QUESTION:
Dear Dr. Heller,
I just heard a radio show that you were on here in Gainesville Sunday June 17th. I was very impressed with your show and I learned some things about ADHD that I did not know. I have a nine year old son who has been diagnosed with ADHD. He was on Ritalin first and then we moved him to Concerta, 18mg. He took the medication for a couple of months. I think the medication worked for a couple of weeks and then just seemed not to work. We went back to see our family physician and he put my son on Concerta, 36mg. I have been scared to give him the medicine, because of all the bad press, as you said in your show.
My question is can I start giving him this medicine now that he has been off of his medicine for a month, or does he need to start back on the 18mg pill. I would really appreciate your help.
Thanks so very much.
ANSWER:
Because the medication leaves the system in a day, if the higher dose is too much,
you'll know, and can lower the dose subsequently. Starting him on 36mg seems a
reasonable course of action based on the 18mg dose no longer being effective.
There are many reasons medications like Concerta "stop working" - and,
inadequate dose is one of them. Interestingly the size of your child has no bearing on how
much medication is necessary (J Am Acad Child Adolesc Psychiatry April 1997: "...the
findings fail to support the practice of titrating methylphenidate on the basis of body
weight in children with ADHD.")
Thank you for your kind comments.
