2 Long acting stimulants per day?

[SurvivorFan]

Hello, I am curious if anyone else has a kiddo who metabolizes their stimulant at a very fast rate and requires 2 long acting doses?

My son takes 20mg of Focalin at 7am and its out of his system around 1:30. We do a 10mg booster of short acting methylphenidate in the afternoon at 2pm(because thats the med he was on previous before the focalin) but again thats out of his system by 4pm and even so does not give the same benefits we see with the focalin so evenings can be challenging. He does also take guanfacine which does help some. From 7:30 to 1:30 things go so well so I have been wondering about asking to try another long acting at 1pm so would be in his system by 1:30 and out by 7/7:30.

His appetite is pretty much the same on or off stimulant so not concerned about that so much.

[Onthemove1971]

Yes. Our son (15yrs old) takes his long action as he gets out of the car at school. He can get through the before school with no medication. He also takes Guanfacine at bed and before school. This has really worked well for him. His grades were slipping and he was not focused in class so we added an am and pm dose of Guanfacine. Hope this helps.

I assume you guys are working with a child psychiatrist, if not I really recommend someone skilled to help you.

[SurvivorFan in reply to Onthemove1971]

Does your son take a long acting right before school and another long acting after?

Our son also takes 1mg guanfacine in am and 2mg in the evening. We have tried 3 times to get in to see a child psychiatrist but each time get told to wait until a certain month to call, we do, and then told their schedules are full. We are not unhappy with his neurologist I was just hoping to hear if other kids do better with 2 long acting a day

[Onthemove1971 in reply to SurvivorFan]

Yes. That is what our son takes 2 long acting. He does very well. Could you give him his am dose a little later? Then it will last longer at school.

[SurvivorFan in reply to Onthemove1971]

I would love to wait until right before school to give it to him but he is pretty dysregulated in the morning. He is up at 6:45 and school does not start until 9am. I could totally deal with it if it were just him not being focused but the loud obnoxious behavior is wearing on everyone. I'm really glad to hear the 2 long acting works well for your son. I feel like if ours could have his second dose at 1pm it could really help.

Thank you so much for replying. Its nice to get feedback from someone who has gone through it.

[GingerC in reply to SurvivorFan]

Oh boy I feel like we have the same kid. He is on the same regiment too.

[SurvivorFan in reply to GingerC]

Same as in 2 long acting to get through the day? His neurologist is on board to give it a try so we start tomorrow. The only thing I'm worried about is if he will have the "crash" around 8 but hopefully since he will have the guanfacine in his system and in bed winding down it won't happen. Fingers crossed for us! 🤞

[CatzBCrazy]

hello. I was searching for “booster” and this thread came up. My son 11, takes Jornay Pm. It is amazing. It kicks in 12hrs later so mornings are wonderful. It just wears off and he needs a booster. I really think he needs another extended release in the afternoon. The amphetimine 5mg doesn’t get him far and the evenings are a joke. No focus for HW. We end up doing it in the am before school. What did you decide on meds? Is it working?

[SurvivorFan in reply to CatzBCrazy]

We did end up trying another long acting dose of Focalin at 1pm but unfortunately we noticed he was becoming pretty emotional and easily upset in the evenings so we discontinued. It makes no sense to me. Its clear his first dose of Focalin at 7am only lasts roughly 5 and half hours so you would think 2 would be okay. (stimulants do not keep him awake in the evening) We ended up with Focalin XR at 7am along with 2mg guanfacine and then a methylphenidate 15mg booster at 12:15pm and a 10mg booster at 3:15pm. He takes 2mg guanfacine again around 4. It is not ideal having to do this many doses but he just seems to do better going this route...for now.

[Onthemove1971 in reply to SurvivorFan]

it sounds like you are working with a child psychiatrist?

There is no crash for us. It hhashas gotten through: homeowork,, tutoring and sports.

I know what yoyou mmmeammmean ababoaboabouabout surviving behaviors.

Good luck

[SurvivorFan in reply to Onthemove1971]

Yes, we are working with a child psychiatrist. Thankfully she specializes in ADHD and anxiety and feel pretty supported by her.

For him it seems he needs to slowly come off the stimulant through the day but still definitely needs some on board. When we give the last booster of 10mg along with the guanfacine it is pretty smooth sailing (on most days) Thankfully, we have more room to adjust times or add on even another small booster if he wakes up extra early or we are having a late family gathering or what not. He for sure is most willing and level headed to do homework related things from 7:30-12pm so we do the bulk of homework things before school starts.