Pre Teen Is Able To Stop Using 54mg of Concerta!

Posted on January 5 2010

Written by Brad Oostindie, MA, LLP

Gary (not his real name) is a 12 year old who had been taking Concerta (a common stimulant medication) for a number of years to address his problems with focus and distraction.  Over time his dosage was increased to 54mg per day, which is considered a high dose of this type of medication.  Prior to taking this medication he experienced problems with sustaining focus, distraction, and difficulties related to completing homework and other academic difficulties. Even with taking the medication he had difficulties with completing homework, sustaining attention and focus on tasks, and impulsivity. 

When assessed at Ready To Focus, it was found that he did indeed have a slow wave dysregulation.  Individuals with slow wave issues tend to have problems sustaining focus and with distraction and also tend to respond well to stimulant medication as the medication tends to help the brain activate (i.e. Get out of its slow wave pattern). Unfortunately, the assessment also showed that even though he was taking the medication, his performance on neuropsychological tests measuring sustained focus and distraction was still in a range considered impaired.    He started a home-based biofeedback/neurofeedback program following a researched training regimen used all over the world in neurofeedback treatment centers for this slow wave dysregulation. 

After approximately 20 hours of training (while on his 54 mg of medication) we observed his neuropsychological testing improve from impaired to the average range.  At that point his parents decreased his medication to 36 mg and he completed another 10-15 hours of treatment.  When retested at the 35 hour mark of total training (at 36mg) his scores remained in the average range.  The medication was again reduced to 18 mg for another 5-10 hours of training and he was retested.  Again – the results showed scores in the average range.  At that point the big step was taken to eliminate all medication and train for another 5-10 hours before retesting.  The last retesting showed attention scores in the above normal range, and distraction scores in the low average range.  So, after approximately 45 hours of training Gary was off from the stimulant medication entirely, and scoring better on the neuropsychological tests than he was while on it. 

Subjectively, during that time Gary (who had completed the first 3-4 months of school while doing all this) was doing his homework unassisted every night.  Typically both he and his mother would have to do homework every night together – a 1-2 hour process each night.  Also, he obtained higher academic scores/grades than in years past. 

Because of the fact his distraction scores remained lower than what we would like them to be, we will have Gary continuing on an office-based once a week training schedule for the next month or two (also called “maintenance therapy”).  The goal is to help him maintain his gains, improve the distraction piece even more, and make sure the gains stick.  Research shows that approximately 80% of those who benefit from biofeedback/neurofeedback (minimum 20 hours training) maintain the gains in the one, two, three, and five year follow up studies.  Because of how far he has come, and the areas yet to improve, we will do the maintenance therapy to make sure there is no regression. 

Update (February 3, 2010):  After one month of maintenance therapy (one neurofeedback session per week) and no medication Gary did indeed show some regression.  We responded to this by restarting 18 mg of Concerta and doing one more month of the home based program.  He has quickly responded to this and is back on track.  We plan on continuing neurofeedback training on the 18mg for a few weeks, then training off the medication entirely for a few weeks to see if we can have complete success with getting him off the medication entirely!   

CATEGORIES

LATEST POSTS

SUBSCRIBE