Concerta 72mg | ADHD Information

My daughter is 8 yrs old and is taking concerta 72mg. She has became very violent. Should this happen? For an example she hit my middle daughter with a stick in the leg. Also tried to strike a friend watching them while I work 2nd shift. I need help. Please help me. I can't speak on behalf of anyone excpet myself, I can definately say that Concerta seems like a drug that can go either way and it will be obvious.  It's pretty much an upper and if she has too much energy inside of her and she doesn't know what to do with it she's going to act out.  Why don't you have her dr. switch her to the strattera and give that a try.  asap

my son (6 1/2) was on 54 mg for almost a year when we realized he was acting strangely so we took him down to 36 mg and it has been wonderful.  maybe you need to try lowering the dose, even if you've tried it once before and felt it wasn't effective enough.  i've been guilty of expecting too much from meds, in fact, if my son wasn't "perfect", what ever that is, i assumed it just wasn't working and took the dose up or tried another med altogether.  maybe it's too much for your daughter or maybe you should try another med.  what else have you tried?  does she exhibit this behavior only when on meds?  i'll keep your family in my prayers.

The first 3 or 4 days on Concerta my 10 year old son became very angry/agitated each evening when coming down.  It would last for about an hour and a half.  He would beat his bed and tear off all the sheets and basically trash his room.  I decided that maybe he should go outside and run.  He would do that for about an hour, acting angry the whole time.  He would then come in and again trash his room.  His doctor  was suprised by this behavior.  After the first 3 or 4 days he adjusted well and the evenings went very smooth.  After about two months we increased his dossage and worried that the angry behavior would return, but fortunately it didn't.  However, lately (two months later) he seems to get easily angered in the evenings again but not nearly as drastic as when he first went on Concerta. 

So far it has worked marvously.  Each week he would come home with 6 C or D papers and 6 A papers.  All in the same subject.  Now he rarely comes home with anything less than a B+. Now if something would work for me.  I'm on my third medication and nothing seems to help.

The most important question to ask about agitation and stimulants is :

WHEN is the agitation in response to taking the dose?  If the agitation is right as the extended release medicine is wearing off (Concerta, Metadate, Ritalin LA, Adderall XR..) then it is *rebound agitation* and best treated by giving a small dose of immediate stimulant prior to the extended release wearing off.  This reduces the rate at which the extended release drug concentration falls in the blood and the associated agitation.  Alternatively another type of extended release formula can be tried.

If the agitation is during the whole time the dose is active then that is agitation from too high of a dose, the dose just needs to be lowered.  If lowering the dose results in loss of positive benefits, another medicine may need to be tried.

My first reaction is that 72mg is a really high dose for an 8 yr old. My 8 yr
old is on Concerta at 27mg (recently bumped up from 18mg). We have
experimented for 4 yrs with various forms of Ritalin. We started with the
short-acting variety. We were part of a national study of ADHD (and
Ritalin use) in preschoolers. So we monitored the different dosage levels
very carefully (weekly physician visits, weekly questionnaires for we
parents and my son's teacher, frequent observations by psychologists).

What I noticed was an overfocusing and an irritability (getting upset easily
and throwing huge tantums -- sobbing uncontrollably over almost
nothing) when the dose was too high. So now I know the signs to look for
whenever we are experimenting with a different dose or stimulant
medication.

Separately, my husband was recently diagnosed with ADHD. He started
Concerta at 36mg, and after a month or two, increased to 54mg. He has
noticed a big improvement in his ability to organize, plan and focus. One
day he accidentally took 2 pills (total of 108mg). He said it made him feel
pretty hyper and agitated.

So, all that being said, I am wondering if the dose you are giving your
child is simply too high. If you are not seeing the benefit you'd hoped for
at a lower dose, I might try another stimulant medication. Based on my
experience, I would be inclined to try the shorter acting version (say of
Adderall) first, until you get the dosage right. It is easier to see the
effects, and the effects wear off quicker if you get an adverse reaction.

Finally, as for a sleep aid -- we have struggled pretty much my son's
whole life with getting him to sleep at night. Stimulant medications only
made this worse. Recently we started giving him 1mg of melatonin (his
doctor advised us to try this) about an hour before bedtime. It has been a
miracle for us! I believe melatonin is a lot safer than many of the
alternatives being discussed to help induce sleep at night -- and it is easy
and cheap to try (no Rx needed).

Best of luck to you. Hope my experience is of help.Hi Dawn, my 11 year old son who weighs 64.5 pounds is on the same dose as your daughter. He is very calm and mellow on concerta, and of all the medicine he has taken this is the only one that works, that's why he takes such a big dose. I would say she's not supposed to be hitting while on it, but i'm not a doctor. I would talk to your daughters Dr. and let them know whats going on. My son was violent while on adderall.  Every medication effects each kid differently, so it's hard to tell what they'll say to you. I'm 28yrs and tried concerta 36mg's... It was fine while I was on it then I quit. Later tried 54mg's and flushed them down the toilet 3 days later. Just a weird irritated feeling. Tried 36mg's again later on it spiked my anxiety within hours. So I quit. Only thing I can say... Is if you ask a child to describe being irritable... They more than likely don't know the word. Let alone being able to explain that their bugged with people around at certain times of the day or whenever... Moreover, it'd be hard to have a child come out and say I don't feel good with people around me etc etc... Feelings like this are explained naturally as the mind/child grows up in life. That's why communication is very hard between children and adults on issues like this... It's not the simple, "are you sad?", "are you happy?" questions. It's the inbetween stuff in which the adult mind knows from experience in life. If I think about... This would be a tough med for child not knowing what a 'come down' feeling is. Come down... I know its the drug and go to bed. A child may look at it/feel it as an irritable feeling for worse case self pain/suicide. Just my opinion.I guess the question I have... What time of the day did she hit the other? Depending on diet and acitivity through out the day... the irritable state could be as early as 3-4 pm in the afternoon and higher % in the evening. But if the fight was early morn after waking or mid day after taking the med... Then I'd look at something else... As in the med not working at all.

I'm 24, ADHD with hyperactivity and innatentiveness and I take Concerta. Over the years I've also taken Ritalin, Adderal, Dexedrine, and Strattera (made me sleepy, paranoid, and scared).

Concerta should not act as "upper"/stimulant for a child who really does have an ADHD brain -- stimulants typically (not always!) act very differently on ADHD children (usually a calming effect) than they would on say, their parents, if they have "normal" brains (I hate the word "normal"...its so subjective!)

I know I'm older, but my parents have a very very hard time understanding me and my brother who is also ADHD. Its even more difficult with kids under 10 that can't really articulate how they are feeling or what is working and what isn't. If children are aggressive, angry, paranoid, or depressed on a medication, they need to try an alternative medication. Perhaps Strattera would work? It didn't for me, but then again, Concerta does!

Also, ADHD children often have other learning challenges. This does NOT make us stupid - I think I'm very intelligent! However, if ADHD is the only "disorder" being dealt with, I'd suggest doing other tests/behavioral counseling in addition to trying alternate medications.