Concerta Question??? | ADHD Information
My son was on concerta for 2 1/2 years (from 7 - 9 ) and the max he ever took was 36 mgs. I absolutely would not give him 72!!!!
I agree with the above posters, you should begin at 18 then raise it to 27 if you see nothing happening (that is NOTHING). No side effects at all - no moodiness, sleeplessness, appetite reduction...
I'm shocked a Dr. would give you those instructions with Concerta.
Stims are supposed to work right away. If they don't, he may have something other than ADHD or you can try Straterra (which DOES take a while to kick in and can also cause problems if the child has something other than ADHD--a mimicker). Time will tell. I agree it's smart to go to a NeuroPsych. Anyone specializes in a disorder is going to see the disorder in every child and, since all childhood disorders have similiar symptoms, they could easily be wrong. Wish they had a blood test but they don't yet.I came across this subject, looking for exactly what is being talked about here.
My 8 yr old grandson is taking 54mg of Concerta...and it's not working anymore either.
His mom..(my DIL) says that he is fine all through the school hours, but it's after school, that he can't get his homework done, without going over it 4 times. And he has started crying about the littlest things.
She thinks the doctor will up his dose...from what I am reading here..that's NOT the way to go. (I'm starting to get very worried)
Its a touchy situation here, and dil gets very touchy when I ask how that is all going, as my son and I were opposed to it. He was 6 when she put him on it. When she told me this latlest developemnt...I had to pick my mouth up off the floor.
I wanted to give it alittle more time...She has adhd herself..so I know that my grandson probley has symtoms of this...but to go to 72mg of this..just doesn't seem right.
I know for a fact she won't go with ritilin..or anything else...just concerta. I don't know why? I think I might point her to this post when they come for a visit next week end...
Thanks eveyone for sharing... I really appreciate it.
KathyZ
My son started on Concerta at age 7. It made him really moody and twice as bad once he came off the medication. He had this response with all stimulants...he also became very angry and violent at times. They then prescribed meds to ease with the come down but they weren't much better. I took my son off all meds for the last 2 weeks (he had been on them for a year and a half) and he is happier now than he has been in a long time. He is currently going through an evaluation at Childrens Hospital to see if ADHD is the real diagnosis.My 7 year old son was recently diagnosed with ADHD. The doctor started him on Concerta 36MG once a day and in a couple of days wants me to go to two a day (72mg). This sounds really high for a 7 year old. My biggest question is, has anyone had a side affect of being really moody with this drug? His first day with this drug was today and he was extremely cross with everyone. He cried about everything and frowned all day long. He seemed worse then usual rather than better. How long does it take to see any changes once medicine is started? Is it normal for a child to undergo mood changes when first started a drug therapy? Please someone shed some light on my situation.
I am so lost on what to do next. HELP!
Sarah, welcome! What kind of doctor diagnosed your son and what kind of doctor is prescribing his meds?
The Concerta doses you are talking about are very high for a 7-year-old. In addition, even if a doctor intends for a target dose of say, 36 mg, it is customary practice to start at the lowest dose -- 18 mg -- see how the child does and then adjust as needed every week or two. Furthermore, the highest recommended dose for a pediatric patient is 54 mg. I do know a few kids who take 72 mg Concerta, but they are big strapping teenagers. In my opinion, you are not getting sound medical advice. I would recommend having your son evaluated by a neuropsychologist to make sure you are dealing with ADHD and then go to a board-certified child psychiatrist for medication management if meds are warranted.
Again, welcome and good luck.
Thanks for the welcome...I am sure I will be asking many new questions with all of this so new to me.
Well here is were this gets even more tricky...the doctor he is seeing is very well know. She is a specialist with the ADHD, has written many books, has a hospital wing named after her, she is board certified and on the national board of child ADHD. All this back ground, I thought she would know what she is talking about, but I am like you in that this dosage sounds very high. On the other hand we didn't see any results at all other then more severe moodiness then usual. Is this because not enough time has passed or does the dosage need to be higher???
Sarah, it sounds as if she is a well-qualified doctor, but unfortunately, doctors who specialize in ADHD generally see ADHD in every kid they evaluate. Furthermore, what kind of doctor is she -- developmental pediatrician, psychiatrist, etc?
I have to tell you I have been around the block a few times with my son, who is now almost 13 and was first diagnosed with ADHD and anxiety 3 years ago (he now has a diagnosis of bipolar disorder). He took Concerta for 1.5 years. As I stated above, it is standard medical practice to start children on 18 mg Concerta. That is what my son started at at age 9, and two weeks later it was raised to 27 mg because 18 mg was wearing off too early. A full year later he was raised to 36 mg when 27 mg wasn't enough to help him concentrate in school. The pattern I am describing is much more typical for a young child, not what you were told by your son's prescribing physician.
Moodiness as a side effect can mean many things. It can mean the dose is too high (not generally too low). It can mean the child doesn't have ADHD. It can mean it may take a few days for the child to adjust to having been exposed to a stimulant. It can mean Concerta is not the right med for your son. The interesting thing about stimulants is you generally see positive results on the very first day if it's the right med at the right dose. You should try it out for a few days, but if your son continues to be moody and irritable, I would recommend you go back to the doctor and say it's not right. And I think I would still recommend you find another doctor. Expert or not, her advice on dosing Concerta is way off.
Consult with a neuropsychologist. She'll do broad-spectrum testing and if there are any co-existing conditions she'll find them. I started my son on Concerta at age 8 at 18mg and within a year 54 mg wasn't working at all. Then we switched to regular adderal, then to adderal xr, then to strattera with a little ritalin thrown in. A neuropsych dxed him and his pediatrician prescribed for him. If I had a second child just now dxed with ADD, I wouldn't go with concerta again. From what I saw and have read, kids seem to build up a tolerance to it.
Sarah, continue to pray. God hears and answers our prayers. In all of this struggle with ADD at my house, sometimes the only thing I had to hang on to was that God loves me and my child and that his grace is sufficient for all things.
Sarahb,
I answered your post relative to concerta on the med board .
Crying is a symptom of too high a dose of concerta. Every person is unique, it surprises me that she started out so high,too
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To first answer your question on what type of doctor she is, she is a Psychiatrist. She specializes in child psychiatry.
You have been very helpful though. I think I am going to try it for an additional day or two but I am not going to up the dose without first consulting her again if I do not see any other changes. As I stated before she said after two days to go ahead and give two pills a day which would be 72mg. If there is no positive feedback from 36mg, then why increase the dose. That much does make sense to me.
I just hope we can find something that will help him soon...for his sake and everyone elses. He is a very loving child at times but these times are rare. All I do is continue to pray that God will lead us in the right direction.
Concerta can lose its effectiveness over time. Concerta is the exact same medication as ritalin, just a different release mechanism. If it starts losing its effectiveness, it is wise to change the type of medication within the ritalin family. For example, there is Metadate CD, Ritalin LA, even Focalin is in the same class of meds.
My son had this happen. The problem with Concerta is that when it starts losing its effectivenss and you raise the dose, you begin with the side effects of too much meds without the benefits. If you take your child off the concerta for a while and use another med, then go back to concerta after a few weeks, you should notice a huge improvement.
What I did was give my son 36 mgs on the weekdays and 27 on the weekends, and that helped with the effectiveness for a while.
all three of my kids are on concerta my 8 year old is 18mg and my 10 and 11 year old are both on 36mg. And they are doing alot better my middle guy went up 2 and a half grade levels in eight weeks when he started.
mind you he is board now doing nothing but that is another story.