what kind of doctor is this?
Some docs, especially pediatritians are very conservative. Younger kids tend to have a higher metabolism and can burn through the med quickly. The PATS study (pre schoolers) only went up to 22.5mg/day so the doc is trying to not exceed a dose he/she feels there is safety data for. If this is a pediatritian, I would ask for a referal to a child psychiatrist if the pediatrician is getting out of his/her comfot zone for med management.
Another route to take is look at the other extended release meds compared to givine 7.5mg 3x a day of the immediate release med.
Concerta at 18mg is the same as 3 doses of 6mg each day. It is supposed to last 10-12 hours so covers 3 doses.
FocalinXR at 10mg is like 20mg/day methylphenidate (it is approximately twice as strong because it is only the active isomer). This would be like 10mg methylphenidate tuice a day, because it is supposed to last 8-10 hours or 2 doses. A 2.5mg immediate release is available if a boost is needed after school. This would fit within the 25mg limit the doc is comfortable with.
Both ritalin LA and Metadate CD have 20mg forms which are like 10mg twice a day. A 5mg boost after school might be helpful and still be in the 25mg limit the doc is setting.
Or there is the patch. The dosage is not comparable to oral forms. It even gets more effective several weeks after first starting it and may need to be reduced. So if you did not see effects with it, keep it going for several weeks and see if it becomes more effective.
These are ways in which you can work within the doc's comfort zone.
Probably being conservative because he is so young. The meds have not been researched in kids under 6. I would speak to a Psychiatrist for meds. My 5 year old son is on 18 mg of Concerta - its like we aren't giving him a thing. His dr. said we can't go over 25 mg - why is that? It was my understanding with these meds. that it's whatever works - it has nothing to do with age/weight. I am SO frustrated. Your doctor is being very conservative. 18mg is a very low dose. Dosage does not depend upon age or height or weight or hair color. It depends on the amount that works for that particular person.deegypook, you need to change meds. Ritalin LA is a 10 hour med, my daughter did better on that than Concerta.i was diagnosed with ADHD at age eight. until fifth grade my parents saw no need to put me on medication. in fifth i started ritalin(20mg) and i continued with this until now(freshmen year). the doctor put me on concerta(36mg) because of the longer lasting effect. i dont even find it helps me concentrate at all, and the side effects are awful. eye twitches, high energy(scary high), dizziness(that was so bad i had to quit dance classes, and irregular heartbeat. my doctor told me to ignore these symptoms because "theyll go away." i find these symptoms are ones i cannot live with especially since the meds dont help me concentrate like they are supposed to!Are the meds not helping with overstimulation or impulsive control? Have you tried adding guanfacine/tenex - have you read any posts on it? Lots of parents have their children taking that in addition to the stimulant or even alone. My son has had great success with it. We started it along with the concerta at the begining. We found that if concerta was alone, it wasn't as helpful without the guanfacine. It really helps our son and his impulsiveness. It realaxes him.
I feel bad since you had found a med that was successful for your son then it all changed. I didn't realize there was a recall.
Since you know that he is successful with a med, it just takes some time to find the right one, and the right dose. Have you thought of seeing a psychopharmacolgist to help with them meds? Our son sees one. This doctor knows his meds inside and out!!
I know how hard it is. I truly wish you the very best for your son!!
Why are the other meds not working? Not hleping symptoms or side effects? there are a few other stmulants you have not tried. Adderall and Focalin are the first two that come to mind. Strattera is non stimulant and worth a try.
Why did he stop the Daytrana? The recall was only for the backing and the ones that have replaced it the backing works fine. If that worked for you, ask to go back to that. We put my daughters on an hour (or more) before she has to get up, this is to avoid a morning booster as she does not tolerate oral stimulants, especially the short acting ones.
I am really needing some advice or direction. At this point - I don't know what to do. My 5 year old is not reacting to his stimulant medications. Right now we are on 36 mg of Concerta and its like we are not giving him anything - and to my husband - his symptoms are wrose. He was doing great on Daytrana (10 mg patch with a 5 mg boost of Ritalin in the AM) until the recall and then his psychiatrist wanted to try other oral forms - with no success (plain Ritalin, Metatdate CD, Vyvanse, Concerta - we have tried these).