I am not really sure if the current medicine is right for him. Need advice~

[Dahvina]

Hello everyone,

This is my first post, so I have many questions to ask, but I tried to narrow it down to what is my most current concern.

My 9 years old DS was diagnosed with ADHD a year ago and is now taking Adderall XR 15mg. We started his medicine last year, around May, with a smaller dose and settled on 15mg after some adjustment. We took a break for the summer and since September 2023 he has been taking it again regularly.

I asked his pediatrician for possible side effect and she noted the general side effects, such as being unable to sleep, and a lose of appetite. Although he already had those things prior to starting medication, not extremely, but slightly. I couldn't tell if it got worse because of the medication. Since starting medication, he has also showed more mood swings (getting agitated easily, and easily upset at his younger sister or older brother). I asked the doctor if that could be the side effect, and she said it could have been.

The reason we took a break during the summer from Adderall XR was due to our traveling abroad and his medication not being allowed in some countries. You can bring if you get advanced permission, but the fact that it is banned in some countries worries me even more about if it is really safe for my DS.

I tried to seek help from a Psychiatrists (I was only able to see Psychiatrist RN in my area), because the Pediatrician could not provide me with clear answers. However, that time with the Psychiatric RN seemed wasted from my perspective. Maybe I was not asking the right questions? or maybe I do not even know what questions are the right questions to ask.

So, questions I have been trying to answer are: When the medicine is showing side effect, then would it be severe enough for me to notice right away or do smaller changes count as well? The Pediatrician also mentioned 15mg is a very small dose, is this true? I really do not want to give him too much medicine, but I already give him Adderall, and Melatonin at night to help him sleep. My DS mentioned that Melatonin seemed to help him at night. So I do not know if increasing medicine would help smooth out his mood, or perhaps changing to a different medicine would help or would that just be a waste of time. There did appear to be a lot of different options. Does anyone have same concern or success on switching medicine and why? Any advice is welcome, and thank you for reading such a long message.

[Formyson8]

I would absolutely look at increasing his dose. 15 mg is not very much. It is not like many other drugs that build up in your system. If you up his dose and he has a bad reaction you can can go back to 15 mg the next day.

[Dahvina in reply to Formyson8]

Thank you for the info. 😀

[adhdmom1]

Hi Dahvina,

In short, Adderall can you make irritable and easy to anger. In my experience, increasing the dose does not alleviate these symptoms. I have a 6 yr old with a severe case of ADHD and he takes 25 mg of adderall and 2 mg of Intuniv. My first suggestion would be to see a child psychiatrist ( if you haven’t already) Psychiatrists know this disease and can help with medication management. With that said, you could try another medication to help balance the side effects of the Adderall. My son takes 2mg of Intuniv which helps alleviate his anxiety. As far as switching medications and/or increasing the dose, I can’t speak to that. My son does great with Adderall but some people need Ritalin. It depends on the person.

[Dahvina in reply to adhdmom1]

Hello adhdmom1,

Thank you for your answer. I did look for a psychiatrist in my area, but when I searched all of them were RN (except one) so I thought it did not matter since the majority were RN. But I was very disappointed after I had an appointment with them, because she couldn't clear my worries either. I felt like it was such a waste of time, and money. Would seek out a real doctor might change this?

[MustbeS]

hello! So I definitely have experience in this with my child. He is now 14 years old and he is on a medicine that gives barely any side effects. He basically eats his lunch. He doesn’t have mood swings and he does a lighter dose on the weekend, a stronger dose of it on the weekdays during school or when he has work to do. I have been on many of them, Adderall, etc. The doctor I have had me read the book running on Ritalin. And it explained how every pill basically has different side effects. You just have to find the one that works for him. So I would say if you have a great doctor , they would probably do a trial run with another one. And within two weeks, you can definitely see if there’s a change for the better. And if not, go back to the last one that you have and maybe increase the dose and wait-and-see. But in my experience, the mood swings don’t really ever level out. They come and go if the medicine is not really functioning with them . My son is now on Adzenys. It’s fantastic. Hang in there you’ll figure it out and get it right for him soon enough.

[Dahvina in reply to MustbeS]

Thank you for your reply. I should definitely read that book for more information as well. When you do the trial run, do you get comments from the teacher?

Thank you

[SandalSox]

Hello,

Did the medicine help when you first started using it or was there no effect?

If it initially helped, then I agree maybe the dose needs to be increased. But if it feels like it never really made a difference, then maybe a different medication might be needed?

[Dahvina in reply to SandalSox]

His school life seemed much better compared to the time before taking the medicine. I will take that into consideration, and see if increasing might help or change anything. Thank you.

[Elijah1]

If he is irritable when on the medication, consider co-existing anxiety. If he is irritable after the medication wears off, this can be ADHD.

[Mamamichl]

so your kid is on adderall and vyvanse? Both of those are stimulant meds. Vyvanse does give my partner mood swings when he come off of it, which is why mid day he does a dectroamphetamine. He also takes anxiety meds and it helps him tremendously. The booster mid day helps to make sure the brain isn’t shocked into when the medicine wears off for the day.

Small side effects can be concerning, but you are on a smaller dose. I wouldn’t worry too much if it’s not extreme. Adults go into the 50s. Raising could be beneficial if he is getting some relief from the meds but it’s not quite where you want it, but keep an eye on the mood swings and make sure they don’t get worse. I’m more concerned about him being on two separate stimulants. I know it’s common to pair a stimulant with a constituent, but I’ve not heard of two stimulants.

[Dahvina in reply to Mamamichl]

Hello, Thank you for your reply. He is only taking Adderall XR. The other medicine he is taking is just a Kid Melatonin to help him sleep.