June 2, 2017 at 1:35 pm #50814
We just started our 9 yo son on ADHD meds — 18mg. of Concerta. He has mixed type ADHD but errs on the fairly hyperactive side. His teacher reported that he was more focused during school and seemed to be more under control but last night when we told him he couldn’t play screens he absolutely flipped out and would not let it go. He argued with us for over an hour about it when normally he would have cried and gotten upset and then probably moved on after 15 minutes. This time he was relentless in his arguing, very composed but would not let it go, so a bit different from usual. Could this be an effect of the medication — increased aggressiveness/argumentativeness? Also we did not observe any changes in his ability to control his impulses and sounds like the teacher didn’t either. He got in trouble for a couple things at school and did some annoying things that angered his peers. In general, when would we be able to determine if the meds are having the desired results? Thanks.
June 4, 2017 at 3:43 am #50867
With any ADHD medication the effects are always different depending on the individual. My son is now 15; but like your son, he was diagnosed as having mixed ADHD at a very early age (5 years old) and I made the decision to start him on Concerta two years later. I immediately saw a difference in his grades, as he went from failing to straight A’s nearly overnight. However, the gradual change in his personality, mood swings and emotional stability became too much for him and our family. He had signs of depression, anxiety, insomnia, uncontrollable violent crying and would inflict self harm almost every night. His triggers included: Being told to get off his video game; homework; chores; asking how his day went….you name it! With concerta the medication wears off in the evening and puts the body through withdrawls, so as he increases the mg’s I assume his side affects will worsen. 54mg’s is when we called it quits.
Keep a close eye on your little man. I would hate for him to go through what my son did. Look into Focus Factor for children/adults and HCF (Happy Calm Focused). They are supplements that can be purchased through Amazon.com. My son has been taking them for the past 2 weeks and they are incredible! Everyday is better than the last…he is able to do his homework (online summer classes to keep his mind engaged), he does his chores without me asking, and i don’t repeat myself 5-15x. I think the best part is his confidence and personality have made a comeback.
As for your son getting in trouble and picking on his peers, that will pass. He is still so young and I feel that it’s normal for boys to have more energy. 🙂 Check with his school/teachers to see if they have accommodations for students with ADHD. Meeting your son halfway in a creative learning atmosphere will help keep all their students engaged, not just kiddos that suffer with ADHD.
I hope my experience helps you! Let me know if you have any questions… I am happy to help if I can.
June 5, 2017 at 8:29 am #50882
Thank you so much, Peanut0214! Truthfully, I’m worried about all the same things you mentioned your son going through. My son is extremely intense with serious challenges just going with the flow. It takes so little for him to be triggered and yes since we started the 18mg. of Concerta I feel all his issues may have been aggravated. And frankly, I really haven’t seen any changes in his focus. The doctor wants us to go up to 2 pills this week — 36mg. and I must say I’m kind of worried. I don’t understand how a stimulant is supposed to make him have an easier time controlling his impulses….
What are the active ingredients in the supplements you mentioned? Also, does your son undergo any counseling or coaching for ADHD? I’m beginning to wonder if I need to get him involved in that too. My husband and I feel at our wits end with many aspects of his behavior. It’s so hard to stay positive with him when everything about this kid can feel like a major obstacle at times.
Thanks for your feedback.
June 5, 2017 at 9:13 am #50886
Sometimes, behavior gets worse if the dose is too low. Sometimes, these types of reactions signal that it’s not the right stimulant or type of stimulant. This primer on stimulants will help you understand the process of getting the right medication better:
My son (now 14) got stuck a lot too (also called perseveration). It’s really frustrating to deal with. We found that two things help:
(1) the broken record approach: where your answer is always basically the same: “I’m sorry you’re upset about not being able to use electronics right now. This isn’t the right time, but you will have the opportunity again tomorrow.” You may need to change up your phrasing each time, as repeating the exact same thing can set some kids off even more.
(2) use the “magic phrase”: “How can I help you?” Showing empathy and validating your child’s emotions (whether you think they’re appropriate or not) are two of the most powerful parenting approaches for kids with ADHD. You may not always get an appropriate answer (in this instance, he could answer abruptly, “let me have screen time right now”), but it’s not going to be a switch you flip to suddenly stop the perseverating and outburst, it’s just going to help diffuse it. Eventually, you’ll come to recognize when these flare-ups might happen and use this phrase before he falls into full-blown meltdown.
Another strategy I’d employ is routine and structure. For instance, he has an hour of screen time every day, at 7 pm, or after homework is complete, or whatever works for you. Then, he knows when to expect to be able to play electronics and when not to. That will help to keep these battles to a minimum.
ADDitude Community Moderator, Author & Mentor on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism
June 5, 2017 at 11:41 am #50890
18mg of Concerta will likely provide your son around 8 – 10 hours of relief, and considering the timing of the screen play argument (night), he could have been coping with some withdrawal. He was probably feeling a little sick, likely tired, maybe anxious, irritable, and feeling the return of his ADHD symptoms, when you asked him to stop screen play. And if he had been playing video games, particularly, stopping them could have been especially hard – I have personal experience in this area. Here’s a little info on the topic of ADHD and video games, if you don’t already know:
It might have been bit of a “perfect storm” for him, so to speak. I could see how your husband and you’d feel overwhelmed by the sheer energy it takes, trying to help keep your son on track. You’re both probably exhausted. I hope you can find a way to get some time for yourselves, and recharge.
- This reply was modified 2 years, 8 months ago by Penny Williams.
June 11, 2017 at 12:47 pm #51189
look into “rebounds” from stimulants. In myself and my oldest son – we get 4 hours from a stimulant. XR’s were no different. Most people do fine, but we didn’t. Concerta, vyvanse, rebounds caused extreme anxiety and agitation – 50x worse than taking no medicine ever. My son was prescribed Vyvanse when he was 18 – and the rebound was terrifying. Now he takes Adderall, every 4 – 5 hours, just like I did years ago. Its the most success he has had on a med. Another thing that can curb bad rebounds is a really low dose of Ativan, or even a really low dose of Ritilan to curb the rebound.
Boy though, I am going to check into that Happy Calm Focused though – I have a 16 year old that needs help too, and I could use help again – but don’t want to ever go back on the stimulant roller coaster again – it was too difficult because of rebounds and my biological make up.
June 12, 2017 at 2:40 pm #51220
My 7 year old son struggled with similar side effects for about a year, including trying many different types of stimulant medication. We finally figured out something that works for him – a high dose of a non-stimulant (intuniv 3mg) and a low dose of a stimulant (adderall 5mg). I suspect that any stimulant would work with the intuniv because they all worked well for him at school, it was just coming down off them in the evenings at home when his aggression and defiance was bad. I was reluctant to add a non-stimulant to deal with the side effects of a stimulant but eventually we ran out of options. The upside is that the non-stimulant alone works well enough for weekends and summer (including homework, at least most of the time) so he is taking a lot less of the more dangerous stimulant drug.
June 12, 2017 at 5:23 pm #51228
My son started meds very young much to my dismay but it did have the same response you are experiencing in your child at school. However, the rage and anger were horrible in the evening. At the time my son was taking Ritalin and I allowed it to continue for about 2 years only to read more and find out it can be a common side effect. We changed to Adderall and those symptoms almost entirely went away. He still has all the common anger and upset that can be associated with ADHD however now it is manageable and milder.
June 12, 2017 at 10:09 pm #51260
A long argument suggests you are arguing, in the illusion that if you give him the proper information, he will understand, and will then cooperate. Not likely. If he agrees with you, which he won’t, then he doesn’t get what he wants. When you argue, you are making him judge and jury, and he will never rule in your favor.
Think of an argument as like a tennis game. It can’t happen unless you bat the ball back. You are not obligated to produce the better argument, and he won’t agree even if you do. You are not obligated to produce one more answer than he does. The fact that you are the parent means your will wins, period.
You should allow him one “how come,” and one “yes but.” More than one is misbehavior, and that misbehavior should have an understood consequence.
Also when extinguishing a behavior, it always gets worse before it gets better. If you put a quarter into a Coke machine and it doesn’t deliver, you don’t just go away and never return. You shake the handle, maybe shake the machine, maybe insert another quarter and try again, and maybe look for the manager to see what he can do.
Likewise, if you cut off a kid’s access to a misbehavior, he doesn’t just say “Oh, well,” and never do it again. He will increase his efforts to get around your new method and make you do as you did in the past, which had worked for him at the time.
June 12, 2017 at 10:46 pm #51267
My 9YO son also takes Concerta, started at 18mg, then bumped up to 27mg around Thanksgiving last year. Oppositional Defiant Disorder is one of the additional issues that we’ve had to contend with, as well as his ADHD, very common problem especially in boys I’m given to understand. Our pediatrician recommended a couple of books, Taking Charge of ADHD and Your Defiant Child both by Russell Barkley. I’ve not finished both books yet, but the theme is consistency, consistency, consistency and VERY clear limits with good follow up on your end. We’ve seen much better results by making sure that his dad and I are both being consistent with the rules, whether they be screen time or keeping his room picked up or homework time. We’ve also seen much better emotional stability by adding in an AHA/DHA (fish oil supplement). We give a daily dose of Barleans Omega Swirl in the Lemon Zest flavor-it tastes pretty good and isn’t chalky or too tart. We’ve also started seeing a counselor a couple of times a month as his struggles with ADHD have caused a self esteem problem. Thankfully he has an amazing support network at school as well, his resource teacher and her team are nothing short of amazing. Also, keep in mind that Concerta isn’t the only med out there, don’t be afraid to talk to your pediatrician about what you’re seeing and ask to make a change. You know your boy best and if something’s not right you have to advocate for him to make the change!!
June 12, 2017 at 11:06 pm #51271
The best information I’ve seen on this is from Dr. Daniel Amen. http://Www.amenclinics.com
Your son could be in need of something to help balance the chemicals in his brain besides bringing the frontal lobe into alignment. If you give a stimulant to a person who might have anxiety, temporal lobe imbalance or what Dr. Amen calls “ring of fire” which would be overactive area like basil ganglia or cingulate, the stimulant will increase frustration, anger and oppositional behaviour. Those areas need to be calmed first before putting them on a stimulant so they get the focus without the agitation and defiance. He has more of this in his Healing ADD book, or you can also take the quiz on his website answering the questions for your son. Dr. Amen has subdivided into seven types as opposed to the basic three. They get much more detailed. Our brains are really very complex so often one medication isn’t enough to balance every area.
Once you have the right med balance, you will have a much better time teaching behaviour.
In the meantime, having the conversation with him when he is not upset will help prepare him for those times when he is upset.
Giving minimal choices is important for oppositional behaviour. Would you like A or B? Being firm that those are the options when they make other demands, however remain calm at all times. (Easier said sometimes). Hope this helps!
June 13, 2017 at 2:22 pm #51313
Not all ADHD medication is a stimulant. One exception is Strattera. Not only does it not keep one awake at night and not suppress the appetite, but it also does not cause blood pressure to rise. (I am 75 years old and have a problem with hypertension, so Stattera, though expensive, addresses that problem.) There is another brand that is approved for children only, also expensive, and there is a new one mentioned in this publication, that may be available in a couple of years.
- This reply was modified 2 years, 8 months ago by genedoug.
June 16, 2017 at 12:10 pm #51456
Thanks everyone for the feedback and advice.
My son has been in two physical fights this week and his mood has been down in general so we’ve called it quits on Concerta — had gone up to 36 mg. He’s always been a passionate kid and has a really tough time just going with the flow so if things don’t go his way or the way he expects things go south quickly. I’m hoping there might be a medication that works better for him because I still think he might benefit from medication to manage his ADHD symptoms. His focus was definitely enhanced and in a way he seemed more subdued and under control but he just didn’t seem right. He seemed down and somewhat dark and definitely combative on the Concerta. So, the benefits did not outweigh the costs….
I was given the name of a pediatrician that specializes in ADHD and is supposedly great at getting the right medication for kids with ADHD so I’ve reached out to her and hope to hear back. Will report back if that yields new insights.
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