Increasing Concerta Dose ??? | ADHD Information

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My ADHA 9-year-old son has been on Concerta for 4 months now.  He is presently taking 27mg in the AM.  I would like to increase this amount because I still see way too much impulsivity.  His doc wants to see how the next 3 months go with schooling (we homeschool), and then talk about an increase.

How did any of you handle this??  Is waiting normal even though I am pretty sure he needs more?  Since the doc basically has all the power, how do I convince her that he needs a larger dose.  His weight is stable, and he is sleeping fine with the use of Melatonin.

Any advice would be appreciated.  We are somewhat at the beginning of this jouney.

Thank you.

I would ask the Psych why he wants to wait. If the 27mg is not helping his symptoms then he may need an increase or a change to another med. IMO waiting 3 mos is unnacceptable.

He is actually seeing our GP for the meds, and a Psychologist for counseling, etc.  I guess I could get a recommendation from him to the GP for an increase.

I hate to be mean to the GP, she is a long-time friend of the family.  Maybe, I sould consider changing doctors, or pursuing a Psychiatrist, so the meds could be dispensed by someone else.

Suggestions??

Thanks.

A psychiatrist is ususally the best for meds.

I agree that seeing a psychiatrist is your best choice for med management. They are much more comfortable with dosing and switching meds when needed.

I too think three months is way too long to wait.

Thank you.  I will look for a Psychiatrist within my HMO.

I appreciate your help. 

I am in kind of the same position.  My son (8) has been on Concerta 27 mg for about 4 months also.  I think it works grreat for the focus, but not as much on the impulsiveness.  We made it through the summer, and the doc suggested we wait until at least 3 weeks into school (or progress report time) to re-evaluate.  He too sleeps fine and has not lost any weight or appetite.  I think he needs an increase, but I am scared that increasing the meds will instigate the side effects.    a
SftWrmRain39448.0208796296

Barb -

Wow - OK I will definitely be looking into the Melatonin thing.  It was recommended by our Pyschologist and OK'd by our GP.

Thanks.

I have a 6 yr. old son, he is AD/HD, Bi-Polar, ODD, & IED.  He started taking Concerta a little over 2 yrs. ago.  May 2005 we started him on Concerta 27mg. along with Resperdal 0.25mg. x2 daily.  It worked well for about 5 months and we increased his Risperdal several time between October 2005-June 2006.  He had to be hospitalized in the last part of June 2006 because he was out of control by this time.  They put him on Focalin 10mg x2 and Risperdal 0.50 x3 daily. That didn't work at all!  We moved to Marion, Ohio in July 2006 and we finely got one of the best child psychiatrist in the state.  He put my son back on Concerta but this time 36mg.and gave me extra if need to increase.  My son is now up to 72mg. of Concerta a day, along with a list of other medicine.  But I here to tell you that just a small increase can do wonders.  Like the lady said before it is a very good idea to have your son be medicated by  a psychiatrist.  Most are very much into working with you to do medicine change at home and between appointments.

Best of luck!  

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SftWrmRain39448.0125231482My 8 y.o. started Concerta 36 mg today. Good day at school but some hyper
stuff for the last hour before dismissal. We had been using Focalin XR 10 mg
in the am, Focalin 5 mg at 1 pm and 4 pm. We needed to rotate off the
Focalin because it was metabolizing too quickly. Is it true that the Concerta
is enough different that we should be able to restart Focalin in a few weeks
without the problem of the fast metabolizing? We did this switcheroo once
before with Adderal but that made him aggressive and impossible. Or is
there some other med. that can be given as a booster in the afternoon once
the Concerta has worn off? Homework was impossible today and he hates
how his brain feels when he has no meds left.
Thanks for any help you can offer.Sounds like he is burning it up quickly.
I would check his diet for artificial stuff and make sure no sodas during the day.  The dose may be too low.  Guanfacine may help get through homework.
We used 5 mg Ritalin as an afternoon booster.

Just as an update, our psychologist sent a recommendation to our GP to increase the Concerta, and she agreed.  My son is now on 36mg daily.  We just started this week, so I am still observing him.

I had reluctantly decided to pursue the pyschiatrist, as you guys recommended, but he has SUCH a GOOD relationship with this counselor.  With the situation as it is now, I am going to wait and see if I think this dose is enough.

Thanks again.

Hmmm... I found the concerta will titrate quickly if you are not on the right dose.  Last summer I weaned my son off concerta 54 and made big diet changes.  When he started back to school I tried 36 first way too much... 27 was to much too.  We went with 18 for bout 6 months and then the trouble started... we went up to 27 for about 6 weeks and then had to go to 36.  Finally we ended the year at 45.  You are the mommy and you live with the child.  I would call the Dr and say waiting 3 months is just not working and you have to do something to save your son's self esteem.  Ask for her help in a kind funny friendly way.  If we lose our sense of humor everything becomes a confrontation.