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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by Jakeo29 on December 31, 2008, at 12:59:24
I found the optimal dose of Concerta, seems high, but it works best at this dose. Unlike Adderall, Concerta does not give me any Euphoria or sense that I can take on the world feeling. It just keeps me awake, and in turn, I can focus. I am still a little disorganized and have sleepiness from time to time-but some of it is psychological, therefore I have to walk the walk. 72mg/day-I start to notice effectiveness. 92mg/day-reasonable. 108mg/day, optimal effectiveness (90%) relief from hypersomnia symptoms of Narcolepsy. Above 108/mg-No further improvements noted. I was reading that 108mg day is not really 108mg of Ritalin throughout the day. The equation turns out to be the equivalent of 25mg of Ritalin 3X daily. At this dose, it seems to have the wakeful effects of about 40-50 mg/day of Adderall, just without the Amphetamine high. Although I dislike talking about stimulants to my doctors because I they are stigmatized as speed. There is nothing "speedy" about Ritalin for me. Sometimes I wonder why it's a CII substance. I think they could get away with CIV for Concerta. In fact, Caffeine is more speedy and addictive to me. Have a happy or hopefully happy new year! It's good to be done with another year of adversity, maybe this year will be different for all of us. -Jake
Posted by Jakeo29 on January 1, 2009, at 10:59:27
In reply to Concerta update, posted by Jakeo29 on December 31, 2008, at 12:59:24
I saw my sleep doctor and he was concerned about Concerta dosages above 72 mg/day. Combining the additive effects of Strattera 80 mg/day and my addiction to Caffeine, I forgot to take into account the sympathetic effects of too much Norepinephrine from the ramped up dopamine levels from the stimulants. My Blood pressure was 160/100 which normal for me should be 120-130/80-90. That's why we see our doctors. :) Interestingly enough I felt relaxed and focused at higher dosages, however high blood pressure is a red flag that we need to trend downward. We will stay at 72 mg/day of Concerta, and I will talk with my pdoc on Monday to reduce the Strattera to the next lower dose. ~60 mg/day to reduce Norepinephrine ramping effects. Higher blood pressure is a bigger risk than keeping awake. What is intriguing is that I lost 13 pounds in a month. 205 down to 193. At first one would conclude that it is solely the stimulants, which partially yes. However not sure if the sleep doctor understood that I have been doing massive amounts of physical hard labor snow blowing for 4-6 hour stretches in extreme cold and lots of snow. My normal weight should be 185. He is concerned that my weight loss is too rapid and I disagree. I was 205 because I sat on my duff all summer and in the last month I have been working very hard. I have been eating a lot too. However, due to the higher blood pressure, it is a sign that I may be more stimulated than I realize. I would think my blood pressure would be lower, but I did go see the doctor right after snow shoveling for 4 hours, and the dopamine/norepinephrine/ephredrine released from exercising is naturally adding too the stimulant combo too. Thus, if I am highly physical, lower dose stimulants are needed. Sitting around all day at school studying is when higher dosages of stimulants are needed as long as blood pressure is not to exceed 130/90. The biggest concern with 160/100 pressure is a sign that it could further progress into hypomania. What is Interesting is Adderall always lowered my pressure where Concerta in combination with Strattera seems to raise it. And I need to reduce my Caffeine dependence which is way more addictive than any controlled stimulants! Any thoughts on this feel free to respond or if any have had similar experiences when finding right dosages of medication while keeping BP in check. -Jake.
This is the end of the thread.
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