THanks for the feedback. All what I suspected. He is taking 72mg now. The risperdal is at 1mg two times a day. We tried lithium very briefly. In my opinion, not long enough. We do have a neuropsych appt on NOv 1. Also, a neurologist next week. I have been doing my research, doc thinks adhd, I think bipolar. After being on the 90 for about a week was ok. Did fine on the 72 for one day. Then today, on the floor at school, screaming yelling. In the office 3 times. I had to pick him up an houor early. Then he tried to escape the office to run back to his class. Did not want to go home. Loves his new teacher and school. Been there a week and half. At last school, always wanted to come home. Anyway. I got some more books from the librarry on bipolar. After all his testing is over, I am going to switch to a different psych. I am trying to get an appointment with Dr. Findling, at Univ. Hosp/ Case WEstern REserve Univ he specializes in child and adolescent mood disorders.
Thanks for taking the time to reply
I hope your appointment goes well!!
Remember that the meds work opposite on a child with ADHD than with a normal child. They have a metabolism that is like it's nuclear burning compared to us fogies with the coal burning ones we have. They can tolerate a higher dose typically - especially when they are out playing all the time - burning off the excess as they go. I'm confident you'll find the middle ground - and it does get better as he reaches puberty. Maybe not gone - but more manageable and different issues to worry about.
Acting up sometimes is just a young man's way. I was like that - but more passive aggressive about it. When you can't verbalize the frustration - it can come out with foot stomping, book throwing and even full blown temper tantrums and striking out to some extent. I could not make others understand my frustration and I made everyone notice me - though they never got my point.
Sounds like you are on top of things - so good for you and good luck!
Mood stabilizers like Trileptal are good alternatives to lithium with much fewer side effects. The combination of low dose Risperdal with a mood stabilizer tends to be much more effective than either drug alone. I personally take risperdal and Lamictal (another mood stabilizer) and the combo works beautifully for me. Lamictal has the risk of serious, sometimes life threatening rash called Steven-Johnson's syndrome, and that risk is increased in children so it is generally not used for pediatric patients. Trileptal, however, is very safe and very effective for many. Highest I have ever come across is 72mg in male 19yrs old, Heavy Build, Large Frame, 5.10 in Height. Must support the idea of Second Opinion. Not a Doc. but have seen Consertaxl used by many and there is information of other's experiences on this board.Thank you shakespeare and Glen
I have been using another great site bpkids.org for a lot of info. I just want him to succeed and this is not only hard for me to deal with, but, I know he doesn't like it either.
I have heard of lamictal, lots of bp kids are on it. As young as my son. THey just say go really slow with the dosage and it is actually very safe.
HIs risperdal is only 1mg am and 1mg pm. It was higher, but Iwondered if theat was making him worse. Pdoc says no. I want to try seroquel. I understand that ithas mood stabilizing properties as well as a calming effect. So, his next appointment maybe.
Thanks again
All this at 6 years old? Are you sure? Bipolar? Hmm..90mg of Concerta at that age? I'm on 54 at 30 years old, can't imagine what 90 would do to a 6 year old!
Have you sought out 2nd and 3rd opinions?
Just curious..this seems very serious too me.
I 100 percent agree with the previous poster. Most ADHDers don't rage for that amount of time over schoolwork. In addition, I have NEVER heard of a 6-year-old on that high a dose of Concerta.
I would recommend having your son evaluated by another child pscyhiatrist to rule in or out bipolar disorder. I would also urge you to take your son to a neuropsychologist, who can evaluate him for other childhood disorders. You really need to get an accurate diagnosis before you can put the proper interventions into place. Good luck!
Just curious to know what doses are being given to your kids. My son 6, may be bipolar. But, pdoc is still fixed on adhd. We have briefly increased him concerta dose to 90. He is doing fantastic in school last three days. But now she is concerned that tis is too high. we decided to back down to 72 and see what happens. God, I hope it still works. I like getting good notes from his teachers. At 54 mg he rages all day. He doesn't want to do his schoolwork, so he throws a fit at school, can last 40 min. Many times each day. Will refuse to go to art, music, etc... Very Very difficult to manage. He also takes risperdal. but, doesnt' help that much.
Anyway, any feedback that I can get on dosages above 54 would be great. Thanks.
Concerta has been approved in doses up to 72mg in adolescents, but not in younger children. It happens occasionally, but it's uncommon to go above 54mg in children.What dose of Risperdal does he take? It can be a wonder drug for those kind of problems. I myself take a low dose. Have you ever considered adding in a mood stabilizer like Trileptal? Risperdal alone isn't a great mood stabilizer until you hit the 2-4mg range, and then you can have some pretty unpleasant side effects. In low doses it can augment mood stabilizers and the result can be dramatic.gretchen,
What else have you tried?
had to take my son off concerta because of the rages. We were at the maximum dose of 72 mg. I wish it had worked.