Question about afternoon booster......

[palooka23]

Our 9 yr old son was just switched to Concerta. He had been taking 15mg of Adderall XR for about 9 months and when we went to renew his RX the doctor informed us of the recent Canadian "situtation" regarding Adderall. Of course she recommended we no longer give him Adderall and after much thought, we agreed. So we are now on Concerta (18mg). He has only taken it for 2 days. It seems to work great so far but he only gets about 8-9 hours out of it. This is great for school hours, but he is a very active young man. He plays sports in the evening and also takes piano. With the adderall we could give him a booster on busy nights and he would do ok. He mentioned to me last night during baseball practice that he felt "like his meds have worn off" because he had trouble controlling himself and concentrating.
I have a couple of questions that of course I will ask the doc, but also wanted to ask here:

Since he has only been on it for 2 days will it eventually stretch out to the 12 hours as described after he takes it regularly? The adderall never lasted more than 7-8 hours, and we would give a booster around 4pm to last the rest of the evening if necessary.

What meds are given as a "booster" to last an additional 4-5 hours when one is taking concerta? Is it regular release Ritalin?

[Scattered]

Originally Posted by palooka23

Our 9 yr old son was just switched to Concerta. He had been taking 15mg of Adderall XR for about 9 months and when we went to renew his RX the doctor informed us of the recent Canadian "situtation" regarding Adderall. Of course she recommended we no longer give him Adderall and after much thought, we agreed. So we are now on Concerta (18mg). He has only taken it for 2 days. It seems to work great so far but he only gets about 8-9 hours out of it. This is great for school hours, but he is a very active young man. He plays sports in the evening and also takes piano. With the adderall we could give him a booster on busy nights and he would do ok. He mentioned to me last night during baseball practice that he felt "like his meds have worn off" because he had trouble controlling himself and concentrating.
I have a couple of questions that of course I will ask the doc, but also wanted to ask here:

Since he has only been on it for 2 days will it eventually stretch out to the 12 hours as described after he takes it regularly? The adderall never lasted more than 7-8 hours, and we would give a booster around 4pm to last the rest of the evening if necessary.

What meds are given as a "booster" to last an additional 4-5 hours when one is taking concerta? Is it regular release Ritalin?

I just went on Concerta too and had the same problem with in not lasting long enough. My doctor told me to take another Concerta at 11AM (I'm also on 18 mg) and that worked out perfectly for me. Kids have a bit shorter day, so you should definately talk to your doctor about it first. Mine never got anywhere near 12 hours (more like 6 - 8) and that is also what the pharmastic told me is pretty much what most folks find, but everyone is different.

Good luck!

Scattered

[Joyfullife]

I'm having the same trouble. I started on 18mg yesterday, and I feel it wearing off by late afternoon. By evening, I feel like I've totally crashed. Would a higher dose last longer? Does this stuff "build up" in your system?

[ApeMan]

I've been taking 54mg of Concerta a day now, for a few weeks. I definitely notice that it doesn't have as a strong of an effect as Dexedrine (I used to take 10mg, 3 times a day). I'm bumping up my Concerta dose to 72mg for today, to see if it's any better.

Also, I still have some Dexedrine left over so I'm using about 5 or 10mg a day in the afternoon, to keep me going when the Concerta wears off. Other days, I'll drink a cup of coffee in the afternoon, or sip cola through the evening, for the same reason.

I only have 5 more weeks of school left, and so I'm trying really hard to do my best. This includes trying to take the best combination of stimulants... I really need to be able to focus for 12+ hours a day to be successful this term.

[Scattered]

My understanding is that Concerta does not build up in your system. When it's time is up, it's gone! Better talk to your doctor about getting longer coverage. Mine was real willing to work with me on that.

Scattered

[ApeMan]

It seems to me that the effects of Concerta have warn off on me. I've been taking it for about 4 or 5 weeks. And I'm up 72mg a day (one dose in the morning). I've decided to stop taking it and switch back to Dexedrine, which is much more effective for me. Also, with Dexedrine, I can vary the dose more easily and take it 3 or 4 times a day, to keep me at a more constant level of efficiency (with respect to school work, studying, etc). Concerta sounded like a great possibility, but unfortunately I don't think it worked for me.

[Gregster]

Ritalin is the easiest thing to use to "top up" Concerta so that your son has coverage for his entire day - the drug is the same, methylphenidate. It's too bad that you felt it necessary to change meds due to Health Canada's knee jerk reaction - on behalf of all Canadians, I appologize. It's likely that the Canadian ban won't last - they are setting up an independant review panel to look at the decision and my belief is that they will find the ban has no merit - when you look at the data and remove the cases where the patients had either a know heart condition, a family history of heart problems or other extenuating circumstances, the death rate is pretty much at the "baseline" - the normal number of sudden deaths you would expect in a population the size of the Adderall prescription base.
Some people find that one drug works better than another - some prefer the methyphenidate that's in Concerta and Ritalin and some prefer the amphetamine based meds like Adderall and Dexedrine and presumably to some it makes no difference.
If I was in your position, and found that the Concerta isn't working as well as the Adderall, I wouldn't worry about the Health Canada scare and would put my child back on the medication that worked best. If Concerta works the same or better, I would stay with it, of course - all other things being equal.
Regards,
Greg

[palooka23]

Thank you for the info Greg. I agree that the FDA probably will never recall it here in the US. My problem is the following; I have an enlarged heart and thickening of the heart walls. Certain times I have also been told that I have a murmur. I went through a battery of tests last year and was found to be "normal". Knowing this, I am concerned over my son inheriting the heart issues I have and decided its best to change to concerta rather than risk a potential issue later.
He seems to be doing well on the Concerta, its been about a week and aside from a bit of emotional lability in the afternoon all is well. He actually seems to be calmer and also more mellow than on the Adderall, but I save my judgement for the long term results. Right now the only issue is longevity. He has a visit with the Dr. tomorrow and she has indicated that she wants to bump him to 36mg. It is her opinion that might give the length he needs. I am concerned over this because it seems like 18 mg works good. I dont want him to be "zombied" out. But she says that bumping to 36mg would not exacerbate the side effects. (Ive read that 95% of all kids on Concerta take 36mg) I still think that on very active days he is going to need a booster. On a busy night he may be involved in activities until 9 pm. I dont think he will get ANY med that will go from 7am to 9pm.
Anyone think that 36mg plus a booster (my guess 5-10mg) is too much for a 60lb 9 yr old?

[Scattered]

My doctor staggered my two 18 mg Concerta doses by about 4 hours (7AM and 11AM). That gave me the longevity I needed and didn't keep the dose as high as long. You might ask your doctor what he thinks. Also when we got the dose a bit too high I didn't become a zombie I actually got a bit more anxious (normally it calms me down).

Scattered