How is dosage determined?

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    • #135769

      Hi everyone,

      I understand that dosing for stimulant medication is not determined by body weight. I am curious how it is determined for younger children. My son is 6 years old and is currently taking 5 mg of focalin (generic) ER and then at 1 he takes 5 mg of focalin IR. I think he needs to be on a higher dose – perhaps 50% higher or maybe even double the dose for each pill. How can you tell if the dose is correct? There is definitely a difference in his hyperactivity when he is off and on medication but it doesn’t seem like there is enough of a difference.

    • #135770

      Usually providers will start at a low dose initially to minimize side effects and monitor for response. Depending on the provider, dose increases vary in terms of how quickly they do them and in what increments. If you’re thinking that your son might benefit from a higher dose, speak with the provider about those concerns. It may be helpful to go in prepared with notes. Has the current dose been effective in any way? What have you noticed that changed with the medication? What issues are you still noticing that seem to be a challenge? Do the symptoms seem different after the medication is given? When does the medication appear to wear off?

      There’s no hard and fast science as to how to do the dosing. Working closely with your prescribing provider is the most important thing. They will be careful not to be too aggressive usually because they don’t want to cause severe side effects. I’d suggest listening to some of the webinar podcasts by Dr. William Dodson for more detail. He offers great information and education on medication management.

    • #135815
      Penny Williams

      The best practices standard of care is to always start a stimulant medication at the lowest dose and increase only if and when needed, to determine the optimal dose for that individual. The doctor needs your feedback and maybe the school’s to determine if/when changes in dose (or medication) are needed. I always advise parents to keep a daily journal when starting and adjusting medication. Note all of the following with the time for each: medication taken, supplements taken, if any, what he ate and when, sleep, and positive and negative behavior with the environment, antecedent and what happens after. This will help you and your son’s clinician immensely.

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

      Free Webinar Replay: Medication Management: How to Use and Adjust Stimulants Safely

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

    • #135850
      Aaron Lewis

      It could be time to switch medications. You need to talk to your child’s clinician and see if changes medications may work. I’m thinking of possibly switching back to Ritalin, which I haven’t taken in more than 20 years.

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