Newley diagnosed ADHD - Med dosing struggles

[Aussiewiggles]

Hello, My son is 7. He was diagnosed ADHD in October - for lack of focus and impulse control. We started on Focalin 5mg (extended release) and he did ok but struggled in the afternoons, it seemed the medication was wearing off too early. His doctor upped the dose to 10mg and told us to try for three weeks then test 15mg. The 10 did good but seemed just not enough. When we tested 15mg, things got wild. A lot of behaviors we had never seen before. He was crawling around his classroom roaring at other kids and teacher. The next day he got very angry at school and was throwing things and destroying things in the class room. We had never experienced anger issues before. We immediately dropped back down to 10mg. Then his doctor wanted to add in anxiety medication. This also did not go well. He had an ok week at school but come the weekend, we were dealing with extreme tantrums and anger again. His doctor again had us stop the anxiety meds so he is back to just Focalin 10mg. That has been since Monday this week. Tuesday was a fantastic day at school and at home. Tuesday night he struggled sleeping (which is not common) and had a rough day on Wednesday with just too much energy, not wanting to listen, refusing to do work in class. Do you guys think he needs a new medication or do I need to give the Focalin 10mg a longer chance with out other meds? Before we started medication he struggled sitting still and following directions but we never had any of the other issues.

[Adhdquestion]

My son is almost 7 and his symptoms are similar to your son’s. Based on my experience with my son’s meds and what I have been told by his child psychiatrist, you should see the effects/benefits of the medication on his ADHD symptoms within a day or two since he is on a stimulant. Side effects are a different story, they can appear right away or take days/weeks or more to show up and side effects may resolve themselves in time as the body adjusts to the medication but sometimes do not go away. In my non-medical opinion, based on my knowledge, if the ADHD symptoms are overall not being helped enough within the first week (too much energy, not listening, etc) then it sounds like the current med/dose is not right. There of course will be some ups and downs (perfection is not a realistic goal) but overall, you should see a positive improvement quickly with a stimulant. The sleeping issue sounds like a side effect so that’s different. Our psychiatrist also said if irritability is a side effect, like your son experienced, that usually doesn’t go away so backing down on the dose sounds in line with that. Our psychiatrist said he used to prefer Focalin ER but his complaint was it usually doesn’t last the whole day and would need a short lasting supplement/booster (obviously depending on how quickly the individual child metabolizes the Focalin). Now that there are 24 hour meds (like Azstarys and Jornay PM, a few examples) that give smooth all day coverage, he prefers one dose, if it works for the child. However, there are lots of people that have success on Focalin ER and also do well with multiple doses throughout the day. Just giving you one opinion but discuss more with your doctor. Good luck!

[GoDukes]

I'm sorry to hear about your son's struggles but it's good to hear you're trying different things and continuing to make adjustments. It can be exhausting but it's all you can do. You'll always be his biggest advocate.

We tried a number of meds when my son was around the same age. We ended up on Foculin because that seemed to have the best results. Over time though, he had significant anger and agitation issues. I think the stimulant aspect of Foculin was causing those side effects. We ended up trying Straterra which is a non-stimulant ADHD med. It seems to be doing the trick. His anger side effects have definitely gone away. He has been on this for a couple of years now and he is in high school and doing well. It's just another option you may want to consider and talk to your doctor about. Good luck!

[Daisy_chain_necklace]

We initially tried Focalin, but it didn't quite work out for my son (6). We switched to Quillivant extended release, and so far, it's been the best experience. As he grows, we'll need to adjust his dosage, but for now, we're giving him 1.5mg in the morning and another 1.5mg at school.

We've found that splitting the dose helps to minimize irritability when the medication wears off. By staggering the doses, we can create a smoother transition and reduce the likelihood of mood swings.

I think trying a new medication could be a good next step. But I know how hard it is to start that process again with another not knowing how things will go. Hang in there!

[Elijah1]

Some children don't get an 8-12 hour effect from Focalin XR capsules. It seems to lose effect after 4 hours. If you like the Focalin effect, consider using the tablets, which last about 4 hours, perhaps starting with 2.5 mg in the morning and at lunchtime and increasing to 1-1/2 tablets if needed.