My 12 year old son just started taking 18 mg. Concerta last Saturday. The weekend was awesome - for the first time in over a year we had family harmony and he seemed happy. When bedtime rolled around he became very sad and weepy (he is very upset about the recent ADHD diagnosis and what he has labeled his "defective brain"). Next evening same thing. I spent 45 minutes in his bedroom trying to calm him down. It seemed to be an emotional "crash".

The next evening he flew into a rage over some homework (this was typical before the meds) and pounded the stairs with his fists for a minute until it passed. Afterwards he was mortified and said he did not understand why he was in such a rage over something so trite but felt he could not stop himself or control the rage he felt. I told him that he did contol it by pounding the stairs until it passed. Then he was crying more and said he was so scared about where all that anger came from and that he is not "normal". (He is highly gifted and sometimes thinks too much)

Has anyone had these emotional outbursts? Is it the medication wearing off? The first few days seemed like a miracle - he was so pleasant and happy then gradually it seemed he was "adjusting" to the medication or something and it's not "working" as well now.

The good news is he seems to have no appetite or sleep issues whatsoever but I am alarmed about the evening roller coaster of emotions. I am considering a short acting low dose Ritalin to get us through homework which has always been the nightmare here. Any thoughts? This is all new to me!!

Hi there,

My 8year old daughter has been on concerta since june. we started her on 36 that was the recommended dosage. she is now at 27. she takes 18 on the weekends but we both dont feel it is enough for during the week. with the lighter dosage, the wearing off in the evenings is much more noticable. basically by 8pm it is gone and she is back to her old charming self, if not worse.

i would talk to his doctor about this and assure yourself that he is at the right dosage for his body weight etc. What i find with my daughter is that she learns alot during the times she is medicated and her behavour during non medicated times has improved.

i hope you experience this benefit as well.

If I gave her Ritalin at night, she would be up all night. it really makes her wakeful.

This is commonly referred to as 'rebound' and is sadly quite common. Some doctors recommend adding a small dose of regular release Ritalin in the afternoon, others combine Concerta with Strattera to avoid the 'crash' in the evenings.

For me it was the main reason for wanting to come off stimulants - I sometimes got panic attacks almost every evening at the same time, when the Concerta was wearing off. Also I felt irritable sometimes, or either very tired or very hyper.

Rebound with Concerta has been a real problem for me. I ended up going on Concerta twice a day (but I'm an adult -- I doubt a kid is up long enough for that -- but adding a very dose of Ritalin later in the day might help). Most of the worst of the rebound effect improved over time as I got used to the medication. I still do occasionally have major rages over very minor things (this wasn't the case before meds). It's enough of a problem than my husband and I are talking about me working toward getting off the medication. The thing that helps me the most with emotions is heavy duty exercise (something aerobic -- preferably out doors). I managed to get all the way through college successfully by exercising 3 or 4 times a day (even without meds). With or without medication exercise is a real blessing and it's value shouldn't be ignored for an ADHD child or adult. Hallowell and Ratey's books (Driven to Distraction, Delivered from Distraction) discuss the importance of exercise especially if a child is having rebound problems, and they have lots of other helpful ideas as well. Delivered from Distraction has many good suggestions on helping stop negative thought patterns your boy might utilize as well.

Hope things go well for you
Scattered