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Ask 4arrows~Increase or switch ADHD med?

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Ask 4arrows is a format whereby a Sonlight sister can post anonymously asking a question or requesting prayer.  Here is the post from our Sonlight sister:

 

 

My student is in college, so I wasn't sure I should post this publicly, but I'd still love feedback on this.

He has taken methylphenidate (Ritalin) extended release on school days for a few years. The first year or so it helped a lot, and then it wasn't as effective. We talked with his doctor and increased from 20 to 30 mg, which worked for about a semester. Last spring he stopped taking it though because he felt it really wasn't helping anymore. Still, he's frustrated with his focus/concentration struggles and wishes he could get the results he did initially, so we're going to talk with his dr. again.

I'm thinking it might make sense to consider switching stimulants, but I'm curious if people have really found a big difference--if one didn't work as well for their student as another? At this point, I don't think we'd try a non-stimulant. He had a bad reaction to Strattera, so that one's out. I think there's only one other non-stimulant that is for adults (I know intuniv is for ages 6-17). Plus, he tends to sleep in on weekends and finds it more challenging to keep up with a med that requires keeping a regular level.  I'd also be interested in knowing if switching within one stimulant category (ie, methylphenidate) makes a difference--or if it only makes a difference to switch to the other category (amphetamine-based).

I also wondered if the CD version, or even taking two doses of the non-extended release might work differently for him...so hard to know. I've also read that a short-acting can be added to the ER--has that worked better for anyone? Since he hasn't taken it at all since last winter, I am going to have him try it again this week and to take some notes--when he takes it, when he feels it kicks in, when it peaks, when it wears off etc..., and if it's not effective, to try to list the issue.

Anyway, I'd love to hear experiences about increasing or switching and how that worked out for you. If you'd prefer to PM, you can post asking me to PM you. Thanks for any help or thoughts.

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SewWhat?

26ds certainly did find help when switching drugs, after one wasn't working as well anymore. Your body does become sort of immune to stimulants after a period of time. He had some luck with Concerta after the Ritilan stopped working well. He decided to stop taking the meds in 11th grade and I figured it was up to him by that point, so it's been a while since I've dealt with the meds to remember which all he took from about 3rd grade to 11th.

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ajbmom

We have tried Adderal, Ritalin, Strattera, and Concerta.  All of those were tried in elementary school.  He's a Junior now and has been taking Concerta since 3rd grade.  It still works well for him.

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doxa

Trial and error is absolutely part of the process.  

 

My son started out on Ritalin (3rd grade) and it worked, but eventually he grew to hate it because it quashed his creativity.  He had a hard time articulating how it made him feel, but after I did some digging online (looking at the experiences of others) and put that together with his statements like, "Like I don't feel like Legos are fun anymore", I could tell that it was really "zombifying" him and sucking the fun out of his life somehow.

 

We went to a specialist and switched to Adderall XR, which was much better.  He got his Lego Mojo back.  Focus was good for a year or two.  Then we noticed a kind of troublesome "crash" time.  He would take the meds at 7:00 or 7:30, and by 2:30 he was DONE.  He would just be so tired and suddenly unable to do one. more. thing.  It was a pretty hard crash.

 

So we went back to his doctor and he suggested Vyvanse, which has a much gentler/slower delivery mechanism and lasts longer, then tapers off longer.  It's an easier "on/off" if that makes sense.  That has been working very well for him over the past two years although I do fret about his lack of appetite.  His doctor assures me that his weight is fine and if we load up on breakfast and then do a big dinner late (toward bedtime) he will be fine.  

 

So far, so good, thank God.  All of which is to say -- yes, definitely switch if one isn't working.  

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4arrows

Update from our SL sister:

 

Thanks for your responses! My son ended up switching to Concerta, and it's been much better for him wrt focus and concentration, and no side effects.

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SewWhat?

Update from our SL sister:

 

Thanks for your responses! My son ended up switching to Concerta, and it's been much better for him wrt focus and concentration, and no side effects.

Great update :)

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slac

Update from our SL sister:

 

Thanks for your responses! My son ended up switching to Concerta, and it's been much better for him wrt focus and concentration, and no side effects.

This is good to know.  Virginia is having a shortage of the Daytrona patch, which is what my ds wears.  He has one patch left and then he has to start Concerta.  He hasn't been able to take it in the past, like 5 years ago, and I hoping he can now.   

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