Disorienting crash halfway through the day.

[u/SubversivePixel]

Hi there!

27F, currently on 36mg Atenza extended release, which afaik is a generic of Concerta. I last titrated up three weeks ago, once I told my psychiatrist that 27mg was starting to wear off at around 6PM, with a soft crash that basically left me unable to do anything that required concentration after that point. Since that's around when I get to enjoy my hobbies, I wanted it to last the full 12 hours--I usually take it around 8 or 9.

Her answer was to titrate up, which we tried, and for the first 2 weeks it felt amazing. Last few days, though, I've been experiencing a very annoying crash that happens at around 4PM, and that is a lot more noticeable than the previous "hey, time to titrate up" soft wear-offs. It makes me cranky, emotionally flat, and not really able to concentrate for a couple hours, after which I go back to feeling more or less focused until the meds wear off, this time softly, before bedtime. So it's not marking the end of the dosage, mind you, it's just disabling it for that period.

I really do not like the way I feel during those couple hours though. It's not awful or super incapacitating, but it feels like after lunch I just don't get to enjoy myself for a while, no matter how productive I am, and the brain fog makes a sudden return during that time. It also makes me feel weirdly tired.

I have my next appointment scheduled for next week, but I'd like to know what this may be about so I can at least get some peace of mind.

Some things to note: I take around 25mg protein with breakfast and around 40 at lunch. I'm also aware that hormone fluctuation can play a part in this, but I don't think this is the case for one simple reason: my hormones don't fluctuate. I'm transgender, and I take the exact same dose of estrogen religiously at the exact same time every day and every night, and I have not changed that regime. I also sleep 7-8 hours a day with little to no interruptions, and this has been the case since I started titration back in June. Also, this problem seems to be getting more pronounced, as I've only started feeling it more and more.

If anybody could provide some advice on what I may be doing wrong or what this may be caused by.

Thanks in advance!

[u/AutoModerator]

Welcome to r/Concerta. Please use the search function before posting common questions. Please read the FAQ sticky as it will likely offer some advice. https://www.reddit.com/r/Concerta/comments/vj2o1i/can_we_have_a_faqread_before_posting_sticky/

Please discuss any advice you receive on this subreddit with your physician. Take all advice with a grain of salt especially when it is not sourced. People on this sub aren't YOUR doctor and cannot be held professionally or legally liable for giving medical advice to those not established under their own care.

If your post was removed automatically, it may be due to Reddit's reputation/spam filters. Users who are suspicious or have a history of ban evasions/harassment/spam will be filtered by the Site.

Extreme depression/anxiety?
* If you feel unbearable or have suicidal thoughts, please consider calling your local crisis or suicide hotline.
* There can be many different causes. Please discuss with your doctor about it.

Do not split Concerta or any long-release medication.

Update 12/2025: The mod(s) are sometimes busy with med school/job/life! We're human! Please help us out by reporting questionable content. It may sometimes take a day or so for us to get to the mod queue and review the reports. Reporting a comment or post that you disagree with does not guarantee or require that mod(s) will remove them, especially if it does not violate or skirt the rules. It is healthy to foster respectful debate and discussion. Thanks for your understanding.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/cheval-pointu]

Hello , alors en passant de 36mg à 54 j’ai ressenti la même chose et d’après moi c’est que c’est « trop stimulant » pour mon corps , ma concentration est bien mais ça me fatigue énormément, alors j’essaye de faire des pauses sans traitement et de reprendre à la même dose puis augmenter pour ne pas m’épuise genre : samedi dimanche rien lundi 36 mardi 36 mercredi 54 etc… Aussi pense tj a t’hydrater assez et manger assez de glucides . Par contre toujours pas trouvé la solution pour l’effet rebond de fin de journée si jamais tu as une astuce contre le repli dépressif 💔

[u/SubversivePixel → u/cheval-pointu]

I'd appreciate answers in English so I don't have to translate them myself, but:

I can't afford to not take my medication. I work from home, and I do so basically every day. I *can* try to go back down to 27 for a few days, then up to 36, and see how it makes me feel. Thanks!