Concerta XL and sleep problems | ADHD Information

Hiya - my first post although I've been reading and lurking for some time!   My son was diagnosed with ADHD & Aspergers earlier this year, and after behaviour techniques had little effect he was prescribed ritalin. He is only 6 and very small in height and weight so he was put onto the lowest dose (5mg twice a day). He was on this dose for about six weeks and we noticed a dramatic improvement in his behaviour and concentration both at home and at school.   At the follow up appointment about a week ago, his doctor said she wanted him to go onto Concerta xl and he's now been on it for a week. We absolutely love this new medication - again even more improvements in his behaviour and it is more consistent, whereas when the ritalin wore off around lunch time and again around 5pm he would get jittery and lose focus. He is on 18mg concerta xl.   BUT he is wide awake at night! The only downside we have found to the concerta is that he just isn't getting tired. It isn't uncommon to go to check on him around midnight to take him to the toilet and find him wide awake playing in his room! It is not so bad during the school holidays, but it is obviously a concern for when he goes back to school. He doesn't seem to be overly sleepy during the day though ... he just is rarely asleep before midnight.   I've read that it is a side effect of the concerta, but does anyone have any suggestions? We've tried winding him down with bedtime stories and a proper bedtime routine but nothing has worked! He's just AWAKE!   Dee xhave you tried natural remedies like melatonin or passiflora comp,we have a lotion from the homeopath also.the melatonin worked like a charm for about 6 months for us.My 7 year old is on concerta as well. His pediatrician recomended 3mg of melatonin at night. Works like a charm! He is asleep in about half hour after taking it. His doc said it is the best med with the least side effects. Good luck!I like concerta and I found out from this forum that Melatonin worked for some, I tried it and it is helpful.  It may also take a few weeks for him to adjust to concerta.  I had to adjust the timing of my dose to make it the most effective - if the effects are good, give it a little time to adjust!!!   

Hi Dee,

There are probably several ways to approach this with your doctor. Here is what we are doing.

My daughter was on 27mg concerta until today (she is taking a 1 month holiday to gain weight) and was doing well. For the first few weeks, she did wonderful. She read in the evening and went to bed on time and to sleep well (something that has been a problem since birth-She says she cannot stop her brain to sleep). After the first few weeks, she started being more scattered and hyperactive in the evening. It is as though the meds are wearing off earlier. She is back to being up very late and I am concerned

She is now starting on guanfacine (tenex) to see what affects this has on her. It is used for calming and is expected to help her sleep. It also is expected to help keep weight on her (without meds she is a small child~55 pound 10yo). The plan is to get the quanfacine started now and add the concerta back when school starts. We will then optimize further for the best effect for school and homework. We would have just added the guanfacine is she had already been in school.

Hope that helps.