Tugga concerta
The physician who elects to use CONCERTA ® for extended periods in patients with ADHD should periodically re-evaluate the long-term usefulness of the drug for the individual patient with trials off medication to assess the patient's functioning without pharmacotherapy. Daily dosages above 72 mg in adults are not recommended. Stimulant medications cause a modest increase in average blood pressure about 2 to 4 mm Hg and average heart rate about 3 to 6 bpm [see Adverse Reactions 6.
The symptoms must cause clinically significant impairment, e. Withdrawal following chronic therapeutic use may unmask symptoms of the underlying disorder that may require follow-up. Children, adolescents, or adults who are being considered for treatment with stimulant medications should have a careful history including assessment for a family history of sudden death or ventricular arrhythmia and physical exam to assess for the presence of cardiac disease, and should receive further cardiac evaluation if findings suggest such disease e.
Caution is indicated in treating patients whose underlying medical conditions might be compromised by increases in blood pressure or heart rate, e. Administration of stimulants may exacerbate symptoms of behavior disturbance and thought disorder in patients with a preexisting psychotic disorder. Adults with such abnormalities should also generally not be treated with stimulant drugs. The Combined Type requires both inattentive and hyperactive-impulsive criteria to be met.
Concerta has gained immense popularity and remains one of the preferred choices for ADHD treatment. Treatment-emergent psychotic or manic symptoms, e. Its reputation is backed by extensive clinical research studies demonstrating its effectiveness. Sudden deaths, stroke, and myocardial infarction have been reported in adults taking stimulant drugs at usual doses for ADHD. The symptoms must not be better accounted for by another mental disorder.
Chronic abusive use can lead to marked tolerance and psychological dependence with varying degrees of abnormal behavior. CONCERTA has a high potential for abuse and misuse. Prior to initiating treatment with a stimulant, patients with comorbid depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder; such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression.
While the mean changes alone would not be expected to have short-term consequences, all patients should be monitored for larger changes in heart rate and blood pressure. Chronic abusive use can lead to marked tolerance and psychological dependence, with varying degrees of abnormal behavior. If improvement is not observed after appropriate dosage adjustment over a one-month period, the drug should be discontinued.
Other methylphenidate regimens: Clinical judgment should be used when selecting the starting dose.
Side Effects of Concerta: What You Need to Know
CONCERTA ® methylphenidate HCl Extended-Release Tablets are available in the following dosage strengths: mg tablets are yellow and imprinted with "alza 18," mg tablets are gray and imprinted with "alza 27," mg tablets are white and imprinted with "alza 36," and mg tablets are brownish-red and imprinted with "alza Sudden death has been reported in association with CNS stimulant treatment at usual doses in children and adolescents with structural cardiac abnormalities or other serious heart problems.
Daily dosages above 54 mg in children and 72 mg in adolescents have not been studied and are not recommended. Drug treatment may not be indicated for all patients with ADHD. Although the role of stimulants in these adult cases is also unknown, adults have a greater likelihood than children of having serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems.
The recommended starting dose of CONCERTA ® for patients who are not currently taking methylphenidate or stimulants other than methylphenidate is 18 mg once daily for children and adolescents and 18 or 36 mg once daily for adults see Table 1. Patients who develop symptoms such as exertional chest pain, unexplained syncope, or other symptoms suggestive of cardiac disease during stimulant treatment should undergo a prompt cardiac evaluation.
Careful supervision is required during withdrawal from abusive use since severe depression may occur. Improvement may be sustained when the drug is either temporarily or permanently discontinued. Learning may or may not be impaired. A mg dosage strength is available for physicians who wish to prescribe between the mg and mg dosages. Appropriate educational placement is essential and psychosocial intervention is often helpful.
The diagnosis must be based upon a complete history and evaluation of the patient and not solely on the presence of the required number of DSM-IV characteristics. CONCERTA can be diverted for non-medical use into illicit channels or distribution [see Drug Abuse and Dependence ()].
What are the Effects of Concerta on the Body?
Frank psychotic episodes can occur, especially with parenteral abuse. The use of CONCERTA exposes individuals to the risks of abuse and misuse, which can lead to the development of a substance use disorder, including addiction. If you are a consumer or patient please visit this version. Adequate diagnosis requires the use of medical and special psychological, educational, and social resources. When remedial measures alone are insufficient, the decision to prescribe stimulant medication will depend upon the physician's assessment of the chronicity and severity of the patient's symptoms.
Dosing recommendations are based on current dose regimen and clinical judgment. It is generally agreed, however, that pharmacological treatment of ADHD may be needed for extended periods. If such symptoms occur, consideration should be given to a possible causal role of the stimulant, and discontinuation of treatment may be appropriate. Although some serious heart problems alone carry an increased risk of sudden death, stimulant products generally should not be used in children or adolescents with known serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, or other serious cardiac problems that may place them at increased vulnerability to the sympathomimetic effects of a stimulant drug.
If paradoxical aggravation of symptoms or other adverse events occur, the dosage should be reduced, or, if necessary, the drug should be discontinued. Doses may be increased in mg increments at weekly intervals for patients who have not achieved an optimal response at a lower dose. Conversion dosage should not exceed 72 mg daily. Specific etiology of this syndrome is unknown, and there is no single diagnostic test. Caution should be exercised if administered to nursing mothers 8.