20 mg vyvanase for 4yr old son. Too much to soon?

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    • #110254
      Sean62
      Participant

      Our pediatrician prescribed 20mg of vyvanase for my 4yr old son. He was just beginning the process of diagnosis. It seemed like we were hostages to his demands and outbursts and problems at pre school with behavior. My wife and I trusted that he knew exactly what he was doing here. As I stayed up with him for at least 24 hrs straight I has time to find this site at get a little info about protocols in treatment. When I realized that he could have started at 5mg I was baffled. We are in the process of an evaluation with a pediatric psychiatrist who is specialized in this. I stopped the vyvanase. I’m new here. Absorbing as much as I can. Haven’t seen anything about treatment like this for a 4yr old.
      Similar stories out there? Thanks
      Sean

    • #110255
      mpea
      Participant

      20 mg of vyvanse for a 4 year old is just shocking 🙁 I would never take my child to that doctor ever again. I hope you find a good child psychiatrist

    • #110264
      Fluttermind
      Participant

      Not a parent yet (but my future kids will probably have ADHD – I have it, MIL has it, and husband suspects he has it), but I’d never give a four-year-old these meds at the behest of his teachers and non-specialist doctor, and I say that being a huge fan of stimulants because they’ve changed my life for the better.

      Keyword MY life. I take stimulants because the quality of MY life was degraded by ADHD symptoms. Is your son at a point where he himself feels impaired by yet-to-be-diagnosed ADHD or it’s reducing his quality of life? I’d guess not because he’s a four-year-old and preschool is (literally) fun and games. I think for a kid that young, some things to start with would be clean diet with more protein (especially for breakfast) and way less added sugar and refined carbs, and making sure he has ample time to run himself ragged outside. Seriously, diet and exercise WORKS, but it’s much harder to pull off in today’s climate of structured indoor playtime/school and our godawful food supply. Back in the day, kids would be turned out all day, enabling them to get a hit of endorphins and keep ADHD symptoms in check, but today, those same kids can’t cope because they’re cooped up and have no release, and they cross over into having a disorder.

      Lastly, even though I’m a fan and proponent of stimulants for ADHD treatment in (older) kids and adults, I find it extremely distasteful for PRESCHOOL teachers to advocate that you drug your kid for their convenience, and that your kid’s doc would go along with it and prescribe him an inappropriately high starting dose of amphetamines before he’s even formally diagnosed. Just… ugh.

    • #110269
      Sean62
      Participant

      Thank you, confirmed my instincts. Found a pediatric psychiatrist about an hour away. First she met with us. In a week she’ll meet with my son.
      I like the approach right away. First thing she said said was that this drug has not been studied enough for kids under 6. Not ruling out meds, but needs much more info and history before going there. I had him once a week sessions with pediatric therapy they feel he has sensory issues. Starting this week it’s going to be 2 sessions a week. Time to re set here after allowing things to move way to quick
      Thanks Sean

    • #110298
      Penny Williams
      Keymaster

      The standard best practice for ADHD medication is to start at the lowest dose and increase only if and when needed. The doctor who prescribed 20 mg starting out should not be treating patients with ADHD because he/she has no knowledge on the subject, not even the general best practice.

      ADHD medication dosage isn’t based on age or size like most medications. ADHD stimulant effectiveness depends on metabolism, genetics, and the individual’s neurotransmitter needs. A 40 lb 4-yr-old could need a max dose and a 200 lb adult could only tolerate the lowest dose. It’s all very individualized.

      Glad to see you’re going to a specialist.

      A Patient’s Primer on the Stimulant Medications Used to Treat ADHD

      Penny
      ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism

    • #110302
      Dr. Eric
      Participant

      I am always a huge fan of how my MD did it.
      Generally referred to “titrating” up.
      We did a couple of days at 5mg, then 10mg, then 15 mg…
      We took notes on positive benefits and side-effects at each level, and we used the dose that had the highest benefit with no side-effects.

      As a professional, when I was in a smaller community, I could often guess who the child’s MD was based on what their prescriptions were. I don’t like thinking that the prescription did more to identify a single MD’s pattern than an individual’s needs.

      With that said, if a doctor takes the time to do this, it is possible for children to have very high doses.
      I have seen some big variances in individual’s responses to meds. I have seen people get huge benefit from extremely small doses. On the other hands, I have seen kids barely get any response from a dose that would give me a stroke… literally.

    • #115359
      bumpywx
      Participant

      Just my two cents, but we recently (early April ’19) saw a pediatric psychiatrist to get our 4 year old son on medication, and it was a difficult conversation. That said, we started on Intuniv ER just under 2 weeks ago at 1mg. She said that we will re-evaluate within a month, and then determine if a higher dose is needed, or a different medication is needed (her plan B). We asked what ‘plan B’ meant, even though she insisted that Intuniv would work. She indicated that Vyvanse would be her second choice. I don’t recall particular dosing amounts for Vyvanse, but I assume the lowest dose, since we are on the lowest dose of Intuniv that is offerend now.

      Either way, as I posted in a different post, we haven’t seen any “results” yet on the Intuniv, and are getting impatient, since pre-school is still a major struggle with fighting, hitting, knocking shelves over, etc.

    • #115595
      Angelacawein
      Participant

      Wow, that is crazy. I am surprised insurance filled 20 mg for a 4 year old. There are usually restrictions on age. Vyvance is something like 6 years old, Mydayis is 13 years old, and the others are 3. I have seen 8 different psychiatrists over the years for my kids. They all have said start with the lowest dose. There is a swab test they can do now Genesight to see what medication works best for them. I wish you all the luck, it is an endless battle.

    • #115671
      iix ADHD iix
      Participant

      I would have never wanted to be on meds until probably 18. At the age of 4 I was not even close to being ready for psych meds. No way at all I’d give someone that young medicine. Never.

    • #116198
      bumpywx
      Participant

      Just an update to my earlier post — my son was taken off of Intuniv last week and now is on 10mg of Vyvanse. This is day 6, and so far, nothing, unfortunately. We did the genesight test, and Vyvanse was in his “green” zone, too. Possibly he needs 20mg? His behavior is still just as challenging as it was. Still aggressive, still non-compliant. he has good moments, but they don’t last for hours or all day typically.

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