*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Concerta withdrawal is possible in anyone who takes Concerta, even if the medication is not being abused. It may also be referred to as a Concerta crash. Withdrawal symptoms can be physical or mental, including anxiety, nausea, fatigue, and foggy thinking.
It is important to discuss medication withdrawal risks with your prescriber. If you want to discuss your current prescription with a provider or are considering a prescription for Concerta, online psychiatry platforms such as Klarity and Circle Medical can be good places to start. They are two platforms that can and will offer assessments and prescription consultation for stimulant medications, which are controlled substances. They can also discuss the risks of Concerta withdrawal and how to avoid it.
Boxed Warning: Methylphenidate (Concerta) – Risk of medication misuse or abuse
Methylphenidate, the active ingredient in Concerta, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Concerta has a risk of misuse (abuse) which can lead to dependence on the medication.
Concerta is a controlled substance, which means that it’s more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
What Is Concerta & How Is it Used?
Concerta, also called by its generic name methylphenidate, is a medication that is used for the treatment of attention-deficit hyperactivity disorder (ADHD) in children 6 years of age and older, adolescents, and adults up to age 65. 1,2 Concerta is an extended-release formulation that allows the medication to be slowly released in your body over a period of time.
Concerta belongs to a class of medications called central nervous system (CNS) stimulants and it is believed to work by blocking the reuptake of chemicals such as dopamine and norepinephrine by neurons, leading to more of these chemicals being available to manage symptoms such as hyperactivity and impulse control.1,2 Brand name Concerta comes only as an extended-release tablet, but other brands and generic methylphenidate can come in an immediate or extended-release formulation.
Is Concerta Addictive?
Concerta is classified as a schedule II medication which means that there is a high potential for abuse which may lead to severe psychological or physical dependence, better known as an addiction.1,2 Behaviors such as using more than what has been prescribed to you by a doctor, combining substances with Concerta to obtain a desired effect, and people with a history of substance abuse are at a higher risk of addiction.
There are serious health consequences that can result from using Concerta incorrectly, which can lead to medical events that require emergency intervention. Short-term problems that can happen are dangerously high body temperature, irregular heartbeat, seizures, and high blood pressure. If there is chronic abuse of Concerta, a person may experience heart problems, psychosis, anger, and paranoia.3 Using Concerta in ways that are not indicated by your healthcare provider also increases your risk for experiencing Concerta withdrawal.
Post-Acute Withdrawal Syndrome (PAWS): Symptoms, Causes, & Treatment
Post-acute withdrawal syndrome (PAWS) includes persistent impairments resulting from the cessation of alcohol, benzodiazepines, or other substances. Post-acute withdrawal symptoms often include anxiety, mood swings, and sleep disturbances that last weeks or months. The exact causes of PAWS are unknown, but research suggests that increased tolerance may be a factor.
What Is Concerta Withdrawal?
Concerta withdrawal is when the body becomes used to the medication, becoming dependent on it, so when a person stops taking it, the body goes into withdrawal. It is also important to note the difference between addiction vs dependence.
Addiction is a psychological state where a person has obsessive or compulsive behaviors with the aim of consuming more of the drug, while dependence is a physical or psychological response from the body that requires more of the substance in order for you to feel well and function normally. Dependence is not addiction, although it can be a symptom of it.
Addiction and dependence are a main concern with stimulant medications for ADHD whereas nonstimulant ADHD medications avoid this issue. These are medications that are not recognized for causing dependence as they work in a different manner than stimulant medications.4
To avoid withdrawal from Concerta, it is important to talk with your healthcare provider before you stop taking your medication. You should never stop taking your medication suddenly. Your healthcare provider will help you create a plan to slowly taper (decrease) the amount of Concerta you are taking to help avoid withdrawal symptoms.
Factors Influencing Concerta Withdrawal
There are several factors that can influence the course of Concerta withdrawal in an individual. You would have to consider how the medication was taken, where you would expect larger doses and longer periods of use to have more intense withdrawals. Other medications and individual patient factors can also influence how Concerta withdrawal will go for an individual.
Factors that influence Concerta withdrawal include:1,2
- Length of time taken: The length of time Concerta withdrawal occurs depends on how long a person was taking Concerta.
- Dosage: Most who are on Concerta are prescribed between 18 mg to 72 mg. Those on higher Concerta doses typically have longer withdrawal times as the body processes it more.
- How you get off of Concerta: The way you quit Concerta matters. If you stop all at once instead of gradually tapering off the medication, then you can experience side effects.
- Other medications: Some medications can affect how long Concerta stays in the body. Depending on how they interact, it can make withdrawal symptoms worse.
- Individual genetics: Each person is different and can process medications at different rates. Some people may experience withdrawal immediately and others may not experience it at all.
Concerta Withdrawal Symptoms
Concerta withdrawal, also known as Concerta crash, can have a variety of both physical and mental symptoms. These symptoms can follow long-term usage of Concerta or it can even be present in shorter periods where a person was binging the medication. The amount of time Concerta was taken can determine how long a person experiences withdrawal symptoms.5 Some side effects are common, while others may be more severe or even rare; these symptoms may require immediate medical attention.
Common Concerta Withdrawal Symptoms
As a person withdraws from Concerta, they experience side effects that can be both physical and psychological in nature. Physically, you may feel more agitated or slower, while your mental health may be affected negatively. This can leave you with depression-like symptoms. These symptoms usually last 1 to 3 weeks, varying on how long it lasts depending on individual factors, like if you’re using Concerta with other substances.5
Common Concerta withdrawal symptoms include:5
- Impaired memory
- Anxiety and irritability
- Fatigue
- Insomnia followed by excessive sleepiness
- Loss of interest in activities you liked
- A profound sense of dissatisfaction and unease/unhappiness
- Agitation (e.g., jitteriness, nervousness, etc.) or slow movements (e.g., slow reflexes, feeling like you’re moving in slow motion, etc.)
Post-Acute Withdrawal Syndrome (PAWS): Symptoms, Causes, & Treatment
Post-acute withdrawal syndrome (PAWS) includes persistent impairments resulting from the cessation of alcohol, benzodiazepines, or other substances. Post-acute withdrawal symptoms often include anxiety, mood swings, and sleep disturbances that last weeks or months. The exact causes of PAWS are unknown, but research suggests that increased tolerance may be a factor.
Duration of Concerta Withdrawal Symptoms
For chronic and regular stimulant use, such as Concerta, severe withdrawal symptoms can last several days, while less severe symptoms, such as fatigue or concentration issues, can last around 1 to 3 weeks. This factor can change depending on the amount and length of time a person has been using Concerta.5
Concerta Withdrawal Timeline
You can expect withdrawal symptoms from Concerta to stop in about 1 to 3 weeks for people with chronic and regular stimulant use.5 If you are using Concerta as prescribed, then it should be a shorter time given Concerta’s half-life, which is the amount of time it takes for half of Concerta to leave your body. The half-life for Concerta is 3.5 hours, so compared to extended-release Adderall, another stimulant medication, which has a half-life of 10 hours, Concerta leaves the body rather quickly.1,2
Withdrawal symptoms would likely be seen within 12 hours of the last dose of Concerta.5 It entirely depends on how much a person is taking and their individual factors when it comes to how long symptoms last. Some may experience post-acute withdrawal symptoms (PAWS), which are symptoms that persist for months or longer after the substance has been stopped. Primarily, they are symptoms related to mood or anxiety.
Here is the timeline for Concerta withdrawal:6
- First 24 hours: Symptoms of withdrawal usually present after stopping Concerta. People may develop headaches, feel very tired, and find it hard to concentrate.
- 2-7 days: Symptoms peak over the next several days. Mood swings may appear during this time, such as anxiety or irritability.
- Days 8-21 and beyond: Withdrawal symptoms gradually go away and become more manageable. Dysphoria, or the sense of unease and unhappiness, may persist for months for some.
How to Cope With Concerta Withdrawal Symptoms
Withdrawal symptoms can be incredibly taxing both physically and mentally. It is important to be mindful of how you are feeling and to practice healthy coping mechanisms so you can avoid any harmful behaviors that may come up as you come off Concerta. Not all coping skills are viable options for people, so it is important to identify what your needs are and to address them.
Here are 9 number strategies to help relieve symptoms of Concerta withdrawal:8
- Prioritizing sleep: Adequate sleep can have a significant impact on mental health. Quality sleep helps to prevent existing mental health conditions from worsening, which is important since withdrawal symptoms can include emotional imbalance.
- Exercising regularly: The mental health benefits of exercise can help to cope with the stress of withdrawal effects. Regular activity may be helpful as it provides a distraction and can make you feel physically better long term.
- Speaking with a therapist: Therapy works for many people. Therapists are trained to help with tough recoveries, such as withdrawal symptoms. They provide tools needed to help deal with your stressors as well as give you guidance if you need it.
- Take time to unwind: Withdrawal symptoms are taxing and can leave you stressed. Being mindful of your stress and setting time aside for things you enjoy can help mitigate the impact of the symptoms.
- Self-care: Self-care can include a variety of activities, but most aim to be mindful and care for your physical, mental, emotional, or spiritual well-being. It can help to manage the stress that often comes up when dealing with withdrawal.
- Online support groups: Online support groups can be a great option to help cope with withdrawal symptoms as you get in touch with people who are experienced with the process as well as other individuals who can provide solidarity with your struggles.
- Explore your spirituality: Spirituality can have a big impact on mental health if it is important to you. Finding comfort in what you believe in can help you cope with the stress of withdrawal symptoms.
- Recognize when you need more help: It is hard dealing with withdrawal symptoms, especially when it makes you feel unwell. Sometimes we are not able to cope with what we are feeling, so it is important to ask for help if you feel you cannot handle what is going on.
- Talk to others: It is important to include your community and family if it is an option. Having a trusted support system where you can express your feelings and concerns can help with how mentally and physically taxing withdrawal symptoms can be.
Concerta Detox and Withdrawal Treatment
There are not any specific medications used to treat Concerta withdrawal or addictions. Any medications that may be used are without research for their efficacy and safety, but they still may be used off-label. Currently, the strongest evidence is for psychosocial treatments, particularly combining contingency management with cognitive behavioral therapy (CBT).
Contingency management is a type of treatment strategy that focuses on providing meaningful rewards when the person in treatment reaches therapy goals. CBT is a type of therapy that helps a person to improve their mood and functioning by recognizing destructive thinking which may negatively impact them.7
Patient’s struggling with Concerta addictions or withdrawal should be treated under the medical supervision of a primary physician or psychiatrist. If you are interested in the convenience of telehealth psychiatric services, then online psychiatry services are available. Choosing to work with a therapist may also be beneficial.
When to Seek Professional Help for Concerta Withdrawal
If you are experiencing withdrawal effects from Concerta, such as having any motor, emotional, or energy level issues, then you should contact a doctor. This is especially important if you think your side effects will cause you harm, such as falling asleep while doing dangerous activities, or if withdrawal-associated depression is making you have suicidal thoughts. Seek immediate medical help if you think you are a danger to yourself or others.
Questions to Ask Your Health Team About Concerta Withdrawal
Not all medications are appropriate for people, sometimes, a person needs to stop a medication because it does not work as intended. If you need to stop Concerta, then you should ask your doctor, psychiatrist, or pharmacist what to expect and how to handle withdrawal symptoms if you get them. They can outline how the process will go and what to expect for future treatments potentially.
In an emergency, immediately call 911 or whatever emergency service is available to you. Immediate response is necessary to prevent any long-term harm from coming to a person.
Questions to ask your care team about Concerta withdrawal include:
- Why do you think I should stop this medication?
- Should I stop taking Concerta all at once or over some time?
- What are the risks of stopping Concerta?
- When could I start feeling withdrawal symptoms?
- What should I do if something feels off during my withdrawal process?
- Would starting a new medication help limit the withdrawal symptoms?
- Could my ADHD symptoms get worse after I stopped taking Concerta?
- Are there any other medications I can take for my ADHD while coming off of Concerta?
- How long do Concerta withdrawal symptoms last?
In My Experience
In my experience, many people tolerate Concerta well and do not have many issues with crashing or withdrawing. If they do experience it, they are usually managed with techniques such as scheduling “booster doses” to their regimen later in the day to keep away withdrawal effects, reduce the dose of Concerta, or try a new medication or formula. The process of finding what medication is right for you is one of trial and error. It helps to be open and honest about any side effects you may be feeling and to seek immediate medical care if required.
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
Online Psychiatry
Circle Medical – ADHD Diagnosis and Treatment. Affordable and accessible ADHD evaluations and treatment, including possible controlled substances medication if clinically appropriate. Diagnosis and prescription over video. Insurance accepted. Same & next day appointments available. Visit Circle Medical
Personalized, Affordable ADHD Treatment
Klarity Health – The providers on Klarity offer comprehensive, personalized ADHD treatment. From diagnosis to therapy to medication management, a Klarity provider will be there for you. And, if needed, they’re able to prescribe controlled substances, like Adderall and Concerta. Visit Klarity Health
ADHD Medication Management + Therapy
Brightside Health – Different people experience ADHD in different ways. That’s why Brightside Health develops personalized plans that are unique to you and offers 1-on-1 support from start to finish. Brightside Health accepts United Healthcare, Anthem, Cigna, and Aetna. No controlled substances. Appointments in as little as 24 hours. Start your free assessment.
ADHD Management Tools
Inflow App – Inflow is the #1 science-based app to help you manage your ADHD. Their support system helps you understand your neurodiverse brain, and build lifelong skills. Free Trial
For Further Reading
- ADHD Medication: Stimulants & Nonstimulants for Adults & Children
- Treatment for Adult ADHD: Medication, Therapy, & Self-Help Strategies
- Concerta Vs Adderall: Differences, Similarities, Side Effects, & More
- National Resource Center on ADHD
- What is ADHD?
- Concerta Side Effects: What They Are & How to Manage Them
Do you think you have ADHD?
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Best Online Psychiatry Services
Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.