No, stimulant doses are not based on weight.
Forgot to ask you -- did she take Concerta with orange juice or anything else acidic? Acid ruins the time-release delivery of long-acting stimulants.
Aren't all these meds also based on the persons weight . If so that would explain why some take the amounts they do. I also herd on the radio that meds/behavior mod are the best way to go. This came from a adhd/add professional.
RN Tx.
RESPONSE TO BUGZAPPER:
I know Focalin is not exactly like Concerta. But she didn't respond to the long acting Focalin XR 10 mg ... which is supposed to release 5mg immediately, and another exact 5 mg 4 hours later. Don't you feel that it is strange that she wouldn't respond well to the XR but does to the IR version of the exact same medicine in this case?
RESPONSE TO SMALL MOM:
Concerta 72 mg shouldn't be too much for her. I say this because it is a 12 hour release, and she is taking about the same amount of Focalin over that period. (1 mg Concerta = 2 mg of Focalin)
Nova,
Where I come from, I guess we do math a little differently. Here's how I see it:
72 mg Concerta/3 = 24 mg every 4 hours
7.5 mg Focalin roughly = 15 mg Concerta every 4 hours
It seems to me 72 mg is pretty high. If it were my daughter, I'd start her at a lower dose (say 36 mg) and gradually titrate up every few days. Even though both Focalin and Concerta are from the same stimulant family, the body still needs to adjust because they are different formulations.
Time release is how all meds and vitamins should be which allows the body to take it in as needed at that time. If not when a person has a high matobolizm they may get rid of some cause it's not getting it when it needs it. To me it all just be in a liquid form cause then it goes straight to the blood. This allows it not have to go to the gi system first which for some doesn't work well. The older one gets the worse all our gi tracts can process or has enzyme production. Got this from a Nutrition professional. The desk reference that Dr.'s have use of says liquids absorbtion is only about 98 % and pills 10 %. This is why I prefer liquids over pills. Liquids can be also covered in ones favorite juice they like or food. The time release can have this effect because it is rated by TOTAL output.
Does anyone else have this problem? My 16 year old daughter is a very high level athlete. She does fine on immediate release Focalin. But whenever I try to switch her to a time relase product , it is not effective. For instance, yesterday I switched her from Focalin 7.5 mg every four hours to Concerta 72 mgs in the morning. She has practice at 1:00 PM. Her coach called me that night to tell me that she was out of control and unfocused. When I previously switched her to time release Focalin, the same thing happened. Does anyone have some thoughts on this?
Compliance is a major issue with my daughter. There is no way she'll remember to take meds 4 times daily. I really need to convert her to a once or twice daily med. Can anyone help?
Good thread. again,Compliance is a major issue with my daughter. There is no way she'll remember to take meds 4 times daily. I really need to convert her to a once or twice daily med. Can anyone help?
[/QUOTE]To Buggzappers:
The reason I need to switch is that she eityher forgets to take the meds during the day .... or loses them all together.
December 2005 - Volume II - Issue XII
ADHD - Adrenalin & Similarities to Stimulant Medication
Statement: My intent in this newsletter is to express as quickly as possible my own beliefs and opinions on matters. I have no problems with people who disagree with my opinion and have even been swayed to rethink my position from time to time. We are still taking book orders for my new book "ADHD and The Criminal Justice System" and you can get my author's discount from the http://www.addcorridorcoaching.com/book.asp
The first ADHD poster a positive approach to ADHD is also available at this web site
http://www.addcorridorcoaching.com/poster.asp
Read past issues of newsletters at this link http://www.addcorridorcoaching.com/newsletters.asp
NEWSLETTER:
While on the Sheriff's Department for 17 years and having undiagnosed ADHD, I often found myself getting involved in two other employees dispute and ending having both of them turn against me and being on the receiving end of both their attacks. Maybe some of you can relate to this problem. In my case this had been a life long problem and I always wondered how I had gotten myself embroiled in other peoples business. I also had a tendency to blurt out opinions or express some thought that was either rude, unnecessary or hurtful. Being the apologetic, people pleaser that I was, I always seemed able to mend the fences and patch things up quickly. Looking back I now realize my ADHD, like most of yours, provides you with some gifts or talents that are useful and some that you would love to throw out with the weekly trash.
I was always kind of a fast talker, not in terms of trying to deceive others, but rather the rate and speed at which I talked was faster than it should have been. I guess that was my hyperactivity showing itself. By now you are probably asking yourself what all of this has got to do with similarities between Adrenalin and Stimulant medication? I will explain.
As you know many people with ADHD are attracted to high stimulus activities and careers such as emergency room medicine, military, paramedics, fire and even police officers. Unfortunately a formal ADHD diagnosis in some of these fields while actively employed could be problematic. But, the fact remains that the variety, unpredictability and lack of routine days appeals to our sense of adventure.
In my own case and only years later after getting diagnosed with ADHD did I realize something very important. I had been told on many occasions at the scene of fatality accidents, and other high stress emergency matters that I seemed to be a lot calmer than my co-workers had anticipated me being. It seemed that my speech was calmer and slower and more directed. I seemed to think more clearly and react more appropriately. I actually remember thinking during these times that I was more effective too. The fact that others noticed it too was somewhat of a surprise to me. It was only after I had started Ritalin in 1996 and had been on it for months that I noticed the similarities I felt to those old exciting incidents experienced while working on the Sheriff's Department.
I then realized that what probably was happening back then was that my body was involuntarily producing adrenalin and that forced chemical and blood circulation to areas of my body, most noticeably my brain and sped up brain functioning much like stimulant medication does for those of us with ADHD. My brain operated more efficiently and I calmed down, and performed better, much like I do when I take my medicine. If you have read my letters before or seen the cover of my book you know I like the analogy of a spinning toy TOP. When it is spinning slower it wobbles and wanders around on the floor or table in random directions. But grab the spindle and pump it up and down and the top speeds up and straightens up and spins with almost no noticeable movement from its place on the floor or table. It is operating at peak effeminacy and continues to do so till the speed wears down and it starts slowing down again.
To summarize an ADHD person taking stimulants gets a similar result as people who get a adrenalin rush. Adrenalin is natures way of making us operate at our peak efficiency in times of emergency or high stress. Stimulants mimic this activity in those of us with ADHD and allows us to operate more effectively in our day to day functions.
The TOP analogy is a great way to explain to non-believers or skeptics why doctors give a stimulant medication to someone who has hyperactive tendencies. Most people would think it would make a hyperactive person even more hyperactive. I used to think this way. In reality it speeds up our brain and body metabolism and helps bring our lives into balance.
Hope all of you have a happy and successful 2006. Happy New Year
Talk to you next month
Patrick Hurley
addcorridorcoach@aol.com
If you know on anyone who might like this newsletter please forward it to them and tell them to go to my web site at www.addcorridorcoaching.com and sign up.
Hopefully I've found a solution for my daughter. She takes Concerta 36mg in the morning WITH a Focalin 5 mg immediate release. She then takes the Focalin 5 mg every 4 hours until about 6:00 pm. I am comfortable with this because if she forgets to take the Focalin, I know that some of the Concerta will be in her system throughout the day. I also make sure she takes a Focalin IR before every game and practice.
I'm wondering if anyone has any thoughts on this? I also wonder why the time release meds never ever worked for her alone?
Nova,
Last winter my 12-year-old was on that combination of meds exactly -- 36 mg Concerta with a 5 mg boost of regular Focalin at 4 pm for homework. It worked very well because he was taking Concerta early in the day (at 6 or 6:30 am) so Concerta was starting to wear off. I guess how well it works would depend somewhat upon when your daughter's games are and when she would be taking the Focalin boost. I definitely think it's worth a shot.
Oh I guess I should have mentioned WHAT I do for you nova!! Sorry! I work in a manufacturing plant - moving around a large area making changes to machinery and lifting and moving boxes full of heavy chips. Potato chips to be exact. Lots of focus and energy required - my meds (dexedrine spansules) give both.
Although the dex seems weight unspecific - my 20mg dose is for me at 210 lbs (about 90 plus kilos?) and my height is 6 foot 2 inches (about 188 cms I believe). LOL - I live in Canada and still use imperial measures for myself! Too rich!!
I take NOTHING else pharmaceutical or otherwise after the dex wears off. I find it keeps working long after it has mostly gone from my system (that takes a while to work into your system that way it seems) - and my sleep is usually wonderful and deep and my stress is at zero most days unless it is merited by the situation.
Impulse is GONE. I feel the urge deep in my head but is easily ignored (Cognitive Behavior Therapy - or CBT has helped with that). I can still say yes to urges if I wanted to - but do I really??
Anger - I feel that too. But at the source of what angers me - and usually I verbally let loose. I haven't gotten into a fight at all - not even close. But I am large and that probably defuses some incidents all by itself LOL.
Mixing 2 ADHD meds (with MDs consent) is getting more and more usual. Just follow the directions to the letter and report any side effects. The best part of most ADHD meds (other than antidepressants and Stratterra) is that they are gone from your system fairly fast so there's no real long-term affect if there are troubles. Just take precautions as usual.
Good luck!
Glen... what type of work do you do? My daughter's problem is not energy but FOCUS. Does the Dexedrine XR help in that way? May I ask your height/weight and what dose you take? Do you take anything after the dex wears off? Also, my daughter is very impulsive and angers quickly. Do you think that the dex could make it worse?
One last thing... does anyone have any thoughts on taking Concerta and piggy backing Focalin while the Concerta is still working in order to give her add'l focus in a critical situation.... like before a game .... or taking SAT's?
I have a similar problem with my 17 year old ds with remembering to take meds. He is on Ritalin LA twice a day sometimes taking a short acting Ritalin if necessary for late homework/activities. We are interested in the Ritalin patch that may be released soon. Even with an alarm watch, he still forgets.Have you tried your daughter on dexedrine sulfate spansules (XR)? I am as close to an athlete in my work as it gets. The meds are taken for me about half hour before work - and work fine for 6 to 9 hours. I sweat it out all day believe me - and I have NEVER felt a drop-off that I hear from others.
The benefit for an athlete in dexedrine is that it is a great one for keeping energy levels up - especially if needed. I almost run all day at work - many times doing the job of 2 people. I don't sit EVER - except for 2 - 20 minute breaks over 8 hours. So you can see if I had the energy drop it would be noticed by me.
Just a thought - I've been on dex spansules now 13 months with no troubles. And I at 38 have better energy than I did at 17. So dig that!!
I am the original poster whose daughter has ADHD but is also a high level athlete. I am going to have her try Concerta 36 mg to make sure she has med in her system throughout the day (she tends to get very impulsive and has a temper) .... then have her take a single Focalin 5mg immediate release one hour before games and practices. This way she'll be only taking meds twice a day at the most ... and compliance will be less of an issue. I was wondering if anyone has any input, opinions or thoughts about what I am going to do. Thanks.