Has anyone felt like they or their child developed tolerance to a stimulant at theraputic doses? If so, any tricks for combatting it???
My 9 year old dd has been on adderall for a little over three years. We have slowly had to increase her dose to achieve the same results. She started at adderall XR 10mg which worked great at the time then after 4-6 months lost a good bit of its effectiveness so we bumped her to 15mg which again worked great for a time. She then went to 20mg and slowly to 25 and now at her current dose of 30mg. She has been on 30mg for quite a while now but it is not working that great. It doesn't work as well as the 10 did originally. Her dr. will not increase her above the 30mg which I can understand because we can't just keep increasing it. She has tryed concerta, focalin XR and Daytrana which were not that great. Any suggestions?
Thanks so much for reading!!!!! Jo
We are experiencing this with my 11 year old son as well who is currently on Adderall XR 50mg. We added some clonidine recently and this seems to have helped. We have also been through Concerta, Ritalyn, Focalin etc. We can't use patches because of my sons skin problems. You can try not administering the medications on weekends and holidays, as I have heard this helps. Of course, with my son if we try to give him a medication holiday from his Adderall he is way out of control and I am ready to box him up by noon. Because his pills come in 25mg I can get away with giving him just one on the weekend instead of two if we are not going anywhere and don't expect any company.my son has been on ritalin for 5 ys we did swap to concerta xl but only for a month then swapped back, he 1st started on 5mg twice a day then 10m twice day then 15m twice day and is now on 20mg twice a day and 10mg at 4pm (50) but i dont always give him the 10mg depends what we are doing/ going out
i used to hate it when i had to break tablet in half, even with the pill cutter i used to turn it to dust lol
he has been fine on this dose since october
my sons pead told me that has there bodys grow and there weight changes the dose as to be increased
The only thing I too have ever heard of that helps to restore effectiveness is taking breaks but it is next to impossible not to give her her meds on the weekends. She is SOOOOOOOOOOOOO hyper and impulsive, even worse then before she ever started stimulants. We will give her a long break over the summer as we did the last two summers in hopes of restoring some of the meds effectiveness. It makes for a really long summer!! She was off for 4 weeks last summer but her behavior never seemed to return to "normal" for her. I have read in some posts here that it takes some kids 6 weeks of no meds before they return to normal. When we stop the meds it's like her adhd symptoms are exagerrated, kind of like constant rebound. We will try 8 weeks off this summer. Wish us luck!!!!!!!! It is isolating b/c I don't really feel like it is fair for her to be around people. UGH!
Thanks for reading. Jo
My child's dr. (a developmental pediatrician) said that 90% of kids can stay on the same ADHD meds dose for a year. My child is one of the unlucky 10% whose body seems to keep adjusting to it, and we keep needing to increase the dose. The dr. said that often these kinds of kids reach max. dose on one med. and then need to start over with another one. By the time they reach max. dose on that one, the body often has forgotten about the original med. and it's effective again.Hi. I have a 14 yr old who has been on stimulants for several years. We've tried many of them at varying doses.
My opinion is of course based on our personal experience with stimulants, but one thing you need to keep in mind is the term "therapuetic dose" is a very fuzzy term. It is different for everyone....unfortunately there are no "standard" therapuetic doses, regardless of what the manufactuer's drug insert says. There are some kids (mine was one) whose body chemistry, brain chemistry, and metabolisms are such that "standard" therapuetic doses do absolutely nothing. I think this subset of ADHD children really do exist, and my child falls into this subset.
This is where having a true expert doctor who really knows his/her pharmacology is a make or break issue. In our case........ we had to find a board certified child/adolescent psychiatrist to do this. He had knowledge of drug doses and drug combos that a standard physician would never attempt.
In our case..... my child did best on Concerta, but not standard dose Concerta. He is on high doses and it works really well. He's been on the same dose now for about a year and a half. But is was hell finding that dose... his "therapuetic" dose and it took years, not months. Most parents and physicians, because of the "trial and error" approach you have to take to find the right dose and med struggle with this terribly. In our case....... for a long time, my son was undermedicated and not truly at his "therapuetic" dose..... which as NOTHING close to the "standard" dose that the manufacturers put in writing.
So......... the question is, is your child really developing a tolerance.... or have they just never really received THEIR unique therapuetic dose?
It is a hard, hard issue. Good luck. Discuss this with your doctor and remember, there is a small subset of children who do require non-standard doses. My prediction is that most physicians, being conservative, would tell you this is hogwash and just go about prescribing stimulants to the same "standard" cookie cutter approach........therefore there are always going to be some kids who just never get the right dose.
Undermedicating is just as big a problem as over medicating. Get someone who really knows what they are doing to manage your child's meds!!
Okiemom
My new doc is a psychopharmacologist, a child/adolescent psychiatrist, a general psychiatrist..he specializes in bipolar and mood disorders but the first day he told me he also treats ADHD. He seems to know what he s doing but if 72 concerta did nothing for me and I asked for him to titrate up beyond that, I doubt he would do that. I already went to a doc who refused to rx stimulants b/c he thought I was drug-seeking to lose weight (long story). I don't want another doctor thinking the same thing...he'd probably just change my med.my son was also on adderall xr and we had to constantly keep increasing his dosage every 3 months until he reached the dose of 20mg. We could not increase it anymore so we switched the meds to dexedrine 15mg and was on it for 2 years without any dosage increase. It was wonderful. He was taken off of it last year to see how he would do without the dexedrine and no good. He just started the dexedrine 15mg again yesterday. This was the only stimulant that we never had to do an increase in the dosage.