Concerta, How do you know it’s working? - CHADD's ADHD Pare...

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Concerta, How do you know it’s working?

Whitecarnation profile image
10 Replies

This may seem a strange question. My son is on his 3rd week of Concerta. 18mg week 1, 36mg week 2 and now on 54mg. He is having trouble saying if it is having any positive effect. The first week he had a low level headache for a few days, which wore off. Now he is on the high dose he said he is having trouble getting to sleep at night ( not that he usually goes to bed early), and his appetite is reduced. He also said today that he feels like something isn’t quite right but he doesn’t know what. It’s a bit awkward because he has left school and isn’t starting college until 12th September, so he hasn’t had to focus on things he is not interested in.

How long does it take for positive effects to be noticed, and the side effects to reduce? I would be grateful for any information you have .

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Whitecarnation profile image
Whitecarnation
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10 Replies
STEM_Dad profile image
STEM_Dad

What are the ADHD traits that he has struggles with? Memory? Attention? Distractibility? Impulsivity? Hyperactivity?

Do you see any change in his behavior?

Does he notice any change in his focus, attention, memory, or emotional regulation?

Some people say that stimulants make them feel more calm and help quiet the business of their mind.

I'm a dad who has ADHD, myself. I knew that my meds were working when I felt the thoughts in my mind slow down, so that I could pick out one thought and focus on it intentionally. I didn't exactly feel more calm, but I did feel less anxious, and a bit relieved that I had some control over my attention.

(I have Inattentive ADHD. My first medication was Adderall XR, but I've since changed to non-stimulant atomoxetine, aka Strattera.)

Whitecarnation profile image
Whitecarnation in reply to STEM_Dad

We have to fill in his next report form in a couple of days, so will try and go through all these things with him. As he has inattentive type, he keeps everything in and doesn’t say much.

STEM_Dad profile image
STEM_Dad in reply to Whitecarnation

He might also be introverted, like me. It took me a while, being forced to talk to people in my first job (a retail sales job that was very customer service oriented) and some very encouraging coworkers helped bring me out of my shell. It's not the right method for every introvert, but it worked for me.

I also tended to bottle everything up, and now tend to bottle up just the negative emotions.

He may be introspective. If so, maybe some freeform journaling will help bring things to the surface.

A good test would be for him to try things that have been difficult for him, and see if there's any improvement with his inattentiveness.

~~~~~

Just curious, does he experience at least a few of these symptoms?

• Prone to daydreaming

• Easily confused or mentally foggy

• Spacey or inattentive to surroundings

• Mind seems to be elsewhere

• Stares blankly into space

• Underactive, slow moving or sluggish

• Lethargic or less energetic

• Trouble staying awake or alert

• Has drowsy or sleepy appearance

• Gets lost in own thoughts

• Apathetic or withdrawn, less engaged in activities

• Loses train of thought or cognitive set

• Processes information not as quickly or accurately

STEM_Dad profile image
STEM_Dad in reply to STEM_Dad

Those are the proposed symptoms of a condition similar to ADHD, Predominantly Inattentive presentation.

It's best known as Sluggish Cognitive Tempo (SCT), and also known as Concentration Deficit Disorder (CDD).

(The psychological community is still studying it, and hasn't yet come to a consensus to formally recognize it in the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5.)

Studies show that it can be a comorbidity with ADHD.

~~~~~

Medication studies for SCT have yielded that it doesn't respond particularly well to methylphenidate medications (such as Concerta), but does respond to Strattera (atomoxetine).

I have Inattentive ADHD symptoms, plus also the symptoms proposed for SCT, and I'm on atomoxetine...and it seems to work well for all my symptoms. (At first, my doctor put me on Adderall XR, but it only treated my ADHD symptoms partially, and I still had most of the SCT symptoms.)

FitsInNoBox profile image
FitsInNoBox

Just here to say that my son also has trouble telling me if concerta is working. We have tried it off and on, but I always figure that if he doesn't like meds, and I don't notice significant behavior changes, I don't see the point? Would love to read others' tips for how to tell.

Knitting20projects profile image
Knitting20projects

If he doesn’t have many demands on him yet, I would just wait until school starts to assess for an improvement in his executive functioning. I would give the medicine more time to see if the side effects improve. I think the inattentive type ADHD would be less dramatic a response until there are academic or work demands put on him. My thoughts at least.

Whitecarnation profile image
Whitecarnation in reply to Knitting20projects

Thank you. That is what I am thinking. We’ve been waiting 6 months for the titration and it just comes in the holidays.

Crazyboymomma profile image
Crazyboymomma

my son, although younger, had full blown panic attacks from concerta. Had to leave class, go to the office, principal could not talk him down, and he had to come home. This was two days in a row and I took him right off. Completely fine after that. It was hard for him so explain how he felt, but based on his actions, it could best be described as a panic attack. I felt awful thinking about how anxious and scared he felt.

STEM_Dad profile image
STEM_Dad in reply to Crazyboymomma

Unfortunately, stimulants can can that effect on some people. I think I've read that anxiety is one of the more common side effects, but I'm not surprised that someone could be triggered into a panic attack. That's probably a less common side effect.

Taking a different stimulant might have the opposite effect, and be calming, or might also trigger anxiety/panic attack.

For me, Adderall triggered a concerning physiological side effect... tachycardia (elevated heart rate). Not at my starting dosage, but once it was increased. It didn't make me more anxious (on the contrary, it made me feel better I'm some ways, but not euphoric or high).

But for me, a non-stimulant has been treating my ADHD symptoms very well.

There are more medication options than ever before, so there's a good chance that there's medication which will work for you son's ADHD.

Rgalle profile image
Rgalle

My son started concerta 3 years ago at the low dose and gradually upped it. Once it kicks in it works great! He couldn't get through school without it. I saw a difference right away, too. The side effects are what come and go. He had twitching and eye blinking that started at first but eventually worked itself out. We just switched from concerta to focalin because he wasn't gaining weight and focalin is better for the appetite, per our doctor. Again, the side effects of twitching are back but I do think he is eating more BUT his obnoxiousness before and after the pill wears off is at it's high.

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