Hello, I live in Japan.

I take 36 mg of Concerta every day, but pharmacies are receiving virtually no stock at all—not the 18 mg, 27 mg, or 36 mg strengths.

In Japan, we first obtain a prescription from our doctor, submit it to a dispensing pharmacy, and then receive the medication from the pharmacy.

My doctor prescribed me 36 mg Concerta a month ago, and I submitted the prescription to my pharmacy immediately. Unsurprisingly, they had none in stock, and they still have no idea when they will receive more. I now have only four doses left.

Every pharmacy I have contacted has told me the same thing: they have no estimated restock date.

Apparently, until a few months ago, pharmacies were receiving about one box of each strength per month. Now, however, they do not seem to be receiving any at all.

Only three medications are approved for treating adults with ADHD in Japan:

• Concerta (extended-release methylphenidate)
• Strattera (atomoxetine)
• Intuniv (guanfacine)

I have tried both Strattera and Intuniv, but neither worked for me. Strattera made my mind feel strangely quiet, which I found uncomfortable, while Intuniv significantly worsened my depression.

Honestly, I am angry with Japan’s Ministry of Health, Labour and Welfare.

Pharmacy-to-pharmacy transfers of Concerta were recently permitted as an exceptional measure. However, this is practically meaningless when the medication itself is barely being distributed anywhere.

In my case, only stimulant medications such as Concerta are effective and tolerable.

Vyvanse (lisdexamfetamine) is another stimulant ADHD medication, but in Japan it is approved only for children and generally cannot be prescribed to adults. Adults may continue taking it only as an exception if they began treatment with Vyvanse during childhood and it remains effective after they reach adulthood.

Immediate-release Ritalin (methylphenidate) was previously misused in Japan. As a result, its approved use is now restricted to narcolepsy, and it cannot be prescribed for ADHD.

At this point, rather than continuing to rely solely on Concerta, I would like Japan’s Ministry of Health, Labour and Welfare to consider the following exceptional measures:

1. Expand Ritalin’s approved indication to include ADHD.
2. Approve Vyvanse for the treatment of adults with ADHD.

Unfortunately, Japan’s regulations are extremely strict, so I doubt either change will happen.

This has become a serious social issue in Japan. Many people with ADHD say they can no longer function properly in their daily lives because they cannot obtain their medication, and I am one of them.

What is the current Concerta supply situation like in your country? Are alternative medications such as Vyvanse, Ritalin, or other treatments available to you?

Thank you for reading!

Is it safe to take methylphynidate as a first thing in the morning after waking up??

I

I completed a Master degree despite how difficult is to focus or read a whole book. I have dyslexia and deficit of attention.
Now in my 40s my focus is getting worse, probably because I also parent alone 2 kids.
So I was prescribed concerta 18mg and should double after second week. I noticed my anxiety and panic getting worse, so I decided not to double. I stayed at 18mg and felt it helps me to focus on my tasks as reading and comprehension.
Unfortunately, this medication brought me panic and anxiety raises. I feel like the world will end tomorrow, that my problems are bigger and I wont make it, as if a stone is weighing me down. All this anxiety crisis only taking 18mg.
I conclude this medication isn’t for me.
Anyone else?
Did the psychiatrist prescribed something else?
Ty

Title: My experience with Focalin XR crashes, switching to Concerta, and the effects of Lexapro and caffeine

Just wanted to share my experience with ADHD medication in case it helps someone dealing with similar issues.

I initially started on Focalin XR, but struggled with its duration and crashes:

• 10 mg: Started working after about 1 hour, but the benefits were already fading around 4 hours, followed by a crash around 5 hours. Occasionally, I'd get a very weak second wave around 7–8 hours.
• 15 mg: Similar short duration, but much worse crashes. I'd experience heavy sleepiness followed by several hours of agitation and irritability.

After some trial and error, I found a few things that helped:

• Escitalopram (Lexapro): I was taking it in the morning, around the same time as my stimulant. It seemed to contribute to daytime sleepiness and what I initially thought were stimulant crashes. Moving it to the evening noticeably improved things.
• Switching to Concerta: Focalin XR's release formulation simply didn't seem right for me. Concerta has provided smoother, longer-lasting coverage, without the same abrupt crashes. I'm still figuring out the ideal dosage.
• Caffeine: I discovered that coffee could significantly worsen agitation, stress, and irritability when combined with stimulants. I've since started avoiding it, which seems to help.

Overall, things have improved, although I'm still fine-tuning my treatment.

This is just my personal experience, not medical advice. Everyone responds differently to medication, and what worked for me might not work for you. Always discuss medication changes with your doctor.

Before or after diagnosis? How often ?

I would like to know to what extent Nicotine affects ADHD.

Thanks.

I've been on 18mg concerta for a year, even though my official dose was 36mg. Would have some shakiness and slightly elevated heart rate, as well as a pretty bad emotional crash when it wore off. I recently started taking the 36mg in the form of two 18mg pills (36mg pills aren't available in my city, Concerta is extremely tightly controlled). I usually take the second 18mg half an hour to one hour after the first one so as to hopefully level out how each pill releases the medication into my body. The first two days were incredible, I was so focused. But around the third or fourth day, I started to experience an elevated heart rate, definitely worse than it had been on 18mg, but I kind of just shook it off as panic attacks. By the 9th day, I was having an extremely strong sensation of my heart pounding, a lot of chest pain, shortness of breath, etc. But I was also extremely anxious that day so once again shook it off as a really bad panic attack. But in the three days after that, I kept experiencing the same thing. I could feel my heart pounding all night, was struggling to stand in the shower, feeling dizzy. It wasn't a constant thing, but it would usually start around 3pm and continue until I woke up the next morning. Last Thursday, I was running late to an event and had to walk really fast so I wouldn't be too late. When I arrived, my heart was pounding harder than I had ever experienced in my entire life. It felt like it was flipping and even skipping beats. My chest felt like it was on fire, but not in the sense that one does after exercising, just the pain from how hard my heart was beating, and sometimes some additional stabbing pains. That night when I was lying in bed trying to sleep, even just moving my body slightly or adjusting my pillow would set my heart rate off again, pounding and flipping. I considered going to the hospital but I genuinely could not move an inch without my heart going wild. I only took 18mg the next day and felt a lot better, just the usual amount of elevated heart rate. Today I went back to 36mg and, while I'm not in pain, I can definitely feel my heartbeat much too strongly, almost like it's beating through my entire body. I'm going to meet with the psychiatrist on Monday, but I just wanted to ask if this is something anyone else may have experienced on Concerta?

What does it do and feel like

what do i do? im scared it’ll come up and i’ll have what u get with mushrooms where ur like omg its coming up i feel horrible my heart is racing and its too late what do i do why did i take this, will i have that? not worried about the lonf term just first day.

27mg btw