Evening Medication

[kondasa]

My 7 year old does very well on 10 mg of focalin XR during the day, but it typically wears off around 3 pm. The doctor said that is fine because it gets her through school. Her grades are fine, but she really struggles during her evening activities to the point of falling so far behind that she may not be able to continue on swim team or in cheer leading in the future. I want her to have these activities because it is great for her!

I asked the doctor about extending her medication and she said it wasn't a good idea because of weight gain and sleep. Do any of your children use a fast acting supplement for the evening to help with activities? if so, what kind and what is the hour release. Ideally I would love something that lasted 1-2 hours for those critical activities... is there anything even like that? When she has cheer or swim during the day instead of at night she is a different kid...but unfortunately most of the practices are in the evenings.

[Onthemove1971]

Yes we use a ER ( extended release ) at 6am and a short action at 3:30-4pm for tutoring/sports, could not live with out it but we also use a focus medication with counters that and helps with sleep.

[kondasa in reply to Onthemove1971]

can I ask what you mean by, "but we also use a focus medication with counters that and helps with sleep"

[Onthemove1971 in reply to kondasa]

Of course..no problem. It took use.a very long time to find this perfect combination.

methylphenidate 30mg mutiphase am and pm same but 10mg with guandacine er 1mg extended release 24 hour.

He sees a pediatric psychiatrist who is very skilled at being able to judge what dose and time he needs what. best thing we ever did and he sleeps very well every night.

Hope this helps.

[kondasa in reply to Onthemove1971]

it really does-- thanks

[Ldydy24]

Absolutely. Sounds like she needs a short acting Focalin dose that my son uses throughout the day. He can’t use the XR dose (chews through it in 4 hours). They last up to 4 hours, I give him a dose in the late afternoon to help with soccer and homework. Without it he wouldn’t be able to function. He takes a melatonin gummy (1.5) over the counter from Walmart to help sleep. He used to take Clonodine (.01) dose plus the melatonin but has recently come off of it during the summer. I used to stagger the meds about an hour a part and by 9pm he was sound a sleep. You certainly have options.

[Onthemove1971]

Just curious.. are you seeing a "doctor" or a pediatric psychiatrist? I really didn't want another specialist in my life but once I saw one who read my son's personality and listened to what we wanted SHE ( Yes and amazing, smart women) nailed the dose, time and type to give him. It really is a science with how the medication interacts with their personality. It took a little while with a few trials.

Also I almost died when she said he needed 2 medications.. I couldn't deal with 1, but once she told me why I got it... I then shortly after added the pm dose with no problem.

We spent so much time chasing out of date medications that didn't work for him with his general doctor who would not increase his dose ( I do not blame his gen. doctor, he just doesn't understand really how to manage medications.

Hope this helps to understand how we got where we are.

[kondasa in reply to Onthemove1971]

We were seeing a primary care doctor... but I just decided to make an appointment with a pediatric psychologist who has more knowledge in this area to try to help with evenings.

[Onthemove1971 in reply to kondasa]

I think you will really benefit with establishing with a Specialist, so much changes with our kids and they really help a lot.

Let us know what you think once you have your visit.

Take care

[kmo1350]

Hi, I was having the same issue, my son takes 20 mg of focalin xr in the morning, I would see it start wearing off in the afternoon so my Dr suggested a small booster dose to get him thru his evening activities. So he takes 5 mg of regular focalin(Not extended) after school and it has been wonderful. It's just enough to get him thru his evening activities but doesn't effect his sleep. I would ask your dr if that would work for your son.

[AngelamarieQ in reply to kmo1350]

That’s what we do too.

[Boymom3]

My son uses focalin xr. We were having trouble in the after school program. The doctor prescribed a very low dose short acting (3 hours) focalin to be administered at school about 30 minutes before the program started. It helped and was fully out of his system by bedtime.

[AngelamarieQ]

Focalin Xr in the morning and Focalin short acting at 4:00 pm to help with homework and other activities. She takes melatonin to sleep (gummy 3 mg).

Perhaps your primary doctor thinks she already lost considerable weight and adding more Focalin is dangerous.

In our case, our daughter was satisfied with less food during her main meals, but ate large snacks. She was always keeping her weight or gaining as she grew taller.

See a psychiatrist. Good luck!

[floydwhite]

there are several choices my son's dr. writes a prescription for a "booster" dose. its a lower dosage to get through evening activities and homework. weve done this for a few years and it works great. i only give ot if he has a game or something

[llop]

This is what we do for my 7 yr old son

short acting 5 mg Focalin at 6:30 am.

extended release 10 mg at 8 am.

Short acting 1 pm.

This is what helped him get through school. 😕

We see a pediatric psychiatrist.

[seller]

I understand about the sleep/weight issues, but I think you are definitely on the right track as far as evening activities go. It won't be too long and your daughter will have homework, projects, etc in the evenings and she will need something to get all of you through this! We gave our son a small dose of methylfenidate and this allowed him to focus on evening activities. Homework was a horrible battle without that additional medication. I think you have to tell her physician that being on the swim team and cheerleading are more important that worrying about weight loss or sleep problems that may not even occur. ADHD kids have enough challenges and being successful in after-school activities improves their self-esteem.

[kondasa]

Thank you for your replies. I just made her an appointment with a Psychiatrist to get a second opinion. Unfortunately my area on have 2 pediatric psychiatrists and both aren't accepting new patients... so we are trying someone who specializes in all types of patients. I am interested to see what he says when we meet with him.