Expert: Dr Billy Levin - 4/17/2008

Question
Hi Dr. Levin.  My son has been taking Concerta for his ADHD for about 5 years.  I tried all the "all natural" products and diets before giving in to medication.  He is extremely hyper and impulsvie when the medications wears off. Now, he started going through puberty about 8 months ago and I was HOPING he would calm down and maybe not need medicine, but he's still just as hyper and impulsive. I thought maybe the testosterone would relax him. Is ADHD supposed to get better after puberty?  Thanks much,,dara

Answer
Firstly it would be important to understand I can only make comment as I have not examined your son. Please forgive me for being frank, but how do I tell you what you need to know but hide the truth?
  Trying natural products do not work, and neither does the diet. You have not been given insight into this condition thus the questions you ask are very relevant but the answers  should be part of the training and insight to doctor gives you when prescribing.
    When the medication wears off he must be hyperactive. The medication controls, it does not cure. Testosterone makes them worse, not better! After puberty there might be a little improvement in the next few years, but  not months. Some  severe ADHD patients might need medication life-long unfortunately. Some mature and eventually  do not need medication. He obviously still need his medication.
        Concerta works well only if the dose is optimal. What dose is he getting and how was it established what works best for him?  It is also essential to take medication every day, week-ends included.