Concerta 18 too much?

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    • #117491

      We just tried Concerta, the lowest dose (18 mg) for our 10 year old yesterday. He took it at 7:30 on a weekend, so we could watch how it would work. Around 9:00 he was having more engaged, longer conversations with adults than usual. Around 10:30 he was helping with a mechanical task with too much stick-toitness – doing something not necessary. People had to keep telling him to stop. I guess you’d call that perseveration. At about 1:00 he crashed big time. He got super tired and he was lying on the ground. Totally out of character. He went to go to his afternoon sport, but he wasn’t even able to participate because he had zero energy. This has never happened in all his years of sports. He looked bad too – dark circles under his eyes. By dinner he was more normal again, but with fewer ADHD behaviors than usual – less wiggly at the table, better ability to stick to a train of thought. Bed time at 9:00 didn’t work – he seemed more relaxed than usual, but couldn’t get to sleep until 11:00 pm. There wasn’t any point during the evening where there was a rebound of ADHD symptoms.
      My husband considers this a complete bust and doesn’t want to try a second day. I can see his point, my son has a well rounded life, and wrecking the afternoons to concentrate better in school wouldn’t be a reasonable trade-off. Maybe it would be worth it for the last two years of high school where marks count, but not in grade five. He is somewhat annoying and fairly incapable of getting work done when he’s in a high ADHD state, but he’s still really nice, and a fun guy to be around, so we don’t have people from the school sending notes home about bad behavior.
      I am very sensitive to caffeine, and it lasts much longer for me than for other people, so maybe this boy doesn’t metabolize drugs in an average way. Has anyone else had this experience?

    • #117611
      Penny Williams

      This could be attributed to several things. When my own son first tried Concerta, after trying a few other ADHD meds, it was the worst day he’d had, and he had had many stinkers. BUT, after that first day, the Concerta worked well for him. He just needed time to adjust to his neurology working differently. That’s one possibility. The others are that this is the wrong medication or wrong type of stimulant for him, or that the dose is too high or too low.

      There are two types of stimulants: amphetamine (Adderall, Vyvanse, Evekeo…) and methylphenidate (Ritalin, Concerta, Quillivant…). Almost everyone does well on one type or the other, but not both. ADHD medication takes a lot of trial and error to find the right medication and dosage for an individual. The first medication tried rarely is the right one.

      A Patient’s Primer on the Stimulant Medications Used to Treat ADHD

      ADHD Medications Rarely Work Perfectly On the First Try

      ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism

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