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  #1  
Old 11-27-10, 06:33 AM
Cjj0803 Cjj0803 is offline
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6 Year old 10mg dose of Ritalin 4 hour acting, emotional side effects?

Hi Ihope someone can help me my son turned 6 in October and has been diagnosed with ADHD, Dyslexia and Dysgraphia, he has been perscribed a 4 hour dose of Ritalin 10mg. He has been taking it for a bout a week and there is a huge improvement in his concentration, he is never particularly hyperactive but I am finding when the 4 hours wear off he is having a come down today he cried for about 40 minutes then went on an angry rampage throwing things at me and pinching himself it lasted about 2 hours and he said once calm that he was sad and angry and didnt know why. He then reverted to his normal self.

Does anyone know if this is a side effect of the Ritalin, will his body get used to it? should I try giving a smaller dose. He isnt due for a review until February and I tried calling and asking some questions but they werent interested in looking at him again until february just told me to keep a diary of it.

It was horrible to see him like this as he wasnt himself at all his eyes were different and I just couldnt get through to him, then after he was very embarassed about his behaviour.

Any advice would be welcome.
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Old 11-27-10, 11:30 AM
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Re: 6 Year old 10mg dose of Ritalin 4 hour acting, emotional side effects?

Is there a different doctor you can take him too? I'm appalled at the response you got from them and the length of time before the next appointment.

I would cut the dose in half if I were stuck in your position and stop altogether if that does not help.
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Old 11-29-10, 08:24 PM
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Re: 6 Year old 10mg dose of Ritalin 4 hour acting, emotional side effects?

That is the strangest thing I have heard. You are having problems with the new med and the doctor says well talk about it in Feb?!?! If you cant talk to the doctor soon, I agree with the above poster, do a smaller dose for a while. 10mg is a pretty hefty dose. Just cut the pill in half, or even in quarters for a few days.
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Old 11-29-10, 08:41 PM
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Re: 6 Year old 10mg dose of Ritalin 4 hour acting, emotional side effects?

I have to disagree with the previous people that have responded to the OP.
Don't cut the dosage yet. 10 mg is not very strong.

You may want to change your doctor if you are not comfortable with the response you received.
But I would leave the dosage alone for more than one week. One week is not enough time to allow side effects to subside.

I observed similar behavior in my son during the first week that he was on Adderall. Around the time that his Adderall IR (10 mg) was wearing off, he became very emotional and would cry over nothing. It has now been 5+ weeks and that has fully gone away. I believe it was one of those initial side effects that wears off.

So if your child has only been on Ritalin for one week, I would not necessarily quit so soon. Give it a few more weeks at the same dosage to see if the side effects subside. If you saw a huge improvement in his concentration, then that would suggest that it is working.

You wrote, "he is never particularly hyperactive". Does that mean that you believe he is the Inattentive form of ADHD?

If so, you might want to consider switching to Adderall. I have read that Adderall is more effective for ADHD-PI (predominantly inattentive) children. We took the research to our doctor when discussing which medication to try. Our doctor agreed that it made sense to go with Adderall based on the info.
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Old 11-29-10, 08:46 PM
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Re: 6 Year old 10mg dose of Ritalin 4 hour acting, emotional side effects?

It sounds like possibly rebound to me.

A single dose of immediate release Ritalin might not be the right thing. Your doc might be wanting to insure that he has taken the med for a long enough time for your son to become accustomed to it, thus the Feb return.

I would consider asking if you can split the dose- 5 mg in the a.m. and followed by the balance of 5 mg four hours later as is needed. That will still give him the 10 mg prescribed while allowing for possibly a smoother come down. It will also give him longer coverage.
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Old 11-29-10, 08:48 PM
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Re: 6 Year old 10mg dose of Ritalin 4 hour acting, emotional side effects?

Cjj,

I am an adult who was trying instant release Ritalin (methlyn, actually) 10mg 2x a day, going up to 20mg at a trial dose. I did this for one week. I noticed a "dip" after the Ritalin wore off that left me feeling dispondent and what I guess a clinically depressed person feels like. I have severe ADHD, but not Depression somehow.

I powered through it OK and this aftereffect of depressed feeling lasted about two hours. Knowing that this feeling was likely from the Ritalin aftermath was so helpful to me to be able to say This will be over soon, this is an artifact of the medicine, not "mine". When I stopped taking Ritalin, beginning the next day, I felt almost euphoric for about a day and a half. I do not have bipolar issues, I don't think (never diagnosed or suspected; never experienced mania and so on). So, I can imagine what a six year old would feel like. Must be like a rollercoaster. I don't know what else to say or what conclusion to draw.

The days that I had the yucky depressed feeling, I think I could trace it back to not eating well that day or a lack of sleep. I didn't have the Ritalin shockwave effect I think, when I took a nap and or remembered to have a balanced (even small) lunch / snack.

It may actually be that your doctor has seen this hundreds of times - but they are not communicating with you effectively it sounds like.
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Old 11-30-10, 01:12 PM
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Re: 6 Year old 10mg dose of Ritalin 4 hour acting, emotional side effects?

For some reason my Predominantly Inattentive son also became very emotional on Ritalin. He reported being 'sad' all day while on it but it sounds like your son does great on it until the end of the day. It is wonderful that his concentration is better and that the Ritalin is helping.

Though kids who are Predominantly Inattentive may need a slightly lower dose than hyperactive kids, 10 mg is still a pretty low dose and it seems like the dose is not really the issue here as he does well while he is on it and does not complain of anxiety, tummy pain, sadness or other symptoms.

I agree with ADHDTigger, that this sounds an awful lot like he is not transitioning well as the medicine leaves his system. This would happen also at a lower dose and it also happens with regular Adderall (not sustained release). A lower dose may not help his concentration as much but you can cut the pill in half and try it for 4 hours on a Saturday and see how it goes. Also make sure that he has eaten something as the medicine is wearing off because an empty stomach and low blood sugars at the time the medicine is leaving his sytem can be a recipe for disaster. (A smoothy or a small glass of high protein chocolate mile is sometimes a God sent for my son on Vyvanse)

Adderall works better for people who have what my son had and that is a reaction to the Ritalin while the medicine is at it's peak (30 minutes to 3.5 hours after taking it). Ritalin works slightly differently from Adderall and folks who do not tolerate the Ritalin often do tolerate the Adderall but having said that, Adderall causes the exact same symptoms that you describe in some children as the Adderall is wearing off.

I think that a more gradual delivery delivery system, a medicine that will enter and leave his system in a gradual manner (like Concerta for instance if hes stays on a Ritalin like product or Vyvanse, if he is switched to an Adderall product) might not cause these emotional symptoms as the medicine is wearing off.

About that mean doctor.... I am in health care and sometimes doctors simply are not listening. They come by it honestly though because they are dealing with stressful situations in their offices routinely. It is inexcusable but unfortunately they can be completely inattentive. If this doctor is yours to keep and there is no getting a better one, the best thing to do is to call the office and speak to the nurse. The nurse is often the only reliable route to action as she is better able to relay the message to the doctor at a time and in a manner that will get his/her attention and it turn actually do something about your son's problem. Good luck and stick in there. It gets better.

Tess http://primarilyinattentiveadd.com
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Old 11-30-10, 02:52 PM
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Re: 6 Year old 10mg dose of Ritalin 4 hour acting, emotional side effects?

So essentially you have a couple choices. 1. Keep giving the med and make your child suffer through the side effects. 2. Start slow and gradually increase the dose over a couple weeks. Ive already told you which option I would choose.
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