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Original poster

How long to tell if ADHD medication is working?

22 replies

taxesfornhspls · 26/09/2022 12:07

DS, aged 16, is on 2nd week of ADHD medication. Dose was 10mg first week, now 20mg and increases to 30mg next week. So far he is just saying he feels angrier, more emotional and also very tired about 4/5pm when it wears off as it is daily release.

He desperately wanted medication in the hope he would be able to focus and pass exams. Would he know by now as he is getting quite despondent especially as we have been told to give him the tablet at the same time each day for the first 3 week trial so he has to be woken at weekends. Thanks

OP posts:

serenghetti2011 · 26/09/2022 12:18

My son started on 10mg mediket was ok on that it’s when it went up he complained of tummy aches, nausea etc but was much chattier coping better at school but said he felt like he wasn’t himself and he wouldn’t take them anymore. He’s 11. We see adhd specialist nurse on Thursday for r/v if they don’t suit your son, go back for review. I hope things get better, it’s so so hard

Original poster

taxesfornhspls · 26/09/2022 13:33

Yes thanks we will have a review at the end of 3 week trial but just wanted to see if was likely to improve or if other people know quickly if it is working/how side effects are

OP posts:

Iggii · 26/09/2022 13:41

My dc is on his third type of medication, Medikinet did not help him at all, elvanse did but he didn't like the side effects. It's not been the quick fix we'd hoped for, but we are still ploughing on.

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user9825401 · 26/09/2022 13:42

Should work straight away.

Iggii · 26/09/2022 13:43

We had four weeks on each dose of Medikinet, I think you are lucky to titrate up so fast - though that might increase the side effects.

Iggii · 26/09/2022 13:44

It won't work "straight away" until the dose is right, though.

HardLanding · 26/09/2022 13:47

user9825401 · 26/09/2022 13:42

Should work straight away.

Incorrect.

In children especially, they’re given a tiny dose and increases are done slower. For a multitude of reasons.

I spent a year dicking around with Xaggitin, LR and IR, before I gave up and asked for Elvanse, which meant weaning off the Venlafaxine I was on (and was useless anyway).

I improved on Xag, but it gave me terrible rage/headaches when it wore off. Elvanse is much, much better for me, the difference is like night and day.

maranella · 26/09/2022 13:50

It doesn't sound to me like the medication is working right OP. I'm a newbie to ADHD meds for my DS, but when he started taking the low dose last week he said he felt calmer. He's due to titrate up next week, but the positive effects of the medication were immediately obvious and we could tell that it was working as it should. If it's making your DS feel angry I'm pretty sure it's not supposed to do that. Have you spoken to the doctor about he's feeling?

user9825401 · 26/09/2022 20:39

To be clear if it's the right dose, it should work straight away.

I saw that as someone who had taken these meds for years as has my son and am familiar with titration/optimum dosage and it's effects when it's working the way it should be.

Original poster

taxesfornhspls · 26/09/2022 20:46

thanks but he has only done a part week on 20mg and then will move to 30mg so it is not right dose yet. Presume side effects of more irritable or emotional could pass?

OP posts:

TriedAndBested · 26/09/2022 20:52

What is he taking? If it's a stimulant like methyl phenidate or dexamphetamine then it should start working within 30min or so. They don't have to build up in the body. If it's something like atomoxetine I believe that does have to build up in the body so might be a few weeks but I'm not sure.

His side effects sound fairly common. I had the same thing and it took months to subside. I recommend dosing more frequently but smaller doses (if he is taking an instant release version and not an extended release one).

If it really doesn't work then very very slowly increase the dose (with your prescriber's approval but really go slow because those side effects might get worse.

oh just read your post again. Increasing your dose by 10mg (of any stimulant) every week is way too fast. I'd do 5mg increases maybe every couple of weeks or preferably increase the frequency of dosing rather than each dose. When I took stimulants I used to crash at exactly the same time..it's basically the meds wearing off. Very unpleasant. Again, smaller but more frequent doses will help with that.

you don't say how frequently he is dosing so is he taking an xr (extended release version) only once a day? In that case 5mg of instant release one shortly before 4pm might help.

However, most importantly, have a chat with your son about what his expectations are. It took me a while to learn how to work with the meds. They don't help with procrastination. Zero. If anything they'll make it worse as you run the risk of focussing too hard on your distractions. They help with the actual focus once you sit down and eg try to read material or try to understand something. If they don't help with that I'd ask for a different medication. He will still need behavioural techniques and strategies to deal with procrastination.

TriedAndBested · 26/09/2022 20:54

Also, make sure he's drinking lots of water. They give you a terribly dry mouth which probably doesn't help with focus.

TriedAndBested · 26/09/2022 20:56

taxesfornhspls · 26/09/2022 20:46

thanks but he has only done a part week on 20mg and then will move to 30mg so it is not right dose yet. Presume side effects of more irritable or emotional could pass?

For me it took a few months (about 3-4) to pass. It can be really unpleasant. Also, does he take medication holidays? If he does I'd recommend cutting them out initially. Once the side effects have subsided it might help to have a medication free day or weekend but as long as he's got side effects I've found it's better to take them every day.

PixellatedPixie · 26/09/2022 21:01

In my experience, the child needs to be at least on the maximum dose for a few days before you notice the full effects. For my kid the difference is like night and day. From often being grumpy and angry and having incredibly low frustration tolerance she is now cheerful and bubbly and able to focus.

Original poster

taxesfornhspls · 26/09/2022 21:16

He is on equasym - it is instant release not a build up. 10mg first week, 20mg 2nd and 30mg the third and then review it. Presume 30mg would be final dose if it works. we are half way through second week.

We have been told to take at same time every day for the first 3 weeks so no weekends/holidays off. Not sure after the first 3 weeks.

OP posts:

BrioLover · 26/09/2022 21:48

My son is on Equasym, the slow release one. For context he is 9, is about 142cms tall and weighs 34kgs. He is on 20mg and that is the correct dose for him.

So my feeling is that the dose is simply not high enough for a 16 year old so stick with it. When we started last year, on 10mg, it took a few weeks to get used to feeling different, and that was again at the correct dose for his height and weight.

Is he also taking it at weekends? We found that taking a break at weekends did not help at all, in fact it made the side effects worse. Now that he's been on it a year he can miss a day or two with no ill effect.

BrioLover · 26/09/2022 21:49

Oh sorry just read that he's taking it continuously. I'm hopeful that 30mg will be a sweet spot for him - although it might need to be higher if he is a big lad.

Original poster

taxesfornhspls · 26/09/2022 21:54

thanks for this - no he is not big. is there a dosage chart for weights available?

My son says can it give chest "pains" (not bad at all)?

OP posts:

BrioLover · 26/09/2022 22:35

It's not just done on weight and height so there isn't a chart, it's more complex than that as it also depends on how the body metabolises the medicine. And the psychiatrist will also ask questions about things like his mood at each appointment. We're being seen 2-3 times per year at the moment.

If you get the box out and look at the side effects there will be a list of things you need to seek medical advice for - if he's having chest pains I'd be quite concerned.

Original poster

taxesfornhspls · 26/09/2022 23:08

i dont think it is actual chest pains - just a flutter on occasion. he had never thought to mention it - just me asking about side effects and advising him against drink and drugs with the adhd meds then he mentioned it but said there was no pain.

OP posts:

TriedAndBested · 27/09/2022 11:02

taxesfornhspls · 26/09/2022 23:08

I'd get the flutter checked. As far as I know stimulants can slightly I crease your BP. Does he drink anything caffeinated? I'd recommend cutting that out.

Equasym is not instant release. It doesn't need to build up though to start working. Extended release just means that an initial dose is released as soon as he takes it and the rest gradually over the next 6-8h. From what I've heard though often extended release versions of work for a along as advertised.

When you say it doesn't work what do you mean exactly? What exactly is your son hoping will happen?

Original poster

taxesfornhspls · 27/09/2022 15:04

Not sure I said it doesnt work. My son was hoping to be able to tell that it was working and he says he cant. He is hoping he will be able to concentrate/focus to study and not do crazy impulsive things! He is still on lower dose to phase in.

I had suggested he doesnt vape or take body building supplements or anything he might try with the medication so will reiterate that if he does it could have side effects or that even drinking cocacola etc with it could be causing the flutters thanks.

OP posts:

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