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Old 11-17-11, 02:51 PM
amm8589 amm8589 is offline
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So Upset About Son's Meds....Please Help

DS, who is in 7th grade, started ADHD meds in August. He started with Metadate CD, 30 mg, but they caused significant Tics. He was switched to Concerta, 27 mg, and it seemed to work great for the last 7 weeks, but now he is starting to have muscle spasms in his arms. Today he is complaining of chest pains. Obviously I'm not going to give him anymore Concerta and we will be meeting with the doctor, but I'm seeking some input.

The side effects are obviously serious, but the medications have otherwise exceeded our expectations. He is doing SO much better in school, both academically and behaviorally, and he has many more friends this year. He is calm, focused, excited to learn, etc. His teachers report that he is a "different kid", and they don't even know that he is on meds. With a high IQ, he has always been smart enough to earn straight A's but his ADHD prevented him from doing so. He is reaching his potential this year, finally.

I'm positively heartbroken that the medication is causing these side effects when everything else is going so well. He is even eating and sleeping great. Anyone else ever have this problem? Could non-stimulant meds work just as well?
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Old 11-17-11, 04:00 PM
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Re: So Upset About Son's Meds....Please Help

First of all, that is great that you saw such positive results from the medications. This provides real hope that you can find something that works well without these side effects.

General study results indicate that non-stims are not as commonly effective as stims, but both can work great for the right person. The bottom line is that every person reacts differently. Your doctor can hopefully provide good insight into what to try next if he/she is well-versed in ADHD meds. Keep us all posted!
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Old 11-17-11, 04:14 PM
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Re: So Upset About Son's Meds....Please Help

Another possibility is that methylphenidate is the wrong direction for him. Has he been trialled on Adderall?

Something to also consider is that some people have a sensitivity to the mechanisms that make a med long acting. I know personally that immediate release meds work great but long acting meds don't for me. The challenge for your son would be that he would have to dose at school and that can have social ramifications.

Another thing to keep in mind is that some do better on one stim, less well on another. That your doc tried another long acting med in the methylphenidate family is actually a good thing- the release mechanism of Concerta is different so he was looking for an indication that changing the release would solve the tic issue.

I have heard that combining the stim with Intuniv will help to manage the side effects as well as provide an assist to the stim. That might be a good direction of discussion with the doc.

Hang in there!
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Old 11-17-11, 08:56 PM
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Re: So Upset About Son's Meds....Please Help

Also consider that for many, racemic formulations of stimulant ADHD meds (Ritalin, Adderall) have more significant side effects than purely-dextro isomers (Focalin, Dexedrine).


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Old 11-23-11, 06:11 PM
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Re: So Upset About Son's Meds....Please Help

I second the suggestion to try Adderall or Vyvanse, as the methylphenidate seems to cause unacceptable side effects. I also had physical side effects on methylphenidate that caused the doctor to tell me to stop it right away that very day. But I haven't had those reactions with Adderall or Vyvanse.

It's also possible that 27mg of Concerta is too high for him. Some people's bodies are really sensitive to medication doses. I'm really sensitive to Ambien, so much that I have to cut the smallest pill in half, sometimes even a quarter. The doctor said I'm the most sensitive patient to Ambien that he's ever had. So perhaps stepping down to 18mg of Concerta would help.

Finally, I've heard that a low dose of Intuniv (aka Tenex) is sometimes added to a stimulant. Intuniv is a non-stimulant medication that helps ADHD (primarily impulsivity and hyperactivity I believe, but don't take my word on that), and it also helps tics for some people.
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Old 11-29-11, 04:20 PM
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Re: So Upset About Son's Meds....Please Help

Thanks to everyone who has responded. It has been a long two weeks and I want to take a moment to update you.

The chest pain my son experienced turned about to be an illnesss. He had a bad cough for several days, as did one of my other sons. Once the coughing stopped, he was fine. So that was a huge relief.

The twitching, however, is an ongoing issue. My doctor immediately stopped the Concerta and wanted to see if the twitching would cease. It did not. I was so surprised. He was off it for four days, back on for two (for school - he had six tests in two days), and then took a one week break over the Thanksgiving holiday. There were days he would twitch, other days he wouldn't. Doc said if it were the meds, he would have stopped twitching by at least day 2 off meds.

So now I'm making an appt. with a pediatric neurologist to see what he thinks. My son's twitching is sporadic and non-consistent. I really don't know what to think.

Thanks for listening and I will keep you updated.

amm8589
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Old 11-29-11, 05:17 PM
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Re: So Upset About Son's Meds....Please Help

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Originally Posted by amm8589 View Post
Doc said if it were the meds, he would have stopped twitching by at least day 2 off meds.
Not true at all. Some people have lasting tics from stimulant medication. It can take months or even years for tics to disappear in some cases.
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Old 11-29-11, 08:07 PM
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Re: So Upset About Son's Meds....Please Help

my son is not on medication, but i totally understand about your child and his potential to have had straight A's. my son just had an honor roll assembly and bc he can't finish his work he was unable to achieve this recognition. good luck to you and your son. i do hope you find something that will make him more comfortable.
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Old 11-29-11, 10:34 PM
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Re: So Upset About Son's Meds....Please Help

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Originally Posted by amm8589 View Post
Thanks to everyone who has responded. It has been a long two weeks and I want to take a moment to update you.

The chest pain my son experienced turned about to be an illnesss. He had a bad cough for several days, as did one of my other sons. Once the coughing stopped, he was fine. So that was a huge relief.

The twitching, however, is an ongoing issue. My doctor immediately stopped the Concerta and wanted to see if the twitching would cease. It did not. I was so surprised. He was off it for four days, back on for two (for school - he had six tests in two days), and then took a one week break over the Thanksgiving holiday. There were days he would twitch, other days he wouldn't. Doc said if it were the meds, he would have stopped twitching by at least day 2 off meds.

So now I'm making an appt. with a pediatric neurologist to see what he thinks. My son's twitching is sporadic and non-consistent. I really don't know what to think.

Thanks for listening and I will keep you updated.

amm8589
Glad to hear that the chest pains were due to the cough... that must have been a big relief.

Stimulant medications can exacerbate tics, but according to my son's developmental pediatrician they do not cause the tics. Tics are a fairly common occurance and are more frequent in boys, from what I have read. Quite often they will resolve on their own, over time. (I'm talking about tics observed in unmedicated kids)

My son is having similar problems with Focalin XR so I am planning to do a trial of Intuniv (extended release guanfacine- not a stimualnt) over the Christmas break. Ideally, if he responds well to it, we will be able to use it as a stand-alone medication and eliminate the Focalin.

We also took a med holiday over Thanksgiving and the tics were significantly reduced by the end of the week, but they resumed as soon as he started the Focalin again.

Please fill us in on what the pediatric neurologist recommends.
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Old 03-07-12, 09:50 PM
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Re: So Upset About Son's Meds....Please Help

It's been a long time since I posted on this thread, but wanted to give an update. My son stopped meds over Christmas break and the tics were completely gone, so it was definately the meds. The doctor wanted us to stop giving him breaks, thinking that maybe if he just was on them all the time (i.e., weekends), his body would adjust. So we tried that and the tics were not as frequent, but still there.

I had decided last month that I would just stop all meds when all of the sudden his tics seemed to get worse. We went away for a week, he took no meds, and the tics were awful. It ruined my vacation.

Long story short, I read somewhere that concerta (and other stimulants) can cause the adrenal glands to secrete magnesium, and that supplements can help. I bought some magnesium glycinate, gave him 100 mg in the morning, and 100 mg in the evening. By the third day, the tics were totally and completely GONE. It has been two weeks and he has not had one single twitch. It seems too soon to tell after such a short time, but I"m holding out hope that maybe we have finally found the core of the problem.

It explains why his tics didn't start right away - it was weeks before his first tics appeared. After a two-week break at Christmas, he was great, but we resumed the concerta, and the tics started again a few weeks later. Since he wasn't taking any breaks on weekends, it was constant stress on the adrenal gland, and even our one week vacation wasn't enough time for him to get back to normal.

Never did see the neurologist. Not sure that I will now since it was clearly the meds.

Will keep you posted on how this magnesium experiment goes!
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Old 03-08-12, 12:24 AM
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Re: So Upset About Son's Meds....Please Help

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Long story short, I read somewhere that concerta (and other stimulants) can cause the adrenal glands to secrete magnesium, and that supplements can help. I bought some magnesium glycinate, gave him 100 mg in the morning, and 100 mg in the evening. By the third day, the tics were totally and completely GONE. It has been two weeks and he has not had one single twitch. It seems too soon to tell after such a short time, but I"m holding out hope that maybe we have finally found the core of the problem.
Interesting; when I read this I realized that ds' afternoon tic (looks like he's wiping his ear on his shoulder) hasn't been present in the week since I added a multi-vitamin back in .
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Old 03-08-12, 01:22 AM
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Re: So Upset About Son's Meds....Please Help

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Originally Posted by amm8589 View Post


Long story short, I read somewhere that concerta (and other stimulants) can cause the adrenal glands to secrete magnesium, and that supplements can help. I bought some magnesium glycinate, gave him 100 mg in the morning, and 100 mg in the evening. By the third day, the tics were totally and completely GONE. It has been two weeks and he has not had one single twitch. It seems too soon to tell after such a short time, but I"m holding out hope that maybe we have finally found the core of the problem.

It explains why his tics didn't start right away - it was weeks before his first tics appeared. After a two-week break at Christmas, he was great, but we resumed the concerta, and the tics started again a few weeks later. Since he wasn't taking any breaks on weekends, it was constant stress on the adrenal gland, and even our one week vacation wasn't enough time for him to get back to normal.

Never did see the neurologist. Not sure that I will now since it was clearly the meds.

Will keep you posted on how this magnesium experiment goes!
Great job searching for answers to help your child !!!! Huge Kudos.
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Old 03-08-12, 10:46 AM
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Re: So Upset About Son's Meds....Please Help

Interesting that you have had this result. I have added an electrolyte packet a couple of times a week to my son's routine, and I have also noticed a reduction in tics.

However, when I discussed it with his developmental pediatrician she said she could think of no medical explanation why this would be effective in reducing tics.
I may see if I can find the info on adrenals and magensium and send it to her.
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Old 03-08-12, 11:30 AM
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Re: So Upset About Son's Meds....Please Help

Quote:
I'm positively heartbroken that the medication is causing these side effects when everything else is going so well. He is even eating and sleeping great. Anyone else ever have this problem? Could non-stimulant meds work just as well?
**Red Light warning, Tics increased with meds, can be Tourettes and
Methylphenidate should not be taken in presence of Tourettes or epilepsy !! Glenrose rehabilitation centre, Child Psych, history. ***Please Talk to your Doctor
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Old 03-08-12, 12:02 PM
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Re: So Upset About Son's Meds....Please Help

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**Red Light warning, Tics increased with meds, can be Tourettes and Methylphenidate should not be taken in presence of Tourettes or epilepsy !! Glenrose rehabilitation centre, Child Psych, history. ***Please Talk to your Doctor
Anna, he is diagnosed with ADHD, not Tourette's Syndrome. And stimulants are known to aggravate tics in those diagnosed with ADHD as well...
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