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Please help, any advice on changing from equasym xl to concert xl?
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Please help, any advice on changing from equasym xl to concert xl?

Hi, my 11yrd son was diagnosed with ADHD with emotional and behavioral problems 2 yrs ago. He was on 40mg equasym xl but we are trying concerta xl 36mg to see if its effects last longer. That was 2 weeks ago and all hell is breaking loose here!
The change in his aggression and reasoning is worrying, I've tried speaking to his doctor about dosage but all I got was ' I will send a form for you to fill in and once we get that and speak to his school, he will call?'?!??
I'm not trying to drug my child , he is getting extremely confrontational and I have been hit numerous times. Would it be unreasonable to try to speak to his doctor or am I expecting too much too soon from my adorable boy?
Thank you in advance.
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Avatar_m_tn
   Hope some of the advice helps.  I also almost always suggest buying the book - "The ADD/ ADHD Answer book," by Susan Ashley.   its about 10 bucks on Amazon.  It has a ton of stuff that should help at home and at school.
   Do let us know what happens when the doc finally changes the med.  It may help others!   Best wishes.
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787406_tn?1339206783
I also have a son who is now 27 that has ADHD and bipolar. Have you had him tested for Bi-polar?   ADHD does not cause aggression, bi-polar does.     My son deals with his without meds. He works out with weights every day to give him the adrenaline he needs to bypass the moods and hyperness. I would suggest you get him weights to start out with. My son is now normal in every way as long as he works out.
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2196504_tn?1351395795
Hey, thank you so much for answering.
I have bipolar disorder, rapid cycling since childhood and my eldest has just been diagnosed with bipolar disorder too.
His issues are vast bless him, he also has  Asperger traits.
It has taken since he was 4 to get a diagnosis of ADHD with emotional and behavioral problems, they won't even retest for possible Aspergers as he is. ' too high functioning '
I will wait and see if there is anymore advice heading my way and take it from there.,he is not in a good place at the moment, bless him.
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Avatar_m_tn
   Its hard to read between the lines but it sounds like the equasym xl was working for you, but it didn't last long enough?  Concerta is pretty close to the same med.  Typically doctors start out with a low dose - wait to see how it works - and then adjust the dose.  If you child is acting as he did before he started the equasym xl, I would say that the concerta dose is not strong enough.
   I imagine he wants to speak to the school to try and get a feeling for how your child is doing there.  Like is he ok in the morning and then as the afternoon wears on - he starts getting worse?   Of course, if this behavior is like nothing that you have ever seen before.  Then its a whole different ball game.
   Kind of maddening though that the doc is taking so long.  This is something that he should have expected.
   By the way, I think I have some stuff on the differences between bipolar and ADHD if you are interested.  And I do disagree a bit.  ADHD can cause aggressive behavior.  Its how long the aggression lasts and the triggers of it that make the difference.
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2196504_tn?1351395795
I have been asking myself constantly " did we actually take 20 big steps back"because his behavior is on par to having no medication in his system at all. I for the most part can deal with the hyperactivity., it's the aggression and abusive behavior I have an issue with. Where he cant cope with conflict, he is now actively seeking conflict out even within the couple of friendships he has managed to make and maintain.  I understand that medications can differ. He has been on this new one just over 2 weeks and I am watching what progress he had made with his impulsive nature disappear. I'm not trying to make my life pleasant ( if only)  I'm trying to keep him level and that isn't happening.
And we decided to change medication because his doctor didn't want to add an instant release boost after school. This just feels like a mistake, is 2/3 weeks an acceptable time frame , If the dosage needs looking at? Any replys appreciated, thanks
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2196504_tn?1351395795
I wanted to say ' Thanks ' for your advise earlier and just wanted to clarify something I said, which on reading doesn't quite sound how it meant.
When I said his medication was changed because of his doctors reluctance to prescribe a small dose of instant release medication after school.
What I meant is my son's ADHD wasn't properly undercontrol before the medication switch.  He is very aggressive if he thinks he is being attacked and he unfortunately has impulse and conflict issues too, By the time he gets back from school and with the added fact that the medication has worn off , he is nearly impossible to deal with because he will hit out and he does, regularly!
I didn't want anyone to be under the impression that I WANT him medicated 24/7 because really don't and he does have a therapist he sees weekly, And has done for 3 years now, just wanted to point that out medication
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2196504_tn?1351395795
I wanted to say ' Thanks ' for your advise earlier and just wanted to clarify something I said, which on reading doesn't quite sound how it meant.
When I said his medication was changed because of his doctors reluctance to prescribe a small dose of instant release medication after school.
What I meant is my son's ADHD wasn't properly undercontrol before the medication switch.  He is very aggressive if he thinks he is being attacked and he unfortunately has impulse and conflict issues too, By the time he gets back from school and with the added fact that the medication has worn off , he is nearly impossible to deal with because he will hit out and he does, regularly!
I didn't want anyone to be under the impression that I WANT him medicated 24/7 becausei really don't and he does have a therapist he sees weekly, And has done for 3 years now, just wanted to point that out medication isn't the only thing we doing either. Thanks
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Avatar_m_tn
   Yes, for a stim med, two to three weeks is an acceptable time frame to see if it is working or not.  I believe that you are saying the old med did work while he was in school?  Important to know!
   And no, this is not about making your life more pleasant (although thats a nice side effect).  This is about helping him.
   Hopefully, you have filled out the form and also talked to the school so that they also fill out the info quickly.
   Other thoughts.  See if you can find a good physical release for him when he comes home from school.  He needs to burn energy!  The weather is warmer now.  Hopefully, he can get out and move!
   Finally, glad to hear he is seeing a therapist.  But you also want to be involved with the therapist.  Hopefully, he/she is giving you strategies to work with him when he comes home.  And things to reinforce what is being told him.  Also, if he is seeing the therapist in the afternoon, then the therapist must also have noticed the change you are talking about.  Have the therapist contact the doc and tell the doc to get off his rear and do something.
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2196504_tn?1351395795
All good points you pointed out. What I will say is that people that ' know ' him, have remarked on the very evident change in behaviour. He doesn't always save it up especially for me/home. I . will take your advise, as well as the fact that he is already up and bouncing off the walls and trying to start an argument.  I have no idea why but I do not argue. I listen, I will discuss and I will negotiate but never argue.
Thanks for the advise and for taking the time.
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Avatar_m_tn
   Hope some of the advice helps.  I also almost always suggest buying the book - "The ADD/ ADHD Answer book," by Susan Ashley.   its about 10 bucks on Amazon.  It has a ton of stuff that should help at home and at school.
   Do let us know what happens when the doc finally changes the med.  It may help others!   Best wishes.
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2196504_tn?1351395795
I just wanted to take a moment to thank sandman2 for all the great advice, If I could I would at least 'best answer' 3 of your replys, as it is I chose one by mistak, hense this quick post.
Best advice without judgment that I could ever have hoped for!
Keep up the good work and thank you .
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2196504_tn?1351395795
Just thought I would make one final update to my question, so that hopefully if someone else is looking for advice regarding equasym XL and concerta XL, whether it be making a change from one to the other or the differences that I personally found between how they helped my sons ADHD.
For my son there was no comparison between them, for my son equasym XL is the most beneficial . I am repeating using the term ' my son ' intentionally, beccause if there is one thing  that can be gained from his experience, I would like it to be this.
Medications work differently and individually, even if they are the same type of medication but  a different formulation and release,
what I still can't help but wonder and I guess I will never fully understand why is thisq The dfference between how they helped my son's ADHD was so dramatic,what I canbsay with certainty that the difference in the timed release formulation was obviously a big factor in my son's case.
I found that though my son's ADHD was helped by one medication iit ddn't mean that he would gain any ' benefit' from taking the other.
That should finish this off nicely.
Take care.
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Avatar_m_tn
    It has always amazed me as I have read the posts and researched the meds, how often it really is a trial and error process as to which med works best.  You would think that they have figured it out by now.  But everybody is different and almost every med does work slightly differently.  
  Keep in touch and let us know how things are going.  We all learn from these posts.  And if I can ever be of help - well you know where to find me!
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Avatar_m_tn
I have ADD, and am on 36mg concerta xl. Im 15 and have been taking it scince 11. To help me do better in my exams, the doctor said on exam days I can take 1x36mg and 1x18mg. I tryed 3x36mg. I got high and even though I passed my exam, I got addicted. I now take 3x36mg on every exam day. This probably won't help, but  concerta xl makes you happy and is quite addictive so he probably wants more. If you miss 1 however you become angry and suisidal so you CAN'T miss it. I hope this helps
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Avatar_m_tn
   See my other comments to you.  Hopefully, you have only been taking 3x36 on just exam days.  If so you are showing restraint.  But ya, you gotta stop that.  Among other things you will soon run out of meds and then you are messed up as they won't refill.  
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