Adderall XR | ADHD Information
Thank you for the compliment...this is my area of study and I find psychotropics fascinating. In answer to your question, this is one of the many advantages of Concerta's release mechanism. If you look at concerta.net, go into Prescribing Information and it will show you the PDR (physician's desk reference) information. The reason there is not much rebound is because Concerta continues to release medication all day. As you reach the end of the 10-12 hour period, it continues to release methylphenidate more and more slowly until the tablet is empty. The other meds you listed all work by releasing the drug in two "pulses" 4 hours apart. So in a 20mg dose, the second pulse releases 10mg and then a few hours later you are rebounding from that dose. With Concerta it is more like getting 6mg, then 4mg, then 2mg. So at the end you only rebound from 2mg rather than 10mg. Does that make sense? Because it takes off slow and ends slow (called an ascending profile) some people find that it takes too long for the med to "kick in" in the morning, which may be why your doc thinks he needs something that releases 50% in the AM. To counter that problem, some people take a small dose (ie 5mg) of Ritalin in the morning with the Concerta to jump start it until it really starts to reach therapeutic levels. You know how you and your child respond best, so if you've found something that works, stay with it! Concerta really is the most sophisticated drug on the market and mimics the natural rhythm of most people's days. Sorry for the long post, hope that kind of answered your question! BTW, why the Trileptal? Does he have bipolar disorder? Trileptal is an anticonvulsant and works beautifully as a mood stabilizer. Lots of people have a lot of success with it. shakespeare38620.578587963Shakesphere,
You know so much meds, I have written on other post and I feel I am always, slapped in the face with information that I know of. You seem as though you are well educated on all drugs and still looking for more.
Son is on Concerta 27mgs/Trileptal 600mgs he had a horrible reaction with Adderall XR 20,25,30. If he took a low dose of fast acting Adderall in the evening he became hyper, and happy, no focusing at all. My husband would come home and ask if he actually took it.
Why is it that Concerta, he isn't displaying all those rebound issues?...Tried to ask shrink, he still to this day thinks he would benefit from a drug that releases 50% first. Have not found the drug yet? Any advice you may have would be great!
He has tried Ritalin LA, Focalin XR, Adderall XR seem as though we always go back to Concerta.
I take Concerta 27 mgs also. No rebound issues at all. I sleep well...
Montana Mom
Shakesphere,
You should be a doctor or maybe your already trying, I am going to suggest this to the shrink, A booster in the am of regular Ritalin along with the Concerta , Just might do the trick. He always wants us to switch medicines that release at 50% and my son always does bad.
I will ask him for the 5 mgs. So our drug would be Concerta 27 mgs and Ritalin 5mgs in AM, then we wouldn't have to deal with the nights.....Doc always wants to add 5mgs Ritalin in the evenings and I am always like no way. I am not dealing with the crashing crap again. I think if he gets more concentration during the day, he would have less homework and less stress in the evenings.
I've never really heard of anybody taking a booster in AM they are always referring to PM dose boosters.
Thank you so much.
Montana Mom
You should read some of my other post with our Adderall XR ordeal, I know some have amazing results on it. Ours was pure hell, you can just e-mail me back with your thoughts.
Your a true Romeo!!!!!!!!!!!!!!
Shakesphere,
We are not hoping for Bi-polar disorder, being a final diagnosis.
The Adderall XR was just horrible for us.... The Trileptal is suppose to even him out since he was displaying horrible depression/anxiety issues. Trileptal can also be used for ADHD, ODD and depression, anxiety...etc. He takes a small dose 600 mgs, bi-polar in children is suppose to be given doses at 900 mg to 1200 mgs. We hope not, but will deal with what ever happens.
Montana Mom
You're quite right, Trileptal has many therapeutic uses... obviously you have studied up on these meds. Kudos for that! Too many people are too willing to put their children on whatever the doc says and just hope for the best. And yes, I am trying, God willing!
I wouldn't worry too much about the "diagnosis." They're just words. The important part is finding the treatment that works. Trileptal works very well to level out anxious depression that doesn't respond well to standard treatments. It may also make it easier for him to take stimulant meds, as they sometimes exacerbate anxiety and depression. I will look up your adderall xr experiences... I'm interested. My email is available on my profile. Just email me and I'll respond. Good Luck!!
shakespeare38620.6094560185And I'd rather be someone other than Romeo... that whole dying thing that he did really doesn't sound appealing to me!
Yeah, the only med that does a pretty good job of eliminating the peaks and valleys is Concerta. It uses an osmotic OROS delivery system that actually releases a steady stream of medication over 10-12 hours. I once read a description of it comparing it to an IV drip slowly pushing out the drug to keep blood levels even. It even has a second compartment with a higher concentration of medication to help counteract the "dip" that many of us feel in the afternoon! Unfortunately its a methylphenidate product, and I don't do well with methylphenidate. 
I do envy those who do well with it, however, and I wish there was a d-amphetamine formulation with such a sophisticated design!I'm going to get off of this damn machine and try to do something productive...lol! I'll check my email later tonight. Talk to you later!Go and get to work Shakespeare!!!!!!!!!! Talk to you later....
Well then back to Shakesphere it is and not Romeo.
Doc, wanted to use the Trileptal, because he felt like if he did have something inside of him. That 1st line Antidepressants, could also make the demons show there little faces. So that is why we played it safe with the Trileptal added into his therapy for ADHD and ODD, If he does had ODD, I would say it is rather a light case. Doc, said, ODD, is just a combination of habits, more generalizing in medical terms, just to put some behaviors somewhere. I am not really concerned about that.
I read all the information I can possibly read on this drug, I am well aware that we could be dealing with other issues in later years, and Iam willing to deal with them if and when they come.
He has never displayed in night terrors, he has never played with matches, he has never been in a fight with another child, meaning a fist fight, he never went to the school and tried to run the classroom, he has never really cussed at us, He just had one hell a time on Adderall XR that is all I can say.
So if he is Bi-polar then we will just deal/ seek treatment and really have to counsel him on this when it is warranted with his maturity level.
I have something for you on a less serious note, When we went to the shrink's office the first time, the shrink asked us if he had been dabbling in a little Jack Danials or a little marijuana. My husband, responded "well if he is, this would explain alot." LOL, LOL, LOL
Montana Mom
How old is he? We ADDer's are well known for substance abuse! I was certainly "dabbling" in those things when I was a teenager!! Probably explains a lot about me now, come to think of it...
Also, not to get too much into my own history, I have bipolar as well as ADHD. It sounds scary because we all have this image of what "manic-depression" is. And certainly at times it can be scary, but we've come a long way from the days of lithium and thorazine. Bipolar is a very navigable condition with a lot of excellent treatment options. And the new statistics estimate that as much as 3-4% of the population could have bipolar disorder in some form, as opposed to the less than 1% that we used to believe suffered from the illness.
I know this is not a bipolar chat board, so sorry to get off topic. I just want to encourage you not to worry too much if (and that's a big if) the worst should occur. Obviously you're willing to go the distance to get him the help he needs, otherwise you wouldn't be on this site! That's really what its all about.
He is 12 years old. Most definitly is not experimenting with type of substance.
Believe me with the reaction to Adderall, I will for sure no if he trys a little dooby or what ever.
One time I smoked you no what, only one time in my life. I became very hyper.........from it. Did not like the way it felt, and that was it for me.
Now a few drinks on the lighter side. I had a party or two, in my days, and just loved the club seen. But, haven't drank in probably 15 years now and would rather have a diet coke with a smoke. I know how terrible, cigs....I just like them and have been unable to conquer that habit. The shrink did ask me when I gave them up when I was pregnant with him, I told him as soon as I found out I was pregnant with him, never even had tylenol or sudafed.
Montana MOM
Shakespeare
A little later tonight I am going to e-mail you on my crazy sister and see what you think of her. It could be in the genes.... I am just really concerned for her.
Does a 10mg capsule of Adderall XR contain 10mgs TOTAL? Meaning you'd get 5mgs immediately and the 2nd 5mgs in the later release? Or does that mean you get 10mgs each time, making the entire capsule 20mgs?
Thanks for your help! I looked on the Adderall website and didn't find that this was explained.
That explains the peaks and valleys.My son is on 15mg XR and he is doing great
BumpAuntie Bumps!