OK, we go to the psychiatrist tmrw for ADHD medications

[StressedM0mma]

The psychiatrist is leaning towards Concerta. I asked earlier about this, I just wan tmy ducks in a row prior to heading tin there. I hate being ill prepared. I know several of you mentioned the crash. How long does the medication work? And, what happens when it wears off? Am I going to be dealing with the raging and ugliness that we now have under control? And, the big thing is, Is it going to amp up her anxiety? I have been reading that people with anxiety shouldn't take it. She really wants help focusing, and to actually be awake in the morning.

 

[InsaneCdn]

I don't know about any connection to anxiety... difficult child has that issue, and Concerta had no impact on that part.
Concerta's primary impact will be "focus" - just like all the methylphenidates.
Because it is long-acting, she will get 10-12 hours of effect... IF the dose is high enough. (difficult child 2 needed more, difficult child 1 needs less).
But... because it is long-acting, it takes something like 45 minutes to kick in. This is something to specifically discuss with psychiatrist... how to get the impact first thing in the morning. Standard Ritalin takes 15-20 minutes to kick in.


Rebound... may or may not happen. difficult child 2 gets it, difficult child 1 does not. For difficult child 2... he gets "irritable" for about 45 minutes as the dose is wearing off. We learned to expect it, and "when" to expect it... and he had "down time" during the transition (crashed with a book, or took a bath, or walked the dog - stuff that didn't involve other people)

 

[greenrene]

Concerta was absolutely wonderful for my difficult child. No side effects, no rebound. The only problem we had was that, over the years she ended up needing such a high dose that she was taking 2 of them ($$$$$$$$$ until we reached out deductible!), and the doctor didn't like having her on that high of a dose. Vyvanse has also worked well for her.

Good luck!

 

[justour2boys]

My youngest difficult child is using Concerta and it is working well. There is a generic now so that helps. Also, yes my difficult child 2 did have some rebound so his dr added Intuniv that he takes at 4:00 pm and that really helps. With the intro of Intuniv, we started with generic Tenex twice a day and then moved to the brand name once-a-day Intuniv.

Also, Concerta is a long acting "wrapped" in a short acting medication. So what works in our house is to give it 30 minutes before breakfast so it gets a "head start" in the digestive system.

 

[TerryJ2]

Did you get the scrip? Take any yet?

 

[StressedM0mma]

Terry, thanks for checking in. We did get the script. This morning was our first morning with it, and I saw no difference. She is on 27mg. of Concerta. So we will see what happens while she is at school, and then when it starts to wear off this afternoon. We go back to the psychiatrist in 2 weeks to see if we need to up the dose or not. I am not even sure what a reasonable dose is. I do know she was no more alert than normal. Does it take a couple days to see a difference? I thought it was a fast acting medication. So, we will see.

 

[greenrene]

It shouldn't take a couple of days - it's not one of those "build up in your system" medications. A reasonable dose is totally dependent on the individual - some do fine with a small dose, others (like my difficult child) end up needing more. When my difficult child was in 4th/5th grade, she was taking the 72 AND the 27 combined.

 

[InsaneCdn]

27 is a LOW dose for Concerta. At her age... yes, there's some people who only need that much, but... even when K2 was under 90 lbs... 36 wasn't enough, she had to go to 54 (and now that she's grown a LOT... 54 still works; its part of the mystery of medications!)

Doesn't sound like adverse reactions to it... wish you could get a dosage adjustment faster than two weeks!

 

[StressedM0mma]

Thanks IC. I would like to have gotten in sooner too. But... I am leaving right now to pick her up. So we will see what she has to say.

 

[DDD]

We started with 54 if I recall. The one thing I love about the stims is that they are quick in/quick out. Fingers crossed that it helps you guys although the dose does seem very low. Hugs DDD

 

[StressedM0mma]

Well, I asked her if she felt any different at school, and she said no, except that she didn't yawn at all. So, I am guessing we will need a higher dose. But, at least it is a start. husband said that when he got home, difficult child came downstairs and had a long conversation with him. He was amazed! She never volunteers info, and she told him all about her day at school and the barn without him having to drag it out of her. (I wasn't home at the time.) So, maybe it did help a little bit. But I figured it would have been out of her system by 6 at night. I gave it to her around 6 a.m.

 

[InsaneCdn]

There's a second set of "side effects" that they don't tell you about... and that is the behaviours that show up when the medication is having some positive effect, and they come home from their day with "something left over". Sounds to me like tonight was more the "something left over" than directly the effect of the medication. But... if that low dose means she isn't totally wiped before she gets home, then... a little more just might be the right direction (increase at next appointment).

 

[StressedM0mma]

IC, that is what I was thinking. Just a little increase might be what we need. It is doing nothing to get her moving in the morning. She is still a pain in the rear to get out of bed. I was hoping that the medications would give her a little jolt to get moving. But... not so much. I laughed when she was whining this morning because she would be late since she needed to stop at her locker. She said it was because she has no pants that fit. (Not that she waits until the last possible minute to get out of bed.) I will give her that she has only 2 pairs of jeans that fit right now. Between the horse riding and the abilify she has gained a few pounds. And, her legs are more muscular. She looks much better with the extra weight. So, it looks like we will be heading out to get new pants.

 

[DDD]

Are you giving her the pill before she has to get out of bed? That was a mega help at my house. "Morning sleepy head. Open your mouth and swallow. Hand me the glass. Go back to sleep for awhile." OILA! By wake up time the PIA behaviors were mellowed by the pill. on the other hand, I sure am glad I don't have to get up that early any more. DDD

 

[InsaneCdn]

So, it looks like we will be heading out to get new pants.​

Read more: http://www.conductdisorders.com/for...ity-disorder-medications-50468/#ixzz27gvoCpn1​

And THOSE are the kinds of issues we will GLADLY take... the ordinary ones!

Went through that with a different dimension with difficult child 1... inseam. New pants. 3 weeks later, new pants were "floods", and no, he didn't cut them off. He literally grew that much. Ouch on the pocket book but... it's just a "normal" problem!

 

[StressedM0mma]

DDD, yes she does get her medications 30+ minutes before she has to wake up. We have done that for years. IC, my easy child grew like that. She is now 6'2" and has a 37" inseam!! We went out after school today, and she found 3 pair that she liked. She also got a pair of ankle boots. I can handle the "normal" problems. I just hate having to drag her butt out of bed every morning.
She did have that "leftover" again tonight. It was about 6:15, and she sat at the table talking to husband. She was showing him the stuff she got at the craft store to make the sign to hang over her horse's stall. She was also talking about her math test she took yesterday. She was mad at herself for only getting an 89! That is the child I remember. She said she would have had more time to take her test, but to get the extra time you have to have all of your homework in, and she was missing 2 assignments. Natural consequences. Gotta love them. So, we ha a nice evening. She is now upstairs talking to friends and her sister on her computer.
I think adding a little more Concerta will be where we are headed. difficult child had an interesting thought at dinner tonight. She recognized that she is on the higher end of almost all of her medications. That she wonders if her body just processes it differently. She even needs alot of Novocaine at the dentist. And, when she had surgery, they mentioned it took her longer than usual to go under. Just an interesting little thought.

 

[TerryJ2]

The conversation is exactly what our difficult child did, when he first started Adderall! It was like magic.

 

[DDD]

Sounds like she just may not be a "morning person". Personally I prefer my day to start around ten, lol. DDD

 

[StressedM0mma]

She would love for her day to start around 1 if she were allowed. husband used to be the same way until he was about 30.

 

[DDD]

by the way, lol, I guess you know there are educational organizations that TRY to get schools to start later in the day for teens because studies show many kids just can't function at their best in the early morning hours. I bet I've read about the initiative for ten years or twenty. The people are all experts but the public school system wants to keep things the way they have always been. Sigh. The good news is that after high school if she does college there are afternoon and night courses so she can go with her own flow. Hugs. DDD