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    ADHD, meds and counselling
    mommyiam1 posted:
    My nephew is almost severe ADHD as well as has been abused in his early life. He has some anger issues. They put him on Concerta with a generic ritalin. Since he has been on the concerta he ahs become somewhat violent and trhows things at his mother and other kids as weel as hitting anyone he can get to. Is this the concerta or is their another issue? His psychologist is out of town and my sister cannot get into someone else till he returns. Has anyone experienced this side effect or have any help for us.
    Boyzmomee responded:
    This is something for a physican to answer.

    Since psychologists can't prescribe medications, contact the physician who is, either the psychiatrist or primary.

    If the physcian is out of town, they usually have someone covering for them while they are gone.

    Hopefully Dr. Quinn will see this and be able to help.

    How long has he been on the meds? Is this something new?
    mommyiam1 replied to Boyzmomee's response:
    He's been on meds for about a year. My sister ahs been fighting for them because she a hs medicaid and so does my nephew. But he is now 6 yrs old, so hopefully they can do something. Thank you for your help.
    Gina Pera responded:
    Hi there,

    I'm sorry to hear of your nephew's situation.

    I wish there was a simple answer. ADHD, however, is not the simple condition it's often made out to be.

    When you say he's taking Concerta with a generic Ritalin, do you mean he takes the Ritalin at night, after the Concerta wears off?

    What dosage of Concerta is he taking? Was he started on a very low dose and gradually increased with careful observation about whether his symptoms were getting worse or better?

    Is he better while the Concerta is in effect and his anger comes through after the generic Ritalin kicks in? Or is the anger present throughout the day?

    These are questions that would inform a helpful answer.

    Meanwhile, I would point to some potential problems, based on ADHD treatment in general:

    1. ADHD often comes with "traveling companions," such as anxiety and depression. In some people, anxiety and depression manifest as irritability and anger.

    Sometimes the anxiety/depression is secondary to the ADHD itself (that is, a reaction to untreated ADHD challenges). Therefore, when the person with ADHD receives appropriate treatment and ADHD symptoms lesson, the depression and anxiety can decrease.

    Other times, the depression/anxiety is just part of that person's biochemical nature. In these cases, treating a person's ADHD with a stimulant without addressing the depression/anxiety (perhaps with an anti-depresant) can worsen irritability, sleeplessness, etc.

    2. ADHD often creates emotional dysregulation, meaning the person can get angry very quickly -- and just as quickly find something very funny and forget what they were angry about.

    3. Immediate-release Ritalin is known to create, in some people, a "Ritalin Roller Coaster," where behavior is worse than baseline after the medication wears off. For some, the generic Ritalin is even worse, especially if they react badly to the various binders, fillers, and colorants.
    mommyiam1 replied to Gina Pera's response:
    He takes the ritalin during the day, and has asleep medicine, but I'm not sure what it is, and the concerta is taken at night. He was started on a slightly higher dosage of concerta but is down a bit, i think he's on 10 mg He is better after the concerta wears off. He hasn'r been aggressive as much until he was put on the concerta. He is alos currently taking Depakote as well. My sister has an appointment with his counsellor tomorrow. He does have some anger issues as well. They are being dealt with. Thank you for your help.

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