How do you know when the medicine is working? My son is 6 years old and is ADD. He is currently on 10 mg of Adderall XR with an additional pill of Adderall 5 mg taken after lunch. BUT his teachers still tell me that he gets very distracted. He will sit at his table (tables with 4 to each) and watch everyone else doing their worksheets, but will not do his. His Reading Recovery teacher tells me that he gets so distracted by the pictures that he loses the meaning of the story.

How do you know when to stop and say "I don't think this medicine is working". We have tried Strattera (horrible reaction to that - changed his personality, too), Concerta (quit eating and sleeping on this), and now Adderall. At first, he crashed really bad around supper time, but that seems to have leveled off now. Any suggestions or thoughts??

How far should the meds take him in being able to sit and do his work?

Thanks!:confused:

How long has your son been on his meds? When my son was first diagnosed (age 4) he was put on adderall. and later he was on adderall XR his Dr. at the time told me that the medication can take 4-6 weeks to build up in his system. you should see results with in 1wk but the full effect can take longer.

He has been on 10 mg for about 3 weeks now. I thought stimulants were effective immediately...When he was on Strattera it took almost 4 weeks for it to start working. Thanks

I would guess that one would be at the right dosage when you're satisfied with the results. My son started with 18mg Concerta. It worked great then appeared to stop working after while. We then upped it to 27mg which worked again and is where we are now. He's functioning at this dosage so IMO there is no need to up-it anymore.

From your description it doesn't sound like the current medicine is helping him to focus better. IMHO.

Out of curiosity, how long did you keep him on the Concerta prior to switching? My son appetite is affected with this too ... even tried switching because of it but ended up switching back to Concerta because although his appetite dwindled he still ate. Plus, I do not give him Concerta on the weekend (and summers) in an effort to allow him to catch-up with eating. He didn't sleep well "initially" but after he understood it was all due to the medicine he seem to do okay.

What other alternatives have your doctor discussed?

We tried Concerta for about 10 days before the Dr took him off. He wasn't sleeping or eating on it.

I talked to the dr. today - he is thinking about what changes to make over the weekend and going to call me back on Monday to see how the weekend went. My son is now starting to say things like "I feel like I am in someone else's body when I take the medicine" which really concerns me!

The dr is talking about putting him back on Strattera for the lunchtime pill instead of Adderall which makes me very nervous because we tried Strattera and it made him act like he was "drugged" all of the time. VERY frustrating - I can see changes in him, but teachers act like it is not working at all! Okay, I am venting now!

Thanks for your thoughts!

Straterra has an anti-anxiety component that some kids don't need. Our developmental pediatrician uses it only as a last result..even with my middle one who has an anxiety disorder. It stays in the blood stream and so takes laonger to level out, than stimulants.

It is not unusual for kids to say the meds "make them feel like someone else" when they start to work. It does make them feel different and they don't know how else to describe this. My daughter told me that for three years, before she understood that it did make her feel like someone else...it made her feel like someone with more control of herself and situations. At almost 11 she is now mature enough to know and want that feeling of control that her meds give her. She is on 40 mg of Focalin (was on 108 mg Concerta) and so she is like a whole different person without it.

Stimulants are generally effective immediately. You may have a hard time finding the correct dosage. Everybody proceeses the stimulants a bit differently, though and maybe you have a misdiagnosis which would result in more hyperactivity from the meds.

At six I hope you have addressed and ruled out any sleeping issues, and sensory issues. Both of these, as well as allergies, can look like ADHD. A school-based evaluation may not screen for sensory integration issues, generally because you have to request OT specifically and even at that you have to have an OT who is certified or has vast experience to recognise and diagnose SID. Unfortunately most schools do not have anyone.

We had a lot of the same issues with my son, and finally decided to treat him only for his sleep disorder and continued his sensory therapy on a weekly basis. It's been a struggle but he is doing better now and we don't have as many melt-downs as we had with the meds.

It's hard to know what is right for your child, but make sure you look at all of the options.

i have never understood this, too.

I find that stimulants make me MUCH MORE impulsive (verbally interrupt others), talk to fast (speedy), impulse buying (wish i'd never discovered ebay.ca).

Emma

Jacycee - what do you mean by sensory issues? We did not have any sleeping problems until he started on the drugs. We go back to the dr. next week - I am going to ask about the allergies. Thanks!

My daughter was on Adderall and I took her off of it because she quit eatting, was tired, etc. Looking back, and from the advice of pediatrician, I took her off of it too soon... after little more than a week. Kids need time to adjust to medications before we make decisions, which is so tough for a parent.

my son is 17, has been on Adderall XR, 20 mg for 4 weeks now. I think it is helping. He goes in today for his recheck. I think he needs a little higher dose. He has been in this second semester for two weeks and things are ok for now. I just don't want him slipping cause then it is hard to catch back up. Stimulants help when they need to get help focusing. He would just not pay attention, not turn things in , just not always get it done. Strattera didn't work, then kept him off of any meds. But now that he is a junior, he really needs to be more focused and happy.

I am learning to be patient with the meds - we go to meet with his teachers today - I need them to have some patience, too! He is eating better, now (been on 15 mg Adderall for 3 weeks now) and sleeping better, too. Hopefully everything else will get better!

Sara,

I don't really have an answer for you, but I thought some comments from my son's pediatrician and some of my thoughts might help.

First, the pediatrician said that improvement in even one area is terrific, but we should expect ALL the symptoms to go away. We've been very lucky in that the first med he tried - Adderall XR - was pretty much a miracle med (for both him and me!). He started at the beginning of the school break and as soon as he went back there was a DRAMATIC improvement in all his problem areas. In addition, he's so much happier because he doesn't spend his day frustrated or missing out on fun in order to finish his work. Homework is a BREEZE compared to the last 2 years.

It can take some time to get up to a dose that will show progress, though. Too low or too high, and side effects might hide any progress.

The downside -- he has some trouble sleeping. It was bad at first and now it's okay. He spends some time reading if he can't go to sleep right away and he's generally out within 2 hours of bedtime on the worst nights. Getting up in the morning has always been a problem (also for his nonADD brother), but no moreso since starting Adderall.

The other downside -- DS is a scrawny kid who cannot afford to lose ANY weight. We are VERY concerned about this possibility even though his appetite is not very affected. I'm sure his metabolism is higher.

His doctor's suggestions included giving him weekends off, but I haven't been able to bring myself to do that to him. He's not a behavior problem (AT ALL), but I can't imagine going without my "fog sweepers" for two days and I know he doesn't want to. Also, it's not easy to go back and forth like that.

His doctor's other suggestion is to load him up with high-calorie, slow metabolizing foods. You know, the kind that we adults avoid these days :p.
Right in front of both boys, he suggested DS start having milk shakes at dinner time instead of just milk. He also suggested adding a "bulk-up" to it. So, since his brother can stand the extra calories himself, they now drink their milk with a small scoop of ice cream and a packet of Carnation's Instand Breakfast mixed in. It's not only a supplement, it's an additional 200 calories or so. They love it & I let them pick their flavors each night. It's not a lot of work, either. I just use a hand blender.

To get DS to eat as much as possible, I've been straight-up with him. If he loses ANY weight, we'll have to take him off the meds. He does NOT want that, so he's pretty motivated to eat....

So, we're holding steady with some fantastic results and hoping the few "minor glitches" don't become major problems.

Hang in there and be patient. You'll get it figured out, even if that means you find he is misdiagnosed (doesn't sound like that's the problem, though).

Good luck!!!

Well according to Thomas Brown, Attention Deficit Disorder: The Unfocused Mind in Children and Adults about 20 - 30 percent of folks don't respond to medication. Of those that do respond another 30% or so do so only partially. Your son may need adaptations in his learning environment or accomodations to enhance his strengths and minimize his weaknesses. My meds help me tremendously, but I'm still very ADD just a little less so. I have to set up strategies that help me work around my weak areas. There are charts that you can fill out to comparing his behavior on and off meds to see how much improvement there is. And definately keep in touch with his doctor to see if dosing, another medication or a combination of medications might be warranted.

You might check out Russell Barkley's book Taking Charge of ADHD or Daniel Amen's book Healing ADD. Both have useful strategies to use to improve ADD problems.

Scattered

Well according to Thomas Brown, Attention Deficit Disorder: The Unfocused Mind in Children and Adults about 20 - 30 percent of folks don't respond to medication.
Interesting. Every other source I've read says 10%, and that's only to some form of stimulant. Add in other meds and it's probably closer to 5%.

I haven't seen any of the actual studies these numbers came from, though.

Thanks for all of your comments - we had a meeting with his teachers yesterday. They are trying everything they can think of to get him to do his work. His reading recovery (which he has tested out of) said his medicine isn't consistent. He will be working along really well and then just seem to fall off. He goes off on a tangent and it takes several minutes to get him back to the story. They suggested going beyond our pedriatrician for help - I am going to look into that next. Any suggestions on where or who to go to?

Probably go to a child psychologist that will work with him on how to deal with this.

My psychiatrist is also concern about the weight problem. What's strange is I do eat when I'm on adderall, I eat the same but even if I do I lost weight. I lost 2 pounds this last month, it's odd coz I ate a lot during January. Emma, adderall have the same effect on me, it make me talk to much, my family even told me I talk way to much and it seem to annoyed them maybe it's coz I usualy don't talk when I'm off my medication and they not familiar with me being talkactive and also they are short temper and are annoyed easily.lol:) I really need to gain some weight before my next appointement with the psychiatrist if I want her to add adderall IR to my XR. It's sure hard to find the right dose and combination that work for us. Good luck to all of you, I understand how hard it is to deal with ADD and med!
Take care!
Peace Sun