Experience On Medikinet XR for ADHD

[Toogood2betrueItisnt]

Sorry, I posted this here for traffic.

8 year old dc is AuADHD, and his ADHD is the combined type. He was on Medikinet 10mg for 7 days; school did not see much difference. He is on 20mg for 23 days. We have noticed he gets a hyper euphoric reaction in the morning, is much better through the day, and has a crash after school. The crash doesn't manifest in a melt down, but he is very withdrawn, irritable, and quiet. He is also getting acid reflux whixh isn't helping his appetite.
Has anybody experienced similar, and what worked? I definitely feel he needs a booster to combat the crash, but I'm not sure about the morning spike, especially when a lower dose wouldn't work for daytime.

Sorry that should say XL, not XR.

I don’t have any experience but it looks like the medication isn’t quite right yet for him. Make sure you document everything as it will help them get the dosage right. I am on the ADHD Reddit (which is really active so a good resource) and the crash in the afternoon is quite common and the drs tend to split the dosage up throughout the day to combat it.

My daughter is on that one I think 30mg. She experienced an afternoon crash and so they prescribed a 10mg quick release. She won’t take it though as it’s ’embarrassing’ to go to the school office.

Thank you, that's a shame that your dd will not go. Ds loves to be being taken out, I think to get out of the classroom for a bit to be honest, so will prefer it.

How was your dd with the initial spike after taking it at first? I was not expecting a high, and for him to become so hyper before it settled. Reducing the dose is not enough for through the day. I know I can get a booster dose for the crash, but what about the morning. The specialist nurse did say it can take a lot if fine tuning. He almost threw up his breakfast this morning with stomach acid as well.

She doesn’t seem to have a morning spike. She also doesn’t eat breakfast so cannot comment on that.

Medikinet has quite an annoying release in that it releases 50% in one go, and then the remaining 50% over the rest of the day. Concerta's long release might be better, or Elvanse, which both release over a longer period and don't have that initial spike.

He's on the wrong drug. Unfortunately it can take a while to get the right drug and right dose. But he shouldn't have to go through the nausea, vomiting and daily crashes. Ask to be seen again and fit a different medication.

Thank you. It is a shame, because during the day it seems to be making him calmer. It is the morning spike, and evening crash which are the issues. I also don't like the acid reflux it is causing him.

My DD is similar, 20mg in the morning and a 10mg top up around lunchtime which definitely helps.

As has been said, Medikinets release profile is not necessarily suiting him. It’s designed for the school day too so after the initial release, the remainder is released over 8 hrs. Concerta XL has a more tapered profile and is released over 12 hrs so prevents both the morning high and it continues into the evening. Have a chat with your prescriber to see if they will change it.

Thank you, it is good to know there is a 12 hour type that is more gradual. I am going to contact the specialist nurse today; she was really helpful and said to contact any time. I did not want to even give him it this morning, but did reluctantly. I want to hear from the nurse first on next steps as do not want tomake things even worse!

You could also ask about Equasym. It has a medium release profile over 6 hours so it's good for the school day but shouldn't (in theory) impact sleep like concerta can.