Gifted Issues Discussion homepage Forums Twice Exceptional Starting Concerta

Hi there

my son started Ritalin, and then went on to Concerta. He now has one short acting 10 mg Ritalin at the same time as a 18mg Concerta. This combination has been effective in reducing his impulsive behaviour, however is appears he still has very impulsive thoughts. He is also a bit more teary than normal. We go back to the doctor on January 10. Just wondering, did anyone out there notice similar symptoms with their child, and did it help when they increased the Concerta? Is it true that gifted kids need higher dosages of Concerta due to having more neurons in their brain? Looking forward to your responses

Astroboy concerta releases 22% of the total dose fairly immediately (in the coating) and then trickles the rest of the dose through the day, theoretically maintaining that initial dose. So 18mg concerta is theoretically 4mg maintained for 12 hrs. It is quite a low dose. Every child is different but I find my DD is more teary/moody on too low a dose but doesn't eat or sleep on too high a dose and gets a bit too speedy/obsessive/odd. The day we tried her on Ritalin LA 30, which is actually two doses of 15mg, she counted every green street sign coming home (400 and something) and then decided to measure the largest room in the house, counting out every cm as she went. Neither of which is at all normal behaviour for her). It's been tricky for us finding the right dose but every time we've tried no meds it is immediately apparent how much better she is on than off.

A friend's daughter was on another version of methylphenidate (Biphenton) and she too was more emotional. It really helped her for awhile and then she outgrew it. Increased doses interfered with her sleep (even with melatonin). They switch to Strattera which seems to be working well.

It is interesting. Some days he is fine, but other days he isn't. Today he was fantastic. No issues at all! It was brilliant. We went shopping like a 'normal' family! I love those days. He did not run off. We had long detailed conversations. He randomly stopped strangers at the shops to have conversations with them about Christmas, etc. It was awesome. The psychiatrist did say that we may need to double the dose, so we will see what happens then. So far, apart from the emotional issues, his only other issue appears to be appetite during the day. However, if I get get a big hot breakfast into him in the morning then all is okay. We have just switched our meals around, so we have dinner in the morning, and breakfast at night.

Astroboy - try a smoothie with protien powder and flax oil at lunch.

Also consider the possibility that something else is causing the variability - for us our DD needs BOTH the RPAH elimination diet and medication. Intolerance doesn't work like alergy, it's a load issue and causes very variable and hard to recognise patterns that you will likely not think have anything to do with food.

This works for my DS8 - whey isolate powder, milk, banana, vit. D drop. (He gets his omegas at breakfast). I send the shake in his school lunch. All of his desk wiggles have disappeared... now the only piece of his combined type ADHD that shows at school is the inattentive.

(Fyi, remember the kidneys though - too much protein is bad, so track and measure any supplements...)

We use pure egg white albumen as our DD is GF/CF, also we put the oil in to make sure she gets some fat at lunch as well as protien and carbs.... She gets the equivalent of 1-1.5 eggs in her lunch, which is what we'd like her to have and is all she can tolerate before it tastes bad (the pure egg protien has no colours or flavours).

I like that idea... I hadn't thought of egg protein. DS seems ok with the whey, but I might try the egg. Where do you get it? (I've never seen it in the store - mind you, I've never looked for it).

I am in Australia, so not too much help to you, but it's not in stores here, I had to Internet order from a body building store. I imagine it might be the same for you? Google pure egg albumen.

I'll do that... thanks. DS loves eggs and I worry about the cholesterol, but I've never seen a supplement that's just the protein. Will google