Dosage, increased anxiety second realease, 54+18 not working. HELP

[Vitto123]

First of all, I would like to apologize for my misspelling because I am not an English native speaker.

I have been diagnosed as an adult as ADHD and started with Atomoxetina. Here in Spain Adult ADHD is widely unknown as have increase knowledge among doctors and public opinion about kids, so I decided after a long life seek for a serious diagnose in one of the best centers for adults in my country. There, after lots of test, dialogue with relatives and my couple, psicologist and my psych confirmed my ADHD, but decided to switch with Concerta together with the previous Xanax I was taking before sleep.

We started about two months ago with 27 mg, first day there was a lot of side effects, but after three days all return to normal and I was able to concentrate, less impulsive, more stable at social relations. Effects started to low after one week, so we started titration process. We titrate 9mg after 9mg, with light side effects until we reach 72 mg. It work very well, was like anti-anxiety pill, althought in the afternoon (life-times are different in Spain, afternoon for us is after 2-3 pm), when the second dose of Concerta. Mainly like if you take a lot of coffee, increasing a “drug feeling” with nausea and intestinal problem.

Already in 63 mg (36+27) had the phenomena, but wasn´t intolerant.

So, when I change to 36+36, because with 63 I had slight troubles with concentration and other issues, at first in the morning it was like tune the radio. Like if you are trying to find a Radio Channel I suddenly al works, smoothly, but after 5 hours it start to increase nausea and a kind of nervousness, but as I was at home that three days and had an appointment with my doc on Monday, last Monday, I continue hoping this effects will calm with time. My first day at job, instead, but I live far from my job so from I take my pill until I start to work there were two hours. This symptoms increased a lot mixed with the stress of work (I´m a Lawyer) so in the afternoon I told my doc but he said if it was working so well in the morning to wait a bit and changed my prescribed Xanax for Lormetazepam for better sleep, equivalent dose.

The night after changing Xanax I ended at ER. After my first dose of Lormetazepam I woke up zombie, I drove and I felt really panic, sweating, and in the afternoon I had an increase ataxia, dizziness, nausea, headache, anxiety. So much that I had a medical leave until today. In ER they changed back Lormetazepam for Xanax. I talked with my psych that night and he said to me to maintain Xanax and Concerta 36+36 dose, plus 54+18 for the days that I have to wake up very early and meetings at evenings. Second they, I took 36+36 and I was sick from the previous days schock. Third day, 36+36 feeling better, recovering from whatever happens with benzo change, but having nausea and fever after 5 hours of 36+36. Fourth day, this Friday, the same. Saturday, bit desperate, I took the second option, 54+18 after six hours. No side effects but I big decrease in the effectiveness. Today 54+18 after three hours. No side effects, but starting effects in late afternoon.

I am scare due to my kind of work of taking again 36+36 tomorrow because I have clients, partners and I don´t want being sick half of the day. My problem is that my work requiere a lot of concentration in the morning, when I mainly have to go to Court, where I have to keep my concentration, and my speech, etc. So if I decrease the dose in the morning I am a mess and you can imagine the consequences for my job. It´s clear for me that this first release dose of 36+36 it´s my dose of Methylphenidate, but the increase in the afternoon is just killing me with dramatic consequences in my performance. Why do you think it´s happening, someone with the same experience?

For me the substance, methylphenidate, work just perfect in the correct dose, and I don´t know if there is no further possibilities or if you have had a similar problem.

In Spain we have just two stimulants approved for ADHD: methylphenidate, under methylphenidate hydrochloride called Medikinet, and Concerta, and after Vyanse. Atomoxetina was totally ineffective for me.

I just hope if someone can help me a bit because my next doc appointment is late November or give me some advice.

PS: Also, if someone have any explanation about with happens with benzo change, it could be very helpful.

Thank all.

[sarahsweets]

Is it possible that you were suffering with minor withdrawal from the xanax? I know you switched to a drug in the same class with similar dose but I wonder if its possible?

[Vitto123]

Could be, but it was totally different from my previous withdrawal, like a shock.

Anyway, what I don't understand is why 54+18 it's working worse than 36+36 and if there is anyway to improve morning effectiveness without so bad side effects in the midday.