Child Development

What is Concerta Crash? What to Know

This article has been medically-reviewed by:

Attention-Deficit/Hyperactivity Disorder or ADHD is one of the most prevalent and widely known neurodevelopmental disorders.

It can cause a number of different symptoms that impact a person's life and functioning, including but not limited to difficulty with tasks that require sustained mental focus, forgetfulness, trouble remaining seated when expected to do so, acting as though one is "driven by a motor" or always on the go and restlessness or fidgeting.

Some people with ADHD primarily experience symptoms of inattention, whereas others mainly experience symptoms of hyperactivity and impulsivity or a combination of the two.

Concerta, also called methylphenidate, is a medication that is used to treat ADHD in children, teens, and adults who are between the ages of 6 and 65. It is a central nervous stimulant that has been proven effective in reducing ADHD symptoms.

Concerta has been approved by the FDA for the treatment of ADHD since the year 2000, meaning that it has been prescribed for over 20 years. But, if you are a parent who is considering this medication for your child, it is normal and expected to have questions. One of the things you might have heard about upon researching Concerta is something called "Concerta crash." 

What is Concerta crash, and how do you know if it's something that your child might be experiencing? Here's what you should know about "Concerta crash" and how to prevent it. 

What is Concerta Crash?

Most often, individuals who take Concerta ingest it once daily in the morning. Concerta is a prescription that can be taken with or without food. Unlike some other commonly prescribed ADHD medications, the effects of the medication can last for up to 12 hours.

"Concerta crash" is a nickname for what happens when the amount of the medication decreases in a person's body. When this happens, you may notice a range of unfavorable symptoms.

Concerta isn't the only medication that this can occur with. In fact, any stimulant medication runs the risk of a possible crash. However, there are things that can be done to prevent this from taking place. 

Why it happens

Why might a crash occur after Concerta or another ADHD medication wears off? Simply put, the way that Concerta works is that it increases dopamine in the brain, thus reducing ADHD symptoms and allowing people to focus better.

However, when Concerta wears off, so does this dopamine-enhancing effect. This may cause a rebound in ADHD symptoms as well as withdrawal symptoms. We might also describe the crash from Concerta as withdrawal or a "rebound effect," especially with reference to ADHD symptoms, from the medication

Symptoms

There are symptoms you can look out for when it comes to Concerta withdrawal. Symptoms of "Concerta crash" can include but aren't restricted to:

  • Difficulty concentrating.
  • Restlessness or excessive activity. 
  • Changes in mood, such as feeling sad or down. 
  • Feelings of tiredness or drowsiness.
  • Feelings of anxiety or nervousness.
  • Irritability or agitation. 

Although not necessarily dangerous, they are something to address and can be uncomfortable symptoms to experience. 

How to Prevent and Manage Concerta Crash

To prevent and manage a Concerta crash, especially if it happens more than once or if you notice these symptoms repeatedly, one of the first steps you want to take is to talk with your child's doctor. The reason why is that these crashes may indicate a need to change your child's medication routine in some capacity. 

What might a doctor do if your child experiences Concerta crash? If your child experiences Concerta crash, a physician may:

  • Reduce the dose of Concerta. Sometimes, Concerta crash may indicate a need to lower the dose a person takes. As a result, your child's doctor may choose to reduce the dose that your child takes of Concerta to something lower. In children who are between the ages of 6 and 12, the standard dose of Concerta ranges from 18 mg/day to 54 mg/day. In teenagers who are between the ages of 13 and 17, the standard dose of Concerta ranges from 18 mg/day to 72 mg/day. Once the dosage is right, the crashes may alleviate. 
  • Add a "booster dose" to their routine. Since Concerta or stimulant crash is essentially a withdrawal from the medication, a booster dose later in the day can mitigate the effects of the withdrawal and reemergence of ADHD symptoms associated with a crash. 
  • Try a new medication or formula. In some cases, problems with Concerta, such as a Concerta crash, might mean that it's not the right fit for your child. They may benefit from a medication that does not last as long, for example. There are other medications out there that treat ADHD, and if symptoms continue, a doctor may choose to take your child off of Concerta or try a new medication. 

It is important that you make any of these changes as directed by a doctor and not on your own. Ensure that your child takes Concerta as prescribed, and if you have questions about Concerta or any of the changes that need to be made to mitigate Concerta crashes, don't hesitate to speak up. Your child's doctor is there to answer your questions.

It is normal for trial and error to be necessary as people find the right medication regimen for them as a unique individual, and this includes the dosing of medications like Concerta. All of our bodies and minds are different, even among those of us who live with the same condition. 

Side Effects and Risks of Concerta

Outside of the possibility of the "Concerta crash," there are other potential side effects and risks of taking Concerta that individuals and families may want to know about. Let's go over the common side effects and risks associated with Concerta that you may want to be aware of. 

Concerta side effects

Side effects of Concerta can include but aren't limited to:

  • Increased blood pressure
  • Stomach pain 
  • Indigestion, nausea, or vomiting
  • Changes in mood 
  • Feeling nervous, anxious, or irritable
  • Blurry vision 
  • Trouble sleeping
  • Sweating
  • Rapid heart rate
  • Heart palpitations
  • Loss of appetite
  • Weight loss
  • Dry mouth
  • Dizziness
  • Headaches 

Potential risks of taking Concerta

There are also a number of serious possible risks affiliated with Concerta. These can include but aren't limited to:

  • Slowed growth in children. Studies show that Concerta can lead children to develop less height and weight than other kids. This is true for other central nervous system stimulant drugs as well, such as Adderall.
  • Dependency. Central nervous system stimulants like Concerta may be abused, misused, or lead to dependency in some cases; however, for individuals with ADHD, prescribed stimulant medication may also have a protective effect against substance use. 
  • Withdrawal. Withdrawal from Concerta is a potential risk of taking Concerta, and this risk can increase when Concerta is taken at a higher dose. This is why a person's regular dose may be lowered if someone experiences withdrawal effects attributed to Concerta crash.
  • Heart attack and stroke. Though some populations are at a higher risk than others, heart problems can occur in those who take Concerta. To prevent cardiovascular effects, a physician should check an individual's blood pressure and pulse every six months. 
  • Serotonin toxicity. Central nervous system stimulants like Concerta can increase the risk of serotonin toxicity, also known as serotonin syndrome, especially if taken alongside other medications or supplements that raise serotonin levels. 
  • Drug interactions. A total of 184 medications that we know of can interact with Concerta. These interactions may range from mild to major, and they may or may not cause a need to change a person's medication regimen. Make sure to speak with your child's prescribing doctor about any other medications or supplements they take if they receive a prescription for Concerta. 

Remember that, when a medication is prescribed by a doctor, it is because the prospective benefits may outweigh the risk. Central nervous stimulants like Concerta have a Grade A recommendation for the treatment of ADHD and are the first choice in medications for those with ADHD.

Make sure that your child receives the regular, recommended medical monitoring that they need and that you discuss any effects that cause concern or may cause concerns with your child's prescribing doctor.

Medical monitoring can help prevent, treat, and detect possible risks. Other interventions, such as games, behavior therapy, parent training, and supportive techniques can be beneficial for children with ADHD alongside a medication that is prescribed by their doctor.

Takeaway 

Concerta is an FDA-approved treatment for individuals who live with Attention-Deficit/Hyperactivity Disorder (ADHD). A person may take Concerta alongside the pursuit of other treatments or interventions, such as behavior therapy, parent training, and more.

If a person takes other medications or supplements, this is something that should be discussed with their prescribing doctor. Crashes cost by Concerta can look like a reemergence of ADHD symptoms and symptoms of withdrawal.

It may indicate a need to lower the dose of Concerta that a person takes or change their medication routine in another way. Consult a mental health professional immediately if you notice any effects that may be a cause for concern.

This article is for informational purposes and is not a substitute for individual medical or mental health advice. Please consult with your or your child's prescribing doctor before changing, starting, or stopping a medication routine.