Ritalin - "Meh" Results?

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Hey, everybody. I post here a lot because I'm OTS. I also have one Aspie child, one classic/Kanner autistic (moderate) child and my youngest has had some autistic-like behaviors but an autism DX has been ruled out many times - however, he was recently DXd with ADHD.

I don't like to jump to medication and we gave this a good long non-drug trial, actually several years in special ed with part-time mainstreaming, with OT, of course. We didn't officially have the ADHD DX until this summer but we had suspected it.

So we agreed to try our son on Ritalin. He started at 5mg and the psych told us to increase up to 20 max if necessary, and if nothing happened then, we would try a different medication.

Well, he's up to the 20mg and...we "sort of" have success. And sort of not. The way the doctor described it, it seemed as if results, if any were to happen, would be more or less immediate and they would be quite notable. The teacher has noted *some* focus improvement - on his chart he was at about 69% as far as positive behaviors and this week, since starting the max dose, he's been up to 79%. But that's till only 79%. Remember this is for focus and behaviors, not for academics.

What do you all think? I'm supposed to call the doctor to let him know if any of these dosages worked and if not, we're supposed to try something else. Is this the kind of "improvement" we're supposed to see? FTR, he only takes the medication for school. We don't really have so much of an issue at home. He does need a ton of redirection and reminding but he's not bouncing off the walls and a danger to himself or anything. He's in fourth grade now and this time is critical for academics as it's all getting much harder in prep for middle school, and without the focus, he's beginning to fall behind even though he's very bright.

I think adderall is another one you should ask your doctor about.

Thanks, Alex! I am going to call my son's doctor.

Unfortunately, even though psychiatry is a specialization, the medical tools are really pretty poor: basically it works by figuring out what generally works in a given situation, and then it's mostly trial-and-error. So, trying other medications in the same class (like Adderol) is a good direction to go; bringing ideas to your doctor is completely OK and if the doctor isn't respectful when you do so, or doesn't give you the pros and cons of your suggestion, that's a good indicator it's time to find a new doctor.

I love the website http://www.crazymeds.us/ - it's got a lot of information about what is out there and what people's experience is when they've taken it.

Thanks so much, momsparky.

Alex, how funny, I didn't suggest a specific alternative medication, just asked for the change as the doc had said might happen and he was the one who suggested Adderall. Let's see what happens. I truly hope we can work together to find a way that my little boy can focus long enough to learn. He is SO bright. But he can't focus...that's really hurting him right now.

ADHD is often misdiagnosed. It was in me.

Also some psychiatrists are questioning the use of stimulants at all. It is a stop gap for many becuase it is known to wear off, and the number of viable stimulant you can try is small.

It doesn't help with coping strategies, or adaptability, you just have to hope it doesn't wear off, and you don't know the long term effects.

Just think it it starts to wear off in the middle of university. That person is then stranded with no coping skills.

I was misdiagnosed with inattentive type ADHD. I have executive dysfunction. Stimulant make me drowsy, dexedrine actually put me to sleep, which is ironic as it is used to treat narcolepsy.

I'm not worried about the medicine being used for my son in place of coping skills, he has been in OT and special ed since first grade and has had OT and SDC since his second year of life and continuously receives therapies in-class as well as instruction for me at home. We aren't actually using medicine rather than giving my son coping skills, it's in addition to what we already have in place and is meant to enable him to focus enough to move forward academically, not to take the place of knowledge of how to act in the world.

I realize ADHD can be misdiagnosed, as nearly any condition can be, but two separate doctors who are not at all connected have so far diagnosed him with it, as well as our having been advised that ADHD was suspected in his prior assessments via the school.

We definitely aren't just giving our child drugs to get him to step into line without having thoroughly explored all possibilities.

I do wish you success.

Tried them all with my two boys over the years. Ritalin was great for the older one but the younger one didn't get results from it. Adderall he couldn't take because he felt the speed buzz and it freaked him out. Strattera made him much more negative than ever. Vyvanse was the best. It was great! He was able to concentrate and focus and wasn't all over the place. He could also eat and sleep. It worked 15 hours solid and didn't have a harsh comedown. It took about am hour or two to kick in but I'd give it to him early AMD let him go back to sleep. I'd dose him at 5am when I got my husband up and by 630 when I got him up it was working. He took it for years without having to up the dose. I'd really look into it. I swear by that.

I can only speak of my own experience, your mileage may vary- but stimulants such as norpramin and concerta [timed release methylphenidate] made me cross and hot, but Strattera made me calm and focused for the first time in my life. I recommend people with ADHD [inattentive subtype] and aspie issues at least ask their pdocs for more info about Strattera.

Thanks, everyone. This info is so helpful.

I started my son on one 5mg of Adderall this morning to watch for side effects. He was totally fine. We are supposed to do the same with this as the Ritalin, increase if necessary up to 20mg and see if it will work for him. He will be taking it for school tomorrow.

But I am definitely going to research the suggestions here too.

I am new here but found this interesting. Our 15 year old son is on methylphenidate (has been for a while). Intuniv as well. This probably will come as a shock to those who are familiar with methylphenidate but our son's dose is 30mg 7am 20mg 11am and then a last dose of 10mg w/3mg Intuniv and 5mg Lexapro.

The ritalin has been the only medication that seems to work, although short acting. I'm not a big fan of stimulants but the only reason we like the ritalin is it's easy to adjust doses. We have been down the road: Daytrana, Vyvanse, Strattera and most long acting Rx were inadequate. With our son maturing and seems like his cohones are getting bigger based on his choice of words some days - we are considering revisiting not just OT, but a switch in meds to perhaps help with his aggressive and unpredictable nature.

I think I read in this thread about Psychiatrists and trial and error. Our son's Pediatricians will/would not write a prescription for 60mg a day but they state that the Psychiatrists are the chemists, and are allowed to adjust/test/guinea pig as need be.

All the best
Terry

Thank you! We started the Adderall 5mg yesterday, 10mg today and today was a very good day at school...will repeat the 10mg tomorrow...I'd like to go as low as we possibly can while still seeing results.

How long are you giving to trial a given dosage before trying an increase? Doctors who go "low and slow" usually give each dose a 2-4 week trial before increasing to the next dose.

Ritalin and Adderall are in different classes of stimulants, so if one doesn't work it makes sense to try the other. Most of the other stimulants use the same medication as one or the other, just differ in delivery. There's one that's related to the SSRI's, that takes several weeks to become effective -- I think that's Straterra. The parents forum on addforums.com is a good place to ask med questions.

Has your son been screened for learning disabilities? There's something like a 40% co-occurrence between dyslexia and ADHD, so even Russell Barkley says any child diagnosed with one should be screened for the other.

in my own experience, Strattera came on like a lamb so to speak, but within a week I noticed newfound clarity of mind and calmness. IMHO it is the best of the frontal lobe stimulants as it lacks the "burn" of the amphetamine-type drugs.

Thank you...he routinely gets screened soup-to-nuts as he is in the Autism Spectrum and Related Disorders (ASRD) program in our district.

We're giving each increase three to five days.

Adderall isn't working out. My son is grunting compulsively and was staring into space at school all throughout the day. May give Ritalin a second try.

I have used Equasym XL 40mg for a few years now. It works fine for me but there is a bit of an odd feeling with it about an hour after taking it but after that it's fine.

I'm not too sure what the US equivalent to Equasym is. Maybe it has already been mentioned here.

I wish you and your son all the best Nowherewoman. I know it's not easy.

It might be different for me because I am an adult with ADHD but all I know is that since my medication my life has completely changed and I am a better functioning person for it. It calms my thoughts down and it has made me a much more confident person as well because I can take verbal instructions a lot better. Also my concentration is far better as well.

Ritalin is a good choice as well. I used to have that with the Equasym. The idea was to just give me a boost during the day. It did work and it really heightened my concentration and I felt really intelligent with it because I could focus on what people were saying to me and give back clear responses.

All the best anyway.