Concerta Update | ADHD Information

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My son has only ever been on Concerta and done great on it for about 2 years.  The only down side we have seen is a decrease in his appetite.  He'll eat great before taking it, and in the evenings when he is coming off it, but He will not eat lunch at school and is so picky its driving me crazy.  Dont know if i can attribute that pickiness to the meds or just his sensory issues though. 

About 3 weeks ago he was upped to 36 mg and the doctor added Tenex 1mg at night.  His hyperness improved, as did the swing in the evening before going to sleep. but now I am seeing problems at bedtime, bad nightmares and fears,  and he is newly afraid of the dark.  He even wet his bed one night.  We have never had any sleeping problems with our son, has anyone else seen this reaction to a higher dose or the addition of Tenex?

 

wow wish I could find a good therapist like you have! Where we live it is fustrating.  Its a big suburb, of LA but for some reason there are few specialists here and we have to travel at least an hour to get services.  Add in the cost in time & money and it gets difficult.  The one we had tried locally just didnt help us much, gave me some strategies I added to my arsenel but did nothing for my kid himself. So we keep trying.  Now I have a psychiatrist for him, so we will see if she can start to help us.  Its such a game of trial an error isnt it?   Well small steps I guess right? 

 

Yes, it took us a couple of tries before we found this therapist through our pediatrition. It has helped my son a great deal in opening up and speaking his feelings. The only prob he is not on our insurance and my mom is paying but she has cancer and not a long time left. We will deal with it when the time comes.Spamula, I am so sorry to hear about your mother having Cancer.  I will certianly add you & your mom to my prayers.  My sister is a Breast Cancer survivor and my mom is 85 and in ill health so I can understand a little of what you may be going through.  We all do the best we can do dont we?  Hang in there.

well his therapist said he had a flat affect at his appt. yesterday. I am feeling bad for pressuring the doc to increase to 27mg. At 18 everyone said he was lovely and no bad news from teacher, but at home he was hyper and impulsive, disrespctful and I didn't think he was focused enough for school. Now I feel bad and think he  should be put back on the 18mg for a while longer.GUILTY! That's how I feel. Camstermom- My doc will not in anyway add Tenex to the mix. Many People I have heard have succsess with this combo. I wonder why he is so against it? And by the way he is still hyper at 27mg.

Hi Spamula,

I know exactly what you mean about the guilt. Thats how I felt about my sons recent dosage increase. But dont feel guilty.  If he is fine at school and not at home, what is the difference?  Is it the amount of structure? Is his disapline consistant? Does he have set routines or are things more lax because of the holidays etc?  I know I struggle with that daily, and yeah its my bad not sticking with things for whatever reason, and usually ends up in my kid being difficult. It's especially hard for me cause he is off track for 6 weeks right now.  I don't know what to do with him truth be told! LOL 

I had never heard of Tenex before.  We had our first meeting with a new Psychiatrist and she is the one who changed the meds.  My son was so uncomforatable seeing her, hid under her desk for the first half, then when I tried to have him sit on the couch, he got a bit defiant and ended up litteraly bouncing off the walls.  I said he was not usualy like that, he was showing off.  My pediatrician didnt want to up him from 27 mg.  I though things were basically ok at that level.  But I didnt want to put him on any antipsychotic drugs, she agreed that was not the way to go, but felt the hyperness and impulsitivity needed to be addressed first.

We did have swings coming off in the evening, but that didnt bother me so much. We stuck to our routines and bedtime was fine.  And before taking it in the morning he was often pretty wild, but again nothing we couldnt manage. By the time he had breakfast & got to school the meds were kicking in.

But in November we started to see an escalation in defiant behavior at home.  He started not listening so much.  I was getting worried and fustrated with him.  He had an episode at school where would not get out of the car to go in. long story short,  The Principal & assistant principle ended up carrying him in kicking & screaming, and told me to leave.  When I called the principal to see what had happened.  she was able to gleen that he was scared of the subsitute teacher. He walked to class on his own, but wouldnt go in untill his regular teacher came out & reassured him.  His relief was huge to see her I was told.  The teacher worked with me to overcome his fears and  he was fine after that for a while, then the problem in December happened at school where he was suspended.  That is when we immeadiatly took him to a Psychiatrist.

So now we are coming off a tramatic event, seeing a new doctor that really knows nothing more than I'm telling her, she thinks we just need to get the hyperness under control.  so that is where we started. 

 Truthfully I have seen more change in his behavior using cognative behavior modification, getting more consistant with his disapline and using time outs for the smallest of infractions, and structuring his day more, further limiting his time on the TV and playing videogames or on the computer. Those things he has to earn.  He is playing outside more being more active and is spending more time playing with his toys.  Its harder on me to be consistant I tell ya, but It is better for my kid so I need to work on it more.  The first day or two it is hell, hes almost constantly in time outs, but then he drastically changes for the better.  I sometimes get complacent though when he is good, and let things slip and wham, we are back to problems.  But I have seen an improvement with the higher dosage in the amount of hyperactivity during the day though.  Im just not sure the Tenex is needed.

I have a meeting with the Psychiatrist in 2 weeks unless I can get an earlier appointment, so for now I will continue to monitor things.  We are going to have him go to bed earlier.  8 pm is regular time, on days off school we allow 9 pm, but I'm going to go back to the earlier time for a while, see if it makes a difference.

Camstermom39823.4375925926After speaking with my DS 10, he was able to tell me he was more comfortable on the 18mg. He said the 27mg made him too tired and didn't help as much. So a call to the psychiatrist on Monday to get the Rx changed. Today I gave him the 18 again and we'll see what happens. My Ds has Anxiety issues and Adjustment disorder so I can relate with the sub-issue. He loves his teach but so far I feel he still lack focus. Hopefully we can work it out soon. the last 2 years has been hard dealing with meds that haven't worked and side effects.

 How old is your son again?  Mine will be 7 in March. He is not able to communicate easily how he feels. Something we are working on with him. As I research more about ADHD that seams to go along with it as well.  He did say his head was quieter on the medicine, though. You are lucky your son can relate the difference to you.  I have to try to figure it out on my own, such a guessing game.

I wont really get a handle on the med changes untill he gets back into school in February.  We will have to evaluate the differences there.  He is doing fairly well in the classroom, but acts differently there than at home.  He focuses better on work there, but still rushes through it and has difficulty working independently. He finishes so quickly and seams to not be listening when the teacher is teaching, but if she stops & asks him a related Question, he is able to answer correctly so she knows he is paying attention.  go figure!  So i will need her imput on his behavior changes.

What kind of side effects have you seen with your son?

How did you get him to open up?  I am starting to see a little bit of opening up with my kid, but its like pulling teeth.  Its like his little brain just cant access that information, but then he can remember things that happened years ago or something he sees on tv, or something said within his hearing all the time.  I just cant figure it out! 

We try to process with him, today I want you to tell me 3 things that you do in class, when I pick you up.  Even with that it s difficult.  he cant seem to tell me anything they work on, and specifics just dont happen. He hasent started lying yet, but what he says happens is often different from other kids say happen.  so far I have always found our kid tells the truth.  He doesnt get that if he lies he may avoid trouble, like the "normal kids" do... thankfully! But try & get other people to believe that...sheesh. My kid is ADHD so he HAS to be the bad kid all the time.  This is just not true!

WE dont have tics thankfully.  He does have certian noises he makes that are stressors, stuff we usually see before taking meds or when he is really overwhelmed.  Kinda like a grrrrrrrrr sound, and now he likes to put his finger to his lips, shake it up & down and go blublublub.  how do I make that sound in writing!? LOL  its more cause he thinks its being funny though.  he also likes to do the spongebob laugh.  LOL

 

My kid has a hilarous and somwhat dry sense of humor.  He is great at timly one liners that I have no idea where he gets them!  heheh 

Camstermom- It took a LONG tiime before my son was able to open up. Alot of therapy which has been invaluable, as well as us giving him the opportunity,(I tell him he won't get grounded if he tells the truth,and I stick by it)except the time he stole from my mom, He was grounded and had to make an apology to her. He was so worried my mom would hate him he was very nervous. Maybe that incident helped him come to grips with lying route. I can only hope. He also has a dry sense of humor as do I, some people don't get it. My son is slly and goofy in the am and pm and but seems to do ok in school. but barely with the Concerta27 and he didn't like how it made him feel so I backed him down for now to 18.

The meds have done wonders but his therapist is a young cool guy and knows how to work Jake. He specialices in ADHD.

I hope eeverything goes well for you and he opens up to you about the meds soon, try asking him questions. one day mine actually answered back!

Camstermom- My son is 10 and it took quite alot of asking this year to get him to open uo his feelings then to tell us. It has been a long road this year with the help of therapy by an excellent psychologist, we are almost there.

The meds are another story. Ds had bad tics on his last med Vyvanse,So far the only tic I see so far is throat clearing, but it could also be an allergy and he has bad ones (outdoor).He is actually eating which is a switch but it is only 18 mg.

You are right mine does not act the same at school and at home but our teacher refuses to take the time to talk. She says no news is good news. I am going to set up a new 504 meeting as well after vaca next week.We will get news then.

Well we went up to the 27 and all my DS wanted to do is sleep Bizzare. He kept on complaining so we put him back down to 18mg. He is Horrible after school. The homework load is putting to much pressure on him.He may need a booster after school to get through the homework. This is dissapointing as the Vyvance lasted 12 solid hours and he did his homework( then he flipped out and had to come off) Thus the concerta. HHEELLPP!!Clonidine 1/2 of a 0.1 mg pill after school makes all the difference in the
world.

My son's problem on the stimulants is that from about hour 2 - 4 after
taking the meds, he starts picking, Right now it's his fingers, fingernails,
hangnails, etc.

Last year it was his face and his leg.....

The Clonidine is supposed to help with side effects, but his Concerta dose
is so high that I don't know if anything could help.

He's on 27 mg + 36 mg concerta every a.m. along with a 1/2 Clonidine,
then takes 1/2 Clonidine after school and a whole clonidine at bedtime.

I know without the Clonidine he would not be able to settle down.

He is a straight A+ student, so I hate to jinx things by making changes
although the 'picking' is driving me crazy.

He also does the throat clearing, but of course he does have a little bit of
allergies and we have had colds lately..

AHHHH !!! the worries never, never end, do they!!!As of now his Psych is totally against the tenex or clonodine. I am not sure why.I would find out why, because there are a ton of kids being helped by
those meds.
Clonidine is labeled as a blood pressure medicine. That scares some, I'm
sure. It needs to be tapered off if the decision would be to stop it. It can
cause drowsiness, but that is what brings my hyper DS back down to
earth (and out from under the table or off the top of the desk!!!) It is what
keeps the 'even keel' in our house.

DS (age 9) has been on it for 3 1/2 years. One problem one day: we
thought we'd stop the stimulant and dr. told us to continue the Clonidine
as it has to be tapered...NOT stopped abruptly. WEll, he fell into a deep
sleep.. you could call it passing out.... because the Clonidine was just too
much to give without the stimulant to balance it out.

We gave him a 1/2 dose from then on whenever we decided to stop the
stimulant... which has only been one other time..

Thanks Metis. We are giving him time to eat before we up the med, but expect to do so shortly. I hate the "anorexia" side effect of this med. Yoo Hoo!! Here we go againWe love Concerta.... but why do all these long acting meds give us the
promise of 12 hours.

I've yet to see it!!

well less than a week till we up the Concerta. I am not really looking forward to it as he is already not eating much. Although it may help in school next week when we go back. He was on it for 2 weeks and teach didn't say much about the difference and it was pretty big. I also wish it lasted 12 hours. Getting nervous.My son's appetite has not been affected as much on the Concerta as it was
on the Focalin. We try to get in a decent breakfast, after school snack,
supper, and occasionally a bed time snack.

I know he doesn't eat much of the school lunch. Not sure if that's due to
appetite being decreased by the medicine, or due to the content of the
school lunch!!

DS (age 9) also takes Clonidine and generic Zoloft, so those may make a dif.

Jeaniejo- thanks for your post, so far on 18mg he is eating more at night and a small lunch and of course breakfast. He has an ice cream sundae everynight before bed. I have heard so many great things about Tenex or clonodine with the Concerta now, It really makes me wonder. I asked doc about it 6 months ago and he said no and refused. He also takes generic Zoloft. Today is the day we go to the psych to check on the meds.2 weeks into this @ 18mg and my sons therapist noticed a Huge difference with the change from the Vyvanse to Concerta, all good, His teacher didn't notice anything DUH?? except that he didn't have tics anymore YEAH!  2 more weeks and we see the doc again to detirmine if he needs to go up at that point. My only complaint is it wears off too soon, 8 hours.YAY spamula!