Adderall and night waking

[SurvivorFan]

Hi!

We recently switched my son from Focalin to Adderall. This is the first time switching from methylphenidate to amphetamine for him. He has always been a pretty good sleeper.

Since starting the Adderall he can fall asleep fine but has each night woken at midnight and again around 4am. Not hyperactive just restless.

Does this go away eventually for most or is this a sign it wont work out most likely? He is taking last 10mg XR dose at noon.

Adhd symptoms and irritability has decreased considerably since the switch so would be a bummer if this doesn't work out.

[BVBV]

My son had been a great sleeper since 10 weeks but he would wake in the middle of the night when taking any extended release stimulant, even with just taking once in the morning. He didn’t have the issue in the short release versions.

[SurvivorFan in reply to BVBV]

Thanks! We never had this issue with the Focalin. Today I decided to test out just how long the Adderall immediate release tabs would last for him. He has always metabolized so quickly and would need a methylphenidate immediate release every 2 and a half hrs. Today he only needed 2 doses of Adderall immediate release (first dose at 7am and second at 12:45) I'm blown away. He's asleep now...fingers crossed for better night sleep!

[Aloysia in reply to SurvivorFan]

I'm curious why you switched from Focalin to Adderall... My son also metabolizes quickly. I discovered by accident that when using a patch (Daytrana) instead of pills, that the medication lasts the normal amount of time in his system. This may be something you want to try if you're open to him staying on Methylphenidate. My son also was able to use a smaller mg dose via patch and still see results in his focus (vs the dosage he needed to take via pill). So if you do try it, start at a lower dose and add patches or 1/2 patches every couple of days to find the correct mg dosage.

[SurvivorFan in reply to Aloysia]

We switched from Focalin because it was feeling like it was not being very effective anymore. His behavior was way more hyper, obnoxious/just overall more times of being dysregulated.

We have tried other long acting forms of Methylphenidate and his anxiety was through the roof so we decided to try amphetamines this time.

He is back to being regulated, sweet, and laughing a lot but now we have the night waking. Ugh! We did 2 doses of short acting with last being at 12:45pm yesterday and he still woke up at midnight. I have been having to give him half a benadryl to get him back to sleep which does work for the rest of the night but obviously not a long term solution.

I really hope this is something that will improve with time...

[adoptivemom]

Hi! Any updates on this? Did the night waking subside once he adjusted to the new medication? We are about to start our son on the generic Adderall (the methylphenidate made him much more anxious and agitated). Just curious how it worked out long term.

[SurvivorFan in reply to adoptivemom]

Hi!

We tried for a few weeks but ended up going back to the Focalin. Adderall worked great for him and he needed less doses but the night waking obviously isant a side effect that can be tolerated long term. His doctor said that it likely wouldn't improve.

My son also was extremely anxious on methylphenidate extended release but does just fine on Focalin. It's made differently and is supposed to have less side effects.

[adoptivemom]

Thank you! I appreciate that feedback, I'll keep that in mind if the Adderall doesn't work out for him. I would love to be at point where anything helps!!

[SurvivorFan in reply to adoptivemom]

It's such a tough road sometimes trying to find the right med and or combo! We've definitely been through it to land where we are today. Don't give up, keep an open mind, keep notes on med/behavior, and let the doctor know right away when it's not working for your kiddo. My son needs to have 2 long acting stimulants plus a booster, intuniv, and zoloft to balance his adhd and social anxiety. When it works, you'll know Never did I imagine my 9yr would need all that, but it's what's needed right now and to see my little guy feeling good is what matters

[adoptivemom in reply to SurvivorFan]

I'm so glad you found a combination that is working!!

My son seems to be needing a second dose of the extended release. Is that normal? I see you said your son takes 2 long acting ones (are they at the same time? Or staggered? ) and the booster - is that at school? Sorry - I am just trying to figure it out. The Adderall is helping in the morning, but the afternoons seem harder - after lunch he is acting like the med already wore off. I didn't expect that so soon. Thanks for your replies! I really appreciate it!!

[SurvivorFan in reply to adoptivemom]

Yes, my son is a fast metabolizer of the meds so he requires 2 long acting Focalin and one booster dose. His schedule looks like this : Focalin 20mg at 6:45am, Focalin 20mg at 11:30am, and 15mg short acting methylphenidate at 4:15pm. This gets him to about 7:15pm. He also takes Intuniv in the morning 2mg.

It's important to keep track of when teachers/you start to see that med is wearing off. Then you know to give it 30min before that time so there is no crash/dip before next dose begins to work! Doing it this way as well as adding on the intuniv has helped us a lot in avoiding the crash.

[adoptivemom]

Thank you so much!! That's exactly what I was trying to find online yesterday but could not find it!! His teacher has said the last 2 days he was very different at 1:00 - like before the medication. And at first I didn't believe her that it could wear off so fast. But I guess it's a possibility!! He is fast with everything else so I'm not surprised he's metabolizing it so quickly. I'll follow up with his Dr and see about a booster dose.

He takes prozac in the morning too which has helped him tremendously. I don't know when that wears off? I'll ask her about that too.

Thank you again!

[SurvivorFan in reply to adoptivemom]

That's so helpful that she noted the time and that it's so apparent. Makes it easier! It sounds like he would need another long acting at 12:30 then and maybe even a short acting after school if he gets a crash early evening. The short acting only last my son about 2 and half hours so it doesn't interfere with sleep if he takes it by 4:30.

My son takes Zoloft daily am. That doesn't wear off like a stimulant, just needs once a day. I hope everything works out smoothly for you and your son It sounds like if it's going well during the morning then he is just metabolizing quickly and adding on those other doses should help!