15 year old starting Concerta - his observations

[verona]

Hi, My son was diagnosed with ADHD-inattentive when he was 11 years old. He took medication (Concerta) during grade 6 and grade 7, but stopped since we didn't see a big improvement and he suffered from loss of appetite.

He is very bright but has been struggling at school. His grades last year (grade 9) weren't very good. He decided that he wanted to try medication again to see if it would help him - he says that he can't pay attention to lessons at school even if he tries to concentrate.

So he has been on Concerta for a few weeks now (started at 36 mg and now he is at 45 mg). He told me today (after a session with a math tutor) that on the medication he can't think about multiple things at once, whereas normally he can. He doesn't like how "his brain feels" and thinks that he will not be able to do complex tasks as well as off the medication.

Does anyone have experience with something like that? I've heard of kids feeling "flat" if the dosage is too high, but that isn't really what he is describing.

Thanks for any input.

[healthy11]

Hi. When your son says that "on the medication he can't think about multiple things at once," I can't help but wonder if he's really describing being able to focus for the first time? And when he thinks he won't be able to do complex tasks as well, I wonder if he really means he doesn't feel as "creative?" He may imagine he's a good multitasker, but since you've said his grades last year weren't very good, it seems like he probably wasn't doing complex tasks all that well, anyway.

Although my son has been taking Adderall for his ADHD rather than Concerta, he initially didn't like the way medication affected his thought process, either. He basically said that he couldn't switch from one thing to the next as easily, so he thought that was boring, and he didn't think he was as much fun to be around. I have read articles over the years that say people with ADHD may be more "outside the box" (aka, creative) thinkers, but when ADHD people take medications I'm not sure if they lose the creativity so much as increase in their focus. www.psychologytoday.com/blog/here-there-and-everywhere/201106/is-the-adhd-brain-more-creative

Since schools tend to require less "creative" effort than focus, I suspect it would be beneficial for your son to at least wait until the first grading period before judging if the medication is hampering or helping him.

[Mayleng]

I agree with Healthy. My son always feels that way when he is on medication, he is 19 and has been on Metadate CD since he was 6. Your son is probably able to focus on one thing at a time instead of his brain going all over the place. I would suggest he not give up too easily and give it time. He will get used to he feeling. My son does not use his meds on weekends or holidays. He will be starting his second year of college at the end of the month. He would not have survived school if not for his medication.

[michellea]

Ditto healthy and mayleng - My son has been on Concerta since age 8 he is now 18. There have been times in his recent past that he decided not to take his meds (long drives, homework on a Sunday, Archery tournament). When he reflects back, he realizes that he is more focused and better skilled on meds. Yes, he is less spontaneous. But that also means that he stays on topic and is able to use routines and strategies for academic and leisure tasks.

I wonder if your son is just not accustomed to zeroing in on one thing at a time? As others have said - multi-tasking is a big myth. Usually it means jumping from one thing to another and not fully immersing oneself in a task - usually resulting in a haphazard approach and less than optimal outcome.

That said - at one point we increased my son's dosage and he was indeed "FLAT". Extremely quiet, almost zombie like. And when the meds wore off, he felt very cranky - not typical for him. When you son was on the 36, was his affect different than on the 45? 45 is not a super high dose for a high schooler - but everyone is different. What have you observed?

I just read this article regarding ADHD that I think may be helpful for both of you: www.additudemag.com/slideshow/28/slide-1.html

Best of luck!

[verona]

Thanks everyone for this input. He is ready to continue with the medication and see how things go at school (starts Monday!). The good news is that he starting to realize that his grades are important and wants to do better (this is new).

Neither he nor I have noticed a difference between the 36 and 45 mg dosage. He has a doctor's appt in mid-September to evaluate whether he should try a higher dose.

In terms of behaviour, affect, focus, etc, I haven't noticed any major difference since he started the medication, although I see him mostly in the evening when it has probably mostly worn off. He has always been good at hyperfocusing on things of interest (used to be reading and some academic tasks, now mostly computer related activities) but has very poor organization. He has a lot of trouble switching from one task to another and seems to get distracted listening to instructions (and so misses important information at school).

He told me he feels like he can't hold as many things in his mind at the same time on the medication (sounds a bit like working memory?), but as you all have said, maybe he just isn't used to being more focussed.

Thanks again for your input and also the helpful article.