Am I giving my child the right medication?

[dayle]

My 6 year son is on 18mg concerta for his ADHD.  I would say that he is more of the HD of ADHD, very Impulsive. He has no issues with his school work. But from a social perspective he is that labled kid. As he can not control is impulsivity. He has been on the meds for almost 6 months and I feel that they are not working anymore. the first month was a dream, but now its like they have worn off. Is this the time where I increase his dose? I'm so unsure of what to do. I have his teacher telling me that maybe its more of a sensory thing and that he needs deep pressure OT, and on the other hand I have friends telling me "oh he is just a 6 year old boy, leave him be"  I do not know what to do, but all I know is that he has no friends because he is the naughty kid.  

[Mayleng]

What dosage is he on?

[healthy11]

Dayle, let me welcome you to Millermom's forum. I also have a son with ADHD, and his hyperactivity definitely caused more problems when he was in early elementary school than it causes now that he's 20-something. You can read about my son's story here: millermom.proboards.com/thread/13329/future-teacher-parent-interview

Is your son in kindergarten or 1st grade? Is he attending a public school? Do you mind if I ask whether he's "big for his age" in either height and weight? (Stimulant dosages seem less dependent on body size than other meds, but if he's had/having a growth spurt, it could make a difference.) If I understand correctly, your son started on 18 mg. Concerta, and has remained on the same dosage for 6 months, but it's no longer effective. Have you been getting it from the same pharmacy the entire time, or did you perhaps get a 30-day supply of Brand-name Concerta to start with, and since then, it's been filled with a generic? There have been concerns raised about the effectiveness of generics, and not all generics are even the same...one might work effectively, another brand of generic not: www.fda.gov/Drugs/DrugSafety/ucm

Who diagnosed him with ADHD and prescribed your son's medication? (His regular pediatrician, or a child psychiatrist, or ?) If you don't have a regular follow-up appointment scheduled soon, I would definitely call and explain what you've been seeing in your son's case. Maybe they'll recommend that you try a different dosage, or even a different medication entirely.

[dayle]

Thank you so much for the Welcome. I live in South Africa, so He is in Grade R with is probably the equivalent to kindergarten. He starts grade 1 next year. He attends a preschool here in Durban and there are probably about 25 kids in his class. I would not say he is big for his age, he is quite tall, 1.24 meters tall and weighs about 22 kg's. We took my son to a paediatrician in Feb of this year. He has a small assessment done. But the writing is on the wall, its very clear of the impulsiveness. The Dr prescribed Concerta 18mg. You see, my daughter (8 years old) is currently on 30 mg of Ritalin LA as she is ADD. Was diagnosed in November 2015. So we had played around with meds until we found the correct one for her. So I had tried my son on Ritalin left overs that we had from my daughter) before we saw the Dr. Ritalin was not the correct meds for him as , as his mood when the meds wore off was needles to say not very nice. He could not control his emotions. Anyway so we told the Doctor all of this and he suggested Concerta. So to cut a long story short, I am now in a situation where I think I need to try the 27mg concerta as it almost looks like the meds he is currently on are not touching sides. His outbursts in class are becoming in tolerable and the negativity surrounding him because of that is awful.

[Mayleng]

It takes a while to find the correct dosage and the right medication. I would suggest you give 27mgs a try, it is still at the lower end of the dosage. If you find that Concerta is not the right medication, give Metadate CD a try (if you can get it in South Afrida). My son has been on that since he was 6 yrs old and he is now 20 yrs old and in college. Healthy's son was/is on Adderall, my son was not able to take it as it made him angry and moody. Don't be afraid to try various dosages and medication till you find the right one. Hang in there.

[healthy11]

Dayle,
I've been a moderator of Millermom forum for a many years, and we've had members from various English-speaking countries worldwide, but I'm not sure if anyone has said they're from South Africa before. As I mentioned, everyone is welcome, it just might mean that some of the educational "legal" advice won't apply to you. (Especially regarding IEP's, which are Individual Education Plans that public schools in the U.S. are supposed to follow, for children who have disabilities.) Do schools in South Africa have any kind of "formal documentation" that can be used to inform teachers about a child's special needs, and suggest accommodations that will allow the student to do better in the classroom? For example, see www.additudemag.com/slideshow/5/slide-1.html

How long is your son in school for Grade R? (In the U.S., some preschool/kindergarten programs are only half-day, while others operate on the same schedule as older students.) I would imagine that your son's Grade R class has time to go out on the playground every day and run around, to "burn off some energy," but as he gets older, each Grade will spend more time on academic subjects (language, maths, etc.) and have less time for recess, which could make it even more difficult for him, since he doesn't like sitting still. Studies show that exercise is especially important for children with ADHD: www.sciencedaily.com/releases/2016/05/160502131413.htm

It sounds like you're already "on the right track" by doing research and asking questions, not to mention having another older child with attentional issues. Your children are fortunate to have you for their mother!