How long before I give up on a stimulant?

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My son has been taking Metadate for three years. Currently, it is not working, so we upped the dosage to the upper limit (60 mg). So far, it doesn't seem to be working at all.

I can't remember -- how many days do I give the meds a chance to work before I decide for or against it?

Please do not post any anti-med posts --

*trying to resist urge* Okay, ...

3 years is a long time to be on a med, IMO. Have you tried seeing how things go without it?

Yes, we tried the first two weeks of school off the meds, to see if he could do well without them (after having been off of meds the entire summer).

The results were catastrophic.

He went from being an A student to a C student, forgetting to write down assignments, ALL of his teachers report his not being able to pay attention, homework takes FOREVER. Last year, we did not have these problems. He has gained 30+ pounds and five inches of height, so the meds needed to be adjusted for sure -- but I'm wondering if we just have to switch to a different med. If this continues, there's no point in his even going to school, as he is getting ABSOLUTELY NOTHING from class, and we spend the entire evening, every single night, reteaching what he missed by not paying attention in school. And it seems to me that he is trying his hardest to pay attention -- he just can't.

To give you a short answer, I believe the recommended time to wait for a change is two weeks. This is just what I have heard though so dont take it as an official answer. I also checked WebMD, but was unable to find any information here. I would ask how long did you start seeing results after you started the medication for the first time. That might give you an indication of how long it would take to see results.

To give a more thorough response:

All stimulants (coffee, Ritalin, etc.) affect brain chemistry and as such, the body builds resistance over time. As the human body adapts to the stimulant, it takes a higher and higher dosage in order to achieve the same results. That's why drug addicts keep having to take a higher and higher dose in order to get the same high. So, usually when ADHD meds are recommended, they start out at a low dose and gradually increase in quantity as the person develops a resistance to the drug.

That being said, there is a limit to how high you can make the dose. Many people overlook the fact that ADHD meds are illegal drugs in small amounts. For example, Ritalin is just a small dose of cocaine. And just as cocaine can be dangerous, Ritalin can be dangerous in high amounts. Thus the limit. If your son's resistance has built to the point where he can no longer get the effect of the drugs without taking unsafe doses, then you get to your current situation.

Generally people can only get 2-5 years of use out of a medication before reaching the safe limit. It obviously varies from person to person but 5 years is pushing it. The only effective way to extend this period is to try another type of stimulant with a slightly different chemical make up. Thats why there are so many varieties on the market. While your son's system may have built up immunity to his current meds, different meds wont have the same immunity and you may get a few more years.

That being said. Meds are not long term solutions. Even with changing meds up, it only maybe a decade at most before he builds a resistance to all the meds on the market. You may want to start working on other coping strategies now, so that when all meds fail he isnt left high and dry.

Hi my son is on strattera and it takes time building up in his system. From memory I was told to give it 4 to 6 weeks before we could see any results.

Are hormones at play with your son as well? ADHD drug (if thats what your sons are, this is what my sons are) only give bout a 10% edge. It maybe time to try something else.

Tracker, you bring up a lot of good and valid points, all of which I agree with. The only problem is -- we tried to actually pull him off of the meds at the beginning of school. Coping mechanisms? Trust me, if I thought they would work at all, I would try it. I've tried using fish oil and zinc as a replacement for the meds -- isn't working. I've tried feeding him a big protein breakfast to help him through the day -- isn't working. It's not like I'm married to the idea of meds. My son has been improving in his social skills without the meds, and so I thought I would try not doing the meds at the beginning of the year to see if he could handle school without them. The change is dramatic, and HE is unhappy. He wants to do well in school. When you are not athletic, not particularly good at conversation, the only thing you have left is the fact that you're good at school. Take that away, and the poor kid feels like he has NOTHING.

But it is VERY true -- there is a limited time of effectiveness with these meds. I think that the hope is with ANY parent, (and possibly any student who takes these drugs) , that the drugs will buy some time until the student is MATURE enough to develop coping skills. And if your student is typically two or three years behind his peers in maturity (as many people on the spectrum are as children), that maturity level isn't going to come quickly.

Perhaps I should have been more clear.

When I said coping skills, I didnt mean taking other supplements, I meant developing alternative ways of doing things. For example, see these posts:

http://www.wrongplanet.net/postt107847.html

http://www.wrongplanet.net/postt108477.html

http://www.wrongplanet.net/postt107135.html

Basically setting up different organizational systems and being strategic with your spacing out.

To be honest, I dont know what I would be diagnosed with today if I was in the public school system. Two decades ago when I entered school the prevailing knowledge was that if you weren't severely ret*d there was nothing else going on. Diagnosis of ADHD, ADD, AS, HFA, etc. are all after my time. But I suspect that due to the amount of time I spent spaced out in school, forgetting assignments, disorganized, etc. I probably would have gotten a diagnosis of ADD or something like that. So, I don't know if I am in the same position as your son, but I can tell you that having a better, clearly laid out organizational system did help me keep things strait.

Yeah, Tracker, I knew you weren't talking about supplements as a substitute for the ADHD meds. In fact, I've been contemplating getting one of those squeeze balls, to see if that kind of behavioral adjustment might actually help him pay attention. We'll try it with homework first, at home, and if it seems to help, send it with him to school.

I'm also thinking about getting my son a netbook that he could take to school -- don't know if it's allowed, or a cool thing to do, in middle school, but it's a possibility to help that's something other than meds.

We are also thinking, somewhat, of homeschooling if things don't work out. I only hesitate because, surprisingly, my son feels like he's doing better socially this year -- I hate to yank him out of a situation where he feels comfortable and actually has friends. That would seem to be counterproductive. My question for you, Tracker, is this:

You're an engineer, correct? If you had organizational problems and trouble with handing in assignments on time or concentrating on things that weren't of interest to you (I'm just making these assumptions -- maybe you didn't have any problems with this), how did all of that work when you went to engineering school? I could see where homeschooling might be beneficial -- he could spend more time studying important things, less time doing all the useless stuff that is done at school, and have less stress. But then if you make the leap to college, suddenly you're back into time constraints, having to read hundreds of pages about history (for a GE class, in a subject you don't care about) and having to hand things in on time. How does one do that?

I have a squeeze ball, and it has worked wonders! I highly recommend it!


I would advise against that for one reason only - distraction. You're also taking a big risk with a notebook computer - what if it gets lost or stolen, or someone spills water on it? IMO, you'd be better off with a limited technology assistant, such as an AlphaSmart or an eMate (no longer made)...they allow for word processing and other productivity, without the distractions that full-blown computers provide. I highly recommend one...if your son's school doesn't have them (they probably do), they are pretty inexpensive on eBay.

schleppenheimer and gramirez, would you please elaborate on the squeeze ball concept? What is it, and how do you use it to help pay attention? Thanks.

I don't know if someone mentioned but chewing gum helps me. And I drink a lot of coffee. I know it is bad for the kids but can't be worse than these drugs.

Care to explain? I've been drinking coffee religiously since I was 8 years old, and haven't had any negative side effects.

I highly recommend coffee - but the majority of adults think it's a royal sin to let kids drink coffee...apparently drugging them is more humane. (I'm not trying to beat up the OP by any means - it's just that many people wouldn't even consider it)

Last edited by gramirez on 16 Oct 2009, 3:45 pm, edited 1 time in total.

Well for me, it has greatly reduced my stress level. I am normally a nervous wreck and get anxious very easily...squeezing a ball helps to relieve my anxiety and stress so I can focus much easier.

yeah, ishould rephrase that to "i know they say it is bad..." probably because the same "wake up" effect would be too much for most NT people. and i completely agree with a drugging remark. 100% on spot.

I've bought a few for my son but he can't resist doing more than squeezing it, and then the ball is on the floor or ...

schleppenheimer I’m not anti meds, however stimulants are known to wear off. When they wear of depends on the person. There is still no evidence of long term benefit to using stimulants for attention. This has been the finding of public investigations into their use for attention problems.

The problem is not the drugs at all it is the way they are being prescribed. On the never, never. Kind of similar to the pre-credit crunch mentality.

It might not be what you want to hear but that is the reality. You might have a kid who takes stimulants through high school and each time one stops working they try another. Get to adulthood nothing works, his attention problems are severe enough that he won’t be able to support himself.

It isn’t “wrong” that he took them in high school, but he might have taken them at different times and spread them out, maybe at least got some saving in the bank before he blows out. It is a harsh example but something to think about.

Knowing that they don’t last forever at least them you can make an informed choice, without having a false sense of security. It is not that they are useless, just that their usefulness is time limited. You can’t blame someone who is struggling to want to take them.