Ritalin LA | ADHD Information

OK I don't know how many of you have been following the saga of Chase and our medication woes....he had been on Concerta 54mg and it worked very well from March until about a month ago, when I noticed that he was having afternoon issues on the bus, and not completing work consistently in his last class of the school day.  So I made an appt with the doc to discuss a med/dosage change.  The next day, the patient assistance program that we had been getting the med through (free) dropped him from their program because apparently our 00 deductible is "too low" and given that the insurance would cover the med after the deductible was met, we were ineligible.  W/o the patient assistance program, and using our piddly discount prescription card the med is 0 a month....we could do it, but it would be difficult.  So, given that we were having a problem with the concerta anyway, we decided to try a new med...

I called some of the other company reps for their patient assistance programs, and 3 of them told me that I should just check the "no insurance" box, since I effectively have little to no prescription coverage until the deductible is met which is unlikely to happen.

I did so, and Novartis has sent me a letter that states that if I can send them a letter saying that I have been denied for Healthy Start (which I have) Chase is accepted, and in the meantime they are sending me a card that will be good for 3 months.  So, we will be starting on Ritalin LA shortly.  They also make Focalin and Focalin XR, so hopefully if the Ritalin does not work out, we can switch to one of them.

I am resigned to the fact that I will most likely have to give him a short acting pill in the late afternoon to accomplish homework, but how long can I expect the morning dose to last?  Will it make it the whole school day?  Chase has to get on the bus at 8:10 and does not get off til 4:00.  So that is 8 hours if I give the pill at 8....

I must also say that I have no huge behavior issues with him, most of his difficulties stem from interactions with the other children at school and on the bus which we hope that the guanfacine will address once he gets accustomed to the full dose, which he has been taking for about a week.  He is not hyperactive at all, and if the med works well at school, he should not bring tons of homework home to do and I am kind of looking forward to the med wearing off at an earlier time for eating and sleeping issues....I can get through homework even with him unmedicated if not too much comes home at least until our next appt on Jan 29th. 

Thanks in advance for any input you may have....
Anybody???  From my research, a lot of parents had trouble with it lasting the whole school day, but some say it is great...

Hi Chasesmom79,

According to the comparason chart, the duration is about 8 hours (but the usual "everyone is different" cautions are applicable). Half of the dose is immediate release and the other half is delayed release. This is compared to 10-14hrs duration for the concerta.

http://www.myadhd.com/treatment_tools/medicationchart.html

My son was on Ritalin LA for a few months.  We switched because it had lost it's effectiveness and his doctor didn't want to give him a higher dose because of the appetite supression.  I found that it didn't last the whole school day.  I had to give it to him around 8am, so that by the time it started working he would have at least 20 minutes to get ready for the bus.  However the teacher noticed that it seemed to be wearing off by 3 and school doesn't end until 3:45.

You could have them give him a short acting pill at school toward the end of the day, but that pretty much defeats the purpose of having these long acting pills.

We actually switched to Focalin XR, which you noted was a possible option.  We've had great results from it (I hope they last), but we didn't notice any difference until we got up 20mg (10 was like giving him water).  It also seems to last about 10 hours, which gets a through homework time without the short acting pill.  He wasn't eating much, but I was hoping that it had something to do with the holidays and being off schedule in addition to the medication.  He did actually eat a great breakfast today, and says he ate lunch, although who really knows?

Hi.  DD also started on Concerta.  We only lasted about 1.5 months on it because it made her angry and depressed.  She is now on Ritalin LA.  We titrated up to 50 mg at one point with an afternoon booster.  But the side-effects on her behavior led us to try guanfacine (Tenex) which allowed us to reduce her Ritalin LA dose and eliminate the afternoon booster.  She is on 20 mg now, but we are thinking of reducing/elimating it because of the side effects.  The side effect being she doesn't pay attention to what she is supposed to.  BTW, guanfacine is on the WalMart cheap prescription list.  Her appetite is back and we still use melatonin for bedtime.Yeah if we don't like the Ritalin LA, the same company does the Focalin XR, and it is on the same patient assistance program, so hopefully the switch won't involve a ton of paperwork...

I am kinda hoping I can just get it to last the school day, which is 9:00-3:30.  If I have to, I will drive him and gain 45 minutes...if I have him take the pill on the way...it only takes like 20 minutes to kick in right?  If it wears off after school, I can give him a short acting one for homework, and avoid the med being in his system at dinner time...he is going to pay close attention and tell me when he feels it is wearing off...

I am sure he can get a short acting pill at 1:30 or 2:00 if necessary, and it still will wear off early in the evening...almost preferable than the long acting ones....we will see....

Thanks for your input...hopefully this will work out for the best...

I apologize in advance for my ignorance, but I'm new to this thread (trying to catch up with the three+ years I've missed  a little at a time.)

 

Two questions: What patient assistance progam? Something available in Texas?   And two: How is Ritalin LA different from Ritalin?  Ritalin was a total and complete disaster for my son (think uncontrollable and terrifying hallucinations within a few days of starting the medication.) 

 So (Yes. I know we're not doctors, most of us. Opinions are fine. )What's the probability that Ritalin LA would have different side-effects?  Hallucinations are a no-go, in my book.

emergent, I don't think Ritalin LA will be any different than regular Ritalin.  It's not a different med, just an adapted delivery system.  The capsule actually contains two pills.  One dissolves and goes into the bloodstream like a normal pill.  The other has a coating that takes longer to dissolve and that's how they get the delayed release effect.  If ritalin gave your son hallucinations, I'd stay far away from Ritalin LA.  Have you tried Strattera?  It's a non-stimulant and while it takes anywhere from 2 to 6 weeks to build up in the bloodstream, it may be something that will work for your son.  Good luck. emergent

The patient assistance program is available throughout the U.S.  But it is just ritalin with a different delivery system, that is why when we got booted from the concerta PAP, I chose to try ritalin LA first.

So far, Chase has had one day of school on the ritalin LA, and it sounds like it went great.  He came home and asked me "Is this supposed to be just like the concerta?  Because I like it better!"  I explained that they were both the same drug, just a different delivery system.  He said that he could pay attention better and focus better today than he had been on concerta.  I am not getting my hopes up til I get a report from teachers though....

His appetite is better on the ritalin though.
There are patient assistance programs for focalin, focilan XR and adderall XR as well.  PM me if you want info.....I am the patient assistance program expert lately!

Thanks.

Right now, my son is on Strattera 25 mg -- the same dose he's had for the past two years.  It seems to work very well.  Meaning we don't notice it unless we don't use it. lol! 

Yes.  After the Ritalin Fiasco  (a story I'll tell you one of these days,) we decided to avoid stimulants.  So, when Strattera became available (meaning, after DS turned six, so he was in the recommended age group,) we decided to try it... as a last resort, after non-med options helped but fell short. 

Still looking for a better solution, to tell the truth.  But Strattera seems to be working for now. My son's due for a general check-up.  Maybe it's time to have a heart-to-heart with his pediatrician.

emergent39091.3039814815

Just checked my email again for today..still no emails from teachers...I am going to send a note to all of them on Thursday, requesting a report on the week to be sent home on Friday...especially the ones whose classes are in the late afternoon....

Chase still reports excitedly that he much prefers this med over the Concerta, and he has been much hungrier, I sent a good sized apple and a package of mini muffins in his bookbag in case he was hungry like yesterday, and he ate all of the muffins and most of the apple on the bus ride home.  Even with the periactin, a small afterschool snack was all I could get him to eat....which was better than before the periactin, but this is by far the best!

I am afraid to get happy....but I am starting to...