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I've been prescribed Concerta - got the free 30 day trial.

I'm to start at 18mg for 1 week, then increase to 36mg for one week, and then go to 54mg for the remainder of the prescription, which would be 8 days.

I had a heart attack in November of 2002 and I'm concerned about the references I see all over the place - general web sites, the maker's information and inserts - about not taking Concerta if you have heart problems such as Coronary Artery Disease or have had a recent heart attack.

Having had a heart attack with a 99% blockage in my right coronary artery, I have, and will always have, Coronary Artery Disease.

It was a psychiatrist who prescribed the Concerta. He also has me on 100mg of Amitriptyline SID (was on 200mg when I first saw him), 100mg of Lamotrigine SID, 200mg of Seroquel SID, and 450mg of lithium carbonate BID. I also take 40mg of Lipitor SID.

(SID means once a day, BID means twice a day, TID means three times a day)

He believes I am bi-polar - a diagnosis which I really don't agree with - I've been treated for depression for many years (say 35 of my 57 years) and feel I've always had depression, even as a child.

But this doctor decided on the bi-polar diagnosis on grounds which I think are a bit shaky the first time I saw him.

I'm going along with it for a while to see if the medications do help me - so far I don't think they are doing any good but that is a different issue for a different forum.

About 3 months ago he decided I was ADD and put me on Vyvance for a month - it had absolutely no effect on me, my wife agrees with me on that.

Now he wants me to try Concerta.

He knows about my heart attack but I am not certain he is giving it the weight it should have.

In the past he as been remiss in telling me about possible side effects of other drugs and has never told me about some things to avoid.

For example, with Vyvance you don't want to add any stimulates to the mix - such as caffeine. I learned about that online and then asked him about it and he said "Oh, yes, you want to eliminate caffeine, drink decaffeinated soda and such."

I haven't checked, but I would think the same goes for Concerta, but he did not mention any issues with the Concerta.

I will be sending my a fax about these issues - it is next to impossible to get in touch with him except for emergencies are scheduled appointments and I taken to faxing questions to him.

With the lithium - I was the one who brought up the matter of avoiding ibuprofen, - I have a couple of teeth which need root canals and crowns (the expense is more than we can handle right now) and had been taken ibuprofen to kill the pain in one of the teeth.

Had I not learned about the risks involve with lithium and ibuprofen on my own, I would not know to avoid it.

I also learned on my own that you need to take the lithium with food to avoid stomach problems and that you need to drink 2 to 3 liters of water each day. That's 4 to 6 bottles of water. Had I not learned about this, I would not have known that it is necessary to increase my water intake to avoid the dehydration which lithium can cause.

But, back to my original issue - the literature speaks of not using Concerta if you have had a recent heart attack or coronary artery disease (which I obviously have).

Does anyone know what "recent" means in this context?

And, does anyone on Concerta also have heart problems of any type?

Bob





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