I am desparate! My 16 year old daughter responds to immediate release Focalin. Her dose is 7.5 mg and it lasts about 3.5 hours. It does little for her overall temperment ..... but it really helps her focus on her school work and sports (she's well known nationally in the soccer world).
The main problem is compliance. She simply doesn't take it consistently. The results are disasterous. Leaving ,000.00 lap top computors on the plane. Her coach recently found all her meds lying under the seat of the team bus. She just lost her boarding pass on a layover from Europe and the whole team missed their connection. She goes through a passport every couple of months... leaving it in a hotel room ... etc. This type of thing is not unusual. In fact, she once took the field in a very important game OUT OF UNIFORM! This leads to constant conflict between the two of us. And could ruin a very promising athletic career.
It extends to her daily life. Losing money, not accepting responsibility at home, not turning in homework assignments, impulsive behavior. She simply is the most irresponsibile person I know. She'll never make it on her own in college etc... I have tried every type of behavior modification and it seems like she spends her life grounded outside of school and sports.
We have tried all types of long acting meds. They have absolutely NO effect. We've tried Concerta 72 mg .... Focalin 20 mg XR ..... all to no avail.... it is if she had not taken anything. her digestive tract is normal .... her bowel movements are not excessive so it isn't "just passing through" .... and I am at the end of my rope. Focalin immediate release works. All long acting meds are worthless.
Does ANYONE have a knowledgeable sense of why my daughter might not respond to long acting meds ... and what might help? Thank you.
To Small Mom:
I guess the better word regarding her reaction to the Concerta and Focalin XR would be .... no reaction AT ALL.
She doesn't take the meds with coffee or anything acidic. In fact, she usually doesn't even take them with food at all. But if she does ... it does not seem to make a difference.
Regarding the metabolism of an athlete.... I don't believe that should be an issue. She knows other high level athletes on long acting adhd meds .... one of which is her best friend ... who had a great response to Concerta 28 mg.
I've been working with a very highly regarded Psychiatrist who is primarily a medicator. He has no explanation.
Regarding executive function disorder... NO doubt she has it big time. By the way ... executive functions is primarily located in the left frontal lobe .... not the right lobe. And my daughter IS very right brained. However, she does respond to the immediate release Focalin. The problem is compliance.
Regarding coaching, she is resistant to it. I also have adhd going on, but I've developed all sorts of coping mechanisms. My life is a series of post it notes and other coping mechanisms. It has allowed me to become a very successful entrepreneur..... without medication.
Her problem with coaching, is that she resists all suggestions when she is not medicated. And therein lies the problem. I can count on her being medicated for 3-4 hours a day ... when I SEE her take Focalin in the morning. The meds are otherwise forgotten during the day or lost. So whatever 'coaching" she is exposed to goes right out the window.
Quite a dilemna isn't it? I see only one solution ... to get her responsive to long acting meds. If anyone has ANY explanations and/or solutions..... PLEASE let me know.
If I remember correctly, you said she was a zombie on Focalin XR and Concerta 72 mg. Is that correct?
Does she take her long-acting meds with orange juice or coffee? The acid can harm the long-acting release mechanism of both Focalin XR and Concerta.
Is it possible the metabolism of an athlete can change the way the long-acting meds are absorbed by her body?
What does your doctor say about all this? Are you working with a psychiatrist who has cutting-edge knowledge of psychopharmacology?
Finally, PSM is right in one important respect. The executive function deficits generally inherent in ADHD do not magically disappear by popping a pill. Yes, they may get somewhat better by taking meds, but even on meds, my son still forgets what's due when and what books he should bring home for homework. Your daughter might benefit from ADHD coaching in addition to taking meds.
SmallMom38718.4765740741
To PSM: I am certain that she is not bipolar ... as she is not depressed and much too socially aware to have any autistic connection. She socializes well. The executive function disorder to a degree is almost a certainty. However she is resistant to any external attempts to cope with it. If I put ...etc...etc... I DO know there is also an OCD compenent going on. But I think you missed the point of my post.
The fact is she responds VERY well to immediate release Focalin. She is focused, less impulsive, and in control..... for about 3-4 hours per dose... which is 7.5 mg.
The problem is compliance. She doesn't remember... or simply won't take it on schedule. The answer WOULD have been a 12 or 8 hour medication that she would only have to take once or twice per day. However, every attempt at medicating her this way has failed. She does not respond to ANY long acting medication. We've tried Focalin XR and Concerta 72mg and 36 mg. It is as if she has not taken a thing.
So , my question is, why doesn't she respond to the long acting meds .... but does to immediate release meds? Secondly ... is there anything I can do to make her responsive to them?
Your daughter sounds a lot like me. I'd forget my head if it weren't attached to my body. Has she ever been tested by a NeuroPsych for Excecutive Function DIsorder? Bet she could have it. It's a big part of the spaciness of ADHD. It is right frontal lobe brain damage, and it can't be repaired or medicated away. Anyone who has it has to learn to compensate and she may not be motivated to do that until she gets older. I have to write everything down and then sometimes I forgtet to look at my notes, but I'm better than I was. There is no quick fix though. You may want to see a NeuroPsych to have her tested for this. It is very common, if not the rule, with ADHD, bipolar and high functioning autism and no pill will make it better and the person may look careless, but truly isn't to blame. AS a sidenote, I didn't make it through college and got fired from a lot of jobs too. IF she has EFD, she needs special help, and I'd take her to a NeuroPsych so she can be diagnosed and get the help. With adjustments she may do fine in college and in life. But no medication can fix this.psm090438718.296099537