[senco-forum] Ritalin vs Concerta

He is now taking the equivalent amount of

> He is now taking the equivalent amount of
> ritalin in the form of concerta.

Is he really taking the equivalent of his old dose? ...I suspect not!

There is no such thing as an equivalent dose of Concerta that directly
corresponds to the previous dosing regime for Ritalin. Yes these two
medications do share the same active ingredients. However the
slow-release mechanism of Concerta substantially affects the update
profile which can vary from child to child. The bottom line is this:
When switching to Concerta this modified-release form of medication
needs careful re-titrating.

...incidentally, re-titration is not simply an issue with Concerta.
For I've come across substantial anecdotal evidence there can be
considerable variations in the efficacy of Branded Ciba 'Ritalin' as
opposed to generic 'Methylphenidate' (the active ingredient of
Ritalin's) made by other manufacturers. This has been ascribed to
differences in the manufacturing process, particularily variations in
the dose of Methylphenidate contained within each manufacturers
tablet. I've been told this can vary by as much as 20% across
different brands!

While there may not be a direct equivalent dose, one has to start
somewhere. So an approximate equivalent daily dose of Concerta is
accepted as a bit more than three standard doses of Ritalin. This is
because Concerta is designed to deliver its active ingredient across
roughly the same time period covered by three consecutive doses of
Ritalin.

Unfortunately too many doctors get this wrong, as they assume a
Concerta equivalent is simply the total Ritalin a child currently
takes in a day. Now this works if the child is taking three doses a
day, but *not* if they take only two doses a day! As in these
circumstances the child is receives only the equivalent of 66% (two
thirds) of their old Ritalin dose. Hence a significant number of
children find their switch from Ritalin to Concerta is fraught with
problems!

So Michelle, what was the size of this child's old individual Ritalin
doses? ...and what is the daily dose of Concerta they are now on? If
the Concerta dose is less than 3 times the amount of the old single
Ritalin dose, then you can probably blame this child's behavioural
deterioration on 'Medical Professional' error!

David Bowles
TeacherLab / Education Support

MH> Hello everyone-firstly apologies if this reaches the list
MH> twice but I could really do with some help.

MH> I hope all you clever people out there can help me with a problem, one
MH> of the students in my class is nearly 18 and up untill 2 weeks ago
MH> taking ritalin twice a day (he has been on Ritalin for 10
MH> years). He is now taking the equivalent amount of
MH> ritalin in the form of concerta. However his behaviour has taken a
MH> decided turn for the worse, he is turning over chairs, intimidating
MH> other children, shouting out innapproriate things and generally finding
MH> his behaviour very difficult to control. He is a great guy, helpful,
MH> funny and very likeable apart form these anti social aspects of his
MH> behaviour

MH> I suppose what I am really asking is has anyone experienced these side
MH> effects going from one drug to the other and what is the efficacy of
MH> ritalin in the long term for this student?

MH> I really hope you can help
MH> Michelle