Our son has been on a number of medications and suffered from the corners of his mouth cracking especially on concerta. They would become infected and several times have turned nasty therefore needing antibiotics. Then we went on dex and it was better. Four months ago we had his tonsils and andenoids out and the result was the cracks disappearing!!!!!! (We put this down to not mouth breathing!!) Now we have changed back to a lower dose of concerta - 36mg and it has returned! At a loss to how to treat this. Any ideas??????????
We think this is probably the case. It just was so good for 3 months with no cracked mouth!!!!! I glad someone else has experienced it because I was beginning to think that it was just us!!!!!I can only comment on my own experiences with concerta - when I first started it I became dehydrated and very thirsty. I drink water all day and still cannot get enough water!!! I don't know if that might be the issue or not??mouth breathing could have started it - but probably it's compulsively licking the lips. In dry weather I do terribly to the same result.
Try to get carmex at the pharmacy - it's a waxy stuff that doesn't hurt going on and is great for anything from cold sores to big cracks. He can lick it all he likes it takes a lot to come off.
obsessive things like licking are common - bring it to his attention if you see it - it helps control.
Changing from high dosage of ritatin and concerta to a lower dose of dexamphatamine cleared it up immediately. But alas we are back of concerta - this time 1/3 of the dose and its started again - Thanks for the advice. My son is so incredibly anxious - he has just bgun home schooling because friends and school where far too much work and cause enormous stress.
Hapyrock (formally known as Spencer - something happened!!!!)
The medications in question are all water-soluble, meaning they absorb in water, so when you take the medication, water is effectively "sucked up" out of your body during absorption of the drug. In addition, some of the tics involved in simple physical tourette's specifically mention compulsive lip-licking and smacking in diagnostic criteria. Combine these and it's no wonder you're left with painful sores vulnerable to infection. I once chewed up the entire inside of my mouth without realizing it (while on adderall), only to later discover why my mouth tasted so salty...my gums were torn up and bleeding and I had sores there for weeks. Tics are considered somewhat involuntary, the person can mentally control them, but the urge is so overwhelming that trying to temper that urge can lead to more aggressive tics later. I keep my old braces wax with me just in case I notice my teeth gnawing at the inside of my mouth - it's comforting to know that I can chew away and won't have to deal with the pain later or try to suppress those compulsions. Carmax sounds like a good idea for your son. Also make sure he drinks plenty of water during the entire day. I'm not sure if concerta has the same absorption issues regarding citric acid as amphetamines, but if not, you could try watered down Gatorade or Recharge. If anything else, he could drink some at night before he goes to sleep. Make sure to regulate diuretics in his diet like caffiene. Also, for myself, I notice the tics get really bad only when I'm stressed out or sleep deprived...maybe try to make sure he's sleeping well and that nothing is too overwhelming in his life at the moment. I often had more anxiety growing up (don't know how old your son is) than I ever have with the demands of college academics. Also, the embarrasment of compulsive tics can add even more stress to his life, which in return yields more tics. I'd say try to keep him happy and hydrated, and the rest is up to him unless more medical attention is needed. Good luck. =)Please note that these sores can be due to a number of causes, including vitamin deficiencies, dehydration/chapped lips, and certain toothpastes.