My 7 yo daughter is on 20 mg Rit. LA and the teacher says she is "chirpy" in the am and the teacher likes her this way. She is outgoing, delightful and says intelligent things. However around 12:00 she starts to go downhill in being too active, emotional (crying about the smallest thing) and having problems in the special pm classes such as library, gym. etc. She is gettin the highest scores.

We tried 30 mg Rit. LA but it zoned her out in the am too much and the teacher did not like it. She also started "fluttering" her eye lashes uncontrollably.

So, what do we do? It looks like we have to even out the dosage during the school day. I am now showing up at 12:00 to give her a 5mg normal Rit. We will see how that works. I hope/assume that she will be better in the pm BUT I do not want to have to go to school everyday and we would not rather her have to go to the office and let the volunteer parents give her her meds.

My thought is that we try Concerta since it gives more in the pm. Any thoughts? Also what dosage would be about the same as 20+ mg Rit LA? 18 or 27? We sometimes give her a 5 mg reg Rit at 4:00 to help for evening homework. So that is 30 a day total. Think we should start with 27?

Thanks, Chris

I think you are correct about the 27 (and you may need to increase later to 36).

Take a look at the table below. It tells you the initial and longer dose for concerta.
http://www.concerta.net/active/mccus/en_US/images/concerta/chart_rightdoserange.jpg

I am confused what bid / tid means Bid means twice per day and tid thrice per day but what does bid/tid mean?

If we do the 27 and she is fine in the pm but has problem in the am I could give her a 5 mg normal Rit. in the am, right?

thanks, Chris

It means 2 or 3 times a day. These numbers are a start, and the thing to look at is to compare the initail dose with the individual doses of fast acting ritalin (taken 2 or 3 times a day). I have seen others add a short acting form first thing in the morning to get things started if the long acting med doesnt get going fast enough (you would want to try the concerta alone to see your daughter's response first and check positive effects during the day vs any side effects). Some people also add a low dose short acting form to ease rebound or to extend the effective time a little longer. Work with the doctor to taylor the meds to your child's needs.