Behavior change w/ ADHD meds

DS(9) has been on ADHD meds since he was 6. He is currently on 27 mg of Concerta (generic). Around kindergarten I feel like he became more withdrawn around others. In pre-school he was outgoing and had a lot of friends. He still has friends but he will rarely talk to adults and he absolutely never volunteers for anything in class, parties, etc. He also seems very irritable in the evenings (I assume the meds are wearing off). If you ask him to do something and he doesn't want to do it he has a complete melt-down and if you threaten to punish him sometimes he gets very angry and will sometimes cry and then throw stuff, etc.

I feel like it's the ADHD meds that are making him this way but DH thinks it's just his age and that he is testing us, etc. It's such a double-edged sword because without the meds he would never be doing so well in school but I feel like he is sad or unhappy a lot of the time. Maybe it's the Concerta and we should try a different medication? I know we did Tenex and Strattera in the beginning and they didn't work as well at helping him focus in school. Has anyone with kids on Concerta noticed a change in their kid's personality? What ADHD meds should we consider switching too?

I don't have a lot of experience with the school age group for ADHD, but will soon.

However, my DH suffers from ADHD and has taken something for most of our married and his adult life. He currently takes Vyvanse, but did take Concerta for awhile. He was having problems like you describe with the meds wearing off and his PsyNP prescribed him a low dose of Ritalin to take around 2 pm in the afternoon to ease the let down from the long-acting product.

HTH

My younger DD takes 27 mg of Concerta. There is often a "rebound" effect in the afternoons when it wears off. But I have not noticed her being withdrawn.

Taking an afternoon booster of 5 mg short acting methylphenidate definitely helps and there is less of a rebound when that wears off. We don't do it daily because the Concerta really suppresses her appetite. So we like for the Concerta to be worn off by dinner time. But I will say that the booster at 3 definitely makes for a much smoother evening!

If you think that stimulants work better, you may want to talk to the doctor about trying Vyvanse or Adderall, one of the dexamphetamine class of ADHD stimulants vs. the methylphenidate class.

My DD1 is has ADHD and the medications definitely make her more withdrawn. She was on Vyvanse for a while, until we realized it was making her very withdrawn and increasing her anxiety levels. We switched to Focalin XR recently, because we knew from prior experience that it would not affect her personality as much. Her personality is definitely more muted on medications, but some are worse than others. DD2 also takes Focalin, but the meds do not seem to have the same effect on her. Also, the higher the dose, the more evident the effect on DD1s personality. We've been happy with Focalin XR. The only issue we've had is that it affects DD1s appetite and that it seem to loose effectiveness after a couple of years, which is why we switched to Vyvanse, after trying several meds out.