Concerta Question

I have a similar question with my 10 year old. He was taken off of Adderall though. At first I saw a difference too but I’m not sure if there was truly a difference or if I was just so hoping for a dfference that my awareness was heighened. My son has been on Concerta for about 6 months now and now he is starting to have problems at school again.

Crystal wrote:
>
> My nine year old son was taken off Ritalin and put on
> Concerta last month by his pediatrician. At first the
> difference was daylight and dark, now it’s a nightmare. His
> teacher says he is jumping up out of his seat, disrupting
> classmates, and really not paying attention at all. How long
> should I give this to see if it works? Should we take him
> off of it immediately and go back to Ritalin? The Ritalin
> was no longer effective at the dosage he was taking. He is
> taking 36mg. a day of Concerta. Could he be getting too much?

First thing I would recommend is to talk to the doctor who prescribed the Concerta. I would also ask the teachers for a rating scale of your kid’s behaviors during different times in school. My son’s teachers willingly filled out the Actor’s teacher form when I told them it was for medication management. It will help the doctor to determine what areas your kid is having difficulty in. Sometimes, it is the meds, and other times it can be the situations the kids are in at school. (one class more than another) One reason that the meds might not work after a couple of weeks or months is if your child has grown and put on weight. The meds are prescribed by weight along with symptoms. If your kid’s weight changed in the last couple of months, then he might need more of the med.

My son had an appointment with his pediatrician tomorrow. I intend to discuss my concerns with him then about the medication and get info about the meds. This is the first month he has been on Concerta. I know he cannot have had a significant weight gain since his visit last month (79 lbs.), so I do not believe that is the problem.

I am not sure if I want to yank him off the Concerta after only one month. That doesn’t seem like enough time to see if it will work to me. The main reason I am considering changing his meds at this time is because at his IEP meeting the IEP team said his behavior had greatly declined since he changed meds. He has been having a lot of problems at school lately and gotten into a lot of trouble (tomorrow is his first one-day suspension), and their answer seems to be more medication. I just can’t trust this for some reason coming from the school.

His teacher filled out a ‘Copeland Symptom Checklist For Attention Deficit Disorder’. The results look pretty bad to me. Inattention and Distractability was listed as mild to moderate at 48%, Impulsivity was listed as major interference at 70%, Activity Level Problems was listed as major interference at 72%, Underactivity was listed as moderate to severe at 67%, and Non-Compliance was listed at moderate to severe at 60%. The thing is that this is not his original teacher, she is a replacement since December and this is her first classroom job since she graduated from college. The class keeps getting away from her daily and she doesn’t seem to have their respect.

At any rate, I will be takng his IEP for next year and the addendums for the rest of this year and next to his pediatrician with me tomorrow, along with the checklist from his teacher.

Thank you for your help.

Crystal

The difference with my son was almost instantaneous. He went from fighting with his brothers in the back seat of the car on the way to the drug store to saying yes ma’am and no ma’am to everything that came out of my mouth by the time we had gone out to eat and gotten home. That night I heard something I have not heard in almost ten years in my home, silence. It was amazing. No fighting, no yelling, no hitting his brothers, and everything was great while he was out for AEA week which is when we made the switch. But when he returned to school, things started deteroirating and have been getting progressively worse ever since.

And I was not the only one to see the changes. My father commented on the change in my son when he first spent time with him after the med change. Please see my relpy to “a mom” for more info. And thanks, at least I know he is not alone.

Crystal

From my own experience, a new, inexperienced teacher means a big difference in kids behaviors. Every time my son’s class has a substitute, almost nothing gets done. It takes a while for the kids to get use to the teacher’s teaching habits. Everyone teaches different and the kids probably just aren’t too sure yet how to take her. They probably also “miss” the old teacher. If the rating was done by the new teacher, it might definitely show a problem. She might only know how a class acts from the few months that she student taught, expecting the students to be like the ones described in her books. Ask the ped. but I would ask to sit in on the class (maybe as a classroom volunteer) for a day or two. You could see then if it is the kids or the teacher’s inexperience.

It could be a dose issue. If the Ritalin was no longer effective at the given dose, then Concerta isn’t likely to work at a similar dose, because both meds have the same active ingredient, only Concerta is time release.

He was taking 10 mg of Ritalin at 7am and 12noon and 5mg at 4pm. He is now taking 36 mg of Concerta a day, so it is a little more than before. Interestingly enough I had a realization today, I started giving him his Benadryl for his allergies like I have done every spring for years about the same time as the med switch. Last night and today he didn’t have it because I was out, and his behavior was better. I know this because he was serving a one-day suspension because of his behavior at school.

By the way, we returned to his pediatrician for his ADD checkup today. After I explained the situation and the fact that his teacher is still wet behind the ears and snottin’ green, the doctor said that his behavior changes could be due at least in part to an inexperienced teacher (thanks ‘a mom’). We decided to keep him on the Concerta for now since there is only about a month of school left here and we may try adding other meds this summer. Now I just have to make the school understand that this is in my son’s best interest.

Thanks for the input.

Crystal

Benadryl is sedating to variable degrees. As that subtle grogginess sets in, behavior deteriorates. I know I am more easily irritated when my mind is trying to focus on something after taking a Benadryl. There are nonsedating antihistamines (although these are prescription drugs) and nasal sprays that provide relief for pollen allergy. You might want to discuss with the doctor giving something else a try for the pollen. I also agree with the concern that the inexperienced teacher could be a big factor with the school problems.

The mixture of Benadryl and Concerta could definitely be a cause of the behavior change along with the teacher’s inexperience. Benadryl is a sedating medicine. Concerta is a stimulant medicine. You are combining two meds whose side efffects/effects are battling each other. Does your ped. know that you are combining the two? He might want to try a different med for your son’s allergies that has less side effects than Benadryl. The Benadryl besides helping the allergies can cause dryness of the mouth and eyes, and sleepiness. Like Mary said there are other antihistamines that are not sedating, besides the nose sprays etc. They are available by prescription, so if insurance pays pretty good for prescriptions, it might even be cheaper than an OTC drug.

I stopped the Benadryl completely and his teacher sent a note home today saying what a GREAT day they had. That has to be it. I’ve got a call in to his ped. to get a new antihistamine. Thanks for letting me talk it out until we figured it out. You guys were all a great help.

Crystal

We switched to Concerta a few months ago. We too started with 36mg dose. We too experienced an increase in behavioral problems at school. We called our pediatric neurologist and he recommended increasing the dose to 54mg. We were reluctant to such a high dose (our son is only 7) but he assured us it was safe. After the increase there have been very few problems. I don’t know if this would help you but you may want to ask your doctor. Also worth noting is that the side affects (tiredness, loss of appetite are less than with Ritalin.

My son’s pediatrician said that 36mg. was the highest dosage available. If your child is taking 54mg., then he must be wrong. Learn something new every day, huh?

Since I stopped giving him the Benadryl, he has improved a lot, but the rebound effect when it wears off seems to be worse than the Ritalin was. Any ideas on how to deal with this? And he is having trouble falling asleep. I hate the thought of giving him more meds to make him sleep. Is there something we can do to help him go to sleep that doesn’t involve more medication?

Thanks for the info.

Crystal

Up until recently I believe 36 mg was the highest available dose. Our pediatrician and our pharmacist have both said it is now available in 54 mgs. We have never had any sleep problems so i can’t offer any advice there. Sorry.

My son is 18, a senior in h.s. He was changed from Ritalin to Concerta in December. After 2 suspensions and teacher critiques, I put him back on Ritalin. At first it (Concerta) seemed okay. But, it was a disaster. He was on 36 mg. and I just think 10-12 hours is too long for it to be in effect. He also seemed very quiet etc. Too much in my opinion and his appetite was down for the time period. School is almost over in 6 weeks or so and when he starts college he’ll have 1 hour to 1 hour and a half classes spread out, not 7 hours straight. That was our experience.

Concerta is now available in 54 mg.

http://www.concerta.net/

After two weeks on Concerta we went back to regular Ritalin. Even though it’s the Ritalin in a new time released formula, it didn’t work the same for my 10 year old (which makes no sense!) It gave him headaches/stomach aches and made him more emotional (which makes you think the dose was too high) and yet didn’t control his distractibility (which makes you think the dose was too low).

JulieinSC