When is too much concerta too much?

Discussion in 'General Parenting' started by riskybusiness, Aug 14, 2007.

  1. riskybusiness

    riskybusiness New Member

    Hi Everyone:

    We had our difficult child on Concerta of 27 mg. We hadn't been to a psychiatric for evaulation since our original diagnosis several years ago. Our family Dr. retired and we were given a new one who is very antimedication. He prescribes the Concerta based on weight not on conditions etc.

    We visited a new psychiatric who said that he felt that we should try our son on two different combinations of concerta. A 27 mg with an 18 mg dosage for a few days and then two 27 mg pills to see if there was an improvement. He felt that we would see a big difference. Well...I am feeling frustrated and upset. We have not seen really any positive difference increasing our difficult child's dosage. In fact he seems to be having different problems than he was originally.

    Originally he was very distracted, concentration problems but generally speaking he was in good humour and happy. Now he seems to be thinking of ways to get into trouble. He seems more moody at night, can't seem to get to sleep (which the psychiatric prescribed clonidine 0.1 mg (1/2 to 3 per night as needed) to help the sleeping issue. Today he was trying to figure out how he could shove a feather into a candy dispensing machine at his day camp (our difficult child is 9) to get free candy out. Somehow he figured it out. Now this is something that he would never normally do. Before he might have been distracted and somewhat hyper, but now he seems to think differently. He also has had some interest in sexual thoughts. He is suddenly talking about noticing breasts more etc. Is this normal? Is something that normal 9 year olds start to notice and talk about etc? I have only had one boy so I need some guidance here. Prior to the increase in medications he never even mentioned anything about sexual organs or parts of the body before.

    His teacher at school this year said that she does not find him hyper in any way, but that he needs much redirection to stay on task etc. So perhaps the Concerta controls the hyperness, but....there is still lack of concentration. Now on the upped dosage his behaviour seems more deviant or something. Normally our son is extremely honest (almost to a fault)

    Has anyone else experienced this and does anyone know how Strattera and Adderal etc or any other medications work differently than Concerta? Our pysch is on holidays till mid September so we are running blind here. I could just cry. I don't know which direction to go. Should we stay on the increased dosage and see if it takes weeks to work properly. Are we doing more harm than good by keeping it up higher? Has anyone had negative results with Concerta and did you find your difficult child's to be more easily angered and tempermental because of taking it. Our difficult child seems much more moody and easily angered.

    Any advice at this point is so appreciated. School is coming ...Ahhhhhhh!

  2. Liahona

    Liahona Active Member

    Hi, I'm not a doctor, but I can tell you our experiance with some medications we've tried. We started out going to the pediatrician for ADHD. He gave us Concerta and it worked wonders, but difficult child 1's body mass index dropped dramatically. So, we stopped it and tried Focalin. It made difficult child 1 so manic!!! I've never seen him so bad. His hyperness was sky high, and so were all the other behaviors that come with bipolar. That was the only medication I've stopped without talking to the doctor first. I stopped it after 3 days. That is also when the pediatrician realized difficult child 1's illness was beyond his ability to treat and referred us to a psychiatrist. Some point in this difficult child 1 was also on Zoloft and started having auditory hallucinations. He got off that as fast as we could wean him of it. Some of the other mothers here have said that ADHD medications have made their bipolar kids manic. Also, the pediatrician said that Concerta is a short acting medication. This means that it shouldn't take a few weeks for you to see a difference. What it is doing now is what it is going to do in a few weeks. You should see a difference the day you give it to him and it should be out of his system within 12 hours. (Actually, I've heard this depends more on the childs metabolic rate.) Again remember I'm not a doctor. If it was me and difficult child 1 and the medication wasn't helping (and is making it worse) and the doctor is gone for a month I'd stop giving it to him. Does the docs office have anyone else there to answer questions?
  3. gcvmom

    gcvmom Here we go again!

    Our psychiatrist prescribes stimulants according to clinical benefit, but starts off based on weight and then goes from there, titrating up as necessary. FWIW, difficult child 2 was at 144mg of Concerta (I know, it sounds outrageous, but it was working for a while -- that's before his latest disorder made itself known to us).

    What you describe happening is not a case of too much stimulant with an ADHD child -- if that were the case, he'd be very quiet and withdrawn, and you wouldn't be seeing the bizarre behavior that you're describing.

    In my "unprofessional" opinion, the increased stimulant is bringing out something entirely different -- and I won't even venture to say what since I don't know your son's history. Suffice to say that he probably would benefit from a different class of medication altogether.

    My difficult child 2 became somewhat manic on stimulants over time, even though his primary diagnosis is ADHD (now thought to be severe with an overlapping mood disorder of some sort). On certain medication combos with a stimulant, my difficult child 2 DID show increased interest in things of a sexual nature, at least as far as his limited knowledge and life experience would take him. He also became very goal-directed and would over focus on certain activities -- almost to an obsessive level.

    I'd recommend a prompt phone call to your son's doctor to alert him to these new behaviors. You certainly are right about wanting to nip the problem now before school starts.

    Good luck!
  4. mum2JK&TH

    mum2JK&TH New Member

    For us, I have found difficult child to be more moody and aggressive with the Concerta (27 mgs) but usually when it's not actually in it's working stage, meaning first thing in the morning before he gets his pill and then after it's worn off. This is not his "normal" personality. We took him off for the summer and this disappeared. Unfortunately for us, it seems to be the only medication that works for the other stuff. The Strattera did nothing for the ADHD, Ritalin caused huge rebound effects, Dexedrine made him a nutcase. He is also on Clonidine to help with the tics that are aggrivated because of the medication, but they all seem to do that to him.

    I wasn't aware that Adderral was allowed back in Canada?
  5. riskybusiness

    riskybusiness New Member

    Hello and thank you for all the input. I also am not sure if Strattera is allowed in Canada? I just through it out there because I had heard of it. Today we dropped the dosage down to two 18's because I was just so worried after the past two weeks incidents.

    He also had a type of meltdown last night. It was too late for him to go in the pool and originally we had thought we could but the evening just didn't work out that way. He had a temper tantrum. He was very upset, yelling and then went and crawled under the table and the stayed there. We went in to bring him out and couldn't seem to move him out of his upset mood. This is TOTALLy not at all like our son. He woke in the middle of the night last night and yelled at the top of the stairs at the top of his lungs "thanks alot for not letting me go in the pool" etc etc I flew out of bed because he has never gotten up in the middle of the night like this before and yelled. I said tomorrow will be a better day now I will tuck you in and everything will be okay. He settled right down and said "okay mom" and off to sleep he went.

    It was bizarre. I am so worried about him. I am crying again regularly, it feels like it use to years ago when I would cry every day that he was at school because I didn't know if they were going to send him home or call me etc. On the 27mg of Concerta for the past year at school he has not been hyper at all, but his concentration and focus still was poor. His ability to make friends and keep them is still non existant.

    Is there ever a situation where the medication actually relieves the attention issue and the hyperactivity etc? Or should we just be happy with him not being hyper and live with all the other stuff. Has anyone out there had all their sons symptoms handled with one medication either Adderal, or Focalin etc etc? Actually I am not even abreast of all the other medications for ADHD. What other types are there? I would like to research them on the internet. Our psychiatric is away now till mid September and he is a one man office so there is no one else to consult.

    I am so worried about school now. One more week of camp for our son and I was so hoping that we would have had a solution for him before school started. I just want him to be happy and successful. I want him to feel like he fits in. As moms we weep so for our children when they are having problems. Thank you so much for all your support it makes you feel better just to know that others are out there and can give you some guidance and info as to what happened when they used the medications etc.
  6. DDD

    DDD Well-Known Member

    Concerta is the medication that works for our family. easy child/difficult child took, if I
    remember correctly, 64 mgs and it worked for him. difficult child started
    taking two 36's in the morning two years ago and it works like a
    charm with no side effects at all. To me 72 mgs sounded crazy
    but the psychiatrist we changed to has been in practice over 40 years and
    assured me that even higher doses are viable if needed. Sure
    enough...it's worked!

    As was stated earlier, all the stimulant medications are referred to as "fast
    in and fast out". There is no titration required so you can just
    stop with-o fear of bad effects. Some CD family members have had
    to wait a couple of weeks to feel that the medication was tried out properly. Good luck. DDD
  7. Janna

    Janna New Member

    Here's my situation with the Concerta with my kids:

    My 10 year old is Bipolar/ADHD/Pervasive Developmental Disorder (PDD)-not otherwise specified (Autism). He tried Concerta, several times, alone, and just recently with a Bipolar medication combo (Lithium/Abilify) after a very long time of good behaviors (16 months). The Concerta made him easily agitated, increasingly hyperactive and very aggressive. That was an 18 mg. tablet for a 130 pound kid. Just didn't work.

    My 9 year old is ADHD, Combined Type. He started at 18 mg. with good results. He is 42 pounds. It helped him immensely with hyperactivity, focus and attention. He went from a very problematic child in class to getting "most improved behaviors" at the end of the school year. He also was sent home a couple of weeks ago with a letter from the camp counselors telling me how wonderful he is, a leader, not a follower, great kid, no behavior problems at all, etc. We DID try him on a 27 mg. tablet, and he got glassy eyed, zombified, and we didn't like it, so right back down he went.
  8. gcvmom

    gcvmom Here we go again!

    Are there any other mental health professionals in your area, or is the office you're with now the only one? If you have other options, I'd consider looking elsewhere for another opinion. You have your hands full and cannot afford to wait until mid-September for help.
  9. mum2JK&TH

    mum2JK&TH New Member

    Whereabouts in Canada are you located? Strattera is allowed here in Ontario, but I wasn't sure about Adderall. Ritalin would cause a similar middle of the night behavior as your son, my difficult child would wake up and run up and down the hall or scream out and then go back to sleep. Scared the crap out of us, Concerta does not seem to cause this but he is also on the Clonidine now as well, so it may stop that from happening.
  10. Sara PA

    Sara PA New Member

    Adderall XR (not regular Adderall) was banned briefly in Canada in 2005 because of reported instances of sudden death. It was put back on the market a few months later.
  11. DDD

    DDD Well-Known Member

    Good Grief...this post goes from 2004 to 2012. Perhaps a newer post might be more beneficial.. DDD
  12. recoveringenabler

    recoveringenabler Well-Known Member Staff Member

    DDD, TM broke it into it's own thread in General Parenting.