Honeymoon Over? (Too good to be true...) | ADHD Information

I agree with Dan in Akron - Medication is not solely for behavior modification. Once the chemical balances are straightened out you MUST work on his behavior so HE can change his reactions to situations. He must learn what is appropriate and what is not.

Also - I always hear the of the terrible 2's but from my research 4 year olds have worse behavior issues - that trump any terrible 2's.

He must learn that his behavior is unacceptable - you will not tolerate it. Keep your head about you - don't raise your voice. Try to calm him down - this may take a while for him to adjust but trust me it will eventually get better. Reward the good behavior. Patience is key here and don't give up.

Also - I believe in alternative supplements so I don't have to give my son more medication. Omega 3, Magnesium and I just add B-12. They all took a while but I really think they help.

My son also started FocalinXR about the same time as yours. We also have been having some issues Like he can't stop talking. The doctor and everyone I talked to said it took a good three weeks to see the effect of the medication and to minimize the side effects(we see almost none) he does not want to increase before then. As others have said, keep a journal of your observations so you can give it to the doc when it is time.Good Luck, I also use a behaivior modification plan with or without the meds to help keep things at a reasonable level, with time outs for him when he explodes, just to regroup and process what his choices are. He usually will come out and do the right thing in the end.Yes, good replies to your question so far.

All I can add (IMO) is that from what I have learned so far with our boy Jacob, medication will not make our boys any better... Medication only makes it possible for our boys to act better, if they choose to do so.

Before medical intervention, our boys had no choice. Their misbehavior was due to a neurological condition. Their brains would not permit good behavior. However, once they received proper treatment, they needed to learn coping skills in order to handle stress, anger, boredom, etc.

So what I'm saying is this... Your son's recent mis-behavior may be a result of improper meds, or inadequate dosing, but it also may be just a normal part of being a boy his age. It might be that he just needs to learn, through parental discipline, how to behave properly. Now that he's been diagnosed and receiving treatment, that can happen. But don't be surprised if he resorts back to old behavior patterns in order to manipulate others to get his own way. As the saying goes..."Bad habits are hard to break."

I don't know if what I'm saying is right. It just reminds me of our son and the talks I've had with my wife about similar situations. But nevertheless, keep good notes and speak to your doctor about it next time you go in.Dad in Akron39328.756400463

[QUOTE=3toons][QUOTE=ZiSue]
One thing I've noticed is helping us a bit is that I've started giving him his medication after a high-fat breakfast. I read that this can slow down the absorbtion of the drug, and thought I'd give it a try. So far it's working and the morning CrabFest isn't so bad . . . or else he's just getting used to the drug. I don't actually know. I'm slowly coming to terms with the fact that I'm never really gonna know anything for sure. :)

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Our kids sound exact! Ideas about breakfast suggestions? On a typical morning my little guy gets toaster sticks (without syrup, of course), fruit, and LOTS of bacon! More ideas?

This information is really helpful to me too; thanks all.

3toons, I wanted to say that my son (age 5) just started Focalin XR a few weeks ago as well. I charted his reactions for a few days, and have also noticed that the biggest behavior issues come 3-4 hours after he receives his morning meds, and then a somewhat "easier" difficult time around 5:30.

For us, while the hostility he exhibits then seems unusual, I actually feel he's got more control over his temper than he's had without the meds. Still I plan on asking at his neurologist appt next week if this means the dosage is wrong -- he is so incredibly happy with himself the rest of the time it seems a shame for him to have to deal with this.

I noticed that when you look at the time-release graph that comes in the Focalin info pamphlet, it shows that at exactly four hours there's the biggest drop in the amount that's in their system, and it seems to come on really fast. And the afternoon one (that comes around 5:30) tapers off a lot more gently. Perhaps that sudden drop is just too much for our guys to deal with.

One thing I've noticed is helping us a bit is that I've started giving him his medication after a high-fat breakfast. I read that this can slow down the absorbtion of the drug, and thought I'd give it a try. So far it's working and the morning CrabFest isn't so bad . . . or else he's just getting used to the drug. I don't actually know. I'm slowly coming to terms with the fact that I'm never really gonna know anything for sure. :)

ZiSue39329.5891435185[QUOTE=ZiSue]
One thing I've noticed is helping us a bit is that I've started giving him his medication after a high-fat breakfast. I read that this can slow down the absorbtion of the drug, and thought I'd give it a try. So far it's working and the morning CrabFest isn't so bad . . . or else he's just getting used to the drug. I don't actually know. I'm slowly coming to terms with the fact that I'm never really gonna know anything for sure. :)

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Had the same reaction with Ritalin LA. Wear off before 2nd "dump" of meds. Then changed to different delivery method.

Our son has been on numerous combinations and types of drugs to find a suitable match for the past 7 years. With each change in dose,/ combination / drug, I keep a very to the point table of reaction + , - ,= in 30 minute intervals as an evaluation. From this I can plot low and high points which helps immensely with the introduction of 2nd doses / increasing doses. I also make a note beside changes that I see - if I have a willing teacher, I send this in to school. As a teacher myself, I have used this on a clipboard on my desk for a few days to help parents /doctors work out doses and suitablility of meds. If there is a problem with the meds, patterns will appear. Then when I need to check on what meds were like, I refer back to my "log" . Sometimes I am confused and my specialist will look at it and see the problem immediately!!

Also agree with food and breakfast. Increased protein has worked for us. We have also just gone on a gluten free diet to add to his dairy free diet and the life of the meds has improved by 50 %. The gut seems to have better adsorption of the long acting meds now he is off these irratants.

All the best

My son struggled for about six months after starting Adderall XR at 4 1/
2. The best explanation I heard was from a doctor that tested him for
Aspergers, because his behavior had become so odd. Basically he said
that he hadn't been "on the planet" learning with the rest of the kids, so
he was working through issues now that most three year olds have
figured out, many having to do with temper and impulse control. It just
looked very strange in a kindergartener with a huge vocabulary. Of those
six months, the sixth was the worst! Then he seemed to turn some sort of
a corner, and within six MORE months was acting roughly his age. We did
need to increase the dose after three months, actually adding a second
dose of XR at mid-day.
It could just be that your son is testing new limits in how far he can let
himself go, and then regain control. Or not. Good luck... he very really is
moving forward I bet!
Just to add my experience with Focalin XR. I worked fine for ds, however he
metabolized it so fast that it only lasted about 4 hours. We had to go to the
short-acting Focalin about 3-4 times a day. He was very up-and-down
during the day. Finally switched to Daytrana and it is soooo much better.
No up-and-down if you know what I mean. Just a steadiness throughout the
day. He would get silly as the short-acting med wore off and we would have
to wait for the next dose to kick-in. It didn't work for school. He is now 7
and doing well on Daytrana. If your child metabolizes meds as fast as my
son does, you might need to try Daytrana or Concerta.[QUOTE=JO58]

Focalin Xr releases an immediate burst of meds and then another burst @ 4 hours later so you may be seeing a let down before the second burst is released. I would talk to the dr. about how to handle this.

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This makes a lot of sense!!! I had thought that the time release was consistently medicating throughout the day! I'm calling the doctor tomorrow.

Could be a number of things. Their body chemestry is not the same every day so the absorbtion rate could differ. Even with medciations, he will have good days and bad days as we all do. Give it a bit of time and as suggested monitor and make notes. Fine tuning is part of the process.

I wish they had all of these medication delivery systems when mine was young <sigh>.

Good luck and keep on plugging.

dizfriz

Great replies to your post. I just wanted to add that it could possibly be that the dose is too low.

You may be seeing rebound, early with the "jumping up and down and hitting every object in sight". (I am quoting that from your reply post)

If his activity level is the way it was before the meds, then what good are the meds?

I would call the doctor. I feel your ds need's an increase.

Just my opinion.

Good advice all!!! I'll talk to the dr. regarding upping the dose after we chart his behavior to see if there are consistencies over the next few days.

Bethann, to rephrase, he actually rebounds @ 5:30 pm and the rebound effect is actually quite subtle. It's like he slowly eases back into the child we knew a week ago off medication, so no loss there. When he jumped up and down and hit everything in sight yesterday, it was just a few hours after taking the medication (@12:30 pm) but once he calmed down, he was again the extraordinary "new and improved" son! My husband just reported, however, that my son NEARLY lost it in the car coming home from church today but regained control after a privilege was threatened to be taken away. He said it could have gotten real ugly real quick!

Do you think this could this be rebound early? If so...YIKES!!!

Your replies are fantastic! After being asked if there was a pattern noticed- Yes! Yesterday, after @ 4 hours of taking the medication he pitched his "fit" then today when he nearly lost it in the car with my husband after church was @ 4 hrs. after medication. What's up with that? The rest of the afternoon, he was PERFECT- we had the best afternoon and he was stellar!

I agree sounds like rebound. Some of the other extended release drugs release differently rather than 2 "bursts" and you can avoid that rebound effect.

If you decide your ds needs a long-release form of methylphenidate that dispenses meds more evenly, you might want to consider Metadate CD. I researched the methylphenidates a lot when my child had to discontinue Focalin XR due to getting too flat 2 hours per day, and his flat period coincided exactly with when the concentration levels were highest in the blood. I wanted a med. with a more even distribution, and Metadate CD is more even than Ritalin LA. I should add that I extensively compared only these three (didn't look at Adderrall or Vyvynase because I wanted to stay with methylphenidate, and I didn't look at Daytrana because my child has strongly stated that he does not want a patch. I also didn't look into Concerta because my child took it one day in the past and then stopped being able to swallow the pill. Now he can swallow pills, but he was too flat that one day he took it, so I wanted to try other meds).

Edited to add that the dr. originally suggested trying Vyvynase, but I told him I'd rather stick with methylphenidate since we already saw that worked for him. When I asked him about Metadate CD and explained why I was asking, he agreed with me that it was a great option for ds. He's been on it just a few weeks now, so it's too soon to say how it's working out.

Mom2ADHDboy39328.825775463I have the same question, when is this behavior? All day or is it rebound? Either way if it's new it is probably related to the med and you may need an adjustment or change. Dont get discouraged though, there's is usually some "tweaking" involved.

I'm the school counselor who posted just 4-5 days ago about the incredible success my son has been having on 5 mg. Focalin under the "too good to be true" post. He's truly the most charming, incredible kid on medication and has found a new sense of pride. Me? I'm a much better mommy...much more patient and loving to be with my son now.

HOWEVER, just yesterday, we had a series of nice little tantrums! Not just your run of the meal 4 yr. old tantrums, but pretty aggressive for him. While he's had tantrums before, his ADHD distracts him quickly to another activity to keep him from realizing what he was mad about in the first place (hidden blessing of ADHD). On medication, the tantrum seems to go on and on...and he's much more intense. While I know this could be a side effect of meds. - is this normal that will go away with use? Or is this something more? We've had such incredible results thusfar, I would hate to think we might have to change meds!!!

Is it in the evenings after the meds wear off? If so then it is rebound, and you may want to go to a longer acting med, or change dosages. Oh yeah, give it a few days. Try to write it all down see if there's a pattern for when you call the doc.

It was actually during the day...@ 4 hrs. after the medication was given (its Focalin XR- time release). He was jumping up and down screeching at the top of his lungs and hitting everything object in sight.

Coming off the meds, he gets a little whiny, but he really doesn't seem to show any rebound symptoms. His activity level looks like it did before meds.

Sometimes a behavior modification plan goes well with meds. both in combination works wonders. Things will get worse before better it is the nature of the beast.

I found that it helped me to journal my son's behaviors in the beginning. I wrote down time he went to bed, time he woke up, what he had to eat for breakfast, what happened in between etc. This helped me to "read" him before he went into a outburst/tantrum. We went a while without an outburst and I of course quit journaling. Only to have an outburst recently. Guess what? I'm back to journaling or at least taking some notes. I guess you could say it is similar to Weight Watchers for me. When I quit recording the weight packs on or doesn't come off. The same applies to my journaling or note taking my son's day.

It's possible that the dose is high enough to deal with most situations, but it wasn't high enough to deal with the situation that day he had the tantrum. I'd watch to see if it keeps happening, and then maybe ask the dr. if the behavior warrants a higher dose. Also, keep track of what the situation is when it's happening and what time of day.

One of my son's favorite breakfasts is cheesetoast. It's easy.

First I preheat the broiler. Then I take two pieces of whole wheat bread, spread them with butter, and then top them with shredded cheddar cheese. I put it in the broiler for a few minutes (keeping an eye on it!), pull it out when the bread edges are toasty and then cut off the crust for my crust-hating kid and serve!

The protein, fat, and fiber from the whole grains make for a really good breakfast that takes a long time to digest, I think. I should point out my kid is really underweight and doesn't have any gluten/cassein sensitivities, so while it works great for us it might not for others.

I try not to give juice or sugar or any simple carbs in the morning, because it seems like that would only contribute to the crash in a few hours. Also the nitrites in bacon can cause a -lot- of kids to have behavior problems; mine's one of them. Trader Joe's has uncured bacon without nitrites that's really tasty that we like to buy, but it's expensive. For other protein you could try peanut butter on whole wheat toasted stuff, eggs (my son really gets into helping make scrambled eggs, and you can add all kinds of things to them!), and cashews or other nuts.

The nuts are currently what are getting us through the med-appetite-loss "I don't WANT any lunch Mommy!" period.