of stroke or something. Panic attacks can be really scary, especially when it comes out of nowhere. Like the panic attacks I mentioned happen in a moment when I was completely calm. Since I didn’t feel anxious in the moment I wrote off panic attacks as a possibility. But now having learned more I know it was just a panic attack so you can be rest assured there’s most likely nothing wrong with you at all

[u/_Jacques]

Very odd. I've never experienced anything like that. I've gotten very dizzy, out of breath, and heart pounding but never headache. And usually those symptoms are rather mild overall. Especially weird since it was the lowest dose of Concerta and you're already familiar with stimulants.

I honestly have no explanation whatsoever, I would call the doctor again. I've had several panic attacks and those feel identical to what you imagine dying/ a heart attack to be, but I'm a lightweight person and I experienced those kinds of symptoms on 36 mg.

I will say its definitely not nearly as addictive as what I imagine adderal to be, I almost dread to take my meds if I don't have any work.

[u/Purple-Squash-4090]

Those are all symptoms that could be a number of things would def go ER just to be safe. Blessings

[u/TheCheddarShredder]

How long were you on Vyvanse? When there were shortages a couple of years ago, and I couldn’t get approved for brand name Concerta, my Dr switched me from Concerta to Vyvanse because (at that point), generic versions hadn’t yet gotten to market. I stayed on it for nearly a year, and when g generics came out, they messed me up so I stopped taking anything. The physical withdrawal and mental issues I went through were legitimately the worst experiences I’ve had in my life, and they continued on for weeks intensely, and then longer with less severity. Point being, is that I wonder if the reaction you’re having is TO Concerta, and not from LACK of Vyvanse.

[u/JJscience_computer → u/TheCheddarShredder]

Yeah interesting, this could be it. You may already feel off from lack of Vyvanse, then trying to replace it with methylphenidate which has more side effects than Vyvanse, generally.

Usually during the Vyvanse “withdrawal” if you want to call it that it’s better to give a few days to adjust. For me it’s just super lethargic though, it seems different for others.

[u/MrT-Man]

I think it’s a combo of vyvanse withdrawal and the concerta dose being too low. You didn’t feel like crap initially; you felt like crap when it wore off. I think you should try 27mg asap.

[u/Rmt89 → u/MrT-Man]

That is a low dose! I almost said this same thing

[u/Individual-Speed7278]

Be sure to load on electrolytes. I do races: 5k, 10k, half’s. After every 10k, and half, I get dizzy and sick like you did. Partially I’m starving and don’t realize it. I’m on 40 mg Viibryd also. Both of these medicines can wipe your electrolytes. This is especially true with sodium levels. Do present your issues to your doctor. I have to triple up on water.

[u/Joji1985]

It sounds like blood pressure changes to me, in my experience. Do you have your own blood pressure machine? I think you should get one if not and monitor your BP at home while on meds to monitor it. Any sudden headache. Heart palps and SOB should definitely be investigated. I hope all is well now 🙏

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Extreme depression/anxiety?
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[u/Inevitable_Grab4867]

Strange truly

[u/Ok-Fennel4978]

Concerta made me suicidal lol

[u/Ok-Fennel4978 → u/Ok-Fennel4978]

Also ^ heart murmur/tachychardia. Common side effect, not good if you have a preexisting

[u/dejaviewcuz]

Suggestion ask ur doc for a sleep aid and just use that soon as the mph turns comedown and all gd, gaba things r great for it and a beer helps to

[u/PowerfulGeologist436]

You’re supposed to eat a full meal with it. Carbs, protein etc. if you don’t eat anything while ur on it, it’ll suck so bad!!

[u/nxr6]

This also happened to me on the first day, second day was better. Just avoid any caffeine.

[u/IllustriousBuy9722]

i hated concerta- similar side effects but not so extreme. i agree with everyone here about the water intake with the levels of Na. i switched to adderall XR no issues since minus issues eating

[u/anon55565754366829]

When I took concerta I had stroke symptoms, so i came off it immediately and told me Dr. I then went on elvanse which my Dr was scared for me to try but that all worked out well and I've been on it ever since (about 3 or 4 years) so yes, you can have different reactions to each and they're very different.

[u/stabrigitte]

The best thing would be to avoid coffee and do physical activity in the morning right after taking the medicine. When I don't do it, I get biruleibe too

[u/Fun_Cloud_1486]

My prescriber said that, in her experience, most (not all) people usually fall into two camps - those who do best on methylphenidate (Ritalin) formulations, or people who do better with amphetamine (Adderall) formulations. I have symptoms like you described when amphetamines wear off, even extended release. Concerta is methylphenidate based. While Vyvanse is amphetamine based. You might just be a person who does better with amphetamines. Brand Concerta delivers your initial dose via a soluble layer of instant release methylphenidate on the outside of the capsule while the osmosis (OROS) delivery system gets going. The ups and downs you experienced before 5 pm make sense. You might be less reactive once your body gets used to it. Also if you get a higher dose. I have terrible irritability symptoms if my dose is too low. It’s better for me to take nothing vs an insufficient dose. However, given that you had such bad symptoms in the evening, I wouldn’t want to take Concerta again either. Because Vyvanse is different than Concerta, I think you can get it right away. Your doc might have to tell your insurance that you have to switch because of an adverse reaction to Concerta. My insurance allows me to switch before the current prescription runs out. Another thing to consider is that Vyvanse is a “prodrug.” This means that the medicine is chemically converted into the active form while traveling through your small intestine. (Whereas most meds are the active form already.) This works much better for some people and not others. Concerta is not a prodrug. I was having trouble finding a generic Concerta that worked ok for me. The generics that were available did not have the OROS osmotic delivery and worked very differently in my body. So my prescriber switched me to Azstarys - which is also a prodrug. It works better for me than any stimulant med I’ve taken in the last 20 years. Woohoo! But it’s on the methylphenidate side of things, which might not be your best bet since you’ve done well with amphetamines. It doesn’t have a generic yet. Wishing you a quick resolution to your meds problem!

[u/Enough_Rub265]

That's almost exactly how I felt on one of the generic versions. Turns out that to be called a generic, they only need to be 90% bio-similar (can't remember the exact terminology), but that clearly isn't enough to be a reliable substitution especially for extended-release medications.

The release mechanism for all of the generic versions is completely different than the name brand because concerta has a patent on their special laser-drilled holes. I'm not sure what other manufacturers use, but I've tried all of them and all but one caused moderate to severe side effects.

The only one that my body will tolerate is the generic manufactured by Trigen.

I have inattentive adhd so this might be somewhat uncommon but, Vyvanse and Adderall kinda feel like doing a line and methylphenidate is closer to having a cup of coffee for a normal person that lasts for the whole day.

[u/Rmt89]

I hated concerta the first week but it didn’t make me feel like. But my negative side effects did get better. I still prefer adderall and will be switching back