View Full Version : Focalin XR and titration advice3?

04-16-10, 10:09 AM
Well we are on to drug #2 with my son. We had a golden 1/2 a week with Vyvanse, but it didn't seem to have the right effects for him and didn't do much if anything for his hyperactivity, although we saw some benefit.. At higher doses it was really bad with the side effects. When we went to his follow up and he was on 30mg (tried 20, 40 and 50, too over about 2 1/2 week time span) he was jumping off the exam table and interrupting every two minutes. She felt that was not the drug for him and decided to try something else.

Now we are trying Focalin XR. Yesterday was his first dose at 5 mg (lowest possible dose). I can't really say how it went since it isn't as long acting as Vyvanse. By the time I picked him up at school any benefit was clearly gone and he was off the wall last night! When I asked him he seemed to think it helped him focus at school better than the vyvanse (although he said he found it harder to read because noises bothered him more -- he's 8 and not that great at analyzing his own behavior so I take what he says with a grain of salt ;)).

So his pediatrician said to stay on this lowest dose at least 3 days and said we could go up to 10mg on Sunday if we want. My question is, should I do that or keep him on the lower dose longer (even if we see little effect)? If I do switch him to 10 I will give that dose at least a week, but I just feel 5 will definitely be too low and am anxious to see how 10 does. If I don't do it Sunday I likely won't see it until the following weekend because of school. She said once we get to the right dose (if this works) she will prescribe a short acting boost for afternoon/evening.


04-16-10, 10:25 AM
We are getting ready to try Focalin XR tomorrow over a weekend so we can hopefully see duration and any side effects before school on Monday. The Strattera has only given us very minimal improvements.

My son is also 8 (well, will be a week from tomorrow). We are starting at 10mg. Our Dr said she was sure it would be too low but she and I like to start low and go slow. It's important to get daily feedback from the teacher. If we don't see improvement to where we need to be by Tuesday (based on my and his teacher's observations), we are to increase it to 20mg on Wed which is where she really thinks he needs to be.

I have made up a quick weekly log for his teacher to fill out daily so I know how he's doing and she is pretty good to send emails and notes home anyway. I think it is imperative to have that daily teacher feedback and keep consulting with your dr on the dose. Also be sure to keep a good journal of your own. We haven't done this in the past and it's really hard to rely on memory regarding side effects and improvements.

So based on what my dr told me and what yours told you, I would bump it to 10mg on Sunday. Good luck! I hope you find a good dose that works well for him and I hope we do too!!! Keep us posted!

04-16-10, 05:09 PM
Thanks, Jen! It sounds like going up to 10 on Sunday might be a good idea, then. Please post back this weekend and let me know how it goes with your son. There doesn't seem to be quite as much out there about Focalin as there was about Vyvanse, so I am interested in hearing others' experiences with it.

I did talk briefly with his teacher after school today and she said he had decent focus (although he had to go out in the hall to do his work -- not as a punishment just so he can focus without the distraction in a Montessori classroom) the past two days. Maybe when we get the dosage right he will be able to concentrate in class as well! My big thing is the hyperactivity/impulsivity, so if we can get all of those things under control with this I will be very happy!

04-16-10, 05:49 PM
I would bump it up over the weekend so you can see how it goes. :)

04-17-10, 11:09 AM
Hey! My son is 8 and on 10 mg Focalin XR. We, too, tried Focalin XR after first trying another stim.

My son is very sensitive to all meds and we run into side effects that end up outweighing the benefits. Our solution is (each morning):

10 mg Focalin XR
3mg Intuniv

Each of these alone is "sub-therapeutic dosing", but we get what we need (calm focused eating sleeping child who doesn't have meltdowns or pottymouth) without the side effects of either. We had tried each drug by itself and found that the side effects were too much (insomnia, rebound, anorexia, rages, ODDesque behavior on the stim alone and sleepiness, moodiness on Intuniv alone at the doses needed to treat the adhd).

FWIW, "a little of this and a little of that" seems to be the solution for us. We have been on these doses since January or so and it has been a blessing.