Concerta and depression in young children?

[LhShea]

I am a mother of a 7-year-old son diagnosed with ADHD 3 years ago. He just started Adderall this school year. He started with regular Adderall, but it didn’t last long enough and he was easily agitated when it was wearing off. So we started with the 10 mg of the XR version and bumped up to 20 mg, which is working, like a charm.

My problem is during the past week he has developed a dry hacking cough. It comes and goes all day long. It doesn’t bother him during sleep. He was seen in the ER after a coughing spell lasting 4 hours. Chest x-rays were clear and albuterall treatment temporarily stopped the cough. The pediatrician and pulmonary specialist agree it is not asthma but might be a tic caused by the Adderall. I am at my wits end, he needs the medication but not the side effect. Has anyone ever had this type of side effect and if so how did they treat it?

UPDATE 3/1/04

The doctors decided that his cough was a tic aggravated by the Adderal XR. Now they have put him on Concerta 27 mg. He has only been on it for 4 days but there is no sign of cough. Although already I’m not liking the side effects. He is too quiet now and seems to be “zoned out”. When he starts to come down off the medication he is very quiet and seemingly depressed. At his last basketball game, Sunday 4:30 pm, he didn’t even want to play, he just walked up and down the court for the 2nd period. He sat out the 3rd, sitting on my lap with a “zoned out” stare. I asked him if he were feeling okay, he said yes. When the coach asked him to play the 4th quarter, he started to cry (me too, almost). After the game they had a little party with pizza, juice and cookies. He had certainly come down off the meds, because he ate 3 pieces of pizza, 12 cookies and 2 juicies. He was also running around playing with all the kids, like normal.

I have made a call to the doctor to have his dosage lowered, but is this the way concerta works on some people regardless of dosage? I know he has better control of himself and is doing very well in school, both academically and socially. It took a long time for my husband and I to make the decision to put AJ on medication and it breaks my heart to see my son like this. Are we doing the right thing?

[Lexicon]

Linny, I know that I certainly get like your son does when my medication (Dexedrine) wears off. I'm sure a lower dose will lessen the comedown off Concerta, but I wouldn't think it would make it go away entirely. Some people react to the comedown like this, some don't. I have started taking Effexor as well, and this is making the stimulant comedown effect much less severe. Perhaps your son would do well taking an antidepressant like Effexor alongside his Concerta? Just a thought--it might not help at all, or might present you with even more problems.

I've also heard that some parents have had success giving their kids caffeine as the drugs are wearing off. I read one report that said a nice caffeine-laden Mountain Dew does the trick.