ADD Inattentive and Meds

[keepthefaith]

Hi again, if I am on the wrong board, please move me to the right board but I feel home here : )

DD has taken:
Jan. 2012 - 18 mg concerta
Increased to 27 within 2 mos
Up to 72 by September 2013
we tried Vyvance 20 mg in 8/2013 but she was hyper focused; she would not eat and could not sleep.

She is currently back to Concerta 36 because it seems to help with impulsivity.

I've researched natural, e.g. diet, fish oil and Melatonin (she takes 3mg of Melatonin now and again to help her sleep - she is a restless sleeper these days - she used to sleep well but not since Middle School which starts at 7:15 am so she is up at 5:30 am.

Doctors have me all other place with meds; I have been advised to try Intuitive (sp) and Strattera - any experience with this out there?  Will it help ADD inattentive?  We feel comfortable with Concerta given that Ritalin is well studied; whereas the newer ones make me nervous.  That said if medication will help her (e.g. Strattera), then it's time to try it - like all of you we want to help her.  I was once anti-medication (just me and my husband - I fought him hard before we agreed to Concerta) but if you have a chemical imbalance and meds will help, I can't be close-minded (talked for my situation only - I live by the words "to each his own"- I do not judge).   I have a good deal of depression on my side of the family but I managed to miss that gene - my fear is that DD will think a pill will cure her problems so we talk about what the meds are for - to help but not to fix.  She is also starting CBT therapy through my husband's Employee Assistance Program - we cannot afford the $400 an hour that we were paying to the psychiatrist any longer.   For now, the family doctor manages her meds and he mentioned trying Stratterra.  I haven't had time to research it yet so I appreciate any feedback.

Thanks AGAIN!

[Mayleng]

If it were me, I would try all other stimulants first before Strattera. Strattera takes a long time to ramp and tweak, and in the meantime there are all sorts of side effects. Check out our long thread on Strattera. If you find that Concerta is not quite doing it, give Metadate CD or Ritalin LA a try.

[keepthefaith]

Thanks Mayleng, I searched out and read the thread. I don't think we're ready for this switch; perhaps we should try the others mentioned, e.g. Metadate and Ritalin LA - I thought Concerta was a long acting Ritalin.........lots of info to retain, my brain hurts some days.
Thanks again.

[Mayleng]

Ritalin, Ritalin LA, Concerta, Daytrana, Metadate CD are all in the methyphenidate family. Adderall, Adderall XR, Vyvanse are in the Amphetamine family.

[keepthefaith]

Thanks - but they are all stimulants; which is why I believed they are similar. I will research Metadate and perhaps Focalin as a friend of mine has had good results with this.
Thanks!

[Mayleng]

My son has been on Metadate CD for 10 years, he is 18yrs old now. It has been the best one for him. We have tried ritalin, ritalin la, concerta, adderall, adderall xr and strattera.

[keepthefaith]

Thanks Mayleng; I thanked Empeg re Metadate as I am getting confused - so tired the past 4 weeks. I appreciate your feedback!

[Mayleng]

Good Luck.

[kc4braves]

My son ahs tried most all of the stimulants and also tried Straterra. Concerta works best for him so we keep coming back to it. It is not perfect and, you are right, it does not fix....but it helps a lot. You have to remember that, although, Concerta and Metadate CD, for example, are both in the methelphenidate group, they have different release mechanisms. That just means that they release different amount of the medicine at different times. Therefore, you really can see totally different results from two meds in the same group. It is trial and error and requires a lot of observation and patience. We have been going down this road since age 7 and my son will graduate HS this year.

He does not do well with the amphetamine group. We tried Starterra after 8th grade starting in the summer with the titration process. After several weeks, we did see some positive things but we still had to add a low dose stim for focus (he cannot read with his medicine)....after completing the full titration process we were actually pretty happy but he began having headaches and motion sickness and we finally had to stop it. Some people do have good results, though, but it is quite a process.

He takes Intunive with his Concerta and it has worked pretty well. For our kids, intunive alone was not enough but it does seem to help with impulsive behavior. You do have to be careful, as with any meds, that you watch for side effects. My daughter cannot take much intunive. When she goes about 1 mg, she slows down... She is inattentive and takes forever, we can not slow down.... so we had to back her down. It is a process to figure out what works.

Just briefly, my daughter is 14 and ADHD inattentive. She has done very well since 5th grade with the Daytana patch. Puberty has caused some issuses this year but we are sticking with the patch because, so far, nothing else has really worked well. I have added fish oil and a few other supplements trying to help her with the spaciness and fatigue that she experiences with hormonal changes. She also tried a few other things: Concerta ( very little change with it), Vyvanse ( no help at all but no side effects), Focalin ( helped but too short acting). Daytana has been the most amazing thing for her. If only there was a bigger dosage.

Good luck...and know you are not alone...and things can work out well in the end. Which reminds me, does she have a 504 or anything? With my son, his 504 did address the length of homework assignments. For instance, instead of doing 10 problems for each of 5 concepts covered with homework, he did 5 for each concept. So, he was able to finish in 2 hours but still review all the concepts. He also had extra time, if needed, for projects, etc. I think schools differ in what they allow but there should be some help if you can get an IEP or 504.

Kathy

[keepthefaith]

Mar 28, 2014 12:01:19 GMT -5 kc4braves said:

My son ahs tried most all of the stimulants and also tried Straterra. Concerta works best for him so we keep coming back to it. It is not perfect and, you are right, it does not fix....but it helps a lot. You have to remember that, although, Concerta and Metadate CD, for example, are both in the methelphenidate group, they have different release mechanisms. That just means that they release different amount of the medicine at different times. Therefore, you really can see totally different results from two meds in the same group. It is trial and error and requires a lot of observation and patience. We have been going down this road since age 7 and my son will graduate HS this year.

He does not do well with the amphetamine group. We tried Starterra after 8th grade starting in the summer with the titration process. After several weeks, we did see some positive things but we still had to add a low dose stim for focus (he cannot read with his medicine)....after completing the full titration process we were actually pretty happy but he began having headaches and motion sickness and we finally had to stop it. Some people do have good results, though, but it is quite a process.

He takes Intunive with his Concerta and it has worked pretty well. For our kids, intunive alone was not enough but it does seem to help with impulsive behavior. You do have to be careful, as with any meds, that you watch for side effects. My daughter cannot take much intunive. When she goes about 1 mg, she slows down... She is inattentive and takes forever, we can not slow down.... so we had to back her down. It is a process to figure out what works.

Just briefly, my daughter is 14 and ADHD inattentive. She has done very well since 5th grade with the Daytana patch. Puberty has caused some issuses this year but we are sticking with the patch because, so far, nothing else has really worked well. I have added fish oil and a few other supplements trying to help her with the spaciness and fatigue that she experiences with hormonal changes. She also tried a few other things: Concerta ( very little change with it), Vyvanse ( no help at all but no side effects), Focalin ( helped but too short acting). Daytana has been the most amazing thing for her. If only there was a bigger dosage.

Good luck...and know you are not alone...and things can work out well in the end. Which reminds me, does she have a 504 or anything? With my son, his 504 did address the length of homework assignments. For instance, instead of doing 10 problems for each of 5 concepts covered with homework, he did 5 for each concept. So, he was able to finish in 2 hours but still review all the concepts. He also had extra time, if needed, for projects, etc. I think schools differ in what they allow but there should be some help if you can get an IEP or 504.

Kathy

Thanks Kathy, your reply is very timely as we are going to doctor this week to discuss a change up in the meds; everything you describe re ADHD I and spaciness/fog is DD as well which is why I sometimes attribute her extreme sensitivity and forgetfulness to the hormones. Then I saw this research on the news about how children dx'd with ADHD - a long study on how those "who were treated as children by using both meds and therapy" fare better than those who took no treatment at all, i.e. meds or therapy or supplements.  It's definitely a balancing act.  I'm copying your reply to take to the doctor. It is very individualistic and that is one the points I make the school when they raise medication (which they do and they're not supposed too!) ............I state "that it may take use a few years to find the *right* balance for DD"...........in the meantime, stop telling us that her "medical condition" doesn't warrant her ineligble for services (IEP).

For the last 8 months she has had a 504 plan with minimal accommodations.  If they followed the accommodations, it may have worked for DD but they do not take the 504's seriously.  DD has "checks for understanding" on her plan.  I asked the 504 coordinator "do you ask her to repeat the instructions back to you so that you know she does understand".  Coordinator replies:  "there's no need to because I asked DD 'do you understand' and your DD said 'yes'.........."

Well of course she will say yes!  She doesn't want anyone to think she is "atypical".  We had to literally have 2 separate meetings to have them add 'break down instructions/directions and/or have student repeat back instructions" to her plan.  School Admin Child Study team insisted that the "checks for understanding" vs. "repeat/restate instructions" were the same!

Our 3rd meeting with the CSE (we were turned down the first 2x) is in 10 days.  This time, we have paid for private testing and the Director told my husband the "report is conclusive"..........so we are hopeful.  She has ADHD I, plus a "math disabillity (with the DSM5 code)" and "fine motor disability" on a very comprehensive report.  We have  hope that they will find her eligible.  IEP  preliminary draft my head (with help from her Orton tutor) is ICT classes for the 4 core subjects and resource room for Executive Function help.

I have to now think about the most important things for the IEP (positive thinking!). Then the goals, and lastly that they'll follow the plan (monitor/reports to parents). If they do just a little bit for DD during the school hours, hopefully we'll be able to cut back on the private tutoring (Orton) which is over $600 a month and reduce that to 8 hours a month vs. 12 hours a month, etc.

Thanks so much!  I'm very happy to read success stories!  I know that this is a "blip" in the big scheme of life but it has robbed me of valuable time with her doing simple things such as enjoying life and time with her. My goal is to get past this meeting and start to relax and enjoy the precious days we have because life is too short.  This is particularly poignant for us right now given my friend's dire diagnosis of terminal brain cancer.

Hugs!

[keepthefaith]

PS: I have also read about fish oil and another supplement and will add those as well.
Tks.