Questions on timing ... Ritalin LA | ADHD Information
What time of day do those of you using Ritalin LA give your child the meds? We've been doing around 8:00 am during school, but that has drifted to late morning now that school is out. Since starting Ritalin LA a few months ago, we saw great improvement all around, with one exception: my 8 yr old is finding it harder to fall asleep, even when he's very tired. Now that school is out, the later he stays up, the later he sleeps in ... you can see the pattern.
We were giving him Clonidine before bedtime, but it seemed to have little effect ...was taking several hours to fall asleep (.2 micrograms). So we fazed him off that and tried melatonin. Now that he's off clonidine, falling asleep has been 1, 2, and last night 3 am. Melatonin seems to have no effect (one week at 3 mg).
We tried regular short acting Ritalin, but he really had a strong rebound effect (something we don't see with the LA version). Also tried a half dose of LA ... same effect. We even tried a few days without Ritalin ... he was worse than we remember him to be before ... hyperactive in way we never noticed (perhaps we were used to it then?).
So I'm wondering a few things. First, is 8:00 am too late? Should I wake him up earlier for his med, even if he falls back asleep? Or should we try the SA version? The LA can last 12 hours ... could be lasting longer in my son. Or maybe the Clonidine was doing something afterall, and we need to go back on that. My wife hated the Clonidine ... his sleep seemed agitated to her.
As background, we're just starting out on this process ... only a few months since my son was diagnosed with ADHD (been working on anxiety a bit longer).
Hi and welcome!
We used Ritalin LA for about 8 months. I agree it was much smoother for us than regular release Ritalin. My daughter had no trouble sleeping though. During school we gave it to her about 6:00. It really only lasted the ten hours for her. By 4:00ish it would be wearing off so we had no trouble at bedtime. You could try getting him up just for the pill earlier. I tried this too, woke her up handed her her pill and water she took it and went back to sleep. The other thing is there is (or was) and 8 hour Ritilan. It is Ritilan SR, maybe he would do better on that.
I just re -read your last line of post, does your son have co-exisitng anxiety? My daughter also has co-exisitng anxiety and it complicates everything. We have not used Ritalin LA, but when DD took Metadate CD we gave it early in the morning, about 6:30 am, and NO later than 7. I have gotten up, given DD her meds, and gone back to bed for a while, and that worked well.We've also been giving the Ritalin LA and Clonidine .1 mg around 8 p.m.and our son falls asleep between 9 - 10:00 p.m. with difficulty.
Prior to the Ritalin LA, he was on Focalin XR and Clonidine and he went to
sleep around 8:30 without problem.
School starts tomorrow. We will give it earlier and I may have more to post
after we see when he falls asleep tomorrow night!!!
We also give Clonidine in the morning .1 mg and afternoon 1/2 of a .1 mg
tab.My son take Ritalin LA 30 mg around 8 a.m..
He takes Clonidine 0.1 mg morning and night with a 1/2 tab at 4 p.m.
The Ritalin LA lasts around 8 hours, but the Clonidine keeps him calm the
last 1/2 of the day.
He is starting SOCCER this week with practice on Wednesday around 5:00 or
6:00. I would like to give him an immediate release Ritalin at 4 p.m., but the
doctor does not want to do that.
Has anyone ever given a Ritalin 5 mg. at that time of day?Has he had trouble sleeping in the past? I only ask because you mentioned anxiety. My son never has a problem with sleeping when he gets his meds late, but when he's anxious about something he's up all night. we have given 5 mg at 3:00-4:00 never as late as 5:00How long does the short acting Ritalin 5 mg. last. If I gave at 4;00, would it
keep going through a 6:00 - 7:00 p.m. practice?
Jeaniejo
Every child metabolizes these meds quite differently.
My son has taken a short-acting boost as late as 5:00, but my son metabolizes it in 3 hours. He metabolizes the Rit LA in 7 1/2 hours (a 10-12 hour drug), and Methylin ER in 5 hours (a 6-8 hour drug).
But there are plenty of kids who experience the opposite (i.e. Rit LA lasts 12+ hours).
in general Ritalin LA is supposed to be 10 hours and quick release 4.
As lostship says every person is different though and each delivery system is different, just because you metabolize the long acting quickly it does not mean you'll metabolize the regular release quickly, unfortunately there's no way to know until you try iy.
Diane V39321.0942592593My son takes the Ritalin LA in the morning and a short acting any where between 3 and 5 p.m. We also tried the melatonin and the cholondine with no help. We now take Trazadone at bedtime and it works for us. In about 20 minutes he is sleeping. Our problem is he just doesn't sleep through the night. As for metobolizing the meds. Our Ritalin LA only last 7 -8 hours for us and then the short acting only about 3 hours so there is a significant time of the day we have no coverage no matter how you time the meds. Cheesehead:I hear about rebound from the short acting, Do you notice that?We have tried Adderall and HATED it. Then switched to short acting Ritalin, then Ritalin LA and now the combination of Ritalin LA and short acting. We like how the Ritalin works, just not how long it lasts. So instead of switching, switching and more switching we thought we would stick with what works. Thanks for the tip we will keep that in mind. The doctor mentioned the new Vanyase because it is longer lasting, but then followed up with that it is Adderall based and then decided that would be a bad idea.
We too have found that Ritalin LA lasts about 6 hours with my daughter. We use a short acting booster in the afternoon, if we find that we need one.
We did a trial of Focalin XR as I was told it would last a little longer and have fewer side effects, but my daughter didn't like it. We switched back to Ritalin LA after a couple of days.
I too wish it lasted just a few hours longer. I am hesitant to switch to other longer acting drugs as what we have had such a positive experience with the Ritalin LA and it's delivery system.
Ritalin LA is not a 12 hour it is a 10 hour, Concerta is a 12 hour.
We gave Ritalin La at 5:30 am and it she was rebounding about 3:00. A lot of people only seem to get 6-8 hours out of it though. My daughter is super med sensitive. I agree that the RLA was the "smoothest" med she took, so we did the same thing by adding to it. I just thought I'd throw the Concerta suggestion out there as it is a 12 hour.
Another thought is to add a small dose of LA at lunch. Some people dont like to give meds at school, but if you like the effectiveness of LA over short acting (we did), our doc suggested a 10mg of Ritalin LA about 1:00 to help with rebound and homework. I did not end up trying it as her rebound was just acting silly and we managed and have now swicthed class of meds altogether. Sounded like a good plan though.
To those who have trouble with your kids sleeping from giving them either the long acting meds or a late day dose. Here is my experience that may be of some help:
I have been through EVERY med for ADHD with the exception of Vyvanse. My DS is currently on the Daytrana patch and short acting Focalin. Because he metabolizes meds so quickly, the patch wears off between 4-5pm, so he needs the Focalin for late day. I give the Focalin between 4-5pm. I have even given it to him as late as 6pm when I knew we would be up very late for a special occasion.
To help with sleep, he takes 1.mg of Clonidine, 3-6 mg Meletonin and if for some reason that doesn't help, his physician said it would be ok to give 25-50mg of Benadryl on occasion.
Now keep in mind, my son is 15, weighing about 130 lbs, so these doses are based on his age and weight. But for those having trouble with sleep from the stimulant meds, it might be a good idea to ask your doctor about some of these.
I have also read several comments from forum members about Magnesium having a very calming and sometimes sleepy effect. I will be starting my own son on it this week myself. Check out the Magnesium thread for more. It contains a wealth of terrific information!
HTH!
TimzMom39323.2406828704We don't see any type of rebound, but each child is different. On some nights we do see that the short acting wears off before our activities are over. With it being summer we are up later and the short acting wears off between 7 & 8 p.m. and sometimes we are up until 9 or 10 in the summer and those last two hours or so can be hard, but I wouldn't call it rebound. It's just my son with no meds in his system.
Our next appt I am going to ask the doctor if I can give him a short acting at 5:00 a.m. when he gets up and then do the LA 9:00 a.m. before school and the short acting again in the late afternoon as we have been doing.
It just seems that if I wait until school to give the LA. I have 3 or 4 hours in the morning with no meds. Then the LA wears off by 2 or 3 and we don't give the short acting until 3:30 or 4:00. So we have from 2 until 3:30 or 4 with no meds again.
I know this might sound like I am over medicating. But my son without meds is enough to drive me mad most days!
heard of it lasting for 12 hours on anyone who posts messages on this
board. My son's lasts maybe 6 hours at the most. The thing we like, though,
is that when it wears off he is a HAPPY ENERGETIC HYPER and not nasty and
irritable like he was when his Focalin XR wore off.
He also wakes up happy and we love that.
I do wish it lasted longer. I do wish he didn't have so much anxiety in the
morning hours when it is keeping him setted down.
I wish, I wish, I wish..... we didn't need any of it at all....but we do.
cheesehead, I did that exact thing, 5mg regular release when she got up. Ritalin La before school and 5 mg regualr release after school. You're not overmedicating because there's no med in the a.m. and for us the afternoon dose helped with the rebound we saw from the LA.
Have either of you tried Concerta? It is a 12 hour. My daughter couldnt tolerate Concerta, but lots of kids do really well on it and it does last longer.