7yo son newly diagnosed with ADD

iVillage Member
Registered: 11-15-2009
7yo son newly diagnosed with ADD
Sun, 11-15-2009 - 5:31pm
My son has just been diagnosed with ADD and I have some questions. He is a 1st grader, straight A student, but has a horrible time focusing and paying attention in school. We also have been battling this at home for several years, too, and I have been expecting this diagnosis for quite a while. We just started Concerta only a week ago and we have seen amazing results!!! Even his teacher has been thrilled with the results. Now, here is my question. He is taking 18mg of Concerta. Our pediatrician explained to me that there is a trial and error period with the medication in the beginning. He said that although he is going well on 18mg, he could be doing GREAT on a different dose, and we won't know until we try a higher dose. He wants me to try a higher dose and then if we see that the side effects are too much or if the dose isn't right, then we will back off and go back to the 18 and know that that is the right dose for him. I understand this in theory, but I have a very hard time practicing this trial and error with medication on my child. You see, my son also has moderate to severe asthma and takes a ton of other medicine daily, plus weekly allergy shots. I have been assured by his pulmonologist that the Concerta will not interact with the breathing meds, but I still have a problem with pumping more medication into his body as just a trial and error type of thing.

Is this the normal type of treatment with ADD meds? Is it really all trial and error? Since we have the 18mg pills, our ped is suggesting that I go ahead and give him two pills and try that. Well, that would be jumping straight to the 36mg instead of trying the next dose up which would be 27mg. Does that seem right? The 18mg pills seem to be doing great things for us the way they are. He is doing great in school, great at home, and is still able to sleep at night with no problems. I am just so hesitant to fix something that isn't broken. I'd love to hear what the normal protocol is for everybody else.

iVillage Member
Registered: 06-10-2007
Sun, 11-15-2009 - 5:39pm

HI, and welcome!

Yes, sometimes meds are trial and error, but jumping from 18 to 36 mgs is not the way to go and I personally would not make that big of a jump a week into any med. . I would try 27 mgs first, but only if he needs it. You say he is doing well, then stay at 18. You may be one of the lucky ones who finds the right med right off. Some meds work better for some kids, and also for some types of ADHD, and they are trial and error, but every once in a while you get lucky..

I would really suggest seeing a Psychiatrist for meds, since sometimes Peds just don't have enough knowledge about ADHD, or the meds to rx them. I would ask whoever diagnosed and did the testing and evaluation to recommend someone.

A child may HAVE ADHD, but it is not what they ARE. Never tell a child they ARE ADHD.

iVillage Member
Registered: 11-14-2009
Sun, 11-15-2009 - 11:41pm

I agree with the above reply. Definitely stick with a med & dosage if it's working and try to see a child psychiatrist, if possible. There is definitely an advantage there. But I have to say that sometimes changes are needed not just because it's not the right medication, but also because they grow and their metabolisms change. It took us 3 years to find the right meds for my 9 yo DS with ADHD and 2 years for my 11 yo DD with ADD, so try not to get discouraged if things change.

Best of luck to you!!

iVillage Member
Registered: 03-25-2003
Mon, 11-16-2009 - 9:43am

It's definitely trial & error on the meds. But...well, the way *we* did it was move up the meds when the positive effects weren't enough. Started on Concerta 18, lasted there for awhile (9 months?), moved up to 27 (why on *earth* you'd go all the way to 36, I don't know, AND how on earth are you supposed to double-dose on the 18 and have enough to get through the 30 days before you can get a new script?).

Basically, if you & teachers are satisfied with the 18, I'd stick there--but realize that you almost certainly will be increasing the dosage later, as he grows/body gets used to it/whatever it is. And figuring out when is...um...not very fun, and hard, etc. For us, dosing our kid with ADHD is very much a conversation between Dr, us, and our kid (well, now that he's older!).

iVillage Member
Registered: 03-25-2008
Mon, 11-16-2009 - 11:59am

I agree with the other responses. If everyone is thrilled with the results, there is no reason to move up. It certainly can take a lot of trial and error, but if you've lucked out with the right dosage immediately, that's possible, too.

I agree that a psychiatrist is in a better position to be making the medication recommendations. Ours always recommends small increases in dosage and only when the current dosage stops working as well. You're right in that 27 mg. would be the next stop before going up to 36 mg.

Remember, you're in control with the medication situation, so if you disagree, you don't have to increase the dosage. Put your foot down and say this doesn't seem necessary.

Good luck!

iVillage Member
Registered: 11-25-2009
Wed, 11-25-2009 - 8:38am

I agree with everything that has been posted before but it is also possible that he would have responded to a lower dose of Concerta. If he is doing great on the 18mg, I would under NO circumstances increase his dose. I might try him on half a dose to see if he still was doing great. It seems to me that your pediatrician's trial and error procedure only makes sense if the trial included a lower does.

Also, It sounds like your son has primarily inattentive ADHD. There is a bit of medical literature that suggests that this is actually a different disorder from the Hyperactive/Impulsive or the Combined form of ADHD and that these kids respond to a lower dose of the stimulants.

I have the primarily inattentive type of ADHD as does my son. My son was tried on 10mg of long acting Ritalin which he reported gave him a headache. His teacher, who has ADHD, suggested we drop the dose to 1/2 and he did much better.


iVillage Member
Registered: 11-15-2009
Wed, 11-25-2009 - 9:20pm

Thank you so much for all of your replies.