ADHD medication titration - how do you know it reached the right level?

[Return2thebasic]

How did each of you as parents know when titration reached the right dosage?

Did you pushed until side effects overcome the benefits, or you stopped when you found the outcome was sufficiently satisfying? If it was when until the balance got tipped to the other side, what wes the level of side effects?

Currently DS is on 20mg XL and the difference it has made is noticeably helpful. DH is both impressed and grateful so he wouldn't mind just maintaining this level here. But I feel there's still blockage in his thoughts to organise ideas and expression, even though, has improved to an acceptable level.

We are going to have another appointment with the psychiatrist near end of the month. Just wondering if we shall push for more increase. I got a feeling our psychiatrist wouldn't push more if we don't. Hence, I'd like to hear if anyone here could share your experience if possible.

Thank you!

I have 14yr old DTS they are both on different amounts 30/40 one also gets a top up extra 10mg at lunch ... Which has done amazing things for his afternoon education:)

Tbh I ask his teachers, how's are they doing are they/can they be focused in class is work getting done.

Both are well supported. Dosage goes up with weight and they are checked every 6 months. I suspect after ds1 current huge growth spurt he will need a larger dose.

I would say this would be a good question to ask the psychiatrist.

Do bear in mind that medication won't "fix" everything, like imagine your child is struggling with reading, they have dyslexia, poor eyesight and they are now quite behind.

They can have an eye test and correct glasses and that will help the eyesight, and make it easier (this is like ADHD medication) but it won't fix the dyslexia (because medication can't fix every single area) and because the child is already behind, they still need to spend some time learning the skills and basics that they are lagging. The glasses won't magically catch them up.

But all this said, you definitely wouldn't want to be dealing with dyslexia and trying to catch up without the right glasses as that would be so much harder.

Just take notes on what you're seeing and bring them to the appointment and ask the psychiatrist what their opinion is.

@crazyBadger , thank you for sharing. It sounds like you chose not to push to higher doses until they can't tolerate, but opt to settle with the level that all parties are happy with?

I wasn't aware the dosage is related to weight. Mine is 10yo but tall and slim and he's reacting well at 20mg currently.

@BertieBotts , thank you for the advice! These are very helpful reminders!

DH and I did agree that there's quite some years catch-up for DS to do , learning some basic skills which others have done years ago. But it has absolutely helped . He's much more willing to talk about his daily life now and he's actually capable to express his feelings - which was never the case for years due to a fuzzy brain!

Only just two things make me feel difficult to see,
One is that even though his thinking process has improved, it is really slow at times and sometimes it got so hard making him nearly give up. I just feel the mind is still quite fuzzy. Second thing is on the social side: He seems still can't read the social cue and carrying on going about his own thoughts regardless others' feeling and reaction (like taking over the conversation or trying hard to fit in between someone else's ongoing interaction without realising it's one-sided).

I have ADHD and I perform probably worse than him on the social side. But it's just hurt to see him like that. He's keen, but still a bit clueless when right in the middle.

I will raise these to the psychiatrist and see what he says.

I know medication is not a fixing all sort of solution. But I don't know what else can help with the above.

My DS 7 is also on 20mg Medkinet and it's the perfect dose for him. 10mg didn't do anything and 30mg made him a zombie. It's taken us about a year to find this is the right dose for him. It takes a bit of trial and error.

@justmindinmybiz , thank you! Good to know it's true higher dose resulting in momentary zombie state... Did he have any other side effects apart from that at 30mg please? Thanks again!

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