Son just prescribed Concerta

[tnbsmommy]

Hello all, My ten year old son has ADD, he has previously been on Ritalin, which worked, but gave him stomachaches... We tried Metadate, which didn't do anything, but give ME a headache trying to get him to take it in the mornings. We went back to the Dr. on Friday, (this was a sub dr. his regular dr. was out on medical leave) and she gave us Concerta to try. She gave us 18mg. once a day, and then a prescription for 5mg. of Ritalin, prn in the afternoons, after we left the dr.s office, I was reading through the information on Concerta and saw it is supposed to last 12 hours. Since it seems to me, that the concerta will last through homework time, I didn't get the Ritalin filled. My question is, I see some of you who post here actually take the concerta yourselves, does it seem to last the entire 12 hours? Or do you feel it is wearing off?

Another question I have is, and I know this may be hard to answer, but I am trying so hard to understand what my son is going through, I get so frustrated, when I am trying to help him with homework, and it takes him SO LONG to do a simple page, that shouldn't take 3 minutes to do, can those of you who actually take the medicine try to describe the difference you feel when you are on it vs. when you aren't? It is so hard to comprehend what it feels like when you don't go through it yourself, and a 10 year old can't really describe how he feels so well.

I forgot to add, my son doesn't have the hyperactive part of the condition, only the trouble focusing... I also wanted to ask, the dr.s have told me I can give him the medication only when he has school, I am wondering if it may be more effective if I do give it to him 7 days a week, is there a difference that anyone is aware of? as far as the medication being in his system? I noticed several posts regarding when you first start on the meds, so I am wondering if that means I should give it to him everyday, to keep it in his system, if it would mess him up to only have it on the days he has school.


Thanks in advance for any feedback you can give me about this. I know this is alot of questions, and appreciate the time anyone takes to answer them.

[Chadwick]

Everybody's different. Concerta seemed to last about 10 hours for me. Maybe a tad longer some days. The theory is that the body builds up an acute tolerance to methylphenidate (and maybe amphetamine, too) which is why the Concerta tablet leads to increasing concentrations of methylphenidate peaking at hours 4-8, and then falling off, because during hours 0-4, the body is building up acute tolerance to the drug. Now, this is theory, not necessarily proven, but some people feel this to be true. I personally don't think I develop much in the way of acute tolerance, so for me I notice Concerta becoming quite effective at hours 4-8. Also, theoretically, all your tolerance to the drug is lost over the next 12 hours that you don't have the drug in your system, i.e. evening & while you're sleeping, so this is why it works again with renewed vigor the next day. Some people however seem to develop chronic tolerance to the drug, that is, over months/years of use, they require dosage increases every so often. To ward off this possibility, you might want to consider a drug holiday once per week (Saturdays are great to sleep in, then (medicated) make Sunday a school-functional day for homework, study, and whatnot) or when school isn't in session, i.e. holidays and whatnot.

Regarding what it feels like to have ADD, primarily inattentive. I can start reading something, and if I'm not passionate about it, I'll start getting lots of random thoughts in my head about other things, about my life, about people I know, about tangential topics, and I'll carry on thinking about them and maybe a while later realize crap I just lost 15 minutes and I have to be to work in 5 minutes, so I gotta go now kbye. LOL. It's a problem with "staying on task" especially with things that one does not strictly enjoy. The medication helps me with that tremendously, in theory by raising dopamine levels so that one feels a baseline "satisfaction" even from boring work that wouldn't otherwise raise dopamine levels and produce a sense of contentment.

[tnbsmommy]

Thank you for your response, Chadwick... I think giving him a break on Saturdays, and then starting again on Sundays sounds like a good idea...

We have asked him before why he doesn't do his work... he replied, "Im thinking", my husband asked him, "what are you thinking about?" My son replied, "What you will say if I don't do my work." I know he thinks ALOT... I guess it does make sense that his thoughts jump from subject to subject...

It just gets SO frustrating! I hope and pray this medication helps him concentrate and focus... and he can work to his full potential...

[Chadwick]

You sound like a very loving father. Just tell him you love him, and want him to be happy in life, and will do anything in your power to make that possible. Sometimes, hearing that from my own father inspired me to excel.

[tnbsmommy]

Lol, I am actually his mom... I wish his father was tolerant of all this... he fights me on the medications, and thinks I should just be stricter with him...



I tried to use a "car" analagy I read somewhere about comparing needing meds to a car needing break fluid... that the medicine will help his brain slow down, but I don't know if it really got through to him.

[Chadwick]

LOL I'm sorry. My ADD mind just refused to read your nickname. I somehow thought your nickname was tommy or something. I do that a lot with words that don't immediately leap out as being defined in English. Oh well it all holds true, the concern you show for your son is wonderful. If he's a sensitive child then a little heart to heart might be in order.

[tnbsmommy]

That's ok, sometimes I do feel like Im his mom and dad...

[Chadwick]

Originally Posted by tnbsmommy

I tried to use a "car" analagy I read somewhere about comparing needing meds to a car needing break fluid... that the medicine will help his brain slow down, but I don't know if it really got through to him.

I don't like that analogy at all LOL. The last thing I would have tolerated at that age is someone giving me a pill to slow my brain down. Instead, phrase it thusly: the medication will help you with school. It'll make it easier for you, and less stressful. You'll enjoy it more.

[tnbsmommy]

That is a better idea... thanks for that. I try to make him feel as normal as possible, and I can only imagine how frustrated he must be, when all the other kids are doing their work, and he can't... and is contantly getting singled out so I am trying to help him see that with the meds he won't have that problem, he will be able to do his work...

[tnbsmommy]

Oh, another question, if you don't mind

I noticed alot of weightloss, lack of appetite symptoms associated with the Concerta.. The dr. we saw friday commented on his weight, that he was slightly underweight. and had lost a pound since January, now, seeing the symptoms of lack of appetite, I am concerned he will lose more weight. He told the dr. his "favorite hobby" was eating. This child eats all the time... so I am assuming it is genetics that he is so skinny, I am certainly not starving him, I am wondering if that is something you found was an issue taking concerta...

And thanks again for your responses, it helps tremendously to have someone's input, someone who has been where my son is now.

[Chadwick]

Part of it may be genetic. You have the power to get more calories into him. Fat is a very energy-rich material, 9 calories per gram, whereas the same weight in carbohydrates only supplies 4 calories. I don't mean stuff him with fat, but at his age, fat isn't so bad. The body uses it for construction and energy expenditure, not arterial deposition. If you're concerned about fat, then get one of those newfangled trans-fat free, omega-3 supplemented spreadable butters or whatever that are proven to lower cholesterol. Not that cholesterol is an altogether bad thing per se. It's the body's repair mechanism. A high cholesterol level means the body is repairing itself. By the way, omega 3 from flax seed oil may be a waste, apparently the omega 3 in it is little used by the body, it's best to give him fish oil omega 3 which has natural EPA & DHA in it. But I digress, this has nothing to do with ADD.

Make sure he gets enough protein too! I would recommend supplementing 100mg or so of magnesium citrate per day and a multivitamin w/ mineral as well, especially both of those in the evening with something a bit acidic like orange juice to aid in the absorption of the magnesium. Not in the AM since acidic urine means the Concerta will be less effective.

[tnbsmommy]

Thanks Chadwick, I did start both my children on a multivitamin last month... My daughter takes it fine..my son complains of the taste the entire time...(and then 10 minutes later FINALLY puts it into his mouth...

He hasn't been on meds for almost a month now, b/c I recently found out he needed glasses, and wanted to try(with his teacher's blessing) to see if maybe the fact that he couldn't actually see without getting headaches, and having to work so hard to focus the actual words would help, then while he wasnt on the meds is when I put him on the multivitamin. Giving that to him at night would help, so I only have to fight over ONE pill in the mornings. And I will up his protein.. I am reading around for diet habits, to help him out...

[ApeMan]

Originally Posted by Chadwick

I don't like that analogy at all LOL. The last thing I would have tolerated at that age is someone giving me a pill to slow my brain down. Instead, phrase it thusly: the medication will help you with school. It'll make it easier for you, and less stressful. You'll enjoy it more.

I like the analogy of an ADD's brain being like a busy intersection, where the street lights are broken, and the traffic is trying to move in all directions at once. The net flow of traffic is really slow, (ie. your thoughts can't get where they are trying to go!). However, a stimulant puts a traffic cop in the centre of the intersection, so that the cars (thoughts) can finally get to where they are headed, one car (thought) at a time...

This makes perfect sense to me, because sometimes I can totally picture my thoughts as cars crashing and not making it through the intersection. And also, many of the legitimate cars are getting held up and blocked by bigger trucks or flashier sports cars. Maybe some people are trying drive to work, or someplace else important, and they have to get out and start walking...

I read this in the book, "Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder", by Gavor Mate M.D. It's an awesome book! I would definitely recommending having a look at it, (by the way, it's rather long, so skimming it might be a better idea for most of us).

[Daven]

The loss of appitite is pretty common with any stimulant, but it should get back up there when his body gets more used to the medication..

Concerta only lasted me about 5-6 hours, same with adderall xr. Its just how he metabolizes the substance. Just try to observe when his normal behaviour returns again. When I was on concerta, I was taking it twice a day.

[tnbsmommy]

Apeman, thanks, lol, that actually made sense to me and I will look at that book...

Daven, wow, 5-6 hours... then if that was the case, we would need something later in the day, actually to get him through the whole day at school. I keep in close contact with his teacher, and she is going to let me know asap how things are going and if he is or isn't making it through the day... he is a skinny kid who eats all the time, so he has a fairly high metabolism, he started yesterday on it...he didn't complain of any headaches/stomachaches etc... and ate well last night. I didn't tell him what any of the side affects were, or even that there were any, so I would know if he were to have any, then they would be true side affects. He also did his homework fairly easily and quickly for me... so only time will tell... thanks for the responses!!