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Concerta -- if you or your teen has been on it, tell me about it.


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If you've been on Concerta, or your teen has been, can you tell me about it's progression -- the bad, the ugly, the good? About how long did it take to find the effective dosage? What were the typical side effects and for how long did they last?



DD16 was prescribed this medication today by her ADHD specialist. She isn't new to ADHD, and was first dx'd in second grade around age 7, but it was previously handled (and badly) by GPs who simply prescribed her down a list -- first adderall, then vyvannse, etc. The running theme, obviously, was that they tended to defer to the amphets. The ADHD specialist is the only one in our region, that I'm aware of, in private practice and I am already a patient of theirs (two doctors -- one for children / students; one for adults), but I'm on Evekeo, which is an amp mix. 


I know Concerta is also a stimulant, and we're obviously well versed in dealing with the amphets, but this is our first ride with a stimulant medication that isn't amphetamine or a an amp mix. (She's also done a few rounds on non-stimulant ADHD medication, none of which ended well at all, so we definitely preference stimulants.) 


She hasn't been medicated in a few years, though. She went off Vyvannse at the peak of puberty when, for some reason (hormones are my guess), her previously tried-and-true medication did a 180 and she started having bad thoughts and incredible mood swings. They tried switching her back to her (again tried-and-true) adderall, but it had the same effect. Hormone interference was the presumed reason for the shift, because she'd been on these two medications back and forth for many years previous with no such issues, and when taken off the medications she was in a much better place, emotionally.


With that said, although she hasn't been medicated in years, her ADHD definitely has not been "handled." She was just too terrified to try medication again -- until we found these doctors. Their diagnostics, evaluations, and interviews go far above and beyond any she's had with regular GPs; they preference a much slower and steadier method of titrating dosages, and they will see her frequently (every couple of weeks, at least) until she finds the correct dosage or medication. 


In the mean time, she had her first dose of Concerta this afternoon and seems sluggish and is complaining of a headache. I know it took a few weeks on my Evekeo for the major side effects to kind of leave off. I know it wasn't a pretty few weeks when we were finding my preferred dosage, so I'm trying to be encouraging -- but she's discouraged. She didn't really have "start-up side effects" when she was younger, with her medications -- it was just a matter of finding the optimal dosage. 

We were encouraged to give the Concerta a fair shot for a few weeks, but the doctor is absolutely willing to move her to a different medication. And, considering her age, Vyvannse and adderall aren't off the table (if it was puberty mixing with the medications causing the issue, that shouldn't be a huge problem now).


Anyway, what was your experience with Concerta? 

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Not a teen, but my SN child tried Concerta because that's on the Medicaid formulary and Metadate isn't. They're supposedly the same drug but for whatever reason Concerta led to rebound issues (irritability mostly) after it wore off while Metadate doesn't. We tried to get a treatment waiver for Metadate rather than Concerta. However, after multiple attempts disappeared into a black hole at Medi-Cal, gave up and just pay the co-pay out-of-pocket.


Vyvanse we tried earlier this fall but it made the anxiety issues we were dealing with significantly worse. So we went back to Metadate and then added Zoloft for anxiety.

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