My 6 yo DD was recently diagnosed as a combined type ADHD. I've known that we were heading for this diagnosis for the last 3 years, so it didn't come as a surprise. We are in week 2 on Focalin XR and wanted to get some feedback from others that have recently been on this journey.
The first week was much better than I expected. She was able to focus much better at school. On the weekend, she stuck with a task for 3x longer than she normally would have and seemed to hear me when I spoke to her. Some of the rebound effects were not ideal - her hyperactivity seemed to be amplified 3x over at night. She wasn't able to fall asleep until about an hour later than normal. There was also about an 30-45 minute timespan where she was an emotional wreck when the medicine was wearing off. All of those things I expected. I considered the first week a success.
The second week has been terrible. For the last three days, she has gotten in trouble at school for various things. That leads to a huge fight when she comes home from school. I normally bring her a piece of candy when I pick her up from afterschool care and yesterday when I brought it to her, she threw it at me because it was the wrong kind. She then followed that with 10 minutes of chanting "my mommy doesn't love me" over and over. Please keep in mind, I wasn't yelling, I wasn't doing anything. I brought her the wrong candy. When we got home, it continued to go downhill, she would argue over eating dinner, sitting down at dinner, doing homework, taking a bath, you name it, we fought about it. She had me in tears yesterday before I even made it home from picking her up. Is this normal? Is this part of the adjusting process?
My daughter is smart and she knows how to manipulate situations. I don't know if she is manipulating me or if she really is feeling all the things she is acting out. I don't want to punish her for something she can't control, but at this point, I'm at a loss for how to even discipline her.
Call the doctor. This medication isn't a good fit. In years of dealing with various ADHD medications, I've learned that you can tell right away whether it's a good match. Don't wait for things to improve because they may only get worse.
Let the doctor know what you're seeing and ask about other medications. It can take a lot of trial and error to get it right, so hang in there.
Sigh...there's always the "no drugs" crowd.
As someone who was diagnosed at age 8 with ADHD, and whose sons both have it (my 11 year old has severe ADHD, 10 year old has mild ADD), I get tired of the "you're bad for putting your child on drugs" nonsense. If your child had a seizure disorder, would you withhold medication? Seriously?
Aaaanyway, J., I feel your pain. Starting on meds is a hard and worrisome journey.
Be very open to the fact that Focalin might not be right for her. Or the dosage might be too high or low. Or she might be having withdrawl symptoms when she comes "down."
Also, be CERTAIN that she's getting it first thing in the morning. Taking it later will cause it to wear off later, and it will be harder for her to eat dinner or go to sleep. The weekends are a good time to pay attention to the "coverage time" of her meds. You'll see when she's the MOST focused, when she's the least focused, how long it takes to kick in and wear off (Vyvanse, for instance, took almost 2 hours to kick in for my son). Then you can give it to her at the proper time so you'll know she's covered at the most important parts of her day.
If Focalin is causing problems now, it's not going to get better. It's a stimulant medication. Unlike Strattera and Intuniv, which need to build up in the system, stimulants work at their full potential for just 4-10 hours, depending on the drug. So if she's having these side effects, I don't see them improving. She needs to try something else SOON and get her balanced, or it's going to be VERY difficult to get her to be willing to try something new. She'll fight taking the drugs because of the negative side effects.
So talk to her doc about trying something else. There's no shame in that. We started with Strattera, which didn't work for us (and made DS2 depressed), then went to Vyvanse for DS1, and then added Intuniv because he had withdrawl symptoms each night. Finally Settled on Intuniv for DS2 and Adderall XR with Intuniv for DS1. They're both doing wonderfully on them, but it took time and trial-and-error to get to this point.
Also, I strongly recommend that you take her to a counselor who specializes in ADHD. You BOTH need tools in your toolbelt to adjust and adapt.
And pick up the book "Love and Logic." The fact that you're arguing with her tells me that the skills found in L&L would really help you.
♥
Is it part of the adjustment process? Not usually, no.
Some ADHD meds trigger rages in some people. Others trigger personality changes or suppress personality.
All 3 = discontinue / bad fit
However, some people react really violently to rebound. For MYSELF that = discontinue. For others they love love love a med so much when its active, that they find a way to skip the rebound (XR or another dose), or just "deal" with the rebound.
Being your first med, I wouldn't stay with it until Id tried 3-4 others.
Neurochemistry is different with every individual. It's why there are over 80 ADHD meds on the market. Very tiny differences in the makeup can make a huge difference (love-love-love, really like, s'okay, eh, ugh, NO! Not THAT one!!!) in how a person likes and responds to it.
Myself :
- Ritalin Family makes me physically ill (nausea) v My friend Tim who loooooooves Ritalin family meds. Metadata being his 'magic wand'
- Amphetamine family has varying effects (Adderall the best of them, but it stomps on my personality. I become very Stepfordy v a Rockin Mom on this board who found her magic wand w/ Adderall)
- Straterra is sooooooo clooooose to a magic wand, but I can't write on it. Ugh. Back to the drawing board!! Vs my cousin that flies into rages on Straterra
- Coca type IS my magic wand. But it's a royal pain to travel with. Unless I want to live in the Andes & drink tea... It's not gonna happen.
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One of the most common "Reject!" Quals for a med is triggering rages. Typically, if rages are happening, that med goes into the reject pile. A med should make you MORE yourself. Not less, or different.
My situation my be a bit different, but hope it helps.
I take Focalin-currently 10 mg 3x's a day, but have been on 30mg XR in the past, (only stopped because of insurance $$).
Here's what I've learned with help from my therapist....if you think the drug is working overall-stick with it, (it is a drug that runs through your system through the course of a day-not like a anti depresseant where you have to build up to its efficacy over weeks. So-if the drug seems to be wearing off around say 4pm-and that is an especially stressful time of day-see if your dr will give you a 'booster'...like 5 mg to take just at that time to sort of bridge the gap as the xr wears off. That may also help with her hyperactivity at night-it sounds like maybe the XR is only lasting XXXX amount-causing issues at night.
Be sure she takes it as close to the same time every day too-that makes a difference in how long it lasts.
Once she gets used to it-she'll be able to tell you when the drug is wearing off-for me it's like a light bulb going on as a reminder.
It might be the xr that is doing it.
I found the extended release formulas not right for my daughter.
She is on 10 mg short acting focilin 2x a day.
there is always an adjustment process and it may not be the right meds for her. And here's the think it won't last 24 yrs, the extended release formulas of meds only last 8-10 hrs depending on the child.
Yes she should be punished, having ADHD is not an excuse to misbehave. The medication only helps her stop and think so she can make the right choices. Now why are you giving your ADHD child candy? Sugar is a big no no for ADHD kids, it can flip them upside down and backwards. Give them a burst of bad energy then drops off. That's the nature of sugar. Cut out the sugar/bad carbs ( ie cereal , poptarts, candy ) in her diet and up the protein. I'll bet you'll see an improvement. Not that it will do much by itself but adding some diet changes TO the medication will help a lot.
I think you need to talk to the doctor about this. What I have learned from my kids is there are layers. So what you could be seeing is this corrected the issue of ADHD so now you are seeing another issue that was already there but didn't see the light of day because of the focus on the ADHD.
What I am saying is the medication may be working perfectly you just have another hill to climb. Or it could be showing that just isn't the right med for your daughter.
Another thing you may be seeing is her reacting to the knowledge she will soon be crashing off the meds. There are things I cannot be doing when my Adderall wears off, it will make me agitated and sometimes emotional, I avoid those things if possible. One of them is don't drive my car home from work if my Adderall is wearing off!!
You need to understand what is going on inside of her, it isn't fun, it isn't pleasant and she is unable to articulate it. When I first met my husband I warned him he may witness this, I will say things that are directed at him but they are not, I will say mean things, awful things, and nothing I say has anything to do with him beyond he is in the room! If it was just me and the cat the cat would be a dick at that moment! We have been together three years, he saw it once, it has only happened once. He said my god that is hard to watch. That is why I keep away from that which will cause me to be nuts!
Stress is the biggest one. Deep thoughts is another. If I am working on code or formulas, yikes!!
My kids don't have this problem because I make them play when they are winding down.
Anyway I hope some of this helps but please, talk to your doctor, they will be able to help you more than we can.
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That's it Barbilee, its food, if we just ate better we would function just fine. Sorry but there is no food on earth that can change the chemical make of of your brain, meds do that. If diet changes anything you NEVER had ADHD!
Why do I get the feeling that link you have there will send her to where she can buy the diet plan. Good grief, why do people prey on others like that.
My 10-year old son has ADHD/Aspergers. ADHD meds help him focus, not say every thought in his head, and turn his volume down so that he isn't constantly talking and singing. It doesn't fix everything, especially his Asperger symptoms. He's still grumpy, stubborn, has problems with fine motor and social skills, and focuses on his favorite topics instead of homework. He has tried basic ritalin, Concerta, metadate cd, and now Focalin. They're all in the same drug family, but it took a few tries to get the right balance of how long it lasts and side effects.
The doctor told us that these meds can cause a blood sugar crash in the afternoon. My son has a good breakfast and bedtime snack, but barely eats anything for lunch or dinner. We've asked his teacher to encourage him to eat his snack and lunch to try to prevent the afternoon crash. We give him the medicine on school days only so that he can catch up on eating on the weekends. (summer camp, we gave him 1/3 dose)
He takes benadryl for his allergies which also helps him sleep and a fish oil vitamin because it's supposed to be good for ADHD and mood.
Call the Dr and see what they say. I myself have not dealt with this as I didn't medicate mine but I never judge those who do one bit. You do what's best for your family. I have many relatives and friends that have dealt with meds. They said it took months sometimes to get the right med and dose. If she's acting like that she's probably coming down off of it can since she's not used to it fully yet she does not know how to control her frustration. No she should not be able to get off scott free but she probably does not understand what's going on with herself and she's reacting. You need to talk to her about it but right now I would hold off on punishments till you get everything settled.
Good luck and God Bless!!!
There is ADHD and there is bad behavior. I think you have been dealing with the bad bahvior in this 2nd week. I don't have kids, but my hubby has been on and off these drugs. He tried to blame some of his behavior on the meds, but then it comes down to choices. All the books told me he can't control it. I never believed that. When I wouldn't put up with some of the behaviors it was amazing how fast things changed. Teach your daughter how to behave. That chant should have been stopped after the 2nd time she said it. Find the currency that will make her change. She does that again, she doesn't get any candy for 2 days...whatever...Don't let her use this as an excuse for bad behavior....If you don't stop it now...the teen years will be 10x worse.
Take Care and God Bless!
Try different drugs. Vyvanse works well for my son. You might try the non LA Ritalin to establish appropriate dosage level so as not to interfere with diet & sleep. Once we nailed that, we tried a series of different Long Acting formulas (Ritalin LA, Concerta, Adderall, etc.) until settling on Vyvanse. We've also adjusted the dosage over time, increasing and most recently decreasing his dosage. It's a bit of a moving target, but I feel he continues to benefit significantly from his medication.
