Concerta and acting "spun" ?

[punkybrewster]

My 9 yr old son started on 18mg Concerta this morning before school. Once we struggled with swallowing the pill, he initially acted sleepy (yawning alot). By the time we walked from the car to his classroom, he was amped up and ready to go. I noticed while he was talking to a group of his friends before class, he was literally "bouncng" in place. He seemed totally wired. When I picked him up from school, he was pacing around the room, talking 90 miles an hour, and couldn't focus on me or his teacher. He was spun out.

I was apprehensive about putting him on stimulants (how an upper calms hyperactivity is beyond me), but, his reaction didn't seem to be what the doctor told me the effect should be (calm him down, let him focus, control some of the behavior issues, etc).

Is his reaction (acting wired out of his mind) "normal"? Does Concerta have to "build up" in your system like some other meds? I placed a call into is doctor, but no return call yet, which worries me about what to do tomorrow. He can't go to school all amped out again.

Any feedback?

[Trooper Keith]

Stimulants calm hyperactivity by stimulating the frontal cortex and other parts of the brain, allowing for better inhibition, impulse control, and attentivity...too much, though, and they will just make it worse...see what your doctor has to say.

[Gregster]

Stimulants sometimes calm hyperactivity, and sometimes not. At high doses the calming effect is greater, but calming hyperactivity is NOT what the goal is - you could just give valium if that was what you wanted to do. The improvements you want to see from stimulants is increased focus and improved behaviour (impulse control) and this happens at lower doses of the drug. At higher doses these improvements go away.
The "wired" feeling he may have is probably more profound at first and may wane as he gets used to the drug, I'm not sure about how he appeared when you picked him up - it could be from the drug or perhaps the result of the drug wearing off? How long was it between when he took the pill in the morning and when you picked him up from school? Concerta is supposed to last 12 hours but I don't think in practical terms it really lasts that long. In some people the effects of the drugs wearing off makes their ADHD a bit worse for a short time, in some people this is worse than in others.
Another question to ask is how did he do in class that day? Was his behaviour worse or better? Did the wired appearance continue in the classroom or was it confined to the playground? Often the obvious signs (hyperactivity) of ADHD are used to judge the effectiveness of the medication and hyperactivity is actually the last symptom to go and, according to my doctor, not a symptom you want to treat, since once the medication gets to that level, the other improvements are gone!

[Nucking_Futs]

I would consult your doctor first but my son had a lot of the same issue's when he was on Adderall. What we have found to work well for him is a non-stimulant med, he's currently taking Stratterra and doing very well with the exceptional crying jag when he's tired and the med is wearing off.

[Wheezie]

Punky, I'm wondering if you got any feedback from your son? How did he feel during the day? I remember feeling a bit wired a little while after taking my meds, but, I definatley mellowed as the day continued. Did he feel like he was able to learn more that day? Were distractions less distracting?

Did you get any feedback from his teacher? It'd be good to know how his behaviour was during the time when the medication would have been most effective. Perhaps you'll be able to judge this for yourself this weekend?

As far as "why a stimulant calms hyperactivity?" I think the explanation that made sense to me is the theory which explains that ADHD symptoms may be caused by *underactivity* in the frontal lobe (cortex?) as compared to folks without ADHD. Stimulant drugs stimulate that area of the brain, thus, kicking into gear the more 'normal' response to our environment. Here's one of Big's links to a relevant article http://www.addforums.com/forums/showthread.php?t=11228 But, there are a bunch of theories and no one knows for sure.

Good luck, Punky. If you've got time for an update, we'd love to hear how you and your son are doing.

wheezie

Greg, thanks for the information! It is good to remember that the symptoms that we are looking for improvement in ability to stay on-task, impulse control, and motivation (ideally). Though, this is highly personal since the areas we want to improve in are the areas we have most trouble with, and those vary from person to person.

[punkybrewster]

He took the med at 7:00 am. He was acting tired and yawning alot until about 7:45 am. Then, like I said, I noticed him continously "bouncing" in place while he was engaged in a conversation with a group of his friends. When I picked him up, it was 2:30 pm (so what is that, 7 1/2 hours). When I picked him up from the classroom, he was all over the place, and talking at hyper speed. He couldn't stop. I asked his teacher if he had been like this all day, and she said he had. He was acting "wired" all day in class, she had a hard time getting him to stay still, and couldn't re-direct him.

Once we got home, the same type of behavior continued (constant movement and fast, exaggerated speech). When he did sit down, he alternated between nail biting (something he has never done before), or constantly moving a body part (hands or feet). He couldn't concentrate on his homework at all. After he ate dinner, he said he was tired and that his stomach was upset. I told him go to bed and he went upstairs, but didn't go to sleep, just lied on the bed watching t.v. Finally, around 9:30 pm he went to bed. If he fell asleep right away, I don't know. To me, he seemed "happy" and didn't seem to get as agitated as he usually does. When asked, he kept saying he felt fine (except after he ate dinner, but that might have been more related to getting out of homework than a real symptom of the medication, I don't know).

This morning, he was up at 5:30 am raring to go. He wanted his meds. I'm apprehensive about giving them to him until after I speak with the doctor. I left a message yesterday, but so far, no return call. I didn't give him the meds this morning before school, and when I dropped him off, he was cranky and irritable.

Being new to all of this, I was under the impression that the meds would help calm him down, focus more, and help with some of the ODD issues. I wasn't expecting him to be acting like he was on speed. I guess that's why I'm asking if this behavior is typical, and it will disappear once he's been on the meds for awhile, or, if it sounds like he's not tolerating stimulant meds and should try something. I know only the doctor can say for sure, I'm just apprehensive to begin with, and thought I could get some feedback from people more in the know then myself, until I could speak to the doctor.

Thanks to all who replied. I have another call in, and hopefully will get a response back today, because I won't know what to do over the weekend.

[Nucking_Futs]

The reason most members are leery of giving advice on meds is due to every person being an original being. Everyone reacts to meds in a different way...it could be anything from the right disorder but wrong med to the right med wrong dosage. Be patient and give your doc time to call you back and if all else fails keep calling until he has no choice but to give in and speak to you.

[barfly]

that is how I got when I took to much one day. I was jittery and talked a lot. I tried to do homework, but I couldn't concentrate on what I was doing and it sucked. Also i noticed that the concerta effects me less with the longer I take it.