Question about Concerta

Discussion in 'General Parenting' started by StressedM0mma, Sep 10, 2012.

  1. StressedM0mma

    StressedM0mma Active Member

    For those of you who have or had your difficult children on Concerta what do you think of it? psychiatrist is considering adding it to difficult child's medications. We go back to see her on the 25th, and she is going to go over the teachers questionnaires, and have us fill out one as well, but thinks it may help. How long before it starts to kick in? And, how long in the morning before you see it start to work? Just general ?s. Thanks everyone.
     
  2. AnnieO

    AnnieO Shooting from the Hip

    It has different effects on different people... Jett was on it, and it was horrible. I know another little boy who is on it, and it's a miracle.

    When Jett was on it - he took it with breakfast - went to school. By the time he got home he was aggressive and hyper (it is a stimulant after all). About 7 PM he would CRASH. HARD. Later, bio had the school giving it to him - the crash was at 8 PM. He did not wake. He would get up to pee and pee all over his room, the hall, the bathroom - and not remember it. That was if he woke up.

    But then, like I said, the other little boy? I think he takes it in the morning, does great, no crash. So... Different kids.
     
  3. StressedM0mma

    StressedM0mma Active Member

    Thanks Step. I am hoping it will help with some of our morning issues, and am wondering if some of the other problems are because of ADD. And, am wondering why it took almost a year for this. And, of course it was at my insistence. Sometimes I feel like if I were not suggesting things nothing would happen. psychiatrist did mention giving difficult child B12. So, we will start that tonight. husband has the liquid kind, so we told her she had to start that tonight.
     
  4. InsaneCdn

    InsaneCdn Well-Known Member

    Has she ever used Ritalin or other methylphenedate products? If not, I'd be surprised if they started with Concerta. Usually, they would use Ritalin to figure out how she reacts to it, and roughly what kind of an effective dose is required... and then switch. Ritalin gives about a 3.5 to 4 hour effective dose, and it's out of your system completely in about 8 hours. It can also comes in tiny doses and the pills can be split. I know a kid who needs just 5mg per day - can't function without it. Concerta is a staged-release formula - usually, effective coverage is about 8 hours, and it's out of the system in 12. Rebound effect - either with Ritalin or Concerta - can be partially managed with a small evening top-up dose.

    If she is ADD/ADHD - not some other problem - then stims "often" help... but it isn't guaranteed.
     
  5. StressedM0mma

    StressedM0mma Active Member

    Thanks IC. She has never been on any ADD/ADHD medications. I am not sure why the pdic would jump right to Concerta, and not try Ritalin. It is the same family isn't it? What about Adderall or some of the others? psychiatrist just mentioned the Concerta while we were talking. I would definitely like to get the lowdown on all of this before the 25th when we go back in so that I can be prepared.
     
  6. AnnieO

    AnnieO Shooting from the Hip

    Ritalin and Concerta are the same thing... Methylphenidate hydrochloride. Ritalin tends to be short-acting, while Concerta is time release - though they do have time-release Ritalin...
     
  7. InsaneCdn

    InsaneCdn Well-Known Member

    Concerta and Ritalin are not the same thing (sorry, Step - common misconception). They are based on the same chemical composition - methylphenidate. But, some people who cannot tolerate Ritalin, can use Concerta, and vice versa. So... there's a difference, somewhere. Most who do well on Ritalin, also do well on Concerta. We were told to never use generic methylphenidate, it just isn't as effective and they don't know why. But... Ritalin is not that expensive. Concerta, on the other hand, IS expensive. There are other medications related to these - Folacin is one, I don't know all of them because most aren't available where I am.

    My kids used Ritalin through to about grade 6 or 7, then went to Concerta. I've used Ritalin for 10 years... I like the short-acting approach. I time my dose for when I have to be on my toes. If I want to have a nap, I plan that between doses. I can be "on top" at 7 a.m. for a business function - and also be "on top" at 7 p.m. for a social function... but I can't quite cover the whole day. For someone who is medications compliant and organized, there's a nice side to Ritalin. It is also well known that the rebound effect goes down as age goes up.
     
  8. InsaneCdn

    InsaneCdn Well-Known Member

    Dexedrine and it's cousins, is the other major class of stims. Works on a different set of brain chemicals. The two cannot be combined.

    Strattera is a non-stimulant medication, offers 24/7 coverage for some people. Even when it works, it may not be enough. It isn't unusual to combine Strattera with one of the stims.

    Methylphenidate tends to have an appetite-suppressing effect. That's the only real side-effect we've noticed.
     
  9. StressedM0mma

    StressedM0mma Active Member

    Thanks for all the info IC. I hate to admit I think I would like for her to have a stimulant medication. I am hoping that it will give her that little boost in the morning as well as help her focus and concentrate at school.
     
  10. InsaneCdn

    InsaneCdn Well-Known Member

    Well... I sure can't live without mine. ESPECIALLY first thing in the morning!
    It's 100x better than caffeine.
     
  11. StressedM0mma

    StressedM0mma Active Member

    So, it could break her sleepiness in the morning cycle? She tried coffee and 5 hour energy but they made her jittery. I am going to have my fingers pretzeled that this might be a good choice. Hopefully she fits the criteria. I would have to say she does, considering it took her over an hour to make a "poster" out of a blank piece of paper. All she had to do was color in some letters.
     
  12. InsaneCdn

    InsaneCdn Well-Known Member

    She's dealing with so many layers, that it's hard to figure out which one to crack first. But... if there is some ADD/ADHD in there... the mental energy it takes to get going can be huge, and the mental energy to try to hold it all together (without medications) can add to fatigue, which isn't a good thing when you're dealing with depression.

    K2... well, you can really tell in the morning that her medications haven't kicked in. She takes them at breakfast, and... it takes "forever" to get up and ready, and "forever" to eat breakfast. But before she leaves for school, we see it kick in. And "all" K2 is dealing with (other than normal typical teen stuff) is ADD.

    Caffeine is well-known to have about a 2-hour effect... and horrid rebound!
     
  13. buddy

    buddy New Member

    For q it takes about a half hour to kick in. He does fine on generic ritalin which we use at night. It does have a yucky rebound for him so we dose before that hits till evening medications ...but we can because it doesn't affect his sleep. It at least is one you can stop fairly easily if it doesn't work out.
     
  14. StressedM0mma

    StressedM0mma Active Member

    Thanks Buddy. How is Q doing? Hope the school year is going well. I got the papers form the school psychiatric today, and husband is going to drop off to psychiatrist tmrw. Then all we will have to do is answer our questionnaire. Then hopefully... I giver difficult child her medications about 30 minutes before she has to be up, so that would be fine. I am concerned what happens when the medications wear off. What is the "rebound" that everyone talks about?
     
  15. InsaneCdn

    InsaneCdn Well-Known Member

    When methylphenidate wears off, it can create a real "jumpy" or "irritable" feeling - at least, those are the words that apply in our family. A small (sometimes tiny) follow-up dose can ease the transition from medications to no-medications. Not everybody gets rebound effect. Kids had it, I don't.
     
  16. SmallTownMom

    SmallTownMom New Member

    My difficult child started with Concerta and not Ritalin, I believe it was due to his other diagnosis. Most days it takes 20-30 min to see a difference in his behavior. My difficult child doesn't crash.
     
  17. JJJ

    JJJ Active Member

    If you need it to help in the morning, I would suggest walking it into her room and having her take it as she wakes up so that it kicks in early enough to help.
     
  18. InsaneCdn

    InsaneCdn Well-Known Member

    Our psychiatrist will rx a small-dose generic methylphenidate for an almost-instant (i.e. kicks in within 10 mins on an empty stomach) jump-start in the morning, to get things going before the concerta kicks in.
     
  19. StressedM0mma

    StressedM0mma Active Member

    Thanks everyone for this help. I already give difficult child her other medications about 30 min. before she gets up in the morning. So, that wouldn't be an issue. And, can Concerta be given on an emptyish stomach? She drinks a glass of chocolate soymilk with her medications every morning. IC, I wish our psychiatrist was a little more flexible. She seems quite rigid sometimes in her thinking. 8 more school days until we get to go back in. (Not that I am counting)
     
  20. InsaneCdn

    InsaneCdn Well-Known Member

    You get more effect from Concerta if it is not taken with meals directly. Not sure about the impact of a calcium-based beverage... most medications (except NSAIDs) are better not taken with milk.
     
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