My Forum Comments
NO NO NO NO NO.
Do not EVER play around with your dose unsupervised. Book an appointment with your doctor, explain that the dosage is not working, and ask if you can increase the dose. Only ever increase your dose in accordance with permission or instruction from your care specialist.
What you should ACTUALLY be doing is having regular appointments with your doctor and gradually increasing the dosage after discussing your progress with the doctor until you find the dose at which you find the best effect, with no side effects. As soon as you feel negative side-effects, you should stop increasing the dose.
Do not, under any circumstances, change your dosage on your own. This can lead to addiction, dependency, the medication not working as intended, or issues with your health. Your specialist MUST be appraised of your situation at all times.
Just to note, though- just because you’re not getting the ‘kick’ from your medications anymore doesn’t mean that they’re not working as well. It just means that your body no longer gets the ‘rush’ from taking them. This is normal. You measure their effectiveness by your ability to concentrate, not by the rush of dopamine. If you can still concentrate on work or school, just as well, then you’re fine.
Advice for your son- if he goes ‘numbed out’ or ‘zombified’, that means that either the medication is wrong, or the dosage is wrong. There are about 50 different ADHD medications, which don’t all work in the exact same way, meaning that there’s a ‘right’ medication for most people.
I got medicated in January (27 years old), and I’m not numb in any way, shape, or form. I’m more ‘me’ than I’ve ever been. Just ask my fiancée. Instead of stressing out over trying to figure out whether to take out the food garbage or the main garbage first, and in the process forgetting to do dishes (then stressing about THAT later), I’m getting everything done in half the time it normally takes me, and I’ve more time to do the things I want, and I’m in a better mood while I do them. I still do random dances to make people laugh, I still will happily drip everything to hang out with someone, but when I want and need to focus on something, I’m completely able to.
The RIGHT meds do wonders for you. It’s just a case of finding them. Worst case scenario is that he tries meds and a) none of them work, or b) he just doesn’t like the feeling of being on them (both are really flip sides of the same coin, if they work properly, you should love the feeling), in which case, you just stop taking them, and carry on as before.
But, if your son DOES start taking meds, he has to take them religiously, according to the instructions from his specialist. No ‘days off’, no fiddling with the dosage, no ‘I have an exam tomorrow, I’ll take two’. None of that. If the dose is insufficient, consult the specialist. Any negative side effects? Talk to the specialist. Anything out of the ordinary, makes you want to stop, take more, or whatever? Specialist. Always consult the specialist.
Anyway, that’s my piece. Hope this helps 🙂
Hey, MyGirlG, can I recommend you edit your original post, right at the top, before the main text, since all these new commenters don’t realise that the issue is much closer to resolved than they realise?
why should we be forced to conform to the neurotypical system that doesn’t understand and is unwilling to accommodate us.
Especially when the neurotypical system bears literally no resemblance to any workplace that has ever existed in the world, ever.
You would never, in your workplace, have to work out every single thing using equations that you’ve memorised- you’ll always have a list of equations to reference.
It’s like exams in Literary Analysis that require you to analyse a text you’ve studied without having a copy of the text in front of you. In what world would you be required to do that? When do literary analysts ever work based on their memory? They have an entire SYSTEM for ensuring that published authors NEVER JUST GO ON MEMORY. They’ve even got multiple different methods by which people can record the source of their information! Writing essays based on memorised plots and memorised quotes is PURE bullshit.
They can half make the case for maths-based subjects, only because ‘answering the questions proves you know the formulae’, but is it important to know the formulae by heart if you know how to use them? That’s like saying that before someone is qualified to use a screwdriver, they need to know how to make one. Exams drive me up the wall.
Well done for reaching out!
One of the first things I can tell you is that people with undiagnosed and unmedicated ADHD are actually MORE likely to tend towards self-medication and substance abuse, not less. You can tell your parents that. It’s proven. ADHD treatment helps you control the impulses that would normally propel you towards illicit substances. The same holds true for ADHD Stimulant Medication- they make you less likely to abuse substances, not more.. They’re not gateway drugs, they’re medicines that help you function as you should. Yes, some people abuse their meds, but these people are the exception, not the rule. If you’re straight up and honest with your therapist (including explaining when you don’t think your current dose is working), take your meds as prescribed, and don’t experiment with other substances, there are no risks associated with ADHD medications, vis-a-vis substance abuse. Your parents need to understand that. They wouldn’t stop you having an asthma inhaler, antihistamines, antibiotics, or painkillers. ADHD Medications help you function every bit as much as each of these medications.
That being said, as you have a history of substance abuse, it’s understandable that your therapist may not want you on stimulant medications. This may be due to the fear that you’d take too many and/or abuse them. It could also be due to a fear that they’d have an adverse affect on your body or brain chemistry, based on whatever you’ve taken before. The first thing to find out is what it is that your specialist is worried about. If it’s the former, request to go on extended release medication, which doesn’t give a ‘rush’, making them MUCH harder to abuse. You could even volunteer to accept a ‘reduced prescription’, if there is such a thing- whereby you only get, say, a week’s worth of pills at a time, to prove you don’t intend to abuse them. It’ll be a pain in the arse for getting them filled, but if it gets you treatment, the hassle is worth it. If it’s the second, say that you’re happy to submit to whatever diagnostic tests they’d require to be satisfied that there’s no risk to your body (EEG, EKG, Blood Work, and CT scans are usually a good start), and regular check-ups to monitor your health.
ADHD stimulant medications are, statistically speaking, the most effective medications available. However, there are more non-stimulant options available than just Wellbutrin and Strattera. If your specialist will hold ABSOLUTELY firm on no stimulants, then you need to try the other non-stimulant options. They are very effective for a large number of people, but you need to try all the options, same as you would have to with the stimulants. In the case of stimulants, most people who don’t do well on Ritalin do well on Adderall, and vice-versa. Same for non-stimulants. Try all of them, and try them at different doses, AS GUIDED BY YOUR SPECIALIST AND PHYSICIAN. Make no decisions regarding your medications without consulting them first, whether that’s increasing dosage, reducing dosage, changing the timing of your doses by more than an hour, or changing the medications altogether.
I also recommend dropping the cannabis. Completely. It’s hard to make a case to medical professionals that you’re responsible enough to take controlled substances under supervision while simultaneously imbibing illicit substances. If it’s legal wherever you are, then fair enough, but it still doesn’t paint the best picture. It’s also, actually, the precise opposite of what you want to do to treat your ADHD. Like alcohol, cannabis is a depressant, not a stimulant. It has directly the opposite effect to ADHD medications, even though some people find it efficacious for their ADHD.
Hope this helps! 🙂
Not a parent, but I’d assume you’re under no moral or legal obligation to give them any consideration at all. Your child misbehaves, the teachers are handling the behaviour as best they can, and you are informed and abreast of all the developments, and working with your son to try to minimise these behaviours.
You CAN meet with the other parents and offer an apology and so on, but you could just be opening yourself up for getting an earful over something neither you nor your son can really control. Or, the other parents could be really understanding and considerate. It’s a mixed bag.
Ok, so, I don’t know what would be the best dose for your son, that should be a conversation you have with his specialist, and you should not, EVER decide that on your own, even if your doctor says it’s ok.
Pills cannot be extended release. Capsules are extended release. Here in Norway, I was started on instant release capsules for lower doses, then once we increased my dose past a certain threshold, I’ve switched over to extended release capsules. We’re gradually heading towards the ideal dose for my height and body weight, which is about 60-70mg. Instead of taking one pill every 4 hours, I’m taking one pill per day. The medication keeps working throughout the day. However, for some people, extended release is simply not suitable. It’s more convenient taking just one pill per day that lasts the entire day, but that doesn’t always gel with the way your body works.
By any chance, did your son’s issues coincide almost perfectly with the day he took the capsules for the first time, or only a couple of days after he took the capsules? Because if so, that’s a sign that the delivery mechanism (extended release) is not suitable for him at the dose he’s on.
You should never accept substituted medications if you’ve been on a specific medication for an extended period of time. While generics and capsule versions use the same active ingredient (methyphenidate), the delivery mechanism is different. It can be metabolised faster or slower in your son’s body, and the effect he gets from his medication will change, as you’ve noted. To put it a different way, my SO is on birth control. One month, the pharmacy gave her a ‘bioequivalent’ medication (same active ingredient, different brand), and she broke out, her mood was all over the place, and so on, and so. That is because, while the active ingredient remained the same, the way her body processed it was fundamentally different. It’s not usually a problem for things like antibiotics or sleep aids, anything that you’re only on for a short time, but if it’s a long term medication, changing brands can have negative effects. Not harmful ones, necessarily, just that the medication might not be as effective, or might show more side effects. This possibility is exacerbated if you switch from an instant release pill to an extended release capsule, and is manifesting in your son’s difficulties managing his symptoms.
I’d recommend either having the prescription refilled now (explain the situation to your doctor), return the capsules, and get the medication your son is used to being on, or continue with the capsules until they run out, and then refill the prescription, MAKING SURE you get the old ones. Don’t increase the dose without consulting your specialist, and DO NOT give your son two of the capsules to increase the dose. XR capsules are dispensed containing the appropriate dosage, you’re not meant to take multiple of them.
Hope this helps.
- This reply was modified 5 months, 2 weeks ago by Spaceboy 99. Reason: Edited for clarity
Hey again, Ranma.
I don’t know if I had anxiety or anything else when I was that young (apart from ADHD, obviously), but I spent a lot of time chewing the inside of my mouth. I still do it from time to time. Never enough to damage, but always enough to hurt a little.
There’s a chance that a fidget toy of some kind could help you with that. I’d maybe tentatively recommend a fidget cube, or a fidget pen. Several of them are designed to be noiseless.
Hope this helps 🙂
First off- well done for reaching out 🙂 It’s great that you want to understand more about your condition and how it affects you.
So, the sleep thing- I’m actually a lot like you in that regard. I never felt that I needed particularly much sleep, until I was 18, in a terribly abusive relationship, and leaned too heavily on my ability to go without sleep. I don’t know about it being common, but the reason I used to think that way was essentially because I got my biggest burst of energy and creativity late at night. I felt like hell when I woke up, but because, by the end of the day, I had energy again, I assumed that I didn’t need particularly much sleep. Nowadays, I get my full eight hours, (I use a sunset/sunrise simulating alarm clock to MAKE me tired when I need to sleep), and I realise that, even though I CAN go on very little sleep, I’m actually much better off when I don’t. Getting 8 hours actually mitigates ADHD symptoms, as well.
Physical exercise, likewise mitigates ADHD symptoms, and the attendant tiredness helps calm down your mind before bed.
The sense of direction thing isn’t one I know of, but if we postulate that sense of direction is tied to attentiveness, then a lack of sense of direction could well be an inattentive symptom. Alternatively, it may just be a quirk unique to you 🙂 Although ADHD affects pretty much every part of our lives, there are some things we just find difficult because we’re not very good at them 🙂 Mine is handiwork and building things. Even when I use a ruler, draw guiding lines, and go as carefully as possible, I can’t saw wood in anything remotely resembling a straight line 😛 So my fiancee gets to handle the DIY 😛
I hope this helps 🙂
It is when the decision has been made and largely solved weeks ago, and when every now and again someone suddenly posts on this again, and then she gets five more comments on a solved post.
Hey again G,
Isn’t there one at the top of the post, around the same area you’d normally hit ‘reply’?
If not, maybe you can ask the moderators to change it? You reach them via the normal ‘customer service’ section. Worst comes to worst, I think you can ask them to delete the post.
No, I know 🙂 But 5mg 3 times a day works out to about 15mg a day. The 20mg once a day pills work out to 20 mg a day, but have a ‘bioavailability’ of about6.6mg for the entire day (almost the same as if she was just taking the 5mg, minus the crashes)
Hope this helps 🙂
Just responding quickly, got stuff I need to do, but that’s amazing, good for you and your daughter 🙂
If she’s on the 10mg pills 3 times a day, then the crashing will be because they’re instant release, not extended. When I switched from instant to extended, everything got a lot easier for me.
Next appointment, mention the crashing to her specialist, and maybe she can try 20mg extended, which would be similar to the effect of 3x5mg, but without the crashing.
Also keep an eye on her meds. As she gets older, the effects may lessen. This isn’t because of dependency, but rather because her endocrine system will develop as she gets older, and the way her body processes the chemicals will change. All this means is that she may need a higher dose. This isn’t dangerous.
Congratulations, and here’s to smooth(er) sailing going forward 🙂
Hey there, MyGirlG.
I know you’ve already had this query resolved, but I just wanted to give you my input as well, for what it’s worth. First off, you’ve DEFINITELY made the right decision here. I didn’t get diagnosed until I was almost 28. I’ve struggled with my symptoms, to a greater or lesser extent, for my entire life, and if I’d known years ago that I had ADHD, I’d have gobbled the pills like M&Ms.
It’s great that your ADHD daughter has a physical outlet, and that both of your kids practise mindfulness- these are vitally useful things for everybody, not just kids with ADHD. For people with ADHD, though, they’re doubly important. What you’ve basically done here is given your daughter everything she needs to succeed with ADHD EXCEPT medication. My specialist explains to me that treating ADHD is 70% medication, 30% coping strategies. I’m lucky, in that I’ve HAD to develop coping strategies in order to survive, but a lot of people don’t ever manage to do that, or they learn maladaptive strategies. Your daughter is in the best possible situation for medication to help her, and I applaud your decision.
But I have to warn you ahead of her taking her pills- not every ADHD medication works for every patient. In fact, most people have negative reactions to the first ones they try. This does not mean that all ADHD medications are bad. there are about 50 different medications, with different active ingredients, different release mechanisms, and a whole range of doses to play with. Getting appropriate medication is, more often than not, a case of trial and error, but the benefits you reap from being medicated are unbelievable. I got lucky, and the first medication I tried (Ritalin) was the right one for me. I’m now on an extended release formula, and we’re slowly increasing the dosage up to the correct one for my height and body weight. I have a friend whose mother tried one medication, which went very badly, tried a second one, which went worse, before trying the first one again, but under different circumstances, and she’s experiencing massive improvements herself.
The most effective I’ve ever been in my life was when I was 19 years old. I’d moved out of my mother’s place, and in with my dad. I was cooking every two days, preparing my own food, walking to school every day, and training Martial Arts 20 hours a week. I also had a job 3 days a week. Every day was completely packed, and rigidly structured, and the days where I had free time I would, 90% of the time, take care of my homework. That move was what got me the grades I needed to go to University.
I’ve been on medication for about a month now, nearly two, and the improvements to my life make the ones from my 19-year-old schedule seem like a kid proud of making a mud pie that vaguely resembles a dinner plate. I’m PRESENT in my own life in a way I’ve never experienced. I’ve felt ‘calm’ for the first time in my life. In my job (I work in research), I’m getting more work done, to a higher standard, in less time than I used to. I’ve actually started taking on tasks from different departments because I don’t have enough to do, whereas before, I was drowning in a sea of statistics and unfinished research tasks. I’m giving my opinions to my bosses, and arguing for them in a way that I previously couldn’t, because I couldn’t think straight for long enough to understand my own ideas. Now, people are listening when I speak, and including my input. I should also mention- this is all in a foreign language, because I live abroad. Previously, in meetings, I would drift off after about 3 minutes of hard concentrating, because I’d taken a minute to understand a word, formulated a point, then was trying to hold onto the point until there was a natural break in the conversation. Then I got lost, and the conversation had moved about 20 paces while I was still standing there.
Medication has improved my home life as well. I’m now cleaning things in the house that I previously wouldn’t even have noticed were there, let alone noticed that they were dirty, and I’m doing it effortlessly, without having to set aside time or energy to do it. Last week I cooked two different meals for two different people, each comprised of multiple elements, with different cooking temperatures and times. Four pans on the stove, two different items in the oven, things that needed to be microwaved, and cold items that needed to be put in their own containers and served at the table. I served these two different meals, at the same time, every component piping hot (apart from the cold ones, obviously). Before meds, if I tried to cook a single meal composed of multiple elements, I’d have burnt one thing, undercooked another, left one standing on the stove, and something on the plate was always stone cold. I’m arguing less with my fiancee, helping out more, and I don’t come home at the end of the day feeling like existence itself is a challenge. I come home with energy left in the tank. I can’t adequately express how much of a change that is for me.
What I’m saying is that you’re doing the right thing for your daughter. Your fears are entirely natural, and warranted, given the history in your family. The most important thing, in terms of safety, is to monitor your daughter closely. Ask her how she feels, ask her for feedback, note any changes that worry you. Ask her specialist what you should be on the lookout for. If her personality changes, or she ‘becomes a zombie’, or anything like that, she’s on the wrong medication, and her specialist needs to know. The most important thing is to always communicate everything to her specialist, honestly. As long as you do that, and keep an eye on everything, these medications are perfectly safe, at least insofar as anything can be considered safe. If you can stick with any negative experiences that may crop up, keep an eye on everything, and don’t be afraid, there are a world of benefits available, like the ones I describe above. I did really well for an undiagnosed ADHD person- I actually completed a degree, I moved abroad, and learned a foreign language, without picking up any substance addictions, criminal records, or other problematic tendencies- but every gain was hard won. Every day has been a struggle. Taking medication was like I’d been wearing a weighted vest every day for my entire life, and suddenly it was removed, and I could move more easily than I ever knew was possible. I had no clue life could be this easy, that it IS this easy for everyone else.
I look forward to hearing how your daughter responds to her medications 🙂 Important note, before I sign off: don’t be afraid of increasing the dosage. As long as your daughter takes her medications responsibly, there’s no danger of her becoming addicted or anything, but the ideal dosage for any person is tied to their height, body weight, and metabolic rate, not the dosages written on the pills. Taking more than the minimum available isn’t abusing medicine unnecessarily, it’s taking the right amount in accordance with your needs and how your body processes it.
Don’t be a stranger 🙂 I hope your daughter reaps the full benefits of medication. They’ll do more for her than either of you could possibly imagine 🙂
You’re right- instant release pills usually are given twice daily, but some people find that they only need the medication for part of the day, or that taking an additional dose later interferes with their sleep, etc. etc.
If you want him to have the same effect throughout the day, he’d need to take an additional pill at the same dosage, or a smaller dose in the afternoon, which wouldn’t give the SAME effect, but it would give more effect than unmedicated afternoons, if you understand me.
To be honest, higher dosages are only harmful if it’s more than he actually NEEDS. He’s not going to turn into a junkie or anything just because he’s on a higher dose, AS LONG AS it is the dose he requires, and not just extra medicine for the sake of it.
The reason pills are normally given multiple times a day is to maintain whats called ‘Bioavailability’. If you take one 10mg pill in the morning, and one in the afternoon, your body always has 10mg available throughout the day, even though the daily dose is 20mg. One 10mg capsule would, by this logic, have 5mg bioavailability throughout the day. The fact that your son responds well to 10mg of bioavailability suggests that it’s a good dose for him, and you can give him that dose AGAIN later in the day. It won’t increase his tolerance to the medication, because you’re giving the second one when the first one runs out. Make sense?