Newbie Intro w/med ? | ADHD Information

I'm a newbie here but even I know that your doc is not being helpful. Its also
my understanding that is best to start out with something short acting to see
how it will be tolerated. Then as you work thru the kinks of side effects and
getting the right timing and dosage,then you can move more confidently to
a longer acting one. Also, if there is an immediate bad reaction your child
doesn't need to endure it for 6 to8 hrs- it will all be over in about 4. I also
learned really quickly that playing with dosing and timing changed things
dramatically, so tinkering and experimenting is almost always neceassary. If
you don't have a doc that's willing to go thru the details of what to do and
expect with meds, then i would recc a book called "straight Talk about
pyschiatric medicine for Kids" by Dr. Wilens. it really helps break it all down
for parents. Good luck and don't give up so soon!I had this happen one day because ds had spit his pill into a potted plant after he pretended to swallow it. Another time, I forgot to give him his pill, because it was a late-start day, and I just spaced it out.

Luckily, he has started to figure out that he likes the person he can be with his meds, and he now reminds me if I forget.

Funny, though, when he has a bad day now, it really irritates his teacher, because she has gotten used to his better behavior. It's as if kids who are medicated aren't allowed to have bad days every once-in-awhile. I know all kids are different, but our son, who just turned six and weighs 50 lbs. started 5 mg. focalin xr over Christmas break and although we noticed a great improvement in his behavior at home, it could have also been because of all his new toys. First day back to school the teacher said she noticed no difference in his behavior, so we upped it to 10 mg. the next day, and he has been doing wonderfully in school since then. And YES it lasts longer with 10 mg..about 8 hrs. compared to 5 to 6 on 5 mg. He also had worse rebound on 5 mg. From everything I've read, standard dosage is to start at 5 mg for one week and then up it to 10. If the dosage isn't right, the meds aren't going to work! Sorry to hijack: Kathleen 0515, I've been posting about my sons issues with
getting glazed over , and disengaging on short acting Focalin. ARe you
experiencing that at all with the XR? I think we night switch to XR and see
what happens over feb break

Hello, I have been reading for a few months now. My ADHD son is 6.5 and in 1st grade. He is hyper/impulsive, he does not get personal space, and is very much into getting attention for negative behavoir. I had him dx'd right before kindergarten as I saw how bad pre-school was for him. He got in trouble so much that an eye blinking tic started. I think it was that "Ms. Marge" always shaking her finger in his face. Grrrr! He is now in a wonderful public school w/an IEP and his own paraprofessional. He has no LD's, but his behavoir causes a LD environment, I guess you can say. He is in an "inclusion" class, where there are two teachers, and he has the para. He gets OT for his handwriting, group counceling for social skills and a well managed behavoiral system is in place. They have to change it up on him from time to time, tho, because he is so smart that he figures out ways to beat the system, lol. The vice principal thinks my ds's mind is great, now if we could just harness this force for good instead of evil!  There is also the daily threat of him getting kicked off the school bus because he doesn't sit still and is very noisey. Basically, he is always moving or making some kind of noise.

Soooo, after a horrible trip (for me!) to Fla over Christmas, when my SIL said that I do not enjoy my son and if he were a diabetic I would have to give him insulin, I made the appt w/the neuro pedi and got the rx for Foculin XR. We just started last Tuesday on 5mg. 

Where's my miracle?  I've had to call the doc twice so far. Last week I called because it does not seem to be working long enough and when he comes off it, he seemed more aggitated, crybaby-ish, like sobbing cries if he doesn't get his way. Yesterday, his para was not there and he had a problem at lunch time. He was not hungry and had a headache. The med must have been wearing off because they called me to come get him at the nurse's office and he was very hyper. Perhaps putting on a show for me/us. We were in the hallway leaving and we see my two-faced neighbor (her ds walks on water) and my son's unfiltered mouth tells her "My mom says you're a jerk!"   Oy! 

So again, I call the doc and he said it's not from the med, prolly had a headache from not eating lunch and I should give more breakfast. I told him how it is not lasting the 6-8 hours it's supposed to be lasting. He said that maybe he needs another dose in the afternoon or perhaps another med. He talked briefly about the Daytrana patch. He did not seem interested in upping the Foculin dosage. He said that would not make it last longer.

My question is: does this seem right? Upping the dosage would not benefit him? The med is not causing the headache? His eye blinking has started up again and I read about Daytrana's "tics" side effect. Do I let him try it anyway? The doc seems to dismiss these things I'm concearned with.

Thanks if you made it this far! Hope to hear and learn from those experienced w/these meds...

 

I'm not too experienced, but man does your ds sound like mine!!! It is still strange for me to get on this board and see behaviors that are so similar. WOW. Anyway, stims never worked for us, so we use Straterra. Unfortunately, it doesn't have the benefits I see some parents talking about here, but he is doing so much better in school and that's what counts. I'm considering tenex or something else extra to help with the hyperactivity part, but the Straterra works great for his impulses and concentration and social interactions.

My main concern for you, though, is your unhelpful doc. Any chance you could see someone else? I sort of wish our ped knew more, but he is always willing to listen and confer with experts in the city. It's really important to have a doc who listens to your concerns...and answers them to your satisfaction. OneOrTheOther40211.9054976852

I would change doctors!  Trying to get the medicine right is hard enough with a great doctor.  You don't need someone that is going to act like that!  I recommend a psychiatrist or other medication specialist.  You will find your "miracle" faster and hopefully with the least amount of stress possible.  And I'm not a doctor but I disagree with several things he's saying...

First, maybe the medication isn't supposed to last longer just because the dose is higher but it does! At least for my son anyway.  And I think you'll find others on this site that have had the same experience.  When my son takes 2.5mg of Ritalin it lasts 3 hours (barely!).  When he takes 5mg, it lasts 4 hrs. 

It sounds like your son is having rebound as the meds wear off.  Usually that means he needs a higher dose, an extra dose, or a change in meds altogether.  It's probably not a good idea to switch to another med until you've at least tried the first two options.  If your doctor isn't willing to try these things then get away fast! It will make your life easier in the long run! Good Luck!

Update: Ds is having a rough day at school. I heard from the teacher by email that there was a problem on the bus, another problem during math, he wasn't focused and was mouthing off. I was told he was starving at luchtime and couldn't eat fast enough! Hmmm...perhaps I should ask dh if he actually saw him swallow the med this a.m.! I'll be calling the doc later as well....sigh.

 

Thanks for your replies. The doc we are seeing is a neuro-developmental pedi. I am supposed to call him on Thursday and we'll see what he says then.

Erik had a great day yesterday and even after school at karate. I do not know if it was because of the med or if he just had a good day. It was typical for him to have a bad day and then a good day prior to meds. One thing I did different yesterday we gave him an egg w/his breakfast so he had some more protien than w/just the usual cereal. I did that again this a.m. so we'll see later how his day was ;)

 

yes my son can be that way too. perhaps that contributed. Still,my son had
consistent stomaches, and a couple of headaches, on off for a alittle over a
week until he got used the meds, so you can't rule that out that he's having
these side effects- which are pretty common when starting out. I too load up
my son with breakfast, and that has helped him get through eating almost
no lunch now that he's taking meds. Interestingly , we have a great
reputable pyschatrist, but I too get the feeling that discussing too many
details about meds is not his thing in a weird way. I'm considering seeking
out a pediatric pyhschopharmacologist whose entire purpose is the minutae
of the medication. I find in very interesting, and have endless questions,
and so I think in terms of just meds I'll be better off having a specific
specialist like that. Good luck!

Hello all...I spoke to the doc last week and he wants to keep him on the 5 mg. Since ds is only 44 lbs, he doesn't want to up it to 10mg. I mentioned perhaps splitting one and giving him 7.5 mg, but he said let's wait. I've seen a slight improvement, but I feel he could be doing better.

Is anyone out there w/ a child under 45lbs and giving more than 5mg Focalin XR? Has anyone ever adjusted your child's dose w/out your doctor?

 

I don't think you can split the capsules, because the beads are intermixed for the long lasting effect, so it's different than the short acting pill. Kendal is 49 lbs and is on 10 mg. but I am sure there are plenty of 6 yr old that weigh what Matt does. Sounds like your doctor is on the conservative side. If I were you, I might suggest that you just try two pills one day and see what happens. If it's too much for him, you can certainly go back to the one pill. We didn't get the 10 mg pills for a month, I just had to finish out the 5 mg bottle by giving him two each morning, although I must say it was a pain trying to make sure none of the sprinkles fell off the teaspoon of ice cream!