Heart palipitations

If you are concerned about his heart, and if you have heart disease in the family, insist to your doctor to do a baseline EKG, and ask him to check on your son every 3 months. I was concerned about a family history of heart disease, so had told my son’s doc about my concern and he did a baseline EKG (he was normal) and will be seeing my son every 3 months instead of 6 months.
My son is on Adderall Xr.

I talked to our pharmamcist and he went took the time to answer all my questions and he went over the insert with me. I was shocked to find that one of the side effects of Concerta is an enlarging of the heart.

I am also asked the pharmacist if I should take Robbie off the medication and he warned me against it with out first talking to Robbie’s doctor.

In the meantime I have to find a doctor who will take Robbie off the Concerta and I think he should be seen by a cardiologist. With out comming right out and saying it my pharmacist agreed.

So far as far as behvior goes, Robbie is generally calmer but he seems to be in another world a lot of the time. I also think that some of Robbie’s problems have to do with the loss of his grandmother. Robbie is a very sensitive boy and I think he is having trouble accepting the loss on his grandmother. She adored Robbie. It seemed that shortly after her passing Robbie’s hyperactivity went into high gear.

Nervous Mom, if you don’t feel concerta is right for Robbie you should probably have Robbie see a child pyschiatrist, who might also be able to help Robbie get over losing his grandma. They treat ADHD etc and are able to prescribe medications. If you get a good one they are more knowlegeable about medications than some pediatricians. You should also see a cardiologist if you are concerned about his heart.

How long has he been on Concerta? Research on medications yourself so you understand what it can do and can’t. There is a new non-stimulant meds on the market now called Strattera. It takes a long time/with side effects (4 to 6 weeks) before you see the full benefit but when it works it is wonderful. Not all kids can take it.

Go to ADHD.com and check in on their medication and Behavior forum. You will get lots of information and help from the parents that visit the board.

Good luck

I think what I am going to have to do is to start fresh with another doctor in order to get a referral to a psychiatrist and a cardiologist. This is going to take some time but in the meantime I’m gonna be on eggshells.

Robbie has been on Concerta for nearly 5 months. I don’t know when his palpatations started all I know is I need to have him seen ASAP.

I am not sure how a child grieves but I think our minister may be able to help Robbie. The more I think about it Robbie’s behavior has changed quite a bit since losing his grandmother and being on the Concerta.

I was told to call the Dr if my sons heartrate went over 100 when he started adderall.

It disturbs me that your Dr out and out told you it could NOT be the stim. If he said a mild rate increase was nothing to worry about, I could accept that.

I would find a Dr who would listen

Nervous Mom,

You are the one who decides whether your son should take Concerta, not your doctor. If you are concerned about your child’s health, don’t give him the medication. Concerta only stays in the body a short while and there is no danger to stopping it “cold turkey.” Of course, check with your doctor to be sure, but you are the one who gets to make the decision. One thing of which you should be aware though, is that the heart side effect your pharmacist mentioned is unbelievably rare and is associated only with the concomitant use of clonidine and ritalin (Concerta is a form of ritalin).

Has your child been evaluated for depression? In children, depression often looks like ADHD. Has he lost weight recently? ( Just a thought — f he has, perhaps that is why you can notice his heart beating.) Weight loss can be a sign of depression. Is he sleeping well or does he wake up a lot or have trouble falling off to sleep? Does he seem quieter or angrier or more irritable than before he lost his grandmother? Again, these are depression indicators.

Good luck and I hope you find the answers you need.

Andrea

I want more than anything to get him off the Concerta but I have read that cold turkey is very dangerous.

Robbie has always been thin but since he started to Concerta his appetite is decreased. A lot of the time he doesn’t even eat the lunch I pack for him.

He will be going off the Concerta as soon as I can find a doctor that will take him off it.

Nervous Mom,

What have you read that says stopping stimulants is very dangerous? I have received directly contrary advice from my child’s very well-versed doctor. Many parents, myself included, routinely stop giving our children stimulants on weekends and holidays. My doctor has specifically advised that this is not dangerous. To the contrary, the medications only stay in the bloodstream for a few hours (about 10-12 for Concerta, for example) and then they are gone. There is no withdrawal and no health risk to simply stopping the medication. Of course, there may be a return of symptoms of ADHD that may take some getting used to for the child, but that is quite different. If you are giving Concerta once a day, then it is wearing off 10-12 hours (at the maximum) after you give it. That means that for 12-14 hours of the day, your child has no (or only trace amounts of)Concerta in his bloodstream. Sometimes you can tell when the medication wears off because the child will become irritable or sad for a bit, or you will just see ADHD symptoms return. There are some non-stimulant meds that provide (at least theoretically) round the clock coverage, but Concerta is not one of them. I think you may have been receiving bad advice all around. If your doctor does not listen to your concerns, get a new doctor. You are the mom and you are in charge of your child. On the other hand, there is a lot of disinformation out there about the supposed perils of stimulants and I fear you may have been fed some of it. There are legitimate concerns and risks to giving stimulants, but stopping “cold turkey” is simply not one of them.

Andrea

Nervous Mom, you can stop the concerta anytime you want. The stimulants are only in the system for less than 24 hours (less in some cases - concerta only works for 10 - 12 hours). Where did you read that you cannot stop cold turkey? There is no build up of the stimulants ie. concerta, adderall or ritalin so you don’t have to wean him off unlike Strattera. Your son has not been on it that long in any case. So you can stop anytime you want. Some parent don’t give their children the meds on weekends or the entire summer and only put them on during school. I personally don’t do that, as I think my son benefits from getting his attention all the time, and is learning all the time. You don’t need the doctor to give you the Ok to stop unless there is some underlying condition your son has that you have not mentioned. If you are concerned Stop it now, and find a doctor that is more supportive and knowledgeable about ADD and medications.

Andrea,

The disinformation that you speak of came from my pharamcist and the literature that came with the medication. Now I am more confused than ever.

I wish they had never given Robbie Concerta.

I have been researching frantically and I am beginning to believe that this was a huge mistake.

Robbie’s grandfather, my father in law has been against medicating Robbie. I wish I had listened.

I will not withdraw the medication until Robbie can be monitored. With all due respect Andrea Robbie is a child not a science project.

Ritalin Withdrawal

Ritalin (methylphenidate) is a central nervous system stimulant, similar to amphetamines in the nature and duration of its effects. It is believed that it works by activating the brain stem arousal system and cortex. Pharmacologically, it works on the neurotransmitter dopamine, and in that respect resembles the stimulant characteristics of cocaine. When taken in accordance with usual prescription instructions, it would be classified as having mild to moderate stimulant properties, but when snorted or injected it has a strong stimulant effect.

Ritalin is an addictive drug and mimics the action of chemicals your brain produces to send messages of pleasure to your brain’s reward center. Ritalin produces an artificial feeling of pleasure. Ritalin produces its pleasurable effects by chemically acting like certain normal brain messenger chemicals, which produce positive feelings in response to signals from the brain.

The result is an addiction to Ritalin because the individual can depend on the immediate, fast, predictable high Ritalin provides. At the same time, Ritalin short circuits interests in and the motivation to make life’s normal rewards work. More and more confidence is placed on Ritalin while other survival feelings are ignored and bypassed. Ritalin Withdrawal varies in severity and length. The withdrawal from Ritalin addiction depends on the amount and duration of time an the individual was addicted to Ritalin.

Ritalin Withdrawal symptoms include but are not limited to:
agitation, insomnia
abdominal cramps
nausea
severe emotional depression
exhaustion
anxiety

www.vidyya.com/2pdfs/prescribing_info_hp.pdf

This is the insert that comes with the medication. Note the absence of any cold turkey warnings.

Andrea

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682188.html

Nervous Mom this information is from the national institutes of health and the NIH recommends that you do not go colt turkey from Concerta and that you not stop it without first consulting a doctor.

I would not presume to give you medical advice that is your doctor’s job. I would suggest that you find another doctor for your child.

You need to be able to make informed choices when it comes to the well being of your child.

Please heed this bit of advice and only follow the advice of qualified health professionals.

Nervous Mom:

IMHO you have received some very good advice here. However, the bottom line here is that YOU are the parent. What you do is your decision, and is YOUR responsibility as a parent.

I know that if I had any question about my child’s health care, or the medicine that he was taking, I would make an immediate call to the child’s doctor. I would not stop until I was satisfied with the doctor’s answer. If need be, I would find another doctor. If I felt I was endangering my child’s health in ANY WAY I would not stop until I had all the answers I felt I needed.

Having said that, I echo the advice that you have received here. My son was on Concerta yet the stomache aches/headaches bothered him so I immediately stopped giving him the med. As with ALL MEDS, I had discussed the pros/cons with his doctor before I even gave him the meds. Therefore, I knew that I could safely stop giving him the med with no problems.

[%sig%]

Sorry, due to the delay in posting I need to respond.

I DON’T agree with the message posted immediately before mine that discusses NIH and Concerta. I DO agree with the advice other mothers had posted.

Again I think the only safe advice is the advice of a qualified doctor. To take medical advice from someone on a message board Nervous Mom would be reckless at best.

All I can say that from everything I have read in the scientific literature stimulants do present certain dangers. If they didn’t present dangers then they would not require a prescription from a doctor.

Methylphenidate is the chemical also known as Ritalin and Concerta. Ritalin is faster acting because Concerta is Methylphenidate in a timed release form.

This is only my opinion based on everthing I have read so take this with however many grains of salt you want. Methyphenidate is Methyphenidate regardless os dosing. It is addictive and withdrawing it “cold turkey” is likely to be dangerous. Whether it is or is not in the blood stream is irrellevant. What is rellevant are the changes that it makes on the brain’s chemistry. Withdrawal symptoms are very real and in my opinion nervous mom your concerns are NOT unfounded. Methylphenidate is a powerful drug and it need to be used with GREAT care.

My son had the same problem shortly after switching from Adderall to Adderall XR. My immediate conclusion was that it was the meds. HOWEVER when the school nurse and I tracked when he showed up in her office complaining for several weeks, it was right before music class. It ended up that tryouts for the school musical were coming up and he was having what amounted to “panic attacks”. I has contacted my son’s pediatrician since he was born with an innocent murmer, and he had suggested tracking the times…..as soon as my son then made the decision not to tryout for the musical (though he had been looking forward to it for a year), his racing heartbeat miraculously went away.

It can be the meds but it can be something else.

Nervous Mom DO NOT. I repeat DO NOT stop the Concerta without first consulting a doctor.

Stimulants should not be stopped cold. I nearly dropped my teeth when I read that. That is some very dangerous advice.

I think you added up one and one and came up with three on your conclusion. Anxiety is one of the common side effects of stimulant therapy.