Concerta Question

Discussion in 'General Parenting' started by SRL, Feb 8, 2008.

  1. SRL

    SRL Active Member

    Inquiring for a friend--

    I have a friend whose 10yo is trialing Concerta for ADHD-inattentive type. Mother forgot to give him the medication on day 3 and on day 4 noticed big changes in mood--became very difficult, talked about killing, had to miss 2 days of school. He has been through serious family changes in the past weeks: disfunctional family problems, major family blowup, dad hospitalized for a week then moving out of the house for 3 month trial separation, etc. I'm thinking now that this might not have been the best time to start the medication since it's going to be hard to distinguish between eruption from from family circumstances and side effects.

    Neuropsch evaluation in past year, diagnosis (I think) ADHD inattentive type, Executive Function Disorder, ODD, some various minor processing issues. rule out bipolar but I suspect some mood disorder component as past history included a depressive period with suicidal talk. Family history: Obsessive Compulsive Disorder (OCD), plus recent diagnosis of BiPolar (BP) Type II but it sounds like docs are wavering on that.

    What advice would you give here? Pediatrican didn't feel that the Concerta would cause such a severe reaction. My gut says to discontinue the Concerta until life is more stable and then reevaluate from there. The problem here is that there is no guarantee of future stability for the family and the child really does need some help for inattention.

    Thanks for any help with this--
  2. wiwbar

    wiwbar New Member

    How was he on day one and two? Usually an immediate effect is seen with this medication.
  3. smallworld

    smallworld Moderator

    SRL, I'm with you. Concerta can exacerbate anxiety and cause depression. I agree with stopping the Concerta for now until family issues settle out. Can this child be evaluated by a board-certfied child psychiatrist instead of being treated by a pediatrician?

    My own son was on Concerta at age 10 when we thought his inattention was caused by ADHD. It is only in recent months that we know for sure that he has a mega mood disorder and no ADHD. Mood stabilizers and an atypical antipsychotic (no stimulants for the first time in 4 years) are taking care of 90 percent of his symptoms. Following 6 weeks in day treatment, he has been back in school for 2 weeks and not complaining about inattention.

    Neuropsychs, as good as they are, can be wrong about mood issues. My son's diagnosis a year ago by a well-respected neuropsychologist was Major Depressive Disorder (and the neuropsychologist recommended re-trialing ADs in spite of many bad reactions). Again, in recent months, it has become very clear that my son has a mood disorder with mood swings that need treatment with mood stabilizers and an atypical antipsychotic.

    Good luck to your friend.
  4. SRL

    SRL Active Member

    She said she didn't see any effect on days 1 and 2. He's on the lowest dose (I think she said 18 mg).
  5. SRL

    SRL Active Member

    Smallworld, so if medications for depression or mood disorders are indicated, would it be better to address that first and then reevaluate to see what's needs to be addressed for inattention?
  6. mammamo

    mammamo New Member

    I worked for 2 and 1/2 years with an autistic child. One of the neatest things we did and it worked very well with him is take shaving cream and spray it on a plastic mat, he would take his hands and just move them around in the shaving cream you would not believe it but he would do this continously for and hour he seemed so calm and it helped him to control his repetious had flapping It sounds silly but it really helped him to relax. I don't know why I can work with people that have autism, Obsessive Compulsive Disorder (OCD), ADHD, bipolar etc. but when it comes to my difficult child I feel so out of control.
  7. tryinghard

    tryinghard New Member

    My son had the same symptoms with Straterra and they did not start showing up for a month. But once they did it was really really bad. He is now on Medate and has not talked about hurting himself.