Part 2: Lillian's Journey With ADHD And Concerta

Now that Lillian is on  Concerta for her ADHD, here are some suggestions that were told to us, so I thought I would share some information on  managing stimulants medication in children.

Firstly, Methylphenidate (Concerta) belongs to a group of medications called stimulants. It is used to treat attention deficit hyperactivity disorder ADHD.

How does Methylphenidate work?

It works by increasing the activity of the brain chemicals (neurotransmitters) called dopamine, and to a lesser extent, norepinephrine. This medication activates areas of the brain that control impulsive actions, attention and body movements, thereby improving symptoms of ADHD.

How well does Methylphenidate work in children?

Methylphenidate does not cure ADHD. It aims to improve functioning by reducing core ADHD symptoms such as the inability to pay attention, impulsive behaviour, and hyperactivity. It can also help them tolerate frustration better and improve social and peer relationships. Overall functioning can improve substantially.

Managing appetite:

Stimulant medication strongly lowers appetite. So this is the best way to tell your child....hey do you know that the medicine plays a trick on your brain? It makes you think you are not hungry, but your body really is. If you don't feed it, you might get a headache, stomach ache, feel cranky and tired, so it's really important to eat. If you get a headache or stomach ache first thing you should do is eat or drink something. While starting treatment with a stimulant medication, some children will lose weight. So make sure you weigh your child on a regular basis and keep a close eye on it.

Managing sleep:

ADHD is associated with an increased risk for sleep difficulties, children with ADHD are much more likely to have difficulty turning their thoughts off and falling asleep. They may be more tired during the day even when they are active, and they may experience "restless legs syndrome" which is a feeling of needing to move the legs before sleeping.  Screen activities like watching television, playing on the DS, or computer games etc., should not take place after supper/tea. They are a source of bright light which suppresses melatonin, the natural hormone that produces sleepiness normally. ADHD children often have difficulty falling asleep and have a 90 minutes delay in the release of melatonin. gaming in particular tends to "rev" up the brain and has an addictive quality for many ADHD children, which not only makes it hard to turn the game off, but leaves the child highly alert and resistant to going to bed, so remove all electronics from your child/children at night.

General considerations:

Stimulant medication is usually started off in a low dose and increased slowly each week, which then results in a dose right for them. If your child is doing fine and having no response and no side effects normally the doctor will increase the dosage. If you get a dose in which your child is responding but also the side effects are causing significant problems, the doctor will either inform you that your child should stay at that dose until the side effect abates or lowers the dose.


So as for Lillian, she is having some decreased appetite and sleeping arrangements have some what changed as I have noticed it takes her longer to drop off. I have allowed her to gaze more during the day now, as her eating habits have never been great from day dot, and thus allow her to have a snack before bedtime, such as a few biscuits or even a packet of crisps/chips.


I hope I have been of some help to you out there with children or adolescents with ADHD

April