ADHD Medication

A month ago my 17 yo son started on Concerta XL with low dosage and now at 54mg. He is diagnosed with ADHD inattentive type. I have not yet seen much improvement in his school work, very inconsistent grades (from As to Fs in few weeks). Since he has been on 54 mg Concerta XL now for few days, he still is not motivated to work on his assignments which should be easy for him since has been reading at a college level since 6th grade. I am exhausted and frustrated as to how I can motivate him. Is the medication not working well? I am not sure what to expect as far as motivational level from taking the right dosage of this medication. Thank you for any advice!

[RaquelMonique]

I’m sorry that you’re not seeing improvements. Concerta did wonders for my son for the longest time. But in high school his grades slipped to Fs for a while. One day I said “I’ll buy you a gaming computer if you bring home all A’s”. I was sure I’d win the bet because he was doing so bad but Sure enough, his quarterly report had all A’s!!! Bribing isn’t the answer, but I feel they get bored. Good luck you you

[Taffnus]

I have a good friend who has ADHD and she told me when we first were trying meds for our 17-year old daughter that the medications help with focus not motivation. That is truly important to realize. I’ve felt myself grasping at meds which, so far haven’t worked for my daughter, thinking that they’d provide miraculous work ethic as well. Not the case. The child still needs to put in some effort, come to the table and actually do the work. So, as in RaquelMonique’s situation, finding motivation is key but won’t necessarily come automatically from meds.

[Hidden in reply to Taffnus]

Thank you both for putting things into context. This is isn't something you hear much about in books I've been reading. I'm still debating whether increasing medication is the best thing or wait and see if the motivation comes with the ability to focus better; just thinking out loud. Thanks for sharing your experience!

[janeejo1]

May not be the correct medicine for him. Talk with the doctor that prescribed the medicine. I find providing incentives helps also. Best wishes.

[Elijah1]

The studies of Concerta in the adolescent population found that up to 1/3 had a suboptimal response when the dose was stopped at 54 mg (and the dose has some relationship to weight). Ask the prescribing doctor if a 72 mg trial for a few weeks might be useful.

[Hidden in reply to Elijah1]

Elijiah1, thank you for that suggestion! My son's doctor has informed me that he can do 72mg max for Concerta and could switch to another med if no improvements after trying 54mg and 63mg. I am reluctant to wait and see for too long on 54mg. My son is a big kid over 6 feet and 184lbs , possibly under medicated. I've contacted his doctor to see if we can increase to 63mg since it has been a week on 54mg. Would you mind sharing this study, trying to be more informed in this area.

[Elijah1 in reply to Hidden]

I would increase to 72 mg if he weighs 184 pounds (no need for the small increase to 63 mg). The paper is so old (when Concerta was only brand name in the USA) that it will take some time to find it.

[Hidden in reply to Elijah1]

I feel the same way, but doctors are very cautious. I think a week is sufficient to determine the benefits of the dosage. No worries if you cannot find the study. I think you pretty much summarized the findings.

[ADHD_DAD in reply to Hidden]

Agree with 72. My son is younger a.d a bit smaller than yours (6' amd 165lbs) and now takes 72mg. Frankly, that still seems like too little (med was much more effective when he was smaller) but he's doing well at school. He just really struggles with constant motion and talking. When at school,, he takes an afternoon booster which helps but he doesn't want to take it on days off when he's home all day, and he's been such a good kid that we try to always respect his feelings (if he's being reasonable). By the way, the medication only helps with ADHD; it does nothing about them being teenagers if you get my point.