Having trouble with right med combo for 11 year old son.

[Kristin_B]

Our son was diagnosed with ADHD in December 2022. We started behavioral therapy (DBT training) in January 2022 and also recently started ADHD meds in April 2022. He is currently on Focalin XR (15 mg) right before school and short acting Focalin after school (7.5 mg), We have found that the long acting Focalin does not seem to last more than 5 hours and the short acting lasts 2 hours max. When the Focalin is working, our son does well focusing on school work and sports. However, the coverage time isn't working. He is moody, disrespectful and resistant to daily life tasks (e.g.. getting ready for school) in the morning after he wakes up and also when going to bed. We have tried Vyvanse, but it had a very negative affect on his appetite. Doe anyone have any suggestions for what might help our son have longer med coverage?

[Willowbee37]

What about the extended release concerta? My son was on that and took a low dose short acting booster before games.

[Kristin_B in reply to Willowbee37]

We haven't considered Concerta (although i know someone else who's son takes it and is having success). How long does the extended release Concerta seem to last? Have you noticed any side effects?

Our pediatrician seems to think that Focalin has fewer side effects for that type of medication and when we voiced concerns about coverage length, he suggested trying Vyvanse which I guess is a different stimulant type. Our pediatrician talked about the chemical makeup of Focalin vs the other Ritalin types, which made me feel like I couldn't argue with him to try a different med in that group. LOL. (This is also why i am reaching out here for feedback :))

Vyvanse definitely had longer coverage, but it didn't act as quickly for our son and the loss of appetite lasted the entire day. I feel like the best treatment would be to take 2 Focalin XRs for full day coverage. One at 8am and then one at 1pm. When I suggested that, our pediatrician made it sound like that's not done, and suggested increasing the Focalin XR dose (from 10mg to 15mg) and then take a short acting booster after school.

[Willowbee37 in reply to Kristin_B]

I guess it’s just trial and error cause everyone metabolizes meds differently. My son took extended release in the morning and had trouble sleeping which shouldn’t happen but it definitely was. Now he’s on concerta short acting am/pm and that is so much better. It’s such a bummer to have to play around with these meds cause the side effects can be brutal. Our doc really pushed for focalin as well but he did terrible on it and I wasn’t willing to try another dose.