Could someone explain rebound? | ADHD Information
I am so relieved to read the posts here. My son age 8 ADHD (inattentive type) had the most brutal rebound yesterday and another Mom suggested this forum. Thank you!!! He was swearing and using violent language. Very out of character for this sensitive boy. Lately rebound has been an issue even though he's been taking meds. since Oct. We have been changing doses...I'm going to talk to his Dr. today. I thought he may be hungry (lighter appetite with meds. ,metadate 15mg. in a.m.) too as he picks at lunch, so will push the protein snacks and water. Interesting about the caffeine bridge...
He is also now having trouble sleeping and was awake till 10:30 the last two nights. Bedtime is 8:00. Afternoon dose of metadate 10 mg. at 3:00.
So complicated...
Interesting about the caffeine. I don't think my 5 year old would go for it though, he has never had soda. He likes water, diluted apple juice and Milk (strawberry and chocolate Nesquick). I suppose it is worth a try, isn't everything?
I talked to his psych yesterday about what we can do for the rebound. I mentioned to him about decreasing the frequency between doses. He said that wouldn't work because he would still need to *come down* off of the first dose, even though he was getting a 2nd dose sooner. He suggested we try a different class of meds, getting away from the Methylphenidates. He wanted to try Straterra but I said I wasn't willing to fight another battle by gettting a 5 year old to swallow it. Maybe this summer when he is out of school. For now, we are going to try the Daytrana Patch, 10 mg. He says it is smoother and the come down is more gentle. We'll see, he also said that about the FocalinXR.
I am careful with chocolate because I found that my son is sensitive to the effects of chocolate. He had a triple fudge brownie ice cream and it sent him over the top. We don't have chocolate ice cream in the house anymore.
We did the Feingold diet for 2 weeks and that was the one thing that I discovered. Since he is an extremely picky eater, he almost starved on the diet. He would not eat the allowed foods.
The suggestion about caffeine made me curious because I used to work with a guy (a programmer) who swore that he would have flunked out of college if not for caffeine. He said that he decided on his own that he was ADD and that the caffeine allowed him to focus and study. I thought he was nuts at the time, but that was long before I knew anything about ADD or the stimulants used to treat it.
So I googled and found this thread which some of you may find interesting...
http://wiki.answers.com/Q/What_does_caffeine_do_to_an_ADHD_c hild
Some good comments were made about the pro's and con's, though many of them concern adults with ADHD.
My son will not drink Coke, but I am tempted to make him a smoothie using some black tea.
Here is a recipe for a Green Tea Smoothie, you could probably replace the green tea with black tea. I don't follow this recipe exactly. I change the fruits and add more tea. Sometimes I add a banana or subsitute raspberries and bananas for the mixed fruit. And, I don't share.The one time I did share, my daughter said it would really be good with a shot of rum in it. I guess that might negate most of the healthy properties.
Green Tea Smoothie
2 cups of frozen mixed fruit (peaches, melon and grapes)
3/4 cups of hot brewed green tea
3 tbsp Honey
1 tbsp lemon juice
Combine in a blender and whiz till frothy. Serves 2.
The nutrition information states: 169 calories, 0 fat, 0 cholesterol, 4 gram fiber, 35 mg potassium per serving.
Added bonus is 57% RDA of vitamin C.
This is from www.eatingwell.com/recipes. I have gotten several vegetarian recipes from here and they are quite good.
I have been trying to do a lot of research online. Here is something helpful I found, written by a psychiatrist...
Rebound: Some people who take short acting methylphenidate or amphetamine experience irritability or depression for an hour as the stimulant wears off. Sometimes this is worse than the individual’s behavior before the medication was started. One can avoid rebound by spacing the doses closer together, giving a smaller dose after the final larger dose, or by switching to a longer acting stimulant. Recently several new long-acting stimulant preparations have been released. Although the long-acting compounds often have less rebound, it may still occur in susceptible individuals. Sometimes, we add a tiny dose of short-acting stimulant when the longer-acting stimulant wears off.
[QUOTE=ProDad].My son will not drink Coke, but I am tempted to make him a smoothie using some black tea.
[/QUOTE]
Chocolate works too. Caffeine and sugar. Add that with a high protein snack (peanut butter maybe).
I'm not sure were I read it, or heard it, but I was told until kids reach puberty, caffine works as a downer. Helps them calm down. Now drinks like Mt. Dew and Coke have alot of sugar in them which is counter active to the downer in the caffine, but my boys will both drink a small juice glass of Diet Pepsi (caffine without the sugar) after their glass of milk at dinner. Seems to help with the hour and a half before dinner and bed.
We just got a booster dose of medicine (yesterday) to help put off the rebound effect my son had towards the end of the school day. We will see how it works today, since I have to drop off the medicine to give him till our paper work clears.
My son's doc gives us a short acting focalin at 1/2 his regular dose to take in the afternoon when his focalin xr is wearing off. We don't use it every day anymore (the rebound was horrid at the beginning, not so bad anymore) but we do use it when he's under more stress or when we have to do something that doesn't mix well with him.This might sound crazy but you might want to give your kids a shot of caffeine in the afternoon as a bridge. It is called the paradox effect,and this is why stimulant work for ADHDers. Fix them a protein shake with a cold flavored coffee. 100 mg of caffeine is roughly the same as 5 mg of Ritalin. Try it on the weekend. I found that coffee had a calming effect on my son but he doesn't like the taste. Did you wonder why ADHDers drink so much Mountain Dew? It has something like 52 mg of caffeine in 8 ozs.
I also found that a protein snack right after school helped with rebound. My son tends to eat very little during the day, so he is all whacked out late in the afternoon. I push protein and calorie dense snacks all day long. He likes peanut butter and chicken.
I would liken it to a hangover after drinking too much alcohol... you feel worse than you did before you started (alchol-self medicating). Doesn't sound good, does it? our dd has rebound almost every day in late afternoon for about 1 hour-- food and drinks seam to help-- blood sugar levels? dehydration?I know my son suffers from it. Whenever his Ritalin wears off, 3 and 7 pm, he turns into an emotianl, inconsolable, irrational, irritable, angry little monster. He is only 5, soon to be 6, and is on his 4 med since his dx in September.
His psychiatrist basially agrees to let us try anything, but so far, they all are about the same. We get decent results but the rebound almost keeps us homebound at those times.
I think if I could educate myself more on what causes rebound, then I can do some research and help more in choosing his meds.
My current thinking is that it is the sudden drop in stimulants once they where off?
cali123439559.7459259259I actually just had this conversation with my 8y/o daughters psych yesterday......She is on Daytrana patch, also a stimulant. She wakes up in a good mood, happy, perky, full of energy, but when she gets home from school, she is moody, crabby and generally just not happy. Her psych explained it as something to do with the stimulants wearing off. I dont think a whole lot of research has been done on this, but I am going to try to find out more about it also.