Titration for adhd meds

[dontknowwhat2callmyself]

DD started on meds recently and has been on the same dosage now for 4 weeks (started off on a smaller dose). It's not making any difference to her behaviour or attention and I thought we would have seen changes by now if it was going to be effective - it's Medikinet xl. Pead doesn't seen to be in a rush to prescribe a higher dosage. Can anyone share their experiences with trialling meds. Thanks

[EwanWhosearmy]

We saw a difference on day 1. Also Medikinet xl.

[dontknowwhat2callmyself]

Thanks Ewan. Everything I've researched said differences should be noticed quickly. Dd's dosage just isn't going to work.

[Catgotyourbrain]

Are you under a paediatrician or psychiatrist who specialises in ADHD meds? We have found general CAMHS paeds or psychiatrists can be cautious or downright uninformed about meds.

Our DS is under the ADHD team at CAMHS and they titrate up as far as they can go without side effects and then alllow the child's and parents preferences to set a good level

(for instance DS10 went into 36mg of slow release methylphenidate - he found titanic bit much day to day and now has 18mg plus usually a 5mg top up. Some weekends he doesn't take it and it's useful to see the contrast for us all!!).

What dose is your DC on?

Before we were in the dedicated team we were dealing with psychiatrists who actually didn't know how to pronounce the word 'methylphenidate' - and also told me in all seriousness that we absolutely 'must' take the dose every single day without fail. Fwiw medication 'holidays' are encouraged and some days a child might need extra to concentrate for a particular reason - not rocket science!

[dontknowwhat2callmyself]

We see a Peadiatrician at our local hospital. I don't think she specializes in Adhd meds as such but would see children with a range of developmental issues. Cautious is a good description though. Dd has been on 20mg for 4 weeks now and it clearly not effective! How did you manage to transfer to a specialist?

[Catgotyourbrain]

Ask Google or indeed your paediatrician if there is a socialist ADHD term at your local CAMHS (child and adolescent mental health service) if you aren't under CAMHS what was your referral process to get diagnosed and on to meds? Maybe gp sent you to general paediatrician and that's where you've stayed?

I'd ask to be referred to the ADHD team or failing that to the neurodevelopmental team at CAMHS. ADHD is a neurodevelopmental disorder as is ASD and you would do better to deal with specialists. The perception of it as a behaviour problem needs caution and the understanding of what's going on in the brain will be useful for you and your DD.

Going forward you need more targeted help - for instance lots of ADHD kids have sleep problems and can access sleep help and if needs be be prescribed melatonin.

I don't know how old or heavy your DD is but most specialists would take the dose up as high as side-effects will allow. DS has had a massive improvement to all aspects of his life from it.

[Catgotyourbrain]

'Socialist ADHD term' = local ADHD team sorry!

[dontknowwhat2callmyself]

Yes I've investigated further it's general paediatrics that dd is under so that could explain a lot.

Thankfully she has no problems with sleep her biggest issue being inattention which is having a massive effect on her learning at school.

Thanks for the advice about the specialist team I will take a look to see if there is anything local to us.
It sounds like your son is doing well which is good to hear.

[Allthewaves]

We are under specialist adhd team, just been moved from seeing paediatrician to special nurse as ds is stable. Ds is 8 (7 when we started meds).

We saw immediate effect on behaviour - he was very subdued infact and almost a bit zombie like and not eating, which completely freaked me out. Ended up ringing paed after first wk as I wanted to stop the meds. He reduced dosage, kept it low the. gradual increase over time.

Ds is on equasym xl. He started on 10mg to start (after me freaking), the. increased to 20mg after side effects had become less. He's now on 30mg during the week and 20mg at the weekend. Only thing i'd say is that ds is on the lesser end of adhd as he is impulsive and hyper but not angry or destructive and is a great sleeper

[Allthewaves]

School notice a huge difference between non mediated and medicated ds. He's a real handful without meds, and no work really gets done as he's jumping mentally so much.

[dontknowwhat2callmyself]

DD is very inattentive jumping mentally is a good description. She can't concentrate as she says she has so many thoughts rushing through her brain. She needs a lot of support at school to get her started and on track with work and activities. It could be this isn't the right medication for her.

[Allthewaves]

Sounds like it's not working for your dd. Ds requires very little support apart from being reminded about shouting out and talking over the teacher