Both of my kids did well on concerta. The youngest was on 27mg and the oldest on 36. Only 18% of the kids tested did well on the 18mg in the original clinical trials; most of the kids responded to 36 or 54 (27s were not around at the time of these trials).
If you are seeing no side effects (especially with anxiety in the mix, then I would increase to the next dose and see. There is good reason for a cautious increase of meds to the effective dose when anxiety is involved. It could be made worse by the stimulant or if it was due to the struggles of dealing with ADHD, it may go away with treatment. My youngest had anxiety and depression that cleared up with treatment. For others it can get worse. Your doc is showing cautions based on his experience with this med for his other patients-take advantage of this experience, but keep educating yourself as you are obviously doing.
Oh, the reason my kids have moved to focalin is because it can be sprinkled and the oldest could not routinely swallow the concerta. The youngest did not gain weight on concerta and is too skinny to let her go that way too long so we are trying focalin.
vickie39166.5899421296I agree. I did see a slight improvement on 18mg of concerta with my son, but the teachers reported none until the dosage was upped. After the dosage was upped, he was able to complete work, stay on task, and bring home considerably less work than before meds.
My son in inattentive, though.
Keep in mind that the first drug is not always the one that works...and even if it does work, it may not work for the long run....concerta was good for my son for about 8-9 months, then the effectiveness fell off, and because of appetite issues, we opted to try another med rather than up the dose again...he was on 54mg.
He is now taking ritalin LA, and doing great.
chasesmom7939166.5900115741I would up the meds and if you do not see improvement in a day or two move on to another med. Concerta has been very good to my son and 18 is the lowest dose.
Kristen, my son is also on tenex (he takes the generic, guanfacine), along with 60mg ritalin LA.
The tenex has helped him to stay calmer, more mellow, and to keep his reactions in perspective...to think before he acts. Before the tenex was added, he could not tolerate the 45 minute afternoon bus ride home, the noise and the normal 10 year old boys teasing and taunting (and some bullying from one boy) were too much for him. He would regularly lose his patience and temper and explode, screaming at the group to shut up, leave him alone, etc. Daily, he got off the bus at home in tearful frustration.
Since it was added, he has no trouble ignoring the teasing, asking the boys calmly to stop, and that failing, calmly telling the bus driver who takes care of the problem.
He sleeps better, eats better, and is a happier boy, able to roll with the punches of life with a calm demeanor.
Here is the thread from the medications forum that I used to learn about the med. At the beginning of the 7 pages, Chase was not yet taking the med.
http://www.adhdnews.com/forum/forum_posts.asp?TID=24770& PN=2
i also have a 6 yo. She has tried several things, when she tried concerta we did it for a couple of weeks, she cried every night before bed saying she hated her room and wanted a new house. and once my husband and her were pretending to be tigers and he made a funny noise and she cried. it was a bit much even for my overly emotional girl. Personally i think that no medication is going to work for every one. I also think that because concerta lasted a bit longer for her then the other meds and that the peak of concerta is later in the day, she came down harder. i would say up the meds, but don't wait too long. if it is working it will work, if not it should not take 4 weeks to get to something else.Hi and welcome. It took us about a year to get the right med combo for dd. She started on strattera, added Concerta, added short-acting ritalin. We dropped strattera, then switched to Ritalin LA because she was depressed on Concerta. Then we added in Tenex, and was able to drop the short-acting ritalin and reduce the Ritalin LA dose. Takes a long time to figure this stuff out sometimes.Concerta may not be the med for your child something to consider before upping the dose talk to the doctor. My child is on Ritalin LA. Each med is different for each child, I personally hated my child when she was on Concerta. hi, cr12345mr. i have a question. i am really confused about Tenex. What does it do and what kind of symptoms did it help your DD with?Thank you everyone for all of the helpful information. I have read soTenex (guanfacine) needs to be managed carfully. Start low and slowly increase to the effective dose. Then you need to keep the daily dose the same, no sudden changes. Suddenly stopping can in some people cause a rebound spike in blood pressure. Some kids do not tolerate the med, but many do well on it. Here are the shire results:
http://www.shire.com/shire/uploads/press/shire/CONNEXYN_NDA_ Submission_240806.pdf
We tried my daughter on guanfacine alone. She does much better than no meds (almost perfect for a while), but the addition of a stimulant is needed to get her full effect for school. With time, she has a build up of frustration that starts affecting everything. It may be that the guanfacine would be enough for your son, but keep in mind the addition of a stimulant if the school demands get too much in the future.
vickie39166.9058333333