Just a bit of input--my 7 year old has tried Ritalin LA and Concerta. Two thoughts.
No rebound with Concerta--smooth as butter. You might want to give it a try. But for us, 18 mg. was too high of a dose during the better part the day.
He is on less than 20 mg of Ritalin LA. I take out about 1/3. But it is done and out of his system after 7 hours when he gets another 5 mg. of short acting. Since your sons grades in school are good--maybe you are seeing him after the Ritalin LA is out of his system. Maybe he needs a booster.
Where you were not on ritalin previously, it might be helpful to establish the ideal dosage for short-acting, and then use that to establish your long-acting dosage.
Good luck
we were not able to transfer dose information from short acting to any of the long actings, it is just metabolized too differently. We had a terrible time with Concerta (twice age 9 and age 12), so really another example of how everyone is just so different.
Hi,
I will try to make this brief. My ds was on Wellbutrin because we thought he might have depression. He reacted okay to it but not great. I felt as though it "dulled" him or made him "flat." After several weeks we added Ritalin LA (20mg at first then to 30mg) which we saw a great improvement with. However, as a mom I felt that part of his personality was missing. After school ended we slowly took him off of the Wellbutrin. His last dose was three weeks ago. We now find him incrediably difficult to deal with (not that he was ever easy). His emotions run very high, cries about everything and is more oppositional than ever. Also more scattered in his daily life, forgets things and just not real focused.
Here is my question. Is 30 mg enough for him because the Wellbutrin also had a stimulant in it? I asked his doc who did not want to up the Ritalin LA. But, he is 10 years old, very active, tall for his age (a bit on the skinny side even before stimulants). Is 30mg a high dose for a 10 year old, a low dose or a right in the middle?? He is also on 1mg of Clondine for sleep. On a scale of 1 to 10 for ADHD boys I would put him at a 5 to 6. Any thoughts if his meds should be increased??????
He
Dose is dependant on symptom relief not on weight or age. Talk to the doc. You are dealing with a combination of issues and it can be very difficult to sort them out. He might be adjusting to not having the welbutrin (brain chemistry changes), the ritalin may be not enough, it may be increasing his anxiety or what you are seeing is rebound.. You might also talk to the doc about trying clonidine during the day with the ritalin. It can help to ease the times when the meds are not in his system as well as the transitions from medicated to unmedicated. If the clonidine is too sedating, guanfacine (tenex) works the same way.
It might help to keep a diary of the times meds are given and the behaviors seen at different times of day. This can help sort out if the meds are increasing anxiety or if what you are seeing is due to rebound. It can take time to get to the best treatment. Good luck.
vickie39282.9293634259the Ritlain LA may not be the best choice for him. Sounds like he has never taken it without the Wellbutrin right? Wellbutrin also is supposed to make you feel up or happy. When my daughter took it she was very happy and postiive. I would also talk to the doctor, three weeks is a good amount of time and if he is still acting this way it should change. The dose may be too high rather than too low. As Vickie states stimulants can increase anxiety and he may actually do better on a lower dose or a different medication altogether.Hi,
When we first went down the road of medications we tried him on Concerta and Adderall. Both were horrible with the rebound. That's why we tried the Wellbutrin but I always felt it dulled him. Did not make him happy, he was just flat. So flat and "out of it" in fact he was not getting his contract renewed at his school. When we added the Ritalin LA the change was dramatic as far as school was concerned. His grades at the end of the year were the highest marks possible and of course his contract was renewed. He attends a school that does not give letter grades in the lower school.
I saw no rebound on the LA. Upon completion of the Wellbutrin he was happier for a while and I saw some spark come back to his personality. He described himself as feeling better. Now we are seeing more day to day difficulty regulating his emotions, oppositional behavior and general unhappiness. He blames everyone and everything for his unhappiness.
One additional problem is he seems to be having more difficulty falling asleep than he previously had. He is on 1mg of Clonidine which was helping for a while but now he is having problems. Does that sometimes need to be upped??
My husband and I have an appointment next week with his doc (Ped psychiatrist) to discuss additional meds and other behavioral problems.
Thanks.
I'm glad you are seeing the doctor. We had some rebound with Ritalin LA, but it was more silliness. Who diagnosed him? The ped psych? Does he have a diagnosed co-existing condition? Either anxiety or a mood disorder? Also at 10 hormones can sometimes start to come into play. It's a little young for a male though.
Yes people do take more than 1mg of Clonidine, but sounds like there is more going on than just upping his meds.
He should not feel flat, or oppostional or unhappy. Could he be depressed again? My daughter did VERY well on Zoloft also. She doesnt take it now, but did for a short time and had no problems.
Diane V39283.3527430556Jeaniejo-
We switched to Methylin ER (which is a 6-8 hour). He metabolizes it in 5 hr. He takes it 2x/day (7a.m. and 12 p..m.) so it is done by 5 p.m. When and if we have an evening activity, he takes 5 mg of short acting. The benefit of the ER for him are 1) no noticeable valleys, which we experienced slightly on the Ritalin LA; 2) 10 hour coverage with 2 doses; 3) insurance covers it; 4) 10 mg dose more consistent than opening the 20 mg capsule of LA and dumping 1/3. I did like the LA and might need to go back to it at some point, but right now, this works.
We are able to get him into bed by 8:00 and asleep by 9:00. I am hoping to bump this to 7:00 p.m. when school starts. As a comparison, on some of the other med's and even on the Methylin ER, when the medicine was in his system until 8:00 p.m., the earliest he was asleep was 10:00 p.m. and sometimes as late as Midnite!! UGH!!!!!!
Obviously, I am not yet taking into account the evening homework time. But we will cross this bridge when we get to it.
I have seen all the wonderful feedback on Tenex and have spoken to his dr. about it, but we are waiting for now.
Jeaniejo,
Just read one of your other posts asking about the p.m. short-acting boost and the doc's reluctance to prescribe. First, my son metabolizes the 5 mg in 3 hours. Second, we experienced sporadic rebound on the short-acting UNTIL I devised my own time-release. I cut the 5 mg in half and dose it 20-30 minutes apart. Since doing so, we have seen no rebound. Our doctor sees no problem with doing this.
Hi,
My son is now on RitalinLA 30 and .5 Tenex is the am and 1mg in the PM. It has been about 3 weeks on the Tenex and if there is improvement in his overall moods it is slight. The doc said Tenex can take two to four weeks for full effectiveness. The Tenex is not as effective for the sleep issue. Some nights it seems to work other nights it doesn't.
I wish I had a happy child. He is happy if everything is going exactly as he wants. It's all his agenda and he can't be asked to do anything with out a fight.
School starts next week and I don't know whether to take a sigh of relief or cry.