Expert: Dr Billy Levin - 6/9/2007

Question
Dear Sir,my daughter was born with learning disabilities and was a good student until grade 2. Her teacher said she wasn't paying attention in class. The she was having problems in math. I discussed this with her pediatrician who sent me to see psychologist. In our town she was very well known and suppose to be a expert in her field. I told her what the teacher has said about my daughter and then the Dr gave me a prescription for concerta 36mg and 18mg.She ended up taking 36mg instead of 54mg.I noticed that my child grades were not getting any better, she couldn't remember directions, disorganized, real forgetful and depressed.that was in 1999 and in 2005 I weaned her off of it.After being off of it she was having migraines and in school she couldn't comprehend what she was reading and in math she added when she should subtract. I had the school test her twice and they said she could do the school work even though it took hours to do homework.In 2006 I had her tested for auditory processing that was normal so then there was a new test which was done by an EEG if she had ADD her brain waves would pick it up. Well EEG was normal she didn't have ADD. I have heard that if you have ADD it never goes away. So my child took concerta for 5 1/2 years and didn't have it. What effect does it have on brain. What should I be looking for?

Answer
Unfortunately nothing you have told me makes any scientific medical sense. Psychologists cannot really diagnose a medical condition like ADD, only a doctor trained in this discipline. Concerta is Methylphenidate, which is an antidepressant and cannot cause depression. The dose of Methylphenidate is usually evaluated by titrating the short acting Methylphenidate to optimal dose and then only switching to the long acting  appropriate dose of Concerta. If the dose was established by guessing instead of monitoring ,it might not have been the optimal dose and could not work.Were rating scales ever used to establish to correct dose?r Your description is absolutely typical e of ADD. As a non trained medical person it would be very unacceptable for you meddle with the medical treatment preccribed by a doctor. It is never neccessary to wean anybody off Concerta. You just simply stop it.  Her symptoms are all of an auditory nature which is very much part of ADD including her slow pace at completing her work. So how the test showed no auditory processing problem is quite unacceptable! A EEG has no possible scientific way of assessing ADHD or ADD.You have been fed  with misinformation. Medication is not the cause of migraine, as it is a genetic syndrome caused by certain foods. You have once again been given misinformation about ADHD. It sometimes goes with maturity and sometimes not. Why did your doctor not inform you there are NO long term side effects to the use of Methylphenidate whatsoever. I will suggest firstly, does your daughter, who more than likely has ADD, still have a problem. If so have her assessed by a medical expert. My next suggestion is to you the parent. Speak to sombody who is an expert who will give you the facts and even after that read one of the recognised expert's book. My last suggestion is if you need more information contact me on <adders.org> on the forum "ask the expert". Conclusion: you should be looking for true facts and expertise. Without actually examining your daughter I can only make suggestions and comments, not advise.