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Suggestions for Coping with morning behavior prior to taking medication

CourtDS profile image

My daughter (age 6) has been on adderal 15mg for about 2 months now. We started out with 10 mg which I actually thought was working well but doctor bumped it up to 15 to help ease her out of it in the evenings. My issue is in the morning prior to her taking her medicine (which is a nightmare trying to get her to take it since I have to open the capsule and mix with something on a spoon for her) is she acts like Jekyll and Hyde. She yells and occasionally hits me and refuses to get ready. She yells at her little brother for just looking at her. It’s hard for me to get her to stay on task and then we’re racing out the door to get to school on time. I’ve been waiting until close to when we leave to give her the medicine so that she has plenty of time to eat since it does decrease her appetite. Is this behavior to be expected when the medicine isn’t in their system yet? Once she takes her daily dose she’s a million times better and it’s very pleasant.

17 Replies

My 6 year old is similar in that he really tries to push my buttons getting ready for school. What do you do when she hits you? They have to have a consequence. ADHD or not, medication in their system or not, that isn’t acceptable in my opinion. When my son chooses to act out and cause trouble I make it clear that he’s choosing a negative consequence for himself. I make sure he knows what the consequence will be and I follow through. He does way better on the medication and I understand that but I still don’t allow him to act out without a consequence. It’s tiring and frustrating but you have to stand your ground. I also offer rewards as motivation to make that extra effort to make good choices when not medicated.

Paxtonsmommy profile image
Paxtonsmommy in reply to Boymom3

Any bad side effects of the adderal?

CourtDS profile image
CourtDS in reply to Paxtonsmommy

We only started mid-January with medication. I thought we lucked out and got it right with Adderall on a 10mg dose. After about 6 weeks and several doctor visits we decided to up her to 15mg since the evenings were pretty tough with her. The doctor said a smidge higher dose may possibly ease her out of it wearing off and I think it has. Since it didn’t have a negative effect, we’ve stayed on 15mg. My only issues so far is she does stay up later in the evening. So instead of being asleep by 7:30pm-8pm at the absolute latest she’s up until about 9pm. But she’s getting 10 hours of sleep at night. Then it does impact her appetite and she’s lost a couple of pounds. I’ve learned to constantly have snacks out for her. I try to push high protein foods and I’m constantly offering her food. If she goes several hours without eating, like from breakfast to lunch, then she’s less likely to eat all of her lunch and her appetite decreases from there. Funny thing, this last Sunday I decided not to give her medicine and her sleep and appetite were the same. I was hopeful she eat a bunch and fall asleep early. But she was only off of it for 1 day.

katejames profile image
katejames in reply to CourtDS

Your comment about going several hours without eating means she will likely eat less at next meal made me think. I think my son does that also. I'll have to be aware of that this summer so thank you. He also seems to have the same appetite when he goes a day without meds. He is 12 and so thin. Our mornings have never gotten better for 3 years now - so good luck. Charts did not work for him - he spaces off and doesn't hear our cues. So there is a lot of frustration EVERY morning. Horrible way to start the school day. But I am a stickler on him eating everything and drinking an EnsurePlus on the way to school. I'm pretty sure he eats close to nothing at lunch. He should be much taller by now. Not much we can do. He will chew a bite of food forever - its upsetting but nothing I say changes it. I've read that these meds make swallowing almost a gag reflex so that makes me feel awful for him. He's obviously trying to be good but we really have no idea what they feel and go through. He can get very angry and belligerent at mealtimes. It's hard and I don't have any answers. High calorie food when he does eat and praise.

CourtDS profile image
CourtDS in reply to Boymom3

With the hitting, it’s more of a swatting at me. I tell her that’s unacceptable and then the consequence is either she’s sent to her room or I take away her iPad or the toys she’s playing with at the time. The psychologist that diagnosed her gave me a great idea of “sending her to sorting” as her punishment. I have a large container of red and white beans mixed up. She has to sit in another room and separate out the colored beans into their own cups. If she chooses to whine and complain, it takes long but she can focus and get through it quickly then once she’s done, her “punishment” time is over. I’ve actually been wanting to make a wall chart to track good behavior as well as times of misbehaving to then reward her at the end of the week but I haven’t gotten around to it. I think something visual like that may help her see how well she does and how often she may be acting out. It’s a tough road...

Boymom3 profile image
Boymom3 in reply to CourtDS

Good! My boys get to spend time on their tablet after they are ready for school if they get ready in time. If they spend the time fighting with me...sorry no tablet time. I try to do a natural consequence when I can. Let the punishment fit the crime. Retribution. So they hopefully learn something from their mistakes. I just refuse to let my kids run over me and run the show and use adhd as an excuse. It’s not good for anyone involved. It may take longer and be more challenging for an adhd child, but they can and they have to learn to regulate their emotions and to obey rules like everyone else if they’re going to be successful adults. Again, just my opinion. I do believe the challenges we face make us stronger as much as I wish we didn’t have to go through it. It’s also made me think twice before judging other parents. You never know what they’ve been dealing with. Look for the positive in every situation. Stay strong 👊🏻😉

saidda68 profile image
saidda68 in reply to Boymom3

we go through the same thing every morning ........she has a routine when she gets up and we have to do same thing step by step so we don't have a meltdown........we make sure she gets her rest for sure....our little girl is 8 just made 8 we take it one day at a time and pick and choose our battles if that's makes any sense

I have to give the meds to my 11 yo before she gets up. Then I have a list (you could do pictures if she’s not reading yet) of what she has to do so I don’t nag or argue with her. I just have to say check your list. It makes it easier for both us.

CourtDS profile image
CourtDS in reply to pjv2001

Thank you for this suggestion. It sounds great and I like the idea of pictures!!!

You can tell her that she’s a big girl and can do it herself to make her feel responsible as well as explaining that you don’t like to argue with her. Maybe set up a reward when she does it.

Reading the other comments and looking at my own experience, I think this is a side effect from the Adderal. My son takes it. The 10mg alone was OK but he was still aggressive. We bumped at 15mg following the doctor's reco and it made the problem even worse...

I went back immediately to 10mg (within 2 days) and spoke to the doctor. We added Guanfacine (x2 a day 1mg) to the mix which is a non stimulant that calmed him down. However it was too much for the morning as he was sleepy. After a few tries on when to give the medicine and observing side effects, it turned out the best was Adderal in the morning and Guanfacine at 4pm or so.

After a few weeks of this regiment, I was still not ok with my son wanting to sleep later. He was an awesome sleeper before Adderal. So, after speaking to my doctor, I chose to lower even more the Adderal. Now I give half of the beads (yes, I have to measure myself very carefully each pill) and keep the Guanfacine at 4pm. It works: appetite is up (was awful, sleep is much better, anxiety is down)

I am telling you this long story because the process of finding the right meds or combo of meds is long. You need to try different things and take notes on what you observe to know what works and what does not. More meds is not always the answer. Adderal side effects include aggressivity and irritability. You should deifinitely address this with your doctor. Maybe a switch in meds is necessary. Good luck

My son was aggressive before taking adderol. So aggression was not a part of medication, it is a part of his ADHD and his RAD. He takes guanfacine and risperdone. A consistent morning routine and consisitent consequences are important. Having breakfast with all of his brothers was a problem because he wakes up grumpy, so I created a separate morning routine for older brothers and younger brothers. His older brothers eat breakfast first and go off to school and he eats his breakfast with his younger brothers. It cuts the conflict in half at least. A checklist for what he needs to do also helps so I don't have to walk him through his morning.

When I was deciding to put my son on medication I read a it about morning dosing. Some people gave it to their child as soon as he or she woke up and let them lay in bed for a while. The dr told me give it to my son after he eats. So....I have opted to give the medication to my son kind of in between. He gets dressed. Throws a fit during brushing teeth. Then gets his pill while I’m making breakfast and getting lunches made. I try to pack a lot of snacks in his bag so he has plenty to snack on when he starts getting hungry in the afternoon. The psychiatrist also prescribed Guanfacine at night which extends into the morning.

CourtDS profile image
CourtDS in reply to Cjkchamp

I do somewhat what you do—give it to her before she eats but usually right before she eats. However, the last few weeks she’s been starving when she wakes up so I have her eat right away. Unfortunately that’s completely changed our morning routine which doesn’t help either of us.

What is Guanfacine? Several people have mentioned it on here. I tried to do a little research on it this morning but I didn’t get far.

Cjkchamp profile image
Cjkchamp in reply to CourtDS

Would you be willing to let her snack while she gets ready? Just wondering if it could help at all if her behavior is worse because she is hungry. Guanfacine is actually a blood pressure medication that was found to help with ADHD. Your child is usually started off at 1 mg and then increased by 1 mg increments if necessary. It is a non-stimulant. Psychiatrist prescribed it for my son to help him sleep at night. He was on 1mg for a month and then bumped to 2mg and has remained on that dose. I’ve also read it helps increase the appetite. I know kids not eating causes us to worry and I’m right there with you but I am pleased to say my son grew 1 and 1/4 inches and gained 3 pounds during a growth spurt. We can only do what we can do. Our family pediatrician once told me kids want to be good. I look at the medicine as a way of helping with that. He is no angel and we have a lot of crying (by me), but medications have helped where diet and no dyes and essential oils did not for him. Good luck!

A lot of people have shared similar experiences this morning. I got on this site to ask a similar question about how do you get through morning routines. I just switched my son back to Concerta from Adderall. I felt that he was less in control of his emotions during timeframes when the Adderall was no longer in his system.

I tried giving my son his medicine when he first gets up but getting him to swallow a pill when her first wakes up doesn't work for us. Now I don't expect much from my son in the morning other than him going to the bathroom and brushing his teeth. I put him to bed in clean underwear after a bath. So when he comes downstairs I already have his shoes, school uniform, and eyeglasses sitting in the living room. I let the dogs outside. I help him get dressed. He takes his medicine and then eats breakfast at home. This was an improvement because we normally wouldn't be downstairs for another 30 minutes waiting on him. The only problem is that it puts too much pressure on me to do everything. To be perfect everyday and when he is having an off-day then that makes my day even longer. I also lose the time I would get in the morning for myself before I wake him up because quite frankly I am not getting up any earlier than I already do.

It is very hard to find a balance or to find something that works all the time. I have tried the routine cards but that worked for a short period of time and it was so much work to keep on top of him. 1 or 2 reminders just didn't do work. Some parents mentioned having the child brush their teeth in the kitchen sink. Just get her downstairs and closer to the door. Reality is that it takes a minute to get dressed and another minute or two to do hair. The rest is us struggling to get them to do it themselves. All we can do is hope when they get older they will be able to function better on their own. I also recommend behavioral therapy. It will give you tools on how to respond to her behavior and it will help her deal with her emotions better. I'd take my son back but I can't swing it with work right now.

CourtDS profile image
CourtDS in reply to SandyNJ

Thank you for your input. I’ve given in to do a lot of the morning routine for my daughter as well. Just like you I have her clothes and shoes sitting on the kitchen island ready to dress her while she eats and I brush her hair while she eats too. I just need 5 minutes to get her ready but she wakes up starving and is a little grumpy beast so it’s best for me to now have her eat right away since it helps even out her mood and the rest of us don’t need to deal with the crankiness. I’m not a morning person so dealing with her mood swings is a definitely a test of my patience. The GREAT news though is a little over a month ago we hit our rock bottom with taking her medicine. She was 3.5 hours late to school, that morning was awful. I called her pediatrician and thankfully got us in the following day. Unbeknownst to me, there is a similar medication to her adderall that comes in a dissolveable pill form. It has a citrus taste and is gone in less than 30 seconds. She was keeping her medicine in her mouth for sometimes up to 30 minutes refusing to swallow it. With this new med like it or not, the pill dissolves quickly and what a difference it has made. I don’t need to wake her up 45+ minutes earlier to compensate for taking her medicine, she’s reminding me in the morning to get it for her and it’s so easy to take so there is no negative situations surrounding the medicine. That’s helped our mornings tremendously. She’s still grumpy but I think that’s just her being her but I am going to look into behavior therapy to help us work through this with her.

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