Son with ADHD and ODD

[klyn07]

He is on Ritalin LA 30 mg in the morning at 7, 5mg of Ritalin (good old fashioned, not LA) at 11:30 am, and another 5mg of Ritalin at 4 pm. It just does not seem like enough. I feel like he is over medicated to begin with, it just seems like so much. What else can we do to help him? The slightest things set him off, arguing and eventually crying. He screams at all of us all the time. I feel like I am failing him.

[addprogrammer]

klyn07,

I can't give you the answers - just some generalities that seem to apply and one that I can emphatically state as truth - you are not failing your son.

I am now an ol geezer but I remember VIVIDLY what it was like as a child with ADHD - living hell.

As far as meds ... it depends on the degree of severity of your child's disorder as to how high a dose is too high. The normal indication of stimulant over-medication is the exact opposite of what is expected, namely, the child appears zombie-like with no emotional response to anything. The child appears unaware of environment and becomes totally self-absorbed. Hollering, screaming and crying are symptoms more indicative of under-medicated. Again, many could argue otherwise - and with justification - because it seems everyone responds uniquely to the meds.

The generally accepted maximum methylphenidate cumulative dose per day is 60mg. Your child is under that - 40mg - if I added correctly. Is his dose too high? That I can't say. But it is well under "max." Keep in mind that "max" is more a rule of thumb than an absolute. There may be good reason to prescribe a higher dose.

You need to trust your doctor. If your doctor gives you reasons not to trust him/her get another doctor.

Bob

[fineanddandy]

klyn07,

If I were you, I'd talk to the doc about a longer-acting form of Ritalin. Metadate and Concerta are the exact same med as Ritalin. They act much longer than Ritalin LA and therefore don't have the ups and downs that occur with taking multiple doses. And, the let-down from them in the evening is much smoother than with Ritalin or Ritalin LA.

It sounds to me like son's emotions are a result of the medication wearing off and leaving him "high and dry" - it's not a comfortable feeling. I tried Ritalin LA exactly twice and swore "Never Again"! I was an absolute ***** when it was wearing off. I didn't feel that way on Concerta or Metadate.

[addprogrammer]

Originally Posted by fineanddandy

klyn07,

If I were you, I'd talk to the doc about a longer-acting form of Ritalin. Metadate and Concerta are the exact same med as Ritalin. They act much longer than Ritalin LA and therefore don't have the ups and downs that occur with taking multiple doses. And, the let-down from them in the evening is much smoother than with Ritalin or Ritalin LA.

It sounds to me like son's emotions are a result of the medication wearing off and leaving him "high and dry" - it's not a comfortable feeling. I tried Ritalin LA exactly twice and swore "Never Again"! I was an absolute ***** when it was wearing off. I didn't feel that way on Concerta or Metadate.

klyn07,

I do believe FineAndDandy just hit the nail squarely on the head. I cannot tolerate any ups and downs during the day. Most people experience some degree of "crash" when stimulants wear off. ADHD takes the crash to a new level. Our symptoms return with a vengence. They call it ADHD rebound. I call it getting beat and whipped mercilessly. No wonder the boy hollers. I holler louder. And I'm 56. Not suppose to holler and scream couple times a day.

Another product to consider is Daytrana.

Bob

[Jennita]

This happened with my nephew. It stopped when my brother-in-law took him off meds and tried alternatives like therapy and tutors.