Considering Concerta for son, but have some concerns ...

[Cindy in C-ville]

... and would love input. He's 12 yo, extremely bright, a great reader who reads quickly, deeply, and comprehensively. He's a "mad scientist" kind of kid who wants to grow up to be an archeologist, paleontologist, missionary, engineer, who writes. He has always struggled with doing the "grammar" of subjects - math facts, English grammar, Latin grammar, etc. but LOVES content. We switched to Life of Fred this year for math, and now he loves math. He's highly distracted, impulsive, gets along better with adults and little children than peers, seems to lack an understanding of social cues, easily can go from "1 to 10" with his temper, and can get into such a funk that it seems there is no way out.

 

Academically, he's a grade behind now - not b/c of intelligence, but b/c he has such a hard time sticking to the required work, doing what's hard, etc.

 

Nutritionally, we eat well - at home - homemade ww bread, lots of fruits and veggies, no corn syrup, white flour, white sugar, etc. If we're at someone's house and they serve dessert, I let them have it.

 

I haven't diligently tried supplements. We have Omega Brites, but I just haven't seen them do much good.

 

We saw our dr. today and he had us take home a survey and indicated that Concerta was probably a good option.

 

I really dislike the idea of him being on meds. It just makes me want to cry. I'm afraid of him losing himself. I read about kids going "flat." I don't want that for him. I just want him to be able to reach his potential. He's also small for his age - 8th percentile in height and weight. He can't afford to lose any weight. I've read about some parents who just let their kids eat all the ice cream they want in order to not lose weight on the meds, but I'm not willing to do that, as much as he would love it.

 

Oh, and he LOVES his carbs - pancakes, pastries, etc., but he like asparagus, salmon, Tabasco sauce on everything, really an odd palate.

 

And from the time he was little he has rocked his head back and forth to go to sleep.

 

Thoughts? Wisdom?

 

TIA!!!

[Ottakee]

Honestly, it sounds like there might be more going on here than just ADD/ADHD. What type of doctor did you see? I would suggest a top notch pediatric psychiatrist or neurologist that specializes in these things.

 

Concerta can be very helpful but if you are dealing with something else or in addition, you need to find that out before trying meds.

[LizzyBee]

My 8 yo was on Concerta and the effects on her focus and creativity were wonderful. She could finally hold a thought in her head long enough to act on it. She was on the lowest dose and her personality and mood were not affected.

 

Unfortunately, she only stayed on it for about 2 months because it upset her stomach. We tried Adderall and it was horrible. She went from Tigger to Eeyore; she even cried because it affected her mood so badly. Concerta is just time-released ritalin, so we're trying ritalin now. I think the concerta worked a little better, but ritalin doesn't seem to upset her stomach as much.

[EKS]

Honestly, it sounds like there might be more going on here than just ADD/ADHD. What type of doctor did you see? I would suggest a top notch pediatric psychiatrist or neurologist that specializes in these things.

 

Concerta can be very helpful but if you are dealing with something else or in addition, you need to find that out before trying meds.

 

I agree.

[Cindy in C-ville]

So, Kal and Ottakee, I won't hold you to it, but any guesses? TIA!

[Ottakee]

A few possibilities:

 

Aspergers

food allergies/intolerances

mood disorder

ADD/ADHD with the above

 

 

Those are just a few based in the bit you told us. Could be something totally different though or a combination or ????

 

So, Kal and Ottakee, I won't hold you to it, but any guesses? TIA!

[Cindy in C-ville]

Thanks Ottakee! Now, let me ask you this. Dh and I are getting ready to leave the country for a few weeks for our adoption of Katya. We're really not at a crisis point right now. Would you put this on hold until we return? Mostly, he's a really dear young man. I've wondered about food allergies - another thing is that he really dislikes milk. I DON'T make him drink it, but he does love cheese. I don't think it's Asperger's, but of course, I could be wrong. I know the autism scale is SO broad. Mood disorder - I don't have any idea what that is. Thanks for insight?

[Ottakee]

I would see about getting an appointment with a pediatric psychiatrist now----likely the appointment will be several weeks/months out but at least you would be on the list for an appointment.

 

I personally would likely hold off on the meds until you get back unless you are feeling you are in a crisis situation--sometimes you have to do something quickly.

 

In the meantime, try to write down everything you see---moods, sleep habits (a sleep study might be worthwhile if he is restless or doesn't seem to sleep well), academics, anger, agression, attention span, etc. Just make notes every day and you might see a pattern of things that trigger problems. No matter what, it will help the doctor. NOTHING is too small to mention. You might also record what he eats so you can see if things are better/worse with any different foods.

 

Hope this helps.

[Jamie Z]

Why did you see the Dr. and why did he suggest meds? He sounds very similar to my dd, but my dd doesn't have the scientist, history type focus to her personality. Hers is more of a musical focus. Anyway, it sounds like you are in a groove and maybe would like for him to be a bit more focused but what would be your goal for making the change?

 

I would not make any changes until after you return unless it will be over a month before you travel. Again, though, what is the purpose for making a change--if it is that things have gotten really, really, difficult, you've seen a big change, etc. you might want to weigh that carefully in your decision.

 

Medications....they aren't the big horrible thing that many folks seem to think, or at least they haven't been in my family. However, right now none of my children are taking them, although they have in the past. If your child needs the meds, you usually can see a big difference in the first few weeks (once you get the dosage right) and that helps you decide to keep them on it. If it doesn't make a difference, you stop taking it. However, many, many times, (as they are growing) the medication needs to be adjusted, changed, etc. So, it's not usually a once in life time...."we're going to try meds," and then you are married to it. It just doesn't work that way.

 

Pray about it, weigh the possible results, get some good counsel from those less emotional than you, talk to your husband about it and make your decision. Just because you start him on meds doesn't mean he will always be on meds or that meds are really what he needs.

 

Back to my question.....why did the Dr. recommend meds?

 

Blessings!

Jamie Z.

[WishboneDawn]

 

I really dislike the idea of him being on meds. It just makes me want to cry. I'm afraid of him losing himself. I read about kids going "flat." I don't want that for him. I just want him to be able to reach his potential.

 

I've never heard of the "going flat" in relation to drugs like Concerta. There may well be some who experience that but frankly, Concerta is a drug that stays in the system for only a short time. If you find disturbing side effects there's an easy cure - stop giving him the medication.

 

Honestly, I went on meds for my ADD when I was a teenager and it was a positive experience. I could cut through distractions, stifle impulse, moderate my mood and get on with being me in a way I found very difficult before that. None of my personality or creativity disappeared. I have to say, I think one thing parents often don't put on the balance when making decisions about meds is just how much of a struggle it can be for their kids already. They see and love their child and accept him/her but maybe don't get a chance to see the frustration and difficulty of dealing with things like ADD from the inside.

 

Concerta is low risk but potentially very helpful. Stories of side effects wouldn't merit never trying it for me. I'd simply exercise some caution and keep a close eye on my child to see if anything negative is going on.

[TraceyS/FL]

My DD "tested" on the form the Dev Ped had me fill out SOOOO bad it isn't funny. He indicated she would NEVER be able to sit in a classroom without meds, but she couldn't get them because of her growth disorder, and blah blah blah...

 

The funny part about it is he had NOT read any of her evals - OT, Auditory & Vision - and every. single. one. of his "high points" was explained by another problem she has. Every. Single. ONe. of. Them.

 

I do not believe she is ADHD at all, and thankfully STBXH doesn't either and agrees this child does NOT need meds.

 

I would for sure make an appointment as suggested, and maybe pick up a copy of the OUt of Sync Child to read on that long plane ride.

 

ETA: I want to add, i'm not anti-meds at all, but for this child, they are not what she needs. Heck, even that Dev Ped expressed his SHOCK at how she sat quietly on the table in the room for almost 2 hours. That, "ADHD kids can't normally hold it together that long, even in a medical setting." Get a clue dude and READ her other stuff.... i did not make a behavioral appointment, i made a developmental appt. UGH.

Edited September 16, 2009 by TraceyS/FL

[Cindy in C-ville]

Thanks, ladies. Jamie, GREAT question. For years I have said (to myself and dh) that if he were in a "regular" classroom he would have already been evaluated. Homeschooling has been great for him b/c of the freedom. It's been challenging to figure out how to stimulate his "genius," but also to get him to do the "boring" stuff (math, grammar, Latin, practice his cello, etc.). We've addressed it from the character side of things - growing in self-motivation, doing the hard work first, persevering, impulse control, not getting so easily offended, etc. He is an expert at "stalling" and then just not getting to the work he doesn't want to do. For example, with math (until Life of Fred), it would just take forever until I would tell him to put it away and go on to something else, but then the next day we just wouldn't have progressed any further. As a result, he and his younger brother (by 14 months) are doing ALL the same work this year. It's MUCH better in some ways, but we are concerned that he just is not going to reach his potential. We're concerned that it's more than a character/maturity issue and that if we keep approaching it from this standpoint we're going to really hurt him by expecting more than what he is actually capable of doing.

 

He is a charming, delightful kid a lot of the time. Does this make sense?

[Dobela]

My experience with my son was that when there is chronic stalling, emotional outbursts, and all that, there is something else going on and that it isn't a character issue. Last year I began a quest to find out what that other piece was and our life has changed dramatically-for the better. I only wish I had begun looking sooner when I first started noticing problems.

 

I agree that some of this looks like Aspergers or a mood disorder from my experience. Sometimes even boys have hormonal imbalances. It may just be that he is so worn down from the struggle of learning that he is in a constant state of frustration or even depression from the stress.

 

I have a very intelligent brother who also has autism/aspergers. This part "seems to lack an understanding of social cues, easily can go from "1 to 10" with his temper, and can get into such a funk that it seems there is no way out. " sounds just like my brother at about any age we have documented. Even now in his 30s. At one point he tried ADHD medications and they didn't work. What has worked for him however has been a combination of mood stabilizers and antidepressants. It hasn't cured his lack of understanding of social cues, but it has helped him stabilize his mood and temper to the point that he is on task and pleasant to be with a majority of the time. He has said that he finally feels in control of his body. He takes very small doeses and visits with a psychiatrist/psychologist every 3 months to assess the medications and how he is ding over all. He has had to change specific meds at times due to unwanted side effects, but over all it has been a very positive experience.

[Jamie Z]

Cindy, it does make sense to me. The part about the charming, delightful kid, alot of the time, esp!

 

So, you are wondering if meds will help him focus more and get his work done? And, I'm guessing the Dr. did a simple ADHD assessment and based on that, told you that medication would probably help him?

 

I have friends that say age 12 in boys is usually THE most difficult yr that you have with them. I have other friends that have gone all the way through elementary school without meds and figured out they were essential for middle/high school. I know that probably doesn't help you know what to do, does it?

 

However, if you tried it and it did make a huge difference, wouldn't it be a great solution? Those who gave their input about Concerta are correct, it's in and out of your system--sooo if I was in your shoes, I might be tempted to try it.

 

For the question about Concerta making you flat, let me give an example. My dd has taking ADHD for several yrs. This yr she decided she wanted to try to do school without it (8th grade). Usually, it's the difference between, making A's and making B's and C's. For me, I would rather her make the B's and C's on her own, without the medication because on the meds, she is a bit dryer, a bit less smiley, a bit less of herself. I'm not sure if that makes sense, but I believe it's what those are referring to when they say sometimes it makes children flat. When she started the meds, though, they were essential and really helped her engage in her school work.

 

Now my other daughter, who sounds more like your son, Cindi, has not done as well on stimulant medications, although, they do help her focus. They usually stop working after a while, and sometimes her flatness can be more like a depression. Her ADHD tends to be more on the Autism spectrum than typical ADHD. The meds do help her--but we must keep a very close watch and she sometimes responds better to anti-depressants.

 

So, that's alot said, to just let you know, I'll pray for you. God will give you wisdom. He made you the parent of this precious child and will lead you in the way you should go. I pray that you will feel his peace.

 

Blessings,

Jamie Z.

[Cindy in C-ville]

Thanks, Dobela and Jamie! Your prayers along with your insight mean a lot. Dh and I are both feeling conflicted about starting meds, which I think indicates "wait." We'd like to have some testing done, but I think we'll put it on hold until after we get back from Ukraine. Any other thoughts?

[krystal70]

Cindy,

 

I have 2 boys on Concerta. When we started the olderDS on meds, I cried my eyes out. I was set against it and feared "losing" my wonderful and fun little boy but what I was not thinking about was him and what was best for him. We had tried all kinds of things to help him focus and control his frustration levels but he still chewed his clothes, bit his finger nails, and took hours to do work. We, actually I, finaly gave in and let him try some meds and the impact was astounding! I did not lose my "kid", I actually found a happier one!! He says that it is like he can think now!! As for the weight issue, I had to watch that as well with him but we worked around it for the most part. A lot of fruits and second helpings and never giving him his meds on an empty stomach. He is starting to drink protein shakes with added yogurt and fruit to help him keep his weight up.

 

As for the other comments about the autism spectrum, ODS's anger issues are much better now that his frustration levels are lower due to the meds. That being said though, YDS is on the meds as well but he does have NVLD which is on the spectrum. Once he was on the meds and the other issues were under control (kinda), it was easier to see that something else was going on not related to ADHD. His quick temper, not seeing the social cues, sleeping issues, problems in math and writing, not being able to "get" jokes or to "read between the lines" and so much more led us to keep hunting for an answer. I sometimes wonder if we had not medicated him if we would of just kept blaming all this on ADHD when it was so much more than that.

 

Not saying that you have to do the meds as that is always a personal choice but in these 2 boys it made a huge difference. ODS was able to chill out and YDS was able to get a correct DX.

 

Whatever you choose to do...Good Luck!!

 

http://www.ldonline.org/article/Nonverbal_Learning_Disorders

 

http://www.ldonline.org/indepth/nonverbal

[Cindy in C-ville]

Thank you! I will revisit all of this when we return from Ukraine. I really appreciate all the first-hand accounts!

[TravelingChris]

I have two ADHD children. My oldest refuses to take medicine and claims he doesn't have it and never did. None of the rest of us believe him and all liked him a lot better when he was on medication. He was more thoughtful, kind, generous, and organized on medication. He also was happier when he was medicated properly. He is 20 1/2 so he decides now but I really hope that someday he will realize how much they helped him.

 

My dd16 is more severely ADHD. I haven't had any problems with medicating her for a few years now since she realizes how much the medication helps her. Is she flat on it? I wouldn't call it that. She is more serious and more focused so thereby she isn't silly. WHen the medication wears off, she reverts more to silliness and what I call "verbal diarrhea". Saying phrases she likes over and over-- lines from movies or tv or songs or commercials. They are not the same lines all the time but annoying none the less. She would definitely be far behind in school if she wasn't medicated. She can barely pay any attention if for some reason she missed medication. She eats a lot and is low weight but my youngest was even lower weight much of her life and she never had any ADHD medication since she is not ADHD.

[mchel210]

Im curious if you have tried the Concerta by now?

 

I also was advised to try Concerta. I have to go pick it up today. My son tried Adderall in Elementary and became extremely depressed. Then I was terrified to try any other medications until 4th grade. He started Strattera. Later he developed migraines all the time. I ended up putting him into behavior modification sessions with a psychologist for a year. He got off meds but came home to homeschool for 6th-8th. Now he started back in school last month...and he is doing terrible. The teachers said he cant sit still...he is moving all the time...cant focus. He looses classwork? Hw? etc. I dont even know how you loose classwork in class?

 

Anyways, our dr suggested Concerta since it is longer acting and works very well with older kids. My son just turned 14. He only went back to school because he wants to attend a magnet school next year and he wanted to get back into the swing of a heavy schedule! He is having a horrible time with it. She gave us a mid level dose to start with, something in the 30s, then will raise next month if he has no side effects. I just am terrified to try new meds...but I feel like Im out of options with him. I believe he does need the boost. I do hear tons of positives as well.

 

I was curious as to how your adjustment was and if you even did start it. I realize it has been several months since your post!

[Cindy in C-ville]

We never did start anything. Our life has been so unpredictable with being out of the country to adopt our youngest, Katya, and then adjusting to our "new normal," we didn't feel like it was the right time to evaluate anything. There have just been too many variables. At this point, ds is doing well, but we're open that we may start something in the future.

[WishboneDawn]

I really dislike the idea of him being on meds. It just makes me want to cry. I'm afraid of him losing himself. I read about kids going "flat." I don't want that for him. I just want him to be able to reach his potential.

 

1) Most of these ADD meds leave a person's system very quickly. If you find it does make him "flat" then the cure is easy. Just wait several hours. You can either then stop meds or try different ones. There's simply not a lot of risk involved.

 

2) Your fear may be completely unfounded. It's a little like fearing the drive to the grocery store because you might get in an accident on the way. Possible? Sure. Probable and reasonable? Maybe not. You won't know until you try and even if the absolute worst case scenario occurs and he does lose himself then I refer you back to number one.

 

3) In my experience this idea of a person losing their personality or creativity is the biggest myth surrounding ADD and the reality is often just the opposite. I'm a pretty creative person but it's generally not until I take my ritalin that I have the focus to organize my thoughts into something productive. I have great ideas and intentions but it's generally not until I take my ritalin that I have the discipline to carry through with them. I have a great personality but it's often not until I take my ritalin that it can shine through my frustrations and mood swings.

 

I've said this before but I often find that the one thing parents facing this decision often leave out of the equation is the frustration and pain an ADD kid faces every normal non-medicated day. Every day can be a battle and every failure gives more support to the ideas that a child is forming that they're lazy or stupid or incapable. You're not looking at a kid who's doing fairly well but just might need some help. You're looking at a kid who's floundering and dealing with failures everyday and knowing they have potential but at a complete loss as to how to unlock it. They're not floating and waiting for a life preserver. They're drowning and needing a rescue.

 

I went through all this. Even if I never took meds again it was worth it the first time just so that I could see the fog clear and realize that this wa how other people operated and that was the only difference between them and me. That it was simple chemistry and not character or intelligence. Honestly, the possible benefits are high and the risk is extremely low. I'd tuck away the guilt and fear and give it a try.

[Ottakee]

Dawn has a very good point. A child that is constantly in trouble, having peer/sibling issues, struggling with school work, etc. is hurting. Meds might be a HUGE help. There are risks and benefits to any medication but there are also the risks of NOT using medication when it is indicated.

[Shifra]

We saw our dr. today and he had us take home a survey and indicated that Concerta was probably a good option.

 

Cindy--

 

My husband is a principal of an elementary school (and we have a child who's diagnosed with ADHD), and while I am no expert, my husband specifically said that he would never put a child on ADHD medication if all that it took to diagnose the child was a survey. I agree with the others in the forum, that if I were you, I would probably pursue further testing (preferably with a pediatric neuropsychologist, pediatric psychiatrist or developmental pediatrician) before medicating your son. My son's testing took about 4 hours, just to give you reference.

[Catherine]

I'll echo everything Dawn said-we resisted the idea of meds for years, and when we finally tried them for him almost 1 year ago, it was like a switch going on. He's also very bright, but was so frustrated by academic work-he had little ability to resist distractions, had no ability to plow through anything that was "boring", was oppositional about dumb stuff, the strange palate (seemed to crave very strong taste stimulation)-all of it.

 

He is thriving now, and I am so glad we tried Concerta. I see nothing of the "flattening" at all-he has told me how much Concerta has helped him socially (he was always a bit awkward-more than a bit). He says he can follow conversations and participate, when he couldn't much before, and finds it easier to participate in the give and take of relationships. His relationships with parents and younger sibs are much smoother. I am glad we finally tried it.