My son started Quillivent at 5 and it was great. I can’t remember how many milligrams, but it was nice to be able to go up by tiny amounts to find exactly the right dose. It’s a liquid methylphenidate derivative. It did cause decreased appetite, but we pumped him full of healthy calories when lever we could and took breaks in the summer if we needed.

My son started on methylphenidate at just under 5. He takes a liquid, and we’ve moved the dose up a few times. At 4 he was on 3.75 mL once a day, at 6.5 he has 5mL twice a day.

We monitor growth closely, and loss of appetite has been the main side effect, so he eats like a mad man from 4-8:30 every night once the drug wears off. We added in a fortified chocolate protein drink for school lunches this year to make sure he has something before the school nurse gives the mid day dose.

We give at least one dose every day even on weekends because I also was recently diagnosed and discovered I do so much better with emotional regulation if I take my medicine every day. It turns out the weekend breaks we were giving weren’t helping, and we can address the calorie intake differently. For both my son, as we were learning about his best match dosage, and for myself, the other side effect we experience is headaches and we need to drink a lot of water to prevent that. At one point I thought he was having jaw pain, which can be a side effect, but we learned he was cutting molars!

(Sadly, I do not have the loss of appetite because I’d love to lose some weight!)

Following along. My Ds is also on Guanfacine but we’re weaning him off. He is sooo sleepy and it has really flattened his personality. Dr wants to try a stimulant next.

Op here, thank you for the responses. Super helpful. May follow up with my doctors feedback- emailed them to get their thoughts

I also think that you shouldnt land on any med without trying the dose above just to see if you can optimize the dosage wo side effects.

E.g, have you tried guanfacine 2 mg? Guanfacine is supposed to be weight based dosing.

So keep in mind that there will likely be a LOT of trial and error. It's frustrating but totally normal—it's very individual. Generally, your child will either respond best to methylphenidate varieties or amphetamine varieties, and there are bunch in each class.

Docs like to start with long-acting versions bc, well, they last longer (which is great if they work as planned), but that can also mean that if you have side effects like suppressed appetite or not being able to fall asleep will happen later into the day. Start a trial when you have a few extra days off in the week if you can.

My kid was one who couldn't do long-acting because he metabolizes really slowly, but we did Metadate CD, which was a medium length (6-8 hours) version of methylphenidate. He started stimulants around age 7.

We added guanfacine later to help with emotional regulation.

we started w adderall xr, and then focalin xr, various doses - ended up on vyvanse

We are moderate-severe and at six started methylphenidate 10 mg. I find that it doesn't help with emotional regulation much but the hyperactivity, overstimulation and most importantly the inattentiveness are very helped with the medication.

I’ve posted before as we’ve been on this journey, but my 5yo recently started Guanfacine for adhd (two months ago.) we have seen some improvement, but he is still struggling across the board with his adhd symptoms (inability to focus on non preferred, age appropriate activities at school, emotional regulation and getting overstimulated and hyper). His neuropsych suggested he needs a stimulant.

If you started with stimulants at a fairly young age for pretty moderate-severe combined type adhd, what worked best for your child?

He is currently on 1mg of Guanfacine.