dmid, my son was very sensitive to slight changes in methylphenidate. So i was very careful in giving him an appropriate dose. With Ritalin LA I did it a few different ways. You might think I was nuts but here goes:
1) I counted all of the beads in a capsule, and figured out what was equivalent to a dose of 16.25 mg Ritalin would be. (I think there were consistently 1000 or something)
2) I poured all of the beads on to an index card, used a ruler to push them into a rectangle shape. Drew lines of the rectangle to show the space it covered. Divided the space into an appropriate dose.
3) compared #1 and #2. Surprisingly, they were about the same.
4) Poured the beads back into the gel cap
5) Noticed that the height of the beads in the gel cap matched that of some marking stamped on the gel cap. In the future emptied gel caps to that same marking for an appropriate dose.
This took a lot of time (and a bit of neuroses probably) but the dose was right for him. At some point he was able to tolerate the full capsule. what a relief or me!
I am sooo glad that Chase does well on a standard dose...but I could see myself doing just that sort of thing! So sorry you are having these issues. Ughh! You might want to think about how the stimulant is released into the body. With Concerta, 20% is released initially, and the rest is slowly released throughout the day as the pill is passing through the intestines. With Ritalin LA, 50% of the dose is released immediately, and 50% about 4 hours later. Keep trying to find the right med. I know it's hard!
Chasesmom, that is a great idea and I did think of that. And you can break open the capsules, and we did that when we were first starting out. Unfortunately we had a problem one day - we think that some of the extended release capsules got chewed, and he got way too much meds in the morning, and not enough at all in the afternoon, so we don't want to do that anymore.
It is such a struggle, and I keep trying to remember that everyone goes through this and that their can be a good middle ground - but it is so hard when you see them struggle so much!!
we were having sort of the same thing.. ds was on 30 mg. metadate cd, started having motor tics, i now open the capsule and split the dose in half, so in essence he is getting 15 mg... the tics went away and the teachers really haven't noticed a difference. sometimes the dosage is just too high.I found empty gel caps are available at pharmacies quite helpful.
For reducing the amount of time release beads in Ritalin LA, I measured a specific amount out, replaced the cap. I saved the extra beads in a gel cap for later use.
Ds takes 3 1/4 tabs of 5mg short acting Ritalin sometimes. When the school used to administer it, I put the pills in an empty gelcap to make it easy for them and ensure he was getting the proper dose.
That would be a great idea to keep the time release granules from being chewed, jfla!
Maybe you should look into those empty gelcaps dmid...
Our psych put our ds on 36 mg of Concerta - he was on Focalin XR and it seemed like 15 mg wasn't enough, and 20 mg made him a zombie - especially in the morning.
Unfortunately, the 36 mg of Concerta left him still pretty impulsive in the morning, not so bad in the afternoon. So, she said to try 54 mg. It is NOT working for him - he is very moody and aggressive, he is also having major meltdowns between 5-6 pm - it seems like something will set it off and he will begin screaming at the top of his lungs and flailing about. He had this happening when we first tried the stimulants but it went away after the first few days - I think it is a rebound problem. Last night when he was having his episode, he started screaming that his feet hurt, then he said they itched and tingled - that kind of scared me, although I don't know if it is meds related or not. I ended up last night holding him on my lap, and he just clung to me for dear life until it passed, and 5 minutes later you would not have known that anything happened.
I have a call into the dr. We need to find something else - he was doing so good on the Focalin until we had to up it to the 20 mg.
Is there any way to get to like 17mg of the focalin? I do not know what form the med is in....tablet, or capsule...I have heard of some parents that tweak the dosage (under doctor's consent) by breaking pills into thirds, or shaving the pill a bit....or pouring out some of the powder from the capsule....
I don't want to sound stupid, but it seems that it would be worth a try....if the doctor okays it