Adjusting Meds with Age

[JJMom16]

Hi Everyone,

My nearly 6 year old has been stable on a combination of Concerta 27mg (ADHD), Celexa 20mg (anxiety), Cyproheptadine 4mg (appetite) and Clonidine .1mg (sleep) for 6 months now. Lately, we've noticed an uptick in hyperactivity and a slight decline in appetite.

We met with our psychiatrist who said that the Concerta dose "should stay the same for a long time" and not need to be adjusted, but that he was willing to try 36mg. We're also going to switch out Cyproheptadine and try Hydroxyzine, which he says can help anxiety while increasing appetite.

Does anyone (particularly with older children who have been diagnosed for a while) have experience with changing meds over time? How often have you had to adjust, typically? Is it related to growth, age, or developing some sort of tolerance?

Thank you for your input.

[Bootsie1]

I’ve heard that vitamin C from juices, certain foods and vitamins can cause the medication to be less effective.I always give my son his vitamins at night bc he takes his Concerta in the morning.

I’ve also heard that antihistamines can cause meds to be less effective.

Just something to think abt

[Lauraz180]

Hello. We have just adjusted after 5 years. ds is 11 and only by 5 mg. Not sure it was needed but obviously he is now double the size so doc thought worth trying as focus at school was drifting just slightly.

[Door-mat]

My son is 10 and although he is not on the same combination of drugs as your son . We have had to increase the stimulant over the years as for him it definitely started to lose effectiveness as he grew and put on weight. It just had to be monitored and between school and ourselves we can see when the stimulant (Medikinet in his case) is being less effective. He is currently on 50mg per day .

[msm0nster]

My son started meds at age 5, adderall 2mg and guanfacine 1mg.. he just turned 7 and we have done a few adjustments. Now adderall xr 5mg and 2mg of guanfacine. Vitamin c can render meds less useful so we have him take his vitamins at night. He takes his meds in the morning because the guanfacine kept him awake. Feedback from the teacher was what helped us increase his guanfacine.. we noticed his irritability and his anxiousness at home, she noticed he talked a lot and was getting more in trouble. It's always hard to judge if It's hormones kicking in or aging like a growth spurt, so I welcome his teachers input. How is your daughter in school? Showing more symptoms etc? I feel for these kids, it's tough. You're doing great, keep on keeping on and I hope you get her med doses regulated.

[KristiReeAZ in reply to msm0nster]

That is so crazy to hear because Guanfacine has literally the opposite effect on our son. He takes it in the evening because it makes him tired and helps him to fall asleep (His morning ADHD med is Vyvanse 50 mg). It's so odd to hear how the Guanfacine makes some tired and amps up others.

[msm0nster in reply to KristiReeAZ]

Oh I know! It kept our kiddo wide awake at night. It's so hard to figure medication out that works or that it needs to be taken differently.. such a guessing game!

[JJMom16 in reply to msm0nster]

We actually tried Guanfacine and had insomnia, too, no matter when it was taken! It was a shame, as it really did help with mood. Somehow Clonidine, it's sister med, has been wonderful for improving sleep.

[GoDukes]

That is a good question. We started our son on meds at 7 and he is now 12. We have tried different meds, different combinations and different dosages. Something may work for awhile but that doesn't mean it will last. We have him on a good combination now that seems to be working but I have no illusions that this will keep working as he becomes a teenager. Hopefully it will, but we have to be prepared to try new dosages and meds as his body changes and grows. I'm not sure if he grows a tolerance to the meds too. We will occasionally give him a break from the meds when he isn't going to school in case a growing tolerance is an issue. Not sure if that helps or not. Good luck!

[happydad]

Just to add one more data point: my son is 19 years ago. He used to take Concerta 27mg. He said that it was not strong enough. With the doctor's approval, he changed it to 36mg. He said it worked better.