ADHD -- inconsistent behavior and meds
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Anonymous
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DD has been taking Ritalin LA 10 mg. During the summer it was sufficient (including doing fine with one-on-one tutoring). I suspected it would not be enough for school given the distractions and indeed, while her behavior notes were better than last year when she was not medicated, she still had at least two days a week where she was not doing well behavior or focus-wise and fairly consistently having problems in the later afternoon.
The psychiatrist said this could be more about behavior than the meds, but was agreeable to trying something else as she seemed to be reluctant to put her up at 20 mg of Ritalin. Her appetite has been affected some, but not extremely, and she gained back the 3 pounds she initially lost. So we tried 18mg of Concerta, but if anything the inconsistency got worse. Some days she needed zero or one prompt to get things done, while on her "bad" days, particularly after lunch, she was back to 7, 8, 9 or even 10 prompts, walking around aimlessly, not listening, arguing, etc. In others' experience, did your kids also have this problem until they found the "best" med and dosage, or was inconsistency something the meds never really took care of? I'm thinking we really need to try the 20mg of Ritalin LA. |
Anonymous
| Have you tried Focalin XR? |
Anonymous
| The meds are trial and error unfortunately. I think it's lucky if you find one med and it works well with minimal side effects and even if you do it may need tweaks and changes as your child grows, goes up in weight and the schoolwork demands increase. I can tell you we tried Focalin (XR and reg) and both put her into a zombie-like state as well as Ritalin. We tried Concerta and that didn't work as well in terms of concentration and created tics and anxiety. Since my daughter has ADHD, a combination therapy of Intuniv at night (blood pressure med indicated for ADHD/non stimulant) helps calm her and seems to counteract her daytime Adderrall. Adderall is working very well for her with minimal impact in her personality. She loses appetite but its not as bad as the other meds we have tried. Keep trying to find what works. But even with the meds sorted out, I find some days are inconsistent and I'm not sure why. I once heard a psychiatrist describe the symptoms of ADHD and she said the hallmark is being "consistently inconsistent". I think that no matter what med, some days or times of day may not be consistent. The meds may also be wearing off after lunch and she may need a short-acting med to help her through the afternoon. Hope that helps. You are not alone. |
Anonymous
| I have had the same experience with my DD. Tried different dosages of Vyavanse initially before switching to Concerta. Our pediatrican initially prescribed 18mg of Concerta then up it to 36mg because 18mg was not effective. At 36mg, we had a good balance of ability to focus and ability to maintain appetite. However, this year, we are noticing the meds are less effective than in the past so inconsistencies are increasing. The doctor said the meds loose their effectiveness with time and we are considering upping the dose. |
Anonymous
| what does the Intuniv counteract with the adderall? Does your child have anything else besides the ADHD? |
Anonymous
| Thanks for your replies. Maybe Adderall is something we may try eventually-- it is supposed to be a little more potent than Ritalin. I also thought some inconsistency was normal but for some reason our psychiatrist said that she expected there wouldn't be so much inconsistency once medicated and it was something else besides the ADHD (like anxiety or being upset -- but our DD is pretty much never upset or anxious, so I'm pretty sure that's not it). That struck me as odd since everything I've read about ADHD suggests inconsistency is part of the condition. |
Anonymous
| My dc takes focalin xr. It started out perfect, but is currently less than. Our developmental pediatrician describes ADHD as a disgnosis of inconsistency. Meds won't fix it. |
Anonymous
| We have had the same experience and I was wondering the same. Thanks for the post. |
Anonymous
How long was your dc on the focalin xr before it stopped being effective? |
Anonymous
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My 8 year old son started out taking Focalin XR when he was 6. He didn't stay on it very long. Although it improved his focus, it made him moody and aggressive when it wore off in the evenings. It also curbed his appetite so much that he lost a lot of weight. He was already very skinny.
We switched to Vyvanse and it works well. It may not be as good as Focalin for focus at school, but we haven't seen the mood swings. Also, he's eating more. On days that he has a lot of homework or evening activities, he takes a small booster of Adderall. Also, I've noticed that exercise is incredibly important for my son. He's like a racehorse that just has to run. I'll have him go to the playground for 30 minutes or so before homework and then give him lots of movement breaks. It makes a huge difference in his mood and behavior. On days when he can't get outside, he's much more "antsy". Medication only helps a little. It's important to find other ways to manage ADHD -- like exercise, meditation, organizational charts, etc. |
Anonymous
| Have you looked into the Feingold Diet. My SIL swears by it for her two boys, one has ADHD and the other is Aspergers. |
Anonymous
Wait, did the Dr say that??? |
Anonymous
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Meds are so tricky. We are on our 3rd med trial. I've found Dr. Charles Parker's book on medication rules to be very helpful and it is specific to the treatment of ADHD. He also has a lot of youtube videos and is very active on Twitter.
http://drcharlesparker.com/ |
Anonymous
What is the gist of what he says about meds, please. |
Anonymous
No. I said. Not MD. Focalin worked like a miracle in the beginning 6 mo. It still helps a lot. Have had to play w doses and times of day. Recently added 2.5 fast acting right before school. The meds help but do not make it go away, in our case. PS we found our child meltsdown and crashes from focalin xr when the dose is too high. He was like a devil child between 6 to 8. We backed off 2.5 mg and he became mostly sweet and loving again. I want to try fg diet. Scared of it too. Has anyone here tried it with success. |