Focalin XR 15mg with 4yr old | ADHD Information

wondering if anyone has any advice for me... it is Christmas Eve and I sit here crying as it just took two very difficult hours to get my 4yr old girl to sleep. She was dx with ADHD & ODD about a month ago, started Focalin XR.  We have excellent results and improvement all day at nursery school; she's like a different child, it's a pleasure to be around her..........BUT starting around 7-9:30 each night she is violent, aggressive, laughs in your face, will not listen to any disciplinary measures at all, jumps around, totally hyper.. I am miserable.....then she finally goes to sleep after 2 hrs of this.  I love the Rx results in the daytime and I read other posts and feel this is "rebound" behavior as Focalin XR has worn off. Does anyone have experience with this?  How do you get through this phase or does she need a fast acting dose now also?  I hate to give her more Rx but I will if it is necessary.  Right now, I could use some Xanax myself.  I've got to get help with this soon before I have a mental meltdown...

 

 

 

 

 

Is the aggression/violent behavior new with the Focalin XR?    If the behavior is new,  you might want to try a different med (Ritalin LA,  Concerta, Medadate CD) in the ritalin family.   Each on of these has a different delivery system and that might improve the situation.

With my daughter,  we had the agressive/violent/defiant behavior prior to medication or when her dosage was too low.   She'd work really hard during the day to keep it together than just lose it at night.   At the right levels (we use Concerta and tenex),  she is very even keel.    You could look at dosage as well - though 15 mg of Focalin XR seems like a lot to me for a little one (yes, I know dosage is sympton based not weight based).   A small dose of a short acting in the afternoon might make the rebound less harsh.

If the behaviors aren't new,  the other thing to try is a solid consistent behavior plan.  With my daughter (she was older),  we worked on one behavior - compliance.  Everytime she did want she was asked - big or small - we have her a tally (could be sticker, marble, whatever) on a chart.   Once she earned enough tallies, she received a reward.  It was simple and easy.  We didn't take away tallies for bad behavior - once you earned them they were yours.

For the tantrums,  don't engage.  Don't even try to talk/rationalize with them.  It doesn't work.   Find them a spot to chill and when they are being quiet and rationale, then talk with them.    Teach them a feelings vocabulary.   This might be harder to do with a 4 year old - but talk about what is behind the anger.  Are they frustrated,  disappointmented, scared, etc. 

If you like to read,  Greene's book "The Explosive Child" is a good one.   I don't know the authors off hand but "10 Days to a less Defiant Child",  "Chaos to Calm" and "Transforming the Difficult Child" are also good.  

Finding a good therapist might also be helpful.  It was one of the best things we did for our family.  My only regret is that I didn't do it sooner. 

I've probably rambled long enough.  Hang in there.  Your not alone.  Many of us have been in th exact same position.  4 (even without ADHD) is a tough age.  It gets better as they get older - though there are some nights were my almost 12 year old has me wishing for xanax as well....
We also had horrible rebounds from the FocalinXR. we have tried 2 others since and for now it is Concerta. You are not the only one going through this. With his last med DS was violent and angry all the time. Pulled him off that(Vyvanse) pretty quick after we upped the dose. He is of course older, 10 now but we have been playing the med game for 1 1/2 years now and hope to God that Concerta is the one.i a

I waited in anticipation for someone out there to give me some advice and your kind, helpful words were the best Christmas gift.  THANK YOU!  I was more patient as a result and kept thinking of your advice... don't engage.. it is so HARD sometimes but I just let it me and finally my daughter went to sleep without driving the whole household crazy.  I have also thought seriously about needing to switch to another medication and Dr. agreed he thinks it is the Focalin XR.  He told me to not give it to her today and see how she goes to bed.  She went to bed like a sweet little angel, never put up a fight or anything.  So we will need to try something else.  It is very hard to deal with my daughters behavior and the guilt involved afterwards.  I am working on this.. it is an ongoing process, trying not to "lose it" with her so that I don't feel guilty later because she cannot control herself with this illness.  Anyway, I am looking forward to finding a better med for her and getting some peace and harmony back into our lives in 2009.

Happy New Year everyone and thanks for everyone helping each other on here. I am very glad I found this site.