They will have symptoms if it is too high, such as stomachaches, irritability, etc. I'm kind of surprised how your doctor has done this.
When my son started meds, he started with SHORT acting ritalin, in 5 mg doses. So for example, for the first week, he would get 5 mgs in the morning. The teacher would fill out a checklist of his behaviors (we did a beginning checklist too). Then if there was no noticeable improvement, we went to 7.5 mgs( we cut the 5 mg in half). When the teacher noticed a good improvement in the morning, we would raise it again. If the 10 mgs seemed to high (by side effects, etc.) we'd go back to 7.5 and that would be the dose. Then the longer acting stims would be based on that dose. 5 mgs equate to 18mgs concerta, 7.5 to 27mg concerta, etc.
For older children they can judge the effectiveness themselves. Your children will get rebounds in the beginning, esp. if they jump from no meds to a higher dose. You need to work slowly.
I would go to 27 mgs for a few weeks at least to see how it goes. It could be that concerta isn't right, but just because the beginning sees some rebounds doesn't mean it is wrong.
I may also enlist the aid of a doctor that specializes in ADHD, not a general pediatrician (not sure who you are using). The specialist has much more experience with different meds and outcomes.
Good luck.
Kahren - I was also having either rebound issues with my son (36 mg Concerta) or the meds just weren't working any longer. My son would go through 10 different emotions in 5 minutes. He was very frustrated and emotional. We changed him to Daytrana (the patch), 20mg, and his emotional tantrums have greatly improved in the evenings.Kahren, My son tried just about every med in the same family as ritalin (Methylphenidate). They all gave him the grumpy rebound. He is now taking Adderall and we have not had to increase the dose in about 6 months infact ,we went down by 10mg to 20mg daily. He seems to be doing great on this. He is in a regular 2nd grade class without any modifications or adaptations. I think getting the meds right is all trial and error and I know of many kids that Adderall is great for and just about the same number who do terrible on this med. Good luck in finding the one that works best for your child.
[QUOTE=hawks2921]Why did you go from 18 to 36 mgs? You should have tried 27 mgs if 18 wasn't working.[/QUOTE]
Our Dr. seemed to think they needed 36mg and she mentioned that then I didn't have to get a new prescription - just gave them two of the 18 mg. pills. She said if this appeared to be too much we could move down to the 27mg.
How would I know if it was too much? Do they go zombie-like?
Why did you go from 18 to 36 mgs? You should have tried 27 mgs if 18 wasn't working.Thank you all for your input.
joemom - what med did you switch to? Does it seem to be working out well?
My son is 10 and I began giving him 10 mg "homework" pill at 3:30 when I pick him up from school--he's on 72 mg Concerta daytime. This has helped immensely! rebounds some but boy not much--plus, it's after a warm bath and ready for bed and the wind down, so not as bad.good luckMy son would get grumpy on concerta and not fun to be around...our doctor told us to try food as soon as possible when we saw this behavior. We did switch meds and we don't have a rebound issue anymore.My girls are starting their third week of Concerta. They were on 18mg. for two weeks and just started doubling to 36mg. yesterday. My question is - what is with this rebound thing? Does it ever get any better? My girls are ADD Inattentive only, so they don't get physical or rowdy on the rebound, but they get VERY sensitve and one of them gets so sad. She seems depressed in the evenings and doesn't know why. I hate this! Could we just be on the wrong med? I feel like I'm trading one set of issues for another.
My son has not had rebound issues on Concerta, but I am keeping my fingers crossed, because we are gonna start messing with the dose next week due to major appetite issues.
Others have posted that they use a small dose of fast acting ritalin administered just prior to the long acting dose wearing off to alleviate the rebound issues...the ritalin acts quickly and is out of the system before bedtime.
The higher dose may well make the drug remain in their systems longer and the problem may resolve itself, but if you are seeing good results in school, and rebound is your only issue, speak to your doc about a small ritalin boost to ward off the rebound.
Hi, my DD was on concerta. She too, would come home from school all depressed-looking. She really didn't seem happy at all. I remember, dh went with her on a field trip to the zoo, and she cracked a smile ONCE. That did it for us, we called the doc and asked to change medications. We tried 18, 27, and 36 mg doses. She was on Concerta about 1 1/2 months.
Regarding rebound: We also added a small dose of short-acting ritalin right after school to combat rebound.