This is for parents with ADHD kids...when did you know it was time to advance or change meds?

Question

my son is 7.5 years old and has been on dexedrine since he was 4. He did very well on them but now i find he's alot older and bigger and needs a longer acting medication b/c the time released dexedrine is only good for about six hours. After that, he's so hyper again and acts nuts!!! He's a great kid and all and very bright but is so high strung once it wears off. I saw the doctor and the next step up is adderall 15mg which the doctor stated is the same as dexedrine but lasts 10-12 hours. Im really nervous about starting a new medication. Im going to try it before going back to school and if this doesnt work, we will keep him on dexedrine but give him two capsules one in am and one smaller dose at noon. When did you know you had to change the meds or found that your child with ADHD needed something more stronger? Did you feel guilty and scared of the side effects? Also, my son has good days and bad days. One day he's great to be around and then anther day he's a pain.

Answer 1

I can really empathize with your frustration and fatigue.  I've been there myself, and it can be extremely taxing.  

Try to keep in mind that ADHD kids are different.  A med that works for one child may not work well for another.  It's not uncommon to have to try different medications over a period of time until you find the optimal choice or combination of medications.  As your child grows physically and matures, it's likely that the medication regimen will need to be modified.  It's very unusual that you've been able to make it through the past 3 1/2 years on the same medication.  

It's helpful to keep in mind that there's a lot of documentation and research supporting the fact that the most effective type of treatment for ADHD is a combination of chemical therapy, which you are already pursuing, and behavior modification therapy.  We have a pyschologist, who specializes in adolescent ADHD/ADD, overseeing our son's behavior modification program. It's basically a chart system in which your child learns the benefits of desired behaviors by earning points for them.  Similarly, they get points deducted for undesirable behaviors.  With a certain number of points, they can earn age-appropriate rewards, which are typically not monetary in nature.  Behavior modification becomes increasingly critical to your child and his ability to be successful at this age, when school is becoming more demanding.  My son's behavior modification therapy is covered by my spouse's insurance plan; we just have to pay a $25 co-pay per visit.  The behavior mod therapist also helps the entire family cope with the family's stresses of our son's disorder.  

Although there are numerous books out there, I have found that the gold standard is "Taking Charge of Your Child's ADHD" by Russell A. Barkley, PhD.  It includes a great deal of information about the latest medications and behavior modification techniques.  It also provides a lot of useful information about how to deal with teachers and other school personnel.  

As far as knowing whether a specific medication is working or not, you should know within a period of 5-7 days after you begin the new med.  Be sure to telephone your pediatrician and let him/her know how it's working after the 5-7 days.  In assessing whether the medication is working or not, ask yourself whether the med is effective for about 10 hours.  If not, he may need a stronger (higher) dose.  As far as the afternoon booster is concerned, I would wait until the school year starts and observe how things go with homework in the afternoon.  If it goes poorly, then the afternoon booster is appropriate.  Also, ask yourself whether you simply see an improvement in his behavior, OR do you notice that your son's behavior with the new med is closer to the behavior of a non-ADHD child.  Ideally, the answer should be the latter not the former.  If not, then the medication isn't working as it should be and a change is necessary.  Tell the pediatrician exactly what improvements you see and how the behavior is still missing the mark, if at all.  That information will help the pediatrician to deternine whether a change is necessary.  

When my son originally started on medication, I felt terribly.  I was very concerned that my son's bubbly personality would be suppressed or somehow changed.  But, my pediatrician, who has a great deal of interest in ADHD and experience in this area, explained how pyschostimulants work within the patient, and I quickly learned that his personality would not be altered.  Now, I view his ADHD as being similar to a problem with a car's spark plugs.  When there isn't a proper connection between the car's spark plugs, the car mis-fires and doesn't operate properly.  It's very similar with the neurological transmitters within the ADHD child's brain.  The pyschostimulants help the transmitters to get a good connection so that the brain can operate properly and the patient can be more focused and less distracted.  They don't sedate the patient or change the patient's personality.  However, they can suppress appetite and sleep.  The pediatrician should closely monitor his weight and sleep patterns.  

Good luck to you and your son.  You are your son's number one advocate, so it's important for you to take good care of yourself and find constructive ways to manage your stress.  Talk with your doctor about this.  ADHD can take a huge toll on the primary caregiver, and that shouldn't be taken lightly.  I can see how much you care about helping your son, and he's forunate to have you for his mother.

Answer 2

change them when they don't work anymoar and start to turn your kids into zombies.

Answer 3

My son is on concerta right now, which is a continual release.  It is usually pretty obvious when it is time to change them.  His attention span gets so bad he can't function nearly as well as he would normally.  I really don't feel guilty anymore because he really is so much happier when he is on the medications.

Answer 4

Long-term use of mind-altering drugs can never be good. Especially with a young developing body. America tries to fix people's problems with a little happy pill. I hope your child will one day be able to function in society without the use of DRUGS, because right now he is not developing any sort of self-control skills. He is learning to alter his mind by popping pills.

When your kid is on DRUGS thats not who they really are. WELL JOHHNY THE WAY YOU ARE IS NOT "NORMAL" AND WE CAN NOT DEAL WITH YOU. SO WE WANT YOU TO TAKE THIS LITTLE PILL, OKAY? IT WILL CHANGE THE WAY YOU ACT BECAUSE WE DO NOT WANT YOUR PERSONALITY. WE DO NOT WANT THE NATURAL YOU.

Answer 5

I am talking to the psychiatrist on Tuesday about maybe starting my son on adderal (he is on risperdal right now).  My boyfriends kids are on it, they do great on it.  They still function and have fun but they can do better in school and aren't so out of control.  He said that it was the only medicine that worked for his kids at all.  He gives it to them at 7 am and it works until 7 pm

Answer 6

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