Reply To: Evening "Med Crash" Struggles

Home Welcome to the ADDitude Forums For Parents Treating Your Child Evening "Med Crash" Struggles Reply To: Evening "Med Crash" Struggles


Hi. I feel your pain! Two years ago I could have written your paragraph about being “burnt out, spiteful, resentful and unable to control my own frustrations.”

My 11 y.o. son has ADHD (mixed, but mostly inattentive), anxiety, and a tendency toward depression — so not quite the same cocktail your daughter has. We found Concerta worked well during the day, but once he got used to it, his symptoms were worse than ever before when it wore off (or if we forgot to give it to him on the weekend). We also found ourselves yelling far too much and his self esteem took a huge hit, as we were always angry when the “real” him came out.

We switched to Strattera. It was a ROUGH transition for him emotionally (perhaps because it took place over the Canadian winter, when he has a tendency toward seasonal depression) but has worked out fantastically for him. He has now been on Strattera only (plus a bunch of supplements) for 18 months. It doesn’t help as much with focus as the Concerta did when it was working, but everything is much more even throughout the day. It took 6-8 weeks to see the full benefit, and weeks 1-4 were really, really difficult. So I encourage anyone who is trying it to stick it out. In hindsight, we should have continued the Concerta or a morning dose of Ritalin during the transition.

Strattera definitely does not work for everyone. I was so impressed with it for him that I tried it for myself and had absolutely no benefit. But then stimulants have no benefit for me either, unfortunately.

He has started middle school and if we find him struggling, I’ll consider a small dose of a stimulant for during the school day.

Even without a stimulant, he struggles to fall asleep. We give him magnesium, L-theanine, and melatonin before bed. I recently learned that 300 mcg (roughly 1/3 of a mg) of melatonin is the ideal dosage, and now order it online since I’ve never seen less than 3 mg doses in stores.

Overall, it’s hard to know just how much of his current success is due to Strattera, and how much to Neurofeedback, which he started around the same time. I am sure the Neurofeedback has been beneficial, because once he evened out on Strattera we could still see weekly improvements during periods of Neuro. It’s not cheap, and like medications, it doesn’t work for everyone, but I highly recommend looking into it. We are lucky to have excellent coverage, but if we were paying 100% out of pocket it would probably have cost us around $3,000 so far ($100 per session) and I think that would have been worth it (but of course $3,000 means very different things to different families — if that $3,000 would have otherwise been spent on a family vacation, I’d say neuro could be well worth trying, but if it would have been spent on food then neuro is an expensive and risky experiment.)

Have you looked into EMDR? It sounds kind of wacky, but I’ve been doing it with a psychologist who is not at all wacky and have seen remarkable results for myself in terms of core beliefs about myself that I just couldn’t shake. It is supposed to be effective with PTSD and RAD.

Best of luck! I hope you’ll update this thread after you’ve seen your doctor and tried something new.