We are trying medication for my 11-year-old daughter who has been diagnosed ADHD inattentive and anxiety. She's on a very low dose (1 mg) of Lexapro which seemed to help a lot with her anxiety. Then we started Ritalin, again at a very low dose. Although she reported being able to focus better, the psychiatrist continues to increase the dosage. He said that will know where the right dose when she's no longer hungry in the middle of the day. So right now we are at 20 mg of extended release Ritalin (called Metadate or something like that) and it seems to me like she is getting more anxious and having some trouble falling asleep at night. Have your prescribers also insisted that you up the dosage until there are unmanageable side effects? It makes no sense to me. Thanks for any experience you can share!
Medicate until they stop eating? - CHADD's ADHD Pare...
Medicate until they stop eating?
Does not make sense. Once you start having side effects, you LOWER the dose back down. There should be little to NO side effects except for a slight decrease in appetite during the day, maybe. Go with your mom gut and lower the dose. Higher is NOT better most of the time. It can definitely cause increased anxiety if the dose is too high.
I agree with amewhit that it does not make sense. You should up the dose until your child says that they can focus well at school. If your child is too young to tell you (like 5 or younger), then you ask the teacher for feedback about focus level. Each time you make a change to meds (up or down), ask your child how their focus level is at school. Ask several days in a row, but in different words. Also ask about side effects the same way. This will help you find the right dose, but also discover if this is the correct medication for your child or not. Once you settle on a medication and dosage, check in with your child about focus level and side effects every 3 months or so. As kids grow, things can change and they may need to up the dose or switch to a new medication. Especially after a growth spurt. Also, it's a fallacy that EVERY kid gets reduced appetite from Ritalin - it's just a common side effect that should be manageable if you're aware of it.
I think you’re right to be nervous about that. Our psychiatrist and ped were very attentive to our daughter’s loss of appetite and weight loss (Which reversed itself btw.) The marker of whether the medicine is working should be a meaningful decrease in ADHD symptoms. Loss of appetite is a side effect that might not even happen for some kids. Maybe ask him for clarification? Sometimes doctors just say things in a weird way. Or you could ask your daughter’s ped for their opinion.
I’m with the previous responses- and I would get a second opinion on the dosage. My 7 yr old son started with 10mg Methylphenidate 10 months ago, and it’s been a life saver. His appetite ebbs and flows just like before he started meds. His self confidence is back- which keeps him from immediately giving up in school, and acting out. he has made the quarter honor roll for the first time ever. Stick with it- try going back to a lower dose and give it a solid week. My son and I talk about the meds too- and he recognizes that if there’s something important and challenging he wants to do (ex: a Lego project) he will choose to take meds to help him focus and persevere. He typically doesn’t take them on the weekends, but I let him choose. On weekends, if he seems to have a short fuse I’ll ask if he needs a pill to help him manage, and he is usually able to do without, but not always. And I think it’s good for him to feel in control of his meds. To recognize the help it gives, but also that he can choose to do things that require less focus if he doesn’t want to medicate. Good luck in your ADHD journey- you’re not alone!
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