9 yr old extreme ADHD

[Evloveerly]

my sons psychiatrist just prescribed him 72 mg of concerta. He is 9. Has anyone else had their 9 year old on that high of a dose?

[Onthemove1971]

Thanks for joining this group. Thank you for sharing what you are going through. Our son needed a higher dose of medications. I didn't worry about how much, I worried if it would help him control his impulse control. Each child is different.

We were told medication should stop 60% of his behaviors. The rest is controlled with therapy, educational plan and modification of parenting.

We see here for you any time you need support. If you get a min. You may learn a lot from old posts, so you are not surprised by things that may occur.

[Lizwho930 in reply to Onthemove1971]

I agree. I wouldn’t worry so much about the dose your child needs, as long as you aren’t seeing negative side effects. I know you also mentioned his case was a little more extreme, so I’m sure that is also playing a factor with dosage. My son was on 54 mg at that age and our psychiatrist just lowered his dose to 36 mg. He is now 13. She explained that as they age and mature the goal should be to reduce meds. We were concerned at first that we would start to see negative behaviors again, but I think she was right that he is maturing and learning to control some of the behaviors that were more of an issue (in the classroom) when he was younger. Not sure if this helps!

I would just be sure to communicate with the psychiatrist if you have concerns about any side effects you are seeing that could indicate the dose is too high. We communicate with our son as well to ask him how he is feeling and how the meds make him feel. Of course it was harder at 9 for him to express how he was feeling, but he has shared more as he has gotten older. Otherwise, just know you are taking the right steps to help him be successful at home and in the classroom.

[Mamamichl]

it can go by weight or even biology. Some kids burn it faster. Maybe ask if a lower dose twice a day would work for your situation or if it’s the right med. some kids do just need a higher dose, but not always.

[Onthemove1971]

Are you seeing a difference once he takes his medication?

[Knitting20projects]

I think that’s the maximum adult dose for Concerta. I haven’t seen that dose in a 9 year old (I’m a pediatrician). However, I don’t think that necessarily means it’s an unsafe or incorrect dose. I don’t have child psychiatrist level training or experience so can only speak from what I have seen. I would want to see it was incredibly effective, and that lower doses were insufficient and other medications hadn’t worked well. I say that because there’s zero room to increase it, and I am unsure if anyone would ever feel comfortable with a booster dose later in the day etc. I would ask the doctor his reasons for using that dose. Did he get data such as Vanderbilt forms from you and teachers when your child was at 54 mg, the next lower dose, showing he was struggling? I would have been inclined to consider holding Concerta at 54 mg and adding a trial of guanfacine ER as a second medication. I am unaware of the details of your exact situation and there may be a clear rationale behind it. My previous doctor said she once had an adult who metabolized Concerta so rapidly (and it was so helpful for this man’s ADHD) that she ultimately found he required Concerta 3 times daily. Obviously I think that’s rare, but these situations apparently happen. Pediatricians like me leave those to the experts, though 😂