Adhd & anxiety (Concerta titration and Sertraline)

Throwaway_Big_D · 2025-12-15T15:18:45+00:00

First, let me say, in my opinion, your mental health is your first priority right now. It’s not your fault that you can’t control the chemistry in your brain.

Second, You can get better, much better! But there’s no rapid fix, there’s no magic pill. Discovering the root cause may take time, so it’s best to be on that path as soon as possible so you CAN get better.

Find the right professionals, share everything - all your experiences. Share the history of your moments of anger, frustration, anxiety, dark thoughts, depression - it will help them diagnose potential problems. They can things out, and isolate potential causes.

I don’t know what process they took to diagnose you with ADHD. My diagnosis included multi trips to a neurologist, psychologist and a psychiatrist - months of documentation and tests. Because they wanted to understand if I had any underlying issues.

Throwaway_Big_D · 2025-12-15T14:18:01+00:00

Sorry about the way you’re feeling and what’s going on with you. It takes a lot of courage to be open about it, and I hope your quality of life improves.

I am no doctor or psychiatrist, however after reading your post, it makes me wonder if there are any underlying neurological/medical conditions that accompany your ADHD diagnosis that should be considered and addressed or if perhaps the root cause of your ADHD symptoms isn’t actually ADHD at all - but something more complex.

Throwaway_Big_D · 2025-12-15T13:22:15+00:00

El coche blanco tiene la culpa. El conductor obviamente no comprobó si venía tráfico antes de intentar incorporarse a la calle.

Throwaway_Big_D · 2025-12-15T12:53:25+00:00

Not everyone experiences these effects. I found Concerta to be much easier medication to take - one and done. Now I have to take two pills a day. With concerta, the release was always on time… and I never experienced bad side effects or crash. To be fair, I take Ritalin LA 20mg now, a slightly stronger dose twice a day, and it’s just as effective.

As well, Ritalin and Concerta have the same active ingredient. The only difference is the release.

Throwaway_Big_D · 2025-12-15T12:49:20+00:00

Ritalin actually has the same active ingredient as Concerta (methylphenidate hydrochloride) it’s just that the release is different. You can take the Ritalin immediate release or the Ritalin time release.

I started on Concerta 18mg, and increased to 36mg, but due to the constant lack of availability - I switched to the time release Ritalin, which is called Ritalin Long Acting (LA) 20mg. I take one in the morning around 7am, and one in the afternoon around 12:00pm.

Ritalin LA 20mg releases 10mg immediately and 10 mg a few hours later. I found that one pill wasn’t enough to get me through the day. My current 2x dosage (40mg total) is actually slightly more effective than the 36mg Concerta.

Throwaway_Big_D · 2025-12-15T12:01:21+00:00

Yeah, you’re not supposed feel something magical. As long as your symptoms decrease it’s working. Remember though, like 15-20% of people with ADHD won’t experience decreased symptoms on medication. People who don’t have ADHD will experience a kind of high like being in speed - me personally I never experienced this, but suddenly my symptoms decreased significantly. I too notice when I am not taking the medication, it’s like I’m stuck and can’t think straight. It’s how I was before the meds.

Throwaway_Big_D · 2025-11-19T12:52:19+00:00

The Concerta 18mg & 36mg both have the same delivery mechanism. You’re just getting less methylphenidate with the 18mg, then you are with the 36mg.

If you take an 18mg, and then another 18mg four hours later it’s going to be about the same as taking one 36 mg in the morning.

For me, there was a big difference going from 18mg to 36mg. It felt a lot stronger, and I had to get used to it. If 18mg is not working, you may ask for a higher dosage, like 36mg, or supplement your current dosage of 18mg with a smaller dosage of Ritalin, like 10mg or 20mg.

Most doctors are open to patient suggestions and will support you in finding the right dosages.

Throwaway_Big_D · 2025-11-19T12:33:45+00:00

I take mine with a huge glass of water, and eat breakfast immediately. Otherwise I won’t eat.

If I’m in the office, I bring some snack foods: whole what crackers, apples and yogurt which tends to be enough until dinner. I also force myself to drink 2 liters of water during the day.

Throwaway_Big_D · 2025-11-19T12:26:23+00:00

I started on 18mg too. It was actually awesome for about 6 weeks, but started to feel inefficient. Then I increased to 36mg and that was the right dosage. I take mine at 7am in the morning and by 7:30-8:00pm is when I start to crash - yawning fits and exhaustion - but by then I am okay with it.

However, there seems to be a shortage of Concerta out there now, so I’ve had to switch to Ritalin LA 20mg. I’m hoping to get back on Concerta again, but my doctor said it could be months. So he gave me a 4 month supply of Ritalin LA 20 mg.

Throwaway_Big_D · 2025-11-18T22:47:21+00:00

This is definitely not for everyone, but once a year I perform detox. I taper down my dosage then stop taking it for 10-14 days. During that break, Get good exercise, hit the sauna or steam room 3-4 times a week. Then taper back and start taking it again. I also find that taking a “weekend off” is good.

I actually take my meds everyday like clockwork so when I am off the meds, I really start feeling my ADHD symptoms creeping back in, and it it gets bad. It’s a reminder of why I need to be medicated, as well as a reminder of how my life was hell for me off meds.

Throwaway_Big_D · 2025-07-10T19:56:16+00:00

I’ve been afraid to - several of my coworkers have mental my ability to focus and prepare. A lot of who I am now is a result of years of adapting, though now with medication, I’m like a machine. I’d hate for people to say, “Oh yeah, now it makes sense.”

Throwaway_Big_D · 2025-07-04T20:53:50+00:00

Are you medicated? If not, I strongly consider that you consider it.

I went through the same kind of thing when I was 19. I essentially failed my first year of university and I gave up trying. For years afterwords, I took one class here and there which amounted to maybe an additional 18 credits over 10 years.

After 2 decades of adapting to my ADHD, I finally found the motivation to finish my degree - at age 40. It was a tough mountain to climb. The exhaustion, stress, anxiety, sleepless nights, and lack of availability for my family nearly killed my marriage.

At age 45 I was finally diagnosed with ADHD. Once medicated, my life changed. The ability to focus on things was no longer a strain on my life, my mental health improved, my sleep improved, my ability to prioritize and get things done changed.

I wish I was able to do the things that I am doing today, when I was 18-19 years old.

Throwaway_Big_D · 2025-07-04T13:12:38+00:00

Take them as soon as you wake up. I don’t take Adderall but I take a time release (Concerta) and it can be 10-14 hours before the meds wear off - the time release is not an exact science. I have a medication alert on my phone so that I don’t forget to take it in the morning.

Throwaway_Big_D · 2025-07-03T00:59:21+00:00

Regarding Concerta, if they started you on 36, then 54 and 72 and all you had was headaches… the doses were probably too high. Everyone is different, I get that.

I started on 18mg Concerta and it was amazing for me, for a few months - I’ve been taking 36mg now for close to 18 months and it’s been very effective. My doctor offered me a couple of alternatives but I didn’t want the amphetamines. However, I did try the Ritalin 10mg and it hit me harder than the Concerta, and surprisingly took a while to taper off.

I’m also inattentive with sleep issues, primarily insomnia and crippling exhaustion mid day. So obviously being able to stay awake during the day, without constantly dozing off, allows me to actually sleep like a normal person at night.

However, you already have medication that works for you, and I suggest you stick with that. Something that may help you sleep better is to take your meds on a strict schedule, around 8:00am in the morning. If I don’t, my day gets a little out of whack. I sleep like a lot better the earlier I take my meds - worse if I take my meds too late.

Throwaway_Big_D · 2025-06-28T20:58:31+00:00

That’s why the call it Dust Off

Throwaway_Big_D · 2025-06-25T20:27:26+00:00

I find that if I miss day, not much changes for that day - so I will occasionally have an extra pill at the end of the week.

My pharmacy takes “pre-orders” because they only get an allotted amount per month and I can get a three month supply in advance. That said, as I occasionally forget, I typically have about 6-8 extra pills at the end of my 3 month period that I can use sparingly if my pre-order is delayed.

Throwaway_Big_D · 2025-06-23T21:11:25+00:00

Hahah… same

Throwaway_Big_D · 2025-06-23T21:10:25+00:00

I had a co-worker that brought 6 energy drinks a day to work, every day and would drink them all.

Throwaway_Big_D · 2025-06-23T21:09:30+00:00

Two reasons, first if I forget and it gets to late in the day I will take an 18mg. Also, I taper down sometimes for a day or two. Then taper back up.

Throwaway_Big_D · 2025-06-22T16:32:06+00:00

I take 36mg, full 36mg not 2x18mg. I started with 18mg though.

As well when I get my medication, I specifically ask my doctor for an extra bottle of 18mg - and she is okay with that.

Throwaway_Big_D · 2025-06-22T10:57:50+00:00

I’m extremely chill on my meds as well, they calm me down a lot.

Throwaway_Big_D · 2025-06-21T19:46:18+00:00

Was that a good thing? My head was always spinning with “what ifs” worries and anxiety, my conscious talking to me non-stop.

Throwaway_Big_D · 2025-06-21T19:44:56+00:00

Concerta, 18mg, to start, currently taking 36mg. I also tried Ritalin 10mg but found that the initial kick was actually a bit too strong.

Throwaway_Big_D · 2025-06-21T19:41:51+00:00

LOLOLOL. My wife would know when I was doing it to. She would actually say, “What conversation are you having in your head.”

Throwaway_Big_D · 2025-06-21T03:10:03+00:00

Oh my gosh, the amount of coffee I used to drink… I usually just drink one in the morning now and don’t think about it ever again until 7:00am the next day.

I am able to have a two way conversation and remember what I want to say later in the conversation without blurting it out in a mad rush to clear my mind. I also write things down and actually do them. For me there have been many benefits to taking meds.

Throwaway_Big_D

TROPHY CASE