How many days before deciding medication works or doesn’t?

[Anonymous]

First timer here. We’ve been giving Concerta for three days. Do we need to go longer before deciding to try a different one? There are pros and cons, but definitely doesn’t seem like a perfect fit. It is long-acting and we would like to try the short acting version of the same drug. How much longer should we try the long-acting before we switch to the short? Thanks for any advice.

[Anonymous]

In our experience with stimulants, whatever the medication was doing by day 2, that’s what it will continue to do…. No change in efficacy or side effects after that point. That said, doctors have this two week rule they typically like to abide by. The better relationship/easier ability you have to communicate with with the doctor, the more likely they are to be flexible on that two week rule.

[Anonymous]

Two weeks for you to get a real sense of it and for the kid to process what is going on. Two days just isn't a big enough sample of days. If, say, it helps the kid wind down and sleep, you're probably dealing with a long-term sleep deficit that will take time to fully offset. Conversely if it's interfering with sleep, one bad night could be for any reason but a bunch of bad nights is due to the med.

[Anonymous]

Anonymous wrote:Two weeks for you to get a real sense of it and for the kid to process what is going on. Two days just isn't a big enough sample of days. If, say, it helps the kid wind down and sleep, you're probably dealing with a long-term sleep deficit that will take time to fully offset. Conversely if it's interfering with sleep, one bad night could be for any reason but a bunch of bad nights is due to the med.

+1

[Anonymous]

I usually give two weeks.

[Anonymous]

I would agree with two weeks. It took a few days to see the positive effects but that was probably based on our activities not the medication. But any side effects took more than a week to stabilize. I think the worst of the side effects
We Saw happened 10-12 days out.

[Anonymous]

We’ve been told it is common for ASD kids to be more sensitive to side effects. That is true for ours. We have been though many meds for depression and ADHD. Recently had side effects go away after even more than 2 weeks (3-5 weeks).

[Anonymous]

Our psych said 1 week for stimulants. Two weeks would have been overkill.

[Anonymous]

I think there are two approaches we have taken in our house - if after 5 days you are seeing either no change signaling a dose is too low or side effects that have changed DC so much that DC is no longer acting like DC (emotional lability, for example), then give dr a call - otherwise I totally agree with 2 weeks - we have seen manageable side effects disappear or lessen after that period.

YMMV

[Anonymous]

Whomever you're working with on this should be the one to calibrate. I hope you have an expert and are not just basing it on what you see. The psychiatrist who prescribed for my son is perhaps over-cautious but had meetings with us every 2-3 weeks at the outset while assessing whether the meds were working (it was expensive and time-consuming, yes.) So I would wait til it's time to check back in with your prescriber but it will be at least 2 weeks on this dose, I would bet.

[Anonymous]

My kid had almost catatonic depression from ADHD meds. It’s an unusual response but obviously one day of that was plenty!

[Anonymous]

Anonymous wrote:My kid had almost catatonic depression from ADHD meds. It’s an unusual response but obviously one day of that was plenty!

Can you elaborate? Zombie like? I am curious to hear from parents when the meds didn’t work - what to look for and how to evaluate. Especially during the summer when high demand activities (school, athletics, social activities) are not part of the day to day routine. Thanks in advance.

[Anonymous]

My kid tried a stimulant and was on the floor all day weeping and not talking. Not eating or responding. I’d call that a try once and never again.

Ten years later he got a schizophrenia diagnosis. But it never appeared until adulthood. Schizophrenia patients is a group who never takes stimulants due to it’s causing psychosis.

Kids with autism are about three times more likely to develop schizophrenia. But it’s still a very low frequency event, like 3% of all kids with autism.