Concerta Rebound | ADHD Information
Hi Everyone: I haven't been to the site in a loooong time, but I am finally loosing it and can use some advice if anyone has any. My son has been on Concerta 54 mg for a year now and it has done wonders for him. He had an awesome second grade...never once in the principals office, ya! He is a joy to be with except for first thing in the a.m. and at night when the meds wear off. He gets so out of control and I cannot take it anymore. I have been using the marble system for about 2 months now and it doesn't seem to work...believe me, I have tried every thing to get him to get in control. He just doesn't listen, he makes loud noises, I guess to put it simpy, he acts like a happy, anoying drunk! Sorry to sound so mean...I adore my son, but I cannot take the a.m. or evenings any longer. I thought of asking to switch meds, but he does so well on Concerta during the day that I am afraid to.
Anyone have any similar problems on Concerta? If so, any advice??? Please help. Thanks for listening.
MARS
Have you thought about a quick release ritalin on waking and also when he comes home. We wake our son up at 6:30 and give him a small dose of QR and then he goes back to sleep. We wake him up 40 minutes later and he's right to go. The as he leaves for school at 8:30 he gets his concerta. In the afternoon he gets a QR at about 4:30 and this will take him through to bedtime. It just takes the edge off the rebound. The trick is finding the right amount and also the time so that you don't get the problem where you get a child who won't settle down for sleep. (A problem we know all about
)A lot of people are using Guanfacine (Tenex) in conjunction with stimulants to help with a "24 hour coverage" quite successfully. It help with that evening rebound also. We used it for a few months and it did help.Diane V: I have a perscription for Tenex to give to him before bed, but wasn't sure how it would help out in the a.m. Does it last that long?
HappyRock: I thought of a QR, but am afraid I then won't get any food in him. Breakfast and dinner are his main meals. I know, I want the best of both worlds...too bad we cannot have it!
Thanks!
We used it both in the pm and am. I started a 1/4 pill each then increased to 1/2 pill each. Others use more as prescribed. We used it for tics and restlessness rather than hyperactivity. There is a VERY long Tenex thread check it out, I learned a lot there.
Hi Meli,
The concerta may work at a lower dose than before because of the boost from the tenex. Hopefully you will find the right combo soon.
Ds has been on the tenex and it really dose help with the impulsiveness and hypernass now we are struggling with the other ADHD symptoms that are not cover with the tenex and concerta is what he did the best on and I am continplating tring this one again!
One thing that I really like about the tenex is that his appitite has gotten so much better. Durring the school year I woke him up really early and just had him take the pill then sleep for another hour or so then wake him at the normal time and that worked great. Something you could try with the tenex after he is used to it! It dose last in there system for 12hours I belive!
Thank you everyone for replying! It is so great (and not great) that other parents with children on Concerta are dealing with the same behavior. I wonder if a different stim would react different? My son was on Focalin, but it didn't nothing for him and he was moodier than before any med. I am going to get the prescription I have for Clondin (spelling) filled. I guess it is the same as Tenax, but I don't hear anyone in this thread talking about it. My doc said it is the same, but he wasn't as familiar with tenax for the treatment of ADHD so that is why he prescribe this instead.
I pray all the time that when my son wakes up one morning it will be a calm morning with no craziness.....it hasn't happened yet. I'm not giving up...but it isn't easy!
Clonidine is the same "family" of meds as Tenex or Guanfacine. We started on that, but it was more sedating and my daughter was falling asleep. She is VERY drug sensitive though. For us the Guanfacine was better.Thanks for the info. My doctor originally perscribed the med to help my son sleep so I guess that is why he chose Clonidine instead of Tenex.
I have the same complaint with my almost 11 yo ds on Concerta...well on all the stims really. I feel like I complain too much...that we can't have our cake and eat it, too, but I want to. He gets in so much trouble in teh mornings and evenings, especially if Dad is around. I like the way you explained it. It was nicer tehn what I could think of. I tried to tell the doctor and others that he acts so stupid like something is terribly wrong with him mentally ( guess ADHD is a problem but you know what I mean). He acts super silly way beyond the point of funny, can get wound up and run all around OR be slow and drag around, can follow 1 step commands much less 2 or 3, makes totally unecessary noise that only a small child would find amusing....and I could go on. The worse part is, he doesn't seem to be able to get control of it until someone finally loses their cool completely with him. Then he feels bad and so do we. I would love to know the answer. The doctor keeps saying stricter discipline, but he needs to be here, I think. Once the meds kick in...wonderful, sweet, intelligent child. ( Still has some learning issues and a tad of the immaturity but not nearly as without the meds.) I love that the Concerta works for school but...what about home?
I feel better hearing another parent describe the same behavior that we struggle with, although I wouldn't wish it on anyone. The ritalin booster does help him but he tends not to eat as much at night when we give it. And the only thing I have found that works in the morning is what others have already mentioned....giving a booster or the Concerta before he gets up. But then he won't eat. ( He is almost 11, 56inches and 63 pounds with clothes on. You can count every rib from a distance.) We have just started trying Tenex this week. I haven't really seen much change and it has yet to make him drowsy but......I think he has been a bit calmer in the mornings and evenings. Maybe more able to get control when I point out his wild behavior. We will add a morning dose tomorrow and maybe I will see more noticeable changes. Keeping fingers crossed for you and me.
TLCsmom, sounds like he gets in trouble before the meds kick in and after they wear off.
I would look into the guanfacine/tenex to help with his appetite, as well as any impulsive behavior.
My only other suggestion is the short acting meds that help before the concerta kicks in and after it has worn off.
My son is 10 and is on both concerta and guanfacine, since the start. He went throught the skinny minnies, however, he has been eating for the past year. His body has adjusted to the meds his doc told us.
If he has something going on around 5, we give him another guanfacine (1mg) to get through it.
I'm kind of late on this reply but I just saw it and couldn't resist. I have no
advice for you because I'm living with the same situation. My 10 year old is
on Concerta 36 mg and does fairly well on that dose. However, his is
absolutely unbearable in the mornings. For those who don't believe there is
such a thing as ADHD (such as my grandparents) I would invite them to
witness a morning at our house prior to the meds kicking in. We tried
reward systems too, even had him come up with the rewards that would
mean the most to him, but nothing works for very long. It saddens we to
think he can't function without drugs. One thing we noticed is often the
Concerta makes him too subdued. So now he's been prescribed an anti-
depressant, too. You can read about that nightmare on my own post today,
"Med Trouble". I feel for you. It's hard to think about living life like this on a
daily basis.TLCsmom we had the same problem you are having. Extreme silliness, especially during rebound in the afternoons. The morning was just chaos and "fog". We, like you, used the short acting meds which helped but also caused the appetite supressant. It DID get better once we added the Guanfacine. My daughter is also small at 12 (almost 13) and 5'1" 74 pounds. I'd stick with the Guanfacine for a while and see if it improves I think it will. We only used 1/4 - 1/2 tablet of .1 twice a day. My dd gets side effects easily so we stayed low and it was all we needed when using it. Good luck.When you get to the right dose, it will kick in in about 1/2 hour.I probably should post this on the Tenex thread, but....how long does it normally take for Tenex to "kick in"? I mean...if my ds takes it at 9 or so when he gets up in the summer, how long should it take to work if it is going to? His Concerta used to work in about 30 mins but seems to be taking longer now most days.Oh...I wanted to add that an hour can seem like an eternity if your child is wound up and acting ...well, like his brain isn't working. KWIM?
The behaviors you describe are definitely a rebound of the concerta. When my son was on concerta he was definitely acting that way. It is not the ADHD. When I stopped meds for my son those strange behaviors (acting drunk, inappropriate, etc.) went away. Please don't think that those behaviors would be there without the stims. Obviously the hyperactivity was still there, and the disorganization, but the odd-ness went away.
Hey hawks2921, did your son do that all during the rebound and then some? I am just asking if it eventually stops?
Thanks!
I can compltely relate!!!!! My dd has been on adderall XR for almost 4 years and we have all those same odd rebound behaviors, a happy annoying drunk is a good description. SHe just won't be serious about ANYTHING, and she is loud, hyper, etc. I wake her up 20-30 minutes early to give her the meds and she goes right back to sleep then when she does get up, she is good. In the afternoons she usually gets an IR booster. I am always so worried that her meds will wear off around others- not good. I know this behavior is caused from the adderall rebound b/c they were not present before she began meds. SHe is now on a med break. The thing for us now is that the odd, annoying rebound behavior seems to linger for weeks when we try to take a med break. Anybody experience this? How long does the rebound behavior stick around??
During the school year, she is good while on adderall, it's the times off that are so tough. FOr us it's like she either needs to be on stimulant most of the waking day or we need to treat the rebound. That is why I am interested in the guanfacine.
Good luck to everybody. This can be so tough!
I stopped at the end of 4th grade. My son developed severe tics and destructive ones too - he was picking at his face until it scabbed, he was showing terrible signs of anxiety, etc.
What is your sons diagnosis? My son is ADHD/Tourette's, however the tourettes' is very mild, so I"m not even sure he's really TS. He has a few tics that come and go. Very mild ones. I've seen other children not diagnosed who tic more!
I believe you need to go with your instincts. I agree you shouldn't go against your doctor, but they need to listen to your feelings on the matter and work to come up with a plan you agree with. There are many doctors out there and you need to find the one you are comfortable with. My doctor told me my son must be on meds, probably thru college. When these tics started he said he needed Haldol to stop them. I took him off stims and that stopped them too. A different means to the same end, just that I wasnt' comfortable with giving my 9 year old Haldol.
It is not easy, and there are days I consider starting again. But as you know from the other board we are trying neurofeedback and hope to see enough improvement to not need meds.
Feel free to ask me any other questions you may have.
We had to stop all stimulants due to tics. Some kids cannot tolerate any. There are kids though that only certain meds exacerbate the tics. I hope you can find something that wont make the tics worse. It's a struggle finding the right med when using stimulants, gets even trickier without them.
My daughter is in middle school and still doing this, it's a whole new world especially socially and anxiety wise. I am really worrying about what we will do about high school.
Hey Hawks2921,
How old is your son? How does he do in school without meds? Any effect on both social and academic areas?
I was wondering the same thing as Bethann.My little guy (age 7) did "sort of OK" off the Focalin for a week. We got to
see the happy side of him for awhile, but then some of our famiy
members were having trouble tolerating his impulsiveness.... and he was
getting in trouble. I guess I got nervous because we have a lot of group
activities coming up , so we started stimulants again. Concerta for one
day and he had tics. Can you believe it.... just one day!!!!!
We started Ritalin LA 20 mg today along with his Clonidine 0.1 mg 3 x a
day. I guess the rebound in the afternoon was pretty bad until he got his
Clonidine (I am usually with him 24/7 but not able to be there today.) He
actually bit a relative!!!
After reading some of the messages on this board, I feel now that I didn't
keep him off the stimulants long enough to see what he'd really be like
without them.
Reading about Hawks2921 son being off stimulants for two years makes
me ask the same question... how does he do socially and how does he do
in school.
Do you use any certain method of behavior mod?
I hawks2921
I'm glad you didn't give your son Haldol!
Hi Jeaniejo,
My son is also on concerta. He wouldn't last in school without it. He is very impulsive and hyper, a happy hyper who means no harm, but is ADHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHD
I too don't want to give him these meds, however, they have really saved his life!
I have had my son bite, only several times. It happens when he is overstimulated. I wonder if that happened to your son today. My son is not a "biter". He went to preschool with one. That is where he learned to bite. But when he is overstimulated, it has happened twice. My son is now 10, and it happened last year at a football party. No meds in his system, running around, way too much for my guy!
sorry I sent that too soon, I have a question Jeaniejo about the tics from concerta. What happens to your ds? have you asked the prescribing doctor if there is anything to be done? Can you try another med.?
We go to a psychopharm. who knows about ALL these meds. There are SO many to chose from. I just wonder if there may be something better for your son that will help with the adhd and tics.
Just wondering!!
I hate when our little ones need the meds, but due to tics can't take them so they suffer, really tears me up inside!
I agree with Vickie. My daughter suffered rebound from Ritalin LA,when I discussed with doctor he said the extreme silliness was a sort of "crashing" from the Ritilan. Off meds and mornings she would be silly too, but not like the rebound. They werent really the same thing. Rather than rebound from the med for weeks, this may be that he had problems adjusting to the unmedicated state of ADHD. Similar to adjusting to the meds with the self awarness (think before acting or speaking) they can bring.We have this same problem! I thought it was just the ADHD! Ashley is just horrible in the mornings and nights..ours is hyperactivity and silliness accompanied by extreme fits and just out of control emotional lability. She will burst into tears uncontrollably if you ask her to do something simple- last night it was over taking a bath! Then when she finally gets herself under control she is fine. Its so hard to deal with. It was bad on the Adderall but it seems to be worse with the Daytrana, not sure why. I keep hoping it will just go away. Will it? I dont want to give her another med that is short acting for mornings and nights as I already struggle with medicating her every day with one med.
Tina
You know I've had my son struggle with rebound in the afternoons when we first started meds. He probably still has it, but has learned how to cope. At times he is irritable, but I just ignore it realizing the meds may be wearing down.
I truly believe my mornings with my Darling Son, is due to his adhd. He is immature for his age, however, he is such a happy child. He is very laid back and very compassionate towards others. I don't want that to ever change in him. He is caring and thoughtful to others, but he has his ADHD moments.
I may be wrong in this hope for him, but I do hope that age will make it better. I am not saying that meds will not be in his life forever, which he asks me, but "IT" may get better as he gets older.
hawks2921, that makes me feel better. I've been worried that the meds may have messed up my dd's normal. When we give dd a med break in the summer the first two weeks are what I call "extreme" rebound and then she still has "residual" rebound for a while. The longest break she has had is 4 weeks total which did not get her back to her adhd normal self. I am glad to know that if we kept her off another 2-4 weeks she would probably return to her adhd normal self. We are hoping to keep her off 6 weeks this summer so we shall see.
I know everybody experiences these things differently but I really think that after some have been on stimulants for a while and especially at higher doses that it takes the brain a while to return to normal when the stimulant is stopped. For us, that rebound behavior (early morning, late afternoon and med holiday time) is the hardest part of dealing with adhd!!
I am sorry that others have to deal with this too but it is comforting to know we are not alone.
Thanks
JO58 - I understand exactly what you are saying. To be honest, after my son was off meds for about 3-4 months, I was amazed at the happy, funny, and more socially appropriate child I had. I had forgotten about his personality...while the meds calmed him down they also took away alot of his personality. He was on stims for about 2 1/2 years, and started to have very bad side effects. So once the meds were stopped, he gained about 18 lbs in 6 weeks (much needed!) and grew about 5 inches!
Once we went through all this, and due to the elimination of his bad side effects, we decided to help him med-free. Its been a struggle, but worth it for us.
How old was your son when you stopped the meds?My son is 7; was on focalin XL 40 mg daily and Clonidine 3xdaily. For 6-7
hours daily he had almost NO personality. I liken him to "Stepford Child."
Teachers loved it. He caused no trouble, was a top student, didn't talk
except a few words when a question was asked.
We took him off the Focalin a week ago.
Per doctor's order we continued the Clonidine 3xdaily. We finally got to
see him laugh and play and talk. He also had some trouble doing some of
the things that the stimulants helped him to do.... read, play piano...but
the Clonidine did help... although it did make him tired.
I want to see what he'd be like without the Clonidine, but his doctor says
he needs to keep taking it 3xday. And his doctor informed me I was NOT
TO PRACTICE MEDICINE WITHOUT A LICENSE by not following his orders.
He did prescribe Concerta 52 mg. which he took for one day and it had
the same effect as the Focalin...uptight, nervous, no personality.
I want to see what he'd be like off meds, but I'd like to hear more about
your son and how you do it without meds.
I was really surprised how well TL did without the stim, well... until today
when he did about drive us nuts!!!
My son stopped stims a little over 2 years ago and I can't remember the exact things he did, but I definitely remember that "drunk like" behavior. When we stopped stims he had a very bad rebound effect for about 2 weeks. Then he had what I call "residual" rebounding for the next 5 or 6 weeks. It really took about 2 months for him to be what I would call back to "normal" for him...ADHD normal that is!I just feel our kids are lucky they have us, and not parents who don't
understand or care. Our son is adopted and I know that left in the home he
was born to he probably would have never received treatment or been
understood.
As I read the messages on this message board, I can feel the love and caring
and concern that each of us has for our child/children.
Diane V:
I am sorry the stims aren't working for your daughter. It is very frustrating trying to find the right treatment whether it be meds or the natural way, which we tried for 3 years first. It worked well until our son started school and it just wasn't the best approach for us; even though I still restric certain foods.
Good luck!
Oh thank you. We've been this road before unfortunately. My daughter is almost 13 and was diagnosed at 5 so this is not a new place for us to be in. I'm starting to think by the time we find a plan that works for any period of time she'll be an adult
.My son had the rebound effect too.. If he had eaten andy artificial dyes that day it was way worse. Now he can tell me if it is regualr hyper or dye hyper. Very interesting. I started weaning off of concerta as the school year wound down and started on Tenex at the same time. Now he is taking Tenex only and eating mostly natural, not dyes or MSG. He is his normal cheerful self and not hyper. I really think we have to approach this in layers.
I have been working with my younger one, taking strattera and using the behavior modification by Dr David Stein. The first half of his book got me all p'oed. Then when I got to the discipline part it was so different than what I had been trying and it is actually loving, I mean, no more pleading and anger and dissapointiment in my voice. It has ony been a few days but he seems very calm and cooperative. I sat with him today and we started laughing at a face he was making with his bread crust replacing his teeth. He did it about 4 times and we laughed even harder each time. Then he looked in the mirror and then he stopped and watched the rest of the movie. Last week he would not have been able to slow down. It would have escalated... I wonder.... and not for the first time... Have I found the final layer?
BL Morett......
I need to read up on Tenex. My son's doctor doesn't use it, but I've seen it
mentioned so often on the message board and it sounds like everyone (?)
has been happy with the effects. Will you start the Concerta again when
school starts?
... My son's doctor though about putting my son on strattera because the
stimulants blunt his personality so much. He said it would take 2 - 3
months to get it fully into his system, could cause mood swings... he just
didn't make it sound very inviting, but it sounds like it's working for your
son.
What is the name of the book by Dr. David Stein?
My nephew who is 12 1/2 and has been on meds for his ADHD for many
years is currently off and doing very well. He talks alot, but that's ok!
My son is now 12. As I said before, we took him off meds in 4th grade. It was very difficult in school – however I was extremely lucky to have teachers who were willing to work very hard with behavior modification in school (checklists, rewards, etc.) His grades slipped slightly, he used to be a B to B+ student, however he is now probably a B- student. He is very smart so he can make up for his attention difficulties.