I have a seven year old boy with ADHD. He is hyperactive and has no impulse control.
Since June, he’s been on Ritalin and then in November we switched to 18mg of Concerta. For awhile the concerta worked beautifully. But in March we began to notice some of the wild movement behaviors and he did not have the control he had over the winter. We decided to go to the next dose which is 36mg.
On this dose, I notice he is extremely emotional. He also has had two incidents of going completely nuts once the dose has worn off in the evening. Completely nuts=nudity infront of company, tantrums, leaping and jumping over furniture and other children. He also threw markers at the babysitter last nite in his tantrum. Its almost as if he’s experiencing a rebound on the 36mgs where he didn’t on the 18mgs.
Does anyone supplement with a late afternoon dose Ritalin to counteract the rebound? Getting him to sleep at night is getting difficult even though he’s exhausted and I don’t want to give him a sleeping pill.
Maybe I need a different ritalin based deliver system that is higher than 18mgs but less than 36mgs?
God this stuff is so hard, and it makes me nervous all the fine tuning and “experimenting” to see what works.
I’m still trying to think of an appropriate punishment for terrorizing the babysitter. *sigh*
Any advice would be appreciated.
Re: Help! Concerta and dosage
Thanks Juliein. I’ve heard of Metadate. Thanks for the website info.
Its fascinating, my friends ask me if he’s on the right dose for his age and weight and I tell them it doesn’t matter, its how he metabolizes the drug. Every child is different and you just have to experiment to get it right. Scary but that’s how it is. What a strange world.
Today is a new day and my son started baseball camp. He was thrilled and looked just like any other kid out there. Its the little things that make your day.
Re: Help! Concerta and dosage
Suzanne,
My 9 year old son started with Concerta (18 mg.), but he wasn’t sleeping - and I wasn’t going to give him a pill to get up and a pill to go to sleep. So we tried Adderall. It was terrible! He said it made him feel like crying during the week when he was taking it (and he did!), and made him angry on the weekends when he wasn’t! So we have switched to Methylin (time release methylphenidate) - 10 mg. He also gets 2 1/2 mg. of methylphenidate in the am, and 2 1/2 mg. at lunch time. A total of 15 mg. all day. He is my happy singing, dancing around the house kid again. His grades aren’t as good as they were on the higher dosage, but I’d rather have him happy.
I continually reduced my son’s dosage of meds until we got to the dosage where he is happy, AND he learns. All children react differently to all meds, and is really is trial and error. Trust your instincts where your son is concerned.
Good luck! :)
Lil
Re: Help! Concerta and dosage
Lil,
Thank you for sharing that with me. Its so helpful to hear what other kinds of meds are available and how the dosages are tweaked. I was really unaware of the options.
Thank god for the internet :).
Re: Help! Concerta and dosage
My daughter takes two 18mg Concerta in the early morning before she goes to school. She does fine and we haven’t had any meltdowns. I didn’t want to switch to the bigger pill because some days when she doesn’t have that tense of an academic load we just give her one. She has been doing well on it. Incidently, UCIrvive is doing a field study with concerta. They are going to do clinical trials with adolescents by starting with a 12mg dosage and gradually increase it up to 72 mg to see how kids do……
Re: Help! Concerta and dosage
Thanks pattim!
I also found out from my doc that Concerta is coming out with a 27mg pill and that a transdermal patch is in the pipeline. With patch delivery, less medication is necessary since its absorbed more directly into the blood stream. Good news for all those parents of kids who can’t swallow pills.
Re: Help! Concerta and dosage
My son was on Concerta and began to have OCD symtoms and was terribly emotional also. His doc took him off and we are on Imipramine now. It doesn’t work as quickly or effectively as Ritalin but he isn’t as emotional and can actually get through with his school work better(we home school).I don’t know that I would punish my son about behavior he probably has no control over. Meds are hard to balance sometimes. We have been on Ritalin,Dexadrine,Adderall,Concerta and now Imipramine. Hope this helps a little. Jan
Re: Help! Concerta and dosage
I is interesting that his symptons increased during the winter. I think that ADD has been on the increase for quite a while. You have heard of sick building syndrome. Ritalin is a CNS stimulant and I believe concetra is too. Stimulants tend to calm children down but if you took it you’d be bouncing off the walls. I’ve heard that people have had success using accupuncture. Has mild autism been ruled out? Maybe 36mg causes a paradoxical reaction. If you take him off it completely he’ll have withdrawl symptoms. Get him off processed food and have him checked for food allergies. Way too many kids are on Ritalin and it’s cousins. Kurt Cobain & Robert Downey Jr. were on Ritalin as kids. That ought ot tell you something. Don’t stp looking for other remedies.
As I’m sure you are aware, all kids react differently on meds. Having said that, I know that some people do use an afternoon dose of Ritalin to help even out the rebound. Check with your doctor. For some kids, Concerta just doesn’t work, even tho Ritalin does. If your child had no problems with Ritalin, have you considered switching back to it? Another med to consider is Metadate CD. It contains the same active ingredient as Ritalin/Concerta (methylphenidate) but has a different delivery system than that of Concerta. My 11 year old has had total success on Ritalin, but Concerta was a disaster. We wanted to eliminate school dose (next year is middle school) and the Metadate CD has really worked well.
http://www.metadate-cd.com/