My child started Metadate CD on Wednesday. He took 10 mg on Wednesday, and 20 mg on Thursday and Friday (today). The doctor told us to stay at 20 mg for 2-3 days, and then go up to 30 mg. At 20 mg, we're seeing a lot of appetite suppression during the day. We're seeing more appetite suppression at 20 mg of Metadate CD than we did at 20 mg of Focalin XR! If you're not familiar with these forms of methylphenidate, 20 mg of Focalin XR is twice the strength of 20 mg of Metadate CD. I don't want to call the emergency number over this, so I emailed the doctor, but I doubt I'll hear from him before Monday. Should we stay at 20 mg of Metadate CD for longer to let his body adjust to the new medicine? Will increasing the dose slower decrease the appetite suppression issue, or will it not make a difference? The doctor isn't concerned with raising the dose very slowly because he knows his heartrate, etc. are unaffected by methylphenidate because he did fine on Focalin XR (we're switching off it because he got too flat for a couple of hours each day).
Given the light demands during the sumer, I can deal with him on 20 mg for longer, but I'd like to get him on the right dose as soon as I can. Before school starts, I'd like to see if this medication is the right one for him. We're eligible to increase to 30 mg on Sunday, but I'm wondering if he needs to stay at 20 mg for longer given the heightened appetite suppression.
TIA!
If you are concerned I'd stay at the 20 for a few days. Appetite suppression is always a concern and if you increase the dose you're going to increase the side effect. It may subside or at least get better after a few days, it's worth waiting. If it doesnt get better you can talk to the doctor on Monday.The doctor e-mailed me this morning. The longer we stay at 20 mg, the less side effects we'll see when raising to 30 mg. He said that we should stay at 20 mg for awhile longer if his behavior is tolerable. 10 mg was not tolerable, but given summer demands, I can deal with 20 mg for awhile, so that's what we'll do. Thanks, Diane, for offering your advice!