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s/o ADHD meds--time release vs. tabs, massaging dosage


kbutton
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Please don't quote me as I may remove some details later.

 

I'd like to know more about taking time release formulations vs. tablets. We are doing a trial of meds. We saw changes we were hoping to see (less impulsive, not as much constant noise, not bugging his brother, actually commented when asked that his brain wanted to be "doing something"), and he didn't feel bad or jittery at all on the meds (he was cheerful, alert, accommodating, etc.). Unfortunately, it also brought significant insomnia. We are already at a low dose, and I'm wondering if anyone else has had this reaction to the time release format vs. tablets. When I was younger, I could not take ANY time release preparations of any medication at all, ever. They made me wired and feel jittery--cough medicine, sudafed, it didn't matter. I no longer have problems with TR, but I am not sure what changed. In addition, my side of the family tends to have big reactions to meds of any kind even at low doses, and my hubby's side tends to under-respond to the highest doses of all meds (DH's family are redheads, FWIW). 

 

Anyhow, I was wondering if anyone else had this problem, and if they successfully fixed it with dosing or by switching to tablet forms. My son has been trying so hard this week with school (very high motivation, likes the curriculum I've chosen). The whole time we've HSed (2 full years), it's like he's on a timer--no matter how we switch it up or schedule the day/breaks he just can't be available for a full day, and I'm talking the bare minimum, of school. We've tried a sort of block scheduling (not doing every subject every day, etc. as well). If he wasn't a quick study, he'd be totally floundering and falling behind. I'd be happy with something short acting just for school hours if he could sleep at night. 

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I appreciate the discussion about the downsides of tabs as they wear off as well as the information about how long the various time release options last. 

 

Does anyone have links to good discussion about this? I clearly am not looking in the right places for comparison information, pros and cons. Most of the ADHD books I have are about EF, not meds, but I would visit the library if someone knows of a book with a good discussion about meds. 

 

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Hey there. We had some late nights with xr the first few nights but it's gotten better. Also I believe I read somewhere on here that some people wake the kid up at 6 (or whenever - early) have them take it and then go back to sleep. I do notice if he doesn't take it before 8, he will definitely be up.

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Hey there. We had some late nights with xr the first few nights but it's gotten better. Also I believe I read somewhere on here that some people wake the kid up at 6 (or whenever - early) have them take it and then go back to sleep. I do notice if he doesn't take it before 8, he will definitely be up.

 

I removed the detail about how long he was awake before you saw this--getting up early to give it to him won't help in this case, but I appreciate the suggestion. :-) 

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I'm also interested in people's experiences with the short acting tabs. We tried meds last year with my 6 y/o and the long acting killed his appetite which made him cranky. Short acting led to huge crash & burn meltdowns after they wore off. They worked great while they lasted, though.

 

Older ds takes Concerta plus sleep meds (clonidine and melatonin). The benefit of the Concerta outweighs the downside of having to medicate for sleep in his case. He is still not able to do a full load, though. He tries his hardest but we stick to the basics and only do 4 subjects.

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I hope the new Rx works better, kbutton. We haven't tried the extended release version of anything, so I can't comment on that, but I will say that DS started on meds in April and has had several changes in dosage, as well as trial runs of two alternate meds when the first one caused some weight loss and increased anxiety. So it has been four months, and we're still tinkering to find the right med at the right dosage. I have a feeling we're going to end up back on at the first med with an anti-anxiety med added. Currently DS is on a non-stimulant. It is not proving effective at helping him with his inattention and impulsivity, so it will not be what we stick with. But it has helped him sleep. In fact, he has fallen asleep twice in the car in the afternoons, and he stopped napping seven years ago. He also falls right to sleep at night, even though he usually does not.

 

When DS first began the stimulants, he had trouble sleeping the first night or two, but then went back to his normal nighttime behavior, so he adjusted to it quickly. He was on the 4 hour dosage, which he took at breakfast and lunch.

 

 

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Currently DS is on a non-stimulant. It is not proving effective at helping him with his inattention and impulsivity, so it will not be what we stick with. But it has helped him sleep. In fact, he has fallen asleep twice in the car in the afternoons, and he stopped napping seven years ago. He also falls right to sleep at night, even though he usually does not.

 

Intuniv? It doesn't do jack for my kids but make them sleepy. Dd thinks it works for her, but she can't afford to sleep this much when college starts.

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A short acting stimulant with the lowest dose worked well today. At its peak, we had a few moments of anxiety/anger (probably frustration due to anxiety--looked like anger, but the trigger was anxiety in reading tone of voice, etc.) that may get worse or better after a few days. He was focused, calm, mellow, etc. and did tons of schoolwork. I think he was pretty pleased. Crossing fingers some more. Thanks, everyone!

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DS (10) use a time release patch called Daytrana.  They have a liquid form available as well but the doctor warned that the time release wasn't as effective as it was with the patches.  We are pleased with it.  DS can wear it during school only if he wants to and then pull it or leave it on up to 8 hours to help the entire day.  The only negative side effects are itching at the patch site and it can make the skin red and a little irritated.  Not so much so that ds won't wear it though.  For us I like this more than a pill since we can remove the patch after he's finished his work if we want to.

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My DD used the Daytrana patch successfully for many years. She started on it when it first came out. In fact, she was the first patient her doctor had to use the patch. It does take a little longer to get into the system than an oral version, but that was actually good for us the years that she had a long commute to school. It was so easy to adjust the dosage by taking the patch off earlier or later in the day.

The big down side to Daytrana is the cost. Once time, our insurance changes to where we had a prescription deductible and 1 month of Daytrana cost over $150 about four years ago. Also, when we moved to a very small town, one pharmacy refused to even order it for us due to the cost. I guess he was afraid that I would back out and he would be stuck with an expensive medicine that he could never sell.

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