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Post by teacherabc on Oct 1, 2012 18:06:57 GMT -5
There are a few issues here. The insurance company rejected the preauthorization for Vyanase and said the doctor had to try Ritalin first.
The doctor prescribed Ritalin (at least the generic form of it). The starting dose is 10 mg. The recommended starting dose for adults as I am reading about s is 20 to 30 mg a day. HP is already impatient so I am concerned that starting out with lower than the recommended dose is going to increase his frustration level because it probably won't do anything.
Then, I am concerned about some of the side effects I am reading about. What I read:
Ritalin should not be prescribed for anyone experiencing anxiety, tension, or agitation, since the drug may aggravate these symptoms. Individuals sensitive or allergic to Ritalin should not take it.
HP definitely experiences this (I saw it last night)
Then they talk about it possibly causing sleeplessness. He already has that. Finally, they recommend against it for people with high blood pressure. His pressure has been a little high (130/80 or 90).
I definitely will call the doctor. But should I start having him take the meds before I do.
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Post by beth on Oct 1, 2012 18:30:40 GMT -5
When my youngest was prescribed Adderall, the doctor started him on 10 mg. It did nothing. We were having mega problems with him so after three days I upped it to 20 mg which is what he is on now. His doctor told us to try 10 mg for a week and then up it to 20 mg. As I said, we didn't last the week.
Sleeplessness can be a side effect of stimulants. One of my son's experienced it; the other did not. It did not last long--only a week.
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Post by teacherabc on Oct 1, 2012 18:32:37 GMT -5
HP is 6 feet tall and weighs 300 lbs...so I am wondering about 10 mg of anything doing anything.
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Post by healthy11 on Oct 1, 2012 20:15:28 GMT -5
I concur with what's been said thusfar. Virtually any stimulant has a list of potential warnings/side effects that could scare you, and/or bother a person. It's not just Ritalin. On the other hand, 10mg. is probably not going to have any measurable effect, positive or negative. (Did the doctor tell you how long he should stay at 10 mg? If he just takes it for a day or two, then moves up to 15 or 20mg, the approach might be fine. Of course, HP doesn't exactly have a good track record of taking medications consistently as prescribed, so I'm not sure how the doctor intends to measure the efficacy.)
Did HP tell the Dr. that he's "borrowed" Adderall from Squirrley in the past? Does he remember what dosage he took before feeling any effect?
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Post by beth on Oct 2, 2012 7:47:34 GMT -5
My son weighs 120 and 10 mg didn't do anything so I think you have a point. But I don't think it is just weight.
Interestingly enough the same doctor had my older son just start on 20 mg of Adderall while he wanted the younger one to start at 10mg.
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Post by Mayleng on Oct 2, 2012 11:32:05 GMT -5
It is always better to start low and work your way up. If he has 10mg doses and after say 3 or 4 days does not feel any benefit, he can always call the doctor and ask to up the dose, he can still us his 10mg pills and take 2 of them which will equal 20mgs. That would save time and money. If 20mg does nothing after a few days, then up to 3 pills of 10 mgs = 30 mgs. But he or you need to work out this schedule with his doctor and come up with a plan.
As for side effects, all stimulants have pretty much the same "common" side effects.
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Post by teacherabc on Oct 17, 2012 16:22:34 GMT -5
After a couple of weeks, HP's Ritalin was increased to 3 pills: 30 mg. He took them today for the first time...it seems he is having some effects. I knew something was up when he texted me while I was in the middle of class; something about wanting to talk about learning to take notes...okay...timing was a bit strange. But after I got out of class and texted him, I got a couple of long rambling texts and a few others, totally not responsive to most of what I said. He usually only sends long texts when he's angry and he definitely wasn't. One said "I think something is wrong but idk if it's good or bad...i feel somewhat giddy but I dont think i'm hyper...i want to take down all the notes but i can keep up (sic)i thinking about alot of school shit and i feel like pacing od...i feel so awake and i hate that i need so much help i wanna be a better student bit at the same time i want to play video games and increase my story stuff class is over and blah blah blah my hands keep shaking when im writi.g and typing but then when i pay attention to the hands tosee if they keep shaking i dont they are...imightby halucinating i think something is wrong but i think i feel great idk..." Such a long rambling text is not like him...Neither is the immense number of typos. I also don't know if he really means he is hallucinating. Now I can't reach him.
Should I be worried?
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Post by healthy11 on Oct 17, 2012 16:36:37 GMT -5
Anytime someone changes dosages of a medication, you have to be vigilant. I do not personally know anyone else who has described taking Ritalin and getting "giddy," and the fact he's saying "I think something is wrong but idk if it's good or bad" makes me feel that it does warrant a call to the doctor. It almost sounds like some kind of mania episode, and you've mentioned that various doctors in the past have considered the possibility of him being bipolar. www.come-over.to/FAS/bipolar.htm(You have also mentioned that HP takes other medications, like for high blood pressure, if I recall correctly. Did the doctor who prescribed the ritalin know about all other drugs HP uses? It would also be important to mention if he drinks alcohol or takes over-the-counter products, because even some medications like Benadryl may interact.) |
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Post by teacherabc on Oct 17, 2012 16:51:35 GMT -5
His doctor works Monday to Wednesday, which means I will not be able to get him until Monday. Should HP continue taking them until then?
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Post by healthy11 on Oct 17, 2012 16:58:32 GMT -5
I am not a doctor, but if it was my son, I would have him "back down" from 30mg. (I can't believe that there is no doctor on call to ask questions of, from Thursday-Sunday. Are there any nurses who answer calls when your specific doctor isn't in the office? Often, they can be a source of helpful information. )
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Post by teacherabc on Mar 17, 2013 9:09:38 GMT -5
I wasn't sure whether to post this here or start a new thread.
HP had finally gotten the insurance approval for Ritalin LA, but the generic form. I've been reading about generics being inferior to the real thing and was wondering if anyone had experience with the generic Ritalin LA.
Also, much to my annoyance, the pharmacy, after not having the meds for close to a week, said the insurance company rejected it because it was for 40 mg and they claimed the generic didn't exist in a 40 mg form and the highest was 20 mg.
This morning, I found on the internet that it does, indeed exist in 40 in generic form (and 30 and 20, but not 10). So, obviously, the pharmacy didn't know what it is talking about.
I looked at the letter we got from the insurance company, which said that HP was approved for 30 mg, not 40...so we would have to get a new prescription. But the drug store says it doesn't exist. I will take a walk over to the Duane Reade nearby and see what they say, but I don't want to end up on a wild goose chase. And the drug stores won't tell you over the phone if it is available, because it is a controlled substance and make you come in person (even though the other pharmacy was more than happy to give me the nongeneric 40 mg Ritalin LA even though I wasn't him and he wasn't with me as long as I had the script and if I would have paid them $200). This is all so frustrating. Who has time for this nonsense. Then, HP is asking me for help talking to the doctor, but when I try to help him with medicine issues, the doctor says he wants hP to call him, not me. To me, this seems rather complicated for HP to explain but maybe I am overstepping...
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Post by michellea on Mar 17, 2013 11:48:36 GMT -5
Seems like much of the problem is w the insurance company. Why would they approve him for 30 if the script is for 40. It doesn't sound like 40 is beyond the acceptable level given the drug company makes a 40 mg pill. And if the pharmacy doesn't have 40's but does have 20's why couldn't they give him 2 20's for each daily dose (maybe something to do w it being a controlled substance? - or most probably insurance issues).
Can you have HP call the doc, but stand by in case he needs help? If you are in two locations, how about a conference call?
BTW - my son has used short acting generic ritalin w no problems. He also uses generic concerta with no problems.
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Post by teacherabc on Mar 17, 2013 14:56:15 GMT -5
He does take the short acting one but it wears off and then he forgets. I was thinking of faxing a letter to the doctor and then having him call because that would take the edge off. I am not sure if two 20's would work the same way as one 40. The doctor would know that. I do agree that it is mostly the insurance company, though the doctor must've gotten the letter but didn't notice that the approval wasn't for the 40. And I would imagine that we would run into a problem with the insurance company because they approved 30 so I don't think they would pay for 40, even if it is in the form of two 20's. This is all making my head hurt...
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