DOSE: T+ 0:00	100 mg	oral	Pharms - Bupropion	(daily)
T+ 0:00	2 cups	oral	Coffee	(daily)
T+ 0:00	18 mg	oral	Pharms - Methylphenidate
T+ 24:00	18 mg	oral	Pharms - Methylphenidate
T+ 33:00	4 glasses	oral	Alcohol - Beer/Wine
T+ 48:00	18 mg	oral	Pharms - Methylphenidate
T+ 56:00	22 oz	oral	Alcohol - Beer/Wine
T+ 57:00	22 oz	oral	Alcohol - Beer/Wine

BODY WEIGHT:

130 lb

This was not a 'planned' experience, but a retrospectively scary and unexpected interaction between Concerta & alcohol. I have had a rather extensive history of substance use (and misuse), including Ecstasy, LSD, cocaine, speed, pot, benzos, & a variety of pharmaceuticals (e.g., Soma, etc). My experiences with Ecstasy, LSD, cocaine & speed occurred while I was in my early to mid 20s; I was more or less drug-free (except for alcohol & pot) during my late 20s to early 30s; & I’ve been taking Wellbutrin (200 mg/daily) for approximately 6 years to manage my depression (with intermittent periods of recreational pharmaceutical use).

I would like to note that although I have had depression or its prodromal symptoms for most of my life, starting in childhood, I strongly believe that my use of Ecstasy in particular exacerbated the illness & thoroughly destroyed much of my serotonergic system. For this and other reasons, dopaminergic Wellbutrin has proven to be very effective at keeping the depressive demons at bay (with the added bonus of totally eliminating any cravings I once had for cigarettes).

Since I started the Wellbutrin, I have used alcohol in moderation and excess without any unusual interactions whatsoever. Any bad effects (e.g., vomiting) I attribute wholly to alcohol, although I recognize the possibility of an interaction with Wellbutrin. I am also quite aware that Wellbutrin lowers the seizure threshold, which is potentially lowered even more by alcohol. However, my own experiences combining the two have never produced anything nearly as frightening as what occurred when I combined these two substances with Concerta.

Very recently, my new med prescriber suggested the possibility that I had been living with undiagnosed ADHD all my life. I agreed the likelihood was pretty strong, and in discussion about present symptoms (e.g., extreme procrastination, etc.) we decided to give Concerta a try. I questioned whether combining Concerta with Wellbutrin was a good idea (since they are both centrally activating), but my prescriber said “I do it all the time” and gave me a script for the lowest dose, 18 mg (in the specially designed “spansule” that extends the drug’s release over a period of about 8-10 hours).

I started taking the Concerta in the morning as prescribed with my daily dose of Wellbutrin on a Monday (it might be worth noting that I also drink about 2 cups of coffee each morning). I could feel the effects of the Concerta within an hour, which were subtle but activating. My heartbeat accelerated a bit, but I felt no euphoric rush. I felt a bit more motivated and focused, and got a good amount of work done.

About four hours after taking the Concerta (which coincides with the time that the second “surge” of drug release is supposed to occur), I became sleepy and took a short “nap.” I never feel sleepy taking Wellbutrin alone. I couldn’t say if I actually slept (not surprisingly, my sleep architecture in general has been totally wrecked), but I did come back around after about 30-60 minutes and finished up my work in a productive fashion. Generally, I was encouraged at the thought Concerta might prove to be helpful.

On Tuesday, I repeated the dosing—Concerta & Wellbutrin (plus coffee) in the morning, at approximately 9 a.m., and went to work. I experienced the same sleepiness I had on Monday, but this time it occurred about 2-3 hours (not 4) later. Again, I felt an accelerated heart beat (similar to what I feel any time I drink coffee) and an increased sense of focus. That evening, around 6 p.m., I had the first of perhaps four beers (I apologize for the lack of precision) which I drank over a period of about three hours. My experience on this night with the addition of alcohol was “normal,” and nothing unusual occurred except I got a little buzz. I figured that the Concerta was mostly out of my system when I had my first beer, and likewise I figured that having a few beers was not going to be an issue. Boy was I wrong!

Wednesday started just like Monday & Tuesday. Again, I felt sleepy about 3-4 hours after taking the Concerta, but was generally focused and productive. This day, I decided to have my first of only two beers (the big single size of 1 pt., 6 oz—or 22 oz each) at five p.m. I felt a very slight, but pleasant buzz, and an hour later I drank my second beer. I am now officially off work. I consumed this second beer in about 30 minutes, right outside my apartment and before I walked in for what I expected to be a pleasant chill-out in front of the TV with my boyfriend until bedtime. The last thing I really remember is walking UP to my front door—but not entering it!

Actually, I also remember waking up in bed sometime in the middle of the night (it was dark), dressed in my work shirt (but not my pants). I recall looking over at my boyfriend, who was awake, and saying something like “Boy, was I tired!” and rolled back over into sleep. When I woke up Thursday morning, I felt fine, but was aware that I couldn’t really remember anything about the night before. My boyfriend was having his coffee, and I poured mine. I had not yet taken my meds, since I was having some misgivings about the Concerta and alcohol combination, but I had no idea that these misgivings should have been more like grave concerns.

I said something to my boyfriend about being super tired and sleeping in my clothes. He took a kind of deep breath and said that he was frankly surprised that I had “made it home alive.” Alive? Alive!?! He told me that I stumbled into the apartment like I had been drinking heavily since lunchtime. In the absence of proof to the contrary, he thought that I HAD been drinking heavily since lunchtime. He was gravely and understandably concerned to think that I had driven home in my highly intoxicated state. He told me I was stumbling, slurring my speech, and had thrown myself onto the bed babbling incoherently. Trying to find out where I’d been and/or what I’d been doing, he asked & I apparently replied “I’ve been hanging out with a bunch of like-minded individuals,” and promptly stripped my jeans off & crawled into bed.

You would think perhaps I just slept it off, but no. The next morning, I woke up and drove to my 8 a.m. appointment to discover that the person I was supposed to meet had gone ahead with other plans. Apparently, I had called her the night before to cancel our appointment—this I do not recall AT ALL, along with who-knows-what-other behaviors I engaged in. My boyfriend did not recount additional bizarre or uncharacteristic behaviors, but I am sure it’s fair to say I could have been doing all kinds of crazy things. Fortunately, I was home & stayed home, or else the consequences of my blackout could have been horribly worse.

I would never in a million years have expected those two beers to have affected me so profoundly. One thing in particular which frightens me is how quickly that second beer affected me. One minute I’m enjoying my after-work, pre-dinner beer, and the next I’m a slobbering idiot with absolutely zero recall. And this was after I had consumed an even larger amount of beer the night before with no evident consequences. I flushed the rest of that Concerta down the toilet Thursday night.

I don't think it's enough to just say, 'Don't drink on this medication.' Because people do. And, if TWO beers can cause a serious blackout event, that's even worse! Seems to me they need to have, at the very least, a black box warning about this danger. Meanwhile, I am off the methylphenidates forever.

Exp Year: 2008	ExpID: 70949
Gender: Female
Age at time of experience: Not Given
Published: Sep 13, 2018	Views: 3,526
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Pharms - Methylphenidate (114), Alcohol - Beer/Wine (199) : Combinations (3), Medical Use (47), Hangover / Days After (46), Train Wrecks & Trip Disasters (7), Various (28)