Switching Stimulants

[SurvivorFan]

Hello,

I am hoping there are some parents out there who can give me some positive expereinces they have had switching their kiddo from Ritalin to Focalin. My son has adhd with anxiety. He has been doing pretty great on his current meds behavior and school wise but the "problem" is he is having to take meds 5 times a day. I feel there has to be a better option. I'n the morning (7am)he takes Ritalin 10mg IR, fluxoteine, and 1mg guanfacine. He then needs to take the Ritalin again @ 9am, 12pm, and 3pm. He finishes off the night with 2mg Guanfacine @6pm.

To give a background he has tried the Ritalin extended release (30mg) but his anxiety was through the roof. Stopped playing outside, couldn't go into any room of the house alone, petrified of bugs, lived in a very small "safe bubble" We took him off of that and went back to the immediate release 10mg and the anxiety decreased by a large amount. Once we were back at his baseline anxiety added the Fluxoteine and he is doing amazing! (He has also tried Concerta long acting and was manic)

We are pursuing seeing a child psychiatrist for medication management but its a wait to see her...His current neurologist suggested trying Focalin XR 20mg to eliminate some of the doses.

Should I just be greatful things are going well and leave well enough alone until we can get into seeing the psychiatrist? Have others kiddos had similar experiences and done well switching to a different long acting? Sorry for the long post😜

[Onthemove1971]

Thanks for sharing your experience with us. If I were in your shoes and the wait was not to long I would wait to see the child psychiatrist.

They really consider everything. They can recommend things like taking a long dose of guanfacine at bed.

Medication is complex and so are little ones. You had already done a great job, but know it will work out and really help him.

Good luck,

[SurvivorFan in reply to Onthemove1971]

Thanks for your encouraging words. Sometimes it's nice just to hear from someone who understands your situation I always try to remember in one of your previous posts that your son has no memory of all the early on med changes!

[Onthemove1971 in reply to SurvivorFan]

I am glad knowing that made it easier for you. Hope you find what is right soon.

Big hug!

[BVBV]

My son started with Ritalin but then went to Adderall, Vyvanse, and now Focalin. He doesn’t metabolize the XR formulas as well, his anxiety goes up, the longer span without appetite is NOT good, and we’ve found he doesn’t get a rebound effect with the “immediate release” formulas. I will say, we’ve tried 2 different drug manufacturers for Focalin and one was completely ineffective so keep that in mind moving forward. I know generics need to meet certain criteria but there was a difference in our experience. Best of luck!!

[SurvivorFan in reply to BVBV]

Thanks for your reply! Its so frustrating that it has to be so hard to find what works. Especially when one form of a med works but not the other. You are right in that it is nice that the appetite is greater being on the short release. We also found that the guanfacine helps fill in those previous crash/rebound times really nicely. Have you been happy with the Focalin anxiety wise or have you noticed an increase again? Also, does your kiddo take anything for anxiety? We have not tried an XR formula yet since he has started the Prozac so I wonder if that helps relieve any of it.

[BVBV]

The Focalin has been the best so far. I was scared to try it since it’s in the methylphenidate family and he had such a poor reaction to Ritalin. I could never see him going back to any of the previous drugs, especially Ritalin which made him angry and anxious. He’s doing much better on Focalin, it’s not perfect, but no more of the anxiety ridden/neurotic behaviors we saw with the others. He doesn’t taken any other prescribed drugs, however it’s worth mentioning that the natural supplements we use to help. He takes Zahler’s ChildCalm, Zahler’s KidsActive, Barlean’s Omega Swirl, and he recently started Bacopa Monnieri (which I really think is helping him- he’s doing GREAT at school, and had always struggled behaviorally, even with meds). I also give him zinc a few times a week as he has low levels and I read that a lot of ADHD kids do for some reason.

[SurvivorFan in reply to BVBV]

I really appreciate all the info. I admit I know next to nothing when it comes to adding on any sort of vitamins/ minerals so when we eventually meet with the psychiatrist will ask about it. I'm glad you have figured all this out for your kiddo and are able to share your experience!

[AngelamarieQ]

Hi survivor fan,If what your son is taking is working, stick with it until you see a good psychiatrist that specializes in ADHD. There is no magic pill.

My daughter has been on Focalin from the start and the doctor has adjusted the doses higher and higher and the side effects are still there( defiant/aggressive behavior, loss of appetite and anxiety). We then adjusted to Focalin XR in the morning and a 5 mg short acting as soon as she got out of the bus for her homework. Plus, she had therapy weekly because lost interest in everything. She just wanted to stay in her room all day.

We moved to Europe last year and she is taking another medication that is of the same family as Focalin, but the results are the same. Thus, if I were you, count your blessings and keep things the way they are as your son seems happy and school work is good. Best of luck!

[SurvivorFan in reply to AngelamarieQ]

Thanks for replying. I'm sorry you guys are going through a rough time trying to find the right med. I know it's so hard to go through! I am definitely greatful for where we have gotten to now I just wonder how it will affect him taking meds so many times per day as he grows and his schedule gets busier. I think waiting until we see the right psychiatrist is probably a smart way to go.

[GoDukes]

My son struggles with anxiety along with his ADHD as well and it has been pretty bad at times. The stimulants seem to make that worse. We first tried Foculin XR when he was about 7 and it worked well. We added Guanfacine in the evening to help with the "coming down" issues which caused really bad irritability. This worked for a couple of years but it seemed to be less effective over time and when we increased the Foculin dosage the anxiety got really bad. We tried various things like Ritalin and Concerta which made his anxiety unbearable. He is twelve now and we have him on a higher does of Foculin XR in the morning and Fluoxetine in the evening. We seem to have found a good mix for now but we know this could change in time as well. Keep trying different things, as frustrating as it could be. I'm always being told that a psychiatrist for the meds can be very helpful as well. We are trying to find one right now. Good luck!

[SurvivorFan in reply to GoDukes]

Yes it definitely seems finding a great psychiatrist is the way to go and we just have to be patient until we can get into seeing one! Thank you for sharing your experience!

[Elijah1]

Consider a trial of Daytrana, a methylphenidate patch that is absorbed more slowly through the skin and may not aggravate anxiety.

[SurvivorFan in reply to Elijah1]

Will keep that it mind to ask about. Thank you!