What is Concerta Used For?
Concerta contains methylphenidate, a drug with similar structure and stimulant properties to cocaine and methamphetamines. Methylphenidate is prescribed to treat ADHD in children and adults between the ages of 6 and 65. The term ADHD is an acronym for attention-deficit-hyperactivity-disorder.
Some believe that ADHD is a bonafide diagnosis that may even be related to autism, and that it should be treated as a psychiatric illness.
The DSM 5 edition revised the official diagnostic criteria for ADHD in 2013.2
Symptoms of ADHD have recently been separated into two kinds of ADHD. One is “inattentive ADHD” according to the most current psychiatric literature on diagnosis. This disorder is diagnosed against a set of 9 symptoms. A diagnosis for children under the age of 17 years must include evidence of at least 6 of these nine symptoms for at least 6 months; however, for age 17 and up, a patient only needs evidence of 5 of these 9 symptoms to completely satisfy the criteria for diagnosis:
- Overlooks details in assigned tasks, makes mistakes, careless about details
- Lack of sustained attention during lengthy activities, such as reading, listening to a lecture or playing
- Distracted or non-attentive when being spoken to
- Fails to finish assigned homework or chores, gets easily sidetracked
- Lacks organization skills such as time management, possessions not organized, etc.
- Reluctant to begin lengthy tasks such as preparing a long report that requires sustained focus and effort
- Often loses possessions related to school or work, like pens and pencils, cell phones, etc.
- Gets distracted by outside sounds or other environmental stimuli
- Tends to be forgetful about chores, errands, keeping appointments, etc.
The second diagnostic category for this disorder is called “hyperactive-impulsive ADHD,” and the 9 symptoms to satisfy diagnostic criteria for this psychiatric disorder, (required minimum of 6 of the 9 symptoms under 17 years of age, and a minimum of 5 out of 9 for age 17 and older) are:
- Frequently fidgets, taps with hands, squirms while seated
- When expected to remain seated, often gets up or leaves the area
- Runs about, climbs, restlessness
- Inability to play quietly or participate in leisure activities quietly
- Often active, as if driven by a motor, can’t sit still, is difficult to keep up with
- Talks excessively
- Blurts out answers before a question has been completed or speaks out of turn
- Difficulty waiting in a line, waiting for his/her turn, tends to intrude without permission
- Hyperfocused, becoming overly absorbed in tasks to the detriment of social responsibilities, agreements, appointments, etc.
However, ADHD is considered by some in the mental health field as a fictitious disease model and do not agree that placing a label on a child, or an adult for that matter, is sound medical practice, or that such labels and treatment models lead to any desirable outcome in helping those so labeled to do better in school, in their work or professional career, or to meet the challenges in general that life may bring.3
Some medical experts question the near tidal-wave rise in reliance on medication to relieve boredom, increase interest and attention span, or as a quick fix to calm down overly-boisterous children or adults.
Other questions have yet to be completely answered as to the wisdom of attempting to alter natural brain chemicals and neural pathways in young people and in adults, and why such practices should have become the most frequently chosen option when such significant questions as to potential long-term health and safety consequences still remain glaringly open.5
Giving a child a stimulant such as Concerta during the time of transition from puberty into adulthood raises some important concerns. It is during this time that a child begins to sense the rewards of life. The dopamine areas of the brain, called the mesocorticolimbic region, are just getting wired up and interconnected with other parts of the brain at this time. It is likely that stimulants like Concerta could interfere with this very important age-related development. Additionally, it is very common for children and young adults to abuse Concerta, and then stay up one too many nights in a drug-induced mania. Concerned parties, including physicians, may mistake this drug-induced psychosis as an actual mental disorder and prescribe antipsychotic medications. Unfortunately, this is an all too common event and can result in long-term consequences.
Such questions deserve a serious assessment so that informed decisions can be made regarding the use of drug-based treatments, as well as considering other approaches to improving social skills, workplace management skills, improved strategies and skills for learning, and achieving bettered individual mental health without relying on drugs.
Alternative Names and Slang
Concerta has developed a host of slang terms such as:
- Kibbles & bits
- Kiddy cocaine
- Kiddie coke
These terms would be used in a context of recreational use or diversion.
Concerta is a stimulant, but is probably better known for its paradoxical (non-stimulant) effects particularly in children and teenagers. Some side effects point to health risks and these should be closely monitored, such as:
- Serious cardiovascular events
- Increase in blood pressure
- Psychiatric-adverse events
- Peripheral vasculopathy
- Visual disturbance
- Stunted growth (long-term suppression of growth)
- Gastrointestinal blockage or narrowing
- Platelet count changes requiring hematologic monitoring
The above points are from the warnings listed on the FDA label information for Concerta.1
The following is a list of other commonly reported side effects of drugs containing methylphenidate:
- Nausea, vomiting, upset stomach
- Loss of interest in eating, decreased appetite, weight loss
- Mood swings, i.e., euphoria to irritability, sadness, anger, hostility, etc.
- Insomnia, disturbed sleep, unusual dreams
- Tachycardia, racing heart rate even at rest
- Dry mouth
More serious side effects can include:
- Suicidality (thoughts or attempts)
- Increased violence
- Violent thoughts
- Thoughts of self-harm
- Chest pain, difficulty breathing, shortness of breath
- Poor circulation in fingers and toes causing them to turn blue or white, cold or numb.
- Hearing voices in the head, especially directing the person to do certain things, or other auditory hallucinations
Always talk with your prescribing physician if these or other symptoms appear while taking Concerta.
The FDA warns of the following possible withdrawal effects:1
- Elevated blood pressure
While some people report minimal withdrawal symptoms after stopping Concerta, others report a range of withdrawal effects that may include:
- Psychotic behavior
- Slowed heart rate
- Headaches, can be severe
- Tiredness, fatigue
- Nausea, stomach ache, vomiting
- Panic attacks
- Increased appetite, ravenous hunger
- Cognitive impairment, brain fog
- Mood swings
- Drug cravings
Coming off any medication, especially one that has been taken for years or even decades, may require precise, careful monitoring to ensure the safety of the person during and after the tapering process.
Worldwide statistics collected over many years have shown that a person diagnosed with ADHD would be five times more likely to develop an addiction disorder.6
Tapering from Concerta in a nurturing, well-monitored and health-restorative setting is recommended to avoid the possibility of further health risks.