Hi! I am new here - my son was diagnosed with ADHD Primarily Inattentive this past summer, although the psychologist indicated that he was borderline Combined Type (very much so at home; behaviours more controlled in school).
Connor is currently taking 10mg of regular Ritalin twice per day, at 8am and noon. The teacher has given us FANTASTIC feedback - paying attention, not fidgiting, not calling out answers, completing more work. We are thrilled.
The trouble is the nasty rebound after school, which occurs any time around 5pm and can last from 15 minutes to an hour, depending on the day. Some days he will cry, some days he will scream in irritation. It is horrible, but once it passes he is completely calm.
So - we have an appointment tomorrow for a med review. We initially tried Concerta but it kept him awake at night, frightened. He is sleeping well on two doses of Ritalin.
Has anyone gone from 2 10mg doses of Ritalin to Ritalin SR or LA? I'm in Canada, and only SR is available, 20mg being the smallest dose (so two 10mg released, like he gets now). Did you find similar results? I realize that methylphenedate in different forms acts different. I have also read that rebound is less with the slow release. This would also save him taking a pill mid day at school.
Thanks for any input!!
Jordan M39385.486400463We did not see the same results from regular release Ritilan as Ritilan SR. I liked the SR much better, smoother. We did not find it lasted long enough. It is supposed to be an 8 hour med, so if you dont need late afternon/evening coverage you should be ok.
We can get Concerta. We tried that first but it kept him up all night, and we found that he was paranoid / anxious as he was falling asleep. The longer it took to fall asleep, the more anxious he became, etc. So that is why we switched to 10mg twice per day of Ritalin - he takes his last dose at noon so his sleep is not affected.
I think the same thing might happen if we tried another 10mg at 4. The ped suggested trying 5mg at 4, as coming down from 10 to 5 to 0 is smoother than 10 to 0. I haven't tried that yet because I worry about similar sleep issues, as with the Concerta. I may try it this weekend and see what happens.
Thanks for the ideas - caffeine and exercise! Together, we have found that playing a non-challenging video game or watching a show during the rebound period works, as his mind is otherwised occupied. And, the rebound seems to be less intense as time is going by.
Thanks again! You are all very helpful on this forum!
Jordan M39394.5440277778My daughter is on ritalin and she takes ritalin sr (20 mg x2) tables in the morning and then a 10 mg tablet at 4 p.m. to help with doing homework at night because by the time she gets home from school the ritalin sr is no longer working. She goes to bed around 8 or 8:30 pm and takes 2 mg of melatonin and I don't have problems with her sleeping. Maybe you could try your son on a low does ritalin and if he is having problems sleeping then you could start him on a low dose of melatonin to help with sleep. When my daughter receives her 10 mg ritalin it seems to be wearing off around 7:00.
When I first started on Adderall I experienced pretty strong rebound. I noticed that when I exercised (a good 20+ minute aerobic workout of some sort or another) just about the time my meds were about to wear off--voila!! no rebound!!
So, when you sense the ol' Ritilan wearing off your son before supper, you might try joining him for a jog and see if that helps! Hopefully, with time, his rebound symptoms will lessen appreciably (they did for me) and/or your doc goes along with your suggestion for a meds adjustment... good luck!
I have read that caffeine can help smooth out the rebound. Could be worth a try. I have used caffeine pills with my son later in the day so that I can monitor the dose and he's not getting the other stuff that comes with pop. Have you heard of FocalinXR? it is a 10 hour med (time to do homework, and he still got to sleep with Melatonin. We did still have rebound issues just not as bad, Focalin is a form of Ritalin just dosed differently and milder side effects.Unfortunately we can't get Focalin XR in Canada. We don't even have Ritalin LA yet.
Well, Connor's ped would not prescribe Ritalin SR for him - he said continue taking regular Ritalin twice per day, 10 mg as opposed to Ritalin SR 20mg once per day. This means he has to continue taking it at school. His words - it takes 2 hours to take effect and only lasts 6 hours.
Hopefully one day we will have the LA or Focalin, and I will try for that! Thanks!
well he is partly right, all extended release/long actign meds take much longer to "kick in". A lot of people us a regular Ritalin as soon as they get up, then an extended release (Sr or LA) before they leave for school. This was by the time the SR starts to take effect the regular release is winding down.Good Luck to you, it is hard when certain meds are not available where you live! I hope it works out in the end. Do you have concerta?What about a third dose of the 10 mg ritalin in the afternoon to cover the evening hours?