Increase MG for Concerta? | ADHD Information

Wyatt's Mom - I know exactly how you feel.  My daughter had such a wonderful 4th grade year - I too questioned whether or not she really needed meds.  The past fall, we had 3 really hard months and much of the behavior that started down this road had come back.  It wasn't fun. 

Since the end of November, we have upped her dosage and worked with a therapist. Things are going well again.   We have gone almost 6 weeks with out a major outburst.   It's a night and day difference.

With such great success on meds, what worries most is what happens if she decides she no longer wants to take meds.  Hopefully, she really has learned something from all the behavioral stuff we did and we won't spiral so out of control again...

My daughter is 8 years old ( soon to be 9 ) she has been on 54 mg of Concerta since she was 6 years old .

I spoke with the doctor and she's going to give me a script tomorrow for a week at the 54mg.  Since the kids have Monday off from school it will give me three days to monitor him closely then by the Thursday appointment I should be able to tell if the new dose is helping or if we need to try somthing else.  The last times we increased from 18 to 27 then to 36 I could tell right away.  Thanks for all of the answers.  I was just feeling that the jump from 36 to 54 was alot.  Now that the doctor has called me back and hearing from you guys I feel a little better  about it.  On another note...with him on meds it was easy sometimes to forget he even had a problem so I had started to consider trying to take him off.  This kind of hit me hard in the face.  The social issues are the worst.  I wish I could just take him out of school and protect him from the world.  Oh well...thanks again!  It's great to have this board just to vent.

Concerta dosage is based on metabolism, not age/weight.  My stepdaughter (10, 4th grade) took the 54mg pill from about second grade on.  Recently we've had to increase her meds, and she now takes the 54 plus an 18.  This seems to be working pretty well so far, although it's VERY $$$$ until we meet our annual deductible.

 

Good luck to you...

We just went through something similar with my daughter.   We had a rough few months when her meds were too low.  Since upping her dosages (from 18 mg to 27mg), things have been much much better.   We didn't notice any difference in side effects with the increase of dosage - just POSITIVE changes in her behavior.

I would suggest trying 54mg and if that doesn't work, perhaps try something different then.

My 8 year old was also on Concerta 36 for a while and then quit working.  His doc put him on 54 mg for a month, and then when there wasn't a change, put him on Vyvance 30 mg.  He (the doc) told me that sometimes the one class of medicine just isn't as effective anymore and when you switch to another class, it kick starts (my words-not the docs) into working again.  So far so good for us on the Vyvance.

Good luck!   

Bonkers-was there an increase or change in side effects with the increased med?  Someone told me if he has minimal side effects on the 36 then it will be the same on the 54.  Anyone know if that's true?

It depends on the person, but usually if they do well on 36, they will do better on 54, unless it is too much for their symptoms. MY BEST FRIENDS DS HAS ADHD AS WELL AS MINE HE IS ON CONCERTA 54 MG+ 2 10MG BOOSTERS A DAY. IT SHOULD NOT BE TOO MUCH. AND I AGREE TRY IT FIRST THEN MOVE TO ANOTHER MED.spamula39464.3556828704

2-10mg boosters of concerta or another med?  when are those given?  And THANKS for your answers guys.

Concerta is not dosed by weight, but by symptoms, so 54 mgs  or even higher is not unheard of.  Try it, see if it works, and if not then move to another med.

Hi Everyone, I am really stressing out here and need some advice.  My son is 8, add inattentive.  He has been doing great on 36mg concerta with 1/2mg Tenex in the evening.  The only real side effect that we see is lack of appetite.  He eats alot in the am and pm but not much all day. He only weighs 60lbs.  Before the meds he did poorly in school, could not ride his bike or do anything physical that took effort, wet and or soiled his pants a few times a week.  He just never noticed he had to go.  On Concerta we got our little boy back.  The problem...after a year on 36mg has now gone back down hill to where he was before we strted meds.  We have a doctors appointment but I am afraid to change dose.  Is 54mg for an 8 year old at 60 lbs. too much?  Is it dangerous?  Are we safer to try a whole new med? ALll I can think of today is that my poor little guy is going to be made fum of at school worse than he already is if I don't fix this fast. 

 

 

We started the 54mg on Saturday.  He was very weepy for the first two hours then he was great the rest of the day.  He still slept well.  Yesterday (Sunday) he was back to his old self.  Today (so far) I have not had any calls from the sitter so I am anxious to get home and see how it went.  My ex husband is convinced that the problems are all emotional due to our seperation then divorce which happened 3 years ago.  Yes he has heard us fight a couple of times in the past 3 years but I have explained both times that we were wrong to fight and after answering all of my sons questions I think he's fine.  He also had 12 weeks of counseling and his counsler thinks he's well adjusted.  Besides, if his problems were all emotional and not chemical wouldn't the concerta be making him nuts instead of helping?

Hi,

We just increased my 7 yo son's  Concerta from 36mg (he had been on that strength since he was 4) to 54mg about 2-3 months ago. The increase seemed to be doing the trick until this week.......now the teacher is seeing the old impulsiveness, etc rear it's ugly head again. I am in a quandary over whether to talk to the pediatrician about trying adding Tenex again (we tried at lower dose of stimulant but didn't seem to do the trick) or just changing to another stimulant altogether. He has done so well on the Concerta in the past so I hate to give up without a fight! He hasn't had tantrums in at least 2 years but he's also starting having these again in the evenings with me at home. Any advice on which way to go would be greatly appreciated at this point.

HI MSCoast Mom- As you see from my posts here we have just increased Concerta to 54mg.  Wyatt was also on .5mg tenex.  After a week on the 54 I too started seeing evening tantrums because of rebound I think and I was noticing that although he could fall asleep, he wasn't sleeping as well. He was more wired and cranky during the day since he was over tired.  We just increased the tenex to 1 mg a few days ago and he is back on track.  Maybe it couldn't hurt to try the tenex first before going through trying a new stim.  I think I've read posts here too that some kids are on 72mg of concerta.  Maybe that's what he needs.  I know we've had luck with concerta (ie. no terrible side effects) so I hate to try anything else.  (I don't think I'm helping you)

Both my 9yo and 12yo girls are on 54 concerta.  12yo actually weighs less that 9yo, but this is not d/t med, she has always been tall and thin.  9yo was having probs in school last year, increased anger, not wanting to participate her doc was on maternity leave and doc covering increased her to 72 concerta.  This did not improve behavior, she became more angry and started to have negative self comments, episodes of tearfullnesss and increased anger.  As soon as I could I got her back into regular psychologist and found new doctor.  Basically looked at the whole picture.  Teacher was not helpfull and creating increased pressure and frustration in school so increased incidents of anger.  She was 8 at the time and not able to verbalize probs accurately (or rather since she had tried  verballing probs to teacher and had been told it was all her fault, didn't tell anyone else)  until I found her crying and recognized blatant signs of depression.  I do not think the increase in medication created the problem, but I do wish before I had allowed med to be increased I had looked at all aspects of what was going on at school and at home.  Now anytime school report increased incidents of anger ect. I ask what else is going on.

Hi Jane, We noticed the same thing with Wyatt.  He went up in dose every two weeks until we hit 36mg which he sateyed on over a year and now he's on 54.  I was afraid to go higher every time but it always turned out to be the right thing.  I agree with Okiemom about undemedicatin.  It would be like giving half the dose of an antibiotic.  It might work for a couple of days but it would never fix the problem. 

Hi--

Since many of you have experience with Concerta I'd like to get your feedback.

I just started by 8 YO son on concerta this past weekend.  After 5 days, he appeared to be doing great save for some insomnia.  However, today he reverted to his pre-med state--unfocused and disruptive.  The dosing time was no different.

Have you experienced these patterns with your children on Concerta?  We started with Adderall last fall and it wasn't a good match.  We are optimistic about Concerta but want to get a sense of whether today's incident is part of the adjustment or a warning sign.

I am waiting for the physican to call back to discuss.

Thanks!

JaneB

 

 

 

 

Give it at least 2 weeks before you decide. It takes that long for the body to adjust. I agree with the poster who mentioned Concerta is dosed based on metabolism, not age/ weight.  My son has been on Concerta a long time.  He is now 15.  There is a rare subset of kids whose metabolism is so high when it comes to metabolizing stimulant meds, they require unusually high doses.  My son falls into this category.  He takes, are your ready for this....., 162 mgs of Concerta and has done so for over 2 years.

Many people discuss and know about the dangers of OVERmedicating with stimulants.  Little is discussed about UNDERmedicating.  My son was undermedicated for years....never reaching fully therapeutic dose. He suffered a lot this whole time. Until we got a hold of a psychiatrist who really knew what he was doing and was an expert in psychopharmacology, we never were on the right dose.  Our current doctor knows these meds really well and comes up with combinations and doses that most doctors without the right training and experience, would not touch.

Okiemom
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