How to handle medication for first timers
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I have two kids that were recently diagnosed and we are working through medication for the first time. We’ve gone through a few medications in both the amphetamine and methylphenidate families. Whenever we try a new one, the first day is usually amazing, but after that every day gets a little worse. Usually a bunch of side effects start to show up in the form of “zombie kid” (listless, talking in monotone, tired), depression, anxiety, and lots of crying to the point that they don’t want to continue taking medication. I don’t think we’ve ever gone a complete week with a med before abandoning it. Kids are age 7 and 9.
What should we do at this point? Do we continue with the medication as it’s just part of adjusting? Do we change the dosage? If so, would it be better to go up or down?
Is this something that others have experienced? Did you do anything to help out?
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What medications and dosage are they currently on?
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The medication journey can be a frustrating one. We’ve tried many – it can be a lot of trial and error. Fortunately, most stimulant ADHD medications don’t have a huge ramp up time. Meaning you should know quickly if it’s working or not for your kids. My son, who is 6, was diagnosed with ADHD combined at age 4 and has had success with 20mg of Vyvanse. It’s not perfect but it does significantly improve his ability to focus and reduces his impulsivity and hyperactivity (he has combined). Unfortunately, it also seems to affect his mood. To combat this, we have tried adding Guanfacine and even an extremely low dose of Escitalopram. Neither was an option to continue. Guanfacine turned him into a zombie and the Escitalopram made him very agitated. I suspect the mood will have to be addressed through other means such as therapy, which I am currently pursuing. If I can offer any particle advice, it would be to find a provider that specializes in ADHD if you haven’t already. Your pediatrician is the obvious place to start but is not always the right provider. Sometimes a psychiatrist, or physician that has solid experience with ADHD treatments is the better option. You might also try your local Children’s Hospital. Ours has excellent therapy services and medication management for children with ADHD.
I hope this is helpful in some way. If anything, just to know you’re not alone. You are in the right place. This website has a wealth of information to help parents and children.
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The best care practice is to start at the lowest dose and only increase if and when needed. It’s also not well known that too low of a dose can actually cause worse behavior and symptoms. Most clinicians will have you try an increase in dose before giving up on a medication — those with good knowledge about ADHD medications anyway.
There are a lot of subtleties to getting the right medication and the right dose. This primer can help you understand the process and the nuances better. Make sure you’re working with a clinician that has lots of experience with ADHD medication — it’s daily part of their practice.
A Patient’s Primer on the Stimulant Medications Used to Treat ADHD
Penny
ADDitude Community Moderator, Parenting ADHD Coach, Podcaster & Author, Mom to teen w/ ADHD, LDs, and autism
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