Started medication - pros and cons

[alexlw85]

My daughter (11yrs) started medication last week for ADHD. She has started on 20mg LA Ritalin for 5 days, then 40g LA Ritalin for 5 days, and then 60mg LA Ritalin for 20 days before review with the doctor.

After completing the first 5 days at 20mg, her dose doubled today to 40mg so I will be interested to see how it goes.

The first 3 days she felt nauseous and had tummy aches, however this has settled down. She has been a lot calmer and we have had zero meltdowns. There has still been a little bit of difficulty in the evenings after the meds wear off, but it is not escalating and it has been manageable.

Her teacher said she has been calmer and 'even doing schoolwork'!!!

The only side effect I have noticed that could be impactful is the difficulty getting to sleep. She is not feeling tired and not winding down for bed, and also waking during the night. This is something we used to deal with when she was younger and used to manage with getting rid of sources of blue light and having reading time and a full on bedtime routine before bed. I am going to work with her on her bedtime routine and hope we can resolve it. She was pretty hard to get out of bed this morning!!

[Pennywink]

Glad to hear it seems to be working for you all! The sleep and other side effects may settle in once she gets use to it. My son was actually extra sleepy the first two weeks, it is back to normal now.

You seem to be on the right track. Bed routine & consistent early bedtime are crucial for my son. He also has a white noise machine, stuffed animals & a night light. He also has some anxiety issues, so we keep his door open a crack until my husband & I go to bed.

Fingers crossed she gets to sleeping well for you!

[Onthemove1971]

Alexlw85- one of the pros ( as you are experiencing) is decreasing impulsivity. Decreasing talkativty and acting more appropriate. Research shows also the younger you start medication and keep with it gives them a decrease negative behavior ( drug use, criminal activit) in the futur.

The cons are decrease appetite sometimes. Also we give a booster dose in the PM to get through homework and sports. So coordinating all the medication and not forgetting to give, renew the RX and having everything for him.

I will say since our son has been so stable he rarely feels any different when he takes him medication.

Hope this helps.

[Cjkchamp]

A weighted blanket helped my son with falling asleep and staying asleep when he was on stimulants.

[Skywalkerfamily]

2 comments:

* I am not a doctor, just the parent of an 11yr old boy with ADHD (diagnosed at the age of 6), but I feel 60mg is a lot. When we had to "accept" to medicate our kid we started with the lowest possible dose (10mg) then went up really slowly (took us more than a year to go up) and we are waiting a long time before any change (for instance we recently change from 1 LA to 2 normal at half dose each - we feel there is less of a "down" effect when it wears off). So I would really first see how these 40mg are doing. Maybe it's good enough.

* We have the same issue with sleep. We have monitored his sleep closely (using a fitbit type of watch, which he loves) and even with good bed routine nothing does it and we can see he is tired in the morning... which just doesn't help in terms of attention deficit! Finally, after at least 4 doctors and school aids told us the same thing we have decided to try Melatonin. We tried 1mg at first and it did nothing noticeable. His physician told us we could easily do 5mg, so... we are now trying 2mg about 45 mins before sleep. We'll try this for at least 2 weeks before making any conclusion. If it still doesn't work we'll go to 3mg. I know Melatonin because I use it when i travel so i know it works. We just want to get to the right dose very slowly/progressively. So pretty much the same comment i made about Ritalin: don't increase it too quickly...

Hope that helps

[alexlw85 in reply to Skywalkerfamily]

Thank you for your reply and advice regarding the dose. The doctor spent a lot of time thinking about dose as my daughter is adult size, not typical size for 11yo. She is 173cm and 80kgs. I am feeling that the 40mg will be a good dose and I am so happy she had a good sleep last night! I would definitely consider the melatonin too if it becomes an ongoing symptom. I love your idea of using the fitbit to monitor sleep! She has a birthday coming up soon - so that has given me a plan.

[jmhunter1014]

Our son is 8, and started on 9mg Concerta, then 18, then 27, then 36, then back to 27, and now we're on 20mg FocalinXR. No matter what the med or dosage, it's had an impact on his sleep. Having a wired child up til 1am sucks, but it's worth it. Our pedi recommended we give him a low dose of melatonin to help with bedtime, and it's helped tremendously! We give it to him about 30 minutes before bed, and he's out like a light within an hour. Maybe give that a try? We were giving him 3mg but have recently found 5mg gummies. Good luck!

[alexlw85 in reply to jmhunter1014]

Thank you! I will talk to the doctor at our review appointment.

[anirush]

My grandson's psychiatrist said ADHD meds calm the brain but often keep it from feeling sleepy. We, too, had to go to Melatonin. We use 5mg gummies which the boys say taste good. They sleep well and are not tired in the morning. Best time to take it is 1/2 to 1 hour before bedtime.

[LRPlove]

Try Luna for Kids! Very low dose, you can even give 2 about 30 min before bed time. A friend of mine has had success with GoodDay Chocolate sleep supplement but my child won’t try it.

[Vickie109]

It sounds like the current medication is helping her. My 10 yr old son was on Ritalin LA 30 mg before switching to Concerta. It worked well for him, it just didn't get him thru the school day. I didn't realize Ritalin LA came in 60 mg. I agree with others, that is a lot of medication and to jump up that much in a month is pretty fast. In my experience, we give each dosage change a minimum of 2 weeks before deciding if the dosage needs to change or not . But, every child is different, just my experience. As for sleeping, my son has done very well on 2 mg Melatonin about 1 1/2 hours before bed. We started with 3 mg, but he started getting headaches and figured out he only needed 2 mg. We recently added a magnesium supplement, we will see how that goes, if we need to continue melatonin. Also, we only give it on school nights. If you give it every day for a long time, it doesn't seem to work anymore. Hope all continues to go well for her!

[alexlw85 in reply to Vickie109]

Thanks for your reply. I think the Ritalin LA comes in 20 and 40, so it would be taking 3x20 or 1x40+1x20. The doctor was unsure what prescription to give due to my daughter being more of an adult size than a child. She is 173cm and 80kgs.

I can vouch for magnesium working for me - thanks for the suggestion. I will talk to the doctor about melatonin at our review.

She had a good sleep last night to my relief - not asleep as early as usual but an improvement on the last week!

[Onthemove1971 in reply to alexlw85]

Just curious are you working with a child psychiatrist?

[alexlw85 in reply to Onthemove1971]

We are working with specialist pediatrician. I see in a lot of posts people work with psychologists, however that is not standard practice where I live (in New Zealand) apart from during diagnosis.

[Hidden]

Yay! One thing you might try is a small dose of melatonin. My daughter is on other medications that make her sleepy, but her psychiatrist also recommended this when she was first diagnosed. Also, we have incorporated physical activity after school and work. She HATES it, but I have noticed that it helps when the meds wear off and she starts spinning around

[KMLMPLS]

We use Zarbees sleep aid at 2 mg every night and it works like a charm. It’s a melatonin supplement and he prefers it. We tried essential oils but not great.