My 6yr olds last doctor put him on rispadol n it was awful!! I only gave him a 1/2 a pill to start out on and it was like putting 100 ADHD kids into my son. I stopped giving it after that. Now we have a new doctor that is awesome n my son loves her, she started him on adderall xr 10mg which wore off to quick because of his weight. So now we have adjusted his meds and he's now on 15mg of adderall in the morning n 15mg in the afternoon n it has made a world of difference. And at bedtime he takes 2mg of Clonidine. Good luck

No, it takes about an hour to reach the blood, depending on the individual. It doesn't need time to build up in the blood system.
It lasts from  8-12 hours (again depending on her particular metabolism, with my son, it only lasts about 8-10 hours) so it should be out of her system by bedtime.  It is one common complaint with Concerta that it doesn't last until bedtime.  We use an afternoon dose of Ritalin if he needs it.

What dose of Ritalin was she on? How many times a day?

Everything I've read on proper dosages of methylphenidate, which includes Ritalin and Concerta, is that if the child is 'zombie'-like, the dose is too high.  

It is *not* a normal side effect and I wouldn't give another dose at that strength.

My two are completely themselves, goofy, happy, etc.  My son has a noticeable change around mid-afternoon, when the Concerta wears off.  He also sleeps better than when we don't give it to him.  Usually.

I would definitely take her back in and have the dosage adjusted. If Ritalin was working, theoretically Concerta should too, but the dosage can be different than what is expected. The lowest dose is 18mg, so I would maybe ask to start there.

What is the timeline for all these med changes?

If they are not giving each change a couple of weeks -at least- before making another change, you are not going to know which med caused what side effect.

She may very well need to come off all meds so that a baseline can be established.

The most impairing symptoms should be treated first. If she has really high anxiety, that should usually be treated before any attention/impulsivity is treated. Some anti-anxiety meds can take a month or more to reach their optimum potency in the blood. Then you might increase or decrease.

The point is to start with one medication. Watch for side effects over a couple of weeks (at least-sometimes longer as I mentioned).
Increase or decrease dosage if needed.
Then, when that medication is stable an doing its job, *then* start another medication if needed. Same thing. Watch for side effects over a couple of weeks. Adjust dosage.

Finding the right medication combo can be challenging, but it should also take a good amount of time to get the right combination.

It is possible that the Concerta wears off in the afternoon which could be why she is different at home. Although most people say their kids become more hyper and aggressive during this time.
It makes me wonder if something is happening at school to trigger the behaviour as well. It may not be *all* about the medication.

Who is prescribing them? If not a pediatric psychiatrist, or someone extremely experienced with complicated children, I recommend finding one.

my 6yr gd was on several things... they changed the Ritalin to Concerta... but she was also taking Risperdol... they decided to take her off the risperdol.... I'm wondering if taking her off it completely was the problem.... yesterday she either had a tantrum or meltdown... we aren't sure which.... and she started throwing things.....they put her in the break room.... she starts taking her clothes off.... and peed on the carpet(it breaks my heart to even write this- cause this is NOT her).... they called my daughter..... in the mean time... she is buck naked in the room until my daughter gets there.... she has horrible aggression in the afternoon - around 1pm.... does coming off risperdol.... cause problems like this? she is now on Concerta and Sertaline.....we have always felt that she had anxiety problems with school.... none of this happens at home..... it breaks our heart that she has been on soooooo many meds to try to help her.... HELP anyone?

My 6yr gd was on Ritalin and Riserdal..... changed to 27mg of Concerta..... having a horrible time getting the pill down her.... but she had her first pill yesterday.... she acted like a zombie.... talked very softly, noise bothered her....the Ritalin Sr was doing the same..... do things even out after awhile? She was having aggression.... then lately at school did not want to be with her class, got to recess, pe, or even eat in the cafeteria.... makes me think the noise sensory is an issue.... plus she wakes up several times a night now!... she used to laugh, talk a lot ..... I miss that part of her!..... any suggestions or help appreciated..... does it take some time to get in the system?