14 year old in Concerta 18 mg - ADHD Parents Toge...

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14 year old in Concerta 18 mg

Pmom
Pmom
22 Replies

Hi, my son is in Concerta 18mg for two weeks now. He is in 9th grade high school. The stimulant makes him focus and do his work in class. The meds wears off around 1pm he said which is ok since PE. is his last class. The.stimulant has side effects on him such as suppressed appetite, can't sleep early, emotional and irritability. He gets so angry easily with the meds which concerns me. He said he almost got in trouble in school because some things irritate him easily. Does anyone have a similar situation when your kids are in stimulant? What did you do? Did you change meds or added more meds? Did you have your child see a therapist and does counselling work with anger issues? My son has a follow up appointment with his psychiatrist next weekend so I wanted.to know what are the options to take to help with his irritability. I am afraid the psychiatrist will increase the dose too because of decrease appetite and lack of sleep. Please advise.

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Pennywink

Hi! I understand your concerns. Sometimes the medication trial can be worse than just dealing with ADHD - but once you get the right balance, it can be a game changer.

Most of my son’s negative side effects faded after a week or two., so hopefully things will settle in for you soon. If not, an increase in meds or a different prescription may be the ticket. But don’t be afraid if the psychiatrist changes things up, as it can be surprising what ends up working.

Is he irritable while the meds are active, or after they wear off? If it’s while active, then it sounds like you may need to change meds / dosage. If it’s after wears off, then it sounds more like med rebound, which there are a few options to help.

As for eating midday, that probably took the longest to settle in for my son. So I just make sure he has a filling breakfast, a snack with some kind of protein after school and a healthy dinner. For lunch I’m a little less picky, and more likely to just prepare anything he might eat (not candy, but maybe chicken nuggets or pizza rolls.)

Best of luck!

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Pmom
Pmom
in reply to Pennywink

Hi, thank you for the reply. The meds make him irritable when active and more irritable when it wears off. I've noticed it is worst on Mondays after school...he gets so emotional and angry. Some days are manageable. I don't give the meds to him on weekends so he can catch some sleep and eat normally. It's only been two weeks so I am really hoping the negative side effects of the meds will fade away. I also give him multivitamins and omega-3 (fish oil or flax seeds) every day. Just curious what are the options for med rebound. It makes me sad to see him so irritable and angry.

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Pennywink
Pennywink
in reply to Pmom

I am curious that it wears off at 1p but it still seems to cause sleep issues. If the sleep issues are only since medication, they may be contributing to the irritability. Many posters here use melatonin to help their kids sleep at night. (Is talk to your prescribing physician first.) We use consistent early bedtime, very very dim night light & white noise machine.

Did your doctor recommend taking weekends off of medication? If not, you might want to try giving it to him then too. This is based off of no data but my own observations / discussions here, so take it with a big grain of salt, but I feel there’s a trend of people who use medication breaks seeming to take longer to move past the side effects.

My main advice is to call your prescribing physician, tell them what you are seeing / doing, and ask if they want you to continue until the next appointment or not. I would also get direct input from teachers first to report if possible. (My son is not a very reliable source of clearcut information.)

Here’s an article explaning med rebound. If his meds are wearing off by 1p, they could just be leaving his system too fast. understood.org/en/learning-...

And another article with more ideas to implement to handle it:

additudemag.com/meltdowns-a...

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Pmom
Pmom
in reply to Pennywink

Thank you so much for the advise. My son's psychiatrist did mention that I can take him out of meds on weekends or holidays if I want to. The reason why I did it because my son wakes up late on weekends so I don't want to give him the meds too late. But definitely will consider your advise. Thanks for posting the links of the articles. I will read them as soon as a I get a chance today.

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Azbee
Azbee
in reply to Pmom

Taking him off of the meds on the weekends is not the answer. I ca my stress enough how important it is to keep the meds consistent so things can level out for him. By stopping the meds on the weekend (I used to do this too) it is creating a viscous cycle every monday morning. The only time you should stop the meds is summer b/c it’s a looonnngg period that is worth it and plan to start him on the meds again 1 -2 weeks before school starts to allow him to adjust at home instead of in school.

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Pmom
Pmom
in reply to Azbee

Thanks for the advise.

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Pennywink
Pennywink
in reply to Azbee

Glad to hear it isn’t just me thinking this is a thing! 😊

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nurse_nelly
nurse_nelly
in reply to Pmom

My son was on concerta for years. I kept telling the dr how emotionally unstable he was and they would decrease, then increase then decrease then add a mood stabilizer, then another mood stabilizer until FINALLY is spoke up and said enough is enough. He started concerta in the 2nd grade and 1/2 at through 6th grade I demanded the Dr take him off everything slowly. By Summer going into 7th grade he was off of everything and I FINALLY got to see what it was like to have my child back. Fast forward to August 7th grade.... Started him on regular released Ritalin 10mg daily in the morning. He was been taking that for a year now and doing SO much better. ONLY med he is one.... I will NEVER to extended release again. Seeing a different Dr who actually said when kids hit puberty they can require less medication. Also noted the concerta used to last him all day when he was 2-5th grade. Then 6th grade only lasted 4 hours. However the regular released Ritalin lasts from 8am-2pm which is actually longer... Kinda weird but we are Definitely on the right track with our son after many years. Hugs to you keep your head up but NEVER worry about demanding or ASKING to try something different. My sons irritability is SO less now on the Ritalin then ever before.

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Azbee

Does he also have anxiety or feel anxious? Reason I ask is that my child’s dr added a beta blocker to take with concerta and it really helped. Also when you start concerta it does make you edgy at first so we try to start the meds at least a week before school starts and make sure he stays on the meds over the weekend, or the cycle of adjustment will start all over again on monday am. Decreased appetite is normal, but is a bummer. Breakfast is your only chance! Must eat a hearty breakfast then take the meds after. Then for lunch try protein shakes even the pre packed muscle milk, etc - whatever he likes that he can make himself eat for lunch OR IF that doesn’t work, just assume he’ll eat his version of lunch when he gets home from school, so have healthy choices or pre made leftovers available, b/c he’ll be starving. Good luck and don’t switch to vyvsnse...the decrease in appetite is waaayyyy worse!

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Pmom
Pmom
in reply to Azbee

Thanks for the reply. I don't think he has anxiety. He is only anxious when he did something bad and he knows he would get punished by his dad (example taking his phone away or electronics away) . Not sure if that counts. Thanks for the advise.

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anirush

My grandson got super angry on concerta. We had to switch him to Intuniv. He is also on a mood stabilizer and an anti-depressant. Not everyone can handle stimulants. You need to talk to his doctor.

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Maggie611

My son also has ADHD, hyperactivity. He is prescribed a stimulant and he too can be extremely irritable when coming off of the medication. They added Guanfacine, which is "a cognitive enhancing" medication used to treat ADHD. It also seems to work with managing irritable side effects. My son has less frequent outbursts. It's not perfect and he still is on edge at times but severity and frequency have considerably decreased. Speak to your psychiatrist about it. Hugs to you on your journey. It's not easy but it's worth it.

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Pmom
Pmom
in reply to Maggie611

My son is ADD inattentive with impulsivity. I've read about the combination meds. I will definitely speak to his psychiatrist about it. Thanks for the advise.

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willandgrace

My freshman boy sounds similar to yours- I recently tried Dyanavel for him. It's extended release. He does not have the CRASH at 4pm anymore. However, the medication has mostly worn off so homework is an issue- He really doesn't like taking any medicine at all because it suppresses his appetite, and he doesn't feel quite "right". But so far we've tried Vyvanse and Dyanavel, and the Dyanavel works better for him. It doesn't really suppress his appetite too much, and he is much less irritable. I think you might want to try it!

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anirush

The Intuniv my grandson is on is also extended release. The mood stabilizer is Guanfacine, too.

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Ocjd

I have a sophomore who started meds last year and had great success as far as school work but had side effects such as extremely suppressed appetite. He definitely gets very cranky when the Concerta wears off right after school. He takes ER during the day which works very well for him and generally gets him through a full day of 5 honors/AP classes. He takes an evening booster for the enormous amounts of homework he has but that is an IR small dose of Ritalin. He does not seem to be as cranky when he comes off of that.

I wonder if your son is feeling angry due to low blood sugar because he is not hungry? My son really needs to eat because he's skinny, tall, and can suffer from low blood sugar and he had to adapt and make himself eat a bit during the day or he could not function as well.

I will emphasize that no answer is correct for all kids. They vary across the board. Definitely speak to your son's physician quickly and tell him/her what is going on so that a change can be made if needed. It really is a trial and error period. Have patience but be proactive. Good luck!

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Blacz

Hi there, my son is taki g concerta too abd side effects the sane but he takes morning and afternoon anotherone for the mood and helps him to sleep better as well. Ask your doctor. He stRted that one be ause minths ago he was engry and anxious everyday and he feels vetter now and his behavior and mood is better.

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Blacz
Blacz
in reply to Blacz

Guafarcine morning and nights

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Pmom
Pmom
in reply to Blacz

Thanks!

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myspecialkid

My child also had some irritability/anger when we first started stimulant med, but it was working for focus. We stuck with the med and the irritability/anger wore off after about 5 weeks. So I would say to stick with current dose if possible (and if there is no serious physical harm/threat from the anger issues). It takes an average of 6-8 weeks for the body to fully adjust to a new med to see the optimal benefit.

We used to have weekend holiday at the beginning as well for the same reason you mentioned. After 2 months we started giving it consistently everyday because mondays seemed to be a drag, and we noticed she needed it for focus at sunday school too.

The lack of sleep may be the reason for the irritability (we use melatonin). Another might be headaches, which he may not complain about if he's not used to the feeling (tylenol should help with the headaches). Sometimes her irritability was due to being hungry but not actually feeling hungry. And that's where I had to teach my daughter to eat a cracker at 11am whether or not she feels hungry.

Hope this helps! Goodluck!!!!

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Pmom
Pmom
in reply to myspecialkid

Thank you!!! This helps a lot. My son came home today agitated from the stressed in school. He wanted to go biking and dirt jumping so I took him and his friend even though I was tired. I wanted him to be happy instead of him constantly asking me to go. Besides I wanted him to have some exercise.

Thanks for the advise.

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NanatoZ

My 7 yo grandson was on Concerta for a year. Everyday he started having angry, intense episodes in the afternoon when the meds wore off. Also, it severely affected his appetite. I spoke with the dr and we switched him to Focalin. So far so good. Good luck to you.

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