IdeaChain

I just found this website and at last feel I found a place that is somewhat objective, with few people trying to sell things. I found this from another website that is for parents of my college (An alulmni website). In either case, my son was diagnosed ADHD and we are new to the medication stuff. It was a hard decision to medicate and I am still in a bit of denial, thinking he may not need this for very long. We started on concerta 18mg and then moved to 36mg. After three weeks, we took him off, it was too strong. This decision and the apparent overdosing increased the stress in the household termendously. We moved him to 5mg of adderall and it did not seem to do too much. We moved him to 10mg and it worked, but again, based on his behavior, it was too much. He became affected within 30 minutes - shy, almost paranoid, wouldn’t talk, etc. I bought a pill cutter and started titrating. Two days at 7.5 mg seems to be great. He is hungry and eating on his own will for the first time in at least three months. He was never a big eater, but I have not heard the words - I am starving- in at least six months. I heard it yesterday. He is six years old and 39 pounds. He did not lose weight on concerta but grew taller and never gained. He was always very thin, as I was as a child. Visually, he looked malnourished.

I guess I just wanted to let other newcomers know that there are alternatives and while extended release pills sound like a great idea, I vote against them to start off with. They allow for no adjustment in dosage (or “titration”). I would rather have my
son go to the nurses office than receive too much or too little medication.

Post-script- he takes 7.5 mg in the morning and nothing more!! It lasts all day. His teacher said that the past two days have been the best ever all year. He has a hard time falling asleep- the only side effect at this dosage. I may try 5mg in a few days again. My lesson: do not be afraid to break some of the rules. No need to change dosages at weekly intervals- I do it every two or three days - after reading one or two clinical peer review studies that recommended this approach. Stern discussion with pediatrician is helpful- now ours is ok with us calling every third day since we are adjusting. We have telephone consultations. I check in with the teacher each morning (I work full time).

In the long run, I would like to take him off the drug during the summer and try some diet and behavioral therapy. Regarding diet, we have reduced his milk intake (he has asthma and allergies- not uncommon, I have heard, for ADHD kids). This summer my only other planned changes are adding flax seed oil, possibly some vitamen supplements, and lots of sleep and play. Recommendations on diet are also helpful, but also controversial. I read the Doris Rapp books on allergies and honestly, I was not very impressed. I still believe that some hyperactivity can be food related- whether as a byproduct of stress from not feeling good having food allergies or a direct result of the food. But I do not fully believe in the highly restrictive diets, such as feingold,etc. In any case, my son is such a picky eater, these are not an option for me.

MY QUESTION:Over the summer, we will start a behavioral therapy. Are there any recommendations on this? There are many books outthere and I do not know which are authors trying to make a buck and which are good, hopefully based on some research or background. Also, the paradox is with the medication, no behavior therapy seems necessary. Do you keep the behavior therapy going when they are on meds even if they have no behavioral issues on meds?

One more thing, when he is off the meds, he seems so crazy- more crazy than before we started. Is this possible? Is this rebound and how long does it last?

thanks. Sorry I wrote so much, but this is my first post.

Susan, I can’t believe they had him on such a high dose of concerta! My child was on 18 mg and he weighs 80 lbs.! We had to take him off all stimulants because he started exhibiting OCD behavior and other abnormal behaviors that were caused by the med. He is on Imipramine now. It doesn’t work quickly like the stimulants but I have seen some improvement in focusing after being on it for 11/2 months. Rebound does occur and can be much worse than the initial behavior. We went through that on Ritalin. Adderal didn’t seem to help my son at all. Diet and behavioral therapy may help some but I haven’t found it useful. We tried the herbal route to to no avail. If he doesn’t have a behavior problem why fix it? Our psychiatrist thought the same.My child never has had a behavior problem, just an attention problem.Hope this helps. Jan

thanks. Yes, like I said, we were new to it and did not know much better about the drugs. Our pediatrician did not think dose was related to weight. And in one respect, I think he is right that the dosage which works may not be related to weight but weight I see now is certainly a limiting factor on how much a child should get. He does have behavioral problems in class without the medications, which is how we started this whole thing. But on the 7.5 mg of adderall, he is a different person - like the person he would be if he could only slow down and gain control to do what he thinks is right. (I do not think the drugs alter his personality, etc.) There is NO behavior problems on the medication.

Thanks for responding. Any suggestions on behavioral therapies?

by the way, regard can rebound be for an hour, a day or anything? Hard to tell when the thing being changed is behavior.

Thanks again. I feel better just knowing there are others out there.

Brain Gym can be used with kids who have ADHD and I also like to do hand clapping games which make them listen and pay attention to refocus. Getting the dose right on meds is tricky. My daughter did fine on 18 mg of Concerta for about 18 months, when she started a growth spurt and puberty and she noticed that she wasn’t able to focus so we went back in to the Dr’sand adjusted the meds…she is on a 36 mg dose now. your son is still a little guy and my kids are bigger in their teens…

Concerta is milder than Dexadrine and Adderall in my opinion. 10 mg of extended release dexadrine can last 16 hours for some people when concerta in an 18 mg dosage doesn’t even phase them. My son who is on Dexadrine doesn’t have the appetite my daughter has. concerta didn’t work for our son…when he was on Adderall he did ok at first and then after 6 months he wasn’t able to focus at home to do his homework..and he started growing so we had to change the meds again and tried Dexadine. It works much better for him but the loss of appetite can be a pain, he forces himself to eat sometimes, and he usually eats smaller portions..

My daughter is very goofy when she is off her meds on the weekend. Many times she requests to be on her meds during the weekend so that she can be calm and in control. I will give her only one 18 mg pill on the weekend but during the week at school she needs to focus so she takes two 18 mg pills. When a child goes off a stimulant there is a rebound. Sometimes they can be very tired and listless and moody especially when they aren’t taking meds on the weekend. When Monday rolls around their body goes into shock again when they start up with meds again and they are regulated by Friday and boom they don’t take them on the weekend and sometimes you will see the tired listless behavior or the hyper wazoos…It depends on the children..

My daughter has bad allergies too, hayfever. We haven’t done the food route, we have done Brain Gym and music therapy. Music therapy is really good for kids with ADHD. You can really improve attention and calm them down through good relaxing music. Check out Advanced Brain Technologies website to check out the music therapies that are available. good luck and you are never alone…let us know if we can help again..

I also adjust dosage with Adderall. My daughter is up to 30mg now. Other dosages just don’t work at all. The book “Brainstorms” by Dr. Horacek helped me understand why a dosage will work for a while then not at all. The liver produces enzymes to break down the medication in response to its presence in the bloodstream. This is why the first day my daughter took 5 mg of Adderall she noticed that it helped her focus. The next day it was as if she took nothing. My daughter has a high hepatic metabolism. that is her liver metabolizes very quickly. So she quickly gets used to the lower dosages and must move up to the higher dosage. At some point (I hope) equilibrium will be acheived. She does not eat at all while on Adderall, and she was always very thin. She grew 3/4 inch but did not gain weight at all. We are in a wait and see mode. If she continues to grow and not gain weight, or stops growing then we may have to switch meds or something.

As to rebound, I also gained new understanding by reading “Brainstorms.” The stimulant medications act on several different neurotransmitters, including dopamin, seratonin and norepinephrine. But the effect wears off at different rates. Dr. Horacek likens theses neurotransmitters to brakes, gas pedal and steering in a car. When they all work well all is fine. But what happens if the brakes don’t work and the steering doesn’t work but the gas is stuck to the floor? Rebound effects! The stimulant medications wear off on dopamine and seratonin but norepinephrine will still be high. This causes rebound problems.

I am having good success with Brain Gym with my son - ADD-Inatt.. His focus and control have improved greatly. We have seen success in school and socially. It had been hard work but I think with the right Brain Gym therapist you would see results. My personal opinion would be to use meds as a last resort. There are too many problems with these drugs and I think we as a society will not be happy when we see the long term results from these meds. I have also known people who have had success with music therapy also. Hang in there and good luck. God bless.

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