Advice for Son with ADHD

My ADHD daughter has always had issues settling down for sleep. Always. ALWAYS. She's been on Concerta for several months now, the extended release tabs, with excellent results. If she takes it at 10:30 AM or later she'll need 3 mg of Melatonin to settle for bed but if she takes it between 7:00 and 8:00 AM (getting together time and leaving time for school) it's perfect and 99% of the time she doesn't need Melatonin. Prior to the Concerta she would frequently ask for half a tablet of Melatonin (1.5 mg).

Melatonin comes in 1 mg, 3 mg, 5 mg, and 10 mg tablets. You can also get it in liquid form. Children shouldn't take more than 6 mg and should always start with the smallest possible dose and build up only to the smallest dose that works for them. It also should only be used under the care of a doctor, especially when in tandem with other medications even though it's a natural supplement. I'd rather not give it to my children at all, and luckily we've virtually eliminated it for my ADHD kiddo.

Have you had your son evaluated by a pediatric neurologist that specializes in ADHD and ADD? They're often much more knowledgeable about the ADHD medications than psychiatrists are because they're so much more, well, specialized in the field. They also will insist on frequent and regular check-ups aka mini-physical exams every 1-to-3 months to monitor the medication effectiveness as compared with the child's sleep patterns, diet, height, and weight as well as physical and mental wellness and activity.

Before you try one more medication, please try some natural aids like Melatonin, there are lots of varieties availalbe, or Valerian Root, a natural herb sleep aid with no contraindications with other meds. Have you tried chamomile tea at night with honey to sweeten it? And a hot bath with epsom salts? My husband is an MD and does not like to prescribe sleep prescriptions to kids, because all of them lose their efficacy over time. Meaning the more you use, the more you need.

It's important to make sure ADD meds are out of the system by bedtime as well. So you cannot be late on a dose. There should be no dosing after 12 or 1pm, so that the child can settle down.

GL!

We tried melatonin in minute doses (I think we cut a 3 mg tablet in something like 32 pie pieces with a razor) and she was able to fall asleep but had nightmares. The doctor prescribed Clonidine 0.1 mg tablets and they have been working very well for her. Clonidine was created as a blood pressure reducer but it seems to work very poorly for that but they found it makes people sleepy about 1/2 to 1 hour after taking it.
The Vyvance at 40 mg may also be too high a dose.

My son is on concerta and risperdal. Used to take vyvanse. The risperdal is prescribed for him to help with his anger problems. Won't get into full detail but it does help him. Yes it helped him sleep because that's what it does, brings a person down from being angered or violent to a zombie somewhat. My son gained a crapload of weight on this medicine ( a side effect). If he dosent have these issues then clonidine helps for sleep! Personally those drugs help my son and he says he feels less angry on them and can tell a difference when he is in school doing his work.

I wouldn't give him risperdal unless he's got an anger issue. My son takes it for anger issues along with his adhd meds and it's a pretty serious med. Try melatonin first... smallest dose first.

I use melatonin myself an it works like a charm. 6mg 1/2 hour before I want to go to sleep and off I drift.

The natural stuff didn't work well for my son, so his doc prescribed clonidine for him

Has he already tried melatonin? This is usually the first step. Many kids with ADHD can't wind down on their own at night and take this. It's what our son's psychiatrist recommended and it's OTC. Start small ... 1/2 of a 1 mg. tablet and up as needed (I wouldn't go higher than 3 mg.). Talk to your doctor first, though, just to make sure you get the ok.

Oh wow, we had a lot of issues with Risperdal. My younger two take Clonidine at night to fall asleep. Works like a charm, they get up fine. My son is friends with our pediatrician's son and he gets clonidine as well. Figure if the doctor gives it to his kid it must be safe.

Please ask the psychiatrist all of your questions. Don't let anyone pressure you into dropping your questions or telling you there isn't enough time. You _have_ to have the answers so you are aware of how the psychiatrist is aiming to help your son.

If you don't know what it is to watch for (or ask the teachers to watch for), then you have more questions for the psychiatrist. If he has a hard time waking up and/or can't stay awake in class, do you call the psychiatrist? do you stop the medication and call the psychiatrist?

Plus, how soon would you see the medication provide any benefit? within a couple of days? a week? or after several weeks? Always ask what is the backup plan, if this doesn't work.

Good luck,
D.