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Over medicated? keep changing meds

Need some help with my son with ADHD. His PCP prescribed him Ritalin after failing on Adderall and Stratera. Dose started at 40mg. Increased over about a years time (maily because his attention was lagging and the school was getting concerned as well as at home doing tasks too) to 90mg a day. (60mg am, 30 mg @2pm). This dose worked for his ADHD symptoms. REcently I learned that the max dose is 60mg for most adults let alone a 11 yr old underweight child (under weight because of all the meds) hes 57.3 lbs weighing in today (and yes we do high calorie foods in small portions, whole milk, eggs, carnation instant breakfast 2xa day with ice cream added Im not looking for bashing on his size because I know its an issue and we are working best we can with it at this time) but recently hes been displaying a lot of neurological issues like involuntary movements. many nurse friends i talk to tell me he needs a full work up on neuro and tests and scans. His PCP today told me to just change meds...we changed to concerta 54mg. Is this too high??? if it is what do i do as his mother? He NEEDS the meds. he can not function with tasks without SOMETHING. Can anyone help me?

I have videos of the involuntary movements that he does.

Hello, friendfamily, just a caveat: we are not doctors, and cannot determine for you what dosage is safe or unsafe for your son. Nor can we diagnose neurological conditions. Does your PCP not agree that your son needs further evaluation? Can you get a second opinion?

I know you guys aren't doctors but when I can get some opinions of others who have been there or talked to doctors who have given advice, it helps me. PCP is only one prescribing meds. There is not a psych within 100 miles of me (that has any openings within the next year I should add) that can do an eval and prescribe meds too. His PCP isn't doing anything but keep changing meds. Everything I read online tells me that max dose is 60mg for kids for Ritalin because it can have harmful side effects over that. About 6 mo ago in school he had "seizure like activity. Some head bobbing, never had convulsion but did space out for 10-15 seconds, got white as a ghost and was disoriented. Had an EEG done and came back normal. Doc said BP was low as well as blood sugar and they called it a fainting spell and the blood didnt get back to his brain fast enough and caused the head bobbing. After that the involuntary movements started which is curling of the wrists non stop. whenever his hands are not busy his wrists curl and his fingers move around a lot. This is during play time, bored time, chores, seat work.... all the time. The nurse at school said its neurological and is from too much medicine. Me not being a doctor and doing what the PCP recommends. we keep medicating him because the meds work for his focus.

My son has zero impulse control. I mean, I'm afraid hes going to cross the road without looking to get whatever is on the other side. Like a dash over the road to get a candy bar. He doesn't think before he does anything then has remorse afterwards but does the same thing the next time around without hesitation. No meds are helping that. Three years of counseling hasn't helped either. He just can not control his behaviors. Its been like this for 5 years. He has things like OCD, hes afraid of the grass this year. Deathly afraid. Wont touch it. Meds haven't helped that.

When the pharmacist yesterday was going over the side effects and such with Concerta for me (first time on it) he asked if it was for my son who was with me, he looked at me like I was nuts ofr giving him that high of a dose. Mind you he is 11, 57lbs and probably 55 inches tall. hes small! But the meds have kept him from growing and wanting to eat meals. but we make him anyway because he HAS to.

And no, the pcp says hes fine and does not need any evaluations. I did show him the videos I have and he says meds need changed...

I dont know what to do...

Has he been to a psychiatrist? I think a pcp is okay if ADHD is controlled well, a psychiatrist is the speciaist for this diagnosis.He/she can talk about whether your son needs testing,etc. It becomes too confusing when everyone is giving you advice.

I just read your response about no psych within 100 mi,etc. I’m wondering where you live. I would do whatever it takes to get your son to a psych and/or neurologist.this child needs to see a specialist. You have already gotten too much unspecialized advice. Your son deserves proper treatment & you deserve peace of mind.

I think adhdgrownup is giving good advice. I hope you can get to a psych soon. You can also get some help with the OCD issues.

at the age of 12 I was on 120mg of Concerta on top of respiridone 2mg, they do sometimes put people on high doses, its not unusual, the doctors have a pretty good knowledge of it as all Ritalin based drugs are controlled drugs meaning they're watched closely, if say you run out too quickly the doctors can often get a police investigation going to find out why, they are very careful with it, and if they believed it was too high they wouldn't be able to prescribe the dose.