After school activities a struggle after meds wear off – please help

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This topic contains 27 replies, has 14 voices, and was last updated by  ddt1981 6 hours, 44 minutes ago.

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  • #91698

    ddt1981
    Participant

    Hi I’m new to this forum. My son is 7 and a half and was diagnosed with ADHD last December. We have tried a few medications but we are currently on Concerta 27mg (the generic) and have been on that since January/ February of this year. My son is having a hard time during late afternoon activities and I just called my doctor to help. I am worried about upcoming soccer practices after witnessing very hyper activity during a family BBQ. Hey was so rough and hyper the kids opted not to play with him. It was heartbreaking. I tried talking to him and correcting him and he wouldn’t listen and was in a sweat from being so hyper and playing so hard. I am worried about his concentration during soccer practice and upcoming after school activities like holiday concerts. My doctor recommended increasing his dose from 27 mg to 36 mg to see if that helps last longer. Our pediatrician is concerned with his weight, at the beginning of the summer he was 53 lbs which was under for his tall height, and now we are at 59 lbs, so that has improved. He also mentioned splitting up the dose for it to last longer. He recommended the higher dose for now, but I worry. Just curious if anyone else has had any experience with after school activity being a struggle and what you have done to help? I just want my son to be able to enjoy the concerts, the practices and not struggle with focus and hyperness. he does wonderful being on the medication and seems to enjoy it and can focus, he got great feedback from school and did awesome, was able to focus and stay in his chair and do worksheets, I just wish it lasted longer for his important activities after school so he could enjoy that and not struggle.

  • #91699

    Aurora122
    Participant

    I feel like you were writing about our 7 year old – right down to the soccer and weight issues. We also get the rebound when the ADHD med wears off. We’re currently trying a small dose of cholonidine to help with the “agitation” in the late afternoon.

    Bascially, we’re not doing the soccer in town any more and doing a buddy soccer on Saturday mornings and a traditional basketball skills development class at a private facility on Sundays. So he’s getting the experiences in a different way.

    • #99364

      ddt1981
      Participant

      Hi! just curious, what is your son taking for medication during the day?
      Nice to hear a similar situation thank you! If we had that option available in our area, I would totally do it. He loves playing with this friends and the social interaction, he just has a hard time focusing on the game and what he is supposed to do.

  • #91727

    JBoom
    Participant

    Keep in mind you can keep trying until you get it right. Which is to say, the change your doctor is recommending isn’t the final step, it’s another try. And if that doesn’t work, you and the doc can keep going on to the next try. Trial and error is really the only way to find the best treatment with ADHD.

    That said, if the current recommendation doesn’t sit well with you, explain that to the doctor. You know things he doesn’t in terms of your child’s sensibilities and temperament. And he knows things that you don’t, in terms of medical treatment options and the risk/benefits of each. The two of you need to combine your knowledge for the best results.

  • #91739

    katherine4
    Participant

    I don’t enroll my daughter in after school activities because she can’t handle the demands of the school day AND yet another structured acactivity. In your son’s case, I don’t think it’s worth giving him more medication. If you want to improve his soccer playing skills, then do a free style form of practice with you and him, or hire a soccer playing babysitter to play with him, preferably on the weekends. I also always encourage people to get the screens out of the lives of their adhd kids, if that is something that you allow at home. In my opinion, it’s harmful. Read Simplicity Parenting. It’s not specifically geared to adhd kids but is definitely applicable.

  • #91745

    ddt1981
    Participant

    Thank you for all the input. I can’t avoid all late afternoon/ evening activities, so I’d like him to be able to enjoy them if at all possible. There are Christmas concerts coming up in a few months- he loves standing up in front of everyone and performing, it is just the sitting still and waiting until his turn is a struggle. Also family BBQ’s and birthday parties in the late afternoons. If there is a solution like a medication change, I would love to try it so he has some help to enjoy and experience events like this in his childhood. I don’t feel that avoiding them all is the answer either… Also for social reasons, I don’t feel that hiring a private babysitter or coach is the answer as I want him to develop social skills and have the ability to play and learn to play in a group out of a school setting if possible.

    • This reply was modified 2 months, 3 weeks ago by  ddt1981.
  • #91748

    brian092271
    Participant

    My son is 8, and was diagnosed last school year with ADHD. His pediatrician initially put him on 20 MG of methylphenidate (generic ritalin). It seemed to help a great deal during the school day, but then the rebound would happen around 5:00 p.m. almost daily. The doc suggested we try 5mg around 4pm. We’ve been doing it ever since, and it makes a big difference.

    I think part of it, though, is the age. 6-8 year old boys are often excitable and easily distracted. I’m 46 and I’m easily distracted! LOL At any rate, if something bothers you about what the doctor is saying, tell them that. Or get a second opinion. Advocating for your child is never a bad thing. Doctors should be more than willing to partner with you to find the right solution for your son.

    I’ll keep you in my thoughts and prayers. If you ever need to talk, I’m here.

    • #99366

      ddt1981
      Participant

      Hi there, just curious, did your doctor supplement the methylphenidate? My doctor said that he couldnt give a low does after taking the concerta, we would have to switch to a 2 part med altogether. just curious what your son takes currently? thank you!

  • #91750

    ddt1981
    Participant

    brian092271 that sounds so similar to my son. I have talked with the doctor just a few minutes ago and he said that he is concerned about his weight and wants to see him a more heavier healthier weight. My son struggles to eat lunch and I try to get him to eat high calorie foods, but he just wants veggies and fruit. If we can get his weight up I’d like to do a second dose for in the evening so he can enjoy the late afternoon/ evening activities. so you do the 20 mg in the morning and then another 5 mg in the evening? does he have a hard time eating and having an appetite? how does he sleep at night? sorry for the questions but this is the option I think would fit my son well…. THANK YOU!!!

    • #99371

      brian092271
      Participant

      No supplement. Just the methylphenidate – 20mg before school and 5mg after.

    • #99377

      ddt1981
      Participant

      Both the 20mg and 5mg is methylphenidate? is it generic or brand name Concerta?
      This is huge, definitely a question I’m going to ask my pediatrician. He said that it was the one dose for this med and only option….

  • #91768

    brian092271
    Participant

    ddt1981 you are so welcome! Every child is different, but my son is about 4 feet 1 inch and weighs in the neighborhood of 51 pounds. He’s smaller than some kids, but energy level is always fine.

    I will say that since he started the meds, his appetite has changed. He often doesn’t want anything to eat until early afternoon. His pediatrician said this might happen, so we don’t worry about it too much. Once he starts eating, he will eat the rest of the day, so he more than makes up for it. It’s a shift, but one that, if you’re aware of it ahead of time, shouldn’t be cause for too much alarm. I’m not a doctor, but that’s what I see with my son.

    He takes 20 mg a bit before the school bus comes. Then another 5mg around 4pm or 5pm. He sleeps at night, but sometimes has a restless sleep. That was true prior to the meds, too, though. He seems well rested each day and doesn’t complain of being tired, and his energy is good. So I think he’s fine. We keep a pretty close watch and talk to his teacher once a week just to check in.

    Don’t apologize for questions. Ask away. I can tell you what I see. But I’m just a parent, not a doctor. 🙂

    • #99389

      brian092271
      Participant

      Yes, both the 20mg and the 5mg are methylphenidate. He doesn’t take anything else.

  • #91790

    caringmom
    Participant

    brian,when yourson does his homwork?if 5 mg in the evening is enough for focus?my son is also 7 years old and having this issue of wearing{ takes methylphenidate) off the medicines.he takes 15 mg sustained release methylpheidate i n morning with 5 mg of aripiprazole{he throws the things and hits when he is not on aripiprazole),t before school then at 1.30 pm he takes his lunch and at 2 p,m, agaihyn 10 mg of methylphenidate sustained he takes release..in the afternoon 1.30 to 2.30 is time when rhe shows the signs of wearing off like yelling,not listening,getting angry over smaller things…then froo{totally different boy at different timings[m 2.30 to 6.30 pm he is okay and the homework is done at 3 p.m..after{ 6.360 p.m. to 8.30 pm wearing off time…so after 6.30 again he is very impulsive and hyper,doesnt listen to anything and with his friends lacks the co ordination… i too b want to cover up his wearinfg off timings ….basically it is in the afternoon and evening ..he.surprizingly after 8.30 pm he ia a quiet boyb n obediant too,i think because of aripiprazole he takes in the morning…any suggestion is always welcome…and sorry for the typing mistrakes actually my backspace and delete keys are not working…sorry again.

    its really nice to have people like ddt,you and other having the same issue on this thread as it really helps to know what can be done,,,

  • #91807

    ddt1981
    Participant

    thank you Brian. the doctors says my son is big for his age at 49″ or so and 59 lbs currently. he was 53 lbs at the last med check and the doctor was very concerned with his low weight in relation to his height and if he didn’t gain weight by next med check we would switch meds. I’m nervous on doing that because he had a huge allergic reaction to one of them we tried early on. so i’ve been trying different foods, shakes, you name it. he just doesn’t have an appetite at lunchtime and doesnt eat much at dinner and says hes full after eating a little.

    I am hoping to supplement his 27 mg of methylphenidate with a smaller dose in the afternoon to help with focus after our next med check. he hates to read, refuses and he is behind in his reading. most everything else he is OK with, alot I have to remember he is a child and will fuss and protest on some things. we tried the first dose of 36 mg today and he’s home with his grandparents so i’m anxious to hear how it goes. he has a hard time falling asleep sometimes, but with extreme cases I give him melatonin 0.5 mg to help and with that he is asleep within a half hour. I worry about him getting overtirred if the restlessness goes on too long during the week. long winded. is any of this similar to your child? how is your child with reading? my son gets so bored and hates to read, I have tried easy to read books about his interests but still hates it. thanks brian!

  • #91861

    ADHDmomma
    Keymaster

    The generic Concerta does not have the same time-release mechanism as brand. The brand is much more evenly disbursed in our experience. When switched to generic, it was almost like my son wasn’t taking any meds at all. You can ask that the doctor write the script for brand only.

    Rebound is also common when meds wear off in the afternoon:

    When Meds Go Bad: After-School Rebound Strategies

    Of course, it could be that he needs a higher dose, or that Concerta or methylphenidates are the right medication for him. There are two types of stimulants: amphetamine (Adderall, Vyvanse, Evekeo…) and methylphenidate (Ritalin, Concerta, Quillivant…). Almost everyone does well on one type or the other, but not both.

    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

    • #99367

      ddt1981
      Participant

      Thank you! We have switched to concerta 32 mg for almost a month now. I am seeing that he is much more even, not as hyper as he was on the generic. however, the teacher is reporting that he is more distracted this year. Groggy in the morning, hard to get going. hyper in the afternoon with less focus. He is allergic to vyvanse. We have a doctors appointment tomorrow, I’m very nervous. Hoping there may be another med out there that would work better for him… but it seems like its either methylphenidate or the vyvanse? He also told me that we couldn’t supplement the 27 mg methylphenidate, we would have to change it altogether. can methylphenidate be supplemented with a different med? He did better at school with the generic methylphenidate 27 mg it just wore off right after school, made everything else hard after school and hard for him to enjoy.

  • #99379

    ADHDaddy
    Participant

    We have the nurse at our 8 year old’s school give him his afternoon dimethylphenidate at 3:00pm every day. This gets him through after school activities, homework, etc. and wears off around 6:30pm. You will of course have to fill out some paperwork to allow them to administer the medication and provide them the medicine, but it is well worth it.

    Good luck!

    • #99380

      ddt1981
      Participant

      Thank you! does your son take a medication before school? If so, what kind is that? thank you very much. I have a lot of questions for the doctor tomorrow…. what is the dose of the dimethylphenidate in the afternoon that he gets? thank you!

  • #99390

    brian092271
    Participant

    We could have had the school administer the 5mg during the school day, but his teacher says he does fine at school. We may adjust though, depending on how he does in the afternoons. So far so good. Definitely depends on your child and what’s best for them. Each child is different.

  • #99420

    mindy fryback
    Participant

    Hi! Same issues here…My son was on a time release (8 hr) 20 mg Methylphenidate and we are switching to a 12 hr time release formula (same dosage). I’m hoping this won’t interfere with his sleep or hunger in the evenings but I thought it was worth a try as he becomes very impulsive at his after school program when the med wears off around 4pm. You may want to explore this option with your doctor. Good luck!

  • #99436

    brian092271
    Participant

    I will say my son’s appetite has changed since we started the methylphenidate. He eats nearly nothing in the mornings on the weekends, but then more than makes up for it in the afternoon and evening. Just another thought I wanted to share.

  • #99451

    gorrye
    Participant

    Both our girls wear the Daytrana Patch, which is a Ritalin patch worn on the hip. It sometimes is a problem for my teenager daughter when it is hot and she sweats it off, but my 10 year old can wear all day and for sports after school. We love it, because it doesn’t have the rebound when it wears off, like other medications. However, it can take 2-3 hours to start working. After you take it off, it stops working in about an hour. There can be more problems with appetite and sleep, however.

    My younger one used to be severely underweight (under 40 pounds at age 7, but she was also small.) I would put ice cream in a thermos jar in the morning in her lunch and it was about milkshake consistency at lunch.

    Hope that helps.

  • #99477

    Mamanessbear
    Participant

    Hi there ALL,

    My son is almost 10 and we’ve messed around with dosing a bit. I came up with a plan after reading online….alot…. and what works well for us is a combination in the morning of 27mg concerta and 18mg together to make 45mg total. Then he takes 10mg Ritalin IR in the afternoon to boost him through the evening. This way he isn’t taking more then 55MG per day TOTAL. He does pretty well with this. Maybe you could keep up with the 27 concerta and add a 5mg Ritalin IR in the afternoon…it’s the same medication just the immediate release instead of timed released which is the Concerta. I’ve read that the common dose is about half their weight in MG, so we are pretty much right there…Hes 100lbs. We were concerned with weight for a while but we’re doing so great in that area now…I just make sure to feed him a good protein rich breakfast. I know he doesn’t eat too well at school lunch time so a big snack/lunch size after school before activities and homework. Then at night he takes 3mg melatonin. I totally threw out the breakfast for breakfast deal because I want to make sure he eats good in the morning so if he wants pizza or a sandwich I’m A-OK with that as long as he eats!!

    Hope this helps!

    Vanessa and Family 🙂

  • #99478

    Art Mom
    Participant

    The greatest advice I can give is to go talk to a naturopath doctor about your child and his symptoms. There are SO many natural and effective vitamins/supplements that have NO side-effects that can help. Our naturopath doctor has our 11 yr-old son (120 lbs.) on EPA Fish Oil (2400mg for agitation) and DHA Fish Oil (2400mg for focus) that I get online through Metagenics http://www.metagenics.com ; Neural Balance (4 capsules for self-regulation) that I get online at http://www.neuralbalance.com; NeuroReplete (1 capsule for movement control, motivation, focus, addiction control) that I get online at http://www.CHKnutrition.com ; Lithium (20mg for aggression) that can be purchased on Amazon or other health stores; Vitamin B6 P5P (100mg) that can be found on Amazon or health stores. My son has been on this regimen for 2 yrs and he is such a different kid with no side effects, weight loss, or having to juggle timing with it wearing off during the day. We continue to get comments from adults who spend time with our son without us present (his Sunday school teacher, his aunt, his teachers, his youth group pastor) who tell us they have seen a difference in his calm and focus. His last teacher said he never would have guessed our son had ADHD if we had not told him. This last summer, our son went on a middle school camping trip without us. Even though he’s not a fan of taking pills and it would be inconvenient to bring all his vitamins/supplements, he asked to bring them because HE NOTICES A DIFFERENCE! A victory in and of itself! I’m just a parent and not a doctor, so I don’t know what supplements or dosages would be right for your child. However, it can’t hurt to get a second opinion from a naturopath doctor. There are many who specialize in ADHD and take medical insurance for office visits.

    • #103841

      ddt1981
      Participant

      Artmom – my pediatrician just recommended fish oil; 1,000 mg of EPA and 2,000 mg of DHA. I’m trying to find online. any suggestions? having a hard time finding a dose that is similar…

  • #102906

    Iceland
    Participant

    Hi.
    First I totally understand your worries.
    We have been and is still going through he same. My son was born with Adhd. Attention deficit, And hyper Activity. He is now 11 and this is constant work,no doubt about that.
    What you have to remember is that your son, like my son, is, when he comes home from school extremely tired. A school day for a child with Adhd is twice as long as the day for a “normal” child.
    He has to focus more to get the job done, he is easily distracted so it’s more difficult to come back and focus on the job. We are working closely with the school and he does most of the work there and a bare minimum at home, he only read at home and sometimes that is enough too much. He is now on(i don’t know if it,s the same medical name in your country ) Sertral. Medicinet CR and Rison.  My Son, as yours, was reluctant to go to football practice and when he went was so hyper and rough that other kids opted out when he asked to play. When they are in this motion, talking to then simply don’t work, they are to “winded” up. So when he had calmed down we had a small “contest”, tell the truth we called it, where we asked him about him and his feelings and he asked us. He told us that he did not feel well because of the medication and wanted a break from football, which we gave him and also through his psychiatrist and doctor, changed his medicine and he is a complete change boy. Don’t get me wrong he has his down days and I mean Doooown.
    All medication after a while stop working simply because the body get used to it so to increase the dose,in my experience, is not a problem and must be done. We are after 2-3 months in touch with the doctor, for him to follow up and also if the need for the increase in the dose. Or adjustment is needed. And sometimes it is as simple as an adjustment of the dosage. Sooner or later this has to be done. It will not harm the child. On the contrary, it will help him to feel better and function better in school and socially.
    When it comes to the weight. Some medication slows down the appetite and some increase the appetite, There are children that need medication to get the appetite up simply because it is too early to change medication and also to get the appetite down. My son was, when his medication ran out, usually late evening, unstoppable, Head in the fridge constantly, eating everything. But that changed when he changed medication. Now he eats when we eat. No more”head in the fridge syndrome” late evening. But You need to have a serious talk with your doctor about that.
    In my opinion, it seems like increasing and splitting up the dose for it to last longer is the solution for you. My wife’s sister has children with Adhd and she is splitting up the dosage, It works perfectly for her children. And they function well at school and in social life.
    We work closely with our psychiatrist and doctor, You should go to. If something worries you ask them and they will answer. The well being of your child comes first
    I’ll love to chat more and help so if my 11 years of experience can help you or others in any way
    please don’t hesitate to send a mail to areyougrinding @areyougrinding.com

  • #102920

    justinross
    Participant

    Hello,

    So sorry for your son’s situation i have been through a similar situation with my son but ENHANCED CBD OIL was the key to to his treatment so i will suggest you try that too trust me it will help.

    Regards

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