Help can’t find a med that worked as good as Focalin and I’m not sure what to do

Home Welcome to the ADDitude Forums For Parents Treating Your Child Help can’t find a med that worked as good as Focalin and I’m not sure what to do

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    • #104312
      stech04
      Participant

      My son started on Focalin when he was 6 loved it and yes when he grew we had to up the does to manage his symptoms. Eventually last year he reached the max dose our doctor was comfortable with and he referred us to behavioral health to get further help. They were comfortable going above that dose and so we did that however now it stopped working and they didn’t wAnt to increase it so we switched to concerta well it didn’t work so we upped the dose it was better but still needed help so the doctor was gone but I had to increase it to the 54 mg and it was working the evening dose to get him through activity’s didn’t do anything it was 10 mg short acting. Went back and she gave me a bit of info about cotempla XR ODT and had us switch to 20 mg immediate release methylphenidate in the AM then took him down to 36mg Concerta XR at noon. It doesn’t work and he still is a mess in the evening. She is going to call to get an update today and change things if needed.

      There isn’t much on the Contempla and what I found reviews aren’t promising.

      My sister did well on daytrana and idk if I should have her try that.

      Also we are trying to stay away from the amphetamine meds his try with Adderall was awful it made him feel bad and I did not like the way he acted on it he was angry irritable and not my sweet boy.

      Any advice?

    • #104360
      Penny Williams
      Keymaster

      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.

      Sounds like you’ve already determined that your son does better on methylphenidates. Interestingly, Focalin is primarily a methylphenidate but has a little dex. My son also can’t take amphetamines. He did well on pure dex though (was too short acting) and Focalin was the worst thing we tried of all of them. You just really never know.

      I found that the higher the dose of the long-acting meds got, the worse the evening crash. I think it has a lot to do with how vast the divide is between a lot of medicine and no medicine. We decided the higher dose wasn’t worth the extremes.

      here’s a great primer on ADHD meds:

      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

    • #104363
      stech04
      Participant

      Hello, yes he seems to metabolize meds very quickly so what should be 9-12 hours of coverage will only last him 4 maybe 5 hours on extended release. I don’t notice much of a change on the lower dose concerta but I’m wondering if we should try daytrana as it is not delivered via the gastric system but the blood stream and maybe he will do better. Also it’s a consistent dose.

      I talked to the doctor at lunch and she wanted to add another immediate release dose in the evening which puts him at 3 times a day for medication. The problem is when he is at school the nurse will give it but when he goes away with Boy Scouts or to his great Grandmas every weekend it is hard for them to remember all those doses and then he acts out and I hear about it.

      He is not able to remember to take them without help even with the app that reminds him he won’t go take his meds someone had to physically give them to him.

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